Assessment of anastomotic leakage: A Novel System for the Training of Surgeons to Perform a Tubular Anastomosis and Objectively Evaluate Anastomotic Leak

Introduction: Dehiscence of the suture line of an anastomosis can lead to reoperation, temporary or permanent stoma, and even sepsis or death. Few techniques for the laboratory training of tubular anastomosis use ex-vivo animal tissues. We describe a novel model that can be used in the laboratory for the training of anastomosis in tubular tissues and objectively assess any anastomotic leak. [See PDF for complete abstract]

Legal Implications of the Use of Export Taxes in Addressing Carbon Leakage: Competing Border Adjustment Measures

The prevailing uncertainties about the future of the post-Kyoto international legal framework for climate mitigation and adaptation increase the likelihood of unilateral trade interventions that aim to address climate policy concerns, as exemplified by the controversial European Union initiative to include the aviation industry in its emissions trading system. The emerging literature suggests that border carbon adjustment (BCA) measures imposed by importing countries would lead to substantial legal complications in relation to World Trade Organization law and hence to possible trade disputes. Lack of legal clarity on BCAs is exacerbated by potential counter or pre-emptive export restrictions that exporting countries might impose on carbon-intensive products. In this context, this paper investigates the interface between legal and welfare implications of competing unilateral BCA measures. It argues that carbon export taxes will be an inevitable part of the future climate change regime in the absence of a multilateral agreement. It also describes the channels through which competing BCAs may lead to trade conflicts and political complications as a result of their distributional and welfare impacts at the domestic and global levels.

Reduction of cement leakage by sequential PMMA application in a vertebroplasty model

PURPOSE Leakage is the most common complication of percutaneous cement augmentation of the spine. The viscosity of the polymethylmethacrylate (PMMA) cement is strongly correlated with the likelihood of cement leakage. We hypothesized that cement leakage can be reduced by sequential cement injection in a vertebroplasty model. METHODS A standardized vertebral body substitute model, consisting of aluminum oxide foams coated by acrylic cement with a preformed leakage path, simulating a ventral vein, was developed. Three injection techniques of 6 ml PMMA were assessed: injection in one single step (all-in-one), injection of 1 ml at the first and 5 ml at the second step with 1 min latency in-between (two-step), and sequential injection of 0.5 ml with 1-min latency between the sequences (sequential). Standard PMMA vertebroplasty cement was used; each injection type was tested on ten vertebral body substitute models with two possible leakage paths per model. Leakage was assessed by radiographs using a zonal graduation: intraspongious = no leakage and extracortical = leakage. RESULTS The leakage rate was significantly lower in the "sequential" technique (2/20 leakages) followed by "two-step" (15/20) and "all-in-one" (20/20) techniques (p < 0.001). The RR for a cement leakage was 10.0 times higher in the "all-in-one" compared to the "sequential" group (95 % confidence intervals 2.7-37.2; p < 0.001). CONCLUSIONS The sequential cement injection is a simple approach to minimize the risk for leakage. Taking advantage of the temperature gradient between body and room temperature, it is possible to increase the cement viscosity inside the vertebra while keeping it low in the syringe. Using sequential injection of small cement volumes, further leakage paths are blocked before further injection of the low-viscosity cement.

Lavage prior to vertebral augmentation reduces the risk for cement leakage

PURPOSE This study aimed at assessing the cement leakage rate and the filling pattern in patients treated with vertebroplasty, kyphoplasty and stentoplasty with and without a newly developed lavage technique. STUDY DESIGN Retrospective clinical case-control study. METHODS A newly developed bipedicular lavage technique prior to cement application was applied in 64 patients (45.1 %) with 116 vertebrae, ("lavage" group). A conventional bipedicular cement injection technique was used in 78 patients (54.9 %) with 99 levels ("controls"). The outcome measures were filling patterns and leakage rates. RESULTS The overall leakage rate (venous, cortical defect, intradiscal) was 37.9 % in the lavage and 83.8 % in the control group (p < 0.001). Venous leakage (lavage 12.9 % vs. controls 31.3 %; p = 0.001) and cortical defect leakage (lavage 17.2 % vs. controls 63.3 %; p < 0.001) were significantly lower in the lavage group compared to "controls," whereas intradiscal leakages were similar in both groups (lavage 12.1 % vs. controls 15.2 %; p = 0.51). For venous leakage multivariate logistic regression analysis showed lavage to be the only independent predictor. Lavage was associated with 0.33-times (95 % CI 0.16-0.65; p = 0.001) lower likelihood for leakage in compared to controls. CONCLUSIONS Vertebral body lavage prior to cement augmentation is a safe technique to reduce cement leakage in a clinical setting and has the potential to prevent pulmonary fat embolism. Moreover, a better filling pattern can be achieved.

New methods to reduce leakage errors in planar near-field measurements

This paper describes two methods to cancel the effect of two kinds of leakage signals which may be presented when an antenna is measured in a planar near-field range. One method tries to reduce leakage bias errors from the receiver¿s quadrature detector and it is based on estimating the bias constant added to every near-field data sample. Then, that constant is subtracted from the data, removing its undesired effect on the far-field pattern. The estimation is performed by back-propagating the field from the scan plane to the antenna under test plane (AUT) and averaging all the data located outside the AUT aperture. The second method is able to cancel the effect of the leakage from faulty transmission lines, connectors or rotary joints. The basis of this method is also a reconstruction process to determine the field distribution on the AUT plane. Once this distribution is known, a spatial filtering is applied to cancel the contribution due to those faulty elements. After that, a near-field-to-far-field transformation is applied, obtaining a new radiation pattern where the leakage effects have disappeared. To verify the effectiveness of both methods, several examples are presented.

CO2 Emission from two old mine drillings (Mt. Amiata, Central Italy) as a possible example of storage and leakage of deep-seated CO2

CO2 Emission from two old mine drillings (Mt. Amiata, Central Italy) as a possible example of storage and leakage of deep-seated CO2

Nanocrack-induced leakage current in AlInN/AlN/GaN

Here we report on the study of nano-crack formation in Al1−xInxN/AlN/GaN heterostructures, on its association with composition fluctuation and on its local electrical properties. It is shown here that indium segregation at nano-cracks and threading dislocations originating from the non-pseudomorphic AlN interlayer could be the cause of the high reverse-bias gate leakage current of Ni/Au Schottky contacts on Al1−xInxN/AlN/GaN heterostructures and significantly affects the contact rectifying behavior. Segregation of indium around crack tips in Al1−xInxN acting as conductive paths was assessed with conductive atomic force microscopy.

Analysis of a rate-adaptive reconciliation protocol and the effect of leakage on the secret key rate

Quantum key distribution performs the trick of growing a secret key in two distant places connected by a quantum channel. The main reason is so that the legitimate users can bound the information gathered by the eavesdropper. In practical systems, whether because of finite resources or external conditions, the quantum channel is subject to fluctuations. A rate-adaptive information reconciliation protocol, which adapts to the changes in the communication channel, is then required to minimize the leakage of information in the classical postprocessing. We consider here the leakage of a rate-adaptive information reconciliation protocol. The length of the exchanged messages is larger than that of an optimal protocol; however, we prove that the min-entropy reduction is limited. The simulation results, both in the asymptotic and in the finite-length regime, show that this protocol allows to increase the amount of a distillable secret key.

A 0.0016 mm(2) 0.64 nJ leakage-based CMOS temperature sensor

This paper presents a CMOS temperature sensor based on the thermal dependencies of the leakage currents targeting the 65 nm node. To compensate for the effect of process fluctuations, the proposed sensor realizes the ratio of two measures of the time it takes a capacitor to discharge through a transistor in the subthreshold regime. Furthermore, a novel charging mechanism for the capacitor is proposed to further increase the robustness against fabrication variability. The sensor, including digitization and interfacing, occupies 0.0016 mm2 and has an energy consumption of 47.7–633 pJ per sample. The resolution of the sensor is 0.28 °C, and the 3σ inaccuracy over the range 40–110 °C is 1.17 °C.

On the leakage-power modeling for optimal server operation

Leakage power consumption is a com- ponent of the total power consumption in data cen- ters that is not traditionally considered in the set- point temperature of the room. However, the effect of this power component, increased with temperature, can determine the savings associated with the careful management of the cooling system, as well as the re- liability of the system. The work presented in this paper detects the need of addressing leakage power in order to achieve substantial savings in the energy consumption of servers. In particular, our work shows that, by a careful detection and management of two working regions (low and high impact of thermal- dependent leakage), energy consumption of the data- center can be optimized by a reduction of the cooling budget.

Leakage and temperature aware server control for improving energy efficiency in data centers

Reducing the energy consumption for computation and cooling in servers is a major challenge considering the data center energy costs today. To ensure energy-efficient operation of servers in data centers, the relationship among computa- tional power, temperature, leakage, and cooling power needs to be analyzed. By means of an innovative setup that enables monitoring and controlling the computing and cooling power consumption separately on a commercial enterprise server, this paper studies temperature-leakage-energy tradeoffs, obtaining an empirical model for the leakage component. Using this model, we design a controller that continuously seeks and settles at the optimal fan speed to minimize the energy consumption for a given workload. We run a customized dynamic load-synthesis tool to stress the system. Our proposed cooling controller achieves up to 9% energy savings and 30W reduction in peak power in comparison to the default cooling control scheme.

Leakage of nitrous oxide emissions within the Spanish agro-food system in 1961-2009

Abstract In this paper we examine the trends of nitrous oxide (N2O) emissions of the Spanish agricultural sector related to national production and consumption in the 1961?2009 period.The comparison between production- and consumption-based emissions at the national level provides a complete overview of the actual impact resulting from the dietary choices of a given country and allows the evaluation of potential emission leakages. On average, 1.5 % of the new reactive nitrogen that enters Spain every year is emitted as N2O. Production- and consumption-based emissions have both significantly increased in the period studied and nowadays consumption-based emissions are 45 % higher than production-based emissions. A large proportion of the net N2O emissions associated with imported agricultural godos comes from countries that are not committers for the United Nations Framework Convention on Climate Change Kyoto Protocol Annex I. An increase in feed consumption is the main driver of the changes observed, leading to a arkable emission leakage in the Spanish agricultural sector. The complementary approach used here is essential to achieve an effective mitigation of Spanish greenhouse gas emissions.

Leakage-aware cooling management for improving server energy efficiency

The computational and cooling power demands of enterprise servers are increasing at an unsustainable rate. Understanding the relationship between computational power, temperature, leakage, and cooling power is crucial to enable energy-efficient operation at the server and data center levels. This paper develops empirical models to estimate the contributions of static and dynamic power consumption in enterprise servers for a wide range of workloads, and analyzes the interactions between temperature, leakage, and cooling power for various workload allocation policies. We propose a cooling management policy that minimizes the server energy consumption by setting the optimum fan speed during runtime. Our experimental results on a presently shipping enterprise server demonstrate that including leakage awareness in workload and cooling management provides additional energy savings without any impact on performance.