Search results for: bilateral laminotomies

Authors: Yi-Hung Ho, Chih-Wei Wang, Chih-Hsien Chen, Chih-Han Chang

Abstract:

Unilateral laminotomy and bilateral laminotomies were successful decompressions methods for managing spinal stenosis that numerous studies have reported. Thus, unilateral laminotomy was rated technically much more demanding than bilateral laminotomies, whereas the bilateral laminotomies were associated with a positive benefit to reduce more complications. There were including incidental durotomy, increased radicular deficit, and epidural hematoma. However, no relative biomechanical analysis for evaluating spinal instability treated with unilateral and bilateral laminotomies. Therefore, the purpose of this study was to compare the outcomes of different decompressions methods by experimental and finite element analysis. Three porcine lumbar spines were biomechanically evaluated for their range of motion, and the results were compared following unilateral or bilateral laminotomies. The experimental protocol included flexion and extension in the following procedures: intact, unilateral, and bilateral laminotomies (L2–L5). The specimens in this study were tested in flexion (8 Nm) and extension (6 Nm) of pure moment. Spinal segment kinematic data was captured by using the motion tracking system. A 3D finite element lumbar spine model (L1-S1) containing vertebral body, discs, and ligaments were constructed. This model was used to simulate the situation of treating unilateral and bilateral laminotomies at L3-L4 and L4-L5. The bottom surface of S1 vertebral body was fully geometrically constrained in this study. A 10 Nm pure moment also applied on the top surface of L1 vertebral body to drive lumbar doing different motion, such as flexion and extension. The experimental results showed that in the flexion, the ROMs (±standard deviation) of L3–L4 were 1.35±0.23, 1.34±0.67, and 1.66±0.07 degrees of the intact, unilateral, and bilateral laminotomies, respectively. The ROMs of L4–L5 were 4.35±0.29, 4.06±0.87, and 4.2±0.32 degrees, respectively. No statistical significance was observed in these three groups (P>0.05). In the extension, the ROMs of L3–L4 were 0.89±0.16, 1.69±0.08, and 1.73±0.13 degrees, respectively. In the L4-L5, the ROMs were 1.4±0.12, 2.44±0.26, and 2.5±0.29 degrees, respectively. Significant differences were observed among all trials, except between the unilateral and bilateral laminotomy groups. At the simulation results portion, the similar results were discovered with the experiment. No significant differences were found at L4-L5 both flexion and extension in each group. Only 0.02 and 0.04 degrees variation were observed during flexion and extension between the unilateral and bilateral laminotomy groups. In conclusions, the present results by finite element analysis and experimental reveal that no significant differences were observed during flexion and extension between unilateral and bilateral laminotomies in short-term follow-up. From a biomechanical point of view, bilateral laminotomies seem to exhibit a similar stability as unilateral laminotomy. In clinical practice, the bilateral laminotomies are likely to reduce technical difficulties and prevent perioperative complications; this study proved this benefit through biomechanical analysis. The results may provide some recommendations for surgeons to make the final decision.

Keywords: unilateral laminotomy, bilateral laminotomies, spinal stenosis, finite element analysis

Procedia PDF Downloads 373

Authors: Chih-Hsien Chen, Yi-Hung Ho, Chih-Wei Wang, Chih-Wei Chang, Yen-Nien Chen, Chih-Han Chang, Chun-Ting Li

Abstract:

Laminotomy is a spinal decompression surgery compatible with a minimally invasive approach. However, the unilateral laminotomy for bilateral side decompression leads to more perioperative complications than the bilateral laminotomy. Although the unilateral laminotomy removes the least bone tissue among the spinal decompression surgeries, the difference of spinal stability between unilateral and bilateral laminotomy and laminectomy is rarely investigated. This study aims to compare the biomechanical effects of unilateral and bilateral laminotomy and laminectomy on the lumbar spine by finite element (FE) simulation. A three-dimensional FE model of the lumbar spine (L1–L5) was constructed with the vertebral body, discs, and ligaments, as well as the sacrum was constructed. Three different surgical methods, namely unilateral laminotomy, bilateral laminotomy and laminectomy, at L3–L4 and L4–L5 were considered. Partial pedicle and entire ligamentum flavum were removed to simulate bilateral decompression in laminotomy. The entire lamina and spinal processes from the lower L3 to upper L5 were detached in the laminectomy model. Then, four kinds of loadings, namely flexion, extension, lateral bending and rotation, were applied on the lumbar with various decompression conditions. The results indicated that the bilateral and unilateral laminotomy both increased the range of motion (ROM) compared with intact lumbar, while the laminectomy increased more ROM than both laminotomy did. The difference of ROM between the bilateral and unilateral laminotomy was very minor. Furthermore, bilateral laminotomy demonstrated similar poster element stress with unilateral laminotomy. Unilateral and bilateral laminotomy are equally suggested to bilateral decompression of lumbar spine with minimally invasive technique because limited effect was aroused due to more bone remove in the bilateral laminotomy on the lumbar stability. Furthermore, laminectomy is the last option for lumbar decompression.

Keywords: minimally invasive technique, lumbar decompression, laminotomy, laminectomy, finite element method

Procedia PDF Downloads 144

Authors: Yu Zhang, Kohei Inoue, Kiichi Urahama

Abstract:

We propose a simplified bilateral filter with binarized coefficients for accelerating it. Its computational cost is further decreased by sampling pixels. This computationally low cost filter is useful for smoothing or denoising images by using mobile devices with limited computational power.

Keywords: bilateral filter, binarized-weight bilateral filter, image smoothing, image denoising, pixel sampling

Procedia PDF Downloads 441

Authors: Taimoor Hussain Alvi, Syed Toqueer Akhter

Abstract:

The focus of this research is to identify Pak-India bilateral trade spillover effects upon Pakistan’s Growth rate. Cross-country spillover growth Effects have been linked with openness and access to markets. In this research, we intend to see the short run and long run effects of Pak-India Bilateral Trade Openness upon economic growth in Pakistan. Trade Openness has been measured as the sum of bilateral exports and imports between the two countries. Increased emphasis on the condition and environment of financial markets is laid in light of globalization and trade liberalization. This research paper makes use of the Univariate Autoregressive Distributed Lagged Model to analyze the effects of bilateral trade variables upon the growth pattern of Pakistan in the short run and long run. Key findings of the study empirically support the notion that increased bilateral trade will be beneficial for Pakistan in the short run because of cost advantage and knowledge spillover in terms of increased technical and managerial ability from multinational firms. However, contrary to extensive literature, increased bilateral trade measures will affect Pakistan’s growth rate negatively in the long run because of the industrial size differential and increased integration of Indian economy with the world.

Keywords: bilateral trade openness, spillover, comparative advantage, univariate

Procedia PDF Downloads 445

Authors: Zihan Yu, Kohei Inoue, Kiichi Urahama

Abstract:

We present a method for de-hazing images. A dark envelope image is derived with the bilateral minimum filter and a bright envelope is derived with the bilateral maximum filter. The ambient light and transmission of the scene are estimated from these two envelope images. An image without haze is reconstructed from the estimated ambient light and transmission.

Keywords: image dehazing, bilateral minimum filter, bilateral maximum filter, local contrast

Procedia PDF Downloads 230

Authors: Mohamed Taher Eldesoky, Enas Elsayed Abutaleb

Abstract:

Background: The changes in foot posture possibly generate changes in the pelvic alignment, although, there is lack of evidence about the effects of bilateral and unilateral flatfoot on possible changes in pelvic alignment. The purpose of this study was to investigate the effect of flatfoot on the sagittal and frontal planes of pelvic postures. Materials and Methods: 56 subjects, aged 18–40 years, were assigned into three groups. 20 healthy subjects, 19 subjects with bilateral flexible second-degree flat foot, and 17 subjects with unilateral flexible second-degree flat foot. 3D assessment of the pelvis using the formetric-II device was used to evaluate pelvic alignment in the frontal and sagittal planes by measuring pelvic inclination and pelvic tilt angles. Results: ANOVA test with LSD test were used for statistical analysis. Both Unilateral and bilateral second degree flatfoot produced significant (P < 0.05) pelvic anteversion in comparison to the healthy subjects (P < 0.05), but the bilateral flatfoot subjects seemed to have more anteversion than the unilateral subjects. Unilateral flatfoot caused a significant (P<0.05) lateral pelvic tilt in the direction of the affected side in comparison to the healthy and bilateral flatfoot subjects. Conclusion: The bilateral and unilateral second degree flatfoot changed pelvic alignment. Both of them led to increases of pelvic anteversion while the unilateral one caused lateral pelvic tilt toward the affected side. Thus, foot posture should be considered when assessing patients with pelvic misalignment and disorders.

Keywords: bilateral flatfoot, unilateral flatfoot, pelvic alignment, foot posture

Procedia PDF Downloads 326

Authors: Anuj Kumar Vaksha

Abstract:

In the post cold war era the foreign direct investments have come to be considered as one of the most critical factors for economic development of a country particularly for the capital scarce countries like the developing and the under developed countries. The rush for foreign direct investments have led to intense competition between the countries treaties to attract foreign investments by entering into alluring Bilateral Investment Treaties (BITs). The Bilateral Investment Treaties are the intergovernmental legal framework for the promotion of private investments from one country to other. With more than 3000 BITs, the web of such BITs are the most dominant development of International Law in the post cold war era. The essence of all these BITs are bilateral cooperation for economic development and thus it is actually the theme of economic development around which the International Law had developed most dominantly in the post cold war era. Within the framework of two generally accepted premises that foreign direct investments are critical for economic development and the bilateral investment treaties are critical for promotion of foreign direct investments, the research paper seeks to explore the perspectives and paradigms on economic development as embodied in various Bilateral Investment Treaties. It seeks to address how and in what manners the perspectives on economic development as embodied in bilateral investment varies between the developed, developing and underdeveloped countries. It goes without saying that economic development is a very broad, complex and operationally intricate concept. In the paradigm of International Law it becomes much more complex and intricate. Understanding the concept of economic development from the perspectives of Bilateral Investment Treaties is a novel idea with far reaching significance. Such a perspective on economic development would help in enriching the contemporary International Law perspectives and paradigms on economic development.

Keywords: bilateral investment treaties, economic development, international Law, perspectives

Procedia PDF Downloads 291

Authors: A. H. Dikko, D. N Tsado, M. S. T. Rita, D. S. Umar

Abstract:

This study was conducted on eighteen (18) New Zealand and chinchilla breeds of rabbits were used. The rabbits were allotted to 3 treatments with each treatment having six (6) animals with two (2) replicates. T1 were castrated, which both testes was removed (Bilateral); T2 were castrated, which only one testes was removed (unilateral) and T3 were not castrated (control). In nutrient digestibility, T1 and T2 (p>0.05) has a higher rate than T3. There was no significant (p<0.05) difference in live weight and dressing weight among the treatment groups. There is a significant (p > 0.05) difference in visceral organs in the treatment groups.

Keywords: New Zealand, chinchilla, castration, bilateral, unilateral

Procedia PDF Downloads 603

Authors: Bo Sun, Ni Zhong

Abstract:

Bilateral investment treaties have played a role in the construction of the Belt and Road, providing institutional protection for Chinese companies' overseas investments. However, such treaties between China and countries along the Belt and Road were signed in the 1980s and 1990s, and their provisions are outdated and insufficiently detailed to provide adequate legal protection for Chinese investors when they initiate investment arbitration against host countries. By studying cases involving China in international investment arbitration, this paper suggests that China should pay attention to further clarifying the identity of "investors", the scope of disputes that can be submitted to arbitration, and the concept of "indirect expropriation" when updating bilateral investment treaties in the future, in order to reduce the risk of losing cases for Chinese investors.

Keywords: belt and road, bilateral investment agreement, investment arbitration, indirect expropriation

Procedia PDF Downloads 210

Authors: Mauricio Plaza, Willian Aperador

Abstract:

Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with a closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is a performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

Keywords: amputation, prosthesis, mobility, hemipelvectomy

Procedia PDF Downloads 377

Authors: Mihai-Ionut Firescu, Mark A. P. Carson

Abstract:

We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

Procedia PDF Downloads 187

Authors: Rusmawati Said, N. Kar Yee, Asmaddy Haris

Abstract:

This study employs a panel data set of ASEAN member states, 17 European Union (EU) countries, 7 American countries and 11 other Asia Pacific countries (China Mainland and Hong Kong SAR are treated as two separated countries) to investigate the role of labour standards in explaining the pattern of bilateral migration flows in ASEAN. Using pooled Ordinary Least Square (OLS) this study found mixed results. The result varies on how indicators were used to measure the level of labour standards in the empirical analysis. In one side, better labour standards (represented by number of strikes and weekly average working hours) promote bilateral migration among the selected countries. On the other side, increase in cases of occupational injuries lead to an increase in bilateral migration, reflecting that worsen in working conditions do not influence the workers’ decision from moving. The finding from this study become important to policy maker as the issues of massive low skilled workers have a significant impact to the role of labour standard in shaping the migration flows.

Keywords: labour standard, migration, ASEAN, economics and financial engineering

Procedia PDF Downloads 353

Authors: Rashmi Yadawad, Disha Narayanan, Ravi Gautam

Abstract:

Through Wall Radar Imaging is gaining increasing importance now a days in the field of Defense and one of the most important criteria that forms the basis for the image quality obtained is the Cross-Range resolution of the image. In this research paper, the Bilateral Back projection algorithm has been implemented for Through Wall Radar Imaging. The sole purpose is to enhance the resolution in the cross range direction of the obtained Back projection image. Synthetic Data is generated for two targets which are placed at various locations in a room of dimensions 8 m by 6m. Two algorithms namely, simple back projection and Bilateral Back projection have been implemented, images are obtained and the obtained images are compared. Numerical simulations have been coded in MATLAB and experimental results of the two algorithms have been shown. Based on the comparison between the two images, it can be clearly seen that the ringing effect and chess board effect have been heavily reduced in the bilaterally back projected image and hence promising results are obtained giving a relatively sharper image with relatively well defined edges.

Keywords: through wall radar imaging, bilateral back projection, cross range resolution, synthetic data

Procedia PDF Downloads 311

Authors: Aamir Shahzad, Hubert Roth

Abstract:

This paper is presenting the bilateral telecontrol of AutoMerlin Mobile Robot having communication delay. Passivity Observers has been designed to monitor the net energy at both ports of a two port network and if any or both ports become active making net energy negative, then the passivity controllers dissipate the proper energy to make the overall system passive in the presence of time delay. The environment force is modeled and sent back to human operator so that s/he can feel it and has additional information about the environment in the vicinity of mobile robot. The experimental results have been presented to show the performance and stability of bilateral controller. The results show the whenever the passivity observers observe active behavior then the passivity controller come into action to neutralize the active behavior to make overall system passive.

Keywords: bilateral control, human operator, haptic device, communication network, time domain passivity control, passivity observer, passivity controller, time delay, mobile robot, environment force

Procedia PDF Downloads 351

Authors: Mehmet Yildiz, Mehmet Kale

Abstract:

The primary aim of the present study was to identify the bilateral balance asymmetries when comparing the dominant (DL) vs. the non-dominant leg (NDL) in the collegian soccer players. The secondary aim was to compare the inter-limb asymmetry index (ASI) when differentiating by kicking preference (right-dominant vs. left-dominant). 34 right-dominant leg (RightDL) (age:21.12±1.85, height:174.50±5.18, weight:69.42±6.86) and 23 left-dominant leg (LeftDL), (age:21.70±2.03, height:176.2±6.27, weight:68.73±5.96) collegian football players were tested for bilateral static and dynamic balance. Balance ability was assessed by measuring centre of pressure deviation on a single leg. Single leg static and dynamic balance scores and inter-limb asymmetry index (ASI) were determined. Student t tests were used for the comparison of dominant and nondominant leg balance scores and RightDL and LeftDL football players’ inter-limb asymmetry index of the balance scores. The results showed that there were significant differences in the dynamic balance scores in favour of the nondominant leg, (DL:738±211 vs. NDL:606±226, p < 0.01). Also, it has been seen that LeftDL players have significantly higher inter-limb asymmetry index when compared with rightDL players for both static (rightDL:-7.07±94.91 vs. leftDL:-183.19±354.05, p < 0.01) and dynamic (rightDL: 1.73±49.65 vs. leftDL:27.08±23.34, p < 0.05) balance scores. In conclusion, bilateral dynamic balance asymmetries may be affected using single leg predominantly in the mobilization workouts. Because of having higher inter-limb asymmetry index, left-dominant leg players may be screened and trained to minimize balance asymmetry.

Keywords: bilateral balance, asymmetries, dominant leg, leg preference

Procedia PDF Downloads 385

Authors: Laura V. Gonzalez, Juan B. Duarte, Luis A. Palacio

Abstract:

Decision making can be conditioned by factors such as the environments, circumstances, behavioral biases, emotions, beliefs and preferences of the participants. The objective of this paper is to analyze the effect ‘amount of information’ and ‘number of options’, on the behavior of competitors under a bilateral negotiation context. For the above, it has been designed an experiment as a classroom game where they negotiate goods, under the condition that none of the players knows exactly the real value of the asset. The game is designed under the concept of zero-sum (non-cooperative game) and focuses on the fact that agents must anticipate the strategies of their opponent to improve their chances of winning in the negotiation. The empirical results show that, contrary to the traditional view of expected utility theory, players prefer to obtain low profits and losses, when faced with a higher expectation of losses, using sub-optimal strategies not in accordance with game theory.

Keywords: bilateral negotiation, classroom game, decision making, game theory

Procedia PDF Downloads 222

Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

Abstract:

In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

Procedia PDF Downloads 128

Authors: Shabana Noureen, Zafar Mahmood

Abstract:

Economies consistently engage in trade across borders and face tariff, non-tariff barriers and other quotas that constitute trade costs. The trade costs imposed by policy barriers on exports are considered an impediment in the export growth rate. This work aims to measure over-year trends in total and bilateral trade costs and their trends in relevance to policy barriers (tariff and non-tariff). The analysis through the micro-founded theoretically based gravity model showed that the total trade costs have a general decreasing trend in the world while in the case of developing countries, the rate by which these trends decline is very low. Bilateral trade cost estimates associated with the policy barriers represent that the non-tariff barriers in a developing country have a major role in sustaining the high trade costs as compared to the tariff barriers. This ultimately leads to a low net declining rate. This work emphasizes that for developing countries the non-tariff barriers are a major factor that renders their exports and to be uncompetitive in the world market.

Keywords: trade costs, policy barriers, tariff barriers, non-tariff barriers, trade policies, export growth

Procedia PDF Downloads 218

Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

Abstract:

Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

Procedia PDF Downloads 99

Authors: Camelia Porey, Binaya Kumar Jaiswal

Abstract:

BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

Procedia PDF Downloads 137

Authors: Teresa Mili

Abstract:

The significance of political and economic factors have barely been neglected while assessing bilateral relations, but the significance of culture as a soft power in Japan-Vietnam relations has largely been understated. While the close ties had their birth ever since the 14th century, this paper sets out with an inductive lens to analyze the role of culture as a variable in bilateral relations. Vietnam, which then had a history of war devastation had taken refuge in Japan and later sought inspiration from Japan’s economy with the simultaneous influence of culture since Japan was a developed nation, and Vietnam a third world country. Evidencing facts with illustrations, the paper shows how the twenty-first century has brought a growing bond as well as the onset of stronger ties between the two states based, primarily, on an emerging convergence of interests and culture. The cultural influence of Japan may be seen much in the Vietnamese cities, through evidences like the growing numbers of Japanese items on sale. The variety in cultural influence may be seen through the acceptance of Japanese fashion trends, mange comic, pop music, cuisine, tourism, Japanese studies and language, the translations of Japanese literature which are very much popular at Vietnam. Using secondary sources as well as assessing travel accounts and official websites, this research work will try to find out how much Japanese culture has influenced Vietnam and whether such influences will be strong enough to qualify culture as an intervening variable in the bilateral relations.

Keywords: influence, culture, language, cold war

Procedia PDF Downloads 124

Authors: Christina Tay

Abstract:

This paper investigates the impact of Information and Communication Technology (ICT) on bilateral trade in goods. Empirical analysis is performed on the United States and 34 partnering countries from 2000 to 2013. Our econometric model fits the data well, explaining 52% of the variation in trade flows for goods trade, 53.2% of the variation in trade flows for goods export and 48% of the variation in trade flows for goods import. For every 10% increase in fixed broadband Internet subscribers per 100 people increases, goods trade by 7.9% and for every 5% increase in fixed broadband Internet subscribers per 100 people, goods export increases by 11%. For every 1% increase in fixed telephone line penetration per 100 people, goods trade increases by 26.3%, goods export increases by 24.4% and goods import increases by 24.8%. For every 1% increase in mobile-cellular telephone subscriptions, goods trade decreases by 29.6% and goods export decreases by 27.1%, whilst for every 0.01% increase in mobile-cellular telephone subscriptions, goods import decreases by 34.3%. For every 1% increase in the percentage of population who used the Internet from any location in the last 12 months Internet, goods trade increases by 32.5%, goods export increases by 38.9%, goods import increases by 33%. All our trade determinants as well as our ICT variables have significances on goods exports for the US. We can also draw from our study that the US relies more rather heavily on ICT for its goods export compared to goods import.

Keywords: bilateral trade, fixed broadband, fixed telephone, goods trade, information and communicative technologies, Internet, mobile-cellular phone

Procedia PDF Downloads 252

Authors: Shelly-Ann Gajadhar

Abstract:

Over the last twenty years, the traditional economic motivations of foreign direct investment have been amalgamated with geopolitical motivations. This is evidenced by the extensive ratification of bilateral investment treaties (BIT) globally and the emergence of state-owned multinational companies (SOMNCs) that directly compete with local domestic enterprises (LDE). This paper investigates the impact that Chinese SOMNCs have on LDEs within Trinidad and Tobago’s construction sector and, determines whether knowledge transfer occurs. The paper employed semi-structured interviews of industry experts and concluded that LDEs predominantly experience adverse spillovers, inclusive of a long-term competition effect, with no technology transfer occurring.

Keywords: foreign direct investment, bilateral investment treaties, knowledge transfer, international business, Caribbean

Procedia PDF Downloads 220

Authors: Apoorva D. R.

Abstract:

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

Procedia PDF Downloads 55

Authors: Preethy Mary Donald, Renjith George Pallivathukal

Abstract:

Dens evaginatus (DE) is a rare developmental anomaly characterized by a slender enamel-covered tubercle which projects from the occlusal surface of an otherwise normal premolar. DE can often interfere normal occlusion and can lead to complications like sensitivity, pulpal exposure and temporo mandibular joint problems. The orthopantomographs (OPGs) and dental records of patients under the age of 20 who attended the faculty of dentistry, Melaka-Manipal Medical College were examined for DE. Results: The prevalence of DE was 23% among the study group. Males presented with a higher prevalence of 67% and females with 33%. The prevalence of Dens evaginatus was distributed as 28% in maxillary central incisor, 52% in maxillary lateral incisors, 12% in mandibular second premolars. Prevalence in permanent dentitions appeared to be higher than deciduous dentition. The bilateral occurrence of Dens evaginatus is an interesting phenomenon. 57% of the cases of the DE were bilateral.

Keywords: deciduous dentition, dens evaginatus, permanent dentition, prevalence

Procedia PDF Downloads 274

Authors: Saidasanov Saidazal Shokhmurodovich, Topolnickiy Orest Zinovyevich, Afaunova Olga Arturovna

Abstract:

Relevance: Bilateral congenital cleft is one of the most complex forms of all clefts, which makes it difficult to choose a surgical method of treatment. During primary operations to close the hard and soft palate, there is a shortage of soft tissues and their lack during standard uranoplasty, and these factors aggravate the period of rehabilitation of patients. Materials and methods: The results of surgical treatment of children with bilateral cleft, who underwent uranoplasty using a flap from the tongue, were analyzed. The study used methods: clinical and statistical, which allowed us to solve the tasks, based on the principles of evidence-based medicine. Results and discussion: in our study, 15 patients were studied, who underwent surgical treatment in the following volume: uranoplasty using a flap from the tongue in two stages. Of these, 9 boys and 6 girls aged 2.5 to 6 years. The first stage was surgical treatment in the volume: veloplasty. The second stage was a surgical intervention in volume: uranoplasty using a flap from the tongue. In all patients, the width of the cleft ranged from 1.6-2.8 cm. All patients in this group were orthodontically prepared. Using this method, the surgeon can achieve the following results: maximum narrowing of the palatopharyngeal ring, long soft palate, complete closure of the hard palate, alveolar process, and the mucous membrane of the nasal cavity is also sutured, which creates good conditions for the next stage of osteoplastic surgery. Based on the result obtained, patients have positive results of working with a speech therapist. In all patients, the dynamics were positive without complications. Conclusions: Based on our observation, tongue flap uranoplasty is one of the effective techniques for patients with wide clefts of the hard and soft palate. The use of a flap from the tongue makes it possible to reduce the number of repeated reoperations and improve the quality of social adaptation of this group of patients, which is one of the important stages of rehabilitation. Upon completion of the stages of rehabilitation, all patients had the maximum improvement in functional, anatomical and social indicators.

Keywords: congenital cleft lips and palate, bilateral cleft, child surgery, maxillofacial surgery

Procedia PDF Downloads 80

Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

Abstract:

Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

Procedia PDF Downloads 192

Authors: Kumar Y., Suman D., Sumathi

Abstract:

Introduction: Burns to the face account for between one-fourth and one-third of all burns. The loss of an eyebrow due to a burn or infection can have negative physical and psychological consequences for patients because eyebrows have a critical functional and aesthetic role on the face. Plastic surgeons face unique challenges in reconstructing eyebrows due to their complex anatomy and variations within genders. As a general rule, there are three techniques for reconstructing the eyebrow: superficial temporal artery island flap, a composite graft from the scalp, and mini or micro follicular grafts from the scalp. In situations where a sufficient amount of subcutaneous tissue is not available and the defect is big such as the case of burns, flaps like the superficial temporal artery scalp flap remain reliable options. In 2018, a 17-year-old female patient presented to the department of Burns Plastic and reconstructive Surgery of Guru Teg Bahadur Hospital, Delhi, India. A scald-burn injury to the face occurred two years before admission, resulting in bilateral eyebrow loss. We reconstructed the bilateral eyebrows using bilateral scalp island flaps based on the posterior branch of the superficial temporal artery. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance, which was consistent with preoperative expectations and the patient stated that she was more comfortable with her social relationships. Among the current treatment procedures, the superficial temporal artery island flap continues to be a versatile option for reconstructing the eyebrows after alopecia, especially in cases of burns. Results: During the 30 days follow-up period, the scalp island flap remained vascularised with normal hair growth, without complications. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance; the patient stated that she was more comfortable with her social relationships. Conclusion: In this case report, we demonstrated how scalp island flaps pedicled by the superficial temporal artery could be performed very safely and reliably to create new eyebrows.

Keywords: alopecia, burns, eyebrow, flap, superficial temporal artery

Procedia PDF Downloads 190

Authors: Ahmad Forouzantabar, Mohammad Azadi

Abstract:

This paper presents sliding mode controller for bilateral teleoperation systems with robotic master and slave under constant communication delays. We extend the passivity-based coordination architecture to enhance position and force tracking in the presence of offset in initial conditions, environmental contacts and unknown parameters such as friction coefficient. To address these difficulties, a nonlinear sliding mode controller is designed to approximate the nonlinear dynamics of master and slave robots and improve both position and force tracking. Using the Lyapunov theory, the boundedness of master- slave tracking errors and the stability of the teleoperation system are also guaranteed. Numerical simulations show that proposed controller position and force tracking performances are superior to that of conventional coordination controller tracking performances.

Keywords: Lyapunov stability, teleoperation system, time delay, sliding mode controller

Procedia PDF Downloads 344

Authors: Hamide Farshad, Mohammadreza Javidi Abdollah Zadeh Aval

Abstract:

As a result of the growing penetration of the media into human life, a new role under the title of "audience" is defined in the social life .A kind of role which is dramatically changed since its formation. This article aims to define the audience position in the new media equations which is concluded to the transformation of the media role. By using the Library and Attributive method to study the history, the evolutionary outlook to the audience and the recognition of the audience and the media relation in the new media context is studied. It was perceived in past that public communication would result in receiving the audience. But after the emergence of the interactional media and transformation in the audience social life, a new kind of public communication is formed, and also the imaginary picture of the audience is replaced by the audience impact on the communication process. Part of this impact can be seen in the form of feedback which is one of the public communication elements. In public communication, the audience feedback is completely accepted. But in many cases, and along with the audience feedback, the media changes its direction; this direction shift is known as media feedback. At this state, the media and the audience are both doers and consistently change their positions in an interaction. With the greater number of the audience and the media, this process has taken a new role, and the role of this doer is sometimes taken by an audience while influencing another audience, or a media while influencing another media. In this article, this multiple public communication process is shown through representing a model under the title of ”The bilateral influence of the audience and the media.” Based on this model, the audience and the media power are not the two sides of a coin, and as a result, by accepting these two as the doers, the bilateral power of the audience and the media will be complementary to each other. Also more, the compatibility between the media and the audience is analyzed in the bilateral and interactional relation hypothesis, and by analyzing the action law hypothesis, the dos and don’ts of this role are defined, and media is obliged to know and accept them in order to be able to survive. They also have a determining role in the strategic studies of a media.

Keywords: audience, effect, media, interaction, action laws

Procedia PDF Downloads 453