Search results for: minimal invasive surgery

Authors: Mishadi Herath, Amin Talei, Andreas Hermawan, Clarina Chua

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Green walls are vegetated structures on building’s wall that are considered as part of sustainable urban design. They are proved to have many micro-climate benefits such as reduction in indoor temperature, noise attenuation, and improvement in air quality. On the other hand, several studies have also been conducted on potential reuse of greywater in urban water management. Greywater is relatively clean when compared to blackwater; therefore, this study was aimed to assess the potential reuse of it for irrigating a green wall system. In this study, the campus of Monash University Malaysia located in Selangor state was considered as the study site where total 48 samples of greywater were collected from 7 toilets hand-wash and 5 pantries during 3 months period. The samples were tested to characterize the quality of greywater in the study site and compare it with local standard for irrigation water. PH and concentration of heavy metals, nutrients, Total Suspended Solids (TSS), Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), total Coliform and E.coli were measured. Results showed that greywater could be directly used for irrigation with minimal treatment. Since the effluent of the system was supposed to be drained to stormwater drainage system, the effluent needed to meet certain quality requirement. Therefore, a biofiltration system was proposed to host the green wall plants and also treat the greywater (which is used as irrigation water) to the required level. To assess the performance of the proposed system, an experimental setup consisting of Polyvinyl Chloride (PVC) soil columns with sand-based filter media were prepared. Two different local creeper plants were chosen considering several factors including fast growth, low maintenance requirement, and aesthetic aspects. Three replicates of each plants were used to ensure the validity of the findings. The growth of creeping plants and their survivability was monitored for 6 months while monthly sampling and testing of effluent was conducted to evaluate effluent quality. An analysis was also conducted to estimate the potential cost and benefit of such system considering water and energy saving in the system. Results showed that the proposed system can work efficiently throughout a long period of time with minimal maintenance requirement. Moreover, the biofiltration-green wall system was found to be successful in reusing greywater as irrigating water while the effluent was meeting all the requirements for being drained to stormwater drainage system.

Keywords: biofiltration, green wall, greywater, sustainability

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Authors: Panupat Chaiworn, Soraya lama

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We study the motion of particles in cylinders which are subjected to a sinusoidal vertical vibration. We measure the rising time of a large intruder from the bottom of the container to free surface of the bed particles and find that the rising time as a function of intruder density increases to a maximum and then decreases monotonically. The result is qualitatively accord to the previous findings in experiments using relative humidity of the bed particles and found speed convection of the bed particles containers it moving slowly, and the rising time of the intruder where a minimal instead of maximal rising time in the small density region was found. Our experimental results suggest that the topology of the container plays an important role in the Brazil nut effect.

Keywords: granular particles, Brazil nut effect, cylinder container, vertical vibration, convection

Procedia PDF Downloads 511

Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

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This paper explores the process of creating and capturing born-global firm opportunities. It reviews the key constructs that underpin the establishment of born-global firms in sub-Saharan Africa. These include entrepreneurial orientation, resources and capabilities, collaboration, and contextual influences. The paper discusses how individuals and entrepreneurs in sub-Saharan Africa can establish home-based born-global firms that seek early international markets from inception. The paper suggests that sub-Saharan African governments should make a favourable microeconomics policy that will enable entrepreneurs and firms to acquire some certain minimal resources and capabilities, in order to develop global products and services.

Keywords: born global-firms, collaboration, internationalisation, dynamic capabilities, entrepreneurship, sub-Saharan Africa

Procedia PDF Downloads 254

Authors: Nagaraju Jarugu, B. R. Narendra

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This paper focused on boost rectification by Single Phase Matrix Converter with fewer numbers of switches. The conventional matrix converter consists of 4 bidirectional switches, i.e. 8 set of IGBT/MOSFET with anti-parallel diodes. In this proposed matrix converter, only six switches are used. The switch commutation arrangements are also carried out in this work. The SPMC topology has many advantages as a minimal passive device use. It is very flexible and it can be used as a lot of converters. The gate pulses to the switches are provided by the PWM techniques. The duty ratio of the switches based on Pulse Width Modulation (PWM) technique was used to produce the output waveform of the circuit, simply by turning ON and OFF the switches. The simulation results using MATLAB/Simulink were provided to validate the feasibility of this proposed method.

Keywords: single phase matrix converter, reduced switches, AC voltage regulators, boost rectifier operation

Procedia PDF Downloads 1172

Authors: Timo Miebach, Kirsten Hoeper, Carolin Felix

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In times of competitive pressures and demographic change, hospitals have to reconsider their strategies as a company. Due to the fact, that operations are one of the main income and one of the primary cost drivers otherwise, a process-oriented approach and an efficient use of resources seems to be the right way for getting a consistent market position. Thus, the efficient operation room occupancy planning is an important cause variable for the success and continued the existence of these institutions. A high utilization of resources is essential. This means a very high, but nevertheless sensible capacity-oriented utilization of working systems that can be realized by avoiding downtimes and a thoughtful occupancy planning. This engineering approach should help hospitals to reach her break-even point. Firstly, the aim is to establish a strategy point, which can be used for the generation of a planned throughput time. Secondly, the operation planning and control should be facilitated and implemented accurately by the generation of time modules. More than 100,000 data records of the Hannover Medical School were analyzed. The data records contain information about the type of conducted operation, the duration of the individual process steps, and all other organizational-specific data such as an operating room. Based on the aforementioned data base, a generally valid model was developed by an analysis to define a strategy point which takes the conflict of capacity utilization and low overtime into account. Furthermore, time modules were generated in this work, which allows a simplified and flexible operation planning and control for the operation manager. By the time modules, it is possible to reduce a high average value of the idle times of the operation rooms. Furthermore, the potential is used to minimize the idle time spread.

Keywords: capacity, operating room, surgery planning and control, utilization

Procedia PDF Downloads 235

Authors: Neerja Meena, Paresh Sukhani

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Dandy walker malformation is a generalised disorder of mesenchymal development that affect both the cerebellum and overlying meninges. Classically dandy-walker malformation consists of a triad of- 1:vermian and hemispheric cerebellar hypoplasia 2:cystic dilatation of 4th ventricle 3: enlarged posterior fossa with the upward migration of tentorium(lambdoid- torcular inversion). Clinical presentation: four months old female child with hydrocephalus and neurological symptoms. Generally- early death is common in classic dandy walker malformation. However, if it is relatively mild and uncomplicated by other CNS anomalies, intelligence can be normal and neurologic deficits minimal. Usually, VP shunting is the treatment of choice for this hydrocephalus. Conclusion: MRI is the modality of choice to diagnose posterior fossa malformation. However, it can be ruled out through using during the antenatal check as the prognosis of this malformation is not good; it's better to diagnose it inutero.

Keywords: Dandy Walker, Mri, Earlydaignosis, Treatment

Procedia PDF Downloads 63

Authors: Sun Tao, Lou Liang, Tan Xing Haw Marvin, Gu Yuandong Alex

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Patients with blood clots in their brains can experience problems with their vision or speech, seizures and general weakness. To treat blood clots, clinicians presently have two options. The first involves drug therapy to thin the blood and thus reduce the clot. The second choice is to invasively remove the clot using a plastic tube called a catheter. Both approaches carry a high risk of bleeding, and invasive procedures, such as catheter intervention, can also damage the blood vessel wall and cause infection. Ultrasonic treatment as a potential alternative therapy to break down clots is attracting growing interests due to the reduced adverse effects. To demonstrate the concept, in this investigation a microfabricated ultrasonic device was electrically packaged with printed circuit board to treat healthy human blood. The red blood cells could be broken down after 3-hour ultrasonic treatment.

Keywords: microfabrication, blood clot, ultrasonic thrombolysis device, ultrasonic device

Procedia PDF Downloads 436

Authors: K. K. Saju, A. R. Reghuraj

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High reflectance of surgical instruments under bright light hinders the visual clarity during laparoscopic surgical procedures leading to loss of precision and device control and creates strain and undesired difficulties to surgeons. Majority of the surgical instruments are made of surgical grade steel. Instruments with a non reflective surface can enhance the visual clarity during precision surgeries. A conversion coating of black oxide has been successfully developed 410 grade surgical stainless steel .The characteristics of the developed coating suggests the application of this technique for developing 410 grade surgical instruments with minimal reflectance.

Keywords: conversion coatings, 410 stainless steel, black oxide, reflectance

Procedia PDF Downloads 439

Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Carlos Roncero-Parra, Alfonso Parreño-Torres, Jorge Mateo Sotos, Alejandro L. Borja

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In this research, different methods based on machine/deep learning algorithms are presented for the classification and diagnosis of patients with mental disorders such as alzheimer. For this purpose, the signals obtained from 32 unipolar electrodes identified by non-invasive EEG were examined, and their basic properties were obtained. More specifically, different well-known machine learning based classifiers have been used, i.e., support vector machine (SVM), Bayesian linear discriminant analysis (BLDA), decision tree (DT), Gaussian Naïve Bayes (GNB), K-nearest neighbor (KNN) and Convolutional Neural Network (CNN). A total of 668 patients from five different hospitals have been studied in the period from 2011 to 2021. The best accuracy is obtained was around 93 % in both ADM and ADA classifications. It can be concluded that such a classification will enable the training of algorithms that can be used to identify and classify different mental disorders with high accuracy.

Keywords: alzheimer, machine learning, deep learning, EEG

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Authors: Asmaa M. Fahim

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In this investigation, the (E)-2-cyano-3-(dimethylamino)-N-(2,4-dioxo-1,2,3,4-tetrahydropyrimidin-5-yl)acrylam-ide (4) which used TAM as a template which interacts with Methacrylic Acid (MAA) monomer, in the presence of CH₃CN as progen. The TAM-MMA complex interactions are dependent on stable hydrogen bonding interaction between the carboxylic acid group of TAM(Template) and the hydroxyl group of MMA(methyl methacrylate) with minimal interference of porogen CH₃CN. The physical computational studies were used to optimize their structures and frequency calculations. The binding energies between TAM with different monomers showed the most stable molar ratio of 1:4, which was confirmed through experimental analysis. The optimized polymers were investigated in industrial applications.

Keywords: molecular imprinted polymer, computational studies, SEM, spectral analysis, industrial applications

Procedia PDF Downloads 141

Authors: V. Giacometti, R. Mirabelli, V. Patera, D. Pinci, A. Sarti, A. Sciubba, G. Traini, M. Marafini

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The particle therapy (PT) is a very modern technique of non invasive radiotherapy mainly devoted to the treatment of tumours untreatable with surgery or conventional radiotherapy, because localised closely to organ at risk (OaR). Nowadays, PT is available in about 55 centres in the word and only the 20\% of them are able to treat with carbon ion beam. However, the efficiency of the ion-beam treatments is so impressive that many new centres are in construction. The interest in this powerful technology lies to the main characteristic of PT: the high irradiation precision and conformity of the dose released to the tumour with the simultaneous preservation of the adjacent healthy tissue. However, the beam interactions with the patient produce a large component of secondary particles whose additional dose has to be taken into account during the definition of the treatment planning. Despite, the largest fraction of the dose is released to the tumour volume, a non-negligible amount is deposed in other body regions, mainly due to the scattering and nuclear interactions of the neutrons within the patient body. One of the main concerns in PT treatments is the possible occurrence of secondary malignant neoplasm (SMN). While SMNs can be developed up to decades after the treatments, their incidence impacts directly life quality of the cancer survivors, in particular in pediatric patients. Dedicated Treatment Planning Systems (TPS) are used to predict the normal tissue toxicity including the risk of late complications induced by the additional dose released by secondary neutrons. However, no precise measurement of secondary neutrons flux is available, as well as their energy and angular distributions: an accurate characterization is needed in order to improve TPS and reduce safety margins. The project MONDO (MOnitor for Neutron Dose in hadrOntherapy) is devoted to the construction of a secondary neutron tracker tailored to the characterization of that secondary neutron component. The detector, based on the tracking of the recoil protons produced in double-elastic scattering interactions, is a matrix of thin scintillating fibres, arranged in layer x-y oriented. The final size of the object is 10 x 10 x 20 cm3 (squared 250µm scint. fibres, double cladding). The readout of the fibres is carried out with a dedicated SPAD Array Sensor (SBAM) realised in CMOS technology by FBK (Fondazione Bruno Kessler). The detector is under development as well as the SBAM sensor and it is expected to be fully constructed for the end of the year. MONDO will make data tacking campaigns at the TIFPA Proton Therapy Center of Trento, at the CNAO (Pavia) and at HIT (Heidelberg) with carbon ion in order to characterize the neutron component and predict the additional dose delivered on the patients with much more precision and to drastically reduce the actual safety margins. Preliminary measurements with charged particles beams and MonteCarlo FLUKA simulation will be presented.

Keywords: secondary neutrons, particle therapy, tracking detector, elastic scattering

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Authors: Sai Maniveer Adapa, Sai Guptha Perla, Adithya Reddy P.

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Thyroid nodules can often be diagnosed with ultrasound imaging, although differentiating between benign and malignant nodules can be challenging for medical professionals. This work suggests a novel approach to increase the precision of thyroid nodule identification by combining machine learning and deep learning. The new approach first extracts information from the ultrasound pictures using a deep learning method known as a convolutional autoencoder. A support vector machine, a type of machine learning model, is then trained using these features. With an accuracy of 92.52%, the support vector machine can differentiate between benign and malignant nodules. This innovative technique may decrease the need for pointless biopsies and increase the accuracy of thyroid nodule detection.

Keywords: thyroid tumor diagnosis, ultrasound images, deep learning, machine learning, convolutional auto-encoder, support vector machine

Procedia PDF Downloads 37

Authors: O. I. Ekwueme

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New media technologies are noted for their immense contributions in various sectors of the economy which are believed to have resulted in the development of European countries. There is an assumption that we cannot have development communication without communication development, but we are not sure if new media technologies contribute to development in the South-East zone, Nigeria. The study employed mixed method and discovered that new media technologies have a very minimal relationship to development in the South-East zone, Nigeria. It was discovered that the media report on development news is basically informative instead of interactive. The South-East zone is scarcely covered unlike other zones. It argued that the communication technologies introduced in Nigeria was as a result of their struggle for independence. It was recommended that media organisations in the South-East zone should give adequate coverage to the zone, and be more interactive.

Keywords: communication, development, new media, technologies

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Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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Authors: Yan Rongxin, Sun Wei, Li Weidan

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Based on the acoustics cascade sound theory, the mechanism of air leak sound producing, transmitting and signal detecting has been analyzed. A formula of the sound power, leak size and air pressure in the spacecraft has been built, and the relationship between leak sound pressure and receiving direction and distance has been studied. The center frequency in millimeter diameter leak is more than 20 kHz. The situation of air leaking from spacecraft to space has been simulated and an experiment of different leak size and testing distance and direction has been done. The sound pressure is in direct proportion to the cosine of the angle of leak to sensor. The portable ultrasonic leak detector has been developed, whose minimal leak rate is 10^-1 Pa·m³/s, the testing radius is longer than 20 mm, the mass is less than 1.0 kg, and the electric power is less than 2.2 W.

Keywords: leak testing, manned spacecraft, sound transmitting, ultrasonic

Procedia PDF Downloads 312

Authors: Martin Kendra, Jaroslav Mašek, Juraj Čamaj, Matej Babin

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The railway transport is considered as a one of the most environmentally friendly mode of transport. With future prediction of increasing of freight transport there are lines facing problems with demanded capacity. Increase of the track capacity could be achieved by infrastructure constructive adjustments. The contribution shows how the travel time can be minimized and the track capacity increased by changing some of the basic infrastructure and operation parameters, for example, the minimal curve radius of the track, the number of tracks, or the usable track length at stations. Calculation of the necessary parameter changes is based on the fundamental physical laws applied to the train movement, and calculation of the occupation time is dependent on the changes of controlling the traffic between the stations.

Keywords: curve radius, maximum curve speed, track mass capacity, reconstruction

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Authors: Ashish Jain, Shivam Tayal

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There has been great interest in the field of Iontophoresis since few years due to its great applications in the field of controlled transdermal drug delivery system. It is an technique which is used to enhance the transdermal permeation of ionized high molecular weight molecules across the skin membrane especially Peptides & Proteins by the application of direct current of 1-4 mA for 20-40 minutes whereas chemical must be placed on electrodes with same charge. Iontophoresis enhanced the delivery of drug into the skin via pores like hair follicles, sweat gland ducts etc. rather than through stratum corneum. It has wide applications in the field of experimental, Therapeutic, Diagnostic, Dentistry etc. Medical science is using it to treat Hyperhidrosis (Excessive sweating) in hands and feet and to treat other ailments like hypertension, Migraine etc. Nowadays commercial transdermal iontophoretic patches are available in the market to treat different ailments. Researchers are keen to research in this field due to its vast applications and advantages.

Keywords: iontophoresis, novel drug delivery, transdermal, permeation enhancer

Procedia PDF Downloads 237

Authors: Karina Zaccari, Ernesto Cordeiro Marujo

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This paper presents a Machine Learning (ML) approach to support Meningitis diagnosis in patients at a children’s hospital in Sao Paulo, Brazil. The aim is to use ML techniques to reduce the use of invasive procedures, such as cerebrospinal fluid (CSF) collection, as much as possible. In this study, we focus on predicting the probability of Meningitis given the results of a blood and urine laboratory tests, together with the analysis of pain or other complaints from the patient. We tested a number of different ML algorithms, including: Adaptative Boosting (AdaBoost), Decision Tree, Gradient Boosting, K-Nearest Neighbors (KNN), Logistic Regression, Random Forest and Support Vector Machines (SVM). Decision Tree algorithm performed best, with 94.56% and 96.18% accuracy for training and testing data, respectively. These results represent a significant aid to doctors in diagnosing Meningitis as early as possible and in preventing expensive and painful procedures on some children.

Keywords: machine learning, medical diagnosis, meningitis detection, pediatric research

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Authors: Jamal Abd Awadallak, Thiago Olinek Reinehr, Eduardo Raizer, Deise Molinari, Edson Antonio, Camila da Silva da Silva

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The hydrolysis of soy oil catalyzed by 1,3-specific enzyme (Lecitase Ultra) in a well-stirred bioreactor was studied. Two forms of applications of the ultrasound were evaluated aiming to increase reaction rates, wherein the use of probe ultrasound associated with the use of surfactant to pre-emulsify the substrate showed the best results. Two different reaction periods were found: the first where the ultrasound has great influence on reaction rates, and the second where ultrasound influence is minimal. Studies on the time of pre-emulsification, surfactant concentration and enzyme concentration showed that the initial rate of hydrolysis depends on the interfacial area between the oil phase and the aqueous phase containing the enzyme.

Keywords: specific enzyme, free fatty acids, Hydrolysis, lecitase ultra, ultrasound

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Authors: Blaž Likozar, Andraž Pavlišič, Matic Pavlin, Taja Žibert, Aleksandra Zamljen, Sašo Gyergyek, Matej Huš

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Ammonia is gaining recognition as a carbon-free fuel for energy-intensive applications, particularly transportation, industry, and power generation. Due to its physical properties, high energy density of 3 kWh kg-1, and high gravimetric hydrogen capacity of 17.6 wt%, ammonia is an efficient energy vector for green hydrogen, capable of mitigating hydrogen’s storage, distribution, and infrastructure deployment limitations. Chemicalstorage in the form of ammonia provides an efficient and affordable solution for energy storage, which is currently a critical step in overcoming the intermittency of abundant renewable energy sources with minimal or no environmental impact. Experiments were carried out to validate the modelling in a packed bed reactor, which proved to be agreeing.

Keywords: hydrogen, ammonia, catalysis, modelling, kinetics

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Authors: Abdallah Benaissa

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In this paper, we consider the problem of asymptotics of double oscillatory integrals in the case of critical points of the second kind, the order of contact between the boundary and a level curve of the phase being even, the situation when the order of contact is odd will be studied in other occasions. Complete asymptotic expansions will be derived and the coefficient of the leading term will be computed in terms of the original data of the problem. A multitude of people have studied this problem using a variety of methods, but only in a special case when the order of contact is minimal: the more cited papers are a paper of Jones and Kline and an other one of Chako. These integrals are encountered in many areas of science, especially in problems of diffraction of optics.

Keywords: asymptotic expansion, double oscillatory integral, critical point of the second kind, optics diffraction

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Authors: Mohanaad Talal Shakir, Saad AJAJ Khalaf, Nawar Ahmed Aljumaily, Mustafa Talal Shakere

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Cloud computing is a model for enabling convenient, on demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. Objectives of this paper are to investigate the role of the Enterprise System and Cloud Computing Services to assist and guide him to ensure the initiative become successful. The cloud computing technology offers great potential for Enterprise such as the speed of dealing with data and product introductions, innovations and speed of response. The use of cloud computing technology leads to the rapid development and competitiveness of enterprises in various fields.

Keywords: cloud computing, information management, marketing, enterprise systems

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: Zin Mar Lwin

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Brain Computer Interface (BCI) Systems have developed for people who suffer from severe motor disabilities and challenging to communicate with their environment. BCI allows them for communication by a non-muscular way. For communication between human and computer, BCI uses a type of signal called Electroencephalogram (EEG) signal which is recorded from the human„s brain by means of an electrode. The electroencephalogram (EEG) signal is an important information source for knowing brain processes for the non-invasive BCI. Translating human‟s thought, it needs to classify acquired EEG signal accurately. This paper proposed a typical EEG signal classification system which experiments the Dataset from “Purdue University.” Independent Component Analysis (ICA) method via EEGLab Tools for removing artifacts which are caused by eye blinks. For features extraction, the Time and Frequency features of non-stationary EEG signals are extracted by Matching Pursuit (MP) algorithm. The classification of one of five mental tasks is performed by Multi_Class Support Vector Machine (SVM). For SVMs, the comparisons have been carried out for both 1-against-1 and 1-against-all methods.

Keywords: BCI, EEG, ICA, SVM

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Authors: Lucia Billeci, Gennaro Tartarisco, Maurizio Varanini

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Fetal cardiac monitoring by fetal electrocardiogram (fECG) can provide significant clinical information about the healthy condition of the fetus. Despite this potentiality till now the use of fECG in clinical practice has been quite limited due to the difficulties in its measuring. The recovery of fECG from the signals acquired non-invasively by using electrodes placed on the maternal abdomen is a challenging task because abdominal signals are a mixture of several components and the fetal one is very weak. This paper presents an approach for fECG extraction from abdominal maternal recordings, which exploits the characteristics of pseudo-periodicity of fetal ECG. It consists of devising a quality index (fQI) for fECG and of finding the linear combinations of preprocessed abdominal signals, which maximize these fQI (quality index optimization - QIO). It aims at improving the performances of the most commonly adopted methods for fECG extraction, usually based on maternal ECG (mECG) estimating and canceling. The procedure for the fECG extraction and fetal QRS (fQRS) detection is completely unsupervised and based on the following steps: signal pre-processing; maternal ECG (mECG) extraction and maternal QRS detection; mECG component approximation and canceling by weighted principal component analysis; fECG extraction by fQI maximization and fetal QRS detection. The proposed method was compared with our previously developed procedure, which obtained the highest at the Physionet/Computing in Cardiology Challenge 2013. That procedure was based on removing the mECG from abdominal signals estimated by a principal component analysis (PCA) and applying the Independent component Analysis (ICA) on the residual signals. Both methods were developed and tuned using 69, 1 min long, abdominal measurements with fetal QRS annotation of the dataset A provided by PhysioNet/Computing in Cardiology Challenge 2013. The QIO-based and the ICA-based methods were compared in analyzing two databases of abdominal maternal ECG available on the Physionet site. The first is the Abdominal and Direct Fetal Electrocardiogram Database (ADdb) which contains the fetal QRS annotations thus allowing a quantitative performance comparison, the second is the Non-Invasive Fetal Electrocardiogram Database (NIdb), which does not contain the fetal QRS annotations so that the comparison between the two methods can be only qualitative. In particular, the comparison on NIdb was performed defining an index of quality for the fetal RR series. On the annotated database ADdb the QIO method, provided the performance indexes Sens=0.9988, PPA=0.9991, F1=0.9989 overcoming the ICA-based one, which provided Sens=0.9966, PPA=0.9972, F1=0.9969. The comparison on NIdb was performed defining an index of quality for the fetal RR series. The index of quality resulted higher for the QIO-based method compared to the ICA-based one in 35 records out 55 cases of the NIdb. The QIO-based method gave very high performances with both the databases. The results of this study foresees the application of the algorithm in a fully unsupervised way for the implementation in wearable devices for self-monitoring of fetal health.

Keywords: fetal electrocardiography, fetal QRS detection, independent component analysis (ICA), optimization, wearable

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Authors: Hassina Gheribi, Salim Boukebbab

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The measurement of the parts manufactured on CMM (coordinate measuring machine) is based on the association of a surface of perfect geometry to the group of dots palpated via a mathematical calculation of the distances between the palpated points and itself surfaces. Surfaces not being never perfect, they are measured by a number of points higher than the minimal number necessary to define them mathematically. However, the central problems of three-dimensional metrology are the estimate of, the orientation parameters, location and intrinsic of this surface. Including the numerical uncertainties attached to these parameters help the metrologist to make decisions to be able to declare the conformity of the part to specifications fixed on the design drawing. During this paper, we will present a data-processing model in Visual Basic-6 which makes it possible automatically to determine the whole of these parameters, and their uncertainties.

Keywords: coordinate measuring machines (CMM), associated surface, uncertainties of measurement, acquisition and modeling

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Authors: Mahdi Farajzadeh Ajirlou

Abstract:

Prior evidence of normal cardiac anatomy is desirable to relieve the anxiety of cases with a family history of congenital heart disease or to offer the option of early gestation termination or close follow-up should a cardiac anomaly be proved. Fetal heart discovery plays an important part in the opinion of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system. Acquisition of ventricular volume and inflow data would be useful to quantify more valve regurgitation and ventricular function to determine the degree of cardiovascular concession in fetal conditions at threat for hydrops fetalis. This study discusses imaging the fetal heart with transvaginal ultrasound, Doppler ultrasound, three-dimensional ultrasound (3DUS) and four-dimensional (4D) ultrasound, spatiotemporal image correlation (STIC), glamorous resonance imaging and cardiac catheterization. Doppler ultrasound (DUS) image is a kind of real- time image with a better imaging effect on blood vessels and soft tissues. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. Spatiotemporal image correlation (STIC) enables the acquisition of a volume of data concomitant with the beating heart. The automated volume accession is made possible by the array in the transducer performing a slow single reach, recording a single 3D data set conforming to numerous 2D frames one behind the other. The volume accession can be done in a stationary 3D, either online 4D (direct volume scan, live 3D ultrasound or a so-called 4D (3D/ 4D)), or either spatiotemporal image correlation-STIC (off-line 4D, which is a circular volume check-up). Fetal cardiovascular MRI would appear to be an ideal approach to the noninvasive disquisition of the impact of abnormal cardiovascular hemodynamics on antenatal brain growth and development. Still, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the mortal fetus, the lack of conventional cardiac gating styles to attend data accession, and the implicit corruption of MRI data due to motherly respiration and unpredictable fetal movements. Fetal cardiac MRI has the implicit to complement ultrasound in detecting cardiovascular deformations and extracardiac lesions. Fetal cardiac intervention (FCI), minimally invasive catheter interventions, is a new and evolving fashion that allows for in-utero treatment of a subset of severe forms of congenital heart deficiency. In special cases, it may be possible to modify the natural history of congenital heart disorders. It's entirely possible that future generations will ‘repair’ congenital heart deficiency in utero using nanotechnologies or remote computer-guided micro-robots that work in the cellular layer.

Keywords: fetal, cardiac MRI, ultrasound, 3D, 4D, heart disease, invasive, noninvasive, catheter

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Authors: Seyed Fakhroddin Hejazi, Mohammad Saleh Sadeghi, Leili Iranirad

Abstract:

Silent myocardial infarction is defined as the appearance of pathological Q waves in the electrocardiogram, without objective signs of myocardial infarction and any minimal or atypical symptoms. Although this condition has been known for a long time, but little is known about its phenomenon and the mechanisms of it remain unclear. Its coincidence with stroke is also still controversial. This case report introduces a middle-aged man with silent myocardial infarction presented with homonymous hemianopia, which except stage 1 hypertension, had no other major cardiovascular risk factors including diabetes mellitus, hypercholesterolemia, family history of cardiac diseases and smoking. In conclusion, this case report indicated that existence of only one cardiovascular risk factor would lead to the development of MI or stroke.

Keywords: silent myocardial infarction, homonymous hemianopia, stroke, hypertension

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Authors: Ugo Galvanetto, Pirto G. Pavan, Mirco Zaccariotto

Abstract:

The discipline of Computer-integrated surgery (CIS) will provide equipment able to improve the efficiency of healthcare systems and, which is more important, clinical results. Surgeons and machines will cooperate in new ways that will extend surgeons’ ability to train, plan and carry out surgery. Patient specific CIS of the brain requires several steps: 1 - Fast generation of brain models. Based on image recognition of MR images and equipped with artificial intelligence, image recognition techniques should differentiate among all brain tissues and segment them. After that, automatic mesh generation should create the mathematical model of the brain in which the various tissues (white matter, grey matter, cerebrospinal fluid …) are clearly located in the correct positions. 2 – Reliable and fast simulation of the surgical process. Computational mechanics will be the crucial aspect of the entire procedure. New algorithms will be used to simulate the mechanical behaviour of cutting through cerebral tissues. 3 – Real time provision of visual and haptic feedback A sophisticated human-machine interface based on ergonomics and psychology will provide the feedback to the surgeon. The present work will address in particular point 2. Modelling the cutting of soft tissue in a structure as complex as the human brain is an extremely challenging problem in computational mechanics. The finite element method (FEM), that accurately represents complex geometries and accounts for material and geometrical nonlinearities, is the most used computational tool to simulate the mechanical response of soft tissues. However, the main drawback of FEM lies in the mechanics theory on which it is based, classical continuum Mechanics, which assumes matter is a continuum with no discontinuity. FEM must resort to complex tools such as pre-defined cohesive zones, external phase-field variables, and demanding remeshing techniques to include discontinuities. However, all approaches to equip FEM computational methods with the capability to describe material separation, such as interface elements with cohesive zone models, X-FEM, element erosion, phase-field, have some drawbacks that make them unsuitable for surgery simulation. Interface elements require a-priori knowledge of crack paths. The use of XFEM in 3D is cumbersome. Element erosion does not conserve mass. The Phase Field approach adopts a diffusive crack model instead of describing true tissue separation typical of surgical procedures. Modelling discontinuities, so difficult when using computational approaches based on classical continuum Mechanics, is instead easy for novel computational methods based on Peridynamics (PD). PD is a non-local theory of mechanics formulated with no use of spatial derivatives. Its governing equations are valid at points or surfaces of discontinuity, and it is, therefore especially suited to describe crack propagation and fragmentation problems. Moreover, PD does not require any criterium to decide the direction of crack propagation or the conditions for crack branching or coalescence; in the PD-based computational methods, cracks develop spontaneously in the way which is the most convenient from an energy point of view. Therefore, in PD computational methods, crack propagation in 3D is as easy as it is in 2D, with a remarkable advantage with respect to all other computational techniques.

Keywords: computational mechanics, peridynamics, finite element, biomechanics

Procedia PDF Downloads 59