Search results for: operative technique

Authors: Rudranil Das

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Wrapping is a basic textile technique; it is having a great quality of decorative view. Since long back it has been embellishing life of people and their culture in different forms. It links cultures, beliefs, thoughts, technology, and above all, people. Through etymology we can study the movement of the word power of wrapping undoubtedly but in depth analyze it could provide many concepts of structural ability. Only in India, more than 105 different processes exist in the way of saree [a type of women attire] wrapping. Then many more other clothing we found in allover world which connects this technique and construction too. One of the main objectives of this study is to enrich wrapping explanation and come up with surfaces by this technique. The deliberate more fragile and stretchable structural framework makes it more appropriate in different users according to their necessity. Developments of design and technology could create new industry segment and generate a marginalized employment for the people too.

Keywords: concept, existence, philosophical attachment, technological advancement

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Abraham J. Rizkalla, Tristan D. Yan

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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

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Authors: Khalid A. Al-Afandy, El-Sayyed El-Rabaie, Osama Salah, Ahmed El-Mhalaway

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This paper presents a high secure data hiding technique using image cropping and Least Significant Bit (LSB) steganography. The predefined certain secret coordinate crops will be extracted from the cover image. The secret text message will be divided into sections. These sections quantity is equal the image crops quantity. Each section from the secret text message will embed into an image crop with a secret sequence using LSB technique. The embedding is done using the cover image color channels. Stego image is given by reassembling the image and the stego crops. The results of the technique will be compared to the other state of art techniques. Evaluation is based on visualization to detect any degradation of stego image, the difficulty of extracting the embedded data by any unauthorized viewer, Peak Signal-to-Noise Ratio of stego image (PSNR), and the embedding algorithm CPU time. Experimental results ensure that the proposed technique is more secure compared with the other traditional techniques.

Keywords: steganography, stego, LSB, crop

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Authors: S. Periyadharshini, K. Ramkumar, S. Jayalalitha, M. GuruPrasath, R. Manikandan

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This paper presents a formulation and solution for industrial load management and product grade problem. The formulation is created using linear programming technique thereby optimizing the electricity cost by scheduling the loads satisfying the process, storage, time zone and production constraints which will create an impact of reducing maximum demand and thereby reducing the electricity cost. Product grade problem is formulated using integer linear programming technique of optimization using lingo software and the results show that overall increase in profit margin. In this paper, time of use tariff is utilized and this technique will provide significant reductions in peak electricity consumption.

Keywords: cement industries, integer programming, optimal formulation, objective function, constraints

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Authors: Ben G. Weber, Michael Mateas

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We present a case-based reasoning technique for selecting build orders in a real-time strategy game. The case retrieval process generalizes features of the game state and selects cases using domain-specific recall methods, which perform exact matching on a subset of the case features. We demonstrate the performance of the technique by implementing it as a component of the integrated agent framework of McCoy and Mateas. Our results demonstrate that the technique outperforms nearest-neighbor retrieval when imperfect information is enforced in a real-time strategy game.

Keywords: case based reasoning, real time strategy systems, requirements elicitation, requirement analyst, artificial intelligence

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Authors: Nadjat Zerf Boudjettou, Fahima Nader, Rachid Chalal

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Knowledge management is to acquire and represent knowledge relevant to a domain, a task or a specific organization in order to facilitate access, reuse and evolution. This usually means building, maintaining and evolving an explicit representation of knowledge. The next step is to provide access to that knowledge, that is to say, the spread in order to enable effective use. Knowledge management in the medical field aims to improve the performance of the medical organization by allowing individuals in the care facility (doctors, nurses, paramedics, etc.) to capture, share and apply collective knowledge in order to make optimal decisions in real time. In this paper, we propose a knowledge management approach based on integration technique of heterogeneous data in the medical field by creating a data warehouse, a technique of extracting knowledge from medical data by choosing a technique of data mining, and finally an exploitation technique of that knowledge in a case-based reasoning system.

Keywords: data warehouse, data mining, knowledge discovery in database, KDD, medical knowledge management, Bayesian networks

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Authors: Abdelhak Soudani

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Using the limit equilibrium method in geotechnical field is very important for large projects. This work contributes to the understanding and analysis of the building unstable slopes by the technique of soil nailed with the used of software called GEO-SLOPE calculation based on limit equilibrium method. To achieve our objective, we began a review of the literature on landslides, and techniques of slope stability. Then, we presented a real case slope likely to slip through the realization of the EastWest Highway (M5 stretch between Khemis Miliana and Hoceinia). We also process the application of reinforcement technique nailed soil. The analysis is followed by a parametric study, which shows the impact of parameters given or chosen on various outcomes. Another method of reinforcement (use of micro-piles) has been suggested for improving the stability of the slope

Keywords: slope stability, strengthening, slip, soil nail, GEO-SLOPE

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Authors: R. H. Bari

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The nanostructured thin films of CdSnO3 are sensitive to change in their environment. CdSnO3 is successfully used as gas sensor due to the dependence of the electrical conductivity on the ambient gas composition. Nanostructured CdSnO3 thin films of different substrate temperature (300 0C, 350 0C, 400 0C and 450 0C) were deposited onto heated glass substrate by simple spray pyrolysis (SP) technique. Sensing elements of nanostructured CdSnO3 were annealed at 500 0C for 1 hrs. Characterization includes a different analytical technique such as, X-ray diffractogram (XRD), energy dispersive X-ray analysis (EDAX), and Field emission scanning electron microscope (FE-SEM). The average grain size observed from XRD and FF-SEM was found to be less than 18.36 and 23 nm respectively. The films sprayed at substrate temperature for 400 0C was observed to be most sensitive (S = 530) to SO2 for 500 ppm at 300 0C. The response and recovery time is 4 sec, 8 sec respectively.

Keywords: nanostructured CdSnO3, spray pyrolysis, SO2 gas sensing, quick response

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Authors: Shiksha Jain, Ramesh Mishra

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One of the most widely used complex signals processing operation is filtering. The most important FIR digital filter are widely used in DSP for filtering to alter the spectrum according to some given specifications. Power consumption and Area complexity in the algorithm of Finite Impulse Response (FIR) filter is mainly caused by multipliers. So we present a multiplier less technique (DA technique). In this technique, precomputed value of inner product is stored in LUT. Which are further added and shifted with number of iterations equal to the precision of input sample. But the exponential growth of LUT with the order of FIR filter, in this basic structure, makes it prohibitive for many applications. The significant area and power reduction over traditional Distributed Arithmetic (DA) structure is presented in this paper, by the use of slicing of LUT to the desired length. An architecture of 16 tap FIR filter is presented, with different length of slice of LUT. The result of FIR Filter implementation on Xilinx ISE synthesis tool (XST) vertex-4 FPGA Tool by using proposed method shows the increase of the maximum frequency, the decrease of the resources as usage saving in area with more number of slices and the reduction dynamic power.

Keywords: multiplier less technique, linear phase symmetric FIR filter, FPGA tool, look up table

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Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

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Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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Authors: Jirayut Phetchuen, Jongkol Srithorn

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The study examines the unloading and repacking process of Read With Me Group Company Limited. The research aims to improve the old work process and build a new efficient process with the Lean Technique and new machines for faster delivery without increasing the number of employees. Currently, two employees work based on five days on and off. However, workplace injuries have delayed the delivery time, especially the delivery to the neighboring countries. After the process improvement, the working space increased by 25%, the Process Lead Time decreased by 40%, the work efficiency increased by 175.82%, and the work injuries rate was reduced to zero.

Keywords: lean technique, plant layout design, U-shaped disassembly line, value stream mapping

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Authors: Khalid Mahmud

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In this paper, an analytic approach is presented to evaluate the Bit Error Rate (BER) and round trip distance for a UWB chipless RFID system using diversity technique at the reader receiver using different modulation technique. The analysis is carried out with multiresonator based chipless RFID tags using frequency range from 3 GHz − 6 GHz and bandwidth of 500 M Hz in outdoor non-line-of-sight (NLOS) environment. SISO configuration is used to communicate from the reader to the tag and SIMO configuration is used do vice versa. Maximal Ratio Combining (MRC) technique is used in the reader. MPSK, DQPSK, DBPSK, BPSK, QPSK and DMPSK modulation techniques are considered with coherent demodulation to evaluate the BER performance. From the numerical analysis of the results, it is found that at a given BER maximum possible round trip distance can be achieved using DMPSK modulation technique. In addition, it has been proved that, while using DMPSK modulation technique, the application of diversity has very little effect on the overall improvement in reader receiver sensitivity and achievable distance. Finally the method not only proves to be a very good way for tag detection in case of a chipless RFID system but also gives a clear insight regarding the interrelationship between BER, read range, reader received power, number of receiving antenna in outdoor NLOS environment.

Keywords: EGC, MRC, BER, read range, diversity

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

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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

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Authors: B. A. Alwahaby

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Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

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Authors: Md.Noman Habib Khan, M. S. Tajul Islam, T. S. Gunawan, M. Hasanuzzaman

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The photovoltaic (PV) panel with no galvanic isolation system is well-known technique in the world which is effective and deliver power with enhanced efficiency. The PV generation presented here is for stand-alone system installed in remote areas when as the resulting power gets connected to electronic load installation instead of being tied to the grid. Though very small, even then transformer-less topology is shown to be with leakage in pico-ampere range. By using PWM technique PWM, leakage current in different situations is shown. The results that are demonstrated in this paper show how the pico-ampere current is reduced to femto-ampere through use of inductors and capacitors of suitable values of inductor and capacitors with the load.

Keywords: photovoltaic (PV) panel, duty cycle, pulse duration modulation (PDM), leakage current

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Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on Early Pregnancy Assessment Clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba, and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. International Classification of Disease 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ±4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs. 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID, but ectopic pregnancy operative management remained unchanged.

Keywords: obstetrics and gynecology, EPAC, early pregnancy assessment, first trimester, emergency department, abortion, pregnancy, COVID-19

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Authors: Khwaja Naweed Seddiqi

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Hydrocarbon resources are important for the redevelopment and sustainable progress of Afghanistan’s infrastructure. This paper aim is to increase the oil recovery of Hitervian reservoir of Angut oil field in north part of Afghanistan by an easy and available method, which is Buckley-Leveret frontal displacement theory. In this paper oil displacement by water that takes placed by injecting water into the under laying petroleum reservoir which called waterflooding technique is investigated. The theory is investigated in a laboratory experiment first then applied in Angut oil field which is now under the operation of a private petroleum company. Based on this study oil recovery of Angut oil field, residual oil saturation, Buckle-Leveret saturation and FBL is determined.

Keywords: waterflooding technique, two phase fluid flow, Buckley-Leveret, petroleum engineering

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Authors: Gagnesh Kumar, Nitin Gupta

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Ternary Content Addressable Memory cells are mainly popular in network routers for packet forwarding and packet classification, but they are also useful in a variety of other applications that require high-speed table look-up. The main TCAM-design challenge is to decrease the power consumption associated with the large amount of parallel active circuitry, without compromising with speed or memory density. Furthermore, when the channel length decreases, leakage power becomes more significant, and it can even dominate dynamic power at lower technologies. In this paper, we propose a TCAM-design technique, called Virtual Power Supply technique that reduces the leakage by a substantial amount.

Keywords: match line (ML), search line (SL), ternary content addressable memory (TCAM), Leakage power (LP)

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Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: Sari F. Alkhatib, Chang Je Park, Gyuhong Roh

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The iterative scheme which is used to treat buildup factors for stratified shields is being investigated here using the layer-splitting technique. A simple suggested formalism for the scheme based on the Kalos’ formula is introduced, based on which the implementation of the testing technique is carried out. The second layer in a double-layer shield was split into two equivalent layers and the scheme (with the suggested formalism) was implemented on the new “three-layer” shield configuration. The results of such manipulation on water-lead and water-iron shields combinations are presented here for 1 MeV photons. It was found that splitting the second layer introduces some deviation on the overall buildup factor value. This expected deviation appeared to be higher in the case of low Z layer followed by high Z. However, the overall performance of the iterative scheme showed a great consistency and strong coherence even with the introduced changes. The introduced layer-splitting testing technique shows the capability to be implemented in test the iterative scheme with a wide range of formalisms.

Keywords: buildup factor, iterative scheme, stratified shields, layer-splitting tecnique

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: A. N. Paithane, D. S. Bormane, S. D. Shirbahadurkar

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It has been seen that emotion recognition is an important research topic in the field of Human and computer interface. A novel technique for Feature Extraction (FE) has been presented here, further a new method has been used for human emotion recognition which is based on HHT method. This method is feasible for analyzing the nonlinear and non-stationary signals. Each signal has been decomposed into the IMF using the EMD. These functions are used to extract the features using fission and fusion process. The decomposition technique which we adopt is a new technique for adaptively decomposing signals. In this perspective, we have reported here potential usefulness of EMD based techniques.We evaluated the algorithm on Augsburg University Database; the manually annotated database.

Keywords: intrinsic mode function (IMF), Hilbert-Huang transform (HHT), empirical mode decomposition (EMD), emotion detection, electrocardiogram (ECG)

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Authors: Chalakorn Chitsaart, Suchada Rianmora, Noppawat Vongpiyasatit

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In order to reduce the transportation time and cost for direct interface between customer and manufacturer, the image processing technique has been introduced in this research where designing part and defining manufacturing process can be performed quickly. A3D virtual model is directly generated from a series of multi-view images of an object, and it can be modified, analyzed, and improved the structure, or function for the further implementations, such as computer-aided manufacturing (CAM). To estimate and quote the production cost, the user-friendly platform has been developed in this research where the appropriate manufacturing parameters and process detections have been identified and planned by CAM simulation.

Keywords: image processing technique, feature detections, surface registrations, capturing multi-view images, Production costs and Manufacturing processes

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Authors: Andrea Gatti, Federica Coppotelli, Ma Primavera, Laura Palmieri, Umberto Tarantino

Abstract:

Aim of study: Scientific literature is scarce of studies and reviews valuing the pros and cons of the paratricipital approach for the treatment of humeral shaft fractures; the lateral paratricipital approach is a valid alternative to the classical posterior approach to the humeral shaft as it preserves both the triceps muscle and the elbow extensor mechanisms; based on our experience, this retrospective analysis aims at analyzing outcome, risks and benefits of the lateral paratricipital approach for humeral shaft fractures. Methods: Our study includes 14 patients treated between 2018 and 2019 for unilateral humeral shaft fractures: 13 with a B1 or B2 and a patient with a C fracture type (according to the AO/ATO Classification); 6 of our patients identified as male while 8 as female; age average was 57.8 years old (range 21-73 years old). A lateral paratricipital approach was performed on all 14 patients, sparing the triceps muscle by avoiding the olecranon osteotomy and by assessing the integrity and the preservation of the radial nerve; the humeral shaft fracture osteosynthesis was performed by means of plates and screws. After surgery all patients have started elbow functional rehabilitation with acceptable pain management. Post-operative follow-up has been carried out by assessing radiographs, MEPS (Mayo Elbow Performance Score) and DASH (Disability of Arm Shoulder and Hand) functional assessment and ROM of the affected joint. Results: All 14 patients had an optimal post-operative follow-up with an adequate osteosynthesis and functional rehabilitations by entirely preserving the operated elbow joint; the mean elbow ROM was 0-118.6 degree (range of 0-130) while the average MEPS score was 86 (range75-100) and 79.9 for the DASH (range 21.7-86.1). Just 2 patients suffered of temporary radial nerve apraxia, healed in the subsequent follow-ups. CONCLUSION: The lateral paratricipital approach preserve both the integrity of the triceps muscle and the elbow biomechanism but we do strongly recommend additional studies to be carried out to highlight differences between it and the classical posterior approach in treating humeral shaft fractures.

Keywords: paratricepital approach, humerus shaft fracture, posterior approach humeral shaft, paratricipital postero-lateral approach

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Authors: Li-Kai Kuo, Shyh-Hau Wang

Abstract:

The kinetic trajectory of the median nerve (MN) in the wrist has shown to be capable of being applied to assess the carpal tunnel syndrome (CTS), and was found able to be detected by high-frequency ultrasound image via motion tracking technique. Yet, previous study may not quickly perform the measurement due to the use of a single element transducer for ultrasound image scanning. Therefore, previous system is not appropriate for being applied to clinical application. In the present study, B-mode ultrasound images of the wrist corresponding to movements of fingers from flexion to extension were acquired by clinical applicable real-time scanner. The kinetic trajectories of MN were off-line estimated utilizing two dimensional Baysian speckle tracking (TDBST) technique. The experiments were carried out from ten volunteers by ultrasound scanner at 12 MHz frequency. Results verified from phantom experiments have demonstrated that TDBST technique is able to detect the movement of MN based on signals of the past and present information and then to reduce the computational complications associated with the effect of such image quality as the resolution and contrast variations. Moreover, TDBST technique tended to be more accurate than that of the normalized cross correlation tracking (NCCT) technique used in previous study to detect movements of the MN in the wrist. In response to fingers’ flexion movement, the kinetic trajectory of the MN moved toward the ulnar-palmar direction, and then toward the radial-dorsal direction corresponding to the extensional movement. TDBST technique and the employed ultrasound image scanner have verified to be feasible to sensitively detect the kinetic trajectory and displacement of the MN. It thus could be further applied to diagnose CTS clinically and to improve the measurements to assess 3D trajectory of the MN.

Keywords: baysian speckle tracking, carpal tunnel syndrome, median nerve, motion tracking

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Authors: Ahmed Mohamed El-Shamy, Akram Abbas El-Awady, Mahmoud Taha Eldestawy

Abstract:

Background: The present study was to evaluate clinically and radiographically the combined effect of split crest technique by ultrasonic bone surgery and platelet concentrates in implant site development. Methods: Forty patients with narrow ridge were participated in this study. Patients were assigned randomly into one of the following four groups according to treatment: Group 1: Patients received split-crest technique by ultrasonic bone surgery with implant placement. Group 2: Patients received split-crest technique by ultrasonic bone surgery with implant placement and PRF. Group 3: Patients received split-crest technique by ultrasonic bone surgery with implant placement and PRP. Group 4: Patients received split-crest technique by ultrasonic bone surgery with implant placement and collagen membrane. Modified plaque index, modified sulcus bleeding index, and implant stability were recorded as a baseline and measured again at 3 and 6 months. CBCT scans were taken immediately after surgery completion and at 9 months to evaluate bone density at the bone-implant interface. Results after 6 months; collagen group showed statistically significantly lower mean modified bleeding index than the other groups. After 3 months, the PRF group showed statistically significantly higher mean implant stability with ostell ISQ units' than the other groups. After 6 months, the PRF group showed statistically significantly higher mean implant stability with ostell ISQ units' than the other groups. After 6 months, the PRF group showed statistically significantly higher mean bone density than the collagen group. Conclusion: Ultrasonic bone surgery in split-crest technique can be a successful option for increasing implant stability values throughout the healing period. The use of a combined technique of ultrasonic bone surgery with PRF and simultaneous implant placement potentially improves osseointegration (bone density). PRF membranes represent advanced technology for the stimulation and acceleration of bone regeneration.

Keywords: dental implants, split-crest, PRF, PRP

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

Abstract:

Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Preeti Kumari, Ridhi Kapoor

Abstract:

 In any communication, security is the most important issue in today’s world. In this paper, steganography is the process of hiding the important data into other data, such as text, audio, video, and image. The interest in this topic is to provide availability, confidentiality, integrity, and authenticity of data. The steganographic technique that embeds hides content with unremarkable cover media so as not to provoke eavesdropper’s suspicion or third party and hackers. In which many applications of compression, encryption, decryption, and embedding methods are used for digital image steganography. Due to compression, the nose produces in the image. To sustain noise in the image, the LSB insertion technique is used. The performance of the proposed embedding system with respect to providing security to secret message and robustness is discussed. We also demonstrate the maximum steganography capacity and visual distortion.

Keywords: steganography, LSB, encoding, information hiding, color image

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Authors: Javed Khan, Aamir Saeed Malik, Nidal Kamel, Sarat Chandra Dass, Azura Mohd Affandi

Abstract:

Low contrast images can result from the wrong setting of image acquisition or poor illumination conditions. Such images may not be visually appealing and can be difficult for feature extraction. Contrast enhancement of color images can be useful in medical area for visual inspection. In this paper, a new technique is proposed to improve the contrast of color images. The RGB (red, green, blue) color image is transformed into normalized RGB color space. Adaptive histogram equalization technique is applied to each of the three channels of normalized RGB color space. The corresponding channels in the original image (low contrast) and that of contrast enhanced image with adaptive histogram equalization (AHE) are morphed together in proper proportions. The proposed technique is tested on seventy color images of acne patients. The results of the proposed technique are analyzed using cumulative variance and contrast improvement factor measures. The results are also compared with decorrelation stretch. Both subjective and quantitative analysis demonstrates that the proposed techniques outperform the other techniques.

Keywords: contrast enhacement, normalized RGB, adaptive histogram equalization, cumulative variance.

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