Search results for: skull base surgery

Authors: K. Sanjayani, C. Saraswathy, S. Sreenivasan, S. Sudhahar, D. Suganya, K. S. Neelukumari, N. Vijayarangan

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Double Base Number System (DBNS) is an imminent system of representing a number using two bases namely 2 and 3, which has its application in Elliptic Curve Cryptography (ECC) and Digital Signature Algorithm (DSA).The previous binary method representation included only base 2. DBNS uses an approximation algorithm namely, Greedy Algorithm. By using this algorithm, the number of digits required to represent a larger number is less when compared to the standard binary method that uses base 2 algorithms. Hence, the computational speed is increased and time being reduced. The standard binary method uses binary digits 0 and 1 to represent a number whereas the DBNS method uses binary digit 1 alone to represent any number (canonical form). The greedy algorithm uses two ways to represent the number, one is by using only the positive summands and the other is by using both positive and negative summands. In this paper, arithmetic operations are used for elliptic curve cryptography. Elliptic curve discrete logarithm problem is the foundation for most of the day to day elliptic curve cryptography. This appears to be a momentous hard slog compared to digital logarithm problem. In elliptic curve digital signature algorithm, the key generation requires 160 bit of data by usage of standard binary representation. Whereas, the number of bits required generating the key can be reduced with the help of double base number representation. In this paper, a new technique is proposed to generate key during encryption and extraction of key in decryption.

Keywords: cryptography, double base number system, elliptic curve cryptography, elliptic curve digital signature algorithm

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Authors: Hashem Shariatmadar, Mozhgansadat Momtazdargahi

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The purpose of control structure against earthquake is to dissipate earthquake input energy to the structure and reduce the plastic deformation of structural members. There are different methods for control structure against earthquake to reduce the structure response that they are active, semi-active, inactive and hybrid. In this paper two different combined control systems are used first system comprises base isolator and multi tuned mass dampers (BI & MTMD) and another combination is hybrid base isolator and multi tuned mass dampers (HBI & MTMD) for controlling an eight story isolated benchmark steel structure. Active control force of hybrid isolator is estimated by fuzzy logic algorithms. The influences of the combined systems on the responses of the benchmark structure under the two near-field earthquake (Newhall & Elcentro) are evaluated by nonlinear dynamic time history analysis. Applications of combined control systems consisting of passive or active systems installed in parallel to base-isolation bearings have the capability of reducing response quantities of base-isolated (relative and absolute displacement) structures significantly. Therefore in design and control of irregular isolated structures using the proposed control systems, structural demands (relative and absolute displacement and etc.) in each direction must be considered separately.

Keywords: base-isolated benchmark structure, multi-tuned mass dampers, hybrid isolators, near-field earthquake, fuzzy algorithm

Procedia PDF Downloads 266

Authors: Hisham A. Hashem, Sameh Galal, Bassem M. Moeshed

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A 36 years old male patient presented to our unit with a history of motor-car accident from 7 months complaining of disfigurement and double vision. On examination and investigations, there was an orbital floor fracture in the left eye with inferior rectus muscle entrapment causing diplopia, dystopia and enophthalmos. Under general anesthesia, a sub-ciliary incision was performed, and the orbital floor fracture was repaired with a double layer Medpor sheet (30x50x15) with removing and freeing fibrosis that was present and freeing of the inferior rectus muscle. Remarkable improvement of the dystopia was noticed, however, there was a residual diplopia in upgaze and enophthalmos. He was then referred to a strabismologist, which upon examination found left hypotropia of 8 ΔD corrected by 8 ΔD base up prism and positive forced duction test on elevation and pseudoptosis. Under local anesthesia, a limbal incision approach with hangback 4mm recession of inferior rectus muscle was performed after identifying an inferior rectus muscle structure. Improvement was noted shortly postoperative with correction of both diplopia and pseudoptosis. Follow up after 1, 4 and 8 months was done showing a stable condition. Delayed surgery in cases of orbital floor fracture may still hold good results provided proper assessment of the case with management of each sign separately.

Keywords: diplopia, dystopia, late surgery, orbital floor fracture

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Authors: Nizar Ahmad

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Peace without community participation will remain a vision, so, this study presents the contribution and efforts made by community base organization in views of local conflict affect population in Pakhtun society. A four conflict affected villages of Malakad Division were selected and a sample size of 278 household respondents were determined through online survey system software out of total 982 households. A Chi-square test was applied to ascertain association between various communication base organizations factors with state of peace in the area. It was found that provision of humanitarian aid, rehabilitation of displaced population, rebuilding of trust in government and peace festivals by communication organization had significant association with state of peace in the area. In contrast provision of training, peace education monitoring and reporting of human rights violation in war zone by local organization was non-significantly related to the state of peace in the area. Community base organization play an active role in building peace in the area but lack capacity, linkages with external actors and outside support. National and international organization actors working in the area of peace and conflict resolution need to focus on the capacity, networking and peace initiatives of local organizations working in fragile context.

Keywords: community base peacebuilding, conflict resolution, terrorism, violence

Procedia PDF Downloads 250

Authors: Marine Shavlakadze

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From the raw material base existed in Georgia (manganese ores, manganese containing mud), particularly, within the point of view of production availability, especial interest is paid to micro- fertilizers containing manganese. As a result of conducted investigation, there was established receiving of such manganese containing materials on the basis of manganese raw-material base (ore, mud) existed in Georgia, which shall be able to maximally provide assimilation ability of manganese, as microelement, in the desired period of time. And also, determinant of effectiveness and competitiveness of received materials with new composition shall become high content (more than 30%) of microelements in them (in comparison with existed similar products), when the total sum of useful components presented in them (active i.e. assimilated) is more than 50-70%, i.e. received materials belong to the materials having low-ballast and functionally revealed possibilities.

Keywords: manganese, fertilizers, non-ballast, micro- fertilizers

Procedia PDF Downloads 236

Authors: Pranita Shivankar, Arun Suryawanshi, Prabodhachandra Deshmukh, S. V. C. Kameswara Rao

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Many undesirable significant changes in landscapes and the regions in the vicinity of historically important structures occur as impacts due to anthropogenic activities over a period of time. A better understanding of such influences using recently developed satellite remote sensing techniques helps in planning the strategies for minimizing the negative impacts on the existing environment. In 1982, a fossilized hominid skull cap was discovered at a site located along the northern bank of the east-west flowing river Narmada in the village Hathnora. Close to the same site, the presence of Late Acheulian and Middle Palaeolithic tools have been discovered in the immediately overlying pebbly gravel, suggesting that the ‘Narmada skull’ may be from the Middle Pleistocene age. The reviews of recently carried out research studies relevant to hominid remains all over the world from Late Acheulian and Middle Palaeolithic sites suggest succession and contemporaneity of cultures there, enhancing the importance of Hathnora as a rare precious site. In this context, the maximum likelihood classification using digital interpretation techniques was carried out for this study area using the satellite imagery from Landsat ETM+ for the year 2006 and Landsat TM (OLI and TIRS) for the year 2016. The overall accuracy of Land Use Land Cover (LULC) classification of 2016 imagery was around 77.27% based on ground truth data. The significant reduction in the main river course and agricultural activities and increase in the built-up area observed in remote sensing data analysis are undoubtedly the outcome of human encroachments in the vicinity of the eminent heritage site.

Keywords: cultural succession, digital interpretation, Hathnora, Homo Sapiens, Late Acheulian, Middle Palaeolithic

Procedia PDF Downloads 139

Authors: Farajallah Adibhashemi

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A retrospective study on causes, surgery findings, results and the follow up of 30 horses with colic in Tehran, Iran. Colic is the main problem horse industry.The causes of colic are related to management like food, sport and medical care. In this study that has been done between 2012-2015 for 30 horses referred to teaching hospital of veterinary medicine faculty of the University of Tehran. Seventy percent of causes was related to management of feeding and twenty percent was for malsporting. The rest of causes was from the anti parasite in bad root. The surgery findings were as follows: 60% displacement of dorsal right and left colon, 20% in impaction of pelvic flexure,10% impaction of the cecum, and 10% impaction of the stomach.

Keywords: horse, colic, Tehran, Iran

Procedia PDF Downloads 339

Authors: Muhammad Saiful Fadhil Reyhan, Yusnita Rahayu, Fadhel Muhammadsyah

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This paper proposed a design of 16 elements, 8x2 linear fed patch antenna array with 16 ports, for 28 GHz, mm-wave band 5G for base station. The phased array covers along the azimuth plane to provide the coverage to the users in omnidirectional. The proposed antenna is designed RT Duroid 5880 substrate with the overall size of 85x35.6x0.787 mm³. The array is operating from 27.43 GHz to 28.34 GHz with a 910 MHz impedance bandwidth. The gain of the array is 18.3 dB, while the suppression of the side lobes is -1.0 dB. The main lobe direction of the array is 15 deg. The array shows a high array gain throughout the impedance bandwidth with overall of VSWR is below 1.12. The design will be proposed in single element and 16 elements antenna.

Keywords: 5G antenna, 28 GHz, MIMO, omnidirectional, phased array, base station, broadband

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Authors: Natalia Koltovaya, Nadezhda Zhuchkina, Ksenia Lyubimova

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We study the biological effects induced by ionizing radiation in view of therapeutic exposure and the idea of space flights beyond Earth's magnetosphere. In particular, we examine the differences between base pair substitution induction by ionizing radiation in model haploid and diploid yeast Saccharomyces cerevisiae cells. Such mutations are difficult to study in higher eukaryotic systems. In our research, we have used a collection of six isogenic trp5-strains and 14 isogenic haploid and diploid cyc1-strains that are specific markers of all possible base-pair substitutions. These strains differ from each other only in single base substitutions within codon-50 of the trp5 gene or codon-22 of the cyc1 gene. Different mutation spectra for two different haploid genetic trp5- and cyc1-assays and different mutation spectra for the same genetic cyc1-system in cells with different ploidy — haploid and diploid — have been obtained. It was linear function for dose-dependence in haploid and exponential in diploid cells. We suggest that the differences between haploid yeast strains reflect the dependence on the sequence context, while the differences between haploid and diploid strains reflect the different molecular mechanisms of mutations.

Keywords: base pair substitutions, γ-rays, haploid and diploid cells, yeast Saccharomyces cerevisiae

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Authors: Mohamed Sanad, Noha Hassan

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A low wind-load light-weight broad-band multi-beam base station antenna has been developed. It can generate any required number of beams with the required beamwidths. It can have horizontal and vertical sectorization at the same time. Vertical sectorization doubles the overall number of beams. It will be very valuable in LTE-A and 5G. It can be used to serve vertically split inner and outer cells, which improves system performance. The intersection between the beams of the proposed multi-beam antenna can be controlled by optimizing the design parameters of the antenna. The gain at the points of intersection between the beams, the null filling and the overlap between the beams can all be modified. The proposed multi-beam base station antenna can cover an unlimited number of wireless applications, regardless of their frequency bands. It can simultaneously cover all, current and future, wireless technology generations such as 2G, 3G, 4G (LTE), --- etc. For example, in LTE, it covers the bands 450-470 MHz, 690-960 MHz, 1.4-2.7 GHz and 3.3-3.8 GHz. It has at least 2 ports for each band in each beam for ±45° polarizations. It can include up to 72 ports or even more, which could facilitate any further needed capacity expansions.

Keywords: base station antenna, multi-beam antenna, smart antenna, vertical sectorization

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Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: Jung Hyun Kim, Gyo Woo Lee

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In this study, the enhancement of the heat release performance of an extruded-type heat sink to prepare the large-capacity solar inverter thru the flow holes in the base plate near the heat sources was investigated. Optimal location and number of the holes in the baseplate were determined by using a commercial computation program. The heat release performance of the shape-modified heat sink was measured experimentally and compared with that of the simulation. The heat sink with 12 flow holes in the 18-mm-thick base plate has a 8.1% wider heat transfer area, a 2.5% more mass flow of air, and a 2.7% higher heat release rate than those of the original heat sink. Also, the surface temperature of the base plate was lowered 1.5°C by the holes.

Keywords: heat sink, forced convection, heat transfer, performance evaluation, flow holes

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Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

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Authors: Abolfazl Mohammadijoo

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In this paper, we are investigating the sliding mode control approach for trajectory tracking of a two-link-manipulator with a wheeled mobile robot in its base. The main challenge of this work is the dynamic interaction between mobile base and manipulator, which makes trajectory tracking more difficult than n-link manipulators with a fixed base. Another challenging part of this work is to avoid from chattering phenomenon of sliding mode control that makes lots of damages for actuators in real industrial cases. The results show the effectiveness of the sliding mode control approach for the desired trajectory.

Keywords: mobile manipulator, sliding mode control, dynamic interaction, mobile robotics

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Authors: S. Dorbani, M. Badaoui, D. Benouar

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The aim of this paper is to investigate the effect of the building fundamental period of reinforced concrete buildings of (6, 9, and 12-storey), with different floor plans: Symmetric, mono-symmetric, and unsymmetric. These structures are erected at different epicentral distances. Using the Boumerdes, Algeria (2003) earthquake data, we focused primarily on the establishment of the deterministic formulation linking the base shear force to two parameters: The first one is the fundamental period that represents the numerical fingerprint of the structure, and the second one is the epicentral distance used to represent the impact of the earthquake on this force. In a second step, with a view to highlight the effect of uncertainty in these parameters on the analyzed response, these parameters are modeled as random variables with a log-normal distribution. The variability of the coefficients of variation of the chosen uncertain parameters, on the statistics on the seismic base shear force, showed that the effect of uncertainty on fundamental period on this force statistics is low compared to the epicentral distance uncertainty influence.

Keywords: base shear force, fundamental period, epicentral distance, uncertainty, lognormal variables, statistics

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Authors: Talat Baran

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Palladium-catalyzed Suzuki coupling reactions are powerful ways for synthesis of biaryls compounds and so far different palladium sources as have been used in catalyst systems. However, the high cost of the ligands using as support materials for palladium ion and so researchers have explored alternative low-cost support materials such as silica, cellule and zeolite. A natural polymer chitosan is suitable for support material because of it unique properties such as eco-friendly, renewable, abundant, low cost, biodegradable and it has free reactive -NH2 and –OH groups. Especially, pendant amino groups of chitosan can easily react with carbonyl groups of aldehyde or ketone by Schiff base formation and thus palladium ions can coordinate with imine groups of Schiff base. This purpose, in this study, firstly a new chitosan Schiff base supported palladium (II) catalyst was synthesized and its chemical structure was characterized with FT-IR, SEM/EDAX, XRD, TG-DTG, ICP-OES and magnetic moment techniques. Then catalytic performance of the catalyst was investigated in Suzuki cross coupling reactions under simple and fast microwave heating methods. Also, recycle activity of palladium catalyst was tested under optimum condition and the catalyst showed long life time. At the end of catalytic performance tests of chitosan supported palladium (II) catalysts indicated high turnover numbers, turnover frequency and selectivity with very small loading catalyst

Keywords: catalyst, chitosan, Schiff base, Suzuki coupling

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Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Yunzi Chen, James Laybourne, Sarah Steven, Peter Carey, David Steel, Maria Sandinha

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Introduction: Bariatric surgery is popular with the rising incidence of obesity. Its well-known benefits include significant and rapid glycaemic control. However, cases of paradoxical worsening in diabetic retinopathy (DR) despite improved glycaemic control have been reported. Purpose: clarification on the evolution of diabetic retinopathy after bariatric surgery. Method: retrospective study of 40 patients with Type 2 diabetes who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2011. Pre-operative and post-operative visual acuity (VA), weight, HbA1c and annual DRSS screening results were analysed. Median follow up was 50 months. Results: No significant change in VA was found during the post-operative period. 85% of patients improved HbA1c post-operatively of which 53% achieved non-diabetic HbA1c of <6.1% - despite this, 2 patients developed new DR. First post-operative screening showed 80% of patients experienced no change, 8% improved but 13% of patients developed new DR (1 case with sight-threatening maculopathy). 80% of these cases persisted up to 24 months. The proportion of patients developing new or worse DR fluctuated over time, peaking at the 3rd annual screening with 26% (15% regressed, 56% stable). The probability of developing new or worse DR postoperatively was significantly associated with a high pre-operative HbA1c (>8%) and male gender. Conclusions: bariatric surgery does not guarantee long-term improvement or prevention of DR. Asymptomatic changes in DR occurred up to 5 years postoperatively. We therefore consider it prudent to continue screening in this cohort of patients.

Keywords: bariatric surgery, diabetic retinopathy, obesity, type 2 diabetes mellitus

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Authors: Majid Moshirfar, Kyle Margulies, Yasmyne C. Ronquillo, Phillip Hoopes

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A total of 66 articles were reviewed to compare glaucoma and its associated surgeries' effect on central corneal endothelium cell density (CECD). The paper reports the average reported central CECD loss at 3-, 6-, 12-, 24-, 36-, 48-, and 60-month post-operation for each glaucoma surgery. ALT, MLT, SLT, CS AGV, VC BGI, Hydrus + phaco, XEN gel + phaco, PRESERFLO, Dual iStent, or Trabectome had no significant impact on postoperative CECD compared to either preoperative CECD or control group CECD. The highest CECD loss was found to be EXPRESS-phaco, AC AGV, CS BGI, CS BGI, AC BGI, and AC BGI at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups, respectively. AC AGV, Trab + MMC, Trab, AC BGI, Trab + MMC, Cypass, and Cypass showed the smallest reduction of CECD at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups.

Keywords: glaucoma, corneal endothelium, cell density, surgery outcome

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

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

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Authors: Titap Yazicioglu

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To examine the results of two different surgery in patients with severe ptosis and poor levator function. The records of 10 bilateral congenital ptosis patients, who underwent Whitnall’s sling surgery on one eyelid and frontalis sling surgery on the other were analyzed retrospectively. All patients had severe congenital ptosis(>4mm) and poor levator function (LF<4mm). Data regarding eyelid position, cosmetic outcomes, and postoperative complications were evaluated. All patients were assessed for a minimum of one year with regard to the amount of correction, residual ptosis and lagophthalmos. The study consisted of 10 patients, with an average age of 9.2±2.4 years. Preoperative diagnosis for all patients was noted as, the average LF was 3.4±0.51mm, vertical lid height was 3.5±0.52 mm and margin reflex distance-1 (MRD-1) was 0.4±0.51mm. The mean vertical lid height was measured as 7.1±0.73 mm in the frontalis sling group and 7.2±0.63 mm in the Whitnall’s sling group at the postoperative 1st month control. However, in patients with Whitnall’s sling, revision was performed with frontalis sling surgery due to failure in vertical lid height in the late postoperative period, and an average of 7.5±0.52 mm was achieved. Satisfactory results were obtained in all patients. Although postoperative lagophthalmitis developed in the frontalis sling group, none of them developed exposure keratitis. Granuloma was observed as sling infection in 2(20%) of the patients. Although Whitnall’s sling technique provides a natural look appearance without interfering with the functional result, we did not find it as successful as frontalis sling surgery in severe ptosis.

Keywords: congenital ptosis, frontalis suspension, Whitnall ligament, complications

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Authors: Ming-Ta Yang, Jyh-Cherng Gu, Chun-Wei Huang, Jin-Lung Guan

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Time base maintenance (TBM) is conventionally applied by the power utilities to maintain circuit breakers (CBs), transformers, bus bars and cables, which may result in under maintenance or over maintenance. As information and communication technology (ICT) industry develops, the maintenance policies of many power utilities have gradually changed from TBM to condition base maintenance (CBM) to improve system operating efficiency, operation cost and power supply reliability. This paper discusses the feasibility of using intelligent electronic devices (IEDs) to construct a CB CBM management platform. CBs in power substations can be monitored using IEDs with additional logic configuration and wire connections. The CB monitoring data can be sent through intranet to a control center and be analyzed and integrated by the Elipse Power Studio software. Finally, a human-machine interface (HMI) of supervisory control and data acquisition (SCADA) system can be designed to construct a CBM management platform to provide maintenance decision information for the maintenance personnel, management personnel and CB manufacturers.

Keywords: circuit breaker, condition base maintenance, intelligent electronic device, time base maintenance, SCADA

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: A. Ras, I. Nait Zerrad, N. Benmouna, N. Boumechra

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Use of base isolators in the seismic design of structures has attracted considerable attention in recent years. The major concern in the design of these structures is to have enough lateral stability to resist wind and seismic forces. There are different systems providing such isolation, among them there are friction- pendulum base isolation systems (FPS) which are rather widely applied nowadays involving to both affordable cost and high fundamental periods. These devices are characterised by a stiff resistance against wind loads and to be flexible to the seismic tremors, which make them suitable for different situations. In this paper, a 3D numerical investigation is done considering the seismic response of a twelve-storey steel building retrofitted with a FPS. Fast nonlinear time history analysis (FNA) of Boumerdes earthquake (Algeria, May 2003) is considered for analysis and carried out using SAP2000 software. Comparisons between fixed base, bearing base isolated and braced structures are shown in a tabulated and graphical format. The results of the various alternatives studies to compare the structural response without and with this device of dissipation energy thus obtained were discussed and the conclusions showed the interesting potential of the FPS isolator. This system may to improve the dissipative capacities of the structure without increasing its rigidity in a significant way which contributes to optimize the quantity of steel necessary for its general stability.

Keywords: energy dissipation, friction-pendulum system, nonlinear analysis, steel structure

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Authors: Bintao Wu, Xiangfang Xu, Yugang Miao，Duanfeng Han

Abstract:

Joining of 1 mm thick aluminum 6061 to titanium TC4 was conducted using Bypass-current MIG welding-brazed, and stable welding process and good bead appearance were obtained. The Joint profile and microstructure of Ti/Al joints were observed by optical microscopy and SEM and then the structure of the interfacial reaction layers were analyzed in details. It was found that the intermetallic compound layer at the interfacial top is in the form of columnar crystal, which is in short and dense state. A mount of AlTi were observed at the interfacial layer near the Ti base metal while intermetallic compound like Al3Ti、TiSi3 were formed near the Al base metal, and the Al11Ti5 transition phase was found in the center of the interface layer due to the uneven distribution inside the weld pool during the welding process. Tensile test results show that the average tensile strength of joints is up to 182.6 MPa, which reaches about 97.6% of aluminum base metal. Fracture is prone to occur in the base metal with a certain amount of necking.

Keywords: bypass-current MIG welding-brazed, Al alloy, Ti alloy, joint characteristics, mechanical properties

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Authors: Azin Shakibabarough, Mojtaba Valinejadshoubi, Ashutosh Bagchi

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Structural vibration means repetitive motion that causes fatigue and reduction of the performance of a structure. An earthquake may release high amount of energy that can have adverse effect on all components of a structure. Therefore, decreasing of vibration or maintaining performance of structures such as bridges, dams, roads and buildings is important for life safety and reducing economic loss. When earthquake or any vibration happens, investigation on parts of a structure which sustain the seismic loads is mandatory to provide a safe condition for the occupants. One of the solutions for reducing the earthquake vibration in a structure is using of vibration control devices such as dampers and base isolators. The objective of this study is to investigate the optimal positions of friction dampers and base isolators for better seismic response of 2D frame. For this purpose, a two bay and six story frame with different distribution formats was modeled and some of their responses to earthquake such as inter-story drift, max joint displacement, max axial force and max bending moment were determined and compared using non-linear dynamic analysis.

Keywords: fast nonlinear analysis, friction damper, base isolator, seismic vibration control, seismic response

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Authors: Patricia Shirley Almeida Prado, Liz Brito, Selma Paixão Argollo, Gracie Moreira, Leticia Matos Sobrinho

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Diffuse idiopathic skeletal hyperostosis (DISH) is a degenerative bone disease also known as Forestier´s disease and ankylosing hyperostosis of the spine is characterized by a tendency toward ossification of half the anterior longitudinal spinal ligament without intervertebral disc disease. DISH is not considered to be osteoarthritis, although the two conditions commonly occur together. Diagnostic criteria include fusion of at least four vertebrae by bony bridges arising from the anterolateral aspect of the vertebral bodies. These vertebral bodies have a 'dripping candle wax' appearance, also can be seen periosteal new bone formation on the anterior surface of the vertebral bodies and there is no ankylosis at zygoapophyseal facet joint. Clinically, patients with DISH tend to be asymptomatic some patients mention moderate pain and stiffness in upper back. This disease is more common in man, uncommon in patients younger than 50 years and rare in patients under 40 years old. In modern populations, DISH is found in association with obesity, (type II) diabetes; abnormal vitamin A metabolism and also associated with higher levels of serum uric acid. There is also some association between the increase of risk of stroke or other cerebrovascular disease. The DISH condition can be confused with Heterotopic Ossification, what is the bone formation in the soft tissues as the result of trauma, wounding, surgery, burnings, prolonged immobility and some central nervous system disorder. All these conditions have been described extensively as myositis ossificans which can be confused with the fibrodysplasia (myositis) ossificans progressive. As in the DISH symptomatology it can be asymptomatic or extensive enough to impair joint function. A third confusion osteoarthritis disease that can bring confusion are the enthesopathies that occur in the entire skeleton being common on the ischial tuberosities, iliac crests, patellae, and calcaneus. Ankylosis of the sacroiliac joint by bony bridges may also be found. CASE 1: this case is skeletal remains presenting skull, some vertebrae and scapulae. This case remains unidentified and due to lack of bone remains. Sex, age and ancestry profile was compromised, however the DISH pathognomonic findings and diagnostic helps to estimate sex and age characteristics. Moreover to presenting DISH these skeletal remains also showed some bone alterations and non-metrics as fusion of the first vertebrae with occipital bone, maxillae and palatine torus and scapular foramen on the right scapulae. CASE 2: this skeleton remains shows an extensive bone heterotopic ossification on the great trochanter area of left femur, right fibula showed a healed fracture in its body however in its inteosseous crest there is an extensive bone growth, also in the Ilium at the region of inferior gluteal line can be observed some pronounced bone growth and the skull presented a pronounced mandibular, maxillary and palatine torus. Despite all these pronounced heterotopic ossification the whole skeleton presents moderate bone overgrowth that is not linked with aging, since the skeleton belongs to a young unidentified individual. The appropriate osteopathological diagnosis support the human identification process through medical reports and also assist with epidemiological data that can strengthen vulnerable anthropological estimates.

Keywords: bone disease, DISH, human identification, human remains

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Authors: Mitra JahangirRad, Sheida Sodagar, Maryam Bahrami Hidaji

Abstract:

This study was conducted with the aim of comparing anxiety, stress, depression and attitude towards death among patients with breast cancer who have undergone mastectomy or breast-conserving surgery. The study method is causal-comparative. Statistical population was all patients with breast cancer referring to Medical Center of Panjom Azar Hospital in Gorgan or oncologists' offices in this city within eight months. They were selected using purposive sampling. Sample size of this study was 45 patients with breast cancer undergoing mastectomy and 70 patients under breast-conserving surgery. Measurement tools in this study were depression, anxiety, and stress scale (Dass-21) as well as Death Attitude Profile-Revised (DAPR). Results of this study in hypotheses investigation showed that anxiety, stress and depression among patients with breast cancer, undergoing mastectomy or breast-conserving surgery is significantly different. However, their attitudes towards death do not differ. From these findings, it can be concluded that although most patients with breast cancer encounter many psychological problems, patients undergoing mastectomy experience more anxiety, stress and depression relative to patients with breast-conserving surgery and it seems that they need more supportive therapy.

Keywords: anxiety, breast cancer, depression, death, mastectomy

Procedia PDF Downloads 387

Authors: Ahmed Hefny Mohamed El-Badwy

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancientegypt, egypt, archaeology, the ancient egyptian

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Authors: Jae-Yong Park, Yeo-Kyeong Lee, Hee-Sun Kim

Abstract:

Purpose: This study aims at investigating the mechanical behaviors of mastication, according to various teeth movement. There are three masticatory cases which are general case and 2 cases of teeth movement. General case includes the common arrange of all teeth and 2 cases of teeth movement are that one is the half movement location case of molar teeth in no. 14 tooth seat after extraction of no. 14 tooth and the other is no. 14 tooth seat location case of molar teeth after extraction in the same case before. Materials and Methods: In order to analyze these cases, 3 dimensional finite element (FE) model of the skull were generated based on computed tomography images, 964 dicom files of 38 year old male having normal occlusion status. An FE model in general occlusal case was used to develop CAE procedure. This procedure was applied to FE models in other occlusal cases. The displacement controls according to loading condition were applied effectively to simulate occlusal behaviors in all cases. From the FE analyses, von Mises stress distribution of skull and teeth was observed. The von Mises stress, effective stress, had been widely used to determine the absolute stress value, regardless of stress direction and yield characteristics of materials. Results: High stress was distributed over the periodontal area of mandible under molar teeth when the mandible was transmitted to the coronal-apical direction in the general occlusal case. According to the stress propagation from teeth to cranium, stress distribution decreased as the distribution propagated from molar teeth to infratemporal crest of the greater wing of the sphenoid bone and lateral pterygoid plate in general case. In 2 cases of teeth movement, there were observed that high stresses were distributed over the periodontal area of mandible under teeth where they are located under the moved molar teeth in cranium. Conclusion: The predictions of the mechanical behaviors of general case and 2 cases of teeth movement during the masticatory process were investigated including qualitative validation. The displacement controls as the loading condition were applied effectively to simulate occlusal behaviors in 2 cases of teeth movement of molar teeth.

Keywords: cranium, finite element analysis, mandible, masticatory action, occlusal force

Procedia PDF Downloads 369