297 resultados para ANASTOMOTIC LEAKS
Resumo:
An anastomosis is a surgical procedure that consists of the connection of two parts of an organ and is commonly required in cases of colorectal cancer. About 80% of the patients diagnosed with this problem require surgery. The malignant tissue located on the gastrointestinal track must be resected and the most common procedure adopted is the anastomosis. Therefore, an anastomotic leak represents a significant problem and increases the duration of hospital stay, which is associated with remedial treatment and recovery, causing, as a result, a negative financial impact. A number of techniques to treat, prevent and even detect an anastomotic leakage are under investigation. However, studies show that these techniques are not always able to prevent an anastomotic leak from occurring. This paper discusses the monitoring of leakage through differently sized and differently positioned leak holes in phantom colons, using physical experiments and a Computational Fluid Dynamics package called FloWorks. © 2011 Taylor & Francis Group.
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Non-invasive ventilation performed through an oronasal mask is a standard in clinical and homecare mechanical ventilation. Besides all its advantages, inevitable leaks through the mask cause errors in the feedback information provided by the airflow sensor and, hence, patient-ventilator asynchrony with multiple negative consequences. Here we investigate a new way to provide a trigger to the ventilator. The method is based on the measurement of rib cage movement at the onset of inspiration and during breathing by fibre-optic sensors. In a series of simultaneous measurements by a long-period fibre grating sensor and pneumotachograph we provide the statistical evidence of the 200 ms lag of the pneumo with respect the fibre-optic signal. The lag is registered consistently across three independent delay metrics. Further, we discuss exceptions from this trend and identify the needed improvements to the proposed fibre-sensing scheme.
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The need for efficient, sustainable, and planned utilization of resources is ever more critical. In the U.S. alone, buildings consume 34.8 Quadrillion (1015) BTU of energy annually at a cost of $1.4 Trillion. Of this energy 58% is utilized for heating and air conditioning. ^ Several building energy analysis tools have been developed to assess energy demands and lifecycle energy costs in buildings. Such analyses are also essential for an efficient HVAC design that overcomes the pitfalls of an under/over-designed system. DOE-2 is among the most widely known full building energy analysis models. It also constitutes the simulation engine of other prominent software such as eQUEST, EnergyPro, PowerDOE. Therefore, it is essential that DOE-2 energy simulations be characterized by high accuracy. ^ Infiltration is an uncontrolled process through which outside air leaks into a building. Studies have estimated infiltration to account for up to 50% of a building's energy demand. This, considered alongside the annual cost of buildings energy consumption, reveals the costs of air infiltration. It also stresses the need that prominent building energy simulation engines accurately account for its impact. ^ In this research the relative accuracy of current air infiltration calculation methods is evaluated against an intricate Multiphysics Hygrothermal CFD building envelope analysis. The full-scale CFD analysis is based on a meticulous representation of cracking in building envelopes and on real-life conditions. The research found that even the most advanced current infiltration methods, including in DOE-2, are at up to 96.13% relative error versus CFD analysis. ^ An Enhanced Model for Combined Heat and Air Infiltration Simulation was developed. The model resulted in 91.6% improvement in relative accuracy over current models. It reduces error versus CFD analysis to less than 4.5% while requiring less than 1% of the time required for such a complex hygrothermal analysis. The algorithm used in our model was demonstrated to be easy to integrate into DOE-2 and other engines as a standalone method for evaluating infiltration heat loads. This will vastly increase the accuracy of such simulation engines while maintaining their speed and ease of use characteristics that make them very widely used in building design.^
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Building installations of cold water are key parts in any model of housing, are homes or condos. However, these systems are subject to failure, which can range from a leak in a device until faults in the structure of water reservoirs and distribution system. These faults are responsible for great economic and environmental costs. In order to reduce these losses, this work proposes the development of a system able to detect the presence and identify some types of water leaks that may occur. For implementation and testing, consumption model was used in a simulator capable of reproducing a similar behavior to a real model and its consequent failures. The detection of leaks is done based on an expert like model having two detection modules, one active and one passive, which use an array of sensors and actuators (valves) to do the sensing. For testing and implementation has been developed a software capable of coupling the system simulator and detector. From the results it can be seen that the system proposed in this work, as well as functioning satisfactorily, can be easily implemented in microcontrollers or embedded systems due to its simplicity.
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On the basis of human evolution and the population increase was necessary, the emergence of new sources of energy, the development of new products and technologies. One such product, object of the industry revolution and of great importance to the development of humanity is the oil, a substance composed primarily of hydrocarbons which give rise to several other products as fuels, lubricants, polymers, solvents, cooking gas, asphalt for roads, fertilizers, medicines, paints, among other. However, mishandling this product may cause leaks and spills that generate huge damages to the environment and the economy. Soon, with the purpose of contributing to decrease is problematic, in this master's work was carried out an intensive search of the possible potential of the fibers of Ceiba pentandra (L.) "Kapok" and Calotropis Procera as bioadsorbents of petroleum in water. The choice of these fibers is due to surface properties such as oleophylics and hydrophobic, their buoyancy and yet, being biodegradable natural polymers derived from the Brazilian Northeast. This research was used experimental planning with response surface methodology (RSM) with the software Design Expert. The results were statistically efficient, obtaining a R2= 0.9995 for Calotropis Procera and a R2= 0.9993 for Kapok. And that, both fibers showed adsorption efficiency, removing more than 80% petroleum in water static and dynamic state.
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Contamination of groundwater by BTX has been featured in recent decades. This type of contamination is due to small and continuous leaks at gas stations, causing serious problems to public health and the environment. Based on these antecedents, the search for new alternatives for treating contaminated water is shown to be essential. Therefore, this study aimed to evaluate the efficiency of removal of BTX by adsorption processes employing commercial alumina (Al2O3) and alumina supported with iron (Fe/Al2O3) as adsorbents. It was prepared by a in a synthetic gasoline solution and distilled water to simulate an actual sample. Initially, the adsorbents were characterized by techniques XRD, TG / DTG, XRF, FTIR and SEM/EDS, several trials, where he was placed synthetic solution to react in the presence of Al2O3 and Fe/Al2O3 in a closed, mechanical stirring system were performed varying the catalyst concentration 2, 4 and 6 g.L-1 every 0, 10, 30 60, 90 and 120 min, aliquots were taken and brought to analysis by gas chromatography flame ionization with headspace extraction. The results indicated that the absorbent which has higher BTX removal capacity was the Fe/Al2O3 at a concentration of 6 g.L-1, pH = 4 and time of 90 minutes reaction, resulting in an efficiency, resulting in a 86,5% efficiency for benzene removal, for the 95,4% toluene, 90,8% for ɱ,ρ- xylene and 93.7% for the θ-xylenes. Subsequently, we performed a kinetic study of the reactions, the values of experimental adsorption capacity (qe) showed agreement with the values of the theoretical adsorption capacity (qc) to the pseudo-second-order model in the adsorption tests using 2 and 6 gL-1 of Al2O3 and assays using 2, 4 and 6 g.L-1 of Fe/Al2O3. A fact corroborated by the R2 values, thus indicating that the chemical interactions are present in the adsorption mechanisms of BTX.
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Novel scientific and technological progress require to seek new sources of electricity. Such response is, inter alia, nuclear energy. Nuclear power stations currently produce around a third of the electricity and 14% of the energy consumed in the European Union. A thorough aspect in the use and development of nuclear energy as power source is safety. Nuclear facilities are designed so that the probability of an accident that may affect people and environment was very low. Reasonably, preventive emergency plans take place in the own nuclear facilities in order to mitigate and minimize the consequences, and otherwise another emergency nuclear plans take place outside facilities. Monitoring programs are also conducted in the nearby nuclear facilities, according to the Recommendation reached on 8th June 2000 by the European Commission on the application of Article 36 of the Euratom Treaty for the checking of the levels of radioactivity in the environment, in order to assess the exposure to the whole population. The main objectives of these plans are to check the presence and evolution of radioactive elements and the radiation levels in the environment; to determinate the causes of its increase, if succeed; to estimate the radiological risk to the population; to set corrected measures, if necessary; to ensure legal compliance on the premises and; to verify the suitability of effluent monitoring program to detect radionuclides leaks and transfer to the environment...
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A água é um recurso essencial e escasso, como tal, é necessário encontrar medidas que permitam o seu uso de modo sustentável e garantam a proteção do meio ambiente. Devido a esta crescente preocupação assiste-se a um movimento legislativo, nacional e internacional, no sentido de garantir o desenvolvimento sustentável. Surge assim, a Diretiva Quadro da Água e a Lei da Água, que é complementada com legislação diversa. Como elemento constituinte do ciclo urbano da água, os Sistemas de Abastecimento têm sofrido evoluções nem sempre adequadas. É neste contexto que, em Portugal, nascem as diversas ferramentas para a melhoria da gestão dos recursos hídricos. As Entidades Gestoras têm como finalidade a gestão eficiente do bem água, e dispõe de dois importantes instrumentos, o Programa Nacional para o Uso Eficiente da Água e o Guia para o “controlo de perdas de água em sistemas públicos de adução e distribuição”(ERSAR). Esta Gestão passa, não só pela abordagem da problemática das perdas de água, reais e aparentes, como também pela análise do comportamento que origina o desperdício. A APA, enquanto entidade gestora, procura maximizar a eficiência do seu sistema de abastecimento, para tal, foram aplicadas as ferramentas propostas pelo ERSAR. Concluindo-se que este sistema tem um total de perdas de água de 34%, devendo-se estas perdas essencialmente ao envelhecido parque de contadores e perdas nos ramais de distribuição (teórico). As perdas comerciais representam cerca de 69%, o que revela que os volumes de água não faturados (medidos ou não) são muito elevados. Por outro lado, a realização do cálculo do Balanço Hídrico e dos índices de desempenho permitem classificar a performance do sistema de abastecimento e compará-la com os seus objetivos de gestão. Atendendo ao volume de água perdido nos ramais, foram efetuadas medições noturnas, verificando-se que no Porto de Pesca Costeira existe um volume de água escoado não justificado. Neste sentido, elaborou-se um plano de ação para aumentar a eficiência do sistema, ou seja, reduzir as perdas totais de 34% para 15%.
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Water systems in the Sultanate of Oman are inevitably exposed to varied threats and hazards due to both natural and man-made hazards. Natural disasters, especially tropical cyclone Gonu in 2007, cause immense damage to water supply systems in Oman. At the same time water loss from leaks is a major operational problem. This research developed an integrated approach to identify and rank the risks to the water sources, transmission pipelines and distribution networks in Oman and suggests appropriate mitigation measures. The system resilience was evaluated and an emergency response plan for the water supplies developed. The methodology involved mining the data held by the water supply utility for risk and resilience determination and operational data to support calculations of non-revenue water. Risk factors were identified, ranked and scored at a stakeholder workshop and the operational information required was principally gathered from interviews. Finally, an emergency response plan was developed by evaluating the risk and resilience factors. The risk analysis and assessment used a Coarse Risk Analysis (CRA) approach and risk scores were generated using a simple risk matrix based on WHO recommendations. The likelihoods and consequences of a wide range of hazardous events were identified through a key workshop and subsequent questionnaires. The thesis proposes a method of translating the detailed risk evaluations into resilience scores through a methodology used in transportation networks. A water audit indicated that the percentage of NRW in Oman is greater than 35% which is similar to other Gulf countries but high internationally. The principal strategy for managing NRW used in the research was the AWWA water audit method which includes free to use software and was found to be easy to apply in Oman. The research showed that risks to the main desalination processes can be controlled but the risk due to feed water quality might remain high even after implementing mitigation measures because the intake is close to an oil port with a significant risk of oil contamination and algal blooms. The most severe risks to transmission mains were found to be associated with pipe rather than pump failure. The systems in Oman were found to be moderately resilient, the resilience of desalination plants reasonably high but the transmission mains and pumping stations are very vulnerable. The integrated strategy developed in this study has a wide applicability, particularly in the Gulf area, which may have risks from exceptional events and will be experiencing NRW. Other developing countries may also experience such risks but with different magnitudes and the risk evaluation tables could provide a useful format for further work.
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Introduction. Routine use of nasogastric tubes (NGT) after abdominal operations is intended to hasten the return of bowel function, diminish the risk of anastomotic leakage and prevent pulmonary complications. The aim of our study was to prospectively assess the tolerability and the safety of the non use of NGT after elective colorectal open operations. Patients and methods. Between March 2009 and December 2010, 110 consecutive patients underwent colo-rectal elective open surgery for neoplasm without nasogastric decompression. We analyzed the incidence of nausea and vomiting, the pulmonary complications, the return of bowel function the deep wound breakdown (fascial dehiscence) and the anastomotic leakage. Results. Only 15 patients (13,6%) reported nausea without vomiting immediately after surgery and 9 cases of vomiting were observed (8%), requiring the insertion of the NGT (nasogastric tube) in 5 (4,5%). A total of 105 patients (96,3%) were NGT free. No deep wound dehiscence was observed and only one real pneumonia occurred. Anastomotic dehiscence occured in 4 patients (3,6%) and a second surgical procedure was needed in three cases. The return of bowel function, except in the last four patients, occurred in 3,8 days average (range 2-7 days). Conclusion. We confirm the uselessness of the NGT in the framework of fast track program adopted in elective open colo-rectal surgery.
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Recent advances in the massively parallel computational abilities of graphical processing units (GPUs) have increased their use for general purpose computation, as companies look to take advantage of big data processing techniques. This has given rise to the potential for malicious software targeting GPUs, which is of interest to forensic investigators examining the operation of software. The ability to carry out reverse-engineering of software is of great importance within the security and forensics elds, particularly when investigating malicious software or carrying out forensic analysis following a successful security breach. Due to the complexity of the Nvidia CUDA (Compute Uni ed Device Architecture) framework, it is not clear how best to approach the reverse engineering of a piece of CUDA software. We carry out a review of the di erent binary output formats which may be encountered from the CUDA compiler, and their implications on reverse engineering. We then demonstrate the process of carrying out disassembly of an example CUDA application, to establish the various techniques available to forensic investigators carrying out black-box disassembly and reverse engineering of CUDA binaries. We show that the Nvidia compiler, using default settings, leaks useful information. Finally, we demonstrate techniques to better protect intellectual property in CUDA algorithm implementations from reverse engineering.
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Internet users consume online targeted advertising based on information collected about them and voluntarily share personal information in social networks. Sensor information and data from smart-phones is collected and used by applications, sometimes in unclear ways. As it happens today with smartphones, in the near future sensors will be shipped in all types of connected devices, enabling ubiquitous information gathering from the physical environment, enabling the vision of Ambient Intelligence. The value of gathered data, if not obvious, can be harnessed through data mining techniques and put to use by enabling personalized and tailored services as well as business intelligence practices, fueling the digital economy. However, the ever-expanding information gathering and use undermines the privacy conceptions of the past. Natural social practices of managing privacy in daily relations are overridden by socially-awkward communication tools, service providers struggle with security issues resulting in harmful data leaks, governments use mass surveillance techniques, the incentives of the digital economy threaten consumer privacy, and the advancement of consumergrade data-gathering technology enables new inter-personal abuses. A wide range of fields attempts to address technology-related privacy problems, however they vary immensely in terms of assumptions, scope and approach. Privacy of future use cases is typically handled vertically, instead of building upon previous work that can be re-contextualized, while current privacy problems are typically addressed per type in a more focused way. Because significant effort was required to make sense of the relations and structure of privacy-related work, this thesis attempts to transmit a structured view of it. It is multi-disciplinary - from cryptography to economics, including distributed systems and information theory - and addresses privacy issues of different natures. As existing work is framed and discussed, the contributions to the state-of-theart done in the scope of this thesis are presented. The contributions add to five distinct areas: 1) identity in distributed systems; 2) future context-aware services; 3) event-based context management; 4) low-latency information flow control; 5) high-dimensional dataset anonymity. Finally, having laid out such landscape of the privacy-preserving work, the current and future privacy challenges are discussed, considering not only technical but also socio-economic perspectives.
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BACKGROUND: in 21st century, endoscopic study of the small intestine has undergone a revolution with capsule endoscopy and balloon-assisted enteroscopy. The difficulties and morbidity associated with intraoperative enteroscopy, the gold-standard in the 20th century, made this technique to be relegated to a second level. AIMS: evaluate the actual role and assess the diagnostic and therapeutic value of intraoperative enteroscopy in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: we conducted a retrospective study of 19 patients (11 males; mean age: 66.5 ± 15.3 years) submitted to 21 IOE procedures for obscure GI bleeding. Capsule endoscopy and double balloon enteroscopy had been performed in 10 and 5 patients, respectively. RESULTS: with intraoperative enteroscopy a small bowel bleeding lesion was identified in 79% of patients and a gastrointestinal bleeding lesion in 94%. Small bowel findings included: angiodysplasia (n = 6), ulcers (n = 4), small bowel Dieulafoy´s lesion (n = 2), bleeding from anastomotic vessels (n = 1), multiple cavernous hemangiomas (n = 1) and bleeding ectopic jejunal varices (n = 1). Agreement between capsule endoscopy and intraoperative enteroscopy was 70%. Endoscopic and/or surgical treatment was used in 77.8% of the patients with a positive finding on intraoperative enteroscopy, with a rebleeding rate of 21.4% in a mean 21-month follow-up period. Procedure-related mortality and postoperative complications have been 5 and 21%, respectively. CONCLUSIONS: intraoperative enteroscopy remains a valuable tool in selected patients with obscure GI bleeding, achieving a high diagnostic yield and allowing an endoscopic and/or surgical treatment in most of them. However, as an invasive procedure with relevant mortality and morbidity, a precise indication for its use is indispensable.
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The main issues related to water conservation in urban centers are the increase in water supply cost, demand growth, pollution and differences in the distribution of water resources. Water conservation, the controlled and efficient use of water, includes both measures as reasonable means of water reuse. Thus, conservation practices are an effective way to meet demand and supply water to new activities and users without jeopardizing the supplying water bodies and preserving the natural environment. This study aims to examine the water management of a shopping mall and the use of rainwater harvesting combined with greywater reuse. For buildings in general, water loss is common due to leaks in the hydraulic and restroom equipment. These losses, which are caused by a high volume of water used and wasted in the system, are often the result of design errors, incorrect maintenance procedures and users' bad habits In southern Brazil, where there is rainfall almost all year long, water shortages occasionally occur, particularly in some winter mouths. One difficulty that appears on rainwater studies is the proper determination of rainwater volume that can be used to address water supply systems. In this work, the simulation method was used to determine this volume. Thus, simulations with the following variables: rainfall, catchment area and water consumption were performed. For mall's hydraulic systems, segmented alternatives are adopted. That is, focusing on the use of rainwater or greywater reuse. Other alternatives of effluent reuse have been slightly discussed due to sanitary issues, those are effluents from toilets and kitchen sinks. The adoption of greywater may be feasible if there is a significant flow of greywater to comply water demand for toilet flushing. The inspections made in this study found that the quantity of sinks was insufficient to supply an adequate amount of water to toilets and urinals. The greywater reuse system was found to be infeasible in terms of demand and supply of water. Conversely, the rainwater harvesting system was entirely feasible and easily supplied water to all restrooms and contributed to the cooling of the air conditioning system with a short payback period. One of the challenges of this work was the need to compare the actual water consumption with a water consumption parameter used in buildings. Thus, a method that addresses the generation of specific consumption indexes for specific activity (like a mall) was used. The water consumption indices showed that this mall has a satisfactory water management program.