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]

Oxygen and indicators of stress for marine life in multi-model global warming projections

Decadal-to-century scale trends for a range of marine environmental variables in the upper mesopelagic layer (UML, 100–600 m) are investigated using results from seven Earth System Models forced by a high greenhouse gas emission scenario. The models as a class represent the observation-based distribution of oxygen (O2) and carbon dioxide (CO2), albeit major mismatches between observation-based and simulated values remain for individual models. By year 2100 all models project an increase in SST between 2 °C and 3 °C, and a decrease in the pH and in the saturation state of water with respect to calcium carbonate minerals in the UML. A decrease in the total ocean inventory of dissolved oxygen by 2% to 4% is projected by the range of models. Projected O2 changes in the UML show a complex pattern with both increasing and decreasing trends reflecting the subtle balance of different competing factors such as circulation, production, remineralization, and temperature changes. Projected changes in the total volume of hypoxic and suboxic waters remain relatively small in all models. A widespread increase of CO2 in the UML is projected. The median of the CO2 distribution between 100 and 600m shifts from 0.1–0.2 mol m−3 in year 1990 to 0.2–0.4 mol m−3 in year 2100, primarily as a result of the invasion of anthropogenic carbon from the atmosphere. The co-occurrence of changes in a range of environmental variables indicates the need to further investigate their synergistic impacts on marine ecosystems and Earth System feedbacks.

Design and operation of ARGONTUBE: a 5 m long drift liquid argon TPC

The Liquid Argon Time Projection Chamber (LArTPC) is a prime type of detector for future large-mass neutrino observatories and proton decay searches. In this paper we present the design and operation, as well as experimental results from ARGONTUBE, a LArTPC being operated at the AEC-LHEP, University of Bern. The main goal of this detector is to prove the feasibility of charge drift over very long distances in liquid argon. Many other aspects of the LArTPC technology are also investigated, such as a voltage multiplier to generate high voltage in liquid argon (Greinacher circuit), a cryogenic purification system and the application of multi-photon ionization of liquid argon by a UV laser. For the first time, tracks induced by cosmic muons and UVlaser beam pulses have been observed and studied at drift distances of up to 5 m, the longest reached to date.

Stability and relapse after orthodontic treatment of deep bite cases-a long-term follow-up study.

The purpose of this long-term follow-up study was twofold-firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relapse.

The impact of Medicare, Medicaid and Schip Extension Act of 2007 (MMSEA) on the long term acute care hospitals

The Long Term Acute Care Hospitals (LTACH), which serve medically complex patients, have grown tremendously in recent years, by expanding the number of Medicare patient admissions and thus increasing Medicare expenditures (Stark 2004). In an attempt to mitigate the rapid growth of the LTACHs and reduce related Medicare expenditures, Congress enacted Section 114 of P.L. 110-173 (§114) of the Medicare, Medicaid and SCHIP Extension Act (MMSEA) in December 29, 2007 to regulate the LTCAHs industry. MMSEA increased the medical necessity reviews for Medicare admissions, imposed a moratorium on new LTCAHs, and allowed the Centers for Medicare and Medicaid Services (CMS) to recoup Medicare overpayments for unnecessary admissions. ^ This study examines whether MMSEA impacted LTACH admissions, operating margins and efficiency. These objectives were analyzed by comparing LTACH data for 2008 (post MMSEA) and data for 2006-2007 (pre-MMSEA). Secondary data were utilized from the American Hospital Association (AHA) database and the American Hospital Directory (AHD).^ This is a longitudinal retrospective study with a total sample of 55 LTACHs, selected from 396 LTACHs facilities that were fully operational during the study period of 2006-2008. The results of the research found no statistically significant change in total Medicare admissions; instead there was a small but not statistically significant reduction of 5% in Medicare admissions for 2008 in comparison to those for 2006. A statistically significant decrease in mean operating margins was confirmed between the years 2006 and 2008. The LTACHs' Technical Efficiency (TE), as computed by Data Envelopment Analysis (DEA), showed significant decrease in efficiency over the same period. Thirteen of the 55 LTACHs in the sample (24%) in 2006 were calculated as “efficient” utilizing the DEA analysis. This dropped to 13% (7/55) in 2008. Longitudinally, the decrease in efficiency using the DEA extension technique (Malmquist Index or MI) indicated a deterioration of 10% in efficiency over the same period. Interestingly, however, when the sample was stratified into high efficient versus low efficient subgroups (approximately 25% in each group), a comparison of the MIs suggested a significant improvement in Efficiency Change (EC) for the least efficient (MI 0.92022) and reduction in efficiency for the most efficient LTACHs (MI = 1.38761) over same period. While a reduction in efficiency for the most efficient is unexpected, it is not particularly surprising, since efficiency measure can vary over time. An improvement in efficiency, however, for the least efficient should be expected as those LTACHs begin to manage expenses (and controllable resources) more carefully to offset the payment/reimbursement pressures on their margins from MMSEA.^

Abundance of zooplankton based on a long-term study at the Galata transect and covers the spring-summer periods from 1967 till 2005

The dataset is based on a long-term study (38 years) at the Galata transect and covers the spring-summer periods from 1967 till 2005. The whole dataset is composed of 360 data of total zooplankton biomass and abundance . Samples were collected in discrete layers 0-10m, 10-20m, 10-25m, 25-50m, 50-70m, 50-100m, 100-150. Mesozooplankton abundance: the collected material was analysed using the method of Domov (1959). Samples were brought to volume of 25-30 ml depending upon zooplankton density and mixed intensively until all organisms were distributed randomly in the sample volume. After that 5 ml of sample was taken and poured in the counting chamber for taxomomic identification and count. Large (> 1 mm body length) and not abundant species were calculated in whole sample. Counting and measuring of organisms were made in the Dimov chamber under the stereomicroscope to the lowest taxon possible. Taxonomic identification was done at the Institute of Fishery Resource by Prof. Asen Konsulov and Institute of Oceanology by Prof. Asen Konsulov, Lyudmila Kamburska and Kremena Stefanova using the relevant taxonomic literature (Mordukhay-Boltovskoy, F.D. (Ed.). 1968, 1969,1972). Taxon-specific mesozooplankton abundance: The collected material was analysed using the method of Domov (1959). Samples were brought to volume of 25-30 ml depending upon zooplankton density and mixed intensively until all organisms were distributed randomly in the sample volume. After that 5 ml of sample was taken and poured in the counting chamber for taxomomic identification and count. Copepods and Cladoceras were identified and enumerated; the other mesozooplankters were identified and enumerated at higher taxonomic level (commonly named as mesozooplankton groups). Large (> 1 mm body length) and not abundant species were calculated in whole sample. Counting and measuring of organisms were made in the Dimov chamber under the stereomicroscope to the lowest taxon possible. Taxonomic identification was done at the Institute of Fishery Resource by prof. Asen Konsulov and Institute of Oceanology by Prof. Asen Konsulov, Lyudmila Kamburska and Kremena Stefanova using the relevant taxonomic literature (Mordukhay-Boltovskoy, F.D. (Ed.). 1968, 1969,1972).

Infrastructure Development of Railway in Cambodia: A Long Term Strategy

Infrastructure development means for the making of living environment, transport and communications, disaster prevention and national land conservation, agriculture, forestry and fisheries, and energy production and supply. Transport infrastructure development in Cambodia involved with (1) road, (2) railway, (3) port, inland-water way and (4) aviation. All model of transport infrastructure have special different kinds of importance. Railway is different from other base important of railways are transport passengers and traffic freight especially transport for heavy goods in huge capacity and in long distance by safer and faster. Transport in Cambodia for traffic freight export import base from Thailand and other via Sisophon and Shihanoukvill port. Traffic is increasing rapidly during nowadays railway condition in adequate of demand required. This is why Railway is selected as the topic of this paper to prevent monopoly of road transport. This paper, does review about infrastructure development plan for Railway in Cambodia as a long term strategy by review and analysis forecast on the previous performance of Royal Railways of Cambodia (RRC) transport traffic involved with condition of infrastructure development of railway in Cambodia. And also review the plan of development RRC but just only detail a plan of rehabilitation that is immediately needed. Suggest some recommendation at the last part. As Cambodia is a member country of ASEAN and also Mekong sub-region. For make sure that transport networks work effectively with a progress of economic integration, we make clear what is important for infrastructure development of railway in Cambodia from the standpoint of the development plan of Mekong sub-region. This paper is organized by 4 sections. Section 1 review about Infrastructure Development of Railway in Cambodia (IDRC) Historical Background, Follow by Section 2 will review the Current Situation of IDRC and some analysis of transport performance from previous years, Then Section 3 review of the focusing on traffic transport of RRC in the future, Section 4 review Infrastructure Development of Railway in Cambodia Future plans in long term; at last conclusion and recommendation. In section 1 does review history background of RRC from the rail first begun. But why is needed to review? Because of history background is involved infrastructure development of RRC in present time. History background made big gaps constraint and obstacle for socioeconomic development and poverty reduction, also left Cambodia with tragedy and left developed behind. After that remain infrastructure development needs huge fund and long time for restoration, reconstruction, rehabilitation and development into new technology as most of world practice.

Estimating the effect of chemical safety standards on firm performance in Malaysia and Vietnam

This paper uses firm-level data to examine the impact of chemical safety regulations imposed by importing countries such as RoHS and REACH on the production costs and export performance of firms in Malaysia and Vietnam. We find that in addition to the initial setup costs for compliance, EU RoHS and REACH implementation causes firms to incur additional variable production costs by requiring additional labor and capital expenditures of around 12% of the variable costs, respectively. We also find that compliance with RoHS and REACH significantly increases the probability of export. Furthermore, we find that compliance with EU RoHS and REACH helps firms to penetrate into a greater variety of countries. Also, we find that multinational enterprises and firms participating in global value chains generally exhibit better export performance and their costs rise less steeply.

The Effect of Sequence of Operations on Fatigue Life of LSP Treated Open-hole Aluminium Specimens

Fastener holes in aeronautical structures are typical sources of fatigue cracks due to their induced local stress concentration. A very efficient solution to this problem is to establish compressive residual stresses around the fastener holes that retard the fatigue crack nucleation and its subsequent local propagation. Previous work done on the subject of the application of LSP treatment on thin, open-hole specimens [1] has proven that the LSP effect on fatigue life of treated specimens can be detrimental, if the process is not properly optimized. In fact, it was shown that the capability of the LSP to introduce compressive residual stresses around fastener holes in thin-walled structures representative of typical aircraft constructions was not superior to the performance of conventional techniques, such as cold-working.

Improvement of Mechanical Properties and Life Extension of High Reliability Structural Components by Laser Shock Processing

Profiting by the increasing availability of laser sources delivering intensities above 109 W/cm2 with pulse energies in the range of several Joules and pulse widths in the range of nanoseconds, laser shock processing (LSP) is being consolidating as an effective technology for the improvement of surface mechanical and corrosion resistance properties of metals and is being developed as a practical process amenable to production engineering. The main acknowledged advantage of the laser shock processing technique consists on its capability of inducing a relatively deep compression residual stresses field into metallic alloy pieces allowing an improved mechanical behaviour, explicitly, the life improvement of the treated specimens against wear, crack growth and stress corrosion cracking. Following a short description of the theoretical/computational and experimental methods developed by the authors for the predictive assessment and experimental implementation of LSP treatments, experimental results on the residual stress profiles and associated surface properties modification successfully reached in typical materials (specifically Al and Ti alloys) under different LSP irradiation conditions are presented. In particular, the analysis of the residual stress profiles obtained under different irradiation parameters and the evaluation of the corresponding induced surface properties as roughness and wear resistance are presented.

Studying the laws of software evolution in a long-lived FLOSS project

ome free, open-source software projects have been around for quite a long time, the longest living ones dating from the early 1980s. For some of them, detailed information about their evolution is available in source code management systems tracking all their code changes for periods of more than 15 years. This paper examines in detail the evolution of one of such projects, glibc, with the main aim of understanding how it evolved and how it matched Lehman's laws of software evolution. As a result, we have developed a methodology for studying the evolution of such long-lived projects based on the information in their source code management repository, described in detail several aspects of the history of glibc, including some activity and size metrics, and found how some of the laws of software evolution may not hold in this case

Contribution to Load-Frequency Regulation of a Hydropower Plant with Long Tail-Race Tunnel

In this paper, a hydroelectric power plant with long tail-race tunnel has been modelled for assessing its contribution to secondary regulation reserve. Cavitation problems, caused by the discharge conduit length, are expected downstream the turbine where low pressure appears during regulation manoeuvres. Therefore, governor's gains should be selected taking into account these phenomena. On the other hand, regulation services bidden by the plant operator should fulfil TSO (Transmission System Operator) quality requirements. A methodology for tuning governor PI gains is proposed and applied to a Hydro power plant in pre-design phase in northwest area of Spain. The PI gains adjustment proposed provides a proper plant response, according to some established indexes, while avoiding cavitation phenomena.

Educational Project for the Teaching of Control of Electric Traction Drives

Electric vehicles constitute a multidisciplinary subject that involves disciplines such as automotive, mechanical, electrical and control engineering. Due to this multidisciplinary technical nature, practical teaching methodologies are of special relevance. Paradoxically, in the past, the training of engineers specializing in this area has lacked the practical component represented by field tests, due to the difficulty of accessing real systems. This paper presents an educational project specifically designed for the teaching and training of engineering students with different backgrounds and experience. The teaching methodology focuses on the topology of electric traction drives and their control. It includes two stages, a simulation computer model and a scaled laboratory workbench that comprises a traction electrical drive coupled to a vehicle emulator. With this equipment, the effectiveness of different traction control strategies can be analyzed from the point of view of energy efficiency, robustness, easiness of implementation and acoustic noise.