Search results for: surgical tool

Authors: Dunwen Zuo, Yongfang Deng, Bo Song

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An attempt is made here to measure the forces of three directions, under conditions of different feed speeds, different tilt angles of tool and without or with the pin on the tool, by using octagonal ring dynamometer in the AA2024 aluminum FSJ (Friction Stir Joining) process, and investigate how four main factors influence forces in the FSJ process. It is found that, high feed speed lead to small feed force and small lateral force, but high feed speed leads to large feed force in the stable joining stage of process. As the rotational speed increasing, the time of axial force drop from the maximum to the minimum required increased in the push-up process. In the stable joining stage, the rotational speed has little effect on the feed force; large rotational speed leads to small lateral force and axial force. The maximum axial force increases as the tilt angle of tool increases at the downward movement stage. At the moment of start feeding, as tilt angle of tool increases, the amplitudes of the axial force increasing become large. In the stable joining stage, with the increase of tilt angle of tool, the axial force is increased, the lateral force is decreased, and the feed force almost unchanged. The tool with pin will decrease axial force in the downward movement stage. The feed force and lateral force will increase, but the axial force will reduced in the stable joining stage by using the tool with pin compare to by using the tool without pin.

Keywords: FSJ, force factor, AA2024 aluminum, friction stir joining

Procedia PDF Downloads 491

Authors: Yung C. Lin, Kung D. Wu, Wei C. Shih, Jui P. Hung

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High speed and high precision machining have become the most important technology in manufacturing industry. The surface roughness of high precision components is regarded as the important characteristics of the product quality. However, machining chatter could damage the machined surface and restricts the process efficiency. Therefore, selection of the appropriate cutting conditions is of importance to prevent the occurrence of chatter. In addition, vibration of the spindle tool also affects the surface quality, which implies the surface precision can be controlled by monitoring the vibration of the spindle tool. Based on this concept, this study was aimed to investigate the influence of the machining conditions on the surface roughness and the vibration of the spindle tool. To this end, a series of machining tests were conducted on aluminum alloy. In tests, the vibration of the spindle tool was measured by using the acceleration sensors. The surface roughness of the machined parts was examined using white light interferometer. The response surface methodology (RSM) was employed to establish the mathematical models for predicting surface finish and tool vibration, respectively. The correlation between the surface roughness and spindle tool vibration was also analyzed by ANOVA analysis. According to the machining tests, machined surface with or without chattering was marked on the lobes diagram as the verification of the machining conditions. Using multivariable regression analysis, the mathematical models for predicting the surface roughness and tool vibrations were developed based on the machining parameters, cutting depth (a), feed rate (f) and spindle speed (s). The predicted roughness is shown to agree well with the measured roughness, an average percentage of errors of 10%. The average percentage of errors of the tool vibrations between the measurements and the predictions of mathematical model is about 7.39%. In addition, the tool vibration under various machining conditions has been found to have a positive influence on the surface roughness (r=0.78). As a conclusion from current results, the mathematical models were successfully developed for the predictions of the surface roughness and vibration level of the spindle tool under different cutting condition, which can help to select appropriate cutting parameters and to monitor the machining conditions to achieve high surface quality in milling operation.

Keywords: machining parameters, machining stability, regression analysis, surface roughness

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Authors: Michelle Roesler, Ian Glendon, Francis O'Callaghan

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This study expands on recent findings and offers a new perspective on recovery from injury and return to work (RTW) after an acute traumatic occupational hand injury. Recovery is a complex medical and psychosocial process. A number of predictor variables were studied simultaneously to identify the bio-psychosocial variables that impede recovery. An unexpected phenomenon to emerge from this study was the high incidence of complications within the hand-injured patient sample. Twenty six percent (n = 71) of the total sample (N = 263) required a second operation due to complications. This warranted further investigation. Results confirmed that complications not only significantly delayed the RTW outcome but also had a profound psychological impact on the individuals affected. Research has found that surgical complications are usually the result of incorrect early assessment and management. A strategic plan needs to be implemented to ensure the optimal level of surgical care is provided for managing acute traumatic hand injuries to avoid such complications.

Keywords: occupational hand trauma, psychological recovery, return to work, psychology

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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

Procedia PDF Downloads 92

Authors: Jui-Pui Hung, Yong-Run Chen, Wei-Cheng Shih, Shen-He Tsui, Kung-Da Wu

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This paper presents the effect on the tooling conditions on the machining stabilities of a milling machine tool. The machining stability was evaluated in different feeding direction in the X-Y plane, which was referred as the orientation-dependent machining stability. According to the machining mechanics, the machining stability was determined by the frequency response function of the cutter. Thus, we first conducted the vibration tests on the spindle tool of the milling machine to assess the tool tip frequency response functions along the principal direction of the machine tool. Then, basing on the orientation dependent stability analysis model proposed in this study, we evaluated the variation of the dynamic characteristics of the spindle tool and the corresponding machining stabilities at a specific feeding direction. Current results demonstrate that the stability boundaries and limited axial cutting depth of a specific cutter were affected to vary when it was fixed in the tool holder with different overhang length. The flute of the cutter also affects the stability boundary. When a two flute cutter was used, the critical cutting depth can be increased by 47 % as compared with the four flute cutter. The results presented in study provide valuable references for the selection of the tooling conditions for achieving high milling performance.

Keywords: tooling condition, machining stability, milling machine, chatter

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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

Procedia PDF Downloads 124

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: Vasudeva Murthy Challakere Ramaswamy

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Background: Conventionally forensic pathology is learnt through autopsy demonstrations which carry various limitations such as unavailability of cases in the mortuary, medico-legal implication and infection. Over the years forensic pathology and science has undergone significant evolution in this digital world. Forensic imaging is a technology which can be effectively utilized for overcoming the current limitations in the undergraduate learning of forensic curriculum. Materials and methods: demonstration of forensic imaging was done using a novel technology of autopsy which has been recently introduced across the globe. Three sessions were conducted in international medical university for a total of 196 medical students. The innovative educational tool was evacuated by using quantitative questionnaire with the scoring scales between 1 to 10. Results: The mean score for acceptance of new tool was 82% and about 74% of the students recommended incorporation of the forensic imaging in the regular curriculum. 82% of students were keen on collaborative research and taking further training courses in forensic imaging. Conclusion: forensic imaging can be an effective tool and also a suitable alternative for teaching undergraduate students. This feedback also supports the fact that students favour the use of contemporary technologies in learning medicine.

Keywords: forensic imaging, forensic pathology, medical students, learning tool

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Authors: G. H. Li, M. Liu, H. J. Qi, Q. Zhu, W. Z. He

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The drilling and riveting processes are widely used in the assembly of carrier rocket, which makes the efficiency and quality of drilling become the important factor affecting the assembly process. According to the problem existing in the drilling of thick stacked plate (thickness larger than 10mm) of carrier rocket, such as drill break, large noise and burr etc., experimental study of the influence of tool material on the drilling was carried out. The cutting force was measured by a piezoelectric dynamometer, the aperture was measured with an outline projector, and the burr is observed and measured by a digital stereo microscope. Through the measurement, the effects of tool material on the drilling were analyzed from the aspects of drilling force, diameter, and burr. The results show that, compared with carbide drill and coated carbide one, the drilling force of high speed steel is larger. But, the application of high speed steel also has some advantages, e.g. a higher number of hole can be obtained, the height of burr is small, the exit is smooth and the slim burr is less, and the tool experiences wear but not fracture. Therefore, the high speed steel tool is suitable for the drilling of thick stacked plate of 2219 Aluminum alloy.

Keywords: 2219 aluminum alloy, thick stacked plate, drilling, tool material

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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: 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

Procedia PDF Downloads 107

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: 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: Dagmar Monett, Sven-Erik Kujat, Marvin Hartmann

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This paper discusses the use of a template-based approach for documenting high-quality requirements as part of course projects in an undergraduate Software Engineering course. In order to ease some of the Requirements Engineering activities that are performed when defining requirements by using the template, a new CASE tool, RED:WIRE, was first developed and later tested by students attending the course. Two questionnaires were conceived around a study that aims to analyze the new tool’s learnability as well as other obtained results concerning its usability in particular and the Requirements Engineering skills developed by the students in general.

Keywords: CASE tool, requirements engineering, SOPHIST template, undergraduate course

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Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

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Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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

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

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Authors: 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

Procedia PDF Downloads 66

Authors: T. R. Hidayat, G. Irawan, F. Kurniawan, E. H. I. Prasetya, Suharto, T. F. Ridwan, A. Pitoyo, A. Juniantoro, R. T. Hidayat

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Swab activities is an activity to lift fluid from inside the well with the use of a sand line that aims to find out fluid influx after conducting perforation or to reduce the level of fluid as an effort to get the difference between formation pressure with hydrostatic pressure in the well for underbalanced perforation. During the swab activity, problems occur frequent problems occur with the rubber swab. The rubber swab often breaks and becomes a fish inside the well. This rubber swab fishing activity caused the rig operation takes longer, the swab result data becomes too late and create potential losses of well operation for the company. The average time needed for fishing the fractions of rubber swab plus swab work is 42 hours. Innovation made for such problems is to modify the rubber swab tool. The rubber swab tool is modified by provided a series of brushes at the end part of the tool with a thread of connection in order to improve work safety, so when the rubber swab breaks, the broken swab will be lifted by the brush underneath; therefore, it reduces the loss time for rubber swab fishing. This tool has been applied, it and is proven that with this rubber swab tool modification, the rig operation becomes more efficient because it does not carry out the rubber swab fishing activity. The fish fractions of the rubber swab are lifted up to the surface. Therefore, it saves the fuel cost, and well production potentials are obtained. The average time to do swab work after the application of this modified tool is 8 hours.

Keywords: rubber swab, modifikasi swab, brush, fishing rubber swab, saving cost

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Authors: Stephen Miller

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The act of applying game mechanics and dynamics (which have been traditionally used in video games) into business applications is being widely trialed in an effort to make conventional business software a bit more participative, fun and engaging. This new trend, named ‘gamification’ has its believers and of course, its critics who still need convincing that the concept is an effective and beneficial business tool worthy of investment. The literature reveals that user engagement of business intelligence (BI) tools is much lower than expected and investors are failing to get a good return on their investment (ROI). So, a software prototype will be designed and developed to add gamification to a BI tool to determine its effect upon the user engagement levels of test participants. The experimental study will be evaluated using the comprehensive User Engagement Scale (UES) to see if there are improvements in areas such as; aesthetics, perceived usability, endurability, novelty, felt involvement and focused attention. The results of this unique study should demonstrate whether or not ‘gamifying’ a BI tool has the potential to increase an individual’s motivation to use BI software more often.

Keywords: business intelligence, gamification, human computer interaction, user engagement

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Authors: Marita Canina, Carmen Bruno

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Digital Do It Yourself (DIY) is a contemporary socio-technological phenomenon, enabled by technological tools. The nature and potential long-term effects of this phenomenon have been widely studied within the framework of the EU funded project ‘Digital Do It Yourself’, in which the authors have created and experimented a specific Digital Do It Yourself (DiDIY) co-design process. The phenomenon was first studied through a literature research to understand its multiple dimensions and complexity. Therefore, co-design workshops were used to investigate the phenomenon by involving people to achieve a complete understanding of the DiDIY practices and its enabling factors. These analyses allowed the definition of the DiDIY fundamental factors that were then translated into a design tool. The objective of the tool is to shape design concepts by transferring these factors into different environments to achieve innovation. The aim of this paper is to present the ‘DiDIY Factor Stimuli’ tool, describing the research path and the findings behind it.

Keywords: co-design process, digital DIY, innovation, toolkit

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Authors: Ana Vieira, Fernando Lau, João Pedro Mortágua, Luís Cruz, Rui Santos

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The air transport impact on environment is more than ever a limitative obstacle to the aeronautical industry continuous growth. Over the last decades, considerable effort has been carried out in order to obtain quieter aircraft solutions, whether by changing the original design or investigating more silent maneuvers. The noise propagated by rotating surfaces is one of the most important sources of annoyance, being present in most aerial vehicles. Bearing this is mind, CEIIA developed a new computational chain for noise prediction with in-house software tools to obtain solutions in relatively short time without using excessive computer resources. This work is based on the new acoustic tool, which aims to predict the rotor noise generated during steady and maneuvering flight, making use of the flexibility of the C language and the advantages of GPU programming in terms of velocity. The acoustic tool is based in the Formulation 1A of Farassat, capable of predicting two important types of noise: the loading and thickness noise. The present work describes the most important features of the acoustic tool, presenting its most relevant results and framework analyses for helicopters and UAV quadrotors.

Keywords: rotor noise, acoustic tool, GPU Programming, UAV noise

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Authors: Hong Lu, Yongquan Zhang, Wei Fan, Xiangang Su

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Bent mandrel has been widely used as precise mould in automobile industry, shipping industry and aviation industry. To improve the versatility and efficiency of turning method of bent mandrel with fixed rotational center, an instantaneous machining model based on cutting parameters and machine dimension is prospered in this paper. The spiral-like tool path generation approach in non-axisymmetric turning process of bent mandrel is developed as well to deal with the error of part-to-part repeatability in existed turning model. The actual cutter-location points are calculated by cutter-contact points, which are obtained from the approach of spiral sweep process using equal-arc-length segment principle in polar coordinate system. The tool offset is set to avoid the interference between tool and work piece is also considered in the machining model. Depend on the spindle rotational angle, synchronization control of X-axis, Z-axis and C-axis is adopted to generate the tool-path of the turning process. The simulation method is developed to generate NC program according to the presented model, which includes calculation of cutter-location points and generation of tool-path of cutting process. With the approach of a bent mandrel taken as an example, the maximum offset of center axis is 4mm in the 3D space. Experiment results verify that the machining model and turning method are appropriate for the characteristics of bent mandrel.

Keywords: bent mandrel, instantaneous machining model, simulation method, tool-path generation

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Authors: Hamza Iftikhar

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The research study focuses on the transgender community's gender recognition challenges. It is one of the issues for the transgender community, interacting directly with the difficulties of gender identity and the lives of these people who are facing gender disapproval from society. This study investigates the major flaws of the transgender act. The study's goal is to look into the strange implications of self-perceived identity as a policy tool for transgender recognition. This policy tool jeopardises the rights of Pakistan's indigenous gender-variant people as well as the country's legal and social framework. Qualitative research using semi structured interviews will be carried out. This study proposes developing a scheme for mainstreaming gender-variant people on the basis of the Pakistani Constitution, Supreme Court guidelines, and internationally recognised principles of law. This would necessitate a thorough review of current law using a new approach and reference point.

Keywords: transgender act, self perceived identity, gender variant, policy tool

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Authors: Konstantinos Pikos, Dimitrios Kaimaris

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Although designing building blocks is a procedure used by many planners around the world, there isn’t an automated tool that will help planners and designers achieve their goals with lesser effort. The difficulty of the subject lies in the repeating process of manually drawing lines, while not only it is mandatory to maintain the desirable offset but to also achieve a lesser impact to the existing building stock. In this paper, using Geographical Information Systems (GIS) and the Python programming language, an automated tool integrated into ArcGIS PRO, is being presented. Despite its simplistic enviroment and the lack of specialized building legislation due to the complex state of the field, a planner who is aware of such technical information can use the tool to draw an initial approach of the final building blocks in an area with pre-existing buildings in an attempt to organize the usually sprawling suburbs of a city or any continuously developing area. The tool uses ESRI’s ArcPy library to handle the spatial data, while interactions with the user is made throught Tkinter. The main process consists of a modification of building edgescoordinates, using NumPy library, in an effort to draw the line of best fit, so the user can get the optimal results per block’s side. Finally, after the tool runs successfully, a table of primary planning information is shown, such as the area of the building block and its coverage rate. Regardless of the primary stage of the tool’s development, it is a solid base where potential planners with programming skills could invest, so they can make the tool adapt to their individual needs. An example of the entire procedure in a test area is provided, highlighting both the strengths and weaknesses of the final results.

Keywords: arcPy, GIS, python, building blocks

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Authors: M. Khalid Alamgir, Javed Ahsan Bhatti, M. Zafarullah Khan

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Thin film of amorphous carbon (DLC) was deposited on 316 steel using Nd: YAG laser having energy 300mJ. Pure graphite was used as a target. The vacuum in the deposition chamber was generated in the range of 10-6 mbar by turbo molecular pump. Ratio of sp3 to sp2 content shows amorphous nature of the film. This was confirmed by Raman spectra having two peaks around 1300 cm-1 i.e. D-band to 1700 cm-1 i.e. G-band. If sp3 bonding ratio is high, the films behave like diamond-like whereas, with high sp2, films are graphite-like. The ratio of sp3 and sp2 contents in the film depends upon the deposition method, hydrogen contents and system parameters. The structural study of the film was carried out by XRD. The hardness of the films as measured by Vickers hardness tester and was found to be 28 GPa. The EDX result shows the presence of carbon contents on the surface in high rate and optical microscopy result shows the smoothness of the film on substrate. The film possesses good adhesion and can be used to coat surgical instruments.

Keywords: DLC, thin film, Raman spectroscopy, XRD, EDX

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Authors: S. Ghorbani, N. I. Polushin

Abstract:

The machinability of workpieces (AISI 1045 Steel, AA2024 aluminum alloy, A48-class30 gray cast iron) in turning operation has been carried out using different types of cutting tool (conventional, cutting tool with holes in toolholder and cutting tool filled up with composite material) under dry conditions on a turning machine at different stages of spindle speed (630-1000 rpm), feed rate (0.05-0.075 mm/rev), depth of cut (0.05-0.15 mm) and tool overhang (41-65 mm). Experimentation was performed as per Taguchi’s orthogonal array. To evaluate the relative importance of factors affecting surface roughness the single decision tree (SDT), Decision tree forest (DTF) and Group method of data handling (GMDH) were applied.

Keywords: decision tree forest, GMDH, surface roughness, Taguchi method, turning process

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

Abstract:

Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Arthi Ganapathy, Rati Tandon, Saroj Kaler

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Introduction: A thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures like lobectomy, pneumonectomy, and segmentectomy of lungs. The arrangement of structures in the lung hilum act as a guide in performing such procedures. The normal pattern of arrangement of hilar structures in the right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In the left lung, it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. The arrangement of hilar structures from anterior to posterior in both the lungs is pulmonary vein, pulmonary artery, and principal bronchus. The bronchial arteries are very small and usually the posterior most structures in the hilum of lungs. Aim: The present study aims at reporting the variations in hilar anatomy (arrangement and number) of lungs. Methodology: 75 adult formalin fixed cadaveric lungs from the department of Anatomy AIIMS New Delhi were observed for variations in the lobar anatomy. Arrangement of pulmonary hilar structures was meticulously observed, and any deviation in the pattern of presentation was recorded. Results: Among the 75 adult lung specimens observed 36 specimens were of right lung and the rest of left lung. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. The normal pattern of arrangement of hilar structures was seen in 22 right lungs and 23 left lungs. Rest of the lung specimens (14 right and 16 left) showed a varied pattern of arrangement of hilar structures. Some of them showed alterations in the sequence of arrangement of pulmonary artery, pulmonary veins, bronchus, and others in the number of these structures. Conclusion: Alterations in the pattern of arrangement of structures in the lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent complications like intraoperative bleeding during surgical procedures.

Keywords: fissures, hilum, lobes, pulmonary

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

Abstract:

Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Sunitha Sampathi, Pankaj Kumar Tiriya, Sonia Gera, Sravanthi Reddy Pailla, V. Likhitha, A. J. Maruthi

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Surgical site infections (SSIs) are the most common nosocomial infections localized at the incision site. With an estimated 27 million surgical procedures each year in USA, approximately 2-5% rate of SSIs are predicted to occur annually. SSIs are treated with antibiotic medication. Current trend suggest that the direct drug delivery from the suture to the scared tissue can improve patient comfort and wound recovery. For that reason coating the surface of the medical device such as suture and catguts with broad spectrum antibiotics can prevent the formation of bactierial colonies with out comprimising the mechanical properties of the sutures.Hence, the present study was aimed to develop and evaluate a surgical suture coated with an antibiotic Ciprofloxacin hydrochloride loaded on gold nanoparticles. Gold nanoparticles were synthesized by chemical reduction method and conjugated with ciprofloxacin using Polyvinylpyrolidone as stabilizer and gold as carrier. Ciprofloxacin conjugated gold nanoparticles were coated over an absorbable surgical suture made of Polyglactan using sodium alginate as an immobilising agent by slurry dipping technique. The average particle size and Polydispersity Index of drug conjugated gold NPs were found to be 129±2.35 nm and 0.243±0.36 respectively. Gold nanoparticles are characterized by UV-Vis absorption spectroscopy, Fourier Transform Infrared Spectroscopy (FT-IR), Scanning electron microscopy and Transmission electron microscopy. FT-IR revealed that there is no chemical interaction between drug and polymer. Antimicrobial activity for coated sutures was evaluated by disc diffusion method on culture plates of both gram negative (E-coli) and gram positive bacteria (Staphylococcus aureus) and results found to be satisfactory. In vivo studies for coated sutures was performed on Swiss albino mice and histological evaluation of intestinal wound healing parameters such as wound edges in mucosa, muscularis, presence of necrosis, exudates, granulation tissue, granulocytes, macrophages, restoration, and repair of mucosal epithelium and muscularis propria on day 7 after surgery were studied. The control animal group, sutured with plain suture (uncoated suture) showed signs of restoration and repair, but presence of necrosis, heamorraghic infiltration and granulation tissue was still noticed. Whereas the animal group treated with ciprofloxacin and ciprofloxacin gold nanoparticle coated sutures has shown promising decrease in terms of haemorraghic infiltration, granulation tissue, necrosis and better repaired muscularis layers on comparision with plain coated sutures indicating faster rate of repair and less chance of sepsis. Hence coating of sutures with broad spectrum antibiotics can be an alternate technique to reduce SSIs.

Keywords: ciprofloxacin hydrochloride, gold nanoparticles, surgical site infections, sutures

Procedia PDF Downloads 256