Search results for: surgical simulation

Authors: Andriana Purnama, Reno Rudiman, Kezia Christy

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Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.

Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair

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Authors: Wenjing Ding, Weiwei Shan, Zijuan, Wang, Chao He

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Liquid spray heat exchanger is the critical equipment of temperature regulating system by gaseous nitrogen which realizes the environment temperature in the range of -180 ℃~+180 ℃. Liquid nitrogen is atomized into smaller liquid drops through liquid nitrogen sprayer and then contacts with gaseous nitrogen to be cooled. By adjusting the pressure of liquid nitrogen and gaseous nitrogen, the flowrate of liquid nitrogen is changed to realize the required outlet temperature of heat exchanger. The temperature accuracy of shrouds is ±1 ℃. Liquid nitrogen spray heat exchanger is simulated by CATIA, and the numerical simulation is performed by FLUENT. The comparison between the tests and numerical simulation is conducted. Moreover, the results help to improve the design of liquid nitrogen spray heat exchanger.

Keywords: liquid nitrogen spray, temperature regulating system, heat exchanger, numerical simulation

Procedia PDF Downloads 293

Authors: Abiodun Ladanu Ajala, Wuyi Oke

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Mathematical simulation and optimization models packaged within interactive computer programs provide a common way for planners and managers to predict the behaviour of any proposed water resources system design or management policy before it is implemented. Modeling presents a principal technique of predicting the behaviour of the proposed infrastructural designs or management policies. Models can be developed and used to help identify specific alternative plans that best meet those objectives. This study discusses various types of models, their development, architecture, data requirements, and applications in the field of engineering. It also outlines the advantages and limitations of each the optimization and simulation models presented. The techniques explored in this review include; dynamic programming, linear programming, fuzzy optimization, evolutionary algorithms and finally artificial intelligence techniques. Previous studies carried out using some of the techniques mentioned above were reviewed, and most of the results from different researches showed that indeed optimization and simulation provides viable alternatives and predictions which form a basis for decision making in building engineering structures and also in engineering planning and management.

Keywords: linear programming, mutation, optimization, simulation

Procedia PDF Downloads 562

Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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

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

Keywords: soft tissue injuries, face, avulsion, classification

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Authors: Yan Lyu, Yiqun Pan, Zhizhong Huang

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In the design stage of a new building, the energy model of this building is often required for the analysis of the performance on energy efficiency. In practice, a certain degree of geometric simplification should be done in the establishment of building energy models, since the detailed geometric features of a real building are hard to be described perfectly in most energy simulation engine, such as ESP-r, eQuest or EnergyPlus. Actually, the detailed description is not necessary when the result with extremely high accuracy is not demanded. Therefore, this paper analyzed the relationship between the error of the simulation result from building energy models and the geometric simplification of the models. Finally, the following two parameters are selected as the indices to characterize the geometric feature of in building energy simulation: the southward projected area and total side surface area of the building, Based on the parameterization method, the simplification from an arbitrary column building to a typical shape (a cuboid) building can be made for energy modeling. The result in this study indicates that this simplification would only lead to the error that is less than 7% for those buildings with the ratio of southward projection length to total perimeter of the bottom of 0.25~0.35, which can cover most situations.

Keywords: building energy model, simulation, geometric simplification, design, regression

Procedia PDF Downloads 156

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Yun-Pang Flötteröd, Jakob Erdmann

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The human behaviors during evacuations are quite complex. One of the critical behaviors which affect the efficiency of evacuation is route choice. Therefore, the respective simulation modeling work needs to function properly. In this paper, Simulation of Urban Mobility’s (SUMO) current dynamic route modeling during evacuation, i.e. the rerouting functions, is examined with a real case study. The result consistency of the simulation and the reality is checked as well. Four influence factors (1) time to get information, (2) probability to cancel a trip, (3) probability to use navigation equipment, and (4) rerouting and information updating period are considered to analyze possible traffic impacts during the evacuation and to examine the rerouting functions in SUMO. Furthermore, some behavioral characters of the case study are analyzed with use of the corresponding detector data and applied in the simulation. The experiment results show that the dynamic route modeling in SUMO can deal with the proposed scenarios properly. Some issues and function needs related to route choice are discussed and further improvements are suggested.

Keywords: evacuation, microscopic traffic simulation, rerouting, SUMO

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Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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Authors: K. Djellabi, M. E. H. Latreche

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The induction heating phenomenon depends on various factors, making the problem highly nonlinear. The mathematical analysis of this problem in most cases is very difficult and it is reduced to simple cases. Another knowledge of induction heating systems is generated in production environments, but these trial-error procedures are long and expensive. The numerical models of induction heating problem are another approach to reduce abovementioned drawbacks. This paper deals with the simulation model of induction heating problem. The simulation model of induction heating system in COMSOL Multiphysics is created. In this work we present results of numerical simulations of induction heating process in pieces of cylindrical shapes, in an inductor with four coils. The modeling of the inducting heating process was made with the software COMSOL Multiphysics Version 4.2a, for the study we present the temperature charts.

Keywords: induction heating, electromagnetic field, inductor, numerical simulation, finite element

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Leal Leonardo, Pires Carlos Augusto de Moraes, Casiraghi Magela

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In this work were realized the modeling and simulation of the catalytic reformer process, of ample form, considering all the equipment that influence the operation performance. Considered it a semi-regenerative reformer, with four reactors in series intercalated with four furnaces, two heat exchanges, one product separator and one recycle compressor. A simplified reactional system was considered, involving only ten chemical compounds related through five reactions. The considered process was the applied to aromatics production (benzene, toluene, and xylene). The models developed to diverse equipment were interconnecting in a simulator that consists of a computer program elaborate in FORTRAN 77. The simulation of the global model representative of reformer unity achieved results that are compatibles with the literature ones. It was then possible to study the effects of operational variables in the products concentration and in the performance of the unity equipment.

Keywords: catalytic reforming, modeling, simulation, petrochemical engineering

Procedia PDF Downloads 479

Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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Authors: Ferdinando Montemari, Antonio Vitale, Nicola Genito, Luca Garbarino, Urbano Tancredi, Domenico Accardo, Michele Grassi, Giancarmine Fasano, Anna Elena Tirri

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The development of guidance, navigation and control algorithms and avionic procedures requires the disposability of suitable analysis and verification tools, such as simulation environments, which support the design process and allow detecting potential problems prior to the flight test, in order to make new technologies available at reduced cost, time and risk. This paper presents a simulation environment for avionic software development and qualification, especially aimed at equipment for general aviation aircrafts and unmanned aerial systems. The simulation environment includes models for short and medium-range radio-navigation aids, flight assistance systems, and ground control stations. All the software modules are able to simulate the modeled systems both in fast-time and real-time tests, and were implemented following component oriented modeling techniques and requirement based approach. The paper describes the specific models features, the architectures of the implemented software systems and its validation process. Performed validation tests highlighted the capability of the simulation environment to guarantee in real-time the required functionalities and performance of the simulated avionics systems, as well as to reproduce the interaction between these systems, thus permitting a realistic and reliable simulation of a complete mission scenario.

Keywords: ADS-B, avionics, NAVAIDs, real-time simulation, TCAS, UAS ground control station

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Authors: Francesco Rizzuto, Matthew Stickland, Stephan Hannot

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The simulation of a positive displacement pump system with commercial software for Computer Fluid Dynamics (CFD), will result in an enormous computational effort due to the complexity of the pump system. This drawback restricts the use of it to a specific part of the pump in one simulation. This research focuses on developing an algorithm that provides a suitable result in agreement with experiment data, without that computational effort. The compressible equations are solved with an explicit algorithm. A comparison is presented between the FV method with Monotonic Upwind scheme for Conservative Laws (MUSCL) with slope limiter and experimental results. The source term for cavitation and friction is introduced into the algorithm with a slipping strategy and solved with a 4th order Runge-Kutta scheme (RK4). Different pumps are modeled and analyzed to evaluate the flexibility of the code. The simulation required minimal computation time and resources without compromising the accuracy of the simulation results. Therefore, this algorithm highlights the feasibility of pressure pulsation simulation as a design tool for an industrial purpose.

Keywords: cavitation, diaphragm, DVCM, finite volume, MUSCL, positive displacement pump

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Authors: Yang Li, Xiaorong Guan, Cheng Xu

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In order to design a suitable control scheme for human extremity exoskeleton, the interaction force control scheme with traditional PI controller was presented, and the simulation study of the electromechanical system of the human extremity exoskeleton was carried out by using a MATLAB/Simulink module. By analyzing the simulation calculation results, it was shown that the traditional PI controller is not very suitable for every movement speed of human body. So, at last the fuzzy self-adaptive PI controller was presented to solve this problem. Eventually, the superiority and feasibility of the fuzzy self-adaptive PI controller was proved by the simulation results and experimental results.

Keywords: human extremity exoskeleton, interaction force control scheme, simulation study, fuzzy self-adaptive pi controller, man-machine coordinated walking, bear payload

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Authors: Maryam Gallab, Hafida Bouloiz, Youness Chater, Mohamed Tkiouat

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The aim of this paper is to present a model based on multi-agent systems in order to manage the maintenance activities and to ensure the reliability and availability of machines just with the required resources (operators, tools). The interest of the simulation is to solve the complexity of the system and to find results without cost or wasting time. An implementation of the model is carried out on the AnyLogic platform to display the defined performance indicators.

Keywords: maintenance, complexity, simulation, multi-agent systems, AnyLogic platform

Procedia PDF Downloads 283

Authors: Stephen Kirkup

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This paper discusses the implementation of the boundary element method (BEM) on an Excel spreadsheet and how it can be used in teaching vector calculus and simulation. There are two separate spreadheets, within which Laplace equation is solved by the BEM in two dimensions (LIBEM2) and axisymmetric three dimensions (LBEMA). The main algorithms are implemented in the associated programming language within Excel, Visual Basic for Applications (VBA). The BEM only requires a boundary mesh and hence it is a relatively accessible method. The BEM in the open spreadsheet environment is demonstrated as being useful as an aid to teaching and learning. The application of the BEM implemented on a spreadsheet for educational purposes in introductory vector calculus and simulation is explored. The development of assignment work is discussed, and sample results from student work are given. The spreadsheets were found to be useful tools in developing the students’ understanding of vector calculus and in simulating heat conduction.

Keywords: boundary element method, Laplace’s equation, vector calculus, simulation, education

Procedia PDF Downloads 138

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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

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

Procedia PDF Downloads 154

Authors: Guoqiang Yu, Mehrana Mohtasebi, Jinghong Sun, Thomas Pittman

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Malignant glioma (MG) is the most common type of primary malignant brain tumor. Surgical resection of MG remains the cornerstone of therapy, and the extent of resection correlates with patient survival. A limiting factor for resection, however, is the difficulty in differentiating the tumor from normal tissue during surgery. Fluorescence imaging is an emerging technique for real-time intraoperative visualization of MGs and their boundaries. However, most clinical-grade neurosurgical operative microscopes with fluorescence imaging ability are hampered by low adoption rates due to high cost, limited portability, limited operation flexibility, and lack of skilled professionals with technical knowledge. To overcome the limitations, we innovatively integrated miniaturized light sources, flippable filters, and a recording camera to the surgical eye loupes to generate a wearable fluorescence eye loupe (FLoupe) device for intraoperative imaging of fluorescent MGs. Two FLoupe prototypes were constructed for imaging of Fluorescein and 5-aminolevulinic acid (5-ALA), respectively. The wearable FLoupe devices were tested on tumor-simulating phantoms and patients with MGs. Comparable results were observed against the standard neurosurgical operative microscope (PENTERO® 900) with fluorescence kits. The affordable and wearable FLoupe devices enable visualization of both color and fluorescence images with the same quality as the large and expensive stationary operative microscopes. The wearable FLoupe device allows for a greater range of movement, less obstruction, and faster/easier operation. Thus, it reduces surgery time and is more easily adapted to the surgical environment than unwieldy neurosurgical operative microscopes.

Keywords: fluorescence guided surgery, malignant glioma, neurosurgical operative microscope, wearable fluorescence imaging device

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Authors: Surinder Pal, Ajay Gupta, Johny Khajuria

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Casting simulation helps visualize mold filling and casting solidification; predict related defects like cold shut, shrinkage porosity and hard spots; and optimize the casting design to achieve the desired quality with high yield. Flow and solidification of molten metals are, however, a very complex phenomenon that is difficult to simulate correctly by conventional computational techniques, especially when the part geometry is intricate and the required inputs (like thermo-physical properties and heat transfer coefficients) are not available. Simulation software is based on the process of modeling a real phenomenon with a set of mathematical formulas. It is, essentially, a program that allows the user to observe an operation through simulation without actually performing that operation. Simulation software is used widely to design equipment so that the final product will be as close to design specs as possible without expensive in process modification. Simulation software with real-time response is often used in gaming, but it also has important industrial applications. When the penalty for improper operation is costly, such as airplane pilots, nuclear power plant operators, or chemical plant operators, a mockup of the actual control panel is connected to a real-time simulation of the physical response, giving valuable training experience without fear of a disastrous outcome. The all casting simulation software has own requirements, like magma cast has only best for crack simulation. The latest generation software Auto CAST developed at IIT Bombay provides a host of functions to support method engineers, including part thickness visualization, core design, multi-cavity mold design with common gating and feeding, application of various feed aids (feeder sleeves, chills, padding, etc.), simulation of mold filling and casting solidification, automatic optimization of feeders and gating driven by the desired quality level, and what-if cost analysis. IIT Bombay has developed a set of applications for the foundry industry to improve casting yield and quality. Casting simulation is a fast and efficient solution for process for advanced tool which is the result of more than 20 years of collaboration with major industrial partners and academic institutions around the world. In this paper the process of casting simulation is studied.

Keywords: casting simulation software’s, simulation technique’s, casting simulation, processes

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Authors: Yonggyu Lee, Byungkyu Jung, Bom Yoon, Jongil Yoon

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MR-based simulation devices have been recently used in various fields such as entertainment, medicine, manufacturing, and education. Different simulation devices are also being developed for military equipment training. This is to address the concerns regarding safety accidents as well as cost issues associated with training with expensive equipment. An important aspect of developing simulation devices to replicate military training is that trainees experience the same effect as training with real devices. In this study, the criteria for performance evaluation are established to compare the training effect of an MR-based simulation device to that of an actual device. K-9 Self-propelled artillery (SPA) operators are selected as training subjects. First, MR-based software is developed to simulate the training ground and training scenarios currently used for training SPA operators in South Korea. Hardware that replicates the interior of SPA is designed, and a simulation device that is linked to the software is developed. Second, criteria are established to evaluate the simulation device based on real-life training scenarios. A total of nine performance evaluation criteria were selected based on the actual SPA operation training scenarios. Evaluation items were selected to evaluate whether the simulation device was designed such that trainees would experience the same effect as training in the field with a real SPA. To eval-uate the level of replication by the simulation device of the actual training environments (driving and passing through trenches, pools, protrusions, vertical obstacles, and slopes) and driving conditions (rapid steering, rapid accelerating, and rapid braking) as per the training scenarios, tests were performed under the actual training conditions and in the simulation device, followed by the comparison of the results. In addition, the level of noise felt by operators during training was also selected as an evaluation criterion. Due to the nature of the simulation device, there may be data latency between HW and SW. If the la-tency in data transmission is significant, the VR image information delivered to trainees as they maneuver HW might not be consistent. This latency in data transmission was also selected as an evaluation criterion to improve the effectiveness of the training. Through this study, the key evaluation metrics were selected to achieve the same training effect as training with real equipment in a training ground during the develop-ment of the simulation device for military equipment training.

Keywords: K-9 self-propelled artillery, mixed reality, simulation device, synchronization

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Authors: Jenan Abu Qadourah

Abstract:

The suitable surface areas for the ST and PV installation are determined based on incident solar irradiation on different surfaces, shading analysis and suitable architectural area for integration considering limitations due to the constructions, available surfaces area and use of the available surfaces for other purposes. The incident solar radiation on the building surfaces and the building solar exposure analysis of the location of Amman, Jordan, is performed with Autodesk Ecotect analysis 2011 simulation software. The building model geometry within the typical urban context is created in “SketchUp,” which is then imported into Ecotect. The hourly climatic data of Amman, Jordan selected are the same ones used for the building simulation in IDA ICE and Polysun simulation software.

Keywords: photovoltaic, solar thermal, solar incident, simulation, building façade, solar potential

Procedia PDF Downloads 113

Authors: Mwafak Shakoor

Abstract:

The purpose of this study was to reduce patient waiting times, improve system throughput and improve resources utilization in radiology department. A discrete event simulation model was developed using Arena simulation software to investigate different alternatives to improve the overall system delivery based on adding resource scenarios due to the linkage between patient waiting times and resource availability. The study revealed that there is no addition investment need to procure additional scanner but hospital management deploy managerial tactics to enhance machine utilization and reduce the long waiting time in the department.

Keywords: discrete event simulation, radiology department, arena, waiting time, healthcare modeling, computed tomography

Procedia PDF Downloads 563

Authors: Youngjae Jin, Daeshik Kim

Abstract:

This paper describes a cycle accurate simulation results of weight values learned by an auto-encoder behavior model in terms of pre-route simulation. Given the results we visualized the first layer representations with natural images. Many common deep learning threads have focused on learning high-level abstraction of unlabeled raw data by unsupervised feature learning. However, in the process of handling such a huge amount of data, the learning method’s computation complexity and time limited advanced research. These limitations came from the fact these algorithms were computed by using only single core CPUs. For this reason, parallel-based hardware, FPGAs, was seen as a possible solution to overcome these limitations. We adopted and simulated the ready-made auto-encoder to design a behavior model in Verilog HDL before designing hardware. With the auto-encoder behavior model pre-route simulation, we obtained the cycle accurate results of the parameter of each hidden layer by using MODELSIM. The cycle accurate results are very important factor in designing a parallel-based digital hardware. Finally this paper shows an appropriate operation of behavior model based pre-route simulation. Moreover, we visualized learning latent representations of the first hidden layer with Kyoto natural image dataset.

Keywords: auto-encoder, behavior model simulation, digital hardware design, pre-route simulation, Unsupervised feature learning

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Authors: Arunas Burinskas, Manuela Tvaronavičienė

Abstract:

Although the new trade theories, unlike the theories of an industrial organisation, see the structure of the market and competition between enterprises through their heterogeneity according to various parameters, they do not pay any particular attention to the analysis of the market structure and its development. In this article, although we relied mainly on models developed by the scholars of new trade theory, we proposed a different approach. In our simulation model, we model market demand according to normal distribution function, while on the supply side (as it is in the new trade theory models), productivity is modeled with the Pareto distribution function. The results of the simulation show that companies with higher productivity (lower marginal costs) do not pass on all the benefits of such economies to buyers. However, even with higher marginal costs, firms can choose to offer higher value-added goods to stay in the market. In general, the structure of the market is formed quickly enough and depends on the skills available to firms.

Keywords: market, structure, simulation, heterogenous firms

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Authors: Hossein Keshtkar, Ali Nasiri Toosi

Abstract:

With the growing concerns about gasoline environmental pollution and also the need for a more widely available fuel source, natural gas is finding its way to the automotive engines. But before this could happen industrially, simulations of natural gas direct injection need to take place to maximize and optimize power output. KIVA is one of the most powerful tools when it comes to engine simulation. Widely accepted by both researchers and the industry, KIVA an open-source code, offers great in-depth simulation and analyzation. KIVA can compute complex phenomena’s which can occur inside the chamber before, whilst and after ignition. One downside to KIVA, is its in-capability of simulating gaseous injections, making it useful for only liquidized fuel. In this study, we developed a numerical code, to enable the simulation of gaseous injection within the KIVA code. By introducing our code as a subroutine, we modified the original KIVA program. To ensure the correct application of gaseous fuel injection using our modified KIVA code, we simulated two different cases and compared them with their experimental data. We concluded our modified version of KIVA’s simulation results came in very close to those measured experimentally.

Keywords: gaseous injections, KIVA, natural gas direct injection, numerical code, simulation

Procedia PDF Downloads 255

Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

Abstract:

The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

Procedia PDF Downloads 175

Authors: Parimalah Velo, Ahmad Zakaria

Abstract:

Introduction: Monte Carlo simulations of preclinical imaging systems allow opportunity to enable new research that could range from designing hardware up to discovery of new imaging application. The simulation system which could accurately model an imaging modality provides a platform for imaging developments that might be inconvenient in physical experiment systems due to the expense, unnecessary radiation exposures and technological difficulties. The aim of present study is to validate the Monte Carlo simulation of thyroid phantom imaging using Geant4-GATE for Siemen’s e-cam single head gamma camera. Upon the validation of the gamma camera simulation model by comparing physical characteristic such as energy resolution, spatial resolution, sensitivity, and dead time, the GATE simulation of thyroid phantom imaging is carried out. Methods: A thyroid phantom is defined geometrically which comprises of 2 lobes with 80mm in diameter, 1 hot spot, and 3 cold spots. This geometry accurately resembling the actual dimensions of thyroid phantom. A planar image of 500k counts with 128x128 matrix size was acquired using simulation model and in actual experimental setup. Upon image acquisition, quantitative image analysis was performed by investigating the total number of counts in image, the contrast of the image, radioactivity distributions on image and the dimension of hot spot. Algorithm for each quantification is described in detail. The difference in estimated and actual values for both simulation and experimental setup is analyzed for radioactivity distribution and dimension of hot spot. Results: The results show that the difference between contrast level of simulation image and experimental image is within 2%. The difference in the total count between simulation and actual study is 0.4%. The results of activity estimation show that the relative difference between estimated and actual activity for experimental and simulation is 4.62% and 3.03% respectively. The deviation in estimated diameter of hot spot for both simulation and experimental study are similar which is 0.5 pixel. In conclusion, the comparisons show good agreement between the simulation and experimental data.

Keywords: gamma camera, Geant4 application of tomographic emission (GATE), Monte Carlo, thyroid imaging

Procedia PDF Downloads 251