Search results for: surgical approach

Authors: Parul Garg

Abstract:

Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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Authors: Ahmad Shahin, Walid Moudani, Ali Bekraki

Abstract:

This research aims at presenting a predictive data mining model to handle an accurate diagnosis of acute appendicitis with patients for the purpose of maximizing the health service quality, minimizing morbidity/mortality, and reducing cost. However, acute appendicitis is the most common disease which requires timely accurate diagnosis and needs surgical intervention. Although the treatment of acute appendicitis is simple and straightforward, its diagnosis is still difficult because no single sign, symptom, laboratory or image examination accurately confirms the diagnosis of acute appendicitis in all cases. This contributes in increasing morbidity and negative appendectomy. In this study, the authors propose to generate an accurate model in prediction of patients with acute appendicitis which is based, firstly, on the segmentation technique associated to ABC algorithm to segment the patients; secondly, on applying fuzzy logic to process the massive volume of heterogeneous and noisy data (age, sex, fever, white blood cell, neutrophilia, CRP, urine, ultrasound, CT, appendectomy, etc.) in order to express knowledge and analyze the relationships among data in a comprehensive manner; and thirdly, on applying dynamic programming technique to reduce the number of data attributes. The proposed model is evaluated based on a set of benchmark techniques and even on a set of benchmark classification problems of osteoporosis, diabetes and heart obtained from the UCI data and other data sources.

Keywords: healthcare management, acute appendicitis, data mining, classification, decision tree

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

Abstract:

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

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

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Authors: Eunjoo Lee

Abstract:

Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: M. Okeke, A. Blyth

Abstract:

Industrial Control Systems (ICS) such as Supervisory Control And Data Acquisition (SCADA) can be seen in many different critical infrastructures, from nuclear management to utility, medical equipment, power, waste and engine management on ships and planes. The role SCADA plays in critical infrastructure has resulted in a call to secure them. Many lives depend on it for daily activities and the attack vectors are becoming more sophisticated. Hence, the security of ICS is vital as malfunction of it might result in huge risk. This paper describes how the application of Prey Predator (PP) approach in flocks of birds could enhance the detection of malicious activities on ICS. The PP approach explains how these animals in groups or flocks detect predators by following some simple rules. They are not necessarily very intelligent animals but their approach in solving complex issues such as detection through corporation, coordination and communication worth emulating. This paper will emulate flocking behavior seen in birds in detecting predators. The PP approach will adopt six nearest bird approach in detecting any predator. Their local and global bests are based on the individual detection as well as group detection. The PP algorithm was designed following MapReduce methodology that follows a Split Detection Convergence (SDC) approach.

Keywords: artificial life, industrial control system (ICS), IDS, prey predator (PP), SCADA, SDC

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Authors: Sarisa Pinkham, Kanyarat Bussaban

Abstract:

The research aims to approximate the amount of daily rainfall by using a pixel value data approach. The daily rainfall maps from the Thailand Meteorological Department in period of time from January to December 2013 were the data used in this study. The results showed that this approach can approximate the amount of daily rainfall with RMSE=3.343.

Keywords: daily rainfall, image processing, approximation, pixel value data

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Authors: P. Mbecke

Abstract:

Developmental social welfare implemented through developmental social work is being applauded internationally as an approach that facilitates social development theory and practice. However, twenty-two years into democracy, there are no tangible evidences that the much-desired developmental social welfare approach has assisted the post-apartheid macroeconomic policy frameworks in addressing poverty and inequality, thus, the derailment of the post-apartheid development approach in South Africa. Based on the implementation research theory, and the literature review technique, this paper recognizes social work as a principal role-player in social development. It recommends the redesign and implementation of an effective developmental social welfare approach with specific strategies, programs, activities and sufficient resources aligned to and appropriate in delivering on the promises of the government’s macroeconomic policy frameworks. Such approach should be implemented by skilled and dedicated developmental social workers in order to achieve transformation in South Africa.

Keywords: apartheid, developmental social welfare, developmental social work, inequality, poverty alleviation, social development, South Africa

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Authors: Thiru Vandeyar

Abstract:

This study sets out to explore how teachers’ beliefs and attitudes about ICT policy influence a consensus approach to the formulation of a school ICT policy. This case study proposes Q- methodology as an innovative method to facilitate a school’s capacity to develop policy reflecting teacher beliefs and attitudes. Q-methodology is used as a constructivist approach to the formulation of an ICT policy. Data capture was a mix of Q-methodology and qualitative principles. Data was analyzed by means of document, content and cluster analysis methods. Findings were threefold: First, teachers’ beliefs and attitudes about ICT policy influenced a consensus approach by including teachers as policy decision-makers. Second, given the opportunity, teachers have the inherent ability to deconstruct and critically engage with policy statements according to their own professional beliefs and attitudes. And third, an inclusive approach to policy formulation may inform the practice of school leaders and policymakers alike on how schools may develop their own policy.

Keywords: ICT, policy, teacher beliefs, consensus

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Authors: Sanjeeb Kumar Mohanty

Abstract:

Content Based Instruction (CBI) in English Language Teaching (ELT) basically helps English as Second Language (ESL) learners of English. At the same time, it fosters multidisciplinary style of learning by promoting collaborative learning style. It is an approach to teaching ESL that attempts to combine language with interdisciplinary learning for bettering language proficiency and facilitating content learning. Hence, the basic purpose of CBI is that language should be taught in conjunction with academic subject matter. It helps in establishing the content as well as developing language competency. This study aims at supporting the potential values of interdisciplinary approach in promoting English Language Learning (ELL) by teaching writing skills to a small group of learners and discussing the findings with the teachers from various disciplines in a workshop. The teachers who are oriented, they use the same approach in their classes collaboratively. The inputs from the learners as well as the teachers hopefully raise positive consciousness with regard to the vast benefits that Content Based Instruction can offer in advancing the language competence of the learners.

Keywords: content based instruction, interdisciplinary approach, writing skills, collaborative approach

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Authors: Shabnam Dadparvar, Laijin Shen, Farzad Ravanbod

Abstract:

Nowadays, the political phenomenon of terrorism is considered as an effective factor on political, social, and economic changes. It has replaced the recognized political phenomena such as revolutions, wars (total war among two or more political units with distinct identities in the form of national states), coups d’état, insurgencies and etc. and has challenged political life in all its levels (sub national, national, and international political groups). In this paper by using descriptive-analytical method, the authors try to explain the spread of this political phenomenon across the world, its definition and types, also analyze different approaches to understand it. The authors believe that the Logical-Rational approach is the best way to explain and understand this phenomenon.

Keywords: logical approach, psychological- social approach, religious approach, terrorism

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Authors: Alexandru Grigorescu, Alexandra Protesanu

Abstract:

Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

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Authors: M. Hadavi, Z. Hashemi

Abstract:

Learning strategies play an important role in the development of language skills. Vocabulary learning strategies as the backbone of these strategies have become a major part of English language teaching. This study is a comparative analysis of Vocabulary Learning Strategies (VLS) use and preference among freshmen and senior EFL medical sciences students with different fields of study. 449 students (236 freshman and 213 seniors) participated in the study. 64.6% were female and 35.4% were male. The instrument utilized in this research was a questionnaire consisting of 41 items related to the students’ approach to vocabulary learning. The items were classified under eight sections as dictionary strategies, guessing strategies, study preferences, memory strategies, autonomy, note- taking strategies, selective attention, and social strategies. The participants were asked to answer each item with a 5-point Likert-style frequency scale as follows:1) I never or almost never do this, 2) I don’t usually do this, 3) I sometimes do this, 4) I usually do this, and 5)I always or almost always do this. The results indicated that freshmen students and particularly surgical technology students used more strategies compared to the seniors. Overall guessing and dictionary strategies were the most frequently used strategies among all the learners (p=0/000). The mean and standard deviation of using VLS in the students who had no previous history of participating in the private English language classes was less than the students who had attended these type of classes (p=0/000). Female students tended to use social and study preference strategies whereas male students used mostly guessing and dictionary strategies. It can be concluded that the senior students under instruction from the university have learned to rely on themselves and choose the autonomous strategies more, while freshmen students use more strategies that are related to the study preferences.

Keywords: vocabulary leaning strategies, medical sciences, students, linguistics

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Authors: Gusa Hall, Barrie Keeler, Achal Khanna

Abstract:

Introduction: NICE guidelines have highlighted the consequences of IV fluid mismanagement. The main aim of this study was to audit fluid prescribing post laparotomies to identify if fluids were prescribed in accordance to NICE guidelines. Methodology: Retrospective database search of eight specific laparotomy procedures (colectomy right and left, Hartmann’s procedure, small bowel resection, perforated ulcer, abdominal perineal resection, anterior resection, pan proctocolectomy, subtotal colectomy) highlighted 29 laparotomies between April 2019 and May 2019. Two of 29 patients had secondary procedures during the same admission, n=27 (patients). Database case notes were reviewed for date of procedure, length of admission, fluid prescribed and amount, nasal gastric tube output, daily bloods results for electrolytes sodium and potassium and operational losses. Results: n=27 based on 27 identified patients between April 2019 – May 2019, 93% (25/27) received IV fluids, only 19% (5/27) received the correct IV fluids in accordance to NICE guidelines, 93% (25/27) who received IV fluids had the correct electrolytes levels (sodium & potassium), 100% (27/27) patients received blood tests (U&E’s) for correct electrolytes levels. 0% (0/27) no documentation on operational losses. IV fluids matched nasogastric tube output in 100% (3/3) of the number of patients that had a nasogastric tube in situ. Conclusion: A PubMed database literature review on barriers to safer IV prescribing highlighted educational interventions focused on prescriber knowledge rather than how to execute the prescribing task. This audit suggests IV fluids post laparotomies are not being prescribed consistently in accordance to NICE guidelines. Surgical management plans should be clearer on IV fluids and electrolytes requirements for the following 24 hours after the plan has been initiated. In addition, further teaching and training around IV prescribing is needed together with frequent surgical audits on IV fluid prescribing post-surgery to evaluate improvements.

Keywords: audit, IV Fluid prescribing, laparotomy, NICE guidelines

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Authors: Nigatu Tadesse, Ying Liu, Juan Li, Hong Ming Liu

Abstract:

Gastric carcinogenesis is a lengthy process of histopathological transition from normal to atrophic gastritis (AG) to intestinal metaplasia (GIM), dysplasia toward gastric cancer (GC). The stage of GIM identified as precancerous lesions with resistance to H-pylori eradication and recurrence after endoscopic surgical resection therapies. GIM divided in to two morphologically distinct phenotypes such as complete GIM bearing intestinal type morphology whereas the incomplete type has colonic type morphology. The incomplete type GIM considered to be the greatest risk factor for the development of GC. Studies indicated the expression of the caudal type homeobox 2 (CDX2) gene is responsible for the development of complete GIM but its progressive downregulation from incomplete metaplasia toward advanced GC identified as the risk for IM progression and neoplastic transformation. The downregulation of CDX2 gene have promoted cell growth and proliferation in gastric and colon cancers and ascribed in chemo-treatment inefficacies. CDX2 downregulated through promoter region hypermethylation in which the methylation frequency positively correlated with the dietary history of the patients, suggesting the role of diet as methyl carbon donor sources such as methionine. However, the metabolism of exogenous methionine is yet unclear. Targeting exogenous methionine metabolism has become a promising approach to limits tumor cell growth, proliferation and progression and increase treatment outcome. This review article discusses molecular alterations that could shed light on the potential of exogenous methionine metabolisms, such as gut microbiota alteration as sources of methionine to host cells, metabolic pathway signaling via PI3K/AKt/mTORC1-c-MYC to rewire exogenous methionine and signature of increased gene methylation index, cell growth and proliferation in GIM, with insights to new treatment avenue via targeting methionine metabolism, and the need for future integrated studies on molecular alterations and metabolomics to uncover altered methionine metabolism and characterization of CDX2 methylation in gastric intestinal metaplasia for potential therapeutic exploitation.

Keywords: altered methionine metabolism, Intestinal metaplesia, CDX2 gene, gastric cancer

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Authors: John Kong Shan Ho

Abstract:

In June 2022, the Law Commission of England and Wales published an options paper to examine how the law on corporate criminal liability can be reformed under the English system. The paper merely details options for reform and does not seek to make recommendations. However, the paper has ruled out the “respondeat superior” approach of the US and “corporate culture” approach of Australia as reform options. On balance, the preferred reform option of the Law Commission is the “senior officer” approach as currently adopted in Canada. This article is written against such background and argues that due to similarities between the English and Canadian systems, the latter’s approach is more ideal to be adopted by the former as a model for reform in this area.

Keywords: corporate criminal liability, identification principle, directing mind and will, England, Canada

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Authors: Fumihiro Ima, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

Abstract:

It is important to know growth rate of brain tumors before surgery because it influences treatment planning including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without administration of contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients and WHO grade 4 in 2 patients), meningioma WHO grade1 in 2 patients and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW-signals than that in low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW-signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

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Authors: Shirin Jalili, Ramin Ghasemi

Abstract:

Lumbar microdiscectomy is the most commonly performed spinal surgery strategy; it is regularly performed to lighten the indications and signs of sciatica within the lower back and leg caused by a lumbar disc herniation. This surgery aims to progress leg pain, reestablish function, and enable a return to ordinary day-by-day exercises. Rates of lumbar disc surgery show critical geographic varieties recommending changing treatment criteria among working specialists. Few population-based considers have investigated the hazard of reoperation after disc surgery, and regional or inter specialty varieties within the reoperations are obscure. The conventional approach to recouping from lumbar microdiscectomy has been to restrain bending, lifting, or turning for a least 6 weeks in arrange to anticipate the disc from herniating once more. Traditionally, patients were exhorted to limit post-operative action, which was accepted to decrease the hazard of disc herniation and progressive insecurity. In modern hone, numerous specialists don't limit understanding of postoperative action due to the discernment this practice is pointless. There's a need of thinks about highlighting the result by distinctive scores or parameters after surgery for repetitive circle herniations of the lumbar spine at the starting herniation location. This study will evaluate the quality of life after surgical treatment of recurrent herniations with distinctive standardized approved result instruments.

Keywords: post-operative activity, disc, quality of life, treatment, movements

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Authors: Asaad Y. Shamseldin

Abstract:

Analytical probabilistic approach is an innovative approach for urban stormwater modeling. It can provide information about the long-term performance of a stormwater management facility without being computationally very demanding. This paper explores the application of the analytical probabilistic approach in New Zealand. The paper presents the results of a case study aimed at development of an objective way of identifying what constitutes a rainfall storm event and the estimation of the corresponding statistical properties of storms using two selected automatic rainfall stations located in the Auckland region in New Zealand. The storm identification and the estimation of the storm statistical properties are regarded as the first step in the development of the analytical probabilistic models. The paper provides a recommendation about the definition of the storm inter-event time to be used in conjunction with the analytical probabilistic approach.

Keywords: hydrology, rainfall storm, storm inter-event time, New Zealand, stormwater management

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

Abstract:

The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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Authors: Fumihiro Imai, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

Abstract:

It is important to know the growth rate of brain tumors before surgery because it influences treatment planning, including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without the administration of a contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after a clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients, and WHO grade 4 in 2 patients), meningioma WHO grade 1 in 2 patients, and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW signals than that low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

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Authors: Sepideh Jabbari Behnam, Zahrasadat Saide Zarabadi

Abstract:

A city is an intertwined texture from the relationship of different components in a whole which is united in a one, so designing the whole complex and its planning is not an easy matter. By considering that a city is a complex system with infinite components and communications, providing flexible layouts that can respond to the unpredictable character of the city, which is a result of its complexity, is inevitable. Parametric design approach as a new approach can produce flexible and transformative layouts in any stage of design. This study aimed to introduce parametric design as a modern approach to respond to complex urban issues by using descriptive and analytical methods. This paper firstly introduces complex systems and then giving a brief characteristic of complex systems. The flexible design and layout flexibility is another matter in response and simulation of complex urban systems that should be considered in design, which is discussed in this study. In this regard, after describing the nature of the parametric approach as a flexible approach, as well as a tool and appropriate way to respond to features such as limited predictability, reciprocating nature, complex communications, and being sensitive to initial conditions and hierarchy, this paper introduces parametric design.

Keywords: complexity theory, complex system, flexibility, parametric design

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

Abstract:

Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: B. Ramesh Naik, T. Venugopal

Abstract:

This paper presents a novel approach which improves the high-level semantics of images based on machine learning approach. The contemporary approaches for image retrieval and object recognition includes Fourier transforms, Wavelets, SIFT and HoG. Though these descriptors helpful in a wide range of applications, they exploit zero order statistics, and this lacks high descriptiveness of image features. These descriptors usually take benefit of primitive visual features such as shape, color, texture and spatial locations to describe images. These features do not adequate to describe high-level semantics of the images. This leads to a gap in semantic content caused to unacceptable performance in image retrieval system. A novel method has been proposed referred as discriminative learning which is derived from machine learning approach that efficiently discriminates image features. The analysis and results of proposed approach were validated thoroughly on WANG and Caltech-101 Databases. The results proved that this approach is very competitive in content-based image retrieval.

Keywords: CBIR, discriminative learning, region weight learning, scale invariant feature transforms

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Authors: Royia Soliman, Salma ElAnsary, Akram Amin Abdellatif, Florian Holzapfel

Abstract:

Model-Based Safety Analysis (MBSA) is an approach in which the system and safety engineers share a common system model created using a model-based development process. The model can also be extended by the failure modes of the system components. There are two famous approaches for the addition of fault behaviors to system models. The first one is to enclose the failure into the system design directly. The second approach is to develop a fault model separately from the system model, thus combining both independent models for safety analysis. This paper introduces a hybrid approach of MBSA. The approach tries to use informal abstracted models to investigate failure behaviors. The approach will combine various concepts such as directed graph traversal, event lists and Constraint Satisfaction Problems (CSP). The approach is implemented using an Object Oriented programming language. The components are abstracted to its failure logic and relationships of connected components. The implemented approach is tested on various flight control systems, including electrical and multi-domain examples. The various tests are analyzed, and a comparison to different approaches is represented.

Keywords: flight control systems, model based safety analysis, safety assessment analysis, system modelling

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Authors: Djamal Hamadi, Sifeddine Abderrahmani, Toufik Maalem, Oussama Temami

Abstract:

In recent years many finite elements have been developed for plate bending analysis. The formulated elements are based on the strain based approach. This approach leads to the representation of the displacements by higher order polynomial terms without the need for the introduction of additional internal and unnecessary degrees of freedom. Good convergence can also be obtained when the results are compared with those obtained from the corresponding displacement based elements, having the same total number of degrees of freedom. Furthermore, the plate bending elements are free from any shear locking since they converge to the Kirchhoff solution for thin plates contrarily for the corresponding displacement based elements. In this paper the efficiency of the strain based approach compared to well known displacement formulation is presented. The results obtained by a new formulated plate bending element based on the strain approach and Kirchhoff theory are compared with some others elements. The good convergence of the new formulated element is confirmed.

Keywords: displacement fields, finite elements, plate bending, Kirchhoff theory, strain based approach

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Authors: Ali M. Alakeel

Abstract:

Assertion-based software testing has been shown to be a promising tool for generating test cases that reveal program faults. Because the number of assertions may be very large for industry-size programs, one of the main concerns to the applicability of assertion-based testing is the amount of search time required to explore a large number of assertions. This paper presents a new approach for assertions exploration during the process of Assertion-Based software testing. Our initial exterminations with the proposed approach show that the performance of Assertion-Based testing may be improved, therefore, making this approach more efficient when applied on programs with large number of assertions.

Keywords: software testing, assertion-based testing, program assertions, generating test

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Authors: Majid Etaati, Hamid Majedi

Abstract:

Relational planning approach proposed by Patsy Healey goes beyond the physical proximity and emphasizes social proximity. This approach stresses the importance of nodes and flows between nodes. Current plans in European cities have incrementally incorporated this approach, but urban plans in Iran have still stayed very detailed and rigid. In response to the weak evaluation results of the comprehensive planning approach in Qazvin, the local authorities applied the City Development Strategy (CDS) to cope with new urban challenges. The paper begins with an explanation of relational planning and suggests that Healey gives urban planners about spatial strategies and then it surveys relational factors in CDS of Qazvin. This study analyzes the extent which CDS of Qazvin have highlighted nodes, flows, and dynamics. In the end, the study concludes that there is a relational understanding of urban dynamics in the plan, but it is weak.

Keywords: relational, dynamics, city development strategy, urban planning, Qazvin

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Authors: Namubiru Zula, Janice Desire Busingue

Abstract:

Pro-active educational approaches have lately been adapted Globally in the Conservation of Natural Resources. This led to the introduction of the co-management system, which worked for some European Countries on the conservation of sharks and other Natural resources. However, this approach has drastically failed in the Fishery sector on Lake Victoria; and the punitive education approach has been re-instated. Literature is readily available about the punitive educational approaches and scanty with the pro-active one. This article analyses the pro-active approach adopted by the Department of Fisheries for the orientation of BMU leaders in a co-management system. The study is interpreted using the social constructivist lens for co-management of the fishery resource to ensure that fishers are also back to fishing sustainably. It highlights some of the education methods used, methodological challenges that included the power and skills gap of the facilitators and program designers, and some implications to practice.

Keywords: beach management units, fishers, education methods, proactive approach, punitive approach

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Authors: Bolatbek Rysbaiuly, Aliya S. Azhibekova

Abstract:

Problems concerning the interpretation of the well testing results belong to the class of inverse problems of subsurface hydromechanics. The distinctive feature of such problems is that additional information is depending on the capabilities of oilfield experiments. Another factor that should not be overlooked is the existence of errors in the test data. To determine reservoir properties, some inverse problems for parabolic equations were investigated. An approach to solving the inverse problems based on the method of regularization is proposed.

Keywords: iterative approach, inverse problem, parabolic equation, reservoir properties

Procedia PDF Downloads 424

Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

Abstract:

Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

Procedia PDF Downloads 123