Search results for: nerve and tendon transfer surgery

Authors: Hamide Azimi Lolaty, Fateme Alsadat Ghanipoor, Azar Ramzani, Reza Ali Mohammadpoor, Alireza Babaei

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Background and Objective: Despite the merits behind orthognathic surgery, self-care training in such patients seems logical. The current research was performed pursuing the goal of outlining the effect of training mindfulness-based self-care on Self-Esteem (SE) and Body Image Concern (BIC) of orthognathic surgery candidate patients. Material and Methods: The present study was performed using a semi-experimental method with pre-and post-design in the control and intervention groups. The eligible patients to enter the Babol-based Shahid Beheshti Orthognathic Surgery Clinic were conveniently divided into two 25-person groups. The variables of Self-Esteem and Body Image Concern were measured before and after executing the eight 90-minute training sessions and in the follow-up period done three months after executing the intervention using Cooper Smith’s Self-Esteem Inventory (CSEI) and Body Image Concern Inventory (BICI). The data were analyzed using ANOVA and the independent t-test and using SPSS-26, the data were analyzed at a 0.05 level. Results: As a result of the intervention, the intervention group’s SE score critically changed on average from 25.4±7.31 in the pre-intervention to 31.16±7.05 in the post-intervention and to 40.45±3.51 in the follow-up period (P=0.01), the intervention group’s BIC score changed on average from 60.28±16.47 in the pre-intervention to 47.15±80.47 in the post-intervention and to 32.20 ± 10.73 in the follow-up period. This difference was meaningful (P=0.001). But due to time and the intervention interaction, the control group underwent this significant reduction with a delay. The study revealed the scores of the SE as 32± 6.84 and that of the BIC as 43.32±10.64 in the control group didn’t result in any meaningful statistical difference (P<0.05). Conclusion: Training mindfulness-based self-care exerts an effect on the SE and BIC of the patients undergoing orthognathic surgery. Therefore, it’s recommended to train mindfulness-based self-care for orthognathic surgery candidate patients.

Keywords: self-care, mindfulness, self-esteem, body image concern, orthognathic surgery

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Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk

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Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.

Keywords: bariatric surgery, mood disorders, obesity, pain

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Authors: Carlos Oliveira Santiago Filho, Ciro Egoavil, Eduardo Oliveira, Jéferson Galdino, Moises Galileu, Tiago Oliveira Correa

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Transfer of Electrical Energy through resonant inductive magnetic coupling is demonstrated experimentally in a system containing coil primary for transmission and secondary reception. The topology used in the prototype of the Class-E amplifier, has been identified as optimal for power transfer applications. Characteristic of the inductor and the load are defined by the requirements of the resonant inductive system. The frequency limitation the of circuit restricts unloaded “Q-Factor”, quality factor of the coils and thus the link efficiency. With a suitable circuit, copper coil unloaded Q-Factors of over 1,000 can be achieved in the low Mhz region, enabling a cost-effective high Q coil assembly. The circuit is capable system capable of transmitting energy with direct current to load efficiency above 60% at 2 Mhz.

Keywords: magnetic induction, transfer of electrical energy, magnetic coupling, Q-Factor

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Authors: Nathan Estrada, Fangjun Shu, Yanxing Wang

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The heat and mass transfer characteristics of a simple shear flow over a surface covered with staggered herringbone structures are numerically investigated using the lattice Boltzmann method. The focus is on the effect of ridge angle of the structures on the enhancement of heat and mass transfer. In the simulation, the temperature and mass concentration are modeled as a passive scalar released from the moving top wall and absorbed at the structured bottom wall. Reynolds number is fixed at 100. Two Prandtl or Schmidt numbers, 1 and 10, are considered. The results show that the advective scalar transport plays a more important role at larger Schmidt numbers. The fluid travels downward with higher scalar concentration into the grooves at the backward grove tips and travel upward with lower scalar concentration at the forward grove tips. Different tile angles result in different flow advection in wall-normal direction and thus different heat and mass transport efficiencies. The maximum enhancement is achieved at an angle between 15o and 30o. The mechanism of heat and mass transfer is analyzed in detail.

Keywords: fluid mechanics, heat and mass transfer, microfluidics, staggered herringbone mixer

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Munish Saroch, Amit Saini

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Introduction: Many children with congenital malformation of inner ear have undergone cochlear implant (CI) surgery. The results for cochlear implant surgery in these children are very encouraging and provide a ray of hope for these patients. Objective: The main objective of this presentation is to prove that even in Mondini’s deformity Minimal incision cochlear implantation improves cosmesis, reduces post-operative infection and earliest switch on of device. Methods: We report a case of two-year-old child suffering from Mondini’s deformity who underwent CI with minimal incision cochlear implantation (MICI). MICI has been developed with the aims of reducing the impact of surgery on the patient without any preoperative shaving of hairs. Results: Patient after surgery with MICI showed better looking postauricular scar, low post-operative morbidity in comparison to conventional wider access approach and hence earliest switch on of device (1st post operative day). Conclusion: We are of opinion that MICI is safe and successful in Mondini’s deformity.

Keywords: CI, Cochlear Implant, MICI, Minimal Incision Cochlear Implantation, HL, Hearing Loss, HRCT, High Resolution Computer Tomography, MRI, Magnetic resonance imaging, SCI, Standard cochlear implantation

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Authors: Manoj Deepak, N. Mathivanan, K. Venkatachalam

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Nerve root stenosis is one of the main cause for back pain. There are many methods both conservative and surgical to treat this disease. It is pertinent to decompress the spine to a proper extent so as to avoid the recurrence of symptoms. But too much of an aggressive approach also has its disadvantages. We present one of the methods to effectively decompress the nerve with better results. Our study was carried out in 52 patients with foramina stenosis between 2008 to 2011.We carried out the surgical procedure of shaving off the medial part of the facet joint so as to decompress the root. We selected those patients who had symptoms of claudication for more than 2 years. They had no signs of instability and they underwent conservative treatment for a period of 2 months before the procedure. Oswersty scoring was used to record the functional level of the patient before and after the procedure. All patients were followed up for a period of minimum 2.5 years. After evaluation for a minimum of 2.5 years, 34 patients had no evidence of recurrence of symptoms with improvement in the functional level.7 patients complained of minimal pain but their functional quality had improved postop. Six patients had symptoms of lumbar canal disease which reduced with conservative treatment. 5 patients required spinal fusion surgeries in the later period. Conclusion: Thus, we can effectively conclude that our procedure is safe and effective in reducing the symptoms in those patients with neurogenic claudication.

Keywords: facetectoemy, stenosis, decompression, Lumbar Foraminal Stenosis, hemi-facetectomy

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Authors: Khamis Al Kalbani

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The effects of a uniform heat source position on the heat transfer flow inside an inclined square enclosure filled with different types of nanofluids having various shapes of the nanoparticles are investigated numerically following one component thermal equilibrium model. The effects of the Brownian diffusion of the nanoparticles, magnetic field intensity and orientation are taken into consideration in nanofluid modeling. The heat source is placed in the middle of a wall of the enclosure while the opposite wall of it is kept at different temperature. The other walls of the enclosure are kept insulated. The results indicate that the heat source position significantly controls the heat transfer rates of the nanofluids. The distributions of the average heat transfer rates varying the position of the heat source with respect to the geometry inclination angle are calculated for the first time. The outcomes of the present research may be helpful for designing solar thermal collectors, radiators, building insulators and advanced cooling of a nuclear system.

Keywords: heat source, inclined, square enclosure, nanofluids

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Timothy T. Hsieh

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Current patent venue transfer laws under 28 U.S.C. § 1404(a) e.g., the Gilbert factors from Gulf Oil Corp. v. Gilbert, 330 U.S. 501 (1947) are too malleable in that they often lead to frequent mandamus orders from the U.S. Court of Appeals for the Federal Circuit (“Federal Circuit”) overturning district court rulings on venue transfer motions. Thus, this paper proposes a more robust two-step burden-shifting framework that replaces the eight Gilbert factors. Moreover, a brief history of venue transfer patterns in the seven most active federal patent district courts is covered, with special focus devoted to the venue transfer orders from Judge Alan D Albright of the U.S. District Court for the Western District of Texas. A comprehensive data summary of 45 case sets where the Federal Circuit ruled on writs of mandamus involving Judge Albright’s transfer orders is subsequently provided, with coverage summaries of certain cases including four precedential ones from the Federal Circuit. This proposed two-step burden shifting framework is then applied to these venue transfer cases, as well as Federal Circuit mandamus orders ruling on those decisions. Finally, alternative approaches to remedying the frequent reversals for venue transfer will be discussed, including potential legislative solutions, adjustments to common law framework approaches to venue transfer, deference to the inherent powers of Article III U.S. District Judge, and a unified federal patent district court. Overall, this paper seeks to offer a more robust and consistent three-step burden-shifting framework for venue transfer and for the Federal Circuit to follow in administering mandamus orders, which might change somewhat in light of Western District of Texas Chief Judge Orlando Garcia’s order on redistributing Judge Albright’s patent cases.

Keywords: Patent law, venue, judge Alan Albright, minimum contacts, western district of Texas

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Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

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Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

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Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

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Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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Authors: A. Dudek, P. Tylec, G. Torbicz, P. Duda, K. Proniewska, P. Major, M. Pedziwiatr

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Background: Conservative treatments of obesity, based only on a proper diet and physical activity, without the support of an interdisciplinary team of specialist does not bring satisfactory bariatric results. Long-term maintenance of a proper metabolic results after rapid weight loss due to bariatric surgery requires engagement from patients. Mobile health tool may offer alternative model that enhance participant engagement in keeping the therapy. Objective: We aimed to assess the influence of constant monitoring and subsequent motivational alerts in perioperative period and on post-operative effects in the bariatric patients. As well as the study was designed to identify factors conductive urge to change lifestyle after surgery. Methods: This prospective clinical control study was based on a usage of a designed prototype of bariatric mHealth system. The prepared application comprises central data management with a comprehensible interface dedicated for patients and data transfer module as a physician’s platform. Motivation system of a platform consist of motivational alerts, graphic outcome presentation, and patient communication center. Generated list of patients requiring urgent consultation and possibility of a constant contact with a specialist provide safety zone. 31 patients were enrolled in continuous monitoring program during a 6-month period along with typical follow-up visits. After one year follow-up, all patients were examined. Results: There were 20 active users of the proposed monitoring system during the entire duration of the study. After six months, 24 patients took a part in a control by telephone questionnaires. Among them, 75% confirmed that the application concept was an important element in the treatment. Active users of the application indicated as the most valuable features: motivation to continue treatment (11 users), graphical presentation of weight loss, and other parameters (7 users), the ability to contact a doctor (3 users). The three main drawbacks are technical errors (9 users), tedious questionnaires inside the application (5 users), and time-consuming tasks inside the system (2 users). Conclusions: Constant monitoring and successive motivational alerts to continue treatment is an appropriate tool in the treatment after bariatric surgery, mainly in the early post-operative period. Graphic presentation of data and continuous connection with a clinical staff seemed to be an element of motivation to continue treatment and a sense of security.

Keywords: bariatric surgery, mHealth, mobile health tool, obesity

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Authors: S. Naveen, V. Sivasubramanian

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A modeling theory is proposed to consider the vaporization of LNG during its contact with water following its release from an underwater source. The spillage of LNG underwater can lead to a decrease in the surface temperature of water and subsequent freezing. This can in turn affect the heat flux distribution from the released LNG onto the water surrounding it. The available models predict the rate of vaporization considering the surface of contact as a solid wall, and considering the entire phenomena as a solid-liquid operation. This assumption greatly under-predicted the overall heat transfer on LNG water interface. The vaporization flux would first decrease during the film boiling, followed by an increase during the transition boiling and a steady decrease during the nucleate boiling. A superheat theory is introduced to enhance the accuracy in the prediction of the heat transfer between LNG and water. The work suggests that considering the superheat theory can greatly enhance the prediction of LNG vaporization on underwater releases and also help improve the study of overall thermodynamics.

Keywords: evaporation rate, heat transfer, LNG vaporization, underwater LNG release

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Authors: F. M. Ali, R. Nazar, N. M. Arifin, I. Pop

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In this paper, the problem of unsteady stagnation-point flow and heat transfer induced by a shrinking sheet in the presence of radiation effect is studied. The transformed boundary layer equations are solved numerically by the shooting method. The influence of radiation, unsteadiness and shrinking parameters, and the Prandtl number on the reduced skin friction coefficient and the heat transfer coefficient, as well as the velocity and temperature profiles are presented and discussed in detail. It is found that dual solutions exist and the temperature distribution becomes less significant with radiation parameter.

Keywords: heat transfer, radiation effect, shrinking sheet unsteady flow

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Authors: C. S. Sona, Makrand A. Khanwale, Channamallikarjun S. Mathpati

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New generation nuclear power plants are currently being developed to be highly economical, to be passive safe, to produce hydrogen. An important feature of these reactors will be the use of coolants at temperature higher than that being used in current nuclear reactors. The molten fluoride salt with a eutectic composition of 46.5% LiF - 11.5% NaF - 42% KF (mol %) commonly known as FLiNaK is a leading candidate for heat transfer coolant for these nuclear reactors. CFD simulations were carried out using large eddy simulations to investigate the flow characteristics of molten FLiNaK at 850°C at a Reynolds number of 10,500 in a cylindrical pipe. Simulation results have been validated with the help of mean velocity profile using direct numerical simulation data. Transient velocity information was used to identify and characterise turbulent structures which are important for transfer of heat across solid-fluid interface. A wavelet transform based methodology called wavelet transform modulus maxima was used to identify and characterise the singularities. This analysis was also used for flow visualisation, and also to calculate the heat transfer coefficient using small eddy model. The predicted Nusselt number showed good agreement with the available experimental data.

Keywords: FLiNaK, heat transfer, molten salt, turbulent structures

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Deborah Zelinsky

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The retina filters millions of incoming signals into a smaller amount of exiting optic nerve fibers that travel to different portions of the brain. Most of the signals are for eyesight (called "image-forming" signals). However, there are other faster signals that travel "elsewhere" and are not directly involved with eyesight (called "non-image-forming" signals). This article centers on the neurons of the optic nerve connecting to parts of the limbic system. Eye care providers are currently looking at parvocellular and magnocellular processing pathways without realizing that those are part of an enormous "galaxy" of all the body systems. Lenses are modifying both non-image and image-forming pathways, taking A.M. Skeffington's seminal work one step further. Almost 100 years ago, he described the Where am I (orientation), Where is It (localization), and What is It (identification) pathways. Now, among others, there is a How am I (animation) and a Who am I (inclination, motivation, imagination) pathway. Classic eye testing considers pupils and often assesses posture and motion awareness, but classical prescriptions often overlook limbic involvement in visual processing. The limbic system is composed of the hippocampus, amygdala, hypothalamus, and anterior nuclei of the thalamus. The optic nerve's limbic connections arise from the intrinsically photosensitive retinal ganglion cells (ipRGC) through the "retinohypothalamic tract" (RHT). There are two main hypothalamic nuclei with direct photic inputs. These are the suprachiasmatic nucleus and the paraventricular nucleus. Other hypothalamic nuclei connected with retinal function, including mood regulation, appetite, and glucose regulation, are the supraoptic nucleus and the arcuate nucleus. The retino-hypothalamic tract is often overlooked when we prescribe eyeglasses. Each person is different, but the lenses we choose are influencing this fast processing, which affects each patient's aiming and focusing abilities. These signals arise from the ipRGC cells that were only discovered 20+ years ago and do not address the campana retinal interneurons that were only discovered 2 years ago. As eyecare providers, we are unknowingly altering such factors as lymph flow, glucose metabolism, appetite, and sleep cycles in our patients. It is important to know what we are prescribing as the visual processing evaluations expand past the 20/20 central eyesight.

Keywords: neuromodulation, retinal processing, retinohypothalamic tract, limbic system, visual processing

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Authors: Nur Ashida Salim, Muhammad Murtadha Othman, Ismail Musirin, Mohd Salleh Serwan

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Over the past few decades, the power system industry in many developing and developed countries has gone through a restructuring process of the industry where they are moving towards a deregulated power industry. This situation will lead to competition among the generation and distribution companies to achieve a certain objective which is to provide quality and efficient production of electric energy, which will reduce the price of electricity. Therefore it is important to obtain an accurate value of the Available Transfer Capability (ATC) and Transmission Reliability Margin (TRM) in order to ensure the effective power transfer between areas during the occurrence of uncertainties in the system. In this paper, the TRM and ATC is determined by taking into consideration the uncertainties of the system operating condition and system cascading collapse by applying the bootstrap technique. A case study of the IEEE RTS-79 is employed to verify the robustness of the technique proposed in the determination of TRM and ATC.

Keywords: available transfer capability, bootstrap technique, cascading collapse, transmission reliability margin

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Authors: Sanjib Kr Pal, S. Bhattacharyya

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Mixed convection of Cu-water nanofluid in an enclosure with thick wavy bottom wall has been investigated numerically. A co-ordinate transformation method is used to transform the computational domain into an orthogonal co-ordinate system. The governing equations in the computational domain are solved through a pressure correction based iterative algorithm. The fluid flow and heat transfer characteristics are analyzed for a wide range of Richardson number (0.1 ≤ Ri ≤ 5), nanoparticle volume concentration (0.0 ≤ ϕ ≤ 0.2), amplitude (0.0 ≤ α ≤ 0.1) of the wavy thick- bottom wall and the wave number (ω) at a fixed Reynolds number. Obtained results showed that heat transfer rate increases remarkably by adding the nanoparticles. Heat transfer rate is dependent on the wavy wall amplitude and wave number and decreases with increasing Richardson number for fixed amplitude and wave number. The Bejan number and the entropy generation are determined to analyze the thermodynamic optimization of the mixed convection.

Keywords: conjugate heat transfer, mixed convection, nano fluid, wall waviness

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Authors: S. Etaig, R. Hasan, N. Perera

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This paper analyses the heat transfer performance and fluid flow using different nanofluids in a square enclosure. The energy equation and Navier-Stokes equation are solved numerically using finite volume scheme. The effect of volume fraction concentration on the enhancement of heat transfer has been studied icorporating the Brownian motion; the influence of effective thermal conductivity on the enhancement was also investigated for a range of volume fraction concentration. The velocity profile for different Rayleigh number. Water-Cu, water AL2O3 and water-TiO2 were tested.

Keywords: computational fluid dynamics, natural convection, nanofluid and thermal conductivity

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Authors: Daniel J. Glauber

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Knowledge transfer between personnel could benefit an organization’s improved competitive advantage in the marketplace from a strategic approach to knowledge management. The lack of information sharing between personnel could create knowledge transfer gaps while restricting the decision-making processes. Knowledge transfer between personnel can potentially improve information sharing based on an implemented knowledge management strategy. An organization’s capacity to gain more knowledge is aligned with the organization’s prior or existing captured knowledge. This case study attempted to understand the overall influence of a KMS within the corporate environment and knowledge exchange between personnel. The significance of this study was to help understand how organizations can improve the Return on Investment (ROI) of a knowledge management strategy within a knowledge-centric organization. A qualitative descriptive case study was the research design selected for this study. The lack of information sharing between personnel may create knowledge transfer gaps while restricting the decision-making processes. Developing a knowledge management strategy acceptable at all levels of the organization requires cooperation in support of a common organizational goal. Working with management and executive members to develop a protocol where knowledge transfer becomes a standard practice in multiple tiers of the organization. The knowledge transfer process could be measurable when focusing on specific elements of the organizational process, including personnel transition to help reduce time required understanding the job. The organization studied in this research acknowledged the need for improved knowledge management activities within the organization to help organize, retain, and distribute information throughout the workforce. Data produced from the study indicate three main themes including information management, organizational culture, and knowledge sharing within the workforce by the participants. These themes indicate a possible connection between an organizations KMS, the organizations culture, knowledge sharing, and knowledge transfer.

Keywords: knowledge transfer, management, knowledge management strategies, organizational learning, codification

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Authors: Naik Nithesh, Andre Rozek

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The heat transfer and friction loss performances of a single rib-roughened rectangular cooling channel having four novel rib shapes were evaluated through numerical investigation using Ansys CFX. The investigation was conducted on a rectangular channel of aspect ratio (AR) = 4:1 with rib height to hydraulic diameter ratio (e/Dh) of 0.1 and rib pitch to height ratio (e/P) of 10 at Re = 30,000. The computations were performed by solving the RANS equation using k-ε turbulence model. Fluid flow simulation results of stationery case for different configuration are presented in terms of thermal performance parameter, Nusselt number and friction factor. These parameters indicate that a particular configuration of novel shaped ribs provides better heat transfer characteristics over the conventional 45° ribs. The numerical investigation undertaken in this study indicates an increase in overall efficiency of gas turbine due to increased thermal performance parameter, heat transfer co-efficient and less pumping pressure.

Keywords: gas turbine, rib shapes, nusselt number, thermal performance parameter

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Authors: Mahmoud S. Ahmed, Hany A. Mohamed, Mohamed A. Omara, Mohamed F. Abdeen

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Experimental study of natural convection heat transfer inside smooth and rough surfaces of vertical and inclined equilateral triangular channels of different inclination angles with a uniformly heated surface are performed. The inclination angle is changed from 15º to 90º. Smooth and rough surface of average roughness (0.02 mm) are used and their effect on the heat transfer characteristics are studied. The local and average heat transfer coefficients and Nusselt number are obtained for smooth and rough channels at different heat flux values, different inclination angles and different Rayleigh numbers (Ra) 6.48 × 105 ≤ Ra ≤ 4.78 × 106. The results show that the local Nusselt number decreases with increase of axial distance from the lower end of the triangular channel to a point near the upper end of channel, and then, it slightly increases. Higher values of local Nusselt number for rough channel along the axial distance compared with the smooth channel. The average Nusselt number of rough channel is higher than that of smooth channel by about 8.1% for inclined case at θ = 45o and 10% for vertical case. The results obtained are correlated using dimensionless groups for both rough and smooth surfaces of the inclined and vertical triangular channels.

Keywords: natural heat transfer convection, constant heat flux, open channels, heat transfer

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Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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Authors: Sundip Charmode, Simmi Mehra, Sudhir Kushwaha, Shalom Philip, Pratik Amrutiya, Ranjna Jangal

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Introduction: Quadrangular space syndrome involves compression of the axillary nerve and posterior circumflex humeral artery and its management in few cases, requires surgical decompression. The current study reviews the surgical approaches used in the decompression of neurovascular structures and presents our reflections and recommendations. Methods: Four human cadavers, in the Department of Anatomy were used for dissection of the Axillae and the Scapular region by the senior residents of the Department of Anatomy and Department of Orthopedics, who dissected quadrangular space in the eight upper limbs, using anterior and posterior surgical approaches. Observations: Posterior approach to identify the quadrangular space and secure its contents was recognized as the easier and much quicker method by both the Anatomy and Orthopedic residents, but it may result in increased postoperative morbidity. Whereas the anterior (Delto-pectoral) approach involves more skill but reduces postoperative morbidity. Conclusions: Anterior (Delto-pectoral) approach with suggested modifications can prove as an effective method in surgical decompression of quadrangular space syndrome. The authors suggest more cadaveric studies to facilitate anatomists and surgeons with the opportunities to practice and evaluate older and newer surgical approaches.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space

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Authors: Zhe Xu, Jian Li, Lvping Li, Zezheng Dong

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This work is to study an optimized transfer strategy of connecting Earth and Mars via the vicinity of libration points, which have been playing an increasingly important role in trajectory designing on a deep space mission, and can be used as an effective alternative solution for Earth-Mars direct transfer mission in some unusual cases. The use of vicinity of libration points of the sun-planet body system is becoming potential gateways for future interplanetary transfer missions. By adding fuel to cargo spaceships located in spaceports, the interplanetary round-trip exploration shuttle mission of such a system facility can also be a reusable transportation system. In addition, in some cases, when the S/C cruising through invariant manifolds, it can also save a large amount of fuel. Therefore, it is necessary to make an effort on looking for efficient transfer strategies using variant manifold about libration points. It was found that Earth L1/L2 Halo/Lyapunov orbits and Mars L2/L1 Halo/Lyapunov orbits could be connected with reasonable fuel consumption and flight duration with appropriate design. In the paper, the halo hopping method and coplanar circular method are briefly introduced. The former used differential corrections to systematically generate low ΔV transfer trajectories between interplanetary manifolds, while the latter discussed escape and capture trajectories to and from Halo orbits by using impulsive maneuvers at periapsis of the manifolds about libration points. In the following, designs of transfer strategies of the two methods are shown here. A comparative performance analysis of interplanetary transfer strategies of the two methods is carried out accordingly. Comparison of strategies is based on two main criteria: the total fuel consumption required to perform the transfer and the time of flight, as mentioned above. The numeric results showed that the coplanar circular method procedure has certain advantages in cost or duration. Finally, optimized transfer strategy with engineering constraints is searched out and examined to be an effective alternative solution for a given direct transfer mission. This paper investigated main methods and gave out an optimized solution in interplanetary transfer via the vicinity of libration points. Although most of Earth-Mars mission planners prefer to build up a direct transfer strategy for the mission due to its advantage in relatively short time of flight, the strategies given in the paper could still be regard as effective alternative solutions since the advantages mentioned above and longer departure window than direct transfer.

Keywords: circular restricted three-body problem, halo/Lyapunov orbit, invariant manifolds, libration points

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Authors: Myung-Gon Yoon, Jung-Ho Moon, Tae Kwon Ha

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This paper considers a robust stabilization problem of a single agent in a multi-agent consensus system composed of identical agents, when the network topology of the system is completely unknown. It is shown that the transfer function of an agent in a consensus system can be described as a multiplicative perturbation of the isolated agent transfer function in frequency domain. Applying known robust stabilization results, we present sufficient conditions for a robust stabilization of an agent against unknown network topology.

Keywords: single agent control, multi-agent system, transfer function, graph angle

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Prashant Kumar, Edamana Prasad

Abstract:

The White light emitting material has an emerging field in recent years due to their widespread application in the field of optoelectronics and cellular display. In the present study, we have achieved white light emission in gel medium through partial resonance energy transfer from different donors (naphthalene, phenanthrene, and pyrene) to lanthanides {Eu(III) and Tb(III)}. The gel was formed by the self- assembly of glucose cored poly(aryl ether) dendrons in DMSO-Water mixture (1:9 v/v). The white light emission was further confirmed by the CIE coordinates (Commission Internationale d’ Eclairage). Moreover, we have developed three different white light emitting system by utilizing three different donor moiety namely, naphthalene-Tb(III)-Eu(III) {I}, phenanthrene-Tb(III)-Eu(III) {II}, and pyrene-Tb(III)-Eu(III) {III}. The CIE coordinates for I, II and III were (0.35, 0.37), (0.33, 0.32) and (0.35, 0.33) respectively. Furthermore, we have investigated the energy transfer from different donors (phenanthrene, naphthalene, and pyrene) to lanthanide {Eu(III)}. The efficiency of energy transfer from phenanthrene-Eu(III), naphthalene-Eu(III) and pyrene-Eu(III) systems was 11.9%, 3.9%, and 3.6%, respectively. Detailed mechanistic aspects will be displayed in the poster.

Keywords: dendron, lanthanide, resonance energy transfer, white light emission

Procedia PDF Downloads 310