Search results for: surgical ambulatory unit

Authors: Subal Kar, Amitesh Kumar, A. Majumder, S. K. Ghosh, S. Saha, S. S. Sikdar, T. K. Saha

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CRLH (composite right/left-handed) based and SRR (split-ring resonator) based filters have been designed at microwave frequency which can provide better performance compared to conventional edge-coupled band-pass filter designed around the same frequency, 2.45 GHz. Both CRLH and SRR are unit cells used in metamaterial design. The primary aim of designing filters with such structures is to realize size reduction and also to realize novel filter performance. The CRLH based filter has been designed in microstrip transmission line, while the SRR based filter is designed with SRR loading in waveguide. The CRLH based filter designed at 2.45 GHz provides an insertion loss of 1.6 dB with harmonic suppression up to 10 GHz with 67 % size reduction when compared with a conventional edge-coupled band-pass filter designed around the same frequency. One dimensional (1-D) SRR matrix loaded in a waveguide shows the possibility of realizing a stop-band with sharp skirts in the pass-band while a stop-band in the pass-band of normal rectangular waveguide with tailoring of the dimensions of SRR unit cells. Such filters are expected to be very useful for communication systems at microwave frequency.

Keywords: BPF, CRLH, harmonic, metamaterial, SRR and waveguide

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Authors: A. Asaga, N. I. Basuki

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The research area is located in Cisarua, Bogor Regency, West Java, with 12,8 km2 wide. This area belongs to mining region of PT Aneka Tambang Tbk. The purpose of this research is to study geological condition, alteration type and pattern, and type of mineralization. Geomorphology of the research area is at young to mature stage, which can be divided into Ciparigi’s Parasite Volcanic Cone Unit, Ciparigi Caldera Valley Unit, Ciparigi Caldera Rim Hill Unit, and Pongkor Volcanic Hill. Stratigraphy of the research area consist of five units, they are Laharic Breccia (Pliocene), Pyroclastic Breccia, Lapilli Tuff, Flow Tuff, Fall Tuff, and Andesite Lava (Pleistocene). Based on mineral composition, it is interpreted that there is magma composition changing from rhyolite to andesitic. Geological structures in the research area are caused by NE-SW and N-S stress direction; they are Ciparay Right Strike-Slip Fault (Pliocene), Cisarua Right Strike-Slip Fault, G. Singa Left Strike-Slip Fault, and Cinyuncung Right Strike-Slip Fault (Pleistocene). Weak to strong hydrothermal alteration can be found in the research area.They are Chlorite ± Smectite ± Halloysite Zone, Smectite - Illite - Quartz Zone, Smectite - Kaolinite - Illite - Chlorite Zone, and Smectite - Chlorite - Calcite - Quartz Zone. The distribution and assemblage of alteration minerals is controlled by lithology and geological structures in Pleistocene. Mineralization produce ore minerals, those are pyrite, marcasite, chalcopyrite, sphalerite, galena, and chalcocite. There are calcite and quartz veins that show colloform, comb, and crystalline textures. Hydrothermal alteration assemblages, ore minerals, and cavity filling textures suggest that mineralization type in research area is epithermal low sulphidation.

Keywords: Pongkor, hydrothermal alteration, epithermal, geochemistry

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Authors: Akinwale S. O., Koya O. A.

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The need to provide ecologically-friendly and effective lawn mowing solution is crucial for the well-being of humans. This study involved the modification of a human-powered lawn mower designed to cut tall grasses in residential areas. This study designed and fabricated a reel-type mower blade system and a pedal-powered test rig for the blade system. It also evaluated the performance of the machine. The machine was tested on some overgrown grass plots at College of Education Staff School Ilesa. Parameters such as theoretical field capacity, field efficiency and effective field capacity were determined from the data gathered. The quality of cut achieved by the unit was also documented. Test results showed that the fabricated cutting system produced a theoretical field capacity of 0.11 ha/h and an effective field capacity of 0.08ha/h. Moreover, the unit’s cutting system showed a substantial improvement over existing reel mower designs in its ability to cut on both the forward and reverse phases of its motion. This study established that the blade system described herein has the capacity to cut tall grasses. Hence, this device can therefore eliminate the need for powered mowers entirely on small residential lawns.

Keywords: effective field capacity, field efficiency, theoretical field capacity, quality of cut

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Authors: Laura Niño Cáceres, Daisy Yoo, Caroline Hummels

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COVID-19 accelerated digital healthcare technology usage in many countries, such as Colombia, whose digital healthcare vision and projects are proof of this. However, with a significant cultural indigenous and Afro-Colombian heritage, only some parts of the country are willing to follow the proposed digital Western approach to health. Our paper presents the national healthcare system’s digital narrative, which we contrast with the micro-narrative of an Afro-Colombian ethnomedicine unit in Bogota called Kilombo Yumma. This ethnomedical unit is building its mobile app to safeguard and represent its ancestral medicine practices in local and national healthcare information systems. Kilombo Yumma is keen on promoting their beliefs and practices, which have been passed on through oral traditions and currently exist in the hands of a few older women. We unraveled their ambition, core beliefs, and practices through asset-based design. These assets outlined pluriversal and decolonizing forms of digital healthcare to increase social justice and connect Western and ancestral medicine digital opportunities through HCI.

Keywords: asset-based design, mobile app, decolonizing HCI, Afro-Colombian ancestral medicine

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Authors: Jonathan A. Sánchez Muñoz, Gustavo Flores Eraña, Juan M. Silva

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Mexican Mezcal industry has reached attention during the last decade due to it has been a popular beverage demanded by North American and European markets, reaching popularity due to its crafty character. Despite its wide demand, productive processes are still made with rudimentary equipment, and there is a lack of evidence to improve kiln energy efficiency. Tec21 is a challenge-based learning curricular model implemented by Tecnológico de Monterrey since 2019, where each formation unit requires an industrial partner. “Problem processes solution” is a formation unity designed for mechatronics engineers, where students apply the acquired knowledge in thermofluids and apply electronic. During five weeks, students are immersed in an industrial problem to obtain a proper level of competencies according to formation unit designers. This work evaluates the competencies acquired by the student through qualitative research methodology. Several evaluation instruments (report, essay, and poster) were selected to evaluate etic argumentation, principles of sustainability, implemented actions, process modelling, and redesign feasibility.

Keywords: applied electronic, challenge based learning, competencies, mezcal industry, thermofluids

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Authors: Vivek Krishna, Nikhil Jain, A. Mary Posonia A., Albert Mayan J

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Terrorism and insurgency are significant global issues that require constant attention and effort from governments and scientists worldwide. To combat these threats, nations invest billions of dollars in developing new defensive technologies to protect civilians. Breakthroughs in vehicle automation have led to the use of sophisticated machines for many dangerous and critical anti-terrorist activities. Our concept of an "Unmanned Ground Vehicle" can carry out tasks such as border security, surveillance, mine detection, and active combat independently or in tandem with human control. The robot's movement can be wirelessly controlled by a person in a distant location or can travel to a pre-programmed destination autonomously in situations where personal control is not feasible. Our defence system comprises two units: the control unit that regulates mobility and the motion tracking unit. The remote operator robot uses the camera's live visual feed to manually operate both units, and the rover can automatically detect movement. The rover is operated by manpower who controls it using a joystick or mouse, and a wireless modem enables a soldier in a combat zone to control the rover via an additional controller feature.

Keywords: robotics, computer vision, Machine learning, Artificial intelligence, future of AI

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: Rizalyn Gonzales, Harold Monteclaro

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This study determined the effects of net height on the capture performance of crab entangling nets. Fishing trials were conducted using nets with the following net heights: 1) 12 meshes down (MD), 2) 24 MD and 3) 50 MD. A total of 1,290 individuals comprising of 87 species belonging to 53 families were caught. One-way ANOVA showed that net height significantly affects various catch parameters such as catch per unit effort (CPUE) of the total and target catch, amount of non-target catch, sizes and species richness. The use of appropriate net height is a potential technical measure for a selective but still efficient crab entangling net fishery. Lower net height significantly reduced non-target catch up to 70%. While lower nets decreased the CPUE of target catch such as blue swimming crab Portunus pelagicus and christian crab Charybdis feriatus up to 65% in 12 MD, catch in 24 MD was not significantly different with that in 50 MD. The use of 24 MD also resulted in capturing larger-sized Portunus pelagicus. Catch species richness decreased up to 58% in lower nets. These results are useful to fisheries managers and government institutions to develop or improve existing regulations towards a sustainable crab fishery particularly blue swimming crabs.

Keywords: blue swimming crabs, catch per unit effort, crab entangling nets, net height

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Authors: Bartosz Kedra, Robert Malkowski

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This paper provides description and presentation of laboratory test unit built basing on 150 kVA power frequency converter and Simulink RealTime platform. Assumptions, based on criteria which load and generator types may be simulated using discussed device, are presented, as well as control algorithm structure. As laboratory setup contains transformer with thyristor controlled tap changer, a wider scope of setup capabilities is presented. Information about used communication interface, data maintenance, and storage solution as well as used Simulink real-time features is presented. List and description of all measurements are provided. Potential of laboratory setup modifications is evaluated. For purposes of Rapid Control Prototyping, a dedicated environment was used Simulink RealTime. Therefore, load model Functional Unit Controller is based on a PC computer with I/O cards and Simulink RealTime software. Simulink RealTime was used to create real-time applications directly from Simulink models. In the next step, applications were loaded on a target computer connected to physical devices that provided opportunity to perform Hardware in the Loop (HIL) tests, as well as the mentioned Rapid Control Prototyping process. With Simulink RealTime, Simulink models were extended with I/O cards driver blocks that made automatic generation of real-time applications and performing interactive or automated runs on a dedicated target computer equipped with a real-time kernel, multicore CPU, and I/O cards possible. Results of performed laboratory tests are presented. Different load configurations are described and experimental results are presented. This includes simulation of under frequency load shedding, frequency and voltage dependent characteristics of groups of load units, time characteristics of group of different load units in a chosen area and arbitrary active and reactive power regulation basing on defined schedule.

Keywords: MATLAB, power converter, Simulink Real-Time, thyristor-controlled tap changer

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Authors: Mikhail Panes, Sergei Pozniak, Nikolai Pozniak

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Purpose: To evaluate the effectiveness of intrastromal donor limbal segments implantation for treatment of progressive keratoconus considering on main characteristics of corneal endothelial cells. Setting: Outpatient ophthalmic clinic. Methods: Twenty patients (20 eyes) with progressive keratoconus II-III of Amsler classification were recruited. The worst eye was treated with the transplantation of donor limbal segments in the recipient corneal stroma, while the fellow eye was left untreated as a control of functional and morphological changes. Furthermore, twenty patients (20 eyes) without progressive keratoconus was used as a control of corneal endothelial cells changes. All patients underwent a complete ocular examination including uncorrected and corrected distance visual acuity (UDVA, CDVA), slit lamp examination fundus examination, corneal topography and pachymetry, auto-keratometry, Anterior Segment Optical Coherence Tomography and Corneal Endothelial Specular Microscopy. Results: After two years, statistically significant improvement in the UDVA and CDVA (on the average on two lines for UDVA and three-four lines for CDVA) were noted. Besides corneal astigmatism decreased from 5.82 ± 2.64 to 1.92 ± 1.4 D. Moreover there were no statistically significant differences in the changes of mean spherical equivalent, keratometry and pachymetry indicators. It should be noted that after two years there were no significant differences in the changes of the number and form of corneal endothelial cells. It can be regarded as a process stabilization. In untreated control eyes, there was a general trend towards worsening of UDVA, CDVA and corneal thickness, while corneal astigmatism was increased. Conclusion: Intrastromal donor segments implantation is a safe technique for keratoconus treatment. Intrastromal donor segments implantation is an efficient procedure to stabilize and improve progressive keratoconus.

Keywords: corneal endothelial cells, intrastromal donor limbal segments, progressive keratoconus, surgical treatment of keratoconus

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Authors: Hyung-Jin Kim, Dae-Wan Kim, Moo-Yeon Lee

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The objective of this study is to experimentally investigate the heat transfer characteristics of 200 W class woofer speaker units with the input voice signals. The temperature and heat transfer characteristics of the 200 W class woofer speaker unit were experimentally tested with the several input voice signals such as 1500 Hz, 2500 Hz, and 5000 Hz respectively. From the experiments, it can be observed that the temperature of the woofer speaker unit including the voice-coil part increases with a decrease in input voice signals. Also, the temperature difference in measured points of the voice coil is increased with decrease of the input voice signals. In addition, the heat transfer characteristics of the woofer speaker in case of the input voice signal of 1500 Hz is 40% higher than that of the woofer speaker in case of the input voice signal of 5000 Hz at the measuring time of 200 seconds. It can be concluded from the experiments that initially the temperature of the voice signal increases rapidly with time, after a certain period of time it increases exponentially. Also during this time dependent temperature change, it can be observed that high voice signal is stable than low voice signal.

Keywords: heat transfer, temperature, voice coil, woofer speaker

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Authors: Boineelo P. Lefadola, Annemarie T. Viljoen, Gerrie E. Du Rand

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The food service sector wastes staggering quantities of food. More than one-third of food produced today gets wasted. This is both perplexing and daunting given that not all that is wasted is accounted for when measuring food waste. It is recognised that the present food waste definitions are ambiguous and do not really take into account all food waste generated. The contention is that food waste in the food service sector can be prevented or reduced if we have an explicit food waste definition in the context of food service. This study, therefore, explores the definition of the concept of food waste in the food service sector and its implications on sustainable food waste management strategies. An ethnographic research approach was adopted. A university food service unit was selected as a research site. Data collection techniques employed included document analyses, participant observations, focus group discussions with front-of-house and back-of-house staff, and one-on-one interviews with staff on managerial positions. A grounded theory approach was applied to analyse data. The concept of food waste was constructed differently by different levels of staff. Whereas managers raised discussion from a financial perspective, BOH and FOH staff drew upon socio-cultural implications. This study lays the foundation for a harmonised definition of the concept of food waste in food service.

Keywords: food service, food waste, food waste management, sustainability

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Authors: Ali Reza Ghaffari, Hassan Saghi

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Given the limitation of fossil resources to supply energy to buildings, recent years have seen a revival of interest in new technologies that produce the energy using new forms of energy in many developed countries. In this research, first the potentials of new energies in Iran are discussed and then based on case studies undertaken in a building in Tehran, the effects of utilizing new solar energy technology for supplying the energy of buildings are investigated. Then, by analyzing the data recorded over a four-year period, the technical performance of this system is investigated. According to the experimental operation plan, this system requires an auxiliary heating circuit for continuous operation over a year. Also, in the economic analysis, real conditions are considered and the results are recorded based on long-term data. Considering the purchase and commissioning building, supplementary energy consumption, etc. a comparison is drawn between the costs of using a solar water heater in a residential unit with the energy costs of a similar unit equipped with a conventional gas water heater. Given the current price of energy, using a solar water heater in the country will not economical, but considering the global energy prices, this system will have a return on investment after 4.5 years. It also produces 81% less pollution and saves about $21.5 on environmental pollution cleanup.

Keywords: energy supply, new energies, new technologies, buildings

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Authors: Imene Skhakhfa, Lahbaci Ouerdachi

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To ensure the overall coherence of simulated results, it is necessary to develop a robust validation process. In many applications, it is no longer content to calibrate and validate the model only in relation to the hydro graph measured at the outlet, but we try to better simulate the functioning of the watershed in space. Therefore the timing also performs compared to other variables such as water level measurements in intermediate stations or groundwater levels. As part of this work, we limit ourselves to modeling flood of short duration for which the process of evapotranspiration is negligible. The main parameters to identify the models are related to the method of unit hydro graph (HU). Three different models were tested: SNYDER, CLARK and SCS. These models differ in their mathematical structure and parameters to be calibrated while hydrological data are the same, the initial water content and precipitation. The models are compared on the basis of their performance in terms six objective criteria, three global criteria and three criteria representing volume, peak flow, and the mean square error. The first type of criteria gives more weight to strong events whereas the second considers all events to be of equal weight. The results show that the calibrated parameter values are dependent and also highlight the problems associated with the simulation of low flow events and intermittent precipitation.

Keywords: model calibration, intensity, runoff, hydrograph

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Authors: Trunov V.O., Ryabov A. B., Poddubny I.V

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Introduction: cystic and solid pancreatic tumors have a relevant and disruptive position in many positions. The results of the treatment of children with tumors and pancreatic cysts aged 3 to 17 years for the period from 2008 to 2019 on the basis of the Morozov State Children's Clinical Hospital in Moscow were analyzed. The total number of children with solid tumors was 17, and 31 with cysts. In all children, the diagnosis was made on the basis of ultrasound, followed by CT and MRI. In most patients with solid tumors, they were located in the area of the pancreas tail - 58%, in the body area - 14%, in the area of the pancreatic head - 28%. In patients with pancreatic cysts, the distribution of patients by topography was as follows: head of the pancreas - 10%, body of the pancreas - 16%, tail of the pancreas - 68%, total cystic transformation of the Wirsung duct - 6%. In pancreatic cysts, the method of surgical treatment was based on the results of MRCP, the level of amylase in the contents of the cyst, and the localization of the cyst. Thus, pathogenetically substantiated treatment included: excision of cysts, internal drainage on an isolated loop according to Ru, the formation of pancreatojejunoanastomosis in a child with the total cystic transformation of the Wirsung duct. In patients with solid pancreatic lesions, pancretoduodenalresection, central resection of the pancreas, and distal resection from laparotomy and laparoscopic access were performed. In the postoperative period, in order to prevent pancreatitis, all children underwent antisecretory therapy, parenteral nutrition, and drainage of the omental bursa. Results: hospital stay ranged from 7 to 12 days. The duration of postoperative fermentemia in patients with solid formations lasted from 3 to 6 days. In all cases, according to the histological examination, a pseudopapillary tumor of the pancreas was revealed. In the group of children with pancreatic cysts, fermentemia was observed from 2 to 4 days, recurrence of cysts in the long term was detected in 3 children (10%). Conclusions: the treatment of cystic and solid pancreatic neoplasms is a difficult task in connection with the anatomical and functional features of the organ.

Keywords: pancreas, tumors, cysts, resection, laparoscopy, children

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Authors: Md. Shah Alam

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Mushfiq Ahmad has defined a Mixed Number, which is the sum of a scalar and a Cartesian vector. He has also defined the elementary group operations of Mixed numbers i.e. the norm of Mixed numbers, the product of two Mixed numbers, the identity element and the inverse. It has been observed that Mixed Number is consistent with Pauli matrix algebra and a handy tool to work with Dirac electron theory. Its use as a mathematical method in Physics has been studied. (1) We have applied Mixed number in Quantum Mechanics: Mixed Number version of Displacement operator, Vector differential operator, and Angular momentum operator has been developed. Mixed Number method has also been applied to Klein-Gordon equation. (2) We have applied Mixed number in Electrodynamics: Mixed Number version of Maxwell’s equation, the Electric and Magnetic field quantities and Lorentz Force has been found. (3) An associative transformation of Mixed Number numbers fulfilling Lorentz invariance requirement is developed. (4) We have applied Mixed number algebra as an extension of Complex number. Mixed numbers and the Quaternions have isomorphic correspondence, but they are different in algebraic details. The multiplication of unit Mixed number and the multiplication of unit Quaternions are different. Since Mixed Number has properties similar to those of Pauli matrix algebra, Mixed Number algebra is a more convenient tool to deal with Dirac equation.

Keywords: mixed number, special relativity, quantum mechanics, electrodynamics, pauli matrix

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Authors: Md. R. Shattique, Md. T. Zaki, Md. G. Kibria

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Fly-ash bricks give a comprehensive solution towards recycling of fly-ash and since there is no requirement of firing to produce them, they are also eco-friendly bricks; little or no carbon-dioxide is emitted during their entire production cycle. As bricks are the most essential and widely utilized building materials in the construction industry, the significance of developing an alternate eco-friendly brick is substantial in modern times. In this paper, manufacturing and potential utilization of Fly-ash made building bricks have been studied and was found to be a prospective substitute for fired clay bricks that contribute greatly to polluting the environment. Also, a comparison between sand made and ceramic dust made Fly-ash bricks have been carried out experimentally. The ceramic dust made bricks seem to show higher compressive strength at lower unit volume weight compared to sand made Fly-ash bricks. Moreover, the water absorption capacity of ceramic dust Fly-ash bricks was lower than sand made bricks. Then finally a statistical comparison between fired clay bricks and fly-ash bricks were carried out. All the requirements for good quality building bricks are matched by the fly-ash bricks. All the facts from this study pointed out that these bricks give a new opportunity for being an alternate building material.

Keywords: coal fly-ash, ceramic dust, burnt clay bricks, sand, gypsum, absorption capacity, unit volume weight, compressive strength

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Authors: Chetan R. Patel, G. J. Joshi

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The present study is carried out on six lane divided urban arterial road in Patna and Pune city of India. Both the road having distinct differences in terms of the vehicle composition and the road side parking. Arterial road in Patan city has 33% of non-motorized mode, whereas Pune arterial road dominated by 65% of Two wheeler. Also road side parking is observed in Patna city. The field studies using vidiographic techniques are carried out for traffic data collection. Data are extracted for one minute duration for vehicle composition, speed variation and flow rate on selected arterial road of the two cities. Speed flow relationship is developed and capacity is determine. Equivalency factor in terms of dynamic car unit is determine to represent the vehicle is single unit. The variation in the capacity due to side friction, presence of non motorized traffic and effective utilization of lane width is compared at concluding remarks.

Keywords: arterial road, capacity, dynamic equivalency factor, effect of non motorized mode, side friction

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Authors: Hassan Hussin Zwida

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The liquified LPG (Liquefied Petroleum Gas) drying system at the Complex is designed to remove water and mercaptans from the LPG stream. Upon saturation of the desiccant beds, a regeneration cycle becomes necessary. The original design routed the regeneration gas, produced during the LPG dryer heating cycle, to the sulfur recovery unit to the incineration. However, concerns regarding high temperatures and potential unit disruptions led to a modification where the gas is currently vented to the acid flare for the initial hour before being diverted to the LP network fuel gas system. While this addresses the temperature concerns, it generates significant smoke due to the presence of liquid hydrocarbons. This paper proposes an approach to recover the regeneration gas and redirect it back to the gas plant's (off-gas compressors) instead of sending it to the AC (Acid Flare), by utilizing the existing pipe 6” and connected to off gas compressor KO (Knock-Out ) Drums . This option is simple to operate, flexible, environment-friendly solution as long-term solution, lower in capital expenditure and increase the company's profitability. The feasibility of this proposal is supported by dynamic simulations. The simulations suggest the possibility of operating two out of the three off-gas compressors and LPG (Liquefied petroleum gas) as a liquid phase, is foreseen to be carried over and gathered at the bottom level of the KO (Knock-Out) Drum.

Keywords: thermal incinerator, off-gas compressors, environment, knock-out drums, acid flare

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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Authors: Haifeng Shi, Kun Song, Yili Zhao

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In China, with the extensive promotion of the ‘aging in place’ pension policy as the background, most of the elders will choose to remain in their current homes and communities, finding out of preference or necessity that they will need to remodel their homes to fit their changing needs. This generation elder born in the 1960s to 1970s almost live in the same form of housing-condominium built from 1982 to 2012. Based on the survey of existing multi-family housing, especially in Tianjin, it is found that the current ‘double two-thirds principles’ is becoming the threshold for modification to existing house, particularly in the project of elevators addition to existing condominium (built from 1982 to 2016 without elevators below 6 floors according to the previous building code). Firstly, this article concludes the local policies of elevator addition nationwide, most of which has determined the importance and necessity of the community-based self-organization principle in the operation of the elevator addition. Secondly, by comparing the three existing community management systems (owners' congress, property management system and community committee) in instances, find that the community-based ‘two-thirds’ principle is not conducive to implement for multi-owned property renovation in the community or common accessibility modification in the building. However, analysis the property and other community management related laws, pointing out the shortcomings of the existing community-based ‘two-thirds’ decision-making norms. The analyzation showed that the unit-based and ‘100% principle’ method is more capable of common accessibility in the condominium in China. Differing from existing laws, the unit-based principle will be effective for the process of decision-making and ‘100% principle’ will protect closely profit-related householders for condominium modification in the multi-owned area. These three aspects of the analysis suggest that the establishment of the unit-based self-organization mechanism is a preferred and inevitable method to solve the problem of elevators addition to the existing condominium in China.

Keywords: aging in place, condominium, modification, multi own

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Authors: Siddarth Kannan

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Objectives: Deep Brain Stimulation (DBS) and Motor Cortex stimulation (MCS) are innovative interventions in order to treat various neuropathic pain disorders such as post-stroke pain. While each treatment has a varying degree of success in managing pain, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesised. The aim of this study was to compare the effect of pain relief offered by MCS and DBS on patients with post-stroke pain and to assess if either of these procedures offered better results. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542). Three databases were searched, and articles published from 2000 to June 2023 were included (last search date 25 June 2023). Meta-analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using the Visual Analogue Scale (VAS). Data analysis of descriptive statistics was performed using SPSS (Version 27; IBM; Armonk; NY; USA). R statistics (Rstudio Version 4.0.1) was used to perform meta-analysis. Results: Of the 478 articles identified, 27 were included in the analysis (232 patients- 117 DBS & 115 MCS). The pooled number of patients who improved after DBS was 0.68 (95% CI, 0.57-0.77, I2=36%). The pooled number of patients who improved after MCS was 0.72 (95% CI, 0.62-0.80, I2=59%). Further sensitivity analysis was done to include only studies with a minimum of 5 patients in order to assess if there was any impact on the overall results. Nine studies each for DBS and MCS met these criteria. There seemed to be no significant difference in results. Conclusions: The use of surgical interventions such as DBS and MCS is an upcoming field for the treatment of post-stroke pain, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done in order to determine the appropriate surgical intervention for post-stroke pain.

Keywords: post-stroke pain, deep brain stimulation, motor cortex stimulation, pain relief

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Authors: Hamidreza Hoshyarmanesh, Sanju Lama, Garnette R. Sutherland

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In tele-operative robotic surgery, an ideal haptic device should be equipped with an intuitive and smooth end-effector to cover the surgeon’s hand/wrist degrees of freedom (DOF) and translate the hand joint motions to the end-effector of the remote manipulator with low effort and high level of comfort. This research introduces the design and development of a microsurgery-specific end-effector, a gimbal mechanism possessing 4 passive and 1 active DOFs, equipped with a bipolar forceps and haptic feedback. The robust gimbal structure is comprised of three light-weight links/joint, pitch, yaw, and roll, each consisting of low-friction support and a 2-channel accurate optical position sensor. The third link, which provides the tool roll, was specifically designed to grip the tool prongs and accommodate a low mass geared actuator together with a miniaturized capstan-rope mechanism. The actuator is able to generate delicate torques, using a threaded cylindrical capstan, to emulate the sense of pinch/coagulation during conventional microsurgery. While the tool left prong is fixed to the rolling link, the right prong bears a miniaturized drum sector with a large diameter to expand the force scale and resolution. The drum transmits the actuator output torque to the right prong and generates haptic force feedback at the tool level. The tool is also equipped with a hall-effect sensor and magnet bar installed vis-à-vis on the inner side of the two prongs to measure the tooltip distance and provide an analogue signal to the control system. We believe that such a haptic end-effector could significantly increase the accuracy of telerobotic surgery and help avoid high forces that are known to cause bleeding/injury.

Keywords: end-effector, force generation, haptic interface, robotic surgery, surgical tool, tele-operation

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Authors: Ozan Kahraman, Hao Feng

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Ultrasonic atomization (UA) is a useful technique for producing a liquid spray for various processes, such as spray drying. Ultrasound generates small droplets (a few microns in diameter) by disintegration of the liquid via cavitation and/or capillary waves, with low range velocity and narrow droplet size distribution. In recent years, UA has been investigated as an alternative for enabling or enhancing ultrasound-mediated unit operations, such as evaporation, separation, and purification. The previous studies on the UA separation of a solvent from a bulk solution were limited to ethanol-water systems. More investigations into ultrasound-mediated separation for other liquid systems are needed to elucidate the separation mechanism. This study was undertaken to investigate the effects of the operational parameters on the ultrasound-mediated separation of three miscible liquid pairs: ethanol-, methanol-, and butanol-water. A 2.4 MHz ultrasonic mister with a diameter of 18 mm and rating power of 24 W was installed on the bottom of a custom-designed cylindrical separation unit. Air was supplied to the unit (3 to 4 L/min.) as a carrier gas to collect the mist. The effects of the initial alcohol concentration, viscosity, and temperature (10, 30 and 50°C) on the atomization rates were evaluated. The alcohol concentration in the collected mist was measured with high performance liquid chromatography and a refractometer. The viscosity of the solutions was determined using a Brookfield digital viscometer. The alcohol concentration of the atomized mist was dependent on the feed concentration, feed rate, viscosity, and temperature. Increasing the temperature of the alcohol-water mixtures from 10 to 50°C increased the vapor pressure of both the alcohols and water, resulting in an increase in the atomization rates but a decrease in the separation efficiency. The alcohol concentration in the mist was higher than that of the alcohol-water equilibrium at all three temperatures. More importantly, for ethanol, the ethanol concentration in the mist went beyond the azeotropic point, which cannot be achieved by conventional distillation. Ultrasound-mediated separation is a promising non-equilibrium method for separating and purifying alcohols, which may result in significant energy reductions and process intensification.

Keywords: azeotropic mixtures, distillation, evaporation, purification, seperation, ultrasonic atomization

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Authors: Taylor Kolody, Farkhund Iqbal, Rabia Batool, Benjamin Fung, Mohammed Hussaeni, Saiqa Aleem

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The rising threat of climate change has led to an increase in public awareness and care about our collective and individual environmental impact. A key component of this impact is our use of cars and other polluting forms of transportation, but it is often difficult for an individual to know how severe this impact is. While there are applications that offer this feedback, they require manual entry of what transportation mode was used for a given trip, which can be burdensome. In order to alleviate this shortcoming, a data from the 2016 TRIPlab datasets has been used to train a variety of machine learning models to automatically recognize the mode of transportation. The accuracy of 89.6% is achieved using single deep neural network model with Gated Recurrent Unit (GRU) architecture applied directly to trip data points over 4 primary classes, namely walking, public transit, car, and bike. These results are comparable in accuracy to results achieved by others using ensemble methods and require far less computation when classifying new trips. The lack of trip context data, e.g., bus routes, bike paths, etc., and the need for only a single set of weights make this an appropriate methodology for applications hoping to reach a broad demographic and have responsive feedback.

Keywords: classification, gated recurrent unit, recurrent neural network, transportation

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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