Search results for: aortic valve stenosis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 325

Search results for: aortic valve stenosis

85 Hybrid Genetic Approach for Solving Economic Dispatch Problems with Valve-Point Effect

Authors: Mohamed I. Mahrous, Mohamed G. Ashmawy

Abstract:

Hybrid genetic algorithm (HGA) is proposed in this paper to determine the economic scheduling of electric power generation over a fixed time period under various system and operational constraints. The proposed technique can outperform conventional genetic algorithms (CGAs) in the sense that HGA make it possible to improve both the quality of the solution and reduce the computing expenses. In contrast, any carefully designed GA is only able to balance the exploration and the exploitation of the search effort, which means that an increase in the accuracy of a solution can only occure at the sacrifice of convergent speed, and vice visa. It is unlikely that both of them can be improved simultaneously. The proposed hybrid scheme is developed in such a way that a simple GA is acting as a base level search, which makes a quick decision to direct the search towards the optimal region, and a local search method (pattern search technique) is next employed to do the fine tuning. The aim of the strategy is to achieve the cost reduction within a reasonable computing time. The effectiveness of the proposed hybrid technique is verified on two real public electricity supply systems with 13 and 40 generator units respectively. The simulation results obtained with the HGA for the two real systems are very encouraging with regard to the computational expenses and the cost reduction of power generation.

Keywords: genetic algorithms, economic dispatch, pattern search

Procedia PDF Downloads 409
84 Regional Anesthesia: A Vantage Point for Management of Normal Pressure Hydrocephalus

Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

Abstract:

Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

Procedia PDF Downloads 52
83 Analysis of an High Voltage Direct Current (HVDC) Connection Using a Real-Time Simulator Under Various Disturbances

Authors: Mankour Mohamed, Miloudi Mohamed

Abstract:

A thorough and accurate simulation is necessary for the study of a High Voltage Direct Current (HVDC) link system during various types of disturbances, including internal faults on both converters, either on the rectifier or on the inverter, as well as external faults, such as AC or DC faults on both converter sides inside the DC link party. In this study, we examine how an HVDC inverter responds to three different types of failures, including faults at the inverter valve, system control faults, and single-phase-to-ground AC faults at the sending end of the inverter side. As this phenomenon represents the most frequent problem that may affect inverter valves, particularly those based on thyristor valves (LCC (line-Commutated converter)), it is more precise to explore which circumstance generates and raises the commutation failure on inverter valves. Because of the techniques used to accelerate the simulation, digital real-time simulators are now the most potent tools that provide simulation results. The real-time-lab RT-LAB platform HYPERSIM OP-5600 is used to implement the Simulation in the Loop (SIL) technique, which is used to validate the results. It is demonstrated how to recover from both the internal faults and the AC problem. The simulation findings show how crucial a role the control system plays in fault recovery.

Keywords: hypersim simulator, HVDC systems, mono-polar link, AC faults, misfiring faults

Procedia PDF Downloads 64
82 Comparison Of Virtual Non-Contrast To True Non-Contrast Images Using Dual Layer Spectral Computed Tomography

Authors: O’Day Luke

Abstract:

Purpose: To validate virtual non-contrast reconstructions generated from dual-layer spectral computed tomography (DL-CT) data as an alternative for the acquisition of a dedicated true non-contrast dataset during multiphase contrast studies. Material and methods: Thirty-three patients underwent a routine multiphase clinical CT examination, using Dual-Layer Spectral CT, from March to August 2021. True non-contrast (TNC) and virtual non-contrast (VNC) datasets, generated from both portal venous and arterial phase imaging were evaluated. For every patient in both true and virtual non-contrast datasets, a region-of-interest (ROI) was defined in aorta, liver, fluid (i.e. gallbladder, urinary bladder), kidney, muscle, fat and spongious bone, resulting in 693 ROIs. Differences in attenuation for VNC and TNV images were compared, both separately and combined. Consistency between VNC reconstructions obtained from the arterial and portal venous phase was evaluated. Results: Comparison of CT density (HU) on the VNC and TNC images showed a high correlation. The mean difference between TNC and VNC images (excluding bone results) was 5.5 ± 9.1 HU and > 90% of all comparisons showed a difference of less than 15 HU. For all tissues but spongious bone, the mean absolute difference between TNC and VNC images was below 10 HU. VNC images derived from the arterial and the portal venous phase showed a good correlation in most tissue types. The aortic attenuation was somewhat dependent however on which dataset was used for reconstruction. Bone evaluation with VNC datasets continues to be a problem, as spectral CT algorithms are currently poor in differentiating bone and iodine. Conclusion: Given the increasing availability of DL-CT and proven accuracy of virtual non-contrast processing, VNC is a promising tool for generating additional data during routine contrast-enhanced studies. This study shows the utility of virtual non-contrast scans as an alternative for true non-contrast studies during multiphase CT, with potential for dose reduction, without loss of diagnostic information.

Keywords: dual-layer spectral computed tomography, virtual non-contrast, true non-contrast, clinical comparison

Procedia PDF Downloads 114
81 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

Procedia PDF Downloads 152
80 Silicon-To-Silicon Anodic Bonding via Intermediate Borosilicate Layer for Passive Flow Control Valves

Authors: Luc Conti, Dimitry Dumont-Fillon, Harald van Lintel, Eric Chappel

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Flow control valves comprise a silicon flexible membrane that deflects against a substrate, usually made of glass, containing pillars, an outlet hole, and anti-stiction features. However, there is a strong interest in using silicon instead of glass as substrate material, as it would simplify the process flow by allowing the use of well controlled anisotropic etching. Moreover, specific devices demanding a bending of the substrate would also benefit from the inherent outstanding mechanical strength of monocrystalline silicon. Unfortunately, direct Si-Si bonding is not easily achieved with highly structured wafers since residual stress may prevent the good adhesion between wafers. Using a thermoplastic polymer, such as parylene, as intermediate layer is not well adapted to this design as the wafer-to-wafer alignment is critical. An alternative anodic bonding method using an intermediate borosilicate layer has been successfully tested. This layer has been deposited onto the silicon substrate. The bonding recipe has been adapted to account for the presence of the SOI buried oxide and intermediate glass layer in order not to exceed the breakdown voltage. Flow control valves dedicated to infusion of viscous fluids at very high pressure have been made and characterized. The results are compared to previous data obtained using the standard anodic bonding method.

Keywords: anodic bonding, evaporated glass, flow control valve, drug delivery

Procedia PDF Downloads 170
79 Osteoprotegerin and Osteoprotegerin/TRAIL Ratio are Associated with Cardiovascular Dysfunction and Mortality among Patients with Renal Failure

Authors: Marek Kuźniewski, Magdalena B. Kaziuk , Danuta Fedak, Paulina Dumnicka, Ewa Stępień, Beata Kuśnierz-Cabala, Władysław Sułowicz

Abstract:

Background: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. Methods: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CaSc) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration. Cardiovascular and overall mortality data were collected during a 7-years follow-up. Results: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. Conclusions: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.

Keywords: osteoprotegerin, tumor necrosis factor-related apoptosis-inducing ligand, receptor activator of nuclear factor kappa-B ligand, hemodialysis, chronic kidney disease, cardiovascular disease

Procedia PDF Downloads 315
78 Rare Diagnosis in Emergency Room: Moyamoya Disease

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

Procedia PDF Downloads 244
77 A Fuzzy Control System for Reducing Urban Stormwater Runoff by a Stormwater Storage Tank

Authors: Pingping Zhang, Yanpeng Cai, Jianlong Wang

Abstract:

Stormwater storage tank (SST) is a popular low impact development technology for reducing stormwater runoff in the construction of sponge city. At present, it is difficult to perform the automatic control of SST for reducing peak flow. In this paper, fuzzy control was introduced into the peak control of SST to improve the efficiency of reducing stormwater runoff. Firstly, the design of SST was investigated. A catchment area and a return period were assumed, a SST model was manufactured, and then the storage capacity of the SST was verified. Secondly, the control parameters of the SST based on reducing stormwater runoff were analyzed, and a schematic diagram of real-time control (RTC) system based on peak control SST was established. Finally, fuzzy control system of a double input (flow and water level) and double output (inlet and outlet valve) was designed. The results showed that 1) under the different return periods (one year, three years, five years), the SST had the effect of delayed peak control and storage by increasing the detention time, 2) rainfall, pipeline flow, the influent time and the water level in the SST could be used as RTC parameters, and 3) the response curves of flow velocity and water level fluctuated very little and reached equilibrium in a short time. The combination of online monitoring and fuzzy control was feasible to control the SST automatically. This paper provides a theoretical reference for reducing stormwater runoff and improving the operation efficiency of SST.

Keywords: stormwater runoff, stormwater storage tank, real-time control, fuzzy control

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76 Effect of Nigella sativa on Blood Pressure, Vascular Reactivity, Inflammatory Biomarkers and Nitric Oxide in L-Name-Induced Hypertensive Rats

Authors: Kamsiah Jaarin, Yusof Kamisah, Faizah Othman Nurul Akmal Muhammad, Zakiah Jubri, Qodriyah Mohd Saad, Srijit Das

Abstract:

Forty (40) normotensive adult male Sprague-Dawley rats aged three months weighing 180-200 g were divided into 4 groups with 10 rats per group: (1) normotensive control; (2) hypertensive rats; (3) hypertensive rats treated with Nigella sativa (2.5 ml/kg/day); and (4) hypertensive rats treated with nicardipine (5 mg/kg/day). After acclimatization, the hypertensive rats of the group 2, 3 and 4 were induced to be hypertensive by giving NW–nitro-L-arginine methyl ester (L-NAME; 30 mg/kg/day) in their drinking water for consecutive 7 days. After one week, rats in the group 3 were given a daily oral dose of 2.5 ml/kg/day of Nigella sativa (NS) by oral gavage. Rats in the group 4 were given nicardipine (5 mg/kg/day) via oral gavages. All rats in this study received L-NAME continuously throughout the treatment duration. The blood pressure will be measured pre-treatment and weekly for 8 weeks using power lab. Blood was taken before and at the end of study for measurement of nitric oxide. At the end of 8 weeks, the rats are sacrificed and descending thoracic aorta was disserted for measurement of vascular reactivity, and intracellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1). Nigella sativa reduced both systolic and diastolic BP compared to control and L-name group. The BP lowering effect of NS was comparable to nicardipine a calcium antagonist. The blood pressure lowering effect of NS was accompanied with an increasing relaxation response to nitroprusside and acetylcholine and reducing vasoconstriction response to epinephrine. L-NAME and nicardipine on the other hand, reduced plasma nitric oxide concentration. In contrast, NS increased NO concentration. However, Nigella sativa had no significant effect on aortic VCAM- 1 and ICAM-1 expression. In conclusion; Nigella sativa oil reduces both systolic and diastolic blood pressure in L-NAME treated rats. The antihypertensive effect of NS was comparable to nicardipine. The BP lowering effect may be mediated via stimulating nitric oxide release from vascular endothelium.

Keywords: Nigella sativa, ICAM, VCAM, blood pressure, vascular reactivity

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75 Non-Invasive Assessment of Peripheral Arterial Disease: Automated Ankle Brachial Index Measurement and Pulse Volume Analysis Compared to Ultrasound Duplex Scan

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

Abstract:

Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

Procedia PDF Downloads 132
74 Two-Dimensional CFD Simulation of the Behaviors of Ferromagnetic Nanoparticles in Channel

Authors: Farhad Aalizadeh, Ali Moosavi

Abstract:

This paper presents a two-dimensional Computational Fluid Dynamics (CFDs) simulation for the steady, particle tracking. The purpose of this paper is applied magnetic field effect on Magnetic Nanoparticles velocities distribution. It is shown that the permeability of the particles determines the effect of the magnetic field on the deposition of the particles and the deposition of the particles is inversely proportional to the Reynolds number. Using MHD and its property it is possible to control the flow velocity, remove the fouling on the walls and return the system to its original form. we consider a channel 2D geometry and solve for the resulting spatial distribution of particles. According to obtained results when only magnetic fields are applied perpendicular to the flow, local particles velocity is decreased due to the direct effect of the magnetic field return the system to its original fom. In the method first, in order to avoid mixing with blood, the ferromagnetic particles are covered with a gel-like chemical composition and are injected into the blood vessels. Then, a magnetic field source with a specified distance from the vessel is used and the particles are guided to the affected area. This paper presents a two-dimensional Computational Fluid Dynamics (CFDs) simulation for the steady, laminar flow of an incompressible magnetorheological (MR) fluid between two fixed parallel plates in the presence of a uniform magnetic field. The purpose of this study is to develop a numerical tool that is able to simulate MR fluids flow in valve mode and determineB0, applied magnetic field effect on flow velocities and pressure distributions.

Keywords: MHD, channel clots, magnetic nanoparticles, simulations

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73 Characteristics of Clinical and Diagnostic Aspects of Benign Diseases of Cervi̇x in Women

Authors: Gurbanova J., Majidova N., Ali-Zade S., Hasanova A., Mikailzade P.

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Currently, the problem of oncogynecological diseases is widespread and remains relevant in terms of quantitative growth. It is known that due to the increase in the number of benign diseases of the cervix, the development of precancerous conditions occurs. Benign diseases of the cervix represent the most common gynecological problem, which are often precursors of malignant neoplasms, especially cervical cancer. According to statistics, benign diseases of the cervix cover 25-45% of all gynecological diseases. Among women's oncogynecological diseases, cervical cancer ranks second in the world after breast cancer and ranks first in the mortality rate among oncological diseases in economically underdeveloped countries. We performed a comprehensive clinical and laboratory examination of 130 women aged 18 to 73 with benign cervical diseases. 59 (38.5%) women of reproductive age, as well as 39 (30%) premenopausal and 41 (31.5%) menopausal patients, participated in the study. Detailed anamnesis was collected from all patients, objective and gynecological examination was performed, laboratory and instrumental examinations (USM, IPV DNA, smear microscopy, and PCR bacteriological examination of sexually transmitted infections), simple and extended colposcopy, liquid-based РАР-smear smear and РАР-classic smear examinations were conducted. As a result of the research, the following nosological forms were found in women with benign diseases of the cervix: non-specific vaginitis in 10 (7.7%) cases; ectopia, endocervicitis - 60(46.2%); cervical ectropion - 7(5.4%); cervical polyp - 9(6.9%); cervical leukoplakia - 15(11.5%); atrophic vaginitis - 7(5.4%); condyloma - 12(9.2%); cervical stenosis - 2(1.5%); endometriosis of the cervix - was noted in 8 (6.2%) cases (p<0.001), respectively. Characteristics of the menstrual cycle among the examined women: normal cycle in 97 (74.6%) cases; oligomenorrhea – 23 (17.7%); polymenorrhea – 4(3.1%); algomenorrhea – noted in 6 (4.6%) cases (p<0.001). Cytological examination showed that: the specificity of liquid-based cytology was 76.2%, and the traditional PAP test was set at 70.6%. The overall diagnostic value was calculated to be 86% in liquid-based cytology and 78.5% in conventional PAP tests. Treatment of women with benign diseases of the cervix was carried out by diathermocoagulation method and "FOTEK EA 141M" device. It should be noted that 6 months after the treatment, after treatment with the "FOTEK EA 141M" device, there was no relapse in any patient. Recurrence was found in 23.7% of patients after diathermoelectrocoagulation. Thus, it is clear from the above that the study of cervical pathologies, the determination of optimal examinations, and effective treatment methods is one of the urgent problems facing obstetrics and gynecology.

Keywords: cervical cancer, cytological examination, PAP-smear, non-specific vaginitis

Procedia PDF Downloads 65
72 The Analysis of Emergency Shutdown Valves Torque Data in Terms of Its Use as a Health Indicator for System Prognostics

Authors: Ewa M. Laskowska, Jorn Vatn

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Industry 4.0 focuses on digital optimization of industrial processes. The idea is to use extracted data in order to build a decision support model enabling use of those data for real time decision making. In terms of predictive maintenance, the desired decision support tool would be a model enabling prognostics of system's health based on the current condition of considered equipment. Within area of system prognostics and health management, a commonly used health indicator is Remaining Useful Lifetime (RUL) of a system. Because the RUL is a random variable, it has to be estimated based on available health indicators. Health indicators can be of different types and come from different sources. They can be process variables, equipment performance variables, data related to number of experienced failures, etc. The aim of this study is the analysis of performance variables of emergency shutdown valves (ESV) used in oil and gas industry. ESV is inspected periodically, and at each inspection torque and time of valve operation are registered. The data will be analyzed by means of machine learning or statistical analysis. The purpose is to investigate whether the available data could be used as a health indicator for a prognostic purpose. The second objective is to examine what is the most efficient way to incorporate the data into predictive model. The idea is to check whether the data can be applied in form of explanatory variables in Markov process or whether other stochastic processes would be a more convenient to build an RUL model based on the information coming from registered data.

Keywords: emergency shutdown valves, health indicator, prognostics, remaining useful lifetime, RUL

Procedia PDF Downloads 67
71 Biaxial Fatigue Specimen Design and Testing Rig Development

Authors: Ahmed H. Elkholy

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An elastic analysis is developed to obtain the distribution of stresses, strains, bending moment and deformation for a thin hollow, variable thickness cylindrical specimen when subjected to different biaxial loadings. The specimen was subjected to a combination of internal pressure, axial tensile loading and external pressure. Several axial to circumferential stress ratios were investigated in detail. The analytical model was then validated using experimental results obtained from a test rig using several biaxial loadings. Based on the preliminary results obtained, the specimen was then modified geometrically to ensure uniform strain distribution through its wall thickness and along its gauge length. The new design of the specimen has a higher buckling strength and a maximum value of equivalent stress according to the maximum distortion energy theory. A cyclic function generator of the standard servo-controlled, electro-hydraulic testing machine is used to generate a specific signal shape (sine, square,…) at a certain frequency. The two independent controllers of the electronic circuit cause an independent movement to each servo-valve piston. The movement of each piston pressurizes the upper and lower sides of the actuators alternately. So, the specimen will be subjected to axial and diametral loads independent of each other. The hydraulic system has two different pressures: one pressure will be responsible for axial stress produced in the specimen and the other will be responsible for the tangential stress. Changing the two pressure ratios will change the stress ratios accordingly. The only restriction on the maximum stress obtained is the capacity of the testing system and specimen instability due to buckling.

Keywords: biaxial, fatigue, stress, testing

Procedia PDF Downloads 102
70 Evaluation of Human Amnion Hemocompatibility as a Substitute for Vessels

Authors: Ghasem Yazdanpanah, Mona Kakavand, Hassan Niknejad

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Objectives: An important issue in tissue engineering (TE) is hemocompatibility. The current engineered vessels are seriously at risk of thrombus formation and stenosis. Amnion (AM) is the innermost layer of fetal membranes that consists of epithelial and mesenchymal sides. It has the advantages of low immunogenicity, anti-inflammatory and anti-bacterial properties as well as good mechanical properties. We recently introduced the amnion as a natural biomaterial for tissue engineering. In this study, we have evaluated hemocompatibility of amnion as potential biomaterial for tissue engineering. Materials and Methods: Amnions were derived from placentas of elective caesarean deliveries which were in the gestational ages 36 to 38 weeks. Extracted amnions were washed by cold PBS to remove blood remnants. Blood samples were obtained from healthy adult volunteers who had not previously taken anti-coagulants. The blood samples were maintained in sterile tubes containing sodium citrate. Plasma or platelet rich plasma (PRP) were collected by blood sample centrifuging at 600 g for 10 min. Hemocompatibility of the AM samples (n=7) were evaluated by measuring of activated partial thromboplastin time (aPTT), prothrombin time (PT), hemolysis, and platelet aggregation tests. P-selectin was also assessed by ELISA. Both epithelial and mesenchymal sides of amnion were evaluated. Glass slide and expanded polytetrafluoroethylene (ePTFE) samples were defined as control. Results: In comparison with glass as control (13.3 ± 0.7 s), prothrombin time was increased significantly while each side of amnion was in contact with plasma (p<0.05). There was no significant difference in PT between epithelial and mesenchymal surfaces (17.4 ± 0.7 s vs. 15.8 ± 0.7 s, respectively). However, aPPT was not significantly changed after incubation of plasma with amnion epithelial and mesenchymal surfaces or glass (28.61 ± 1.39 s, 31.4 ± 2.66 s, glass, 30.76 ± 2.53 s, respectively, p>0.05). Amnion surfaces, ePTFE and glass samples have less hemolysis induction than water considerably (p<0.001), in which no differences were detected. Platelet aggregation measurements showed that platelets were less stimulated by the amnion epithelial and mesenchymal sides, in comparison with ePTFE and glass. In addition, reduction in amount of p-selectin, as platelet activation factor, after incubation of samples with PRP indicated that amnion has less stimulatory effects on platelets than ePTFE and glass. Conclusion: Amnion as a natural biomaterial has the potential to be used in tissue engineering. Our results suggest that amnion has appropriate hemocompatibility to be employed as a vascular substitute.

Keywords: amnion, hemocompatibility, tissue engineering, biomaterial

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69 Failure of Agriculture Soil following the Passage of Tractors

Authors: Anis Eloud, Sayed Chehaibi

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Compaction of agricultural soils as a result of the passage of heavy machinery on the fields is a problem that affects many agronomists and farmers since it results in a loss of yield of most crops. To remedy this, and raise the overall future of the food security challenge, we must study and understand the process of soil degradation. The present review is devoted to understanding the effect of repeated passages on agricultural land. The experiments were performed on a plot of the area of the ESIER, characterized by a clay texture in order to quantify the soil compaction caused by the wheels of the tractor during repeated passages on agricultural land. The test tractor CASE type puissance 110 hp and 5470 kg total mass of 3500 kg including the two rear axles and 1970 kg on the front axle. The state of soil compaction has been characterized by measuring its resistance to penetration by means of a penetrometer and direct manual reading, the density and permeability of the soil. Soil moisture was taken jointly. The measurements are made in the initial state before passing the tractor and after each pass varies from 1 to 7 on the track wheel inflated to 1.5 bar for the rear wheel and broke water to the level of valve and 4 bar for the front wheels. The passages are spaced to the average of one week. The results show that the passage of wheels on a farm tilled soil leads to compaction and the latter increases with the number of passages, especially for the upper 15 cm depth horizons. The first passage is characterized by the greatest effect. However, the effect of other passages do not follow a definite law for the complex behavior of granular media and the history of labor and the constraints it suffers from its formation.

Keywords: wheel traffic, tractor, soil compaction, wheel

Procedia PDF Downloads 449
68 Development of Self-Reliant Satellite-Level Propulsion System by Using Hydrogen Peroxide Propellant

Authors: H. J. Liu, Y. A. Chan, C. K. Pai, K. C. Tseng, Y. H. Chen, Y. L. Chan, T. C. Kuo

Abstract:

To satisfy the mission requirement of the FORMOSAT-7 project, NSPO has initialized a self-reliant development on satellite propulsion technology. A trade-off study on different types of on-board propulsion system has been done. A green propellant, high-concentration hydrogen peroxide (H2O2 hereafter), is chosen in this research because it is ITAR-free, nontoxic and easy to produce. As the components designed for either cold gas or hydrazine propulsion system are not suitable for H2O2 propulsion system, the primary objective of the research is to develop the components compatible with H2O2. By cooperating with domestic research institutes and manufacturing vendors, several prototype components, including a diaphragm-type tank, pressure transducer, ball latching valve, and one-Newton thruster with catalyst bed, were manufactured, and the functional tests were performed successfully according to the mission requirements. The requisite environmental tests, including hot firing test, thermal vaccum test, vibration test and compatibility test, are prepared and will be to completed in the near future. To demonstrate the subsystem function, an Air-Bearing Thrust Stand (ABTS) and a real-time Data Acquisition & Control System (DACS) were implemented to assess the performance of the proposed H2O2 propulsion system. By measuring the distance that the thrust stand has traveled in a given time, the thrust force can be derived from the kinematics equation. To validate the feasibility of the approach, it is scheduled to assess the performance of a cold gas (N2) propulsion system prior to the H2O2 propulsion system.

Keywords: FORMOSAT-7, green propellant, Hydrogen peroxide, thruster

Procedia PDF Downloads 395
67 Simulation-Based Control Module for Offshore Single Point Mooring System

Authors: Daehyun Baek, Seungmin Lee, Minju Kim Jangik Park, Hyeong-Soon Moon

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SPM (Single Point Mooring) is one of the mooring buoy facilities installed on a coast near oil and gas terminal which is not able to berth FPSO or large oil tankers under the condition of high draft due to geometrical limitation. Loading and unloading of crude oil and gas through a subsea pipeline can be carried out between the mooring buoy, ships and onshore facilities. SPM is an offshore-standalone system which has to withstand the harsh marine environment with harsh conditions such as high wind, current and so on. Therefore, SPM is required to have high stability, reliability and durability. Also, SPM is comprised to be integrated systems which consist of power management, high pressure valve control, sophisticated hardware/software and a long distance communication system. In order to secure required functions of SPM system, a simulation model for the integrated system of SPM using MATLAB Simulink and State flow tool has been developed. The developed model consists of configuration of hydraulic system for opening and closing of PLEM (Pipeline End Manifold) valves and control system logic. To verify functions of the model, an integrated simulation model for overall systems of SPM was also developed by considering handshaking variables between individual systems. In addition to the dynamic model, a self-diagnostic function to determine failure of the system was configured, which enables the SPM system itself to alert users about the failure once a failure signal comes to arise. Controlling and monitoring the SPM system is able to be done by a HMI system which is capable of managing the SPM system remotely, which was carried out by building a communication environment between the SPM system and the HMI system.

Keywords: HMI system, mooring buoy, simulink simulation model, single point mooring, stateflow

Procedia PDF Downloads 395
66 Correlation Between Diastolic Function and Lower GLS in Hypertensive Patients

Authors: A. Kherraf, S. Ouarrak, L. Azzouzi, R. Habbal

Abstract:

Introduction: Preserved LVEF heart failure is an important cause of mortality and morbidity in hypertensive patients. A strong correlation between impaired diastolic function and longitudinal systolic dysfunction. could have several explanations, first, the diastole is an energy dependent process, especially during its first phase, it also includes active systolic components during the phase of iso volumetric relaxation, in addition, the impairment of the intrinsic myocytic function is part of hypertensive pathology as evidenced by recent studies. METHODS AND MATERIALS: This work consists of performing in a series of 333 hypertensive patients (aged 25 to 75 years) a complete echocardiographic study, including LVEF by Simpson biplane method, the calculation of the indexed left ventricular mass, the analysis of the diastolic function, and finally, the study of the longitudinal deformation of the LV by the technique of speckletracking (calculation of the GLS). Patients with secondary hypertension, leaky or stenosing valve disease, arrhythmia, and a history of coronary insufficiency were excluded from this study. RESULTS: Of the 333 hypertensive patients, 225 patients (67.5%) had impaired diastolic function, of which 60 patients (18%) had high filling pressures. 49.39% had echocardigraphic HVG, Almost all of these patients (60 patients) had low GLS. There is a statistically very significant relationship between lower GLS and increased left ventricular filling pressures in hypertensive patients. These results suggest that increased filling pressures are closely associated with atrioventricular interaction in patients with hypertension, with a strong correlation with impairment of longitudinal systolic function and diastolic function CONCLUSION: Overall, a linear relationship is established between increased left ventricular mass, diastolic dysfunction, and longitudinal LV systolic dysfunction

Keywords: hypertension, diastolic function, left ventricle, heart failure

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65 [Keynote Talk]: Mathematical and Numerical Modelling of the Cardiovascular System: Macroscale, Mesoscale and Microscale Applications

Authors: Aymen Laadhari

Abstract:

The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.

Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell

Procedia PDF Downloads 228
64 Modeling Flow and Deposition Characteristics of Solid CO2 during Choked Flow of CO2 Pipeline in CCS

Authors: Teng lin, Li Yuxing, Han Hui, Zhao Pengfei, Zhang Datong

Abstract:

With the development of carbon capture and storage (CCS), the flow assurance of CO2 transportation becomes more important, particularly for supercritical CO2 pipelines. The relieving system using the choke valve is applied to control the pressure in CO2 pipeline. However, the temperature of fluid would drop rapidly because of Joule-Thomson cooling (JTC), which may cause solid CO2 form and block the pipe. In this paper, a Computational Fluid Dynamic (CFD) model, using the modified Lagrangian method, Reynold's Stress Transport model (RSM) for turbulence and stochastic tracking model (STM) for particle trajectory, was developed to predict the deposition characteristic of solid carbon dioxide. The model predictions were in good agreement with the experiment data published in the literature. It can be observed that the particle distribution affected the deposition behavior. In the region of the sudden expansion, the smaller particles accumulated tightly on the wall were dominant for pipe blockage. On the contrary, the size of solid CO2 particles deposited near the outlet usually was bigger and the stacked structure was looser. According to the calculation results, the movement of the particles can be regarded as the main four types: turbulent motion close to the sudden expansion structure, balanced motion at sudden expansion-middle region, inertial motion near the outlet and the escape. Furthermore the particle deposits accumulated primarily in the sudden expansion region, reattachment region and outlet region because of the four type of motion. Also the Stokes number had an effect on the deposition ratio and it is recommended for Stokes number to avoid 3-8St.

Keywords: carbon capture and storage, carbon dioxide pipeline, gas-particle flow, deposition

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63 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

Abstract:

Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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62 Frequency of Surgical Complications in Diabetic Patients after Kidney Transplantation

Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

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61 Transformer Life Enhancement Using Dynamic Switching of Second Harmonic Feature in IEDs

Authors: K. N. Dinesh Babu, P. K. Gargava

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Energization of a transformer results in sudden flow of current which is an effect of core magnetization. This current will be dominated by the presence of second harmonic, which in turn is used to segregate fault and inrush current, thus guaranteeing proper operation of the relay. This additional security in the relay sometimes obstructs or delays differential protection in a specific scenario, when the 2nd harmonic content was present during a genuine fault. This kind of scenario can result in isolation of the transformer by Buchholz and pressure release valve (PRV) protection, which is acted when fault creates more damage in transformer. Such delays involve a huge impact on the insulation failure, and chances of repairing or rectifying fault of problem at site become very dismal. Sometimes this delay can cause fire in the transformer, and this situation becomes havoc for a sub-station. Such occurrences have been observed in field also when differential relay operation was delayed by 10-15 ms by second harmonic blocking in some specific conditions. These incidences have led to the need for an alternative solution to eradicate such unwarranted delay in operation in future. Modern numerical relay, called as intelligent electronic device (IED), is embedded with advanced protection features which permit higher flexibility and better provisions for tuning of protection logic and settings. Such flexibility in transformer protection IEDs, enables incorporation of alternative methods such as dynamic switching of second harmonic feature for blocking the differential protection with additional security. The analysis and precautionary measures carried out in this case, have been simulated and discussed in this paper to ensure that similar solutions can be adopted to inhibit analogous issues in future.

Keywords: differential protection, intelligent electronic device (IED), 2nd harmonic inhibit, inrush inhibit

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60 Pulmonary Embolism Indicative of Myxoma of the Right Atrium

Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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59 Outcome Analysis of Various Management Strategies for Ileal Perforation

Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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58 Numerical Analysis of a Strainer Using Porous Media Technique

Authors: Ji-Hoon Byeon, Kwon-Hee Lee

Abstract:

Strainer filter serves to block the inflow of impurities while mixed fluid is entering or exiting the piping. The filter of the strainer has a perforated structure, so that the pressure drop and the velocity change necessarily occur when the mixed fluid passes through the filter. It is possible to predict the pressure drop and velocity change of the strainer by numerical analysis by implementing all the perforated plates. However, if the size of the perforated plate exceeds a certain size, it is difficult to perform the numerical analysis, and sometimes we cannot guarantee its accuracy. In this study, we tried to predict the pressure drop and velocity change by using the porous media technique to obtain the equivalent resistance without actual implementation of the perforation shape of the strainer. Ansys-CFX, a commercial software, is used to perform the numerical analysis. The analysis procedure is as follows. Firstly, the unit pattern of the perforated plate is modeled, and the pressure drop is analyzed by varying the velocity by symmetry of the wall surface. Secondly, since the equation for obtaining resistance is a quadratic equation of pressure having unknown velocity, the viscous resistance and the inertia resistance of the perforated plate are obtained from the relationship between pressure and speed. Thirdly, by using the calculated resistance values, the values are substituted into the flat plate implemented as a two-dimensional porous media, and the accuracy is verified by comparing the pressure drop and the velocity change. Fourthly, the pressure drop and velocity change in the whole strainer are analyzed by using the resistance values obtained on the perforated plate in the actual whole strainer model. Using the porous media technique, it is found that pressure drop and velocity change can be predicted in relatively short time without modeling the overall shape of the filter. Acknowledgements: This work was supported by the Valve Center from the Regional Innovation Center(RIC) Program of Ministry of Trade, Industry & Energy (MOTIE).

Keywords: strainer, porous media, CFD, numerical analysis

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57 Comparison of Two Neural Networks To Model Margarine Age And Predict Shelf-Life Using Matlab

Authors: Phakamani Xaba, Robert Huberts, Bilainu Oboirien

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The present study was aimed at developing & comparing two neural-network-based predictive models to predict shelf-life/product age of South African margarine using free fatty acid (FFA), water droplet size (D3.3), water droplet distribution (e-sigma), moisture content, peroxide value (PV), anisidine valve (AnV) and total oxidation (totox) value as input variables to the model. Brick margarine products which had varying ages ranging from fresh i.e. week 0 to week 47 were sourced. The brick margarine products which had been stored at 10 & 25 °C and were characterized. JMP and MATLAB models to predict shelf-life/ margarine age were developed and their performances were compared. The key performance indicators to evaluate the model performances were correlation coefficient (CC), root mean square error (RMSE), and mean absolute percentage error (MAPE) relative to the actual data. The MATLAB-developed model showed a better performance in all three performance indicators. The correlation coefficient of the MATLAB model was 99.86% versus 99.74% for the JMP model, the RMSE was 0.720 compared to 1.005 and the MAPE was 7.4% compared to 8.571%. The MATLAB model was selected to be the most accurate, and then, the number of hidden neurons/ nodes was optimized to develop a single predictive model. The optimized MATLAB with 10 neurons showed a better performance compared to the models with 1 & 5 hidden neurons. The developed models can be used by margarine manufacturers, food research institutions, researchers etc, to predict shelf-life/ margarine product age, optimize addition of antioxidants, extend shelf-life of products and proactively troubleshoot for problems related to changes which have an impact on shelf-life of margarine without conducting expensive trials.

Keywords: margarine shelf-life, predictive modelling, neural networks, oil oxidation

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56 The Mouth and Gastrointestinal Tract of the African Lung Fish Protopterus annectens in River Niger at Agenebode, Nigeria

Authors: Marian Agbugui

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The West African Lung fishes are fishes rich in protein and serve as an important source of food supply for man. The kind of food ingested by this group of fishes is dependent on the alimentary canal as well as the fish’s digestive processes which provide suitable modifications for maximum utilization of food taken. A study of the alimentary canal of P. annectens will expose the best information on the anatomy and histology of the fish. Samples of P. annectens were dissected to reveal the liver, pancreas and entire gut wall. Digital pictures of the mouth, jaws and the Gastrointestinal Tract (GIT) were taken. The entire gut was identified, sectioned and micro graphed. P. annectens was observed to possess a terminal mouth that opens up to 10% of its total body length, an adaptive feature to enable the fish to swallow the whole of its pry. Its dentition is made up of incisors- scissor-like teeth which also help to firmly grip, seize and tear through the skin of prey before swallowing. A short, straight and longitudinal GIT was observed in P. annectens which is known to be common feature in lungfishes, though it is thought to be a primitive characteristic similar to the lamprey. The oesophagus is short and distensible similar to other predatory and carnivorous species. Food is temporarily stored in the stomach before it is passed down into the intestine. A pyloric aperture is seen at the end of the double folded pyloric valve which leads into an intestine that makes up 75% of the whole GIT. The intestine begins at the posterior end of the pyloric aperture and winds down in six coils through the whole length intestine and ends at the cloaca. From this study it is concluded that P. annectens possess a composite GIT with organs similar to other lung fishes; it is a detritor with carnivorous abilities.

Keywords: gastrointestinal tract, incisors scissor-like teeth, intestine, mucus, Protopterus annectens, serosa

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