Search results for: entropy loss

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

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Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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Authors: Juan Huang, Hugo Ninanya

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Oil has been used as a source of energy and supply to make materials, such as asphalt or rubber for many years. This is the reason why new technologies have been implemented through time. However, research still needs to continue increasing due to new challenges engineers face every day, just like unconventional reservoirs. Various numerical methodologies have been applied in petroleum engineering as tools in order to optimize the production of reservoirs before drilling a wellbore, although not all of these have the same efficiency when talking about studying fracture propagation. Analytical methods like those based on linear elastic fractures mechanics fail to give a reasonable prediction when simulating fracture propagation in ductile materials whereas numerical methods based on the cohesive zone method (CZM) allow to represent the elastoplastic behavior in a reservoir based on a constitutive model; therefore, predictions in terms of displacements and pressure will be more reliable. In this work, a hydro-geomechanical coupled model of horizontal wells in fractured rock was developed using ABAQUS; both extended element method and cohesive elements were used to represent predefined fractures in a model (2-D). A power law for representing the rheological behavior of fluid (shear-thinning, power index <1) through fractures and leak-off rate permeating to the matrix was considered. Results have been showed in terms of aperture and length of the fracture, pressure within fracture and fluid loss. It was showed a high infiltration rate to the matrix as power index decreases. A sensitivity analysis is conclusively performed to identify the most influential factor of fluid loss.

Keywords: fracture, hydro-geomechanical model, non-Newtonian fluid, numerical analysis, sensitivity analysis

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Authors: N. K. Thakur

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A major proportion of the formations drilled for the production of hydrocarbons consists of clay containing shales. The petroleum industry has hugely investigated the role of clay minerals and their subsequent effect on wellbore stability during the drilling and production of hydrocarbons. It has been found that when the shale formation comes in contact with water-based drilling fluid, the interaction of clay minerals like montmorillonite with infiltrated water leads to hydration of the clay minerals, which causes shale swelling. When shale swelling proceeds further, it may lead to major drilling complications like caving, pipe sticking, which invariably influences wellbore stability, wellbore diameter, the mechanical strength of shale, stress distribution in the wellbore, etc. These problems ultimately lead to an increase in nonproductive time and additional costs during drilling. Several additives are used to prevent shale instability. Among the popular additives used for shale inhibition in drilling muds, ionic liquids and nanoparticles are emerging to be the best additives. The efficiency of the proposed additives will be studied and compared with conventional clay inhibitors like KCl. The main objective is to develop a highly efficient water-based mud for mitigating shale instability and reducing fluid loss which is environmentally friendly and does not alter the formation permeability. The use of nanoparticles has been exploited to enhance the rheological and fluid loss properties in water-based drilling fluid ionic liquid have attracted significant research interest due to its unique thermal stability. It is referred to as ‘green chemical’. The preliminary experimental studies performed are promising. The application of more effective mud additives is always desirable to make the drilling process techno-economically proficient.

Keywords: ionic liquid, shale inhibitor, wellbore stability, unconventional

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Authors: Maria Arechavaleta, Mark Halpin

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In the United States, costs of solar energy systems have declined to the point that they are viable options for most consumers. However, there are no consistent procedures for specifying sufficient systems. The factors that must be considered are energy consumption, potential solar energy production, and cost. The traditional method of specifying solar energy systems is based on assumed daily levels of available solar energy and average amounts of daily energy consumption. The mismatches between energy production and consumption are usually mitigated using battery energy storage systems, and energy use is curtailed when necessary. The main consumer decision question that drives the total system cost is how much unserved (or curtailed) energy is acceptable? Of course additional solar conversion equipment can be installed to provide greater peak energy production and extra energy storage capability can be added to mitigate longer lasting low solar energy production periods. Each option increases total cost and provides a benefit which is difficult to quantify accurately. An approach to quantify the cost-benefit of adding additional resources, either production or storage or both, based on the statistical concepts of loss-of-energy probability and expected unserved energy, is presented in this paper. Relatively simple calculations, based on site-specific energy availability and consumption data, can be used to show the value of each additional increment of production or storage. With this incremental benefit-cost information, consumers can select the best overall performance combination for their application at a cost they are comfortable paying. The approach is based on a statistical analysis of energy consumption and production characteristics over time. The characteristics are in the forms of curves with each point on the curve representing an energy consumption or production value over a period of time; a one-minute period is used for the work in this paper. These curves are measured at the consumer location under the conditions that exist at the site and the duration of the measurements is a minimum of one week. While greater accuracy could be obtained with longer recording periods, the examples in this paper are based on a single week for demonstration purposes. The weekly consumption and production curves are overlaid on each other and the mismatches are used to size the battery energy storage system. Loss-of-energy probability and expected unserved energy indices are calculated in addition to the total system cost. These indices allow the consumer to recognize and quantify the benefit (probably a reduction in energy consumption curtailment) available for a given increase in cost. Consumers can then make informed decisions that are accurate for their location and conditions and which are consistent with their available funds.

Keywords: battery energy storage systems, loss of load probability, residential renewable energy, solar energy systems

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Authors: Teja Sai Puligadda

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Satellite images in detail can serve an important role in the geographic study. Quantitative and qualitative information provided by the satellite and remote sensing images minimizes the complexity of work and time. Data/images are captured at regular intervals by satellite remote sensing systems, and the amount of data collected is often enormous, and it expands rapidly as technology develops. Interpreting remote sensing images, geographic data mining, and researching distinct vegetation types such as agricultural and forests are all part of satellite image categorization. One of the biggest challenge data scientists faces while classifying satellite images is finding the best suitable classification algorithms based on the available that could able to classify images with utmost accuracy. In order to categorize satellite images, which is difficult due to the sheer volume of data, many academics are turning to deep learning machine algorithms. As, the CNN algorithm gives high accuracy in image recognition problems and automatically detects the important features without any human supervision and the ANN algorithm stores information on the entire network (Abhishek Gupta., 2020), these two deep learning algorithms have been used for satellite image classification. This project focuses on remote sensing through Deep Neural Networks i.e., ANN and CNN with Deep Sat (SAT-4) Airborne dataset for classifying images. Thus, in this project of classifying satellite images, the algorithms ANN and CNN are implemented, evaluated & compared and the performance is analyzed through evaluation metrics such as Accuracy and Loss. Additionally, the Neural Network algorithm which gives the lowest bias and lowest variance in solving multi-class satellite image classification is analyzed.

Keywords: artificial neural network, convolutional neural network, remote sensing, accuracy, loss

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Authors: Nisha Thapa, Ram Prasad Mainali, Prakriti Chand

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Broadleaf mustard is a commercialized leafy vegetable of Nepal. However, its utilization is hindered in terms of production and productivity due to the high intensity of insects, pests, and diseases causing great loss. The plant protection part of the crop’s disease and damage intensity has not been studied much from research perspectives in Nepal. The research aimed to evaluate broadleaf mustard genotypes for resistance against different diseases. A total of 35 native genotypes of broadleaf mustard were screened at weekly intervals by scoring the plants for ten weeks. Five different diseases, such as Rhizoctonia root rot, Alternaria blight, black rot, turnip mosaic virus disease, and white rust, were reported from the broad leaf mustard genotypes. Out of 35 genotypes, 23 genotypes were found with very high Rhizoctonia Root Rot severity, whereas 8 genotypes showed very high Alternaria blight severity. Likewise, 3 genotypes were found with high Black rot severity, and 1 genotype was found with very high Turnip mosaic virus disease incidence. Similarly, 2 genotypes were found to have very high White rust severity. Among the disease of national importance, Rhizoctonia root rot was found to be the most severe disease with the greatest loss. Broadleaf mustard genotypes like Rato Rayo, CO 1002, and CO 11007 showed average to the high level of field resistance; therefore, these genotypes should be used, conserved, and stored in a mustard improvement program as the disease resistance quality or susceptibility of these genotypes can be helpful for seed producing farmers, companies and other stakeholders through varietal improvement and developmental works that further aids in sustainable disease management of the vegetable.

Keywords: genotype, disease resistance, Rhizoctonia root rot severity, varietal improvement

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Authors: Najlaa Yousef Qusti, Steven J. Brookes, Paul A. Brunton

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Background: Tooth discoloration can be an aesthetic problem, and tooth whitening using carbamide peroxide bleaching agents are a popular treatment option. However, there are concerns about possible adverse effects such as demineralisation of the bleached enamel; however, the cause of this demineralisation is unclear. Introduction: Teeth can become stained or discoloured over time. Tooth whitening is an aesthetic solution for tooth discoloration. Bleaching solutions of 10% carbamide peroxide (CP) have become the standard agent used in dentist-prescribed and home-applied ’vital bleaching techniques’. These materials release hydrogen peroxide (H₂O₂), the active whitening agent. However, there is controversy in the literature regarding the effect of bleaching agents on enamel integrity and enamel mineral content. The purpose of this study was to establish if carbamide peroxide bleaching agents affect the acid solubility of enamel (i.e., make teeth more prone to demineralisation). Materials and Methods: Twelve human premolar teeth were sectioned longitudinally along the midline and varnished to leave the natural enamel surface exposed. The baseline behavior of each tooth half in relation to its demineralisation in acid was established by sequential exposure to 4 vials containing 1ml of 10mM acetic acid (1 minute/vial). This was followed by exposure to 10% CP for 8 hours. After washing in distilled water, the tooth half was sequentially exposed to 4 further vials containing acid to test if the acid susceptibility of the enamel had been affected. The corresponding tooth half acted as a control and was exposed to distilled water instead of CP. The mineral loss was determined by measuring [Ca²⁺] and [PO₄³⁻] released in each vial using a calcium ion-selective electrode and the phosphomolybdenum blue method, respectively. The effect of bleaching on the tooth surfaces was also examined using SEM. Results: Exposure to carbamide peroxide did not significantly alter the susceptibility of enamel to acid attack, and SEM of the enamel surface revealed a slight alteration in surface appearance. SEM images of the control enamel surface showed a flat enamel surface with some shallow pits, whereas the bleached enamel appeared with an increase in surface porosity and some areas of mild erosion. Conclusions: Exposure to H₂O₂ equivalent to 10% CP does not significantly increase subsequent acid susceptibility of enamel as determined by Ca²⁺ release from the enamel surface. The effects of bleaching on mineral loss were indistinguishable from distilled water in the experimental system used. However, some surface differences were observed by SEM. The phosphomolybdenum blue method for phosphate is compromised by peroxide bleaching agents due to their oxidising properties. However, the Ca²⁺ electrode is unaffected by oxidising agents and can be used to determine the mineral loss in the presence of peroxides.

Keywords: bleaching, carbamide peroxide, demineralisation, teeth whitening

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Authors: Harish Bisht, Bahadur Singh Kotlia, Kireet Kumar

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In order to reconstruct past retreating rates, total area loss, volume change and shift in snout position were measured through multi-temporal satellite data from 1989 to 2016 and kinematic GPS survey from 2015 to 2016. The results obtained from satellite data indicate that in the last 27 years, Chaturangi glacier snout has retreated 1172.57 ± 38.3 m (average 45.07 ± 4.31 m/year) with a total area and volume loss of 0.626 ± 0.001 sq. Km and 0.139 Km³, respectively. The field measurements through differential global positioning system survey revealed that the annual retreating rate was 22.84 ± 0.05 m/year. The large variations in results derived from both the methods are probably because of higher difference in their accuracy. Snout monitoring of the Gangotri glacier during the ablation season (May to September) in the years 2005 and 2015 reveals that the retreating rate has been comparatively more declined than that shown by the earlier studies. The GPS dataset shows that the average recession rate is 10.26 ± 0.05 m/year. In order to determine the possible causes of decreased retreating rate, a relationship between debris thickness and melt rate was also established by using ablation stakes. The present study concludes that remote sensing method is suitable for large area and long term study, while kinematic GPS is more appropriate for the annual monitoring of retreating rate of glacier snout. The present study also emphasizes on mapping of all the tributary glaciers in order to assess the overall changes in the main glacier system and its health.

Keywords: Chaturangi glacier, Gangotri glacier, glacier snout, kinematic global positioning system, retreat rate

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Authors: Atwari Rawani, Suresh Prasad Sharma, K. D. P. Singh

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In this paper, an analytical investigation based on energy and exergy analysis of the parabolic trough collector (PTC) with alternate clockwise and counter-clockwise twisted tape inserts in the absorber tube has been presented. For fully developed flow under quasi-steady state conditions, energy equations have been developed in order to analyze the rise in fluid temperature, thermal efficiency, entropy generation and exergy efficiency. Also the effect of system and operating parameters on performance have been studied. A computer program, based on mathematical models is developed in C++ language to estimate the temperature rise of fluid for evaluation of performances under specified conditions. For numerical simulations four different twist ratio, x = 2,3,4,5 and mass flow rate 0.06 kg/s to 0.16 kg/s which cover the Reynolds number range of 3000 - 9000 is considered. This study shows that twisted tape inserts when used shows great promise for enhancing the performance of PTC. Results show that for x=1, Nusselt number/heat transfer coefficient is found to be 3.528 and 3.008 times over plain absorber of PTC at mass flow rate of 0.06 kg/s and 0.16 kg/s respectively; while corresponding enhancement in thermal efficiency is 12.57% and 5.065% respectively. Also the exergy efficiency has been found to be 10.61% and 10.97% and enhancement factor is 1.135 and 1.048 for same set of conditions.

Keywords: exergy efficiency, twisted tape ratio, turbulent flow, useful heat gain

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Authors: Alessandro Preziosi, Antonio Prioletti, Luca Castangia

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Deformable part models achieve high precision in pedestrian recognition, but all publicly available implementations are too slow for real-time applications. We implemented a deformable part model algorithm fast enough for real-time use by exploiting information about the camera position and orientation. This implementation is both faster and more precise than alternative DPM implementations. These results are obtained by computing convolutions in the frequency domain and using lookup tables to speed up feature computation. This approach is almost an order of magnitude faster than the reference DPM implementation, with no loss in precision. Knowing the position of the camera with respect to horizon it is also possible prune many hypotheses based on their size and location. The range of acceptable sizes and positions is set by looking at the statistical distribution of bounding boxes in labelled images. With this approach it is not needed to compute the entire feature pyramid: for example higher resolution features are only needed near the horizon. This results in an increase in mean average precision of 5% and an increase in speed by a factor of two. Furthermore, to reduce misdetections involving small pedestrians near the horizon, input images are supersampled near the horizon. Supersampling the image at 1.5 times the original scale, results in an increase in precision of about 4%. The implementation was tested against the public KITTI dataset, obtaining an 8% improvement in mean average precision over the best performing DPM-based method. By allowing for a small loss in precision computational time can be easily brought down to our target of 100ms per image, reaching a solution that is faster and still more precise than all publicly available DPM implementations.

Keywords: autonomous vehicles, deformable part model, dpm, pedestrian detection, real time

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Authors: Juan Zhou, Lusan Liu, Yanzhong Zhu, Kuixuan Lin, Wenqian Cai, Yu Wang, Xing Wang

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During the past few decades, there has been an increase in the number of coastal land reclamation projects for residential, commercial and industrial purposes in more and more coastal cities of China, which led to the destruction of the wetlands and loss of the sensitive marine habitats. Meanwhile, the influences and nature of these projects attract widespread public and academic concern. For identifying the trend of landscape (esp. Coastal reclamation) and ecological environment changes, understanding of which interacted, and offering a general science for the development of regional plans. In the paper, a case study was carried out in Bohai Bay area, based on the analysis of remote sensing data. Land use maps were created for 1954, 1970, 1981, 1990, 2000 and 2010. Landscape metrics were calculated and illustrated that the degree of reclamation changes was linked to the hydrodynamic environment and macrobenthos community. The results indicated that the worst of the loss of initial areas occurred during 1954-1970, with 65.6% lost mostly to salt field; to 2010, Coastal reclamation area increased more than 200km² as artificial landscape. The numerical simulation of tidal current field in 2003 and 2010 respectively showed that the flow velocity in offshore became faster (from 2-5 cm/s to 10-20 cm/s), and the flow direction seem to go astray. These significant changes of coastline were not conducive to the spread of pollutants and degradation. Additionally, the dominant macrobenthos analysis from 1958 to 2012 showed that Musculus senhousei (Benson, 1842) spread very fast and had been the predominant species in the recent years, which was a disturbance tolerant species.

Keywords: Bohai Bay, coastal reclamation, landscape change, spatial patterns

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Authors: Padmini S. Navalgund, Manasi Naik, Ujwala Patil

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Road hump is a semi-cylindrical elevation on the road made across specific locations of the road. The vehicle needs to maneuver the hump by reducing the speed to avoid car damage and pass over the road hump safely. Road Humps on road surfaces, if identified in advance, help to maintain the security and stability of vehicles, especially in adverse visibility conditions, viz. night scenarios. We have proposed a deep learning architecture adaptation by implementing the MISH activation function and developing a new classification loss function called "Effective Focal Loss" for Indian road humps detection in adverse light scenarios. We captured images comprising of marked and unmarked road humps from two different types of cameras across South India to build a heterogeneous dataset. A heterogeneous dataset enabled the algorithm to train and improve the accuracy of detection. The images were pre-processed, annotated for two classes viz, marked hump and unmarked hump. The dataset from these images was used to train the single-stage object detection algorithm. We utilised an algorithm to synthetically generate reduced visible road humps scenarios. We observed that our proposed framework effectively detected the marked and unmarked hump in the images in clear and ad-verse light environments. This architectural adaptation sets up an option for early detection of Indian road humps in reduced visibility conditions, thereby enhancing the autonomous driving technology to handle a wider range of real-world scenarios.

Keywords: Indian road hump, reduced visibility condition, low light condition, adverse light condition, marked hump, unmarked hump, YOLOv9

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Authors: Ibrahima Farikou, Kolontchang Gatchou Alberic Lionel, Tsiagadgui Jean Gustave, Ngo Yamben Marie-Ange, Handy Eone Daniel

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Introduction: It was in 1956 that Ilizarov pioneered the concept of osteogenesis in distraction by the device that bears his name to help produce bone and soft tissue regeneration and bone consolidation. This technique is not widely used in Africa where, however, its applications are numerous (loss of bone substances, congenital or acquired malformations). Our goal is to bring the indications of Ilizarov's device back to our practice conditions. Methods: Our study was conducted in 2 hospitals over a period of 20 years. For the retrospective phase, this study included all complete usable records of patients operated on in the Ilizarov external fixator department, and for the prospective phase, all patients operated on in the departments with complete usable records. Our sample was consecutive and not exhaustive. Data were analyzed by SPSS software version 23.0. Results: A total of 52 patients were reviewed. The average age of our patients was 14.7 years. The sex ratio was 1.6 in favor of men. The lower limb was the most affected (49), with a predominance of the tibia (62.4%). The average elongation was 6.4 cm. Traumatic acquired pathologies (delayed union, malunion) represented 60.6%. The mean time to union was seven months. Correction of the limb length discrepancy or filling of loss of bone substance was obtained in 75% of cases. Functionally, 80.8% of the patients treated had regained autonomy at the end of treatment, but in 17.3% of the patients, pain and limping persisted. Conclusion: This technique should be popularized in Africa because the benefit that would accrue to patients is invaluable and would be an attractive alternative to many amputations sometimes carried out in Africa by despair.

Keywords: ilizarov, external fixator, limb lengthening, bone regeneration, africa

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Authors: Josef Voracek, Jan Sima

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The main purpose of our study is to state the basic types of fitness customers. This paper aims to create a specific customer typology in today’s fitness centres in the region of Prague. Our suggested typology of Prague fitness centres customers is based on answers to the questions: What are the customers like, what are their preferences, and what kinds of services do they use more often in Prague fitness centres? These are the main aspects of the presented typology. A survey was conducted on a sample of 1004 respondents from 48 fitness centres, which ran during May 2012. We used questionnaires and latent class analysis for the assessment and interpretation of data. Gender was especially the main filter criterion. In the population, there were 522 males and 482 females. Data were analysed using the LCA method. We identified 6 segments of typical customers, of which three are male and three are female. Each segment is influenced primarily by the age of customers, from which we can develop further characteristics, such as education, income, marital status, etc. Male segments use the main workout area above all, whilst female segments use a much wider range of services offered, for example, group exercises, personal training, and cardio theatres. LCA method was found to be the most suitable tool, because cluster analysis is very limited in the forms and numbers of variables and indicators. Models of 3 latent classes for each gender are optimal, as it is demonstrated by entropy indices and matrices of the likelihood of the membership to the classes. A probable weak point of the survey is the selection of fitness centres, because of the market in Prague is really specific.

Keywords: customer, fitness, latent class analysis, typology

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Authors: Wardatutthoyyibah, Satyawan Pudyatmoko, Sena Adi Subrata, Muhammad Ali Imron

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The proboscis monkey is an endemic species to the island of Borneo with conservation status IUCN (The International Union for Conservation of Nature) of endangered. The population of the monkey has a specific habitat and sensitive to habitat disturbances. As a consequence of increasing rates of land-use change in the last four decades, its population was reported significantly decreased. We quantified the effect of land use change on the proboscis monkey’s habitat through the species distribution modeling (SDM) approach with Maxent Software. We collected presence data and environmental variables, i.e., land cover, topography, bioclimate, distance to the river, distance to the road, and distance to the anthropogenic disturbance to generate predictive distribution maps of the monkeys. We compared two prediction maps for 2000 and 2015 data to represent the current habitat of the monkey. We overlaid the monkey’s predictive distribution map with the existing protected areas to investigate whether the habitat of the monkey is protected under the protected areas networks. The results showed that almost 50% of the monkey’s habitat reduced as the effect of land use change. And only 9% of the current proboscis monkey’s habitat within protected areas. These results are important for the master plan of conservation of the endangered proboscis monkey and provide scientific guidance for the future development incorporating biodiversity issue.

Keywords: endemic species, land use change, maximum entropy, spatial distribution

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Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

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Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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Authors: Qiongpeng Dan, Xiyao Li, Qiong Zhang, Yongzhen Peng

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The nutrients removal from wastewater is of great significance for global wastewater recycling and sustainable reuse. Traditional nitrogen and phosphorus removal processes are very dependent on the input of aeration and carbon sources, which makes it difficult to meet the low-carbon goal of energy saving and emission reduction. This study reported a proof-of-concept demonstration of integrating anammox and enhanced biological phosphorus removal (EBPR) by flocs management in a single-stage hybrid bioreactor (biofilms and flocs) for simultaneous nitrogen and phosphorus removal (SNPR). Excellent removal efficiencies of nitrogen (97.7±1.3%) and phosphorus (97.4±0.7%) were obtained in low C/N ratio (3.0±0.5) municipal wastewater treatment. Interestingly, with the loss of flocs, anammox bacteria (Ca. Brocadia) was highly enriched in biofilms, with relative and absolute abundances reaching up to 12.5% and 8.3×1010 copies/g dry sludge, respectively. The anammox contribution to nitrogen removal also rose from 32.6±9.8% to 53.4±4.2%. Endogenous denitrification by flocs was proven to be the main contributor to both nitrite and nitrate reduction, and flocs loss significantly promoted nitrite flow towards anammox, facilitating AnAOB enrichment. Moreover, controlling the floc's solid retention time at around 8 days could maintain a low poly-phosphorus level of 0.02±0.001 mg P/mg VSS in the flocs, effectively addressing the additional phosphorus removal burden imposed by the enrichment of phosphorus-accumulating organisms in biofilms. This study provides an update on developing a simple and feasible strategy for integrating anammox and EBPR for SNPR in mainstream municipal wastewater.

Keywords: anammox process, enhanced biological phosphorus removal, municipal wastewater, sustainable nutrients removal

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Gulcin Yildiz

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Drying (dehydration) is the process of removing water from food in order to preserve the food and an alternative to reduce post-harvest loss of fruits. Different pre-treatment methods have been developed for fruit drying, such as ultrasound. If no pre-treatment is done, the fruits will continue to darken after they are dried. However, the effects of ultrasound as pre-treatment on drying of apples has not been well documented. This study was undertaken to investigate the effect of ultrasound as pre-treatment before oven drying of red delicious and golden delicious apples. Red delicious and golden delicious apples were dried in different temperatures. Before performing drying experiments in an oven at 50, 75 and 100 °C, ultrasound as pretreatment was applied in 5, 10, and 15 minutes. Colors of the dried apples were measured with a Minolta Chroma Meter CR-300 (Minolta Camera Co. Ltd., Osaka, Japan) by directly holding the device vertically to the surface of the samples. Content of total phenols was determined spectrophotometrically with the FolinCiocalteau assay, and the antioxidant capacity was evaluated by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. The samples (both red delicious and golden delicious apples) with longer ultrasound treatment produced higher weight loss due to the changes in tissue structure. However less phenolic content and antioxidant capacity were observed for the samples with longer ultrasound pre-treatment. The highest total phenolic content (TPC) was determined in dried apples at 75 °C with 5 minutes pre-treatment ultrasound and the lowest TPC was determined in dried apples at 50 °C with 15 minutes pre-treatment ultrasound which was subjected to the longest ultrasound pre-treatment and drying. The combination of 5 min of ultrasound pre-treatment and 75 °C of oven-drying showed to be the best combination for an energy efficient process. This combination exhibited good antioxidant properties as well. The present study clearly demonstrated that applying ultrasound as pre-treatment for drying of apples is an effective process in terms of quality of dried products, time, and energy.

Keywords: golden delicious apples, red delicious apples, total phenolic content, Ultrasound

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Authors: Abdelrahman Elsehsah

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The main objective of this study is to assess changes in the water capacity of Aswan High Dam Lake (AHDL) caused by evaporation and seepage losses. To achieve this objective, a comprehensive methodology was employed. The methodology involves acquiring Sentinel-3 imagery and extracting the surface area of the lake using remote sensing techniques. Using water areas calculated from sentinel images, collected field data, and the lake’s water balance equation, monthly evaporation and seepage losses were estimated for the years 2021 and 2022. Based on the water balance method results, the average monthly evaporation losses for the year 2021 were estimated to be around 1.41 billion cubic meters (Bm3), which closely matches the estimates provided by the Ministry of Water Resources and Irrigation (MWRI) annual reports (approximately 1.37 Bm3 in the same year). This means that the water balance method slightly overestimated the monthly evaporation losses by about 2.92%. Similarly, the average monthly seepage losses for the year 2022 were estimated to be around 0.005 Bm3, while the MWRI reports indicated approximately 0.0046 Bm3. By another means, the water balance method overestimated the monthly seepage losses by about 8.70%. Furthermore, the study found that the average monthly evaporation rate within AHDL was 210.88 mm/month, which closely aligns with the computed value of approximately 204.9 mm/month by AHDA. These findings indicated that the applied water balance method, utilizing remote sensing and field data, is a reliable tool for estimating monthly evaporation and seepage losses as well as monthly evaporation rates in AHDL.

Keywords: Aswan high dam lake, remote sensing, water balance equation, seepage loss, evaporation loss

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Authors: D. Sarkar, M. Pal, A. K. Sarkar

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Asphaltic concrete for pavement construction in India are produced by using crushed stone, gravels etc. as aggregate. In north-Eastern region of India, there is a scarcity o f stone aggregate. Therefore the road engineers are always in search of an optional material as aggregate which can replace the regularly used material. The purpose of this work was to evaluate the utilization of substandard or marginal aggregates in flexible pavement construction. The investigation was undertaken to evaluate the effects of using lower quality aggregates such as over burnt brick aggregate on the preparation of asphalt concrete for flexible pavements. The scope of this work included a review of available literature and existing data, a laboratory evaluation organized to determine the effects of marginal aggregates and potential techniques to upgrade these substandard materials, and a laboratory evaluation of these upgraded marginal aggregate asphalt mixtures. Over burnt brick aggregates are water susceptible and can leads to moisture damage. Moisture damage is the progressive loss of functionality of the material owing to loss of the adhesion bond between the asphalt binder and the aggregate surface. Hence, zycosoil as an anti striping additive were evaluated in this study. This study summarizes the results of the laboratory evaluation carried out to investigate the properties of asphalt concrete prepared with zycosoil modified over burnt brick aggregate. Marshall specimen were prepared with stone aggregate, zycosoil modified stone aggregate, over burnt brick aggregate and zycosoil modified over burnt brick aggregate. Results show that addition of zycosoil with stone aggregate increased stability by 6% and addition of zycosoil with over burnt brick aggregate increased stability by 30%.

Keywords: asphalt concrete, over burnt brick aggregate, marshall stability, zycosoil

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: Thipsupar Pureprasert, Niwat Anuwongnukroh, Surachai Dechkunakorn, Surapich Loykulanant, Chaveewan Kongkaew, Wassana Wichai

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Objective: Orthodontic elastic bands made from natural rubber continue to be commonly used due to their favorable characteristics. However, there are concerns associated cytotoxicity due to harmful components released during conventional vulcanization (sulfur-based method). With the co-operation of The National Metal and Materials Technology Center (MTEC) and Faculty of Dentistry Mahidol University, a method was introduced to reduce toxic components by leaching the orthodontic elastic bands with NaOH solution. Objectives: To evaluate the mechanical properties of Thai and commercial orthodontic elastic brands (Ormco and W&H) leached with NaOH solution. Material and methods: Three elastic brands (N =30, size ¼ inch, 4.5 oz.) were tested for mechanical properties in terms of initial extension force, residual force, force loss, breaking strength and maximum displacement using a Universal Testing Machine. Results : Force loss significantly decreased in Thai-LEACH and W&H-LEACH, whereas the values increased in Ormco-LEACH (P < 0.05). The data exhibited a significantly decrease in breaking strength with Thai-LEACH and Ormco-LEACH, whereas all 3 brands revealed a significantly decrease in maximum displacement with the leaching process (P < 0.05). Conclusion: Leaching with NaOH solution is a new method, which can remove toxic components from orthodontic latex elastic bands. However, this process can affect their mechanical properties. Leached elastic bands from Thai had comparable properties with Ormco and have potential to be developed as a promising product.

Keywords: leaching, orthodontic elastics, natural rubber latex, orthodontic

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Authors: S. Sharma, Gaballa Aqeelah, Tawfig Alghbaili, Ali Elmessmari

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There were abrupt discontinuities in the Brute Stack in the northernmost locations during the acquisition of 2D (2007) and 3D (2021) seismic data in the northwest region of the Ghadames Basin, Libya. In both campaigns, complete fluid circulation loss was seen in these regions during up-hole drilling. Geophysics, sedimentology and shallow subsurface geology were all integrated to look into what was causing the seismic signal to disappear at shallow depths. The Upper Cretaceous Nalut Formation is the near-surface or surface formation in the studied area. It is distinguished by abnormally high resistivity in all the neighboring wells. The Nalut Formation in all the nearby wells from the present study and previous outcrop study suggests lithology of dolomite and chert/flint in nodular or layered forms. There are also reports of karstic caverns, vugs, and thick cracks, which all work together to produce the high resistivity. Four up-hole samples that were analyzed for microfacies revealed a near-coastal to tidal environment. Algal (Chara) infested deposits up to 30 feet thick and monotonous, very porous, are seen in two up-hole sediments; these deposits are interpreted to be scattered, continental algal travertine mounds. Chert/flint, dolomite, and calcite in varying amounts are confirmed by XRD analysis. Regional tracking of the high resistivity of the Nalut Formation, which is thought to be connected to the sea level drop that created the paleokarst layer, is possible. It is abruptly overlain by a blanket marine transgressive deposit caused by rapid sea level rise, which is a regional, relatively high radioactive layer of argillaceous limestone. The examined area's close proximity to the mountainous, E-W trending ridges of northern Libya made it easier for recent freshwater circulation, which later enhanced cavern development and mineralization in the paleokarst layer. Seismic signal loss at shallow depth is caused by extremely heterogeneous mineralogy of pore- filling or lack thereof. Scattering effect of shallow karstic layer on seismic signal has been well documented. Higher velocity inflection points at shallower depths in the northern part and deeper intervals in the southern part, in both cases at Nalut level, demonstrate the layer's influence on the seismic signal. During the Permian-Carboniferous, the Ghadames Basin underwent uplift and extensive erosion, which resulted in this karstic layer of the Nalut Formation uplifted to a shallow depth in the northern part of the studied area weakening the acoustic signal, whereas in the southern part of the 3D acquisition area the Nalut Formation remained at the deeper interval without affecting the seismic signal. Results from actions taken during seismic processing to deal with this signal loss are visible and have improved. This study recommends using denser spacing or dynamite to circumvent the karst layer in a comparable geographic area in order to prevent signal loss at lesser depths.

Keywords: well logging, seismic data acquisition, sesimic data processing, up-holes

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Authors: Anthony D. Rhodes, Manan Goel

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We provide a high fidelity deep learning algorithm (HyperSeg) for interactive video segmentation tasks using a dense convolutional network with context-aware skip connections and compressed, 'hypercolumn' image features combined with a convolutional tessellation procedure. In order to maintain high output fidelity, our model crucially processes and renders all image features in high resolution, without utilizing downsampling or pooling procedures. We maintain this consistent, high grade fidelity efficiently in our model chiefly through two means: (1) we use a statistically-principled, tensor decomposition procedure to modulate the number of hypercolumn features and (2) we render these features in their native resolution using a convolutional tessellation technique. For improved pixel-level segmentation results, we introduce a boundary loss function; for improved temporal coherence in video data, we include temporal image information in our model. Through experiments, we demonstrate the improved accuracy of our model against baseline models for interactive segmentation tasks using high resolution video data. We also introduce a benchmark video segmentation dataset, the VFX Segmentation Dataset, which contains over 27,046 high resolution video frames, including green screen and various composited scenes with corresponding, hand-crafted, pixel-level segmentations. Our work presents a improves state of the art segmentation fidelity with high resolution data and can be used across a broad range of application domains, including VFX pipelines and medical imaging disciplines.

Keywords: computer vision, object segmentation, interactive segmentation, model compression

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Authors: Pakawhat Khumkhreung, Yottana Khunatorn

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The flow pattern inside rectangular intake air duct of 300 MW lignite coal-fired power plant is investigated in order to analyze and reduce overall inlet system pressure drop. The system consists of the 45-degree inlet elbow, the flow instrument, the 90-degree mitered elbow and fans, respectively. The energy loss in each section can be determined by Bernoulli’s equation and ASHRAE standard table. Hence, computational fluid dynamics (CFD) is used in this study based on Navier-Stroke equation and the standard k-epsilon turbulence modeling. Input boundary condition is 175 kg/s mass flow rate inside the 11-m² cross sectional duct. According to the inlet air flow rate, the Reynolds number of airstream is 2.7x10⁶ (based on the hydraulic duct diameter), thus the flow behavior is turbulence. The numerical results are validated with the real operation data. It is found that the numerical result agrees well with the operating data, and dominant loss occurs at the flow rate measurement device. Normally, the air flow rate is measured by the airfoil and it gets high pressure drop inside the duct. To overcome this problem, the airfoil is planned to be replaced with the other type measuring instrument, such as the average pitot tube which generates low pressure drop of airstream. The numerical result in case of average pitot tube shows that the pressure drop inside the inlet airstream duct is decreased significantly. It should be noted that the energy consumption of inlet air system is reduced too.

Keywords: airfoil, average pitot tube, combustion air, CFD, pressure drop, rectangular duct

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Authors: Tiziana Biasutti, Daniela Rigamonti, Lorenzo Palmiotti, Adelaide Nespoli, Paolo Bettini

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Aerospace industry is based on the continuous development of new technologies and solutions that allows constant improvement of the systems. Shape Memory Alloys are smart materials that can be used as dampers due to their pseudoelastic effect. The purpose of the research was to design a passive damper in Nitinol, manufactured by Selective Laser Melting, for space applications to reduce vibration between different structural parts in space structures. The powder is NiTi (50.2 at.% of Ni). The structure manufactured by additive technology allows us to eliminate the presence of joint and moving parts and to have a compact solution with high structural strength. The designed dampers had single or double cell structures with three different internal angles (30°, 45° and 60°). This particular shape has damping properties also without the pseudoelastic effect. For this reason, the geometries were reproduced in different materials, SS316L and Ti6Al4V, to test the geometry loss factor. The mechanical performances of these specimens were compared to the ones of NiTi structures, pointing out good damping properties of the designed structure and the highest performances of the NiTi pseudoelastic effect. The NiTi damper was mechanically characterized by static and dynamic tests and with DSC and microscope observations. The experimental results were verified with numerical models and with some scaled steel specimens in which optical fibers were embedded. The realized structure presented good mechanical and damping properties. It was observed that the loss factor and the dissipated energy increased with the angles of the cells.

Keywords: additive manufacturing, damper, nitinol, pseudo elastic effect, selective laser melting, shape memory alloys

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Sze Yee Lee

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The death of a sibling in childhood leads to significant impacts on both the personal and family development of the surviving siblings. Yet, the effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. In particular, there is a gap in the literature about the long term impacts on surviving siblings. This paper explores the experience of adult siblings encountering siblings’ death during childhood with the use of in-depth interviews. Through thematic analysis and in-depth interviews, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges, and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in a family atmosphere, family roles, family relationships, family communication, and parenting styles. More importantly, the author identifies (i) existing continuing bonds, (ii) crying, (iii) adequate social support, (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, 'child-centered' and 'family-centered' interventions for families with siblings' death in a Chinese context are discussed. With the use of age-appropriate language and children’s participation in the preparation of death and after-death arrangements, surviving siblings could be assisted in transforming bereavement into opportunities for growth. In addition, the bereaved family could better cope with grief with open communication platforms, adequate social support, and family education resources. Meanwhile, life-and-death education at both school and community levels could enhance the public’s awareness and understanding of the bereaved individuals to prevent creating further harm to them.

Keywords: children and adolescent bereavement, children-centered, family-centered, sibling’s death

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Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

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Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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