Search results for: bifemoro-bipopliteal bypass
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 109

Search results for: bifemoro-bipopliteal bypass

79 Development of a Diagnostic Device to Predict Clinically Significant Inflammation Associated with Cardiac Surgery

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

Abstract:

Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

Procedia PDF Downloads 263
78 Effect of Fuel Type on Design Parameters and Atomization Process for Pressure Swirl Atomizer and Dual Orifice Atomizer for High Bypass Turbofan Engine

Authors: Mohamed K. Khalil, Mohamed S. Ragab

Abstract:

Atomizers are used in many engineering applications including diesel engines, petrol engines and spray combustion in furnaces as well as gas turbine engines. These atomizers are used to increase the specific surface area of the fuel, which achieve a high rate of fuel mixing and evaporation. In all combustion systems reduction in mean drop size is a challenge which has many advantages since it leads to rapid and easier ignition, higher volumetric heat release rate, wider burning range and lower exhaust concentrations of the pollutant emissions. Pressure atomizers have a different configuration for design such as swirl atomizer (simplex), dual orifice, spill return, plain orifice, duplex and fan spray. Simplex pressure atomizers are the most common type of all. Among all types of atomizers, pressure swirl types resemble a special category since they differ in quality of atomization, the reliability of operation, simplicity of construction and low expenditure of energy. But, the disadvantages of these atomizers are that they require very high injection pressure and have low discharge coefficient owing to the fact that the air core covers the majority of the atomizer orifice. To overcome these problems, dual orifice atomizer was designed. This paper proposes a detailed mathematical model design procedure for both pressure swirl atomizer (Simplex) and dual orifice atomizer, examines the effects of varying fuel type and makes a clear comparison between the two types. Using five types of fuel (JP-5, JA1, JP-4, Diesel and Bio-Diesel) as a case study, reveal the effect of changing fuel type and its properties on atomizers design and spray characteristics. Which effect on combustion process parameters; Sauter Mean Diameter (SMD), spray cone angle and sheet thickness with varying the discharge coefficient from 0.27 to 0.35 during takeoff for high bypass turbofan engines. The spray atomizer performance of the pressure swirl fuel injector was compared to the dual orifice fuel injector at the same differential pressure and discharge coefficient using Excel. The results are analyzed and handled to form the final reliability results for fuel injectors in high bypass turbofan engines. The results show that the Sauter Mean Diameter (SMD) in dual orifice atomizer is larger than Sauter Mean Diameter (SMD) in pressure swirl atomizer, the film thickness (h) in dual orifice atomizer is less than the film thickness (h) in pressure swirl atomizer. The Spray Cone Angle (α) in pressure swirl atomizer is larger than Spray Cone Angle (α) in dual orifice atomizer.

Keywords: gas turbine engines, atomization process, Sauter mean diameter, JP-5

Procedia PDF Downloads 143
77 Left Posterior Pericardiotomy in the Prevention of Post-Operative Atrial Fibrillation and Cardiac Tamponade: A Retrospective Study of 2118 Isolated Coronary Artery Bypass Graft Patients

Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar

Abstract:

Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.

Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade

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76 Techno-Economic Assessments of Promising Chemicals from a Sugar Mill Based Biorefinery

Authors: Kathleen Frances Haigh, Mieke Nieder-Heitmann, Somayeh Farzad, Mohsen Ali Mandegari, Johann Ferdinand Gorgens

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Lignocellulose can be converted to a range of biochemicals and biofuels. Where this is derived from agricultural waste, issues of competition with food are virtually eliminated. One such source of lignocellulose is the South African sugar industry. Lignocellulose could be accessed by changes to the current farming practices and investments in more efficient boilers. The South African sugar industry is struggling due to falling sugar prices and increasing costs and it is proposed that annexing a biorefinery to a sugar mill will broaden the product range and improve viability. Process simulations of the selected chemicals were generated using Aspen Plus®. It was envisaged that a biorefinery would be annexed to a typical South African sugar mill. Bagasse would be diverted from the existing boilers to the biorefinery and mixed with harvest residues. This biomass would provide the feedstock for the biorefinery and the process energy for the biorefinery and sugar mill. Thus, in all scenarios a portion of the biomass was diverted to a new efficient combined heat and power plant (CHP). The Aspen Plus® simulations provided the mass and energy balance data to carry out an economic assessment of each scenarios. The net present value (NPV), internal rate of return (IRR) and minimum selling price (MSP) was calculated for each scenario. As a starting point scenarios were generated to investigate the production of ethanol, ethanol and lactic acid, ethanol and furfural, butanol, methanol, and Fischer-Tropsch syncrude. The bypass to the CHP plant is a useful indicator of the energy demands of the chemical processes. An iterative approach was used to identify a suitable bypass because increasing this value had the combined effect of increasing the amount of energy available and reducing the capacity of the chemical plant. Bypass values ranged from 30% for syncrude production to 50% for combined ethanol and furfural production. A hurdle rate of 15.7% was selected for the IRR. The butanol, combined ethanol and furfural, or the Fischer-Tropsch syncrude scenarios are unsuitable for investment with IRRs of 4.8%, 7.5% and 11.5% respectively. This provides valuable insights into research opportunities. For example furfural from sugarcane bagasse is an established process although the integration of furfural production with ethanol is less well understood. The IRR for the ethanol scenario was 14.7%, which is below the investment criteria, but given the technological maturity it may still be considered for investment. The scenarios which met the investment criteria were the combined ethanol and lactic acid, and the methanol scenarios with IRRs of 20.5% and 16.7%, respectively. These assessments show that the production of biochemicals from lignocellulose can be commercially viable. In addition, this assessment have provided valuable insights for research to improve the commercial viability of additional chemicals and scenarios. This has led to further assessments of the production of itaconic acid, succinic acid, citric acid, xylitol, polyhydroxybutyrate, polyethylene, glucaric acid and glutamic acid.

Keywords: biorefineries, sugar mill, methanol, ethanol

Procedia PDF Downloads 163
75 Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy

Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

Procedia PDF Downloads 152
74 Model-Based Global Maximum Power Point Tracking at Photovoltaic String under Partial Shading Conditions Using Multi-Input Interleaved Boost DC-DC Converter

Authors: Seyed Hossein Hosseini, Seyed Majid Hashemzadeh

Abstract:

Solar energy is one of the remarkable renewable energy sources that have particular characteristics such as unlimited, no environmental pollution, and free access. Generally, solar energy can be used in thermal and photovoltaic (PV) types. The cost of installation of the PV system is very high. Additionally, due to dependence on environmental situations such as solar radiation and ambient temperature, electrical power generation of this system is unpredictable and without power electronics devices, there is no guarantee to maximum power delivery at the output of this system. Maximum power point tracking (MPPT) should be used to achieve the maximum power of a PV string. MPPT is one of the essential parts of the PV system which without this section, it would be impossible to reach the maximum amount of the PV string power and high losses are caused in the PV system. One of the noticeable challenges in the problem of MPPT is the partial shading conditions (PSC). In PSC, the output photocurrent of the PV module under the shadow is less than the PV string current. The difference between the mentioned currents passes from the module's internal parallel resistance and creates a large negative voltage across shaded modules. This significant negative voltage damages the PV module under the shadow. This condition is called hot-spot phenomenon. An anti-paralleled diode is inserted across the PV module to prevent the happening of this phenomenon. This diode is known as the bypass diode. Due to the performance of the bypass diode under PSC, the P-V curve of the PV string has several peaks. One of the P-V curve peaks that makes the maximum available power is the global peak. Model-based Global MPPT (GMPPT) methods can estimate the optimal point with higher speed than other GMPPT approaches. Centralized, modular, and interleaved DC-DC converter topologies are the significant structures that can be used for GMPPT at a PV string. there are some problems in the centralized structure such as current mismatch losses at PV sting, loss of power of the shaded modules because of bypassing by bypass diodes under PSC, needing to series connection of many PV modules to reach the desired voltage level. In the modular structure, each PV module is connected to a DC-DC converter. In this structure, by increasing the amount of demanded power from the PV string, the number of DC-DC converters that are used at the PV system will increase. As a result, the cost of the modular structure is very high. We can implement the model-based GMPPT through the multi-input interleaved boost DC-DC converter to increase the power extraction from the PV string and reduce hot-spot and current mismatch error in a PV string under different environmental condition and variable load circumstances. The interleaved boost DC-DC converter has many privileges than other mentioned structures, such as high reliability and efficiency, better regulation of DC voltage at DC link, overcome the notable errors such as module's current mismatch and hot spot phenomenon, and power switches voltage stress reduction.

Keywords: solar energy, photovoltaic systems, interleaved boost converter, maximum power point tracking, model-based method, partial shading conditions

Procedia PDF Downloads 102
73 Calculation and Comparison of a Turbofan Engine Performance Parameters with Various Definitions

Authors: O. Onal, O. Turan

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In this paper, some performance parameters of a selected turbofan engine (JT9D) are analyzed. The engine is a high bypass turbofan engine which powers a wide-body aircraft and it produces 206 kN thrust force (thrust/weight ratio is 5.4). The objective parameters for the engine include calculation of power, specific fuel consumption, specific thrust, engine propulsive, thermal and overall efficiencies according to the various definitions given in the literature. Furthermore, in the case study, wasted energy from the exhaust is calculated at the maximum power setting (i.e. take off phase) for the engine.

Keywords: turbofan, power, efficiency, trust

Procedia PDF Downloads 270
72 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

Abstract:

Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

Procedia PDF Downloads 49
71 Unconventional Calculus Spreadsheet Functions

Authors: Chahid K. Ghaddar

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The spreadsheet engine is exploited via a non-conventional mechanism to enable novel worksheet solver functions for computational calculus. The solver functions bypass inherent restrictions on built-in math and user defined functions by taking variable formulas as a new type of argument while retaining purity and recursion properties. The enabling mechanism permits integration of numerical algorithms into worksheet functions for solving virtually any computational problem that can be modelled by formulas and variables. Several examples are presented for computing integrals, derivatives, and systems of deferential-algebraic equations. Incorporation of the worksheet solver functions with the ubiquitous spreadsheet extend the utility of the latter as a powerful tool for computational mathematics.

Keywords: calculus, differential algebraic equations, solvers, spreadsheet

Procedia PDF Downloads 312
70 Characteristics of Different Solar PV Modules under Partial Shading

Authors: Hla Hla Khaing, Yit Jian Liang, Nant Nyein Moe Htay, Jiang Fan

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Partial shadowing is one of the problems that are always faced in terrestrial applications of solar photovoltaic (PV). The effects of partial shadow on the energy yield of conventional mono-crystalline and multi-crystalline PV modules have been researched for a long time. With deployment of new thin-film solar PV modules in the market, it is important to understand the performance of new PV modules operating under the partial shadow in the tropical zone. This paper addresses the impacts of different partial shadowing on the operating characteristics of four different types of solar PV modules that include multi-crystalline, amorphous thin-film, CdTe thin-film and CIGS thin-film PV modules.

Keywords: partial shade, CdTe, CIGS, multi-crystalline (mc-Si), amorphous silicon (a-Si), bypass diode

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69 Clinical Case Successful Surgical Treatment of Postinfarction Ventricular Septum Defect

Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

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Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

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68 Bypassing Docker Transport Layer Security Using Remote Code Execution

Authors: Michael J. Hahn

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Docker is a powerful tool used by many companies such as PayPal, MetLife, Expedia, Visa, and many others. Docker works by bundling multiple applications, binaries, and libraries together on top of an operating system image called a container. The container runs on a Docker engine that in turn runs on top of a standard operating system. This centralization saves a lot of system resources. In this paper, we will be demonstrating how to bypass Transport Layer Security and execute remote code within Docker containers built on a base image of Alpine Linux version 3.7.0 through the use of .apk files due to flaws in the Alpine Linux package management program. This exploit renders any applications built using Docker with a base image of Alpine Linux vulnerable to unwanted outside forces.

Keywords: cloud, cryptography, Docker, Linux, security

Procedia PDF Downloads 155
67 Thermal Performance of Radial Heat Sinks for LED Applications

Authors: Jongchul Park, Chan Byon

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In this study, the thermal performance of radial heat sinks for LED applications is investigated numerically and experimentally. The effect of geometrical parameters such as inner radius, fin height, fin length, and fin spacing, as well as the Elenbaas number, is considered. In addition, the effects of augmentation of concentric ring, perforation, and duct are extensively explored in order to enhance the thermal performance of conventional radial heat sink. The results indicate that the Elenbaas number and the fin radius have a significant effect on the thermal performance of the heat sink. The concentric ring affects the performance much, but the degree of affection is highly dependent on the orientation. The perforation always brings about higher thermal performance. The duct can effectively prevent the bypass of the natural convection flow, which in turn reduces the thermal resistance of the radial heat sink significantly.

Keywords: heat transfer, radial heat sink, LED, Elenbaas

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66 Bariatric Surgery Referral as an Alternative to Fundoplication in Obese Patients Presenting with GORD: A Retrospective Hospital-Based Cohort Study

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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65 Performance of the Hybrid Loop Heat Pipe

Authors: Nandy Putra, Imansyah Ibnu Hakim, Iwan Setyawan, Muhammad Zayd A.I

Abstract:

A two-phase cooling technology of passive system sometimes can no longer meet the cooling needs of an increasingly challenging due to the inherent limitations of the capillary pumping for example in terms of the heat flux that can lead to dry out. In this study, intended to overcome the dry out with the addition of a diaphragm, they pump to accelerate the fluid transportation from the condenser to the evaporator. Diaphragm pump installed on the bypass line. When it did not happen dry out then the hybrid loop heat pipe will be work passively using a capillary pressure of wick. Meanwhile, when necessary, hybrid loop heat pipe will be work actively, using diaphragm pump with temperature control installed on the evaporator. From the results, it can be said that the pump has been successfully overcome dry out and can distribute working fluid from the condenser to the evaporator and reduce the temperature of the evaporator from 143°C to 100°C as a temperature controlled where the pump start actively at set point 100°C.

Keywords: hybrid, heat pipe, dry out, assisted, pump

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64 Quantum Dots with Microwave Propagation in Future Quantum Internet Protocol for Mobile Telephony

Authors: A. B. R. Hazarika

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In the present paper, Quantum dots of ZnS are used to study the faster microwave propagation in space and on earth which will be difficult to bypass as quantum key encryption-decryption is difficult to decode. The present study deals with Quantum internet protocol which is much faster, safer and secure in microwave propagation than the present Internet Protocol v6, which forms the aspect of our study. Assimilation of hardware, Quantum dots with Quantum protocol theory beautifies the aspect of the study. So far to author’s best knowledge, the study on mobile telephony with Quantum dots long-term evolution (QDLTE) has not been studied earlier, which forms the aspect of the study found that the Bitrate comes out to be 102.4 Gbps.

Keywords: encryption, decryption, internet protocol, microwave, mobile telephony, quantum key encryption, quantum dots

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63 Data Analytics of Electronic Medical Records Shows an Age-Related Differences in Diagnosis of Coronary Artery Disease

Authors: Maryam Panahiazar, Andrew M. Bishara, Yorick Chern, Roohallah Alizadehsani, Dexter Hadleye, Ramin E. Beygui

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Early detection plays a crucial role in enhancing the outcome for a patient with coronary artery disease (CAD). We utilized a big data analytics platform on ~23,000 patients with CAD from a total of 960,129 UCSF patients in 8 years. We traced the patients from their first encounter with a physician to diagnose and treat CAD. Characteristics such as demographic information, comorbidities, vital, lab tests, medications, and procedures are included. There are statistically significant gender-based differences in patients younger than 60 years old from the time of the first physician encounter to coronary artery bypass grafting (CABG) with a p-value=0.03. There are no significant differences between the patients between 60 and 80 years old (p-value=0.8) and older than 80 (p-value=0.4) with a 95% confidence interval. This recognition would affect significant changes in the guideline for referral of the patients for diagnostic tests expeditiously to improve the outcome by avoiding the delay in treatment.

Keywords: electronic medical records, coronary artery disease, data analytics, young women

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62 Efficient Utilization of Negative Half Wave of Regulator Rectifier Output to Drive Class D LED Headlamp

Authors: Lalit Ahuja, Nancy Das, Yashas Shetty

Abstract:

LED lighting has been increasingly adopted for vehicles in both domestic and foreign automotive markets. Although this miniaturized technology gives the best light output, low energy consumption, and cost-efficient solutions for driving, the same is the need of the hour. In this paper, we present a methodology for driving the highest class two-wheeler headlamp with regulator and rectifier (RR) output. Unlike usual LED headlamps, which are driven by a battery, regulator, and rectifier (RR) driven, a low-cost and highly efficient LED Driver Module (LDM) is proposed. The positive half of magneto output is regulated and used to charge batteries used for various peripherals. While conventionally, the negative half was used for operating bulb-based exterior lamps. But with advancements in LED-based headlamps, which are driven by a battery, this negative half pulse remained unused in most of the vehicles. Our system uses negative half-wave rectified DC output from RR to provide constant light output at all RPMs of the vehicle. With the negative rectified DC output of RR, we have the advantage of pulsating DC input which periodically goes to zero, thus helping us to generate a constant DC output equivalent to the required LED load, and with a change in RPM, additional active thermal bypass circuit help us to maintain the efficiency and thermal rise. The methodology uses the negative half wave output of the RR along with a linear constant current driver with significantly higher efficiency. Although RR output has varied frequency and duty cycles at different engine RPMs, the driver is designed such that it provides constant current to LEDs with minimal ripple. In LED Headlamps, a DC-DC switching regulator is usually used, which is usually bulky. But with linear regulators, we’re eliminating bulky components and improving the form factor. Hence, this is both cost-efficient and compact. Presently, output ripple-free amplitude drivers with fewer components and less complexity are limited to lower-power LED Lamps. The focus of current high-efficiency research is often on high LED power applications. This paper presents a method of driving LED load at both High Beam and Low Beam using the negative half wave rectified pulsating DC from RR with minimum components, maintaining high efficiency within the thermal limitations. Linear regulators are significantly inefficient, with efficiencies typically about 40% and reaching as low as 14%. This leads to poor thermal performance. Although they don’t require complex and bulky circuitry, powering high-power devices is difficult to realise with the same. But with the input being negative half wave rectified pulsating DC, this efficiency can be improved as this helps us to generate constant DC output equivalent to LED load minimising the voltage drop on the linear regulator. Hence, losses are significantly reduced, and efficiency as high as 75% is achieved. With a change in RPM, DC voltage increases, which can be managed by active thermal bypass circuitry, thus resulting in better thermal performance. Hence, the use of bulky and expensive heat sinks can be avoided. Hence, the methodology to utilize the unused negative pulsating DC output of RR to optimize the utilization of RR output power and provide a cost-efficient solution as compared to costly DC-DC drivers.

Keywords: class D LED headlamp, regulator and rectifier, pulsating DC, low cost and highly efficient, LED driver module

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61 Erectile Dysfunction in A Middle Aged Man 6 Years After Bariatric Surgery: A Case Report

Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

Abstract:

Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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60 Balanced Ischemia Misleading to a False Negative Myocardial Perfusion Imaging (Stress) Test

Authors: Devam Sheth

Abstract:

Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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59 Electroencephalography-Based Intention Recognition and Consensus Assessment during Emergency Response

Authors: Siyao Zhu, Yifang Xu

Abstract:

After natural and man-made disasters, robots can bypass the danger, expedite the search, and acquire unprecedented situational awareness to design rescue plans. The hands-free requirement from the first responders excludes the use of tedious manual control and operation. In unknown, unstructured, and obstructed environments, natural-language-based supervision is not amenable for first responders to formulate, and is difficult for robots to understand. Brain-computer interface is a promising option to overcome the limitations. This study aims to test the feasibility of using electroencephalography (EEG) signals to decode human intentions and detect the level of consensus on robot-provided information. EEG signals were classified using machine-learning and deep-learning methods to discriminate search intentions and agreement perceptions. The results show that the average classification accuracy for intention recognition and consensus assessment is 67% and 72%, respectively, proving the potential of incorporating recognizable users’ bioelectrical responses into advanced robot-assisted systems for emergency response.

Keywords: consensus assessment, electroencephalogram, emergency response, human-robot collaboration, intention recognition, search and rescue

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58 Role of Bariatric Surgery in Polycystic Ovarian Syndrome &Infertility

Authors: Ahuja Ashish, Nain Prabhdeep Singh

Abstract:

Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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57 Rotor Concepts for the Counter Flow Heat Recovery Fan

Authors: Christoph Speer

Abstract:

Decentralized ventilation systems should combine a small and economical design with high aerodynamic and thermal efficiency. The Counter Flow Heat Recovery Fan (CHRF) provides the ability to meet these requirements by using only one cross flow fan with a large number of blades to generate both airflows and which simultaneously acts as a regenerative counter flow heat exchanger. The successful development of the first laboratory prototype has shown the potential of this ventilation system. Occurring condensate on the surfaces of the fan blades during the cold and dry season can be recovered through the characteristic mode of operation. Hence the CHRF provides the possibility to avoid the need for frost protection and condensate drain. Through the implementation of system-specific solutions for flow balancing and summer bypass the required functionality is assured. The scalability of the CHRF concept allows the use in renovation as well as in new buildings from single-room devices through to systems for office buildings. High aerodynamic and thermal efficiency and the lower number of required mechatronic components should enable a reduction in investment as well as operating costs. The rotor is the key component of the system, the requirements and possible implementation variants are presented.

Keywords: CHRF, counter flow heat recovery fan, decentralized ventilation system, renovation

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56 Modern Cardiac Surgical Outcomes in Nonagenarians: A Multicentre Retrospective Observational Study

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

Abstract:

Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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55 Comprehensive Review of Adversarial Machine Learning in PDF Malware

Authors: Preston Nabors, Nasseh Tabrizi

Abstract:

Portable Document Format (PDF) files have gained significant popularity for sharing and distributing documents due to their universal compatibility. However, the widespread use of PDF files has made them attractive targets for cybercriminals, who exploit vulnerabilities to deliver malware and compromise the security of end-user systems. This paper reviews notable contributions in PDF malware detection, including static, dynamic, signature-based, and hybrid analysis. It presents a comprehensive examination of PDF malware detection techniques, focusing on the emerging threat of adversarial sampling and the need for robust defense mechanisms. The paper highlights the vulnerability of machine learning classifiers to evasion attacks. It explores adversarial sampling techniques in PDF malware detection to produce mimicry and reverse mimicry evasion attacks, which aim to bypass detection systems. Improvements for future research are identified, including accessible methods, applying adversarial sampling techniques to malicious payloads, evaluating other models, evaluating the importance of features to malware, implementing adversarial defense techniques, and conducting comprehensive examination across various scenarios. By addressing these opportunities, researchers can enhance PDF malware detection and develop more resilient defense mechanisms against adversarial attacks.

Keywords: adversarial attacks, adversarial defense, adversarial machine learning, intrusion detection, PDF malware, malware detection, malware detection evasion

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54 Saudi Human Awareness Needs: A Survey in How Human Causes Errors and Mistakes Leads to Leak Confidential Data with Proposed Solutions in Saudi Arabia

Authors: Amal Hussain Alkhaiwani, Ghadah Abdullah Almalki

Abstract:

Recently human errors have increasingly become a very high factor in security breaches that may affect confidential data, and most of the cyber data breaches are caused by human errors. With one individual mistake, the attacker will gain access to the entire network and bypass the implemented access controls without any immediate detection. Unaware employees will be vulnerable to any social engineering cyber-attacks. Providing security awareness to People is part of the company protection process; the cyber risks cannot be reduced by just implementing technology; the human awareness of security will significantly reduce the risks, which encourage changes in staff cyber-awareness. In this paper, we will focus on Human Awareness, human needs to continue the required security education level; we will review human errors and introduce a proposed solution to avoid the breach from occurring again. Recently Saudi Arabia faced many attacks with different methods of social engineering. As Saudi Arabia has become a target to many countries and individuals, we needed to initiate a defense mechanism that begins with awareness to keep our privacy and protect the confidential data against possible intended attacks.

Keywords: cybersecurity, human aspects, human errors, human mistakes, security awareness, Saudi Arabia, security program, security education, social engineering

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53 Cognitive Approach at the Epicenter of Creative Accounting in Cameroonian Companies: The Relevance of the Psycho-Sociological Approach and the Theory of Cognitive Dissonance

Authors: Romuald Temomo Wamba, Robert Wanda

Abstract:

The issue of creative accounting in the psychological and sociological framework has been a mixed subject for over 60 years. The objective of this article is to ensure the existence of creative accounting in Cameroonian entities on the one hand and to understand the strategies used by audit agents to detect errors, omissions, irregularities, or inadequacies in the financial state; optimization techniques used by account preparers to strategically bypass texts on the other hand. To achieve this, we conducted an exploratory study using a cognitive approach, and the data analysis was performed by the software 'decision explorer'. The results obtained challenge the authors' cognition (manifest latent and deceptive behavior). The tax inspectors stress that the entities in Cameroon do not derogate from the rules of piloting in the financial statements. Likewise, they claim a change in current income and net income through depreciation, provisions, inventories, and the spreading of charges over long periods. This suggests the suspicion or intention of manipulating the financial statements. As for the techniques, the account preparers manage the accruals at the end of the year as the basis of the practice of creative accounting. Likewise, management accounts are more favorable to results management.

Keywords: creative accounting, sociocognitive approach, psychological and sociological approach, cognitive dissonance theory, cognitive mapping

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52 Thermal Performance of Plate-Fin Heat Sink with Lateral Perforation

Authors: Sakkarin Chingulpitak, Somchai Wongwises

Abstract:

Over the past several decades, the development of electronic devices has led to higher performance. Therefore, an electronic cooling system is important for the electronic device. A heat sink which is a part of the electronic cooling system is continuously studied in the research field to enhance the heat transfer. To author’s best knowledge, there have been only a few articles which reported the thermal performance of plate-fin heat sink with perforation. This research aims to study on the flow and heat transfer characteristics of the solid-fin heat sink (SFHS) and laterally perforated plate-fin heat sink (LAP-PFHS). The SFHS and LAP-PFHSs are investigated on the same fin dimensions. The LAP-PFHSs are performed with a 27 perforation number and two different diameters of circular perforation (3 mm and 5 mm). The experimental study is conducted under various Reynolds numbers from 900 to 2,000 and the heat input of 50W. The experimental results show that the LAP-PFHS with perforation diameter of 5 mm gives the minimum thermal resistance about 25% lower than SFHS. The thermal performance factor which takes into account the ratio of the Nusselt number and ratio of friction factor is used to find the suitable design parameters. The experimental results show that the LAP-PFHS with the perforation diameter of 3 mm provides the thermal performance of 15% greater than SFHS. In addition, the simulation study is presented to investigate the effect of the air flow behavior inside the perforation on the thermal performance of LAP-PFHS.

Keywords: heat sink, parallel flow, circular perforation, non-bypass flow

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51 A Structural Constitutive Model for Viscoelastic Rheological Behavior of Human Saphenous Vein Using Experimental Assays

Authors: Rassoli Aisa, Abrishami Movahhed Arezu, Faturaee Nasser, Seddighi Amir Saeed, Shafigh Mohammad

Abstract:

Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.

Keywords: Viscoelastic behavior, stress relaxation test, uniaxial tensile test, Fung’s quasilinear viscoelastic (QLV) model, strain rate

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50 Taking Learning beyond Kirkpatrick’s Levels: Applying Return on Investment Measurement in Training

Authors: Charles L. Sigmund, M. A. Aed, Lissa Graciela Rivera Picado

Abstract:

One critical component of the training development process is the evaluation of the impact and value of the program. Oftentimes, however, learning organizations bypass this phase either because they are unfamiliar with effective methods for measuring the success or effect of the training or because they believe the effort to be too time-consuming or cumbersome. As a result, most organizations that do conduct evaluation limit their scope to Kirkpatrick L1 (reaction) and L2 (learning), or at most carry through to L4 (results). In 2021 Microsoft made a strategic decision to assess the measurable and monetized impact for all training launches and designed a scalable and program-agnostic tool for providing full-scale L5 return on investment (ROI) estimates for each. In producing this measurement tool, the learning and development organization built a framework for making business prioritizations and resource allocations that is based on the projected ROI of a course. The analysis and measurement posed by this process use a combination of training data and operational metrics to calculate the effective net benefit derived from a given training effort. Business experts in the learning field generally consider a 10% ROI to be an outstanding demonstration of the value of a project. Initial findings from this work applied to a critical customer-facing program yielded an estimated ROI of more than 49%. This information directed the organization to make a more concerted and concentrated effort in this specific line of business and resulted in additional investment in the training methods and technologies being used.

Keywords: evaluation, measurement, return on investment, value

Procedia PDF Downloads 158