Search results for: open temporomandibular joint surgery

Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

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Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

Procedia PDF Downloads 95

Authors: Neda Azari Dodaran, Hamid Ahmadi

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Results of 405 finite element (FE) analyses were used in the present research to study the effect of the joint geometry on the ultimate strength and initial stiffness of tubular K-joints subjected to axial loading at fire-induced elevated temperatures. The FE models were validated against the data available from experimental tests. Structural behavior under different temperatures (200ºC, 400ºC, 500ºC, and 700ºC) was investigated and compared to the behavior at ambient temperature (20ºC). A parametric study was conducted to investigate the effect of dimensionless geometrical parameters (β, γ, θ, and τ) on the ultimate strength and initial stiffness. Afterwards, ultimate strength data extracted from the FE analyses were compared with the values calculated from the equations proposed by available design codes in which the ultimate strength of the joint at elevated temperatures is obtained by replacing the yield stress of the steel at ambient temperature with the corresponding value at elevated temperature. It was indicated that this method may not have acceptable accuracy for K-joints under axial loading. Hence, a design formula was developed, through nonlinear regression analyses, to determine the ultimate strength of K-joints subjected to balanced axial loads at elevated temperatures.

Keywords: axial loading, elevated temperature, parametric equation, static strength, tubular K-joint

Procedia PDF Downloads 132

Authors: Prakash Persad, Kelvin Loutan, Trichelle Seepersad

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The Finite Element Method is commonly used in the analysis of flexible manipulators to predict elastic displacements and develop joint control schemes for reducing positioning error. In order to preserve simplicity, regular geometries, ideal joints and connections are assumed. This paper presents the dynamic FE analysis of a 4- degrees of freedom open chain manipulator, intended for striking a curved 3D surface percussion musical instrument. This was done utilizing the new MultiBody Dynamics Module in COMSOL, capable of modeling the elastic behavior of a body undergoing rigid body type motion.

Keywords: dynamic modeling, entertainment robots, finite element method, flexible robot manipulators, multibody dynamics, musical robots

Procedia PDF Downloads 319

Authors: Mohamed Ahmed Gesraha, Amany Ramadan Ebeid

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Aphids are noxious and serious persistent pests in the open fields worldwide. Many authors studied the possibility of aphid control by applying Ladybirds and Lacewings at different releasing rates under open-field conditions. Results clarify that releasing 3rd instar larvae of Coccinella undecimpunctata at the rate of 1 larva:50 aphid was more effective than 1:100 or 1:200 rates for controlling Aphis gossypii population in Okra field; reflecting more than 90% reduction in the aphid population within 15 days. When Chrysoperla carnea 2nd larval instar were releasing at 1:5, 1:10, and 1:20 (predator: aphid), it was noticed that the former rate was the most effective one, inducing 98.93% reduction in aphid population; while the two other rates reflecting less reduction. Additionally, in the case of double releases, the reduction percentage at the 1:5 rate was 99.63%, emphasize that this rate was the most effective one; the other rates induced 97.05 and 95.64% reduction. Generally, a double release was more effective in all tested rates than the single one because of the cumulative existence of the predators in large numbers at the same period of the experiment. It could be concluded that utilizing insect predators (Coccinella undecimpunctata or Chrysoperla carnea) at an early larval stag were faire enough to reduce the aphids’ populations under open fields conditions.

Keywords: releasing predators, lacewings, ladybird, open fields

Procedia PDF Downloads 157

Authors: Okoro Ngozi Priscilla

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Education is the bedrock of development in every nation of the world, and it is very useful in ensuring quality of life for every individual and a better world for the people. Education, therefore, is the basic instrument of economic growth and technological advancement in any society. It is in recognition of this fact that the Nigerian government commits immense resources to ensuring that its citizens acquire education and also policies are being made to ensure the accessibility of education, qualitative higher education is highly recognized as a vital driving force for the socio-economic growth and technological development of nations yet the problem of access to University education in the country persists and therefore brought about the introduction of Open and Distance Learning (ODL) which has as its main objective, the attainment of mass literacy and providing opportunities for those who could not gain admission through designated entrance examination agencies as well as those who could not afford to leave their job to attend a full-time educational programme. Open and distance learning seeks to improve skilled manpower and also improve the skills for those already at work.

Keywords: accessibility, open and distant learning programme, fulltime educational programme, distance learning

Procedia PDF Downloads 439

Authors: Song Shengli, Tan Zhitao, Li Qing, Fang Husheng, Ye Qing, Zhang Xinglong

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Lower extremity power-assisted exoskeleton (LEPEX) is a kind of wearable electromechanical integration intelligent system, walking in synchronization with the wearer, which can assist the wearer walk by means of the driver mounted in the exoskeleton on each joint. In this paper, dynamic analysis and design of the LEPEX are performed. First of all, human walking process is divided into single leg support phase, double legs support phase and ground collision model. The three kinds of dynamics modeling is established using the Lagrange method. Then, the flat walking and climbing stairs dynamic information such as torque and power of lower extremity joints is derived for loading 75kg according to scholar Stansfield measured data of flat walking and scholars R. Riener measured data of climbing stair respectively. On this basis, the joint drive way in the sagittal plane is determined, and the structure of LEPEX is designed. Finally, the designed LEPEX is simulated under ADAMS by using a person’s joint sports information acquired under flat walking and climbing stairs. The simulation result effectively verified the correctness of the structure.

Keywords: kinematics, lower extremity exoskeleton, simulation, structure

Procedia PDF Downloads 410

Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

Procedia PDF Downloads 81

Authors: Victor Emeli, Akansel Cosgun

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This paper explores the navigation among movable obstacles (NAMO) problem and proposes joint path and push planning: which path to take and in what direction the obstacles should be pushed at, given a start and goal position. We present a planning algorithm for selecting a path and the obstacles to be pushed, where a rapidly-exploring random tree (RRT)-based heuristic is employed to calculate a minimal collision path. When it is necessary to apply a pushing force to slide an obstacle out of the way, the planners leverage means-end analysis through a dynamic physics simulation to determine the sequence of linear pushes to clear the necessary space. Simulation experiments show that our approach finds solutions in higher clutter percentages (up to 49%) compared to the straight-line push planner (37%) and RRT without pushing (18%).

Keywords: motion planning, path planning, push planning, robot navigation

Procedia PDF Downloads 147

Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

Procedia PDF Downloads 202

Authors: Daifeng Hao, Guang Feng, Jingfeng Zhao, Tao Li, Xiaoye Tuo

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Objective: To retrospectively analyze the clinical characteristics of incision infection with sternal osteomyelitis sinus tract after cardiac surgery and the operation method and therapeutic effect of filling and repairing with activated PRP gel. Methods: From March 2011 to October 2022, 142 cases of incision infection after cardiac surgery with sternal osteomyelitis sinus were retrospectively analyzed, and the causes of poor wound healing after surgery, wound characteristics, perioperative wound management were summarized. Treatment during operation, collection and storage process of autologous PRP before debridement surgery, PRP filling repair and activation method after debridement surgery, effect of anticoagulant drugs on surgery, postoperative complications and average wound healing time, etc.. Results: Among the cases in this group, 53.3% underwent coronary artery bypass grafting, 36.8% underwent artificial heart valve replacement, 8.2% underwent aortic artificial vessel replacement, and 1.7% underwent allogeneic heart transplantation. The main causes of poor incision healing were suture reaction, fat liquefaction, osteoporosis, diabetes, and metal allergy in sequence. The wound is characterized by an infected sinus tract. Before the operation, 100-150ml of PRP with 4 times the physiological concentration was collected separately with a blood component separation device. After sinus debridement, PRP was perfused to fill the bony defect in the middle of the sternum, activated with thrombin freeze-dried powder and calcium gluconate injection to form a gel, and the outer skin and subcutaneous tissue were sutured freely. 62.9% of patients discontinued warfarin during the perioperative period, and 37.1% of patients maintained warfarin treatment. There was no significant difference in the incidence of postoperative wound hematoma. The average postoperative wound healing time was 12.9±4.7 days, and there was no obvious postoperative complication. Conclusions: Application of activated PRP gel to fill incision infection with sternal osteomyelitis sinus after cardiac surgery has a less surgical injury and satisfactory and stable curative effect. It can completely replace the previously used pectoralis major muscle flap transplantation operation scheme.

Keywords: platelet-rich plasma, negative-pressure wound therapy, sternal osteomyelitis, cardiac surgery

Procedia PDF Downloads 64

Authors: Abdullah Bal, Sevdenur Bal

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This paper purposes a new type of hardware application for training of cellular neural networks (CNN) using optical joint transform correlation (JTC) architecture for image feature extraction. CNNs require much more computation during the training stage compare to test process. Since optoelectronic hardware applications offer possibility of parallel high speed processing capability for 2D data processing applications, CNN training algorithm can be realized using Fourier optics technique. JTC employs lens and CCD cameras with laser beam that realize 2D matrix multiplication and summation in the light speed. Therefore, in the each iteration of training, JTC carries more computation burden inherently and the rest of mathematical computation realized digitally. The bipolar data is encoded by phase and summation of correlation operations is realized using multi-object input joint images. Overlapping properties of JTC are then utilized for summation of two cross-correlations which provide less computation possibility for training stage. Phase-only JTC does not require data rearrangement, electronic pre-calculation and strict system alignment. The proposed system can be incorporated simultaneously with various optical image processing or optical pattern recognition techniques just in the same optical system.

Keywords: CNN training, image processing, joint transform correlation, optoelectronic hardware

Procedia PDF Downloads 483

Authors: Nion Sirimongkonlertkun, Vivard Phonekeo

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This research focused on open burning occurrence in Greater Mekong Sub-Region countries that influences the increase of PM10concentrations. Thailand, Myanmar, and Laos were chosen as a case study, and 2009, 2010, and 2012 were chosen as the year for case study. Hotspot detected by MODIS (Moderate Resolution Imaging Specto radiometer) sensor on board of Terra/Aqua satellites and provided by Rapid Response System was used to represent open burning location in the region. Hotspot was selected through fire confidence with confidence levels of 80-100%. The spatial analysis by GIS was used as the main tool for analyzing and defining the location of open burning at study sites as hotspot with the pixel size of 1 km by 1 km. The total hotspot counts in the study period of four years (2007, 2009, 2010, and January-April 2012) at the regional level, including Thailand, Laos, and Myanmar were 255,177 hotspots or a very high yearly average of 63,795 hotspots. The highest amount was seen in Myanmar (50%), followed by Laos (36%), and Thailand (14%). For Thailand, the majority of burning or 64% occurred in the northern region with the density of 5 hotspots per 100 km2. According to statistics of the 4 years, the increasing rate of hotspot from January to February was 10 times and from February to March was 4 times. After that period, the hotspot started to decline by 2 times from March to April. Therefore, in order to develop a policy which aims to lessen open burning conduction, the government should seriously focus on this problem during the peak period—February to March in every year when hotspot and open burning area is significantly increased.

Keywords: PM10, hotspot, greater mekong sub-region, open burning

Procedia PDF Downloads 344

Authors: R. M. Shabbir Ahmed, Mohamed Haneef, A. R. Anwar Khan

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Analysis of stresses plays important role in the optimization of structures. Prior stress estimation helps in better design of the products. Composites find wide usage in the industrial and home applications due to its strength to weight ratio. Especially in the air craft industry, the usage of composites is more due to its advantages over the conventional materials. Composites are mainly made of orthotropic materials having unequal strength in the different directions. Composite materials have the drawback of delamination and debonding due to the weaker bond materials compared to the parent materials. So proper analysis should be done to the composite joints before using it in the practical conditions. In the present work, a composite plate with elastic pin is considered for analysis using finite element software Ansys. Basically the geometry is built using Ansys software using top down approach with different Boolean operations. The modelled object is meshed with three dimensional layered element solid46 for composite plate and solid element (Solid45) for pin material. Various combinations are considered to find the strength of the composite joint under uniaxial loading conditions. Due to symmetry of the problem, only quarter geometry is built and results are presented for full model using Ansys expansion options. The results show effect of pin diameter on the joint strength. Here the deflection and load sharing of the pin are increasing and other parameters like overall stress, pin stress and contact pressure are reducing due to lesser load on the plate material. Further material effect shows, higher young modulus material has little deflection, but other parameters are increasing. Interference analysis shows increasing of overall stress, pin stress, contact stress along with pin bearing load. This increase should be understood properly for increasing the load carrying capacity of the joint. Generally every structure is preloaded to increase the compressive stress in the joint to increase the load carrying capacity. But the stress increase should be properly analysed for composite due to its delamination and debonding effects due to failure of the bond materials. When results for an isotropic combination is compared with composite joint, isotropic joint shows uniformity of the results with lesser values for all parameters. This is mainly due to applied layer angle combinations. All the results are represented with necessasary pictorial plots.

Keywords: bearing force, frictional force, finite element analysis, ANSYS

Procedia PDF Downloads 315

Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

Procedia PDF Downloads 51

Authors: Eyob Messele Sefene, Atinkut Atinafu Yilma

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The highest strength-to-weight ratio criterion has fascinated increasing curiosity in virtually all areas where weight reduction is indispensable. One of the recent advances in manufacturing to achieve this intention endears friction stir welding (FSW). The process is widely used for joining similar and dissimilar non-ferrous materials. In FSW, the mechanical properties of the weld joints are impelled by property-selected process parameters. This paper presents verdicts of optimum process parameters in attempting to attain enhanced mechanical properties of the weld joint. The experiment was conducted on a 5 mm 6061 aluminum alloy sheet. A butt joint configuration was employed. Process parameters, rotational speed, traverse speed or feed rate, axial force, dwell time, tool material and tool profiles were utilized. Process parameters were also optimized, making use of a mixed L18 orthogonal array and the Grey relation analysis method with larger is better quality characteristics. The mechanical properties of the weld joint are examined through the tensile test, hardness test and liquid penetrant test at ambient temperature. ANOVA was conducted in order to investigate the significant process parameters. This research shows that dwell time, rotational speed, tool shape, and traverse speed have become significant, with a joint efficiency of about 82.58%. Nine confirmatory tests are conducted, and the results indicate that the average values of the grey relational grade fall within the 99% confidence interval. Hence the experiment is proven reliable.

Keywords: friction stir welding, optimization, 6061 AA, Taguchi

Procedia PDF Downloads 73

Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

Procedia PDF Downloads 275

Authors: Ana Bilandzic, Marcus Foth, Greg Hearn

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In a narrow sense, innovation is the invention and commercialisation of a new product or service in the marketplace. The literature suggests places that support knowledge exchange and social interaction, e.g. coffee shops, to nurture innovative ideas. With the widespread success of Internet, interpersonal communication and interaction changed. Online platforms complement physical places for idea exchange and innovation – the rise of hybrid, ‘net localities.’ Further, since its introduction in 2003 by Chesbrough, the concept of open innovation received increased attention as a topic in academic research as well as an innovation strategy applied by companies. Open innovation allows companies to seek and release intellectual property and new ideas from outside of their own company. As a consequence, the innovation process is no longer only managed within the company, but it is pursued in a co-creation process with customers, suppliers, and other stakeholders. Quirky.com (Quirky), a company founded by Ben Kaufman in 2009, recognised the opportunity given by the Internet for knowledge exchange and open innovation. Quirky developed an online platform that makes innovation available to everyone. This paper reports on a study that analysed Quirky’s business process in an extended event-driven process chain (eEPC). The aim was to determine how the platform enabled crowdsourced innovation for physical products on the Internet. The analysis reveals that key elements of the business model are based on open innovation. Quirky is an example of how open innovation can support crowdsourced and crowdfunded product ideation, development and selling. The company opened up various stages in the innovation process to its members to contribute in the product development, e.g. product ideation, design, and market research. Throughout the process, members earn influence through participating in the product development. Based on the influence they receive, shares on the product’s turnover. The outcomes of the study’s analysis highlighted certain benefits of open innovation for product development. The paper concludes with recommendations for future research to look into opportunities of open innovation approaches to be adopted by tertiary institutions as a novel way to commercialise research intellectual property.

Keywords: business process, crowdsourced innovation, open innovation, Quirky

Procedia PDF Downloads 205

Authors: Katherine van Kampen, Reva Qiu, Patricia Farrugia

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Orthopedic surgery has fallen behind when it comes to gender diversity despite medical school classes reaching gender parity. Studies have shown that orthopedic surgery would require 117 years to reach gender parity with the trainee population, the longest time than any other specialty, including neurosurgery, urology, and otolaryngology. The barriers that face women in orthopedic surgery have been well researched, with contributing factors being on-going stereotypes of the field, lack of women mentors, and gender roles outside of the hospital. Furthermore, women in orthopedic surgery face barriers to achieve promotion, publications, and leadership roles leading to a “leaky pipeline,” resulting in less and less women in key academic roles in the field. It is a complex topic with barriers and challenges faced in medical school, residency, and throughout employment. Our scoping review seeks to understand these challenges across a temporal timeline and to further characterize such barriers and the driving factors behind them. To this date, authors did not find a scoping review that seeks to look broadly at factors impacting the decreased amount of women entering orthopedics and the factors that cause women to hit a “glass ceiling”, the idea that women will not achieve the same success as men despite the same qualifications, upon entering the field. This scoping review is the first of its kind to attempt to summarize the large body of research focusing on women in orthopedic surgery from the preconceptions in medical school impacting their desire to pursue orthopedics all the way to employment, including challenges to academic success and financial success. Literature databases will be searched with the following key terms: women, gender inequity, workforce, orthopedics, and citations will be hand searched and collected. Articles included will discuss gender inequality within orthopedics with non-english, patient related articles excluded. Full-text review will seek to characterize the specific barriers faced by women across medical school, residency, and employment. Themes that are expected to be highlighted are workforce data, women in orthopedic leadership, medical student perspectives on the specialty, and gender bias and discrimination in the field.

Keywords: orthopedics, gender equity, workforce, women in surgery

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Authors: Hacer Y. Teke, Sultan Pehlivan, Mustafa Karapırlı, Asude Gökmen, Sait Özsoy

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The case is here presented of a patient with DMD with electrocardiograph findings within normal limits who underwent spinal surgery then developed the rarely seen complication of cardiac tamponade which resulted in death. A 17-year old male with DMD was admitted to hospital for spinal surgery. Due to a postoperative drop in hemoglobin, blood transfusion was administered to the patient, no complication developed and he was discharged on the third day. Four days after discharge, the patient worsened at home and an ambulance was called. Before the nearest hospital was reached, the patient died in the ambulance. An autopsy was performed. A fatal but rarely seen complication of Acute Myocardial Infarction (AMI) is myocardial rupture. 85% of ruptures occur in the first week of AMI but just as they can be seen on the day of the infarct, they can also be seen 2 weeks later. The case presented here had infarction findings related to different times and in different areas.

Keywords: duchenne muscular dystrophy, myocardial infarction, myocardial rupture, anesthesia

Procedia PDF Downloads 465

Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

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The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

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Authors: M. R. Martinez-Torres, S. L. Toral, M. Olmedilla

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Typically, virtual communities exhibit the well-known phenomenon of participation inequality, which means that only a small percentage of users is responsible of the majority of contributions. However, the sustainability of the community requires that the group of active users must be continuously nurtured with new users that gain expertise through a participation process. This paper analyzes the time evolution of Open Source Software (OSS) communities, considering users that join/abandon the community over time and several topological properties of the network when modeled as a social network. More specifically, the paper analyzes the role of those users rejoining the community and their influence in the global characteristics of the network.

Keywords: open source communities, social network Analysis, time series, virtual communities

Procedia PDF Downloads 508

Authors: Rahul Thakur, Onkar Chandel

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Red Hat is the world leader in providing open source software and solutions. A global enterprise, like Red Hat, has unique issues of connecting employees with content because of distributed offices, multiple teams spread across geographies, multiple languages, and different cultures. Employees, of a global company, create content that is distributed across departments, teams, regions, and countries. This makes finding the best content difficult since owners keep iterating on the existing content. When employees are unable to find the content, they end up creating it once again and in the process duplicating existing material and effort. Also, employees may not find the relevant content and spend time reviewing obsolete duplicate, or irrelevant content. On an average, a person spends 15 minutes/day in failed searches that might result in missed business opportunities, employee frustration, and substandard deliverables. Red Hat Knowledge Management Office (KMO) applied 'open source strategy' to solve the above problems. Under the Open Source Strategy, decisions are taken collectively. The strategy aims at accomplishing common goals with the help of communities. The objectives of this initiative were to save employees' time, get them authentic content, improve their content search experience, avoid duplicate content creation, provide context based search, improve analytics, improve content management workflows, automate content classification, and automate content upload. This session will describe open source strategy, its applicability in content management, challenges, recommended solutions, and outcome.

Keywords: content classification, content management, knowledge management, open source

Procedia PDF Downloads 190

Authors: Reem Abou Refaie, Christoph Meinel

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The paper explores the impact of the COVID-19 crisis on the internal as well as external digitalized work practices of public service providers as part of a Public-Private Partnership Model. It focuses on the effect of uncertainty on generating Open Innovation practices. Our inquiry relies on semi-structured interviews (n=14) from a case study of Rwanda’s Public Service Delivery System in the context of research cooperation with IremboGov, the country’s One-Stop-Shop Platform for public services. It presents four propositions on harnessing opportunities for OI in the context of the public sector beyond the pandemic response. Practitioners can find characterizations of OI opportunities and gain insights on fostering OI in Public Sector Organizations.

Keywords: open innovation, digital transformation, public sector, Rwanda

Procedia PDF Downloads 107

Authors: Vidya Iyer, Suresh Babu Loganathan, Yuan Hwa Lee, Kwong Fah Koh

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Introduction: It has been recommended that every patient undergoes careful preoperative evaluation in a preoperative clinic to improve theatre utilization, reduce bed occupancy and avoid unnecessary cancellation due to inadequate optimisation, communication and administrative errors. It also gives an opportunity to counsel patients regarding different aspects of anaesthesia. Methodology: A retrospective audit of all the patients seen in preoperative assessment clinic, referral letters of all the patients postponed / referred to other sub specialities in the perioperative period from June 2012 - June 2013 was done. In our clinic, we retrieved patient records who were awaiting surgery pending clearance by other sub specialities. Those patients, who could continue with their scheduled date of surgery after having been referred, were not included in the file. We also studied details of same day cancellations from the data base, during the same study period. The reasons for cancellation were examined and defined as avoidable and unavoidable. Results: Less than 0.5% was postponed from the scheduled day of surgery. Less than 0.5% was cancelled on the day of surgery. Conclusions: Patients who undergo pre anaesthetic evaluation in a well-established clinic results in adequate preoperative patient optimisation, avoids unnecessary preoperative admission, efficient theatre utilisation and greater patient satisfaction. The benefits are the result of guidelines and timely update of them which are used by the junior doctors and trainees who run the clinic and a dedicated specialist to supervise them.

Keywords: preoperative assessment, clinic, referrals, cancellation

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: Kyeong-Ri Ko, Seong Bong Bae, Jang Sik Choi, Sung Bum Pan

Abstract:

A simple method for testing the posture imbalance of the human body is to check for differences in the bilateral shoulder and pelvic height of the target. In this paper, to check for spinal disorders the authors have studied ways to establish a motion capture system to obtain and express motions of 4-joints, and to acquire data based on this system. The 4 sensors are attached to the both shoulders and pelvis. To verify the established system, the normal and abnormal postures of the targets listening to a lecture were obtained using the established 4-joint based motion capture system. From the results, it was confirmed that the motions taken by the target was identical to the 3-dimensional simulation.

Keywords: inertial sensor, motion capture, motion data acquisition, posture imbalance

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Authors: Vignesh Ratnaraj, Jaewon Chang

Abstract:

Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Rezvan Hosseinian

Abstract:

Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

Procedia PDF Downloads 63

Authors: Nasrin Azarbani

Abstract:

Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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Authors: K. A. Ghazaryan, G. A. Gevorgyan, H. S. Movsesyan, N. P. Ghazaryan, K. V. Grigoryan

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The heavy metal pollution degree in the soils around the Zangezur copper and molybdenum combine in Syunik Marz, Armenia was aessessed. The results of the study showed that heavy metal pollution degree in the soils mainly decreased with increasing distance from the open mine and the ore enrichment combine which indicated that the open mine and the ore enrichment combine were the main sources of heavy metal pollution. The only exception was observed in the northern part of the open mine where pollution degree in the sites (along the open mine) situated 600 meters far from the mine was higher than that in the sites located 300 meters far from the mine. This can be explained by the characteristics of relief and air currents as well as the weak vegetation cover of these sites and the characteristics of soil structure. According to geo-accumulation index (I-geo), contamination factor (Cf), contamination degree (Cd) and pollution load index (PLI) values, the pollution degree in the soils around the open mine and the ore enrichment combine was higher than that in the soils around the tailing dumps which was due to the proper and accurate operation of the Artsvanik tailing damp and the recultivation of the Voghji tailing dump. The high Cu and Mo pollution of the soils was conditioned by the character of industrial activities, the moving direction of air currents as well as the physicochemical peculiarities of the soils.

Keywords: Armenia, Zangezur copper and molybdenum combine, soil, heavy metal pollution degree

Procedia PDF Downloads 279