Pectus Excavatum postsurgical outcome based on preoperative soft body dynamics simulation

Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which an abnormal formation of the rib cage gives the chest a caved-in or sunken appearance. Today, the surgical correction of this deformity is carried out in children and adults through Nuss technic, which consists in the placement of a prosthetic bar under the sternum and over the ribs. Although this technique has been shown to be safe and reliable, not all patients have achieved adequate cosmetic outcome. This often leads to psychological problems and social stress, before and after the surgical correction. This paper targets this particular problem by presenting a method to predict the patient surgical outcome based on pre-surgical imagiologic information and chest skin dynamic modulation. The proposed approach uses the patient pre-surgical thoracic CT scan and anatomical-surgical references to perform a 3D segmentation of the left ribs, right ribs, sternum and skin. The technique encompasses three steps: a) approximation of the cartilages, between the ribs and the sternum, trough b-spline interpolation; b) a volumetric mass spring model that connects two layers - inner skin layer based on the outer pleura contour and the outer surface skin; and c) displacement of the sternum according to the prosthetic bar position. A dynamic model of the skin around the chest wall region was generated, capable of simulating the effect of the movement of the prosthetic bar along the sternum. The results were compared and validated with patient postsurgical skin surface acquired with Polhemus FastSCAN system

Variations of the soft tissue thicknesses external to the ribs in Pectus Excavatum patients

Background: Surgical repair of pectus excavatum (PE) has become more popular due to improvements in the minimally invasive Nuss procedure. The pre-surgical assessment of PE patients requires Computerized Tomography (CT), as the malformation characteristics vary from patient to patient. Objective: This work aims to characterize soft tissue thickness (STT) external to the ribs among PE patients. It also presents a comparative analysis between the anterior chest wall surface before and after surgical correction. Methods: Through surrounding tissue segmentation in CT data, STT values were calculated at different lines along the thoracic wall, with a reference point in the intersection of coronal and median planes. The comparative analysis between the two 3D anterior chest surfaces sets a surgical correction influence area (SCIA) and a volume of interest (VOI) based on image processing algorithms, 3D surface algorithms, and registration methods. Results: There are always variations between left and right side STTs (2.54±2.05 mm and 2.95±2.97 mm for female and male patients, respectively). STTs are dependent on age, sex, and body mass index of each patient. On female patients, breast tissue induces additional errors in bar manual

Variations of the soft tissue thicknesses external to the ribs in pectus excavatum patients

Background: Surgical repair of pectus excavatum (PE) has become more popular due to improvements in the minimally invasive Nuss procedure. The pre-surgical assessment of PE patients requires Computerized Tomography (CT), as the malformation characteristics vary from patient to patient. Objective: This work aims to characterize soft tissue thickness (STT) external to the ribs among PE patients. It also presents a comparative analysis between the anterior chest wall surface before and after surgical correction. Methods: Through surrounding tissue segmentation in CT data, STT values were calculated at different lines along the thoracic wall, with a reference point in the intersection of coronal and median planes. The comparative analysis between the two 3D anterior chest surfaces sets a surgical correction influence area (SCIA) and a volume of interest (VOI) based on image processing algorithms, 3D surface algorithms, and registration methods. Results: There are always variations between left and right side STTs (2.54±2.05 mm and 2.95±2.97 mm for female and male patients, respectively). STTs are dependent on age, sex, and body mass index of each patient. On female patients, breast tissue induces additional errors in bar manual

Brand equity in the Pakistani hotel industry

Brand equity is considered as the most important aspect of branding, which is a set of brands' assets and liabilities, its symbol or name that subtracts from or adds the value provided by a product or service to a firm and customers. The current research endeavor was to identify the interrelationship of customer-based brand equity dimensions (brand awareness, brand loyalty, brand image, and service quality) in Pakistani hotel industry. Data was collected from 821 consumers who experienced the services of Pakistani five star hotels from multiple locations. Mediating regression and stepwise regression analyses were applied for investigation of study hypotheses. Results pointed out positive and significant influences of service quality on all other dimensions of brand equity whereas partial mediations were endorsed among the variables. Researchers and practitioners implications are discussed.

Current trends in the global tourism industry: evidence from the United States

Tourism is one of the largest U.S. industries, serving millions of international and domestic tourists yearly. Tourists visit the U.S. to see natural wonders, cities, historic landmarks, and entertainment venues. Americans seek similar attractions as well as recreation and vacation areas. Tourism competes in the global market, so it is important to understand current trends in the U.S. travel industry. Therefore, this article offers insight into important trends and suggests strategies for policy makers involved in the travel and tourism industry.

An approach to absorptive capacity based on the Portuguese textile industry

The main purpose of this research is to identify the hidden knowledge and learning mechanisms in the organization in order to disclosure the tacit knowledge and transform it into explicit knowledge. Most firms usually tend to duplicate their efforts acquiring extra knowledge and new learning skills while forgetting to exploit the existing ones thus wasting one life time resources that could be applied to increase added value within the firm overall competitive advantage. This unique value in the shape of creation, acquisition, transformation and application of learning and knowledge is not disseminated throughout the individual, group and, ultimately, the company itself. This work is based on three variables that explain the behaviour of learning as the process of construction and acquisition of knowledge, namely internal social capital, technology and external social capital, which include the main attributes of learning and knowledge that help us to capture the essence of this symbiosis. Absorptive Capacity provides the right tool to explore this uncertainty within the firm it is possible to achieve the perfect match between learning skills and knowledge needed to support the overall strategy of the firm. This study has taken in to account a sample of the Portuguese textile industry and it is based on a multisectorial analysis that makes it possible a crossfunctional analysis to check on the validity of results in order to better understand and capture the dynamics of organizational behavior.

An approach to absorptive capacity based on the Portuguese textile industry(Final version)

The main purpose of this research is to identify the hidden knowledge and learning mechanisms in the organization in order to disclosure the tacit knowledge and transform it into explicit knowledge. Most firms usually tend to duplicate their efforts acquiring extra knowledge and new learning skills while forgetting to exploit the existing ones thus wasting one life time resources that could be applied to increase added value within the firm overall competitive advantage. This unique value in the shape of creation, acquisition, transformation and application of learning and knowledge is not disseminated throughout the individual, group and, ultimately, the company itself. This work is based on three variables that explain the behaviour of learning as the process of construction and acquisition of knowledge, namely internal social capital, technology and external social capital, which include the main attributes of learning and knowledge that help us to capture the essence of this symbiosis. Absorptive Capacity provides the right tool to explore this uncertainty within the firm it is possible to achieve the perfect match between learning skills and knowledge needed to support the overall strategy of the firm. This study has taken in to account a sample of the Portuguese textile industry and it is based on a multisectorial analysis that makes it possible a crossfunctional analysis to check on the validity of results in order to better understand and capture the dynamics of organizational behavior.

The portuguese insurance industry: basis for strategic process decision

Nowadays, the Portuguese insurance industry operates in a market with a much more aggressive structure than a few decades ago. Markets and the economy have become globalised since the last decade of the 20th century. Market forces have gradually shifted – power is now mainly on the demand side. In order to meet the new requirements, the insurance industry must develop a strong strategic ability to respond to constant changes of the new international economic order.One of the basic aspects of this strategic development will focus on the ability to predict the future. We introduce the subject by briefly describing the sector, its organisational structure in the Portuguese market, and challenges arising from the development of the European Union. We then analyse the economic and financial structure of the sector. From this point of view, we aim at the possibility of designing models that could explain the demand for insurance, claims and technical reserves evolution. Such models, (even if based on the past), would resolve, at least partly, one of the greatest difficulties experienced by insurance companies when estimating the budget. Thus, we examine the existence of variables that explain the previous points, which are capable of forming a basis for designing models that are simple but efficient, and can be used for strategic planning.

Active and passive behaviors of soft tissues: Pelvic floor muscles

: A new active-contraction visco-elastic numerical model of the pelvic floor (skeletal) muscle is presented. Our model includes all elements that represent the muscle constitutive behavior, contraction and relaxation. In contrast with the previous models, the activation function can be null. The complete equations are shown and exactly linearized. Small verification and validation tests are performed and the pelvis is modeled using the data from the intra-abdominal pressure tests

Occupational exposure to volatile organic compounds in the Portuguese printing industry

In the printing industry, volatile organic compounds main sources are the uses of organic solvents, fountain solutions and cleaning agents. Nowadays, one circumstance which might confuse the exposure reality is that the majority of solvents which are often used have a faint odour. Therefore, the conditions at offset printing in regard to solvent exposure may seem acceptable to workers. Fortunately, general ventilation and local exhaust systems have also become more common, and new printing machines, often with automatic cleaning, have entered the market. The health effects of volatile organic solvents are dependent on the chemicals involved but, normally, are associated with affecting the nervous system, the liver and also the kidneys. The purpose of this study was to document the conditions regarding exposure to volatile organic compounds in an offset printing unit and to permit identify task with higher exposure and with priority for preventive measures application. Exposure assessment was done before and after installation of general ventilation and local exhaust equipments and during printing and cleaning procedure.