Search results for: surgical planning

Authors: Pruthvi Nath Palleti, Sarmada Madhulika Kone

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Communities are formed based on the commonalities that exist in a set of individuals and when the group comes together on identifying those commonalities and to achieve their common goals. Thus, community planning with its vision to strengthen the community mostly involves with making or remaking of commons, which results in making or remaking of communities. This paper looks into different practices of planning around the world and tried to establish a link between commoning (the act of exercising the rights over commons by commoners) and participatory approach to community planning.

Keywords: commoners, commoning, community, participatory planning, urban local bodies

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Authors: Xiuguo Zhao, He Li, Alireza Yazdani, Xiaoning Zheng, Xinxi Xu

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Wound infected poses a serious threat to the surgery on the patient during the process of surgery. Understanding the bacteria-carrying particles (BCPs) transportation and deposition in the open surgical wound model play essential role in protecting wound against being infected. Therefore BCPs transportation and deposition in the surgical wound model were investigated using force-coupling method (FCM) based computational fluid dynamics. The BCPs deposition in the wound was strongly associated with BCPs diameter and concentration. The results showed that the rise on the BCPs deposition was increasing not only with the increase of BCPs diameters but also with the increase of the BCPs concentration. BCPs deposition morphology was impacted by the combination of size distribution, airflow patterns and model geometry. The deposition morphology exhibited the characteristic with BCPs deposition on the sidewall in wound model and no BCPs deposition on the bottom of the wound model mainly because the airflow movement in one direction from up to down and then side created by laminar system constructing airflow patterns and then made BCPs hard deposit in the bottom of the wound model due to wound geometry limit. It was also observed that inertial impact becomes a main mechanism of the BCPs deposition. This work may contribute to next study in BCPs deposition limit, as well as wound infected estimation in surgical-site infections.

Keywords: BCPs deposition, computational fluid dynamics, force-coupling method (FCM), numerical simulation, open surgical wound model

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Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

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Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

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Authors: R. Gupta, P. Jain, S. Das

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One way to approach construction scheduling optimization problem is to focus on the individual aspects of planning, which can be broadly classified as time scheduling, crew and resource management, and cost control. During the last four decades, construction planning has seen a lot of research, but to date, no paper had attempted to summarize the literature available under important heads. This paper addresses each of aspects separately, and presents the findings of an in-depth literature of the various planning techniques. For techniques dealing with time scheduling, the authors have adopted a rough chronological documentation. For crew and resource management, classification has been done on the basis of the different steps involved in the resource planning process. For cost control, techniques dealing with both estimation of costs and the subsequent optimization of costs have been dealt with separately.

Keywords: construction planning techniques, time scheduling, resource planning, cost control

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Authors: Ali Cheshmehzangi, Ayotunde Dawodu

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In urban planning, Floor Area Ratio (FAR) of the site plays a major role in the multiplicity of performances, from humane living environments to energy performance. When one considers the astounding volume of new housing that is going to be constructed across the globe during the next few decades due to growing urbanisation (e.g. particularly in developing world), it is imperative that we have an empirically grounded grasp of which building configurations are more energy efficient. As a common planning metric, it would be helpful to know exactly how managing FAR connects with energy efficiency. Hence, this study puts together a set of modelling of various FARs for a typical residential compound and address the considerations of energy planning integration in the practice of building configuration and urban planning. Such decision makings at the planning and design stage enable us to provide pathways of optimising urban climate at mesoscale of the built environment, i.e. the neighbourhood or community level. In this study, a comparative study is conducted using Eco-Tect Software, using a case study in the City of Ningbo, China. Findings of the study contribute to identifying scenarios of various FAR use and energy planning at mesoscale. The final results contribute to studies in urban climate, from the perspectives of urban planning, energy planning, and urban modelling.

Keywords: China, energy planning, FAR, floor-area-ratio, mesoscale, urban climate, urban modelling

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Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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Authors: Ziwei Huang

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The standard unit of Shenzhen land spatial planning has the characteristics of vertical conduction, horizontal evaluation, internal balance and supervision of implementation. It mainly assumes the role of geospatial unit, assists in promoting the complex development of the business in Shenzhen and undertakes the management and transmission of upper and lower levels of planning as well as the Urban management functions such as gap analysis of public facilities, planning evaluation and dynamic monitoring of planning information. Combining with the application examples of the analysis of gaps in public facilities in Longgang District, it can be found that the standard unit of land spatial planning in Shenzhen as a small-scale geographic basic unit, has a stronger urban spatial coupling effect. However, the universality of the application of the system is still lacking and it is necessary to propose more scientific and powerful standard unit delineation standards and planning function evaluation indicators to guide the implementation of the system's popularization and application.

Keywords: Shenzhen city, land spatial planning, standard unit system, urban delicacy management

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

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Authors: Sabrine Ammar, Mohamed Tahar Bhiri

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Automatic planning has a de facto standard language called Planning Domain Definition Language (PDDL) for describing planning problems. It aims to formalize the planning problems described by the concept of state space. PDDL-related dynamic analysis tools, namely planners and validators, are insufficient for verifying and validating PDDL descriptions. Indeed, these tools made it possible to detect errors a posteriori by means of test activity. In this paper, we recommend a formal approach coupling the two languages Event-B and PDDL, for automatic planning. Event-B is used for formal modeling by stepwise refinement with mathematical proofs of planning problems. Thus, this paper proposes a refinement strategy allowing to obtain reliable PDDL descriptions from an ultimate Event-B model correct by construction. The ultimate Event-B model, correct by construction which is supposed to be translatable into PDDL, is automatically translated into PDDL using our MDE Event-B2PDDL tool.

Keywords: code generation, event-b, PDDL, refinement strategy, translation rules

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Authors: Stanley Yap, Chong Wei Ying, Leow Hon Wei

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Purpose: In Malaysia, an effective financial planning is vital to accumulate wealth and financial independence. However, retirees are required to resume working due to insufficient pension fund. This study examines how the financial decision in retirement planning is being made based on the net worth from the household. Design/methodology/approach: This study uses financial data from a married working couple with children to evaluate their composition of financial position. Numerous financial methods are made pertaining to net worth analysis, insurance needs analysis, investment portfolio rebalancing, estate planning, education planning and retirement planning to enhance the financial decision. Findings: Our results show, firstly, financial planning is essential to achieve financial independence; secondly, insurance needs, education and retirement funding are the most significant for household. Thirdly, current resources are critical to maintain family lifestyle after retirement, emergency funds for critical illness, and the long term children education funding. Practical implications: Refer to the findings, sufficient net worth is priority in financial planning. Different suggestions for household include reduction of unnecessary expenses, re-allocate of cash flow, adequate insurance coverage and re-balancing of investment portfolios to accumulate wealth. It is a challenge to obtain financial independence, hence, there is a need to increase the literature on financial planning. Originality/value: To the best of our knowledge, this is the important paper that uses financial information from household to provide solutions to enhance the efficiency of financial planning industry.

Keywords: net worth, financial planning, wealth and financial independence, retirement planning

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Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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Authors: Tope Olubodun

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Background: Family planning practices help individuals and couples avoid unwanted pregnancies, regulate intervals between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Southwest Nigeria. Aim: This study was conducted to assess women’s knowledge and practice of family planning in two rural communities in Ogun State, Southwest Nigeria, and to determine factors associated with the utilization of family planning among these women. Methods: This was a cross-sectional study conducted among 561 women of reproductive age selected by multistage sampling. The data collection was done using interviewer-administered questionnaires. Data obtained were analyzed using IBM SPSS Statistics version 20. Frequencies were generated, and chi-square test was used to explore associations. The level of significance was set at 0.05. Result: The majority of the respondents were aware of family planning 410 (73.1%). The method most commonly known was male condom 348 (62.0%), then pills 276 (49.2%) and injectables 231(41.3%). The commonest sources of information on family planning were health workers 158 (26.8%), outreaches 162 (27.5%) and TV/radio 136 (23.1%). Respondents that had used family planning, however, only constituted forty–five percent. The methods commonly used were injectables 104 (39.2%) and pills 85 (32.1%). Reasons for choosing not to use family planning include the desire for more children 78 (26.3%), because spouse does not support family planning 56 (18.9%), fear of unbearable side effects 44 (14.9%), and poor knowledge of the methods of family planning as well as where the services can be obtained 39 (13.2%). There is a statistically significant association between age, ethnicity, education, occupation, average monthly income, and use of family planning. Conclusion: Campaigns that promote male involvement in family planning, use of family planning for child spacing, and dispelling of fears is recommended to improve the practice of family planning among such a group of women.

Keywords: family planning, rural, knowledge, practice

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Authors: Farnoosh Faal

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The rapid growth of social media has brought significant changes to the field of urban e-planning. This study aims to review the existing literature on the impact of social media on urban e-planning processes. The study begins with a discussion of the evolution of social media and its role in urban e-planning. The review covers research on the use of social media for public engagement, citizen participation, stakeholder communication, decision-making, and monitoring and evaluation of urban e-planning initiatives. The findings suggest that social media has the potential to enhance public participation and improve decision-making in urban e-planning processes. Social media platforms such as Facebook, Twitter, and Instagram can provide a platform for citizens to engage with planners and policymakers, express their opinions, and provide feedback on planning proposals. Social media can also facilitate the collection and analysis of data, including real-time data, to inform urban e-planning decision-making. However, the literature also highlights some challenges associated with the use of social media in urban e-planning. These challenges include issues related to the representativeness of social media users, the quality of information obtained from social media, the potential for bias and manipulation of social media content, and the need for effective data management and analysis. The study concludes with recommendations for future research on the use of social media in urban e-planning. The recommendations include the need for further research on the impact of social media on equity and social justice in planning processes, the need for more research on effective strategies for engaging underrepresented groups, and the development of guidelines for the use of social media in urban e-planning processes. Overall, the study suggests that social media has the potential to transform urban e-planning processes but that careful consideration of the opportunities and challenges associated with its use is essential for effective and ethical planning practice.

Keywords: social media, Urban e-planning, public participation, citizen engagement

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Authors: Abdel-Aziz M. Mohamed

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This paper presents a state-of-the-art survey of the operations research models developed for internal audit planning. Two alternative approaches have been followed in the literature for audit planning: (1) identifying the optimal audit frequency; and (2) determining the optimal audit resource allocation. The first approach identifies the elapsed time between two successive audits, which can be presented as the optimal number of audits in a given planning horizon, or the optimal number of transactions after which an audit should be performed. It also includes the optimal audit schedule. The second approach determines the optimal allocation of audit frequency among all auditable units in the firm. In our review, we discuss both the deterministic and probabilistic models developed for audit planning. In addition, game theory models are reviewed to find the optimal auditing strategy based on the interactions between the auditors and the clients.

Keywords: operations research applications, audit frequency, audit-staff scheduling, audit planning

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Authors: Nwachi Prosper Louis, Cynthia Ogonna Ikesee

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The urban planning system of cities varies by country, but in general, it is an instrument for establishing long-term sustainable frameworks and plans for social, institutional and economic development. There is limited knowledge, development, and implementation of effective and sustainable urban planning structures and plans that encourage social inclusion in most communities. This has led to social, economic and environmental deficiencies resulting in community isolation and segregation in class, ethnicity, and race. Encouraging public participation in the urban planning process is one of the instruments that cities can utilise to achieve better social inclusion outcomes. This paper explores how public participation can be used as a social inclusion tool in the urban planning process to achieve better outcomes in Abuja urban planning system. The purpose of this study is to investigate the effectiveness of this approach. Also, a conceptual model was developed which evaluates the relationship between public participation and social inclusion outcomes in the urban planning process. It was seen that every community has its peculiar way of life and challenges, and an understanding of these social societal needs is paramount in the urban planning process. Therefore, the involvement of the public in identifying their needs, selecting priorities and identifying strategies offer better chances for developing solutions that are sustainable, feasible and implementable.

Keywords: public participation, social inclusion, urban planning, urban planning process

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Authors: Hong Dongchen, Chen Qiuxiao, Wu Shuang

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Systematic science reveals the complex nonlinear mechanisms of behaviour in urban system. However, in China, when the current city planners face with the system, most of them are still taking simple linear thinking to consider the open complex giant system. This paper introduces the hyper-cycle theory, which is one of the basis theories of systematic science, based on the analysis of the reasons why the current urban planning failed, and proposals for optimization ideas that urban planning compilation should change, from controlling quantitative to the changes of relationship, from blueprint planning to progressive planning based on the nonlinear characteristics and from management control to dynamically monitor feedback.

Keywords: systematic science, hyper-cycle theory, urban planning, urban management

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Naglaa A. Abd Elkader, Haithem A. Farghali

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The present study carried out on fifteen clinical cases of different species of dogs which admitted to surgical clinic of veterinary medicine with different symptoms (Acute vomiting, hematemesis and anorexia). There was diagnostic march which including plain radiograph and endoscopic examination. Treatment was including surgical interference and endoscopic retrieval followed by medicinal treatment. This study was aimed the detection of different foreign bodies by the most suitable method according to the type of the foreign bodies.

Keywords: stomach, endoscopy, foreign bodies, dogs

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Authors: Fumihiro Ima, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

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It is important to know growth rate of brain tumors before surgery because it influences treatment planning including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without administration of contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients and WHO grade 4 in 2 patients), meningioma WHO grade1 in 2 patients and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW-signals than that in low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW-signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

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Authors: Samir Hessas

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Modern medicine is witnessing a profound transformation as advanced technology reshapes surgical environments. Hybrid operating rooms, where state-of-the-art medical equipment, advanced imaging solutions, and Artificial Intelligence (AI) converge, are at the forefront of this revolution. In this comprehensive exploration, we scrutinize the multifaceted facets of AI and delve into an array of groundbreaking technologies. We also discuss visionary concepts that hold the potential to revolutionize hybrid operating rooms, making them more efficient and patient-centered. These innovations encompass real-time imaging, surgical simulation, IoT and remote monitoring, 3D printing, telemedicine, quantum computing, and nanotechnology. The outcome of this fusion of technology and imagination is a promising future of surgical precision, individualized patient care, and unprecedented medical advances in hybrid operating rooms.

Keywords: artificial intelligence, hybrid operating rooms, telemedicine, monitoring

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: DCIS accounts for 20% of malignancies diagnosed by the breast screening programme and is primarily managed by surgical excision. There is variable guidance on defining excision margins, and adjuvant treatments vary widely. This study aimed to investigate the clinical outcomes for patients following surgical excision of small volume DCIS. Methods: This single-centreretrospective cohort study of 101 consecutive breast screened patients diagnosed with DCIS who underwent surgical excision. All patients diagnosed with DCIS had radiological abnormalities <15mm. Clinical, radiological, and histological data were collected from patients who had been diagnosed within a 5 year period, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Outcomes included re-excision rates, radiotherapy usage, and the presence of invasive cancer. Results: Breast conservation surgery was performed in 94.1% (n=95). Following surgical excision, 74(73.27%)patients had complete DCIS excision (>2mm margin), 4(4.0%) had margins 1-2mm, and 17(16.84%)had margins <1mm. The median size of DCIS in the specimen sample was 4mm. In 86% of patients with involved margins (n=18), the mammogram underestimated the DCIS size by a median of 12.5mm (range: 1-42mm). Of the patients with involved margins, 11(10.9%)had a re-excision, and 6 of these (50%) required two re-excisions to completely excise the DCIS. Post-operative radiotherapy was provided to 53(52.48%)patients. Four (3.97%) patients were found to have invasive ductal carcinoma on surgical excision, which was not present on core biopsy – all had high-grade DCIS. Recurrence of DCIS was seen in the same site during follow-up in 1 patient (1%), 1 year after their first DCIS diagnosis. Conclusion: Breast conservation surgery is safe in patients with DCIS, with low rates of re-excision, recurrence, and upstaging to invasive cancer. Furthermore, the median size of DCIS found in the specimens of patients who had DCIS fully removed in surgery was low, suggesting it may be possible that total removal through VAE was possible for these patients.

Keywords: surgical excision, breast conservation surgery, DCIS, Re-excision, radiotherapy, invasive cancer

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Authors: Jincan Li, Mingyu Gao, Zhiwei He, Yuxiang Yang, Zhongfei Yu, Yuanyuan Liu

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Building an appropriate motion model is crucial for trajectory planning of robots and determines the operational quality directly. An adaptive acceleration and deceleration motion planning based on trigonometric functions for the end-effector of 6-DOF robots in Cartesian coordinate system is proposed in this paper. This method not only achieves the smooth translation motion and rotation motion by constructing a continuous jerk model, but also automatically adjusts the parameters of trigonometric functions according to the variable inputs and the kinematic constraints. The results of computer simulation show that this method is correct and effective to achieve the adaptive motion planning for linear trajectories.

Keywords: kinematic constraints, motion planning, trigonometric function, 6-DOF robots

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Authors: Asmaa Benbaba

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This paper aims to reconsider relationships between animal feeding operations (CAFOs) and planning. It stresses the idea of the necessity for a methodological revolution in order to increase the chances for dialogue between different actors and various planning agencies and create possibilities to manage conflicts. The explored case of North Carolina shows limitations in environmental agencies’ actions and methods. It also calls for a more integrated approach among agencies including the local agencies.

Keywords: CAFOs, North Carolina, planning, United States

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Authors: Rahaf Suleiman Altallaa

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City planning involves making plans, organizing and dealing with the cities urban areas. It attempts to organize socio-spatial relationships at exceptional ranges of governance Urban planning offers the social, monetary and environmental effects of defining spatial obstacles and the influence on the spatial distribution of resources. The dreams and methods of reaching such dissemination vary extensively traditionally and geographically and are often challenged through traditional strategies that expose the political nature of application interventions and the bounds of technical know-how claims. Space, network, argument, and postcolonial debates address how present-day socio-spatial organization is formed, what needs to or should not trade, and the way it underscores whether or not a good plan will contribute to a given situation. Inside the absence of an agreed-upon technical justification for the planning exercise, the planning idea has a tendency to focus on normative processes, positioning making plans as an area for participatory democracy.

Keywords: environmental governance, environmental planning, environmental management, sustainable competitiveness, sustainability

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Authors: Fumihiro Imai, Shinichi Watanabe, Shingo Maeda, Haruna Imai, Hiroki Niimi

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It is important to know the growth rate of brain tumors before surgery because it influences treatment planning, including not only surgical resection strategy but also adjuvant therapy after surgery. Amide proton transfer (APT) imaging is an emerging molecular magnetic resonance imaging (MRI) technique based on chemical exchange saturation transfer without the administration of a contrast medium. The underlying assumption in APT imaging of tumors is that there is a close relationship between the proliferative activity of the tumor and mobile protein synthesis. We aimed to evaluate the diagnostic performance of APT imaging of pre-and post-treatment brain tumors. Ten patients with brain tumor underwent conventional and APT-weighted sequences on a 3.0 Tesla MRI before clinical intervention. The maximum and the minimum APT-weighted signals (APTWmax and APTWmin) in each solid tumor region were obtained and compared before and after a clinical intervention. All surgical specimens were examined for histopathological diagnosis. Eight of ten patients underwent adjuvant therapy after surgery. Histopathological diagnosis was glioma in 7 patients (WHO grade 2 in 2 patients, WHO grade 3 in 3 patients, and WHO grade 4 in 2 patients), meningioma WHO grade 1 in 2 patients, and primary lymphoma of the brain in 1 patient. High-grade gliomas showed significantly higher APTW signals than that low-grade gliomas. APTWmax in one huge parasagittal meningioma infiltrating into the skull bone was higher than that in glioma WHO grade 4. On the other hand, APTWmax in another convexity meningioma was the same as that in glioma WHO grade 3. Diagnosis of primary lymphoma of the brain was possible with APT imaging before pathological confirmation. APTW signals in residual tumors decreased dramatically within one year after adjuvant therapy in all patients. APT imaging demonstrated excellent diagnostic performance for the planning of surgery and adjuvant therapy of brain tumors.

Keywords: amides, magnetic resonance imaging, brain tumors, cell proliferation

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Authors: Peggy Näser

Abstract:

Factory planning is a systematic, objective-oriented process for planning a factory, structured into a sequence of phases, each of which is dependent on the preceding phase and makes use of particular methods and tools, and extending from the setting of objectives to the start of production. The digital factory, on the other hand, is the generic term for a comprehensive network of digital models, methods, and tools – including simulation and 3D visualisation – integrated by a continuous data management system. Its aim is the holistic planning, evaluation and ongoing improvement of all the main structures, processes and resources of the real factory in conjunction with the product. Digital factory planning has already become established in factory planning. The application of Building Information Modeling has not yet been established in factory planning but has been used predominantly in the planning of public buildings. Furthermore, this concept is limited to the planning of the buildings and does not include the planning of equipment of the factory (machines, technical equipment) and their interfaces to the building. BIM is a cooperative method of working, in which the information and data relevant to its lifecycle are consistently recorded, managed and exchanged in a transparent communication between the involved parties on the basis of digital models of a building. Both approaches, the planning approach of Building Information Modeling and the methodical approach of the Digital Factory, are based on the use of a comprehensive data model. Therefore it is necessary to examine how the approach of Building Information Modeling can be extended in the context of factory planning in such a way that an integration of the equipment planning, as well as the building planning, can take place in a common digital model. For this, a number of different perspectives have to be investigated: the equipment perspective including the tools used to implement a comprehensive digital planning process, the communication perspective between the planners of different fields, the legal perspective, that the legal certainty in each country and the quality perspective, on which the quality criteria are defined and the planning will be evaluated. The individual perspectives are examined and illustrated in the article. An approach model for the integration of factory planning into the BIM approach, in particular for the integrated planning of equipment and buildings and the continuous digital planning is developed. For this purpose, the individual factory planning phases are detailed in the sense of the integration of the BIM approach. A comprehensive software concept is shown on the tool. In addition, the prerequisites required for this integrated planning are presented. With the help of the newly developed approach, a better coordination between equipment and buildings is to be achieved, the continuity of the digital factory planning is improved, the data quality is improved and expensive implementation errors are avoided in the implementation.

Keywords: building information modeling, digital factory, digital planning, factory planning

Procedia PDF Downloads 237

Authors: Ellen Bautista, Rebecca M. Flueckiger, Easter Dasmarinas, Rajeev Colaco, Fulbert Alec R. Gillego, Alma M. Lozada, Cristina Bisson

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Lactational Amenorrhea Method (LAM) for family planning is at least 98% effective at preventing pregnancy when all criteria are met; (1) the mother is exclusively or nearly exclusively breastfeeding, (2) the mother is amenorrheic (not menstruating), and (3) the baby is six months old or younger. LAM is particularly suited for women interested in family planning accepted by religious authorities. As a majority catholic nation, LAM is a common and accepted form of family planning in the Philippines. The USAID funded, LuzonHealth project conducted a prospective evaluation in Legazpi City to inform the enhancement of guidelines aimed at increasing LAM compliance and encouraging a second form of contraceptive once LAM protection expires. LAM compliance, reasons for non-compliance, family planning referral and uptake of secondary modern family planning methods were tracked over a nine-month period among 521 postpartum women. The evaluation found that at three months postpartum, 97% of women either met LAM criteria or had shifted to a non-LAM modern family planning method. In month six 87% of women no longer met LAM criteria and of these only 35% had shifted to an alternative modern family planning method. This means that at six-months postpartum 65% of the women in this evaluation were not protected against pregnancy through modern family planning methods. By postpartum month nine, 70% of the women had been referred to family planning counseling, yet of those referred only 34% reported using modern family planning methods. This evaluation clearly indicates scale-up of non-LAM modern family planning does not sufficiently complement the scale-down of LAM compliance. There is a need to increase client knowledge and understanding of LAM as a temporary family planning method with a strong focus on preparing to shift to another form of modern family planning once LAM protection expires. Additionally, there is great need to restructure the referral mechanism to ensure efficacy and quality of care.

Keywords: Philippines, family planning, lactational amenorrhea method, contraceptives

Procedia PDF Downloads 212

Authors: Ruth Donkoh, Wing On Lee, Solomon A. Boateng, Portia Oware Twerefoo, Josephine Donkor

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In this paper we defend the value of theories and approaches to educational policy and planning in enhancing the educational developments in Ghana. This mission is achieved by enumerating the recent educational developments in Ghana and juxtaposing it with some educational theories, approaches to policy making, and policy planning to see if the educational developments conform with the theory principles as well as policy making and planning processes. Data collection for the research was made through textual analysis of policy documents as well as review of relevant literatures. The findings reveled that educational developments in Ghana are unable to attain its objectives due to the policies not conforming with the policy formation and planning principles. In addition, was that education planning in Ghana does not follow the policy-administration dichotomy theory principles and likewise the distribution of educational needs goes contrary to the equity theory. We recommend that educational policies in Ghana should be in conformity with the principles of theories as well as the approaches to educational policy making and planning to help meet the needs of learners, attain educational quality, and to help in the accomplishment of educational development objectives.

Keywords: Ghana education, equity theories, politics- administration dichotomy theory, educational policies, educational planning

Procedia PDF Downloads 118

Authors: Jitaree Tantiyasawatdikul, Bantita Jadnok, Sarunya Tijana

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Background: Nutritional status is an important factor before, during, and after an operation. It can help wound healing. If the patients have good nutritional status before and after an operation, wound healing can occur more easily. It can strengthen the immune system leading to decreased infection, reduced length of stay, and reducing the cost to patients and caregivers. Therefore, screening to evaluate the nutritional status of patients in 3B becomes the database for further developing the treatment and also will lead to excellent service from the interdisciplinary team. Objective: To study the nutritional status of patients in surgical ward 3B at Surgical and Orthopedics Nursing Division, Srinagarind Hospital. Method: A descriptive study, to evaluate the nutritional status of 86 patients admitted in 3B between October 2014 and March 2015.The instruments used in this study consisted of two parts: 1) personal data, 2) Screening nutritional status. The data were analyzed by percentage and mean. Results: A sample population of 86 patients aged 22-81 years old, mean age 52.59years, 90.69% are married, female were 55.81%, regular diet 70.93%, patients with no problem oral cavity was 87.21%.The sample population had high incidence of CA 47.67% and secondly cardiovascular disease 36.05 %. Patients with high-risk nutrition was 12.79 % including 45.45% cardiovascular disease and 36.36% CA. Screening of nutritional status of high-risk nutrition was 39.36% severe triceps skinfold (TSF), severe mid-arm muscle circumference(MAMC) 9.09% and severe total lymphocyte 39.36%. Conclusion: The result of nutritional status screening of surgical ward 3B found 12.79% patients with high-risk nutrition including 45.45% with cardiovascular disease .There was no problem with oral cavity and eating.

Keywords: nutritional status, screening, surgical patients, 3B ward, Srinagarind Hospital

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Authors: Alexandra Lipitakis, Evangelia A. E. C. Lipitakis

Abstract:

In this article, a class of e-business strategy planning parameters are introduced and their effect on financial and non-financial performance of e-businesses and organizations is investigated. The relationships between these strategic planning parameters, i.e. Formality, Participation, Sophistication, Thoroughness, Synergy and Cooperation, Entropic Factor, Adaptivity, Uncertainty and Financial and Non-Financial Performance are examined and the directions of these relationships are given. A conceptual model has been constructed and quantitative research methods can be used to test the considered eight hypotheses. In the framework of e-business strategy planning this research study clearly demonstrates how strategic planning components have positive relationships with e-business strategy management and performance.

Keywords: e-business management, e-business model, e-business performance assessments, strategy management methodologies, strategy planning, quantitative methods

Procedia PDF Downloads 354