Abstract: Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.
Abstract: Lignin is a molecule derived from wood and also generated as waste from the paper industry. With a view to its valorization and protection of the environment, we are interested in its use as a superplasticizer-type adjuvant in mortars and concretes to improve their mechanical strengths. The additives of the concrete have a very strong influence on the properties of the fresh and / or hardened concrete. This study examines the development and use of industrial waste and lignin extracted from a renewable natural source (wood) in cementitious materials. The use of these resources is known at present as a definite resurgence of interest in the development of building materials. Physicomechanical characteristics of mortars are determined by optimization quantity of the natural superplasticizer. The results show that the mechanical strengths of mortars based on natural adjuvant have improved by 20% (64 MPa) for a W/C ratio = 0.4, and the amount of natural adjuvant of dry extract needed is 40 times smaller than commercial adjuvant. This study has a scientific impact (improving the performance of the mortar with an increase in compactness and reduction of the quantity of water), ecological use of the lignin waste generated by the paper industry) and economic reduction of the cost price necessary to elaboration of self-compacting mortars and concretes).
Abstract: In this paper, the performance of a simple surge protection for a direct current circuit was simulated. The protection circuit was developed from modified electric macro models of a gas discharge tube and a transient voltage suppressor diode. Moreover, a combination wave generator circuit was used as source of energy surges. The simulations showed that the circuit presented ensures immunity corresponding with test level IV of the IEC 61000-4-5:2014 international standard. The developed circuit can be modified to meet the requirements of any other equipment to be protected. Similarly, the parameters of the combination wave generator can be changed to provide different surge amplitudes.
Abstract: Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.
Abstract: Stiffness sensing is an important issue in medical diagnostic, robotics surgery, safe handling, and safe grasping of objects in production lines. Detecting and obtaining the characteristics in dwelling lumps embedded in a soft tissue and safe removing and handling of detected lumps is needed in surgery. Also in industry, grasping and handling an object without damaging in a place where it is not possible to access a human operator is very important. In this paper, a method for object handling is presented. It is based on the use of an intelligent gripper to detect the object stiffness and then setting a programmable force for grasping the object to move it. The main components of this system includes sensors (sensors for measuring force and displacement), electrical (electrical and electronic circuits, tactile data processing and force control system), mechanical (gripper mechanism and driving system for the gripper) and the display unit. The system uses a rotary potentiometer for measuring gripper displacement. A microcontroller using the feedback received by the load cell, mounted on the finger of the gripper, calculates the amount of stiffness, and then commands the gripper motor to apply a certain force on the object. Results of Experiments on some samples with different stiffness show that the gripper works successfully. The gripper can be used in haptic interfaces or robotic systems used for object handling.
Abstract: Various players are part of the game in an asymmetric war, all making efforts to provide human security to their own adherents. Although a fragile state is not able to provide sufficient and comprehensive services, it still provides special services and security to the elite; the insurgents as well provide services and security to their associates. The humanitarian organisations, on the other hand, provide some fundamental elements of human security, but only in the regions, they are able to access when possible (if possible). The counterinsurgents (security forces of the state and intervention forces) operate within a narrow band defined by the vision of the responsibility to protect and the perspective of the resolution of the conflict through combat; hence, the possibility to provide human security is shaken at this end. This article examines how each player provides human security from the perspective of freedom from want in order to secure basic and strategic needs, freedom from fear through providing protection against all kinds of violence, and the freedom to live in dignity. It identifies a vicious cycle caused by the intervention of the different players causing a centrifugal force that may lead to disintegration of the nation under war.
Abstract: High reflectance of surgical instruments under bright
light hinders the visual clarity during laparoscopic surgical
procedures leading to loss of precision and device control and creates
strain and undesired difficulties to surgeons. Majority of the surgical
instruments are made of surgical grade steel. Instruments with a non
reflective surface can enhance the visual clarity during precision
surgeries. A conversion coating of black oxide has been successfully
developed 410 grade surgical stainless steel .The characteristics of
the developed coating suggests the application of this technique for
developing 410 grade surgical instruments with minimal reflectance.
Abstract: This case study aims to identify the intrastate conflicts between the nation state and armed groups. Nowadays, most wars weaken states against armed groups. Thus, it is very important to negotiate with such groups in order to reinforce the law for the protection of victims. These armed groups are the cause of conflicts and they are related with many of humanitarian issues that result out of conflicts. In this age of rivalry; terrorists, insurgents, or transnational criminal parties have surfaced to the top as a reaction to these armed groups in an effort to set up a new world order. Moreover, the intra state conflicts became increasingly treacherous than the interstate conflicts, particularly when nation state systems deal with armed groups which try to influence the state. The unexpected upraising of the Arab Spring during 2011 in parts of the Middle East and North Africa formed various patterns of conflicts. The events of the Arab Spring resulted in current and long term change across the region. Significant modifications in the level, strength and period of armed conflict around the world have been made. Egypt was in the center of these events. It has fought back the armed groups under the name of terrorism and spread common disorder and violence among civilians. On this note, this study focuses on the problem of the transformation in the methods of organized violence within one state rather than between two state or more and analyzes the objectives, strategies, and internal composition of armed groups and the environments that foster them, with a focus on the Egyptian case.
Abstract: In this paper, the design and evaluation of a handle for laparoscopic surgery is presented. The design of the handle is based on ergonomic principles and tries to avoid awkward postures for surgeons. The handle combines the so-called power-grip and accurate-grip in order to provide strength and accuracy in the performance of surgery. The handle is tested using both objective and subjective approaches. The objective approach uses motion capture techniques to obtain the angles of forearm, arm, wrist and hand. The muscular effort is obtained with electromyography electrodes. On the other hand, a subjective survey has been carried out using questionnaires. Results confirm that the handle is preferred by the majority of the surgeons.
Abstract: A conventional optical coherence tomography (OCT) system has limited imaging depth, which is 1-2 mm, and suffers unwanted noise such as speckle noise. The motorized-stage-based OCT system, using a common-path Fourier-domain optical coherence tomography (CP-FD-OCT) configuration, provides enhanced imaging depth and less noise so that we can overcome these limitations. Using this OCT systems, OCT images were obtained from an onion, and their subsurface structure was observed. As a result, the images obtained using the developed motorized-stage-based system showed enhanced imaging depth than the conventional system, since it is real-time accurate depth tracking. Consequently, the developed CP-FD-OCT systems and algorithms have good potential for the further development of endoscopic OCT for microsurgery.
Abstract: The damage caused by surge waves generated in water
bodies by flow-like landslides can be very high in terms of human
lives and economic losses. The complicated phenomena occurred in
this highly unsteady process are difficult to model because three
interacting phases: air, water and sediment are involved. The problem
therefore is challenging since the effects of non-Newtonian fluid
describing the rheology of the flow-like landslides, multi-phase flow
and free surface have to be included in the simulation. In this work, the
commercial computational fluid dynamics (CFD) package FLUENT is
used to model the surge waves due to flow-like landslides. The
comparison between the numerical results and experimental data
reported in the literature confirms the accuracy of the method.
Abstract: The harsh realities of the scandalous failure of several notable corporations in the past two decades have inextricably resulted in a surge in corporate governance studies. Nevertheless, little or no attention has been paid to corporate governance studies in Mongolian firms and much less to the comprehension of the correlation among ownership structure, corporate governance mechanisms and trend of innovative activities. Innovation is the bed rock of enterprise success. However, the funding and support for innovative activities in many firms are to a great extent determined by the incentives provided by the firm’s internal and external governance mechanisms. Mongolia is an East Asian country currently undergoing a fast-paced transition from socialist to democratic system and it is a widely held view that private ownership as against public ownership fosters innovation. Hence, following the privatization policy of Mongolian Government which has led to the transfer of the ownership of hitherto state controlled and state directed firms to private individuals and organizations, expectations are high that sufficient motivation would be provided for firm managers to engage in innovative activities. This research focuses on the relationship between ownership structure, corporate governance on one hand and the level of innovation on the hand. The paper is empirical in nature and derives data from both reliable secondary and primary sources. Secondary data for the study was in respect of ownership structure of Mongolian listed firms and innovation trend in Mongolia generally. These were analyzed using tables, charts, bars and percentages. Personal interviews and surveys were held to collect primary data. Primary data was in respect of corporate governance practices in Mongolian firms and were collected using structured questionnaire. Out of a population of three hundred and twenty (320) companies listed on the Mongolian Stock Exchange (MSE), a sample size of thirty (30) randomly selected companies was utilized for the study. Five (5) management level employees were surveyed in each selected firm giving a total of one hundred and fifty (150) respondents. Data collected were analyzed and research hypotheses tested using Chi-Square test statistic. Research results showed that corporate governance mechanisms were better and have significantly improved overtime in privately held as opposed to publicly owned firms. Consequently, the levels of innovation in privately held firms were considerably higher. It was concluded that a significant and positive relationship exists between private ownership and good corporate governance on one hand and the level of funding provided for innovative activities in Mongolian firms on the other hand.
Abstract: Electrical impedance tomography is a non-invasive medical imaging technique suitable for medical applications. This paper describes an electrical impedance tomography device with the ability to navigate a robotic arm to manipulate a target object. The design of the device includes various hardware and software sections to perform medical imaging and control the robotic arm. In its hardware section an image is formed by 16 electrodes which are located around a container. This image is used to navigate a 3DOF robotic arm to reach the exact location of the target object. The data set to form the impedance imaging is obtained by having repeated current injections and voltage measurements between all electrode pairs. After performing the necessary calculations to obtain the impedance, information is transmitted to the computer. This data is fed and then executed in MATLAB which is interfaced with EIDORS (Electrical Impedance Tomography Reconstruction Software) to reconstruct the image based on the acquired data. In the next step, the coordinates of the center of the target object are calculated by image processing toolbox of MATLAB (IPT). Finally, these coordinates are used to calculate the angles of each joint of the robotic arm. The robotic arm moves to the desired tissue with the user command.
Abstract: Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation. The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements” The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.
Abstract: Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.
Abstract: Growth and remodeling of biological structures have
gained lots of attention over the past decades. Determining the
response of living tissues to mechanical loads is necessary for a wide
range of developing fields such as prosthetics design or computerassisted
surgical interventions. It is a well-known fact that biological
structures are never stress-free, even when externally unloaded. The
exact origin of these residual stresses is not clear, but theoretically,
growth is one of the main sources. Extracting body organ’s shapes
from medical imaging does not produce any information regarding
the existing residual stresses in that organ. The simplest cause of such
stresses is gravity since an organ grows under its influence from
birth. Ignoring such residual stresses might cause erroneous results in
numerical simulations. Accounting for residual stresses due to tissue
growth can improve the accuracy of mechanical analysis results. This
paper presents an original computational framework based on gradual
growth to determine the residual stresses due to growth. To illustrate
the method, we apply it to a finite element model of a healthy human
face reconstructed from medical images. The distribution of residual
stress in facial tissues is computed, which can overcome the effect of
gravity and maintain tissues firmness. Our assumption is that tissue
wrinkles caused by aging could be a consequence of decreasing
residual stress and thus not counteracting gravity. Taking into
account these stresses seems therefore extremely important in
maxillofacial surgery. It would indeed help surgeons to estimate
tissues changes after surgery.
Abstract: Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.
Abstract: Objective: Safety and efficacy of Ahmed glaucoma
valve implantation for the management of uveitis induced glaucoma
evaluated on the five dogs with uncontrollable glaucoma. Materials
and Methods: Ahmed Glaucoma Valve (AGV®; New World
Medical, Rancho Cucamonga, CA, USA) is a flow restrictive, nonobstructive
self-regulating valve system. Preoperative ocular
evaluation included direct ophthalmoscopy and measurement of the
intraocular pressure (IOP). The implant was examined and primed
prior to implantation. The selected site of the valve implantation was
the superior quadrant between the superior and lateral rectus muscles.
A fornix-based incision was made through the conjunectiva and
Tenon’s capsule. A pocket is formed by blunt dissection of Tenon’s
capsule from the episclera. The body of the implant was inserted into
the pocket with the leading edge of the device around 8-10 mm from
the limbus. Results: No post-operative complications were detected
in the operated eyes except a persistent corneal edema occupied the
upper half of the cornea in one case. Hyphaema was very mild and
seen only in two cases which resolved quickly two days after surgery.
Endoscopical evaluation for the operated eyes revealed a normal
ocular fundus with clearly visible optic papilla, tapetum and retinal
blood vessels. No evidence of hemorrhage, infection, adhesions or
retinal abnormalities was detected. Conclusion: Ahmed glaucoma
valve is safe and effective implant for treatment of uveitic glaucoma
in dogs.
Abstract: Cochlear Implantation (CI) which became a routine
procedure for the last decades is an electronic device that provides a
sense of sound for patients who are severely and profoundly deaf.
The optimal success of this implantation depends on the electrode
technology and deep insertion techniques. However, this manual
insertion procedure may cause mechanical trauma which can lead to
severe destruction of the delicate intracochlear structure.
Accordingly, future improvement of the cochlear electrode implant
insertion needs reduction of the excessive force application during
the cochlear implantation which causes tissue damage and trauma.
This study is examined tool-tissue interaction of large prototype scale
digit embedded with distributive tactile sensor based upon cochlear
electrode and large prototype scale cochlea phantom for simulating
the human cochlear which could lead to small scale digit
requirements. The digit, distributive tactile sensors embedded with
silicon-substrate was inserted into the cochlea phantom to measure
any digit/phantom interaction and position of the digit in order to
minimize tissue and trauma damage during the electrode cochlear
insertion. The digit have provided tactile information from the digitphantom
insertion interaction such as contact status, tip penetration,
obstacles, relative shape and location, contact orientation and
multiple contacts. The tests demonstrated that even devices of such a
relative simple design with low cost have potential to improve
cochlear implant surgery and other lumen mapping applications by
providing tactile sensory feedback information and thus controlling
the insertion through sensing and control of the tip of the implant
during the insertion. In that approach, the surgeon could minimize the
tissue damage and potential damage to the delicate structures within
the cochlear caused by current manual electrode insertion of the
cochlear implantation. This approach also can be applied to other
minimally invasive surgery applications as well as diagnosis and path
navigation procedures.
Abstract: Excessive fretting wear at the taper-trunnion junction
(trunnionosis) apparently contributes to the high failure rates of hip
implants. Implant wear and corrosion lead to the release of metal
particulate debris and subsequent release of metal ions at the tapertrunnion
surface. This results in a type of metal poisoning referred to
as metallosis. The consequences of metal poisoning include;
osteolysis (bone loss), osteoarthritis (pain), aseptic loosening of the
prosthesis and revision surgery. Follow up after revision surgery,
metal debris particles are commonly found in numerous locations. Background: A stable connection between the femoral ball head
(taper) and stem (trunnion) is necessary to prevent relative motions
and corrosion at the taper junction. Hence, the importance of
component assembly cannot be over-emphasized. Therefore, the aim
of this study is to determine the influence of head-stem junction
assembly by press fitting and the subsequent
disengagement/disassembly on the connection strength between the
taper ball head and stem. Methods: CoCr femoral heads were assembled with High stainless
hydrogen steel stem (trunnion) by Push-in i.e. press fit; and
disengaged by pull-out test. The strength and stability of the two
connections were evaluated by measuring the head pull-out forces
according to ISO 7206-10 standards. Findings: The head-stem junction strength linearly increases with
assembly forces.