Search results for: surgical imaging

Authors: Carolina Zambrana, Grover Zurita

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The food loss production that occurs in deficient agricultural production is one of the major problems worldwide. This puts the population's food security and the efficiency of farming investments at risk. It is to be expected that this food security will be achieved with the own and efficient production of each country. It will have an impact on the well-being of its population and, thus, also on food sovereignty. The production losses in quantity and quality occur due to the lack of efficient detection of diseases at an early stage. It is very difficult to solve the agriculture efficiency using traditional methods since it takes a long time to be carried out due to detection imprecision of the main diseases, especially when the production areas are extensive. Therefore, the main objective of this research study is to perform a systematic literature review, of the latest five years, of Precision Agriculture (PA) to be able to understand the state of the art of the set of new technologies, procedures, and optimization processes with Artificial Intelligence (AI). This study will focus on Corns, Potatoes, and Rice diagnostic diseases. The extensive literature review will be performed on Elsevier, Scopus, and IEEE databases. In addition, this research will focus on advanced digital imaging processing and the development of software and hardware for PA. The convolution neural network will be handling special attention due to its outstanding diagnostic results. Moreover, the studied data will be incorporated with artificial intelligence algorithms for the automatic diagnosis of crop quality. Finally, precision agriculture with technology applied to the agricultural sector allows the land to be exploited efficiently. This system requires sensors, drones, data acquisition cards, and global positioning systems. This research seeks to merge different areas of science, control engineering, electronics, digital image processing, and artificial intelligence for the development, in the near future, of a low-cost image measurement system that allows the optimization of crops with AI.

Keywords: precision agriculture, convolutional neural network, deep learning, artificial intelligence

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Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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Authors: Sila Akhan, Muge Toygar, Murat Sayan, Simge Fidan

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Chronic viral hepatitis B, C, and D can cause hepatocellular carcinoma (HCC), cirrhosis and death. The proper treatment reduce the risk of development of HCC importantly, but not to zero point. Materials and Methods: We analysed retrospectively our chronic viral hepatitis B, C and D patients who attended to our Infectious Diseases policlinic between 2004-2018. From 589 biopsy-proven chronic hepatitis patients 3 have hepatocellular carcinoma on our follow up. First case is 74 years old patient. His HCV infection diagnosis was made 8 years ago. First treatment was pegylated interferon plus ribavirin only 28 weeks, because of HCV RNA breakthrough under treatment. In 2013 he was retreated with telaprevir, pegylated interferon plus ribavirin 24 weeks. But at the end of the therapy HCV RNA was found 1.290.000 IU/mL. He has abdominal ultrasonography (US) controls and alpha-fetoprotein (AFP) at 6 months intervals. All seemed normal until 2015 then he has an abdominal magnetic resonance imaging (MRI) and found HCC by chance. His treatment began in Oncology Clinic after verified with biopsy of HCC. And then sofosbuvir/ledipasvir was given to him for HCV 24 weeks. Sustained virologic response (SVR) was obtained. He is on cure for HCV infection and under control of Oncology for HCC. Second patient is 36 years old man. He knows his HBV infection since 2008. HBsAg and HBeAg positive; HDV RNA negative. Liver biopsy revealed grade:4, stage 3-4 according modified Knodell scoring system. In 2010 tenofovir treatment was began. His abdominal US and AFP were normal. His controls took place at 6 months intervals and HBV DNA negative, US, and AFP were normal until 2016 continuously. AFP found 37 above the normal range and then HCC was found in MRI. Third patient is 57 years old man. As hepatitis B infection was first diagnosed; he has cirrhosis and was began tenofovir as treatment. In short time he has HCC despite normal AFP values. Conclusion: In Mediterranian countries including Turkey naturally occurring pre-S/S variants are more than 75% of all chronic hepatitis B patients. This variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. HCV-induced development of HCC is a gradual process and is affected by the duration of disease and viral genotype. All the chronic viral hepatitis patients should be followed up in 6 months intervals not only with US and AFP for HCC. Despite they have proper treatment there is always the risk development of HCC. Chronic hepatitis patients cannot be dropped from follow up even treated well.

Keywords: HCC, HCV, HBV, DAA

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Authors: Yi Zhang, Yuan Tian, Jiehua Chen, Sihong Gu

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Chip-scale spin-exchange relaxation free (SERF) atomic magnetometer makes use of millimeter-scale vapor cells micro-fabricated by Micro-electromechanical Systems (MEMS) technique and SERF mechanism, resulting in the characteristics of high spatial resolution and high sensitivity. It is useful for biomagnetic imaging including magnetoencephalography and magnetocardiography. In a prevailing scheme, circularly polarized on-resonance laser beam is adapted for both pumping and probing the atomic polarization. And the magnetic-field-sensitive signal is extracted by transmission laser intensity enhancement as a result of atomic polarization increase on zero field level crossing resonance. The scheme is very suitable for integration, however, the laser amplitude modulation (AM) noise and laser frequency modulation to amplitude modulation (FM-AM) noise is superimposed on the photon shot noise reducing the signal to noise ratio (SNR). To suppress AM and FM-AM noise the paper puts forward a novel scheme which adopts circularly polarized on-resonance light pumping and linearly polarized frequency-detuning laser probing. The transmission beam is divided into transmission and reflection beams by a polarization analyzer, the angle between the analyzer's transmission polarization axis and frequency-detuning laser polarization direction is set to 45°. The magnetic-field-sensitive signal is extracted by polarization rotation enhancement of frequency-detuning laser which induces two beams intensity difference increase as the atomic polarization increases. Therefore, AM and FM-AM noise in two beams are common-mode and can be almost entirely canceled by differential detection. We have carried out an experiment to study our scheme. The experiment reveals that the noise in the differential signal is obviously smaller than that in each beam. The scheme is promising to be applied for developing more sensitive chip-scale magnetometer.

Keywords: atomic magnetometer, chip scale, differential detection, spin-exchange relaxation free

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Authors: Peter W. Woodruff, Georgios Ponirakis, Reem Ibrahim, Amani Ahmed, Hoda Gad, Ioannis N. Petropoulos, Adnan Khan, Ahmed Elsotouhy, Surjith Vattoth, Mahmoud K. M. Alshawwaf, Mohamed Adil Shah Khoodoruth, Marwan Ramadan, Anjushri Bhagat, James Currie, Ziyad Mahfoud, Hanadi Al Hamad, Ahmed Own, Peter Haddad, Majid Alabdulla, Rayaz A. Malik

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Introduction:- We aimed to test the hypothesis that, using corneal confocal microscopy (a non-invasive method for assessing corneal nerve fibre integrity), patients with schizophrenia would show neuronal abnormalities compared with healthy participants. Schizophrenia is a neurodevelopmental and progressive neurodegenerative disease, for which there are no validated biomarkers. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker that can be used to detect neuronal abnormalities in neuropsychiatric syndromes. Methods:- Patients with schizophrenia (DSM-V criteria) without other causes of peripheral neuropathy and healthy controls underwent CCM, vibration perception threshold (VPT) and sudomotor function testing. The diagnostic accuracy of CCM in distinguishing patients from controls was assessed using the area under the curve (AUC) of the Receiver Operating Characterstics (ROC) curve. Findings:- Participants with schizophrenia (n=17) and controls (n=38) with comparable age (35.7±8.5 vs 35.6±12.2, P=0.96) were recruited. Patients with schizophrenia had significantly higher body weight (93.9±25.5 vs 77.1±10.1, P=0.02), lower Low Density Lipoproteins (2.6±1.0 vs 3.4±0.7, P=0.02), but comparable systolic and diastolic blood pressure, HbA1c, total cholesterol, triglycerides and High Density Lipoproteins were comparable with control participants. Patients with schizophrenia had significantly lower corneal nerve fiber density (CNFD, fibers/mm2) (23.5±7.8 vs 35.6±6.5, p<0.0001), branch density (CNBD, branches/mm2) (34.4±26.9 vs 98.1±30.6, p<0.0001), and fiber length (CNFL, mm/mm2) (14.3±4.7 vs 24.2±3.9, p<0.0001) but no difference in VPT (6.1±3.1 vs 4.5±2.8, p=0.12) and electrochemical skin conductance (61.0±24.0 vs 68.9±12.3, p=0.23) compared with controls. The diagnostic accuracy of CNFD, CNBD and CNFL to distinguish patients with schizophrenia from healthy controls were, according to the AUC, (95% CI): 87.0% (76.8-98.2), 93.2% (84.2-102.3), 93.2% (84.4-102.1), respectively. Conclusion:- In conclusion, CCM can be used to help identify neuronal changes and has a high diagnostic accuracy to distinguish subjects with schizophrenia from healthy controls.

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Authors: Sofiya Rao, Sagnik Dey

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Aerosol-cloud-precipitation interaction continues to be one of the largest sources of uncertainty in quantifying the aerosol climate forcing. The uncertainty is increasing from global to regional scale. This problem remains unresolved due to the large discrepancy in the representation of cloud processes in the climate models. Most of the studies on aerosol-cloud-climate interaction and aerosol-cloud-precipitation over Indian Ocean (like INDOEX, CAIPEEX campaign etc.) are restricted to either particular to one season or particular to one region. Here we developed a theoretical framework to quantify aerosol indirect radiative forcing using Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol and cloud products of 15 years (2000-2015) period over the Indian Ocean. This framework relies on the observationally constrained estimate of the aerosol-induced change in cloud albedo. We partitioned the change in cloud albedo into the change in Liquid Water Path (LWP) and Effective Radius of Clouds (Reff) in response to an aerosol optical depth (AOD). Cloud albedo response to an increase in AOD is most sensitive in the range of LWP between 120-300 gm/m² for a range of Reff varying from 8-24 micrometer, which means aerosols are most sensitive to this range of LWP and Reff. Using this framework, aerosol forcing during a transition from indirect to semi-direct effect is also calculated. The outcome of this analysis shows best results over the Arabian Sea in comparison with the Bay of Bengal and the South Indian Ocean because of heterogeneity in aerosol spices over the Arabian Sea. Over the Arabian Sea during Winter Season the more absorbing aerosols are dominating, during Pre-monsoon dust (coarse mode aerosol particles) are more dominating. In winter and pre-monsoon majorly the aerosol forcing is more dominating while during monsoon and post-monsoon season meteorological forcing is more dominating. Over the South Indian Ocean, more or less same types of aerosol (Sea salt) are present. Over the Arabian Sea the Aerosol Indirect Radiative forcing are varying from -5 ± 4.5 W/m² for winter season while in other seasons it is reducing. The results provide observationally constrained estimates of aerosol indirect forcing in the Indian Ocean which can be helpful in evaluating the climate model performance in the context of such complex interactions.

Keywords: aerosol-cloud-precipitation interaction, aerosol-cloud-climate interaction, indirect radiative forcing, climate model

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Authors: Yasir E. Mohieldeen

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Qatar is one of the most water scarce countries in the World. In 2014, the average per capita rainfall was less than 29 m3/y/ca, while the global average is 6,000 m3/y/ca. However, the per capita water consumption in Qatar is among the highest in the World: more than 500 liters per person per day, whereas the global average is 160 liters per person per day. Since the early 2000s, Qatar has been relying heavily on desalinated water from the Arabian Gulf as the main source of fresh water. In 2009, about 99.9% of the total potable water produced was desalinated. Reliance on desalinated water makes Qatar very vulnerable to water related natural disasters, such as the red-tide phenomenon. Qatar’s strategic water reserve lasts for only 7 days. In case of red-tide outbreak, the country would not be able to desalinate water for days, let alone the months that this disaster would bring about (as it clogs the desalination equipment). The 2008-09 red-tide outbreak, for instance, lasted for more than eight months and forced the closure of desalination plants in the region for weeks. This study aims at identifying favorite conditions for red-tide outbreaks, using satellite data along with in-situ measurements. This identification would allow the prediction of these outbreaks and their hotspots. Prediction and monitoring of outbreaks are crucial to water security in the country, as different measures could be put in place in advance to prevent an outbreak and mitigate its impact if it happened. Red-tide outbreaks are detected using different algorithms for chlorophyll concentration in the Gulf waters. Vegetation indices, such as Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used along with Surface Algae Bloom Index (SABI) to detect known outbreaks. MODIS (or Moderate Resolution Imaging Spectroradiometer) bands are used to calculate these indices. A red-tide outbreaks atlas in the Arabian Gulf is being produced. Prediction of red-tide outbreaks ahead of their occurrences would give critical information on possible water-shortage in the country. Detecting known outbreaks in the past few decades and related parameters (e.g. water salinity, water surface temperature, nutrition, sandstorms, … etc) enables the identification of favorite conditions of red-tide outbreak that are key to the prediction of these outbreaks.

Keywords: Arabian Gulf, MODIS, red-tide detection, strategic water reserve, water desalination

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Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Alina Muradyan, Lina Babayan, Arsen Nanyan, Gohar Galstyan, Vigen Khachatryan

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We present a photometric method for identifying stars, galaxies and quasars in multi-color surveys, which uses a library of ∼> 65000 color templates for comparison with observed objects. The method aims for extracting the information content of object colors in a statistically correct way, and performs a classification as well as a redshift estimation for galaxies and quasars in a unified approach based on the same probability density functions. For the redshift estimation, we employ an advanced version of the Minimum Error Variance estimator which determines the redshift error from the redshift dependent probability density function itself. The method was originally developed for the Calar Alto Deep Imaging Survey (CADIS), but is now used in a wide variety of survey projects. We checked its performance by spectroscopy of CADIS objects, where the method provides high reliability (6 errors among 151 objects with R < 24), especially for the quasar selection, and redshifts accurate within σz ≈ 0.03 for galaxies and σz ≈ 0.1 for quasars. For an optimization of future survey efforts, a few model surveys are compared, which are designed to use the same total amount of telescope time but different sets of broad-band and medium-band filters. Their performance is investigated by Monte-Carlo simulations as well as by analytic evaluation in terms of classification and redshift estimation. If photon noise were the only error source, broad-band surveys and medium-band surveys should perform equally well, as long as they provide the same spectral coverage. In practice, medium-band surveys show superior performance due to their higher tolerance for calibration errors and cosmic variance. Finally, we discuss the relevance of color calibration and derive important conclusions for the issues of library design and choice of filters. The calibration accuracy poses strong constraints on an accurate classification, which are most critical for surveys with few, broad and deeply exposed filters, but less severe for surveys with many, narrow and less deep filters.

Keywords: VO, ArVO, DFBS, FITS, image processing, data analysis

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Authors: Eva Slaninova, Diana Cernayova, Zuzana Sedrlova, Katerina Mrazova, Petr Sedlacek, Jana Nebesarova, Stanislav Obruca

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Cyanobacteria are gram-negative prokaryotes belonging to a group of photosynthetic bacteria. In comparison with heterotrophic microorganisms, cyanobacteria utilize atmospheric nitrogen and carbon dioxide without any additional substrates. This ability of these microorganisms could be employed in biotechnology for the production of bioplastics, concretely polyhydroxyalkanoates (PHAs) which are primarily accumulated as a storage material in cells in the form of intracellular granules. In this study, there two cyanobacterial cultures from genera Synechocystis were used, namely Synechocystic sp. PCC 6803 and Synechocystis salina CCALA 192. There were optimized and used several various approaches, including microscopic techniques such as cryo-scanning electron microscopy (Cryo-SEM) and transmission electron microscopy (TEM), and fluorescence lifetime imaging microscopy using Nile red as a fluorescent probe (FLIM). Due to these instrumental techniques, the morphology of intracellular space and surface of cells were characterized. The next group of methods which were employed was spectroscopic techniques such as UV-Vis spectroscopy measured in two modes (turbidimetry and integration sphere) and Fourier transform infrared spectroscopy (FTIR). All these diverse techniques were used for the detection and characterization of pigments (chlorophylls, carotenoids, phycocyanin, etc.) and PHAs, in our case poly (3-hydroxybutyrate) (P3HB). To verify results, gas chromatography (GC) was employed concretely for the determination of the amount of P3HB in biomass. Cyanobacteria were also characterized as polyhydroxybutyrate producers by flow cytometer, which could count cells and at the same time distinguish cells including P3HB and without due to fluorescent probe called BODIPY and live/dead fluorescent probe SYTO Blue. Based on results, P3HB content in cyanobacteria cells was determined, as also the overall fitness of the cells. Acknowledgment: Funding: This study was partly funded by the projectGA19-29651L of the Czech Science Foundation (GACR) and partly funded by the Austrian Science Fund (FWF), project I 4082-B25.

Keywords: cyanobacteria, fluorescent probe, microscopic techniques, poly(3hydroxybutyrate), spectroscopy, chromatography

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Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

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Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Evan Lowhorn, Rocio Alba-Flores

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The purpose of this work is to develop a method for classifying hand signals and using the output in a drone control algorithm. To achieve this, methods based on Convolutional Neural Networks (CNN) were applied. CNN's are a subset of deep learning, which allows grid-like inputs to be processed and passed through a neural network to be trained for classification. This type of neural network allows for classification via imaging, which is less intrusive than previous methods using biosensors, such as EMG sensors. Classification CNN's operate purely from the pixel values in an image; therefore they can be used without additional exteroceptive sensors. A development bench was constructed using a desktop computer connected to a high-definition webcam mounted on a scissor arm. This allowed the camera to be pointed downwards at the desk to provide a constant solid background for the dataset and a clear detection area for the user. A MATLAB script was created to automate dataset image capture at the development bench and save the images to the desktop. This allowed the user to create their own dataset of 12,000 images within three hours. These images were evenly distributed among seven classes. The defined classes include forward, backward, left, right, idle, and land. The drone has a popular flip function which was also included as an additional class. To simplify control, the corresponding hand signals chosen were the numerical hand signs for one through five for movements, a fist for land, and the universal “ok” sign for the flip command. Transfer learning with PyTorch (Python) was performed using a pre-trained 18-layer residual learning network (ResNet-18) to retrain the network for custom classification. An algorithm was created to interpret the classification and send encoded messages to a Ryze Tello drone over its 2.4 GHz Wi-Fi connection. The drone’s movements were performed in half-meter distance increments at a constant speed. When combined with the drone control algorithm, the classification performed as desired with negligible latency when compared to the delay in the drone’s movement commands.

Keywords: classification, computer vision, convolutional neural networks, drone control

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Authors: Y. Teterin, S. Suleymanova, I. Dmitriev, P. Yartcev

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Introduction: One of the most common complications after pancreas transplantation are pancreatic fluid collections (PFCs), which are often complicated not only by infection and subsequent disfunction of the pancreatoduodenal graft (PDG), but also with a rather high mortality rate of recipients. Drainage is not always effective and often requires repeated open surgical interventions, which worsens the outcome of the surgery. Percutaneous drainage of PFCs combined with endoscopic stenting of the main pancreatic duct of the pancreatoduodenal graft (MPDPDG) showed high efficiency in the treatment of PFCs. Aims & Methods: From 01.01.2012 to 31.12.2021 at the Sklifosovsky Research Institute for Emergency Medicine were performed 64 transplantations of PDG. In 11 cases (17.2%), the early postoperative period was complicated by the formation of PFCs. Of these, 7 patients underwent percutaneous drainage of pancreonecrosis with high efficiency and did not required additional methods of treatment. In the remaining 4 patients, drainage was ineffective and was an indication for endoscopic stenting of the MPDPDG. They were the ones who made up the study group. Among them were 3 men and 1 woman. The mean age of the patients was 36,4 years.PFCs in these patients formed on days 1, 12, 18, and 47 after PDG transplantation. We used a gastroscope to stent the MPDPDG, due to anatomical features of the location of the duodenoduodenal anastomosis after PDG transplantation. Through the endoscope channel was performed selective catheterization of the MPDPDG, using a catheter and a guidewire, followed by its contrasting with a water-soluble contrast agent. Due to the extravasation of the contrast, was determined the localization of the defect in the PDG duct system. After that, a plastic pancreatic stent with a diameter of 7 Fr. and a length of 7 cm. was installed along guidewire. The stent was installed in such a way that its proximal edge completely covered the defect zone, and the distal one was determined in the intestinal lumen. Results: In all patients PDG pancreaticography revealed extravasation of a contrast in the area of the isthmus and body of the pancreas, which required stenting of the MPDPDG. In 1 (25%) case, the patient had a dislocation of the stent into the intestinal lumen (III degree according to Clavien-Dindo (2009)). This patient underwent repeated endoscopic stenting of the MPDPDG. On average 23 days after endoscopic stenting of the MPDPDG, the drainage tubes were removed and after approximately 40 days all patients were discharged in a satisfactory condition with follow-up endocrinologist and surgeon consultation. Pancreatic stents were removed after 6 months ± 7 days. Conclusion: Endoscopic stenting of the main pancreatic duct of the donor pancreas is by far the most highly effective and minimally invasive method in the treatment of PFCs after transplantation of the pancreatoduodenal complex.

Keywords: pancreas transplantation, endoscopy surgery, diabetes, stenting, main pancreatic duct

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Authors: Hassan Qandil

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Using a statistical algorithm incorporated in MATLAB, four types of non-imaging Fresnel lenses are designed; spot-flat, linear-flat, dome-shaped and semi-cylindrical-shaped. The optimization employs a statistical ray-tracing methodology of the incident light, mainly considering effects of chromatic aberration, varying focal lengths, solar inclination and azimuth angles, lens and receiver apertures, and the optimum number of prism grooves. While adopting an equal-groove-width assumption of the Poly-methyl-methacrylate (PMMA) prisms, the main target is to maximize the ray intensity on the receiver’s aperture and therefore achieving higher values of heat flux. The algorithm outputs prism angles and 2D sketches. 3D drawings are then generated via AutoCAD and linked to COMSOL Multiphysics software to simulate the lenses under solar ray conditions, which provides optical and thermal analysis at both the lens’ and the receiver’s apertures while setting conditions as per the Dallas-TX weather data. Once the lenses’ characterization is finalized, receivers are designed based on its optimized aperture size. Several cavity shapes; including triangular, arc-shaped and trapezoidal, are tested while coupled with a variety of receiver materials, working fluids, heat transfer mechanisms, and enclosure designs. A vacuum-reflective enclosure is also simulated for an enhanced thermal absorption efficiency. Each receiver type is simulated via COMSOL while coupled with the optimized lens. A lab-scale prototype for the optimum lens-receiver configuration is then fabricated for experimental evaluation. Application-based testing is also performed for the selected configuration, including that of a photovoltaic-thermal cogeneration system and solar furnace system. Finally, some future research work is pointed out, including the coupling of the collector-receiver system with an end-user power generator, and the use of a multi-layered genetic algorithm for comparative studies.

Keywords: COMSOL, concentrator, energy, fresnel, optics, renewable, solar

Procedia PDF Downloads 154

Authors: Zhengming Wu

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NanoFrazor lithography systems were developed as a first true alternative or extension to standard mask-less nanolithography methods like electron beam lithography (EBL). In contrast to EBL they are based on thermal scanning probe lithography (t-SPL). Here a heatable ultra-sharp probe tip with an apex of a few nm is used for patterning and simultaneously inspecting complex nanostructures. The heat impact from the probe on a thermal responsive resist generates those high-resolution nanostructures. The patterning depth of each individual pixel can be controlled with better than 1 nm precision using an integrated in-situ metrology method. Furthermore, the inherent imaging capability of the Nanofrazor technology allows for markerless overlay, which has been achieved with sub-5 nm accuracy as well as it supports stitching layout sections together with < 10 nm error. Pattern transfer from such resist features below 10 nm resolution were demonstrated. The technology has proven its value as an enabler of new kinds of ultra-high resolution nanodevices as well as for improving the performance of existing device concepts. The application range for this new nanolithography technique is very broad spanning from ultra-high resolution 2D and 3D patterning to chemical and physical modification of matter at the nanoscale. Nanometer-precise markerless overlay and non-invasiveness to sensitive materials are among the key strengths of the technology. However, while patterning at below 10 nm resolution is achieved, significantly increasing the patterning speed at the expense of resolution is not feasible by using the heated tip alone. Towards this end, an integrated laser write head for direct laser sublimation (DLS) of the thermal resist has been introduced for significantly faster patterning of micrometer to millimeter-scale features. Remarkably, the areas patterned by the tip and the laser are seamlessly stitched together and both processes work on the very same resist material enabling a true mix-and-match process with no developing or any other processing steps in between. The presentation will include examples for (i) high-quality metal contacting of 2D materials, (ii) tuning photonic molecules, (iii) generating nanofluidic devices and (iv) generating spintronic circuits. Some of these applications have been enabled only due to the various unique capabilities of NanoFrazor lithography like the absence of damage from a charged particle beam.

Keywords: nanofabrication, grayscale lithography, 2D materials device, nano-optics, photonics, spintronic circuits

Procedia PDF Downloads 72

Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

Procedia PDF Downloads 173

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

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BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

Procedia PDF Downloads 137

Authors: Preetham Shankapal, Jill King, Kori Murray, Corby Martin, Paula Giselman, Jason Hicks, Owen Carmicheal

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Activation of reward and satiety networks in the brain while processing palatable food cues, as well as functional connectivity during rest has been studied using functional Magnetic Resonance Imaging of the brain in various obesity phenotypes. However, functional connectivity within the reward and satiety network during food cue processing is understudied. 14 obese individuals underwent two fMRI scans during viewing of Macronutrient Picture System images. Each scan included two blocks of images of High Sugar/High Fat (HSHF), High Carbohydrate/High Fat (HCHF), Low Sugar/Low Fat (LSLF) and also non-food images. Seed voxels within seven food reward relevant ROIs: Insula, putamen and cingulate, precentral, parahippocampal, medial frontal and superior temporal gyri were isolated based on a prior meta-analysis. Beta series correlation for task-related functional connectivity between these seed voxels and the rest of the brain was computed. Voxel-level differences in functional connectivity were calculated between: first and the second scan; individuals who saw novel (N=7) vs. Repeated (N=7) images in the second scan; and between the HC/HF, HSHF blocks vs LSLF and non-food blocks. Computations and analysis showed that during food image viewing, reward network ROIs showed significant functional connectivity with each other and with other regions responsible for attentional and motor control, including inferior parietal lobe and precentral gyrus. These functional connectivity values were heightened among individuals who viewed novel HS/HF images in the second scan. In the second scan session, functional connectivity was reduced within the reward network but increased within attention, memory and recognition regions, suggesting habituation to reward properties and increased recollection of previously viewed images. In conclusion it can be inferred that Functional Connectivity within reward network and between reward and other brain regions, varies by important experimental conditions during food photography viewing, including habituation to shown foods.

Keywords: fMRI, functional connectivity, task-based, beta series correlation

Procedia PDF Downloads 270

Authors: Omar Khan, Shana Krstevska, Edwin George, Veronica Gorden, Fen Bao, Christina Caon, NP-C, Carla Santiago, Imad Zak, Navid Seraji-Bozorgzad

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Objective: To quantify cellular injury in the substantia nigra (SN) in patients with Parkinson's disease (PD) and to examine the effect of rasagiline of tissue injury in the SN in patients with PD. Background: N-acetylaspartate (NAA) quantified with MRS is a reliable marker of neuronal metabolic function. Fractional anisotropy (FA) and mean diffusivity (MD) obtained with DTI, characterize tissue alignment and integrity. Rasagline, has been shown to exert anti-apototic effect. We applied these advanced MRI techniques to examine: (i) the effect of rasagiline on cellular injury and metabolism in patients with early PD, and (ii) longitudinal changes seen over time in PD. Methods: We conducted a prospective longitudinal study in patients with mild PD, naive to dopaminergic treatment. The imaging protocol included multi-voxel proton-MRS and DTI of the SN, acquired on a 3T scanner. Scans were performed at baseline and month 3, during which the patient was on no treatment. At that point, rasagiline 1 mg orally daily was initiated and MRI scans are were obtained at 6 and 12 months after starting rasagiline. The primary objective was to compare changes during the 3-month period of “no treatment” to the changes observed “on treatment” with rasagiline at month 12. Age-matched healthy controls were also imaged. Image analysis was performed blinded to treatment allocation and period. Results: 25 patients were enrolled in this study. Compared to the period of “no treatment”, there was significant increase in the NAA “on treatment” period (-3.04 % vs +10.95 %, p= 0.0006). Compared to the period of “no treatment”, there was significant increase in following 12 month in the FA “on treatment” (-4.8% vs +15.3%, p<0.0001). The MD increased during “no treatment” and decreased in “on treatment” (+2.8% vs -7.5%, p=0.0056). Further analysis and clinical correlation are ongoing. Conclusions: Advanced MRI techniques quantifying cellular injury in the SN in PD is a feasible approach to investigate dopaminergic neuronal injury and could be developed as an outcome in exploratory studies. Rasagiline appears to have a stabilizing effect on dopaminergic cell loss and metabolism in the SN in PD, that warrants further investigation in long-term studies.

Keywords: substantia nigra, Parkinson's disease, MRI, neuronal loss, biomarker

Procedia PDF Downloads 315

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

Procedia PDF Downloads 249

Authors: Mohammad Afzal Khan, Fatimah Alanazi, Hala Abdalrahman Ahmed, Talal Shamma, Kilian Kelly, Mohammed A. Hammad, Abdullah O. Alawad, Abdullah Mohammed Assiri, Dieter Clemens Broering

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Lung transplantation is a life-saving surgical replacement of diseased lungs in patients with end-stage respiratory malfunctions. Despite the remarkable short-term recovery, long-term lung survival continues to face several significant challenges, including chronic rejection and severe toxic side-effects due to global immunosuppression. Stem cell-based immunotherapy has been recognized as a crucial immunoregulatory regimen in various preclinical and clinical studies. Despite initial therapeutic outcomes, conventional stem cells face key limitations. The Cymerus™ manufacturing facilitates the production of a virtually limitless supply of consistent human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells, which could play a key role in selective immunosuppression and graft repair during rejection. Here, we demonstrated the impact of iPSC-derived human MSCs on the development of immune-tolerance and long-term graft survival in mouse orthotopic airway allografts. BALB/c→C57BL/6 allografts were reconstituted with iPSC-derived MSCs (2 million/transplant/ at d0), and allografts were examined for regulatory T cells (Tregs), oxygenation, microvascular blood flow, airway epithelium and collagen deposition during rejection. We demonstrated that iPSC-derived MSC treatment leads to significant increase in tissue expression of hTSG-6 protein, followed by an upregulation of mouse Tregs and IL-5, IL-10, IL-15 cytokines, which augments graft microvascular blood flow and oxygenation, and thereby maintained a healthy airway epithelium and prevented the subepithelial deposition of collagen at d90 post-transplantation. Collectively, these data confirmed that iPSC-derived MSC-mediated immunosuppression has potential to establish immune-tolerance and rescue allograft from sustained hypoxic/ischemic phase and subsequently limits long-term airway epithelial injury and collagen progression, which therapeutically warrant a study of Cymerus iPSC-derived MSCs as a potential management option for immunosuppression in transplant recipients.

Keywords: stem cell therapy, immunotolerance, regulatory T cells, hypoxia and ischemia, microvasculature

Procedia PDF Downloads 158

Authors: Bagher Bayat, Wouter Verhoef, Behnaz Arabi, Christiaan Van der Tol

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The aim of this study was to follow the canopy reflectance patterns in response to soil water deficit and to detect trends of changes in biophysical and biochemical parameters of grass (Poa pratensis species). We used visual interpretation, imaging spectroscopy and radiative transfer model inversion to monitor the gradual manifestation of water stress effects in a laboratory setting. Plots of 21 cm x 14.5 cm surface area with Poa pratensis plants that formed a closed canopy were subjected to water stress for 50 days. In a regular weekly schedule, canopy reflectance was measured. In addition, Leaf Area Index (LAI), Chlorophyll (a+b) content (Cab) and Leaf Water Content (Cw) were measured at regular time intervals. The 1-D bidirectional canopy reflectance model SAIL, coupled with the leaf optical properties model PROSPECT, was inverted using hyperspectral measurements by means of an iterative optimization method to retrieve vegetation biophysical and biochemical parameters. The relationships between retrieved LAI, Cab, Cw, and Cs (Senescent material) with soil moisture content were established in two separated groups; stress and non-stressed. To differentiate the water stress condition from the non-stressed condition, a threshold was defined that was based on the laboratory produced Soil Water Characteristic (SWC) curve. All parameters retrieved by model inversion using canopy spectral data showed good correlation with soil water content in the water stress condition. These parameters co-varied with soil moisture content under the stress condition (Chl: R2= 0.91, Cw: R2= 0.97, Cs: R2= 0.88 and LAI: R2=0.48) at the canopy level. To validate the results, the relationship between vegetation parameters that were measured in the laboratory and soil moisture content was established. The results were totally in agreement with the modeling outputs and confirmed the results produced by radiative transfer model inversion and spectroscopy. Since water stress changes all parts of the spectrum, we concluded that analysis of the reflectance spectrum in the VIS-NIR-MIR region is a promising tool for monitoring water stress impacts on vegetation.

Keywords: hyperspectral remote sensing, model inversion, vegetation responses, water stress

Procedia PDF Downloads 225

Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

Procedia PDF Downloads 180

Authors: M. J. Gibbons, A. J. Robinson

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Increasing expectations on small form factor electronics to be more compact while increasing performance has driven conventional cooling technologies to a thermal management threshold. An emerging solution to this problem is electrospray (ES) cooling. ES cooling enables two phase cooling by utilising Coulomb forces for energy efficient fluid atomization. Generated charged droplets are accelerated to the grounded target surface by the applied electric field and surrounding gravitational force. While in transit the like charged droplets enable plume dispersion and inhibit droplet coalescence. If the electric field is increased in the cone-jet regime, a subsequent increase in the plume spray angle has been shown. Droplet segregation in the spray plume has been observed, with primary droplets in the plume core and satellite droplets positioned on the periphery of the plume. This segregation is facilitated by inertial and electrostatic effects. This result has been corroborated by numerous authors. These satellite droplets are usually more densely charged and move at a lower relative velocity to that of the spray core due to the radial decay of the electric field. Previous experimental research by Gomez and Tang has shown that the number of droplets deposited on the periphery can be up to twice that of the spray core. This result has been substantiated by a numerical models derived by Wilhelm et al., Oh et al. and Yang et al. Yang et al. showed from their numerical model, that by varying the extractor potential the dispersion radius of the plume also varies proportionally. This research aims to investigate this dispersion density and the role it plays in the local heat transfer coefficient profile (h) of ES cooling. This will be carried out for different extractor – target separation heights (H2), working fluid flow rates (Q), and extractor applied potential (V2). The plume dispersion will be recorded by spraying a 25 µm thick, joule heated steel foil and by recording the thermal footprint of the ES plume using a Flir A-40 thermal imaging camera. The recorded results will then be analysed by in-house developed MATLAB code.

Keywords: electronic cooling, electrospray, electrospray plume dispersion, spray cooling

Procedia PDF Downloads 397

Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

Procedia PDF Downloads 190

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

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Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

Procedia PDF Downloads 90

Authors: Linjie Zhang, Baifen Ren, Xi Zhang, Genwang Liu

Abstract:

Ship detection is of great significance for both military and civilian applications. Synthetic aperture radar (SAR) with all-day, all-weather, ultra-long-range characteristics, has been used widely. In view of the low time resolution of low orbit SAR and the needs for high time resolution SAR data, GEO (Geosynchronous orbit) SAR is getting more and more attention. Since GEO SAR has short revisiting period and large coverage area, it is expected to be well utilized in marine ship targets monitoring. However, the height of the orbit increases the time of integration by almost two orders of magnitude. For moving marine vessels, the utility and efficacy of GEO SAR are still not sure. This paper attempts to find the feasibility of GEO SAR by giving a GEO SAR simulator of moving ships. This presented GEO SAR simulator is a kind of geometrical-based radar imaging simulator, which focus on geometrical quality rather than high radiometric. Inputs of this simulator are 3D ship model (.obj format, produced by most 3D design software, such as 3D Max), ship's velocity, and the parameters of satellite orbit and SAR platform. Its outputs are simulated GEO SAR raw signal data and SAR image. This simulating process is accomplished by the following four steps. (1) Reading 3D model, including the ship rotations (pitch, yaw, and roll) and velocity (speed and direction) parameters, extract information of those little primitives (triangles) which is visible from the SAR platform. (2) Computing the radar scattering from the ship with physical optics (PO) method. In this step, the vessel is sliced into many little rectangles primitives along the azimuth. The radiometric calculation of each primitive is carried out separately. Since this simulator only focuses on the complex structure of ships, only single-bounce reflection and double-bounce reflection are considered. (3) Generating the raw data with GEO SAR signal modeling. Since the normal ‘stop and go’ model is not available for GEO SAR, the range model should be reconsidered. (4) At last, generating GEO SAR image with improved Range Doppler method. Numerical simulation of fishing boat and cargo ship will be given. GEO SAR images of different posture, velocity, satellite orbit, and SAR platform will be simulated. By analyzing these simulated results, the effectiveness of GEO SAR for the detection of marine moving vessels is evaluated.

Keywords: GEO SAR, radar, simulation, ship

Procedia PDF Downloads 177

Authors: Tesfaye Mengistu

Abstract:

Power cables play a crucial role in the transmission and distribution of electrical energy. As the electricity generation, transmission, distribution, and storage systems become smarter, there is a growing emphasis on incorporating intelligent approaches to ensure the reliability of power cables. Various types of electrical cables are employed for transmitting and distributing electrical energy, with cross-linked polyethylene (XLPE) cables being widely utilized due to their exceptional electrical and mechanical properties. However, insulation defects can occur in XLPE cables due to subpar manufacturing techniques during production and cable joint installation. To address this issue, experts have proposed different methods for monitoring XLPE cables. Some suggest the use of interdigital capacitive (IDC) technology for online monitoring, while others propose employing continuous wave (CW) terahertz (THz) imaging systems to detect internal defects in XLPE plates used for power cable insulation. In this study, we have developed models that employ a custom dataset collected locally to classify the physical safety status of individual power cables. Our models aim to replace physical inspections with computer vision and image processing techniques to classify defective power cables from non-defective ones. The implementation of our project utilized the Python programming language along with the TensorFlow package and a convolutional neural network (CNN). The CNN-based algorithm was specifically chosen for power cable defect classification. The results of our project demonstrate the effectiveness of CNNs in accurately classifying power cable defects. We recommend the utilization of similar or additional datasets to further enhance and refine our models. Additionally, we believe that our models could be used to develop methodologies for detecting power cable defects from live video feeds. We firmly believe that our work makes a significant contribution to the field of power cable inspection and maintenance. Our models offer a more efficient and cost-effective approach to detecting power cable defects, thereby improving the reliability and safety of power grids.

Keywords: artificial intelligence, computer vision, defect detection, convolutional neural net

Procedia PDF Downloads 112