Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12

Search results for: fenestration

12 Bionaut™: A Minimally Invasive Microsurgical Platform to Treat Non-Communicating Hydrocephalus in Dandy-Walker Malformation

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher


The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

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11 Bionaut™: A Breakthrough Robotic Microdevice to Treat Non-Communicating Hydrocephalus in Both Adult and Pediatric Patients

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher


Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

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10 Tuning of the Thermal Capacity of an Envelope for Peak Demand Reduction

Authors: Isha Rathore, Peeyush Jain, Elangovan Rajasekar


The thermal capacity of the envelope impacts the cooling and heating demand of a building and modulates the peak electricity demand. This paper presents the thermal capacity tuning of a building envelope to minimize peak electricity demand for space cooling. We consider a 40 m² residential testbed located in Hyderabad, India (Composite Climate). An EnergyPlus model is validated using real-time data. A Parametric simulation framework for thermal capacity tuning is created using the Honeybee plugin. Diffusivity, Thickness, layer position, orientation and fenestration size of the exterior envelope are parametrized considering a five-layered wall system. A total of 1824 parametric runs are performed and the optimum wall configuration leading to minimum peak cooling demand is presented.

Keywords: thermal capacity, tuning, peak demand reduction, parametric analysis

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9 Energy Saving, Heritage Conserving Renovation Methods in Case of Historical Building Stock

Authors: Viktória Sugár, Zoltán Laczó, András Horkai, Gyula Kiss, Attila Talamon


The majority of the building stock of Budapest inner districts was built around the turn of the 19th and 20th century. Although the structural stability of the buildings is not questioned, as the load bearing structures are in sufficient state, the secondary structures are aged, resulting unsatisfactory energetic state. The renovation of these historical buildings requires special methodology and technology: their ornamented facades and custom-made fenestration cannot be insulated or exchanged with conventional solutions without damaging the heritage values. The present paper aims to introduce and systematize the possible technological solutions for heritage respecting energy retrofit in case of a historical residential building stock. Through case study, the possible energy saving potential is also calculated using multiple renovation scenarios.

Keywords: energy efficiency, heritage, historical building, renovation

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8 A Study of New Window Typology for Palestinian Residential Building for More Sustainable Building

Authors: Nisreen Ardda


Fenestrations are one of the main building envelope elements that play an important role in home social-ecological l factors. They play a vital role in providing natural lighting and ventilation, visual, thermal, and acoustical comfort, and also provide weather-tightness, privacy, a feeling of openness. In most home buildings, fenestrations are controlled manually by the occupants, which significantly impacts occupants' comfort and energy use. Culture plays a central role in the Palestinians window operation behavior. Improved windows design that provides the desired privacy while maintaining the appropriate function of fenestration (natural lighting, thermal comfort, and visual openness) is becoming a necessity. Therefore, this paper proposes a window typology to achieve the social and environmental factors in residential buildings in the West Bank. The window typology and reference building were designed in Rivet 2021, and natural ventilation was carried out in Design Builder The results showed that the proposed typology provides the desired privacy and the feeling of openness without compromising natural ventilation as the existing window did.

Keywords: window design, passive design, sustainable built environment, building material

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7 Review of the Anatomy of the Middle Cerebral Artery and Its Anomalies

Authors: Karen Cilliers, Benedict John Page


The middle cerebral artery (MCA) is the most complex cerebral artery although few anomalies are found compared to the other cerebral arteries. The branches of the MCA cover a large part of each hemisphere, therefore it is exposed in various operations. Although the segments of the MCA are similarly described by most authors, there is some disagreement on the branching pattern of the MCA. The aim of this study was to review the available literature on the anatomy and variations of the MCA, and to compare this to a pilot study. For the pilot study, 20 hemispheres were perfused with coloured silicone and the MCA was dissected. According to the literature, the two most common branching configurations are the bifurcating and trifurcating patterns. In the pilot study, bifurcation was observed in 19 hemispheres, and in one hemisphere there was no branching (monofurcation). No trifurcation was observed. The most commonly duplicated branch was the anterior parietal artery in 30%, and most commonly absent was the common temporal artery in 65% and the temporal polar artery in 40%. Very few studies describe the origins of the branches of the MCA, therefore a detailed description is given. Middle cerebral artery variations that are occasionally reported in the literature include fenestration, and a duplicated or accessory MCA, although no variations were observed in the pilot study. Aneurysms can frequently be observed at the branching of cerebral vessels, therefore a thorough knowledge of the vascular anatomy is vital. Furthermore, knowledge of possible variations is important since variations can have serious clinical implications.

Keywords: anatomy, anomaly, description, middle cerebral artery, origin, variation

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6 Analyzing Façade Scenarios and Daylight Levels in the Reid Building: A Reflective Case Study on the Designed Daylight under Overcast Sky

Authors: Eman Mayah, Raid Hanna


This study presents the use of daylight in the case study of the Reid building at the Glasgow School of Art in the city of Glasgow, UK. In Nordic countries, daylight is one of the main considerations within building design, especially in the face of long, lightless winters. A shortage of daylight, contributing to dark and gloomy conditions, necessitates that designs incorporate strong daylight performance. As such, the building in question is designed to capture natural light for varying needs, where studios are located on the North and South façades. The study’s approach presents an analysis of different façade scenarios, where daylight from the North is observed, analyzed and compared with the daylight from the South façade for various design studios in the building. The findings then are correlated with the results of daylight levels from the daylight simulation program (Autodesk Ecotect Analysis) for the investigated studios. The study finds there to be a dramatic difference in daylight nature and levels between the North and South façades, where orientation, obstructions and designed façade fenestrations have major effects on the findings. The study concludes that some of the studios positioned on the North façade do not have a desirable quality of diffused northern light, due to the outside building’s obstructions, area and volume of the studio and the shadow effect of the designed mezzanine floor in the studios.

Keywords: daylight levels, educational building, Façade fenestration, overcast weather

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5 Laparoscopic Management of Cysts Mimicking Hepatic Cystic Echinococcosis in Children (A Case Series)

Authors: Assia Haif, Djelloul Achouri, Zineddine Soualili


Introduction: Laparoscopic treatment of liver echinococcosis cyst has become popular. In parallel, the diagnostic approach of cystic liver lesions is based on the number of lesions and their distribution. The etiologies of cystic masses in children are different, and the role of imaging in their characterization and pre-therapeutic evaluation is essential. The main differential diagnoses of hepatic hydatid cysts can be discovered intraoperatively by minimally invasive surgery. Methods: The clinical data contained seven patients with hepatic cystic who underwent laparoscopic surgery in the Department of Pediatric Surgery, SETIF, Algeria, from 2015 to 2022. Results: Of reported seven patients, five are male, and the remaining two are female. Abdominal pain was the most frequent clinical signs. Biological parameters were within normal limits, Abdominal ultrasound, practiced in all cases, completed by abdominal computed tomography (CT), showed a hydatid cystic. For all patients, surgical procedures were performed under laparoscopy. Total cystectomy in four patients, fenestration or subtotal cystectomy in three patients, respectively. A histopathological feature confirmed the nature of the cysts. During the follow-up period, there was no recurrence. Conclusions: Laparoscopic liver surgery is a safe and effective approach, it is an alternative to conventional surgery and a reproducible method. Laparoscopic surgery approach should follow the same principals with those of open surgery. This surgical technique can rectify the diagnosis of hydatid cyst, the histopathological examination confirms the nature of the cystic lesion.

Keywords: children, cyst, echinococcosis, laparoscopic, liver

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4 Variations and Anomalies of the Posterior Cerebral Artery in a South African Population

Authors: Karen Cilliers, Benedict J. Page


Limited research focuses on the anatomy of the posterior cerebral artery (PCA) and its cortical branches, even though there can be variation in the presence, size, and origin. The PCA branching pattern has not been adequately reported, and the true division point remains unclear. Anomalies of the PCA have been described in the previous literature; however, few examples have been reported. Furthermore, possible differences between right and left, sex, population and age groups may exist. Therefore, the aim of this study was to report on these aspects from a South African population. One hundred and twenty-six hemispheres were obtained consisting of 86 males and 38 females, between the ages of 22 and 84 (average 45 years of age). This comprised of three population groups, namely coloured (n=74), black (n=38), white (n=10) and two unknown cases. The PCA was injected with an isotonic saline and a colored silicone. The external diameter was measured with a digital micrometer, and length was measured with a string and a ruler. Presence and origins of the cortical branches were similar to the literature; however, duplications, triplications, and unusual origins were observed. The diameter and lengths indicated significant differences between the right and left sides, sex, population and age groups. Branching patterns were identified and compared to the prevalence from previous studies. Two fenestrations were observed in the P2A segment. The presence, size, origin, branching pattern and anomalies of the PCA were investigated in this study. The diameter and length can be significantly different, especially between the right and left-hand side. Changes in the diameter and length can be indicative of certain neuropathological conditions and can play a role in aneurysms formation. Adequate knowledge of the normal and abnormal PCA anatomy is crucial for surgery in the vicinity of the PCA. Therefore, future studies should focus on these aspects.

Keywords: branching, cortical branches, fenestration, posterior cerebral artery

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3 A Reminder of a Rare Anatomical Variant of the Spinal Accessory Nerve Encountered During Routine Neck Dissection: A Case Report and Updated Review of the Literature

Authors: Sophie Mills, Constantinos Aristotelous, Leila L. Touil, Richard C. W. James


Objectives: Historical studies of the anatomy of the spinal accessory nerve (SAN) have reported conflicting results regarding its relationship with the internal jugular vein (IJV). A literature review was undertaken to establish the prevalence of anatomical variations of the SAN encountered during routine neck dissection surgery in order to increase awareness and reduce morbidity associated with iatrogenic SAN injury. Materials and Methods: The largest systematic review to date was performed using PRISMA-ScR guidelines, which yielded nine articles following the application of inclusion and exclusion criteria. A case report is also included, which demonstrates the rare anatomical relationship of the SAN traversing a fenestrated IJV, seen for the first time in the senior author’s career. Results: The mean number of dissections per study was 119, of which 55.6% (n=5) studies were performed on cadaver subjects, and 44.4% (n=4) were surgical dissections. Incidences of the SAN lateral to the IJV and medial to the IJV ranged from 38.9%-95.7% and 2.8%-57.4%, respectively. Over half of the studies reported incidences of the SAN traversing the IJV in 0.9%-2.8% of dissections. One study reported an isolated variant of the SAN dividing around the IJV with a prevalence of 0.5%. Conclusion: At the level of the posterior belly of the digastric muscle, the surgeon can anticipate the identification of the SAN lateral to the IJV in approximately three-quarters of cases, whilst around one-quarter are estimated to be medial. A mean of 1.6% of SANs traverses a fenestration of the vein. It is essential for surgeons to be aware of these anatomical variations and their prevalence to prevent injury to vital structures during surgery.

Keywords: anatomical variant, internal jugular vein, neck dissection, spinal accessory nerve

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2 The Impact of Passive Design Factors on House Energy Efficiency for New Cities in Egypt

Authors: Mahmoud Mourad, Ahmad Hamza H. Ali, S.Ookawara, Ali Kamel Abdel-Rahman, Nady M. Abdelkariem


The energy consumption of a house can be affected simultaneously by many building design factors related to its main architectural features, building elements and materials. This study focuses on the impact of passive design factors on the annual energy consumption of a suggested prototype house for single-family detached houses of 240 m2 in two floors, each floor of 120 m2 in new Egyptian cities located in (Alexandria - Cairo - Siwa - Assuit – Aswan) which resemble five different climatic zones (Northern coast – Northern upper Egypt - dessert region- Southern upper Egypt – South Egypt) respectively. This study present the effect of the passive design factors affecting the building energy consumption as building orientation, building material (walls, roof and slabs), building type (residential, educational, commercial), building occupancy (type of occupant, no. of occupant, age), building landscape and site selection, building envelope and fenestration (glazing material, shading), and building plan form. This information can be used to estimate the approximate saving in energy consumption, which would result on a change in the design datum for the future houses development, and to identify the major design problems for energy efficiency. To achieve the above objective, this paper presents a study for the factors affecting on the building energy consumption in the hot arid area in new Egyptian cities in five different climatic zones , followed by defining the energy needs for different utilization in this suggested prototype house. Consequently, a detailed analysis of the available Renewable Energy utilizations technologies used in the suggested home, and a calculation of the energy as a function of yearly distribution that required for this home will presented. The results obtained from building annual energy analyses show that architecture passive design factors saves about 35% of the annual energy consumption. It shows also passive cooling techniques saves about 45%, and renewable energy systems saves about 40% of the annual energy needs for this proposed home depending on the cities location on the climatic zones.

Keywords: architecture passive design factors, energy efficient homes, Egypt new cites, renewable energy technologies

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1 Evaluating Daylight Performance in an Office Environment in Malaysia, Using Venetian Blind Systems

Authors: Fatemeh Deldarabdolmaleki, Mohamad Fakri Zaky Bin Ja'afar


This paper presents fenestration analysis to study the balance between utilizing daylight and eliminating the disturbing parameters in a private office room with interior venetian blinds taking into account different slat angles. Mean luminance of the scene and window, luminance ratio of the workplane and window, work plane illumination and daylight glare probability(DGP) were calculated as a function of venetian blind design properties. Recently developed software, analyzing High Dynamic Range Images (HDRI captured by CCD camera), such as radiance based evalglare and hdrscope help to investigate luminance-based metrics. A total of Eight-day measurement experiment was conducted to investigate the impact of different venetian blind angles in an office environment under daylight condition in Serdang, Malaysia. Detailed result for the selected case study showed that artificial lighting is necessary during the morning session for Malaysian buildings with southwest windows regardless of the venetian blind’s slat angle. However, in some conditions of afternoon session the workplane illuminance level exceeds the maximum illuminance of 2000 lx such as 10° and 40° slat angles. Generally, a rising trend is discovered toward mean window luminance level during the day. All the conditions have less than 10% of the pixels exceeding 2000 cd/m² before 1:00 P.M. However, 40% of the selected hours have more than 10% of the scene pixels higher than 2000 cd/m² after 1:00 P.M. Surprisingly in no blind condition, there is no extreme case of window/task ratio, However, the extreme cases happen for 20°, 30°, 40° and 50° slat angles. As expected mean window luminance level is higher than 2000 cd/m² after 2:00 P.M for most cases except 60° slat angle condition. Studying the daylight glare probability, there is not any DGP value higher than 0.35 in this experiment, due to the window’s direction, location of the building and studied workplane. Specifically, this paper reviews different blind angle’s response to the suggested metrics by the previous standards, and finally conclusions and knowledge gaps are summarized and suggested next steps for research are provided. Addressing these gaps is critical for the continued progress of the energy efficiency movement.

Keywords: daylighting, office environment, energy simulation, venetian blind

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