Search results for: invasive procedure

Authors: Zahra Bakhtiari

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This article explores the development and evolution of the concept of environmental justice, which has shifted from being dominated by white and middle-class individuals to a civil struggle by marginalized communities against environmental injustices. Environmental justice aims to achieve equity in decision-making and policy-making related to the environment. The concept of justice in this context includes four fundamental aspects: distribution, procedure, recognition, and capabilities. Recent scholars have attempted to broaden the concept of justice to include dimensions of participation, recognition, and capabilities. Focusing on all four dimensions of environmental justice is crucial for effective planning and policy-making to address environmental issues. Ignoring any of these aspects can lead to the failure of efforts and the waste of resources.

Keywords: environmental justice, distribution, procedure, recognition, capabilities

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Authors: S. Suman, G. N. Singh

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The present manuscript addresses the estimation procedure of population parameter using Poisson probability distribution when characteristic under study possesses a rare sensitive attribute. The generalized form of unrelated randomized response model is suggested in order to acquire the truthful responses from respondents. The resultant estimators have been proposed for two situations when the information on an unrelated rare non-sensitive characteristic is known as well as unknown. The properties of the proposed estimators are derived, and the measure of confidentiality of respondent is also suggested for respondents. Empirical studies are carried out in the support of discussed theory.

Keywords: Poisson distribution, randomized response model, rare sensitive attribute, non-sensitive attribute

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Authors: Anand Ankush, Wani Mohammed Farooq

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A procedure based on digraph and matrix method is developed for modelling and evaluation of sustainability of Mechanical System in a concurrent engineering environment.The sustainability parameters of a Mechanical System are identified and are called sustainability attributes. Consideration of attributes and their interrelations is rudiment in modeling and evaluation of sustainability index. Sustainability attributes of a Mechanical System are modelled in termsof sustainability digraph. The graph is represented by a one-to-one matrix for sustainability expression which is based on sustainability attributes. A variable sustainability relationship permanent matrix is defined to develop sustainability expression(VPF-t) which is also useful in comparing two systems in a concurrent environment. The sustainability index of Mechanical System is obtained from permanent of matrix by substituting the numerical values of attributes and their interrelations. A higher value of index implies better sustainability of system.The ideal value of index is obtained from matrix expression which is useful in assessing relative sustainability of a Mechanical System in a concurrent engineering environment. The procedure is not only useful for evaluation of sustainability of a Mechanical System at conceptual design stage but can also be used for design and development of systems at system design stage. A step-by-step procedure for evaluation of sustainability index is also suggested and is illustrated by means of an example.

Keywords: digraph, matrix method, mechanical system, sustainability

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Authors: G. A. Kuanaliyeva, G. T. Aigarinova, G. K. Shulanbekova

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This article is devoted to judicial control in criminal legal proceedings of the Republic of Kazakhstan in the light of the new Concept of legal policy till 2020. In article the general characteristic and concept of judicial control, and also its signs and types are considered. Different views of scientists are analyzed. Foreign experiment on application of judicial control is given. The author states also the point sight on this problem and gives the definition to concept of judicial control. The code of criminal procedure of the Republic of Kazakhstan (RK Criminal Procedure Code) doesn't consolidate concept of judicial control. The author in article suggests making change and addition to the existing Code of criminal procedure of the Republic of Kazakhstan by definition of judicial control. The decree of the President of the Republic of Kazakhstan of August 24, 2009 No. 858 approved the Concept of legal policy of the Republic for the period from 2010 to 2020. The new Concept of legal policy of the Republic of Kazakhstan, defines prospects of development of national legal system of the country on the following decade. The concept of legal policy completely mentions also institute of judicial control. Since finding of the independence by Kazakhstan the set of laws, including the rights directed on providing, freedoms and a legitimate interest of citizens was accepted. Certainly, in any country, whatever democratic it was, there are problems to human rights. However, it is obvious that Kazakhstan strongly intends to guarantee all Republic of Kazakhstan proclaimed in the Constitution the rights and freedoms of the citizens. Our country seeks for creation of the constitutional state, tries to provide a guarantee from various arbitrariness in activity of competent government bodies, officials. In the concept of legal policy of the Republic of Kazakhstan it is specified: "...priority of development of the criminal procedure right there is a further consecutive realization of the fundamental principles of the criminal legal proceedings directed on protection of the rights and freedoms of the person". Judicial control just also is such guarantee.

Keywords: rights and freedoms of the person, concept, legal policy, court, judicial control

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Authors: Anwar Jarndal

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In this paper, a genetic-neural-network (GNN) based large-signal model for GaN HEMTs is presented along with its parameters extraction procedure. The model is easy to construct and implement in CAD software and requires only DC and S-parameter measurements. An improved decomposition technique is used to model self-heating effect. Two GNN models are constructed to simulate isothermal drain current and power dissipation, respectively. The two model are then composed to simulate the drain current. The modeling procedure was applied to a packaged GaN-on-Si HEMT and the developed model is validated by comparing its large-signal simulation with measured data. A very good agreement between the simulation and measurement is obtained.

Keywords: GaN HEMT, computer-aided design and modeling, neural networks, genetic optimization

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Authors: M.R Asghari Bejestani, Gh. R. Mohammad Khani, V.R. Nafisi

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Imagined speech recognition is one of the most interesting approaches to BCI development and a lot of works have been done in this area. Many different experiments have been designed and hundreds of combinations of feature extraction methods and classifiers have been examined. Reported classification accuracies range from the chance level to more than 90%. Based on non-stationary nature of brain signals, we have introduced 3 classification modes according to time difference in inter and intra-class samples. The modes can explain the diversity of reported results and predict the range of expected classification accuracies from the brain signal accusation procedure. In this paper, a few samples are illustrated by inspecting results of some previous works.

Keywords: brain computer interface, silent talk, imagined speech, classification, signal processing

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Authors: Aurora Cerri, Niko Pollojani

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The Tirana – Elbasan Road project is the most important highway project in Albania, constructed in the period May 2011 - ongoing. This project included construction of 38 km highway category road including 2.6 km of tunnel. It serves as a corridor connecting the Tirana, Capital of Albania and South-East area, and in the near future it is expected to continue in the direction of Macedonian border. Environmental Impact Assesment procedure for this project is provided by the Albanian Environmental Law No. 10431. This law establishes the regulation of procedures for identifying, assessment and reporting on the effects of certain projects on the environment, and the associated administrative procedures, during the decision-making process by the Ministry of Environment and Tourism for issuing environmental permit, and ensures that all relevant information concerning the environment are provided and considered. Due to the nature and size of the project, during the environmental impact assessment process, the European Union legislation, namely the EIA Directive 85/337 / EEC is considered. Moreover, in some cases, due to the lack of national standards and practical guidelines, when necessary those of EU member countries are considered. This paper presents an analysis of the EIA procedure followed on ‘Tirana – Elbasan’ Road project, with a focus on the application of the main stages of the procedure such as: screening, scoping, review, the EIA report; and consideration of alternatives, measures for impact prevention and reduction, and the public hearing T/discussion.

Keywords: highway, environmental impact assesment, Tirana, prevention

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Authors: Mebrahtu Haile

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Fuels obtained from renewable resources have garnered significant enthusiasm in recent decades due to concerns about fossil fuel depletion and climate change. This study aimed to investigate the potential of Prosopis juliflora pods mash for bio-ethanol production and its hydrolysis solid waste for solid fuel. Various parameters, such as acid concentration, hydrolysis times, fermentation times, fermentation temperature, and pH, were evaluated for their impact on bio-ethanol production using Saccharomyces cerevisiae yeast. The results showed that increasing acid concentration (up to 1 molar H₂SO₄) led to an increase in sugar content, reaching a maximum of 96.13%v/v. Optimal conditions for bio-ethanol production were found at 1 molar H₂SO₄ concentration (4.2%v/v), 48 hours fermentation time (5.1%v/v), 20 minutes hydrolysis time (5.57%v/v), 30°C fermentation temperature (5.57%v/v), and pH 5 (6.01%v/v), resulting in a maximum bio-ethanol yield of 6.01%v/v. The solid waste remaining after bio-ethanol production exhibited potential for use as a solid fuel, with a calorific value of 18.22 MJ/kg. These findings demonstrate the promising potential of Prosopis juliflora pods mash for bio-ethanol production and suggest a viable solution for addressing disposal challenges associated with solid waste, contributing to the exploration of renewable fuel sources in the face of fossil fuel depletion and climate change.

Keywords: prosopis juliflora, pods mash, invasive species, bio-ethanol, fermentation, Saccharomyces cerevisiae, solid fuel

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Authors: Mohamed Hafid, Marcel Lacroix

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This study presents a simple inverse heat transfer procedure for predicting the wall erosion and the time-varying thickness of the protective bank that covers the inside surface of the refractory brick wall of a melting furnace. The direct problem is solved by using the Finite-Volume model. The melting/solidification process is modeled using the enthalpy method. The inverse procedure rests on the Levenberg-Marquardt method combined with the Broyden method. The effect of the location of the temperature sensors and of the measurement noise on the inverse predictions is investigated. Recommendations are made concerning the location of the temperature sensor.

Keywords: melting furnace, inverse heat transfer, enthalpy method, levenberg–marquardt method

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Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

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The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

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Authors: Ebru Dural, M. Zulfu Asık

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Laminated glass is a kind of safety glass, which is made by 'sandwiching' two glass sheets and a polyvinyl butyral (PVB) interlayer in between them. When the glass is broken, the interlayer in between the glass sheets can stick them together. Because of this property, the hazards of sharp projectiles during natural and man-made disasters reduces. They can be widely applied in building, architecture, automotive, transport industries. Laminated glass can easily undergo large displacements even under their own weight. In order to explain their true behavior, they should be analyzed by using large deflection theory to represent nonlinear behavior. In this study, a nonlinear mathematical model is developed for the analysis of laminated glass cylindrical shell which is free in radial directions and restrained in axial directions. The results will be verified by using the results of the experiment, carried out on laminated glass cylindrical shells. The behavior of laminated composite cylindrical shell can be represented by five partial differential equations. Four of the five equations are used to represent axial displacements and radial displacements and the fifth one for the transverse deflection of the unit. Governing partial differential equations are derived by employing variational principles and minimum potential energy concept. Finite difference method is employed to solve the coupled differential equations. First, they are converted into a system of matrix equations and then iterative procedure is employed. Iterative procedure is necessary since equations are coupled. Problems occurred in getting convergent sequence generated by the employed procedure are overcome by employing variable underrelaxation factor. The procedure developed to solve the differential equations provides not only less storage but also less calculation time, which is a substantial advantage in computational mechanics problems.

Keywords: laminated glass, mathematical model, nonlinear behavior, PVB

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Authors: Shahid Mahboob, Hafiz Muhammad Ashraf, Salma Sultana, Tayyaba Sultana, Khalid Al-Ghanim, Fahid Al-Misned, Zubair Ahmedd

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There is an increasing need for an effective tool to estimate the risks derived from the large number of pollutants released to the environment by human activities. Typical screening procedures are highly invasive or lethal to the fish. Recent studies show that fish scales biochemically respond to a range of contaminants, including toxic metals, organic compounds, and endocrine disruptors. The present study evaluated the effects of the surface water contaminants on Cyprinus carpio in the Ravi River by comparing DNA extracted non-lethally from their scales to DNA extracted from the scales of fish collected from a controlled fish farm. A single, random sampling was conducted. Fish were broadly categorised into three weight categories (W1, W2 and W3). The experimental samples in the W1, W2 and W3 categories had an average DNA concentration (µg/µl) that was lower than the control samples. All control samples had a single DNA band; whereas the experimental samples in W1 fish had 1 to 2 bands, the experimental samples in W2 fish had two bands and the experimental samples in W3 fish had fragmentation in the form of three bands. These bands exhibit the effects of pollution on fish in the Ravi River. On the basis findings of this study, we propose that fish scales can be successfully employed as a new non-lethal tool for the evaluation of the effect of surface water contaminants.

Keywords: fish scales, Cyprinus carpio, heavy metals, non-invasive, DNA fragmentation

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Authors: Ya L. V., Benjamin Ong Wei Lin, Wanli Niu, Benjamin Seah Chin Tat

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This article introduces a methodology that improves reliability and cyclability of 2nd-life Li-ion battery system repurposed as an energy storage system (ESS). Most of the 2nd-life retired battery systems in the market have module/pack-level state-of-health (SOH) indicator, which is utilized for guiding appropriate depth-of-discharge (DOD) in the application of ESS. Due to the lack of cell-level SOH indication, the different degrading behaviors among various cells cannot be identified upon reaching retired status; in the end, considering end-of-life (EOL) loss and pack-level DOD, the repurposed ESS has to be oversized by > 1.5 times to complement the application requirement of reliability and cyclability. This proposed battery grading algorithm, using non-invasive methodology, is able to detect outlier cells based on historical voltage data and calculate cell-level historical maximum temperature data using semi-analytic methodology. In this way, the individual battery cell in the 2nd-life battery system can be graded in terms of SOH on basis of the historical voltage fluctuation and estimated historical maximum temperature variation. These grades will have corresponding DOD grades in the application of the repurposed ESS to enhance system reliability and cyclability. In all, this introduced battery grading algorithm is non-invasive, compatible with all kinds of retired Li-ion battery systems which lack of cell-level SOH indication, as well as potentially being embedded into battery management software for preventive maintenance and real-time cyclability optimization.

Keywords: battery grading algorithm, 2nd-life repurposing battery system, semi-analytic methodology, reliability and cyclability

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Authors: Svetlana L. Mishlanova, Evgeniia V. Ermakova, Mariia E. Timirkina

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The paper is concerned with the study of metaphor production in essays written by Russian and English native speakers in the framework of cognitive metaphor theory. It considers metaphorical competence as individual’s ability to recognize, understand and use metaphors in speech. The work analyzes the influence of visual metaphor on production and density of conventional and novel verbal metaphors. The main methods of research include experiment connected with image interpretation, metaphor identification procedure (MIPVU) and visual conventional metaphors identification procedure proposed by VisMet group. The research findings will be used in the project aimed at comparing metaphorical competence of native and non-native English speakers.

Keywords: metaphor, metaphorical competence, conventional, novel

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Authors: Ali Kassem, Yaser Kamal, Mohamed Abdel Wahab, Mohamed Hussen

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Introduction: Atherosclerosis is one of the leading causes of death all over the world. Recently, there is an increasing interest in Carotid Intima-Medial Thickness (CIMT) and Ankle Brachial Index (ABI) as non-invasive tools for identifying subclinical atherosclerosis. We aim to examine the role of CIMT and ABI as predictors of the severity of angiographically documented coronary artery disease (CAD). Methods: A cross-sectional study conducted on 60 patients who were investigated by coronary angiography at Sohag University Hospital, Egypt. CIMT: After the carotid arteries were located by transverse scans, the probe was rotated 90 ° to obtain and record longitudinal images of bilateral carotid arteries ABI: Each patient was evaluated in the supine position after resting for 5 min. ABI was measured in each leg using a Doppler Ultrasound while the patient remained in the same position. The lowest ABI obtained for either leg was taken as the ABI measurement for the patient. Results: Patients with carotid mean IMT ≥ 0.9 mm had significantly more severe coronary artery disease than patients without thickening (mean IMT > 0.9 mm). Similarly, patients with low ABI (< 0.9) had significantly more severe coronary artery disease than patients with ABI ≥ 0.9. When the patients were divided into 4 groups (group A, n = 15, mean IMT < 0.9 mm, ABI ≥ 0.9; group B, n = 25, mean IMT < 0.9 mm, low ABI; group C, n = 5, mean IMT ≥ 0.9 mm, ABI ≥ 0.9; group D, n = 19, mean IMT ≤ 0.9 mm, low ABI), the presence of significant coronary stenosis (> 50%) of the groups were significantly different (group A, n = 5: (33.3%); group B, n = 11: (52.4%); group C, n = 4: (60%); group D, n=15, (78.9%), P = 0.001). Conclusion: CIMT and ABI provide useful information on the severity of CAD. Early and aggressive intervention should be considered in patients with CAD and abnormalities in one or both of these non-invasive modalities.

Keywords: ankle brachial index, carotid intima media thickness, coronary artery disease, predictors of severity

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Authors: Komala Arsi, Ann M. Donoghue, Dan J. Donoghue

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Methionine is an essential dietary amino acid necessary to promote growth and health of poultry. Synthetic methionine is commonly used as a supplement in conventional poultry diets and is temporarily allowed in organic poultry feed for lack of natural and organically approved sources of methionine. It has been a challenge to find a natural, sustainable and cost-effective source for methionine which reiterates the pressing need to explore potential alternatives of methionine for organic poultry production. Fish have high concentrations of methionine, but wild-caught fish are expensive and adversely impact wild fish populations. Asian carp (AC) is an invasive species and its utilization has the potential to be used as a natural methionine source. However, to our best knowledge, there is no proven technology to utilize this fish as a methionine source. In this study, we co-extruded Asian carp and soybean meal to form a dry-extruded, methionine-rich AC meal. In order to formulate rations with the novel extruded carp meal, the product was tested on cecectomized roosters for its amino acid digestibility and total metabolizable energy (TMEn). Excreta was collected and the gross energy, protein content of the feces was determined to calculate Total Metabolizable Energy (TME). The methionine content, digestibility and TME values were greater for the extruded AC meal than control diets. Carp meal was subsequently tested as a methionine source in feeds formulated for broilers, and production performance (body weight gain and feed conversion ratio) was assessed in comparison with broilers fed standard commercial diets supplemented with synthetic methionine. In this study, broiler chickens were fed either a control diet with synthetic methionine or a treatment diet with extruded AC meal (8 replicates/treatment; n=30 birds/replicate) from day 1 to 42 days of age. At the end of the trial, data for body weights, feed intake and feed conversion ratio (FCR) was analyzed using one-way ANOVA with Fisher LSD test for multiple comparisons. Results revealed that birds on AC diet had body weight gains and feed intake comparable to diets containing synthetic methionine (P > 0.05). Results from the study suggest that invasive AC-derived fish meal could potentially be an effective and inexpensive source of sustainable natural methionine for organic poultry farmers.

Keywords: Asian carp, methionine, organic, poultry

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Hossain A., Chowdhury S. I.

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Introduction: The use of a gamma camera is a standard procedure in nuclear medicine facilities or hospitals to diagnose chronic kidney disease (CKD), but the gamma camera does not precisely stage the disease. The authors sought to determine whether they could use an artificial neural network to determine whether CKD was in normal or abnormal stages based on GFR values (ANN). Method: The 250 kidney patients (Training 188, Testing 62) who underwent an ultrasonography test to diagnose a renal test in our nuclear medical center were scanned using a gamma camera. Before the scanning procedure, the patients received an injection of ⁹⁹ᵐTc-DTPA. The gamma camera computes the pre- and post-syringe radioactive counts after the injection has been pushed into the patient's vein. The artificial neural network uses the softmax function with cross-entropy loss to determine whether CKD is normal or abnormal based on the GFR value in the output layer. Results: The proposed ANN model had a 99.20 % accuracy according to K-fold cross-validation. The sensitivity and specificity were 99.10 and 99.20 %, respectively. AUC was 0.994. Conclusion: The proposed model can distinguish between normal and abnormal stages of CKD by using an artificial neural network. The gamma camera could be upgraded to diagnose normal or abnormal stages of CKD with an appropriate GFR value following the clinical application of the proposed model.

Keywords: artificial neural network, glomerular filtration rate, stages of the kidney, gamma camera

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Authors: Mengxiao Li, Johnson Zhang

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Currently, topology optimization technique is widely used to define the layout design of structures that are presented as truss-like topologies. However, due to the difficulty in combining optimization technique with more realistic material models where their nonlinear properties should be considered, the achieved optimized topologies are commonly unable to apply straight towards the practical design problems. This study presented an optimization procedure of composite structures where different elastic stiffness, yield criteria, and hardening models are assumed for the candidate materials. From the results, it can be concluded that a more explicit modeling has the significant influence on the resulting topologies. Also, the isotropic or kinematic hardening is important for elastoplastic structural optimization design. The capability of the proposed optimization procedure is shown through several cases.

Keywords: topology optimization, material composition, nonlinear modeling, hardening rules

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Authors: Sung Yong Kim, Byung Joo Song

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Background: Circulating 25-hydroxyvitamin D (25(OH)D) levels has been considered to be inversely related to breast cancer development, recurrence risk, and mortality. Mean vitamin D levels in Korean population is lower than western countries due to higher incidence of lactose intolerance and lower exposure to sunlight. The purpose of this study was to assess incidence of 25(OH)D deficiency at diagnosis and after adjuvant chemotherapy and to investigate the correlation serum 25(OH)D levels with clinicopathologic features. Methods: From December 2011 to October 2012, 280 breast cancer patients seen at a single tertiary cancer center were enrolled. Serum 25(OH)D was measured at the time of surgery and after completion of adjuvant chemotherapy. Statistical analyses used chi-square test, Fisher's exact test, t-test, and ANOVA. Results: Mean serum 25(OH)D was 18.5 ng/ml. The 25(OH)D levels were deficient (<20 ng/ml) in 190 patients (67.9%), insufficient (20-29 ng/ml) in 51 patients(18.2%), and sufficient (30-150 ng/ml) in 39 patients(13.9%). A notable decrease in 25(OH)D concentration was observed(p<0.001) after chemotherapy but was not related to chemotherapy regimens. It was found significant lower 25(OH)D levels at winter season(from October to March, p=0.030). Subjects with invasive carcinoma (IDC or ILC) had significantly lower circulating levels of 25(OH)D than those with ductal carcinoma in situ(DCIS) (p=0.010). Patients with larger tumor size tends to have lower serum 25(OH)D but there were no statistical significance. Conclusions: Most of the breast cancer patients showed deficient or insufficient serum 25(OH)D concentration. Incidence of vitamin D deficiency was higher in invasive carcinoma than DCIS. Serum 25(OH)D levels were decreased after chemotherapy. Consideration should be given to the supplement of vitamin D to those patients.

Keywords: breast neoplasms, vitamin D, Korean population, breast cancer

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Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

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Authors: A. Rifa’i, Y. Takeshita, M. Komatsu

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The post-rain puddles problem that occurs in the first yard of Prambanan Temple are often disturbing visitor activity. A poodle layer and a drainage system has ever built to avoid such a problem, but puddles still didn’t stop appearing after rain. Permeability parameter needs to be determined by using more simple procedure to find exact method of solution. The instrument modelling were proposed according to the development of field permeability testing instrument. This experiment used proposed Constant Discharge method. Constant Discharge method used a tube poured with constant water flow. The procedure were carried out from unsaturated until saturated soil condition. Volumetric water content (θ) were being monitored by soil moisture measurement device. The results were relationship between k and θ which drawn by numerical approach Van Genutchen model. Parameters θr optimum value obtained from the test was at very dry soil. Coefficient of permeability with a density of 19.8 kN/m3 for unsaturated conditions was in range of 3 x 10-6 cm/sec (Sr= 68 %) until 9.98 x 10-4 cm/sec (Sr= 82 %). The equipment and testing procedure developed in this research was quite effective, simple and easy to be implemented on determining field soil permeability coefficient value of sandy soil. Using constant discharge method in proposed permeability test, value of permeability coefficient under unsaturated condition can be obtained without establish soil water characteristic curve.

Keywords: constant discharge method, in situ permeability test, sandy soil, unsaturated conditions

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Samir Chekchaki, ArifaBeddiar

Abstract:

Nowadays, more and more species are introduced outside their natural range. If most of them remain difficult, some may adopt a much more dynamic behavior. Indeed, we have witnessed in recent decades, the development of high forests of Acacia mearnsii in El Kala National Park. Introduced indefinitely, this leguminous intended to make money (nitrogen supply for industrial plantations of Eucalyptus), became one of the most invasive and more costly in terms of forest management. It has crossed all barriers: it has acclimatized, naturalized and then expanded through diverse landscapes; entry into competition with native species such as cork oak and altered ecosystem functioning. Therefore, it is interesting to analyze this new threat by relying on plants as bio-indicator for assessing biodiversity at different scales. We have identified the species present in several plots distributed in a range of vegetation types subjected to different degrees of disturbance by using the braun-blanquet method. Fifty-six species have been recorded. They are distributed in 48 genera and 29 families. The analysis of the relative frequency of species correlated with relative abundance clearly shows that the Acacia mearnsii feels marginalized. The ecological analysis of this biological invasion shows that disruption of either natural or anthropogenic origin (fire, prolonged drought, cut) represent the factors that exacerbate invasion by opening invasion windows. The lifting of seeds of Acacia mearnsii lasting physical dormancy (and variable) is ensured by the thermal shock in relation to its heliophilous character.

Keywords: Acacia mearnsii De Wild, El Kala National park, fire, invasive, vegetation

Procedia PDF Downloads 357

Authors: Jerome Dalphinis, Vishal Patel

Abstract:

The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

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Authors: R. A. Qawasma, F. M. Haddad, H. O. Salhab

Abstract:

Hemodialysis is a life-preserving treatment for a number of patients with kidney failure. The standard procedure of hemodialysis is three times a week during the hemodialysis procedure, the patient usually suffering from many inconvenient, exhausting feeling and effect on the heart and cardiovascular system are the most common signs. This paper provides a solution to reduce the previous problems by designing a wearable artificial kidney (WAK) taking in consideration a minimization the size of the dialysis machine. The WAK system consists of two circuits: blood circuit and dialysate circuit. The blood from the patient is filtered in the dialyzer before returning back to the patient. Several parameters using an advanced microcontroller and array of sensors. WAK equipped with visible and audible alarm system to aware the patients if there is any problem.

Keywords: artificial kidney, home dialysis, renal failure, wearable kidney

Procedia PDF Downloads 235

Authors: Till Gramberg, Erwin Gross, Christoph Birenbaum

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This paper presents the approach of the Easy2IoT research project. Easy2IoT aims to enable companies in the prefabrication sheet metal and sheet metal processing industry to enter the Industrial Internet of Things (IIoT) with a low-threshold and cost-effective approach. It focuses on the development of physical hardware and software to easily capture machine activities from on a sawing machine, benefiting various stakeholders in the SME value chain, including machine operators, tool manufacturers and service providers. The methodological approach of Easy2IoT includes an in-depth requirements analysis and customer interviews with stakeholders along the value chain. Based on these insights, actions, requirements and potential solutions for smart services are derived. The focus is on providing actionable recommendations, competencies and easy integration through no-/low-code applications to facilitate implementation and connectivity within production networks. At the core of the project is a novel, non-invasive measurement and analysis system that can be easily deployed and made IIoT-ready. This system collects machine data without interfering with the machines themselves. It does this by non-invasively measuring the tension on a sawing machine. The collected data is then connected and analyzed using artificial intelligence (AI) to provide smart services through a platform-based application. Three Smart Services are being developed within Easy2IoT to provide immediate benefits to users: Wear part and product material condition monitoring and predictive maintenance for sawing processes. The non-invasive measurement system enables the monitoring of tool wear, such as saw blades, and the quality of consumables and materials. Service providers and machine operators can use this data to optimize maintenance and reduce downtime and material waste. Optimize Overall Equipment Effectiveness (OEE) by monitoring machine activity. The non-invasive system tracks machining times, setup times and downtime to identify opportunities for OEE improvement and reduce unplanned machine downtime. Estimate CO2 emissions for connected machines. CO2 emissions are calculated for the entire life of the machine and for individual production steps based on captured power consumption data. This information supports energy management and product development decisions. The key to Easy2IoT is its modular and easy-to-use design. The non-invasive measurement system is universally applicable and does not require specialized knowledge to install. The platform application allows easy integration of various smart services and provides a self-service portal for activation and management. Innovative business models will also be developed to promote the sustainable use of the collected machine activity data. The project addresses the digitalization gap between large enterprises and SME. Easy2IoT provides SME with a concrete toolkit for IIoT adoption, facilitating the digital transformation of smaller companies, e.g. through retrofitting of existing machines.

Keywords: smart services, IIoT, IIoT-platform, industrie 4.0, big data

Procedia PDF Downloads 73