Search results for: depth of anesthesia (DoA)

Authors: Bouzidi Yassine

Abstract:

This experimental work was aimed to characterize the porosity of the concrete cover zone using the capillary absorption test, and establish the links between open porosity characterized by the initial absorption, the compressive strength and carbonation depth. Eight formulations of workability similar made from ordinary Portland cement (CEM I 42.5) and a compound cement (CEM II/B 42.5) four of each type are studied. The results allow us to highlight the effect of the cement type. Indeed, concretes-based cement CEM II/B 42.5 carbonatent approximately faster than concretes-based cement CEM I 42.5. This effect is attributed in part to the lower content of portlandite Ca(OH)2 of concretes-based cement CEM II/B 42.5, but also the impact of the cement type on the open porosity of the cover concrete. The open porosity of concretes-based cement CEM I 42.5 is lower than that of concretes-based cement CEM II/B 42.5. The carbonation depth is a decreasing function of the compressive strength at 28 days and increases with the initial absorption. Through the results obtained, correlations between the quantity of water absorbed in 1 h, the carbonation depth at 180 days and the compressive strength at 28 days were performed in an acceptable manner.

Keywords: initial absorption, cover concrete, compressive strength, carbonation depth

Procedia PDF Downloads 336

Authors: Seyed Abolhassan Naeini, Maedeh Akhavan Tavakkoli

Abstract:

Determining soil engineering properties is essential for geotechnical problems. In addition to high cost, invasive soil survey methods can be time-consuming, so geophysical methods can be an excellent choice to determine soil characteristics. In this study, geoelectric investigation using the Wenner arrangement method has been used to determine the amount of soil corrosion in soil layers in a project site as a case study. This study aims to assess the degree of corrosion of soil layers to a depth of 5 meters and find the variation of soil electrical resistance versus depth. For this purpose, the desired points in the study area were marked and specified, and all withdrawals were made within the specified points. The collected data have been processed by standard and accepted methods, and the results have been presented in the form of calculation tables and curves of electrical resistivity with depth.

Keywords: Wenner array, geoelectric, soil corrosion, electrical soil resistance

Procedia PDF Downloads 102

Authors: Murat Çeşme

Abstract:

For a bridge engineer to ensure a safe footing design, it is very important to estimate the maximum scour depth around the piers as accurately as possible. Many experimental studies have been performed by several investigators to obtain information about scouring mechanism. In order to examine the effect of inclination of dual bridge piers on scour depth under clear-water conditions for various uniform flow depths, an experimental research on scaled dual bridge piers has been carried over in METU Hydromechanics Lab. Dimensional and non-dimensional curves were developed and presented to show the variation of scour depth with respect to various parameters such as footing angle with the vertical, flow depth and footing dimensions. Results of the study were compared to those obtained from a similar study performed with single inclined piers to see the effect of the second pier on scour depths. Useful equations for the design engineers were developed based on multiple regression analyses to be used for predicting local scour depths around inclined piers in uniform and non-uniform sediments.

Keywords: experimental research, inclined dual bridge piers, footing safety, scour depth, clear water condition

Procedia PDF Downloads 98

Authors: Negar Ghotbeddin, Izadpanah Zeinab, Tooraj Valinassab, Mohammad Azhir

Abstract:

It is reported on results of a trawls survey in 2011 to assess the amount of biomass and Catch Per Unit of Area (CPUA) and also to determine the distribution pattern of Synodonidae family of demersal fishes (with emphasize on great lizardfish, Saurida tumbil) as one the most important and commercial fish species in the northwest of Persian Gulf. Samples were collected at a total 65 trawl stations selected a stratified random procedure. The study area was stratified to five strata (A to E) covering the depth layers of 10-20, 20-30 and 30-50 m. The catch rates of CPUA and biomass of lizardfishes were estimated to be approximately 316.20 kg/nm2, and 2902.1 tons, respectively. The highest value of biomass of Synodontids was recorded in the east of the study area, Bordkhoon to Dayer (stratum D & E, approximately 1310.6 tonnes) and in depth layer of 30-50 m; and the lowest value was estimated for stratum A (West of Khuzestan Province) and in depth layer of 10-20 m. On the other hand, the highest CPUA was recorded in stratum D and depth layer of 20-30 m; and the lowest value for stratum A and 10-20 m depth. It was concluded that stratum D (namely from Bordkhoon to Dayer) contains the best fishing area from the point of higher density and distribution of Synodontidae in the covering area, and from the point of depth distribution, they are found in depths more than 30 m.

Keywords: Saurida tumbil, CPUA, biomass, distribution, fishing area, Persian gulf

Procedia PDF Downloads 406

Authors: Vimal Kumar Chouksey, S. P. Sharma

Abstract:

This paper deals with theoretical analysis of performance of solar air collector having its duct packed with blackened wire screen matrices. The heat transfer equations for two-dimensional fully developed fluid flows under quasi-steady-state conditions have been developed in order to analyze the effect of bed depth on performance. A computer programme is developed in C++ language to estimate the temperature rise of entering air for evaluation of performance by solving the governing equations numerically using relevant correlations for heat transfer coefficient for packed bed systems. Results of air temperature rise and thermal efficiency obtained from the analysis have been compared with available experimental results and results have been found fairly in closed agreement. It has been found that there is considerable enhancement in performance with packed bed collector upto a certain total bed depth. Effect of total bed depth on efficiency show that there is an upper limiting value of total bed depth beyond which the thermal efficiency begins to fall again and this type of characteristics behavior is observed at all mass flow rate.

Keywords: plane collector, solar air heater, solar energy, wire screen packed bed

Procedia PDF Downloads 236

Authors: Jens Friedrich, Matthias A. Gebele, Armin Lechler, Alexander Verl

Abstract:

Chatter vibrations and process instabilities are the most important factors limiting the productivity of the milling process. Chatter can leads to damage of the tool, the part or the machine tool. Therefore, the estimation and prediction of the process stability is very important. The process stability depends on the spindle speed, the depth of cut and the width of cut. In milling, the process conditions are defined in the NC-program. While the spindle speed is directly coded in the NC-program, the depth and width of cut are unknown. This paper presents a new simulation based approach for the prediction of the depth and width of cut of a milling process. The prediction is based on a material removal simulation with an analytically represented tool shape and a multi-dexel approach for the work piece. The new calculation method allows the direct estimation of the depth and width of cut, which are the influencing parameters of the process stability, instead of the removed volume as existing approaches do. The knowledge can be used to predict the stability of new, unknown parts. Moreover with an additional vibration sensor, the stability lobe diagram of a milling process can be estimated and improved based on the estimated depth and width of cut.

Keywords: dexel, process stability, material removal, milling

Procedia PDF Downloads 525

Authors: Jae Ni Jang, Young Uk Kim

Abstract:

Background: Chat Generative Pre-training Transformer-3 (ChatGPT; San Francisco, California, Open Artificial Intelligence) is an artificial intelligence chatbot based on a large language model designed to generate human-like text. As the usage of ChatGPT is increasing among less knowledgeable patients, medical students, and anesthesia and pain medicine residents or trainees, we aimed to evaluate the accuracy of ChatGPT-3 responses to questions about the American Society of Anesthesiologists (ASA) classification based on patients’ underlying diseases and assess the quality of the generated responses. Methods: A total of 47 questions were submitted to ChatGPT using textual prompts. The questions were designed for ChatGPT-3 to provide answers regarding ASA classification in response to common underlying diseases frequently observed in adult patients. In addition, we created 18 questions regarding the ASA classification for pediatric patients and pregnant women. The accuracy of ChatGPT’s responses was evaluated by cross-referencing with Miller’s Anesthesia, Morgan & Mikhail’s Clinical Anesthesiology, and the American Society of Anesthesiologists’ ASA Physical Status Classification System (2020). Results: Out of the 47 questions pertaining to adults, ChatGPT -3 provided correct answers for only 23, resulting in an accuracy rate of 48.9%. Furthermore, the responses provided by ChatGPT-3 regarding children and pregnant women were mostly inaccurate, as indicated by a 28% accuracy rate (5 out of 18). Conclusions: ChatGPT provided correct responses to questions relevant to the daily clinical routine of anesthesiologists in approximately half of the cases, while the remaining responses contained errors. Therefore, caution is advised when using ChatGPT to retrieve anesthesia-related information. Although ChatGPT may not yet be suitable for clinical settings, we anticipate significant improvements in ChatGPT and other large language models in the near future. Regular assessments of ChatGPT's ASA classification accuracy are essential due to the evolving nature of ChatGPT as an artificial intelligence entity. This is especially important because ChatGPT has a clinically unacceptable rate of error and hallucination, particularly in pediatric patients and pregnant women. The methodology established in this study may be used to continue evaluating ChatGPT.

Keywords: American Society of Anesthesiologists, artificial intelligence, Chat Generative Pre-training Transformer-3, ChatGPT

Procedia PDF Downloads 47

Authors: Spandan Sahu, Amiya Kumar Pati, Kishanjit Kumar Khatua

Abstract:

Rivers are the backbone of human civilization as well as one of the most important components of nature. In this paper, a method for predicting lateral depth-averaged velocity distribution in a two-flow braided compound channel is proposed. Experiments were conducted to study the boundary shear stress in the tip of the two flow path. The cross-section of the channel is divided into several panels to study the flow phenomenon on both the main channel and the flood plain. It can be inferred from the study that the flow coefficients get affected by boundary shear stress. In this study, the analytical solution of Shiono and knight (SKM) for lateral distributions of depth-averaged velocity and bed shear stress has been taken into account. The SKM is based on hydraulic parameters, which signify the bed friction factor (f), lateral eddy viscosity, and depth-averaged flow. While applying the SKM to different panels, the equations are solved considering the boundary conditions between panels. The boundary shear stress data, which are obtained from experimentation, are compared with CES software, which is based on quasi-one-dimensional Reynold's Averaged Navier-Stokes (RANS) approach.

Keywords: boundary shear stress, lateral depth-averaged velocity, two-flow braided compound channel, velocity distribution

Procedia PDF Downloads 129

Authors: D. P. Rollinson, B. J. Dilley, P. G. Ryan

Abstract:

The white-chinned petrel (Procellaria aequinoctialis) is the seabird species most commonly killed by Southern Hemisphere longline fisheries. Despite the importance of diving ability for mitigating longline bycatch, little is known of this species’ diving behaviour. We obtained data from temperature–depth recorders from nine white-chinned petrels breeding on Marion Island, southwestern Indian Ocean, during the late incubation and chickrearing period. Maximum dive depth (16 m) was slightly deeper than the previous estimate (13 m), but varied considerably among individuals (range 2–16 m). Males dived deeper than females, and birds feeding chicks dived deeper than incubating birds, but dive rate did not differ between the sexes. Time of day had no significant effect on dive depth or rate. Our findings will help to improve the design and performance of mitigation measures aimed at reducing seabird bycatch in longline fisheries, such as the calculation of minimum line sink rates and optimum aerial coverage of bird-scaring lines.

Keywords: dive depth, dive duration, temperature–depth recorders, seabirds, bird-scaring lines

Procedia PDF Downloads 573

Authors: Jakkireddy Sravani

Abstract:

Introduction: The maintenance of hemodynamic stability is of pivotal importance in supratentorial surgeries. Anesthesia for supratentorial tumors requires an understanding of localized or generalized rising ICP, regulation, and maintenance of intracerebral perfusion, and avoidance of secondary systemic ischemic insults. We aimed to compare the effects of the combination of ketamine and propofol with propofol alone when used as an induction and maintenance anesthetic agent during supratentorial tumors. Methodology: This prospective, randomized, double-blinded controlled study was conducted at AIIMS Raipur after obtaining the institute Ethics Committee approval (1212/IEC-AIIMSRPR/2022 dated 15/10/2022), CTRI/2023/01/049298 registration and written informed consent. Fifty-two supratentorial tumor patients posted for craniotomy and excision were included in the study. The patients were randomized into two groups. One group received a combination of ketamine and propofol, and the other group received propofol for induction and maintenance of anesthesia. Intraoperative hemodynamic stability and quality of brain relaxation were studied in both groups. Statistical analysis and technique: An MS Excel spreadsheet program was used to code and record the data. Data analysis was done using IBM Corp SPSS v23. The independent sample "t" test was applied for continuously dispersed data when two groups were compared, the chi-square test for categorical data, and the Wilcoxon test for not normally distributed data. Results: The patients were comparable in terms of demographic profile, duration of the surgery, and intraoperative input-output status. The trends in BIS over time were similar between the two groups (p-value = 1.00). Intraoperative hemodynamics (SBP, DBP, MAP) were better maintained in the ketamine and propofol combination group during induction and maintenance (p-value < 0.01). The quality of brain relaxation was comparable between the two groups (p-value = 0.364). Conclusion: Ketamine and propofol combination for the induction and maintenance of anesthesia was associated with superior hemodynamic stability, required fewer vasopressors during excision of supratentorial tumors, provided adequate brain relaxation, and some degree of neuroprotection compared to propofol alone.

Keywords: supratentorial tumors, hemodynamic stability, brain relaxation, ketamine, propofol

Procedia PDF Downloads 25

Authors: Bang Young Kim, Sang Hoon Park, Chul Gyu Song

Abstract:

A conventional optical coherence tomography (OCT) system has limited imaging depth, which is 1-2 mm, and suffers unwanted noise such as speckle noise. The motorized-stage-based OCT system, using a common-path Fourier-domain optical coherence tomography (CP-FD-OCT) configuration, provides enhanced imaging depth and less noise so that we can overcome these limitations. Using this OCT systems, OCT images were obtained from an onion, and their subsurface structure was observed. As a result, the images obtained using the developed motorized-stage-based system showed enhanced imaging depth than the conventional system, since it is real-time accurate depth tracking. Consequently, the developed CP-FD-OCT systems and algorithms have good potential for the further development of endoscopic OCT for microsurgery.

Keywords: common-path OCT, FD-OCT, OCT, tracking algorithm

Procedia PDF Downloads 380

Authors: Sumi Deka, Krishna Gopal Bhattacharyya

Abstract:

This paper evaluate the industrial use of Kala Jamun (Syzygiumcumini L.) Seed powder (KSP) for the continuous adsorption of Cr(VI) in a column adsorption process. Adsorption of Cr(VI) onto Kala jamun (Syzygiumcumini L.) Seed Powder have been examined with the variation of (a) bed depth of the adsorbents, (b) flow rate of the adsorbents and (c) Cr(VI) concentration. The results showed that both the adsorption and the regeneration of the Cr(VI) onto Kala Jamun (Syzygiumcumini L.) seed Powder (KSP) can effectively occur in the column mode of adsorption. On increasing the bed depth, the adsorption of Cr(VI) onto KSP increases whereas on increasing the flow rate and the Cr(VI) concentration of KSP adsorption decreases. The results of the column studies were also fitted to Bed Depth Service Time (BDST) model. The BDST model was appropriate for designing the column for industrial purpose.

Keywords: bed-depth-service-time, continuous adsorption, Cr(VI), KSP

Procedia PDF Downloads 256

Authors: A. Beatti, L. Chipchase, A. Rayner, T. Souvlis

Abstract:

The aims of this study were to investigate the depth of interferential current (IFC) penetration through soft tissue and to investigate the area over which IFC spreads during clinical application. Premodulated IFC and ‘true’ IFC at beat frequencies of 4, 40 and 90Hz were applied via four electrodes to the distal medial thigh of 15 healthy subjects. The current was measured via three Teflon coated fine needle electrodes that were inserted into the superficial layer of skin, then into the subcutaneous tissue (≈1 cm deep) and then into muscle tissue (≈2 cm deep). The needle electrodes were placed in the middle of the four IFC electrodes, between two channels and outside the four electrodes. Readings were taken at each tissue depth from each electrode during each treatment frequency then digitized and stored for analysis. All voltages were greater at all depths and locations than baseline (p < 0.01) and voltages decreased with depth (P=0.039). Lower voltages of all currents were recorded in the middle of the four electrodes with the highest voltage being recorded outside the four electrodes in all depths (P=0.000).For each frequency of ‘true’ IFC, the voltage was higher in the superficial layer outside the electrodes (P ≤ 0.01).Premodulated had higher voltages along the line of one circuit (P ≤ 0.01). Clinically, IFC appears to pass through skin layers to depth and is more efficient than premodulated IFC when targeting muscle tissue.

Keywords: electrotherapy, interferential current, interferential therapy, medium frequency current

Procedia PDF Downloads 346

Authors: Mohammed Abaoli, Omer Kara

Abstract:

The current research has investigated the soil quality status under dryland vegetation of Yabello district, Southern Ethiopia in which we should identify the nature and extent of salinity problem of the area for further research bases. About 48 soil samples were taken from 0-30, 31-60, 61-90 and 91-120 cm soil depths by opening 12 representative soil profile pits at 1.5 m depth. Soil color, texture, bulk density, Soil Organic Carbon (SOC), Cation Exchange Capacity (CEC), Na, K, Mg, Ca, CaCO₃, gypsum (CaSO₄), pH, Sodium Adsorption Ratio (SAR), Exchangeable Sodium Percentage (ESP) were analyzed. The dominant soil texture was silty-clay-loam.  Bulk density varied from 1.1 to 1.31 g/cm³. High SOC content was observed in 0-30 cm. The soil pH ranged from 7.1 to 8.6. The electrical conductivity shows indirect relationship with soil depth while CaCO₃ and CaSO₄ concentrations were observed in a direct relationship with depth. About 41% are non-saline, 38.31% saline, 15.23% saline-sodic and 5.46% sodic soils. Na concentration in saline soils was greater than Ca and Mg in all the soil depths. Ca and Mg contents were higher above 60 cm soil depth in non-saline soils. The concentrations of SO₂^-4 and HCO^-3 were observed to be higher at the most lower depth than upper. SAR value tends to be higher at lower depths in saline and saline-sodic soils, but decreases at lower depth of the non-saline soils. The distribution of ESP above 60 cm depth was in an increasing order in saline and saline-sodic soils. The result of the research has shown the direction to which extent of salinity we should consider for the Commiphora plant species we want to grow on the area. 

Keywords: commiphora species, dryland vegetation, ecological significance, soil quality, salinity problem

Procedia PDF Downloads 195

Authors: A. Bentabet, A. Aydin, N. Fenineche

Abstract:

The mean penetration depth has a most important in the absorption transport phenomena. Analytical model of light ion backscattering coefficients from solid targets have been made by Vicanek and Urbassek. In the present work, we showed a mathematical expression (deterministic model) for Z1/2. In advantage, in the best of our knowledge, relatively only one analytical model exit for electron or positron mean penetration depth in solid targets. In this work, we have presented a simple geometric spherical model of absorbed particles based on CSDA scheme. In advantage, we have showed an analytical expression of the mean penetration depth by combination between our model and the Vicanek and Urbassek theory. For this, we have used the Relativistic Partial Wave Expansion Method (RPWEM) and the optical dielectric model to calculate the elastic cross sections and the ranges respectively. Good agreement was found with the experimental and theoretical data.

Keywords: Bentabet spherical geometric model, continuous slowing down approximation, stopping powers, ranges, mean penetration depth

Procedia PDF Downloads 641

Authors: A. Kampker, P. Burggräf, Y. Bäumers

Abstract:

In order to be competitive, companies have to reduce their production costs while meeting increasing quality requirements. Therefore, companies try to plan their assembly processes as detailed as possible. However, increasing product individualization leading to a higher number of variants, smaller batch sizes and shorter product life cycles raise the question to what extent the effort of detailed planning is still justified. An important approach in this field of research is the concept of determining the economic planning depth for assembly process planning based on production specific influencing factors. In this paper, first solution hypotheses as well as a first draft of the resulting method will be presented.

Keywords: assembly process planning, economic planning depth, planning benefit, planning effort

Procedia PDF Downloads 504

Authors: Bo Wang

Abstract:

This paper proposes a method that can estimate PM2.5 by the images of GF-1 Satellite that called WFOV images (Wide Field of View). AOD (Aerosol Optical Depth) over land surfaces was retrieved in Shanghai area based on DDV (Dark Dense Vegetation) method. PM2.5 information, gathered from ground monitoring stations hourly, was fitted with AOD using different polynomial coefficients, and then the correlation coefficient between them was calculated. The results showed that, the GF-1 WFOV images can meet the requirement of retrieving AOD, and the correlation coefficient between the retrieved AOD and PM2.5 was high. If more detailed and comprehensive data is provided, the accuracy could be improved and the parameters can be more precise in the future.

Keywords: remote sensing retrieve, PM 2.5, GF-1, aerosol optical depth

Procedia PDF Downloads 244

Authors: Negar Riazifar, Nigel G. Stocks

Abstract:

This paper proposes strategies in level crossing (LC) sampling and reconstruction that provide alias-free high-fidelity signal reconstruction for speech signals without exponentially increasing sample number with increasing bit-depth. We introduce methods in LC sampling that reduce the sampling rate close to the Nyquist frequency even for large bit-depth. The results indicate that larger variation in the sampling intervals leads to an alias-free sampling scheme; this is achieved by either reducing the bit-depth or adding jitter to the system for high bit-depths. In conjunction with windowing, the signal is reconstructed from the LC samples using an efficient Toeplitz reconstruction algorithm.

Keywords: alias-free, level crossing sampling, spectrum, trigonometric polynomial

Procedia PDF Downloads 209

Authors: M. S. Kaiser, S. Reaz Ahmed

Abstract:

Chip formation characteristics are investigated during surface finishing of high density polyethylene (HDPE) samples using a shaper machine. Both the cutting speed and depth of cut are varied continually to enable observations under various machining conditions. The generated chips are analyzed in terms of their shape, size, and deformation. Their physical appearances are also observed using digital camera and optical microscope. The investigation shows that continuous chips are obtained for all the cutting conditions. It is observed that cutting speed is more influential than depth of cut to cause dimensional changes of chips. Chips curl radius is also found to increase gradually with the increase of cutting speed. The length of continuous chips remains always smaller than the job length, and the corresponding discrepancies are found to be more prominent at lower cutting speed. Microstructures of the chips reveal that cracks are formed at higher cutting speeds and depth of cuts, which is not that significant at low depth of cut.

Keywords: HDPE, surface-finishing, chip formation, deformation, roughness

Procedia PDF Downloads 146

Authors: Ali Akyar, Osman Serdar Gedik

Abstract:

Depth estimation is a challenging computer vision task that involves estimating the distance between objects in a scene and the camera. It predicts how far each pixel in the 2D image is from the capturing point. There are some important Monocular Depth Estimation (MDE) studies that are based on Vision Transformers (ViT). We benchmark three major studies. The first work aims to build a simple and powerful foundation model that deals with any images under any condition. The second work proposes a method by mixing multiple datasets during training and a robust training objective. The third work combines generalization performance and state-of-the-art results on specific datasets. Although there are studies with thermal images too, we wanted to benchmark these three non-thermal, state-of-the-art studies with a hybrid image dataset which is taken by Multi-Spectral Dynamic Imaging (MSX) technology. MSX technology produces detailed thermal images by bringing together the thermal and visual spectrums. Using this technology, our dataset images are not blur and poorly detailed as the normal thermal images. On the other hand, they are not taken at the perfect light conditions as RGB images. We compared three methods under test with our thermal dataset which was not done before. Additionally, we propose an image enhancement deep learning model for thermal data. This model helps extract the features required for monocular depth estimation. The experimental results demonstrate that, after using our proposed model, the performance of these three methods under test increased significantly for thermal image depth prediction.

Keywords: monocular depth estimation, thermal dataset, benchmarking, vision transformers

Procedia PDF Downloads 32

Authors: Arun Goel

Abstract:

Prediction of maximum local scour is necessary for the safety and economical design of the bridges. A number of equations have been developed over the years to predict local scour depth using laboratory data and a few pier equations have also been proposed using field data. Most of these equations are empirical in nature as indicated by the past publications. In this paper, attempts have been made to compute local depth of scour around bridge pier in dimensional and non-dimensional form by using linear regression, simple regression and SVM (Poly and Rbf) techniques along with few conventional empirical equations. The outcome of this study suggests that the SVM (Poly and Rbf) based modeling can be employed as an alternate to linear regression, simple regression and the conventional empirical equations in predicting scour depth of bridge piers. The results of present study on the basis of non-dimensional form of bridge pier scour indicates the improvement in the performance of SVM (Poly and Rbf) in comparison to dimensional form of scour.

Keywords: modeling, pier scour, regression, prediction, SVM (Poly and Rbf kernels)

Procedia PDF Downloads 451

Authors: Itee Chowdhury, Shikha Modi

Abstract:

Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

Procedia PDF Downloads 127

Authors: N. Dahraoui, M. Boulakroune, D. Benatia

Abstract:

In this paper, the improvement by deconvolution of the depth resolution in Secondary Ion Mass Spectrometry (SIMS) analysis is considered. Indeed, we have developed a new Tikhonov-Miller deconvolution algorithm where a priori model of the solution is included. This is a denoisy and pre-deconvoluted signal obtained from: firstly, by the application of wavelet shrinkage algorithm, secondly by the introduction of the obtained denoisy signal in an iterative deconvolution algorithm. In particular, we have focused the light on the effect of the iterations number on the evolution of the deconvoluted signals. The SIMS profiles are multilayers of Boron in Silicon matrix.

Keywords: DRF, in-depth resolution, multiresolution deconvolution, SIMS, wavelet shrinkage

Procedia PDF Downloads 418

Authors: Hisham A. Hashem, Sameh Galal, Bassem M. Moeshed

Abstract:

A 36 years old male patient presented to our unit with a history of motor-car accident from 7 months complaining of disfigurement and double vision. On examination and investigations, there was an orbital floor fracture in the left eye with inferior rectus muscle entrapment causing diplopia, dystopia and enophthalmos. Under general anesthesia, a sub-ciliary incision was performed, and the orbital floor fracture was repaired with a double layer Medpor sheet (30x50x15) with removing and freeing fibrosis that was present and freeing of the inferior rectus muscle. Remarkable improvement of the dystopia was noticed, however, there was a residual diplopia in upgaze and enophthalmos. He was then referred to a strabismologist, which upon examination found left hypotropia of 8 ΔD corrected by 8 ΔD base up prism and positive forced duction test on elevation and pseudoptosis. Under local anesthesia, a limbal incision approach with hangback 4mm recession of inferior rectus muscle was performed after identifying an inferior rectus muscle structure. Improvement was noted shortly postoperative with correction of both diplopia and pseudoptosis. Follow up after 1, 4 and 8 months was done showing a stable condition. Delayed surgery in cases of orbital floor fracture may still hold good results provided proper assessment of the case with management of each sign separately.

Keywords: diplopia, dystopia, late surgery, orbital floor fracture

Procedia PDF Downloads 227

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak

Abstract:

Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.

Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact

Procedia PDF Downloads 78

Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

Abstract:

Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

Procedia PDF Downloads 296

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

Abstract:

Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

Procedia PDF Downloads 112

Authors: Beloulou Mohamed Lamine, Bouhouf Attef, Meliani Walid, Sellami Dalila, Lamara Abdelhak

Abstract:

Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with post-surgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariate analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature or component, particularly in surgeries that are more prone to chronicization.

Keywords: chronic postsurgical pain, postsurgical chronic neuropathic pain, regional anesthesia and analgesia techniques (RAAT), neuropathic pain score dn2, preventive impact

Procedia PDF Downloads 27

Authors: M. Cherki, I. Taouam, A. Amiri, F. Hmimid, T. Ould Bellahcen

Abstract:

The Moroccan coasts represent an important wealth of red algae which have an economic interest. Among these algae, the Gelidium sesquipedale, which is exploited industrially for its richness in agar. The aim of this study is to establish a general overview of the macronutrient composition of Gelidium sesquipedale and to compare this composition according to three factors: the harvest site (El Jadida, Casablanca and Mohammadia), the harvest depth (coast and depth) and the drying process (open air and oven). Proteins, lipids, and carbohydrates are measured by different methods. The analysis of results show that the protein concentrations of the El Jadida and Mohammadia samples are significantly higher than that of Casablanca (0.026 ± 0.0007 µg/µg DW 0.024 ± 0.001 µg/µg DW and 0.006 ± 0.0007 µg/µg DW, p < 0.05 respectively). However, Casablanca samples are significantly richer in total sugars (0.023 ± 0.002 µg/µg DW, p < 0.05) and less rich in reducing sugars (0.0001 ± 0.00001 µg/µg DW, p < 0.05) compared to other samples. The lipid concentrations of the samples from the three harvest sites do not show any significant difference. With respect to depth, only total protein and total sugar concentrations were significantly higher in the coast versus depth samples (0.035 ± 0.004 µg/µg DW vs. 0.026 ± 0.0007 µg/µg DW and 0.035 ± 0.006 µg/µg DW vs. 0.012 ± 0.005 µg/µg DW p < 0.05 respectively). For the drying process, protein, total sugars and lipid concentrations were significantly higher in open air samples compared to oven samples (0.006 ± 0.0007 µg/µg DW). vs 0.004 ± 0.0003 µg/µg DW, 0.023 ± 0.002 µg/µg DW vs 0.007 ± 0.002 µg/µg DW and 8% vs 4% p < 0.05 respectively). Our results demonstrate that the chemical composition of Gelidium sesquipedale varies according to the harvest region. In addition, samples harvested on the coast and dried in the open air are the richest in macronutrients.

Keywords: biochemical composition, drying, depth, Gelidium sesquipedale, red algae, region

Procedia PDF Downloads 149

Authors: Martin Van, Mohammed Javed, Sarah Hemington-Gorse

Abstract:

Aim: Our aim was to determine the effect of size and tumor depth of basal cell carcinomas (BCCs) on surgical margin clearance. Methods: A retrospective study was conducted at the Welsh Centre for Burns and Plastic Surgery (WCBPS), Morriston Hospital between 1 Jan 2016 – 31 July 2016. Only patients with confirmed BCC on histopathological analysis were included. Patient data including anatomical region treated, lesion size, histopathological clearance margins and histological sub-types were recorded. An independent T-test was performed determine statistical significance. Results: A total of 228 BCCs were excised in 160 patients. Eleven lesions (4.8%) were incompletely excised. The nose area had the highest rate of incomplete excision. The mean diameter of incompletely excised lesions was 11.4mm vs 11.5mm in completely excised lesions (p=0.959) and the mean histological depth of incompletely excised lesions was 4.1mm vs. 2.5mm for completely excised BCCs (p < 0.05). Conclusions: BCC tumor depth of > 4.1 mm was associated with high rate of incomplete margin clearance. Hence, in prospective patients, a BCC tumor depth (>4 mm) on tissue biopsy should alert the surgeon of potentially higher risk of incomplete excision of lesion.

Keywords: basal cell carcinoma, excision margins, plastic surgery, treatment

Procedia PDF Downloads 238