Skin-reducing mastectomy and one-stage implant reconstruction with a myodermal flap: A safe and effective technique in risk-reducing and therapeutic mastectomy

Introduction: Immediate reconstruction following mastectomy for breast cancer has been shown to be oncologically safe and associated with improved psychosocial outcomes for patients. Bostwick described a technique for one-stage implant based reconstruction, combining skin-sparing mastectomy with concurrent reduction of the skin envelope. This report reviews the experience of a single centre using skin-reducing mastectomy and one-stage implant reconstruction in both early stage breast cancer and risk-reducing mastectomy, with specific reference to frequency of complications, implant loss and oncological outcomes.

Methods and results: A retrospective review was undertaken to identify women who had undergone skin-reducing mastectomy and one-stage implant reconstruction using a de-epithelialised dermal flap, between October 2008 and October 2012. One hundred and four consecutive mastectomies, with reconstruction, were performed by two surgeons on 64 patients. No complications were seen in 43.8% of patients. At three months, four implants were lost (3.8% of breast reconstructions, 6.3% of patients), due to either peri-implant infection or mastectomy skin flap necrosis. One patient required unplanned return to theatre for evacuation of a haematoma. Minor mastectomy skin flap necrosis was seen in 10 breasts (9.6% of reconstructed breasts) and superficial wound infection in 8 breasts (7.7% of reconstructed breasts). All of these complications were managed conservatively and none required operative intervention. At a median follow up of 35 months (4-53 months) there had been one episode of ipsilateral axillary nodal recurrence.

Conclusion: One-stage implant reconstruction using a myo-dermal flap technique following skin-reducing mastectomy is safe and should be considered in selected patients. Most complications are minor and will resolve with conservative management. Major complications such as implant failure or immediate reoperation, were relatively uncommon (6.3% patients, 3.8% of reconstructed breasts). Early follow-up suggests that oncological outcomes are satisfactory, but longer follow-up is required to substantiate this. (C) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Characterisation of pavement profile heights using accelerometer readings and a combinatorial optimisation technique

Pavement surface profiles induce dynamic ride responses in vehicles which can potentially be used to classify road surface roughness. A novel method is proposed for the characterisation of pavement roughness through an analysis of vehicle accelerations. A combinatorial optimisation technique is applied to the determination of pavement profile heights based on measured accelerations at and above the vehicle axle. Such an approach, using low-cost inertial sensors, would provide an inexpensive alternative to the costly laser-based profile measurement vehicles. The concept is numerically validated using a half-car roll dynamic model to infer measurements of road profiles in both the left and right wheel paths.

Optimizing the efficiency of the sub-map technique for large-scale simultaneous localization and mapping

A technique for optimizing the efficiency of the sub-map method for large-scale simultaneous localization and mapping (SLAM) is proposed. It optimizes the benefits of the sub-map technique to improve the accuracy and consistency of an extended Kalman filter (EKF)-based SLAM. Error models were developed and engaged to investigate some of the outstanding issues in employing the sub-map technique in SLAM. Such issues include the size (distance) of an optimal sub-map, the acceptable error effect caused by the process noise covariance on the predictions and estimations made within a sub-map, when to terminate an existing sub-map and start a new one and the magnitude of the process noise covariance that could produce such an effect. Numerical results obtained from the study and an error-correcting process were engaged to optimize the accuracy and convergence of the Invariant Information Local Sub-map Filter previously proposed. Applying this technique to the EKF-based SLAM algorithm (a) reduces the computational burden of maintaining the global map estimates and (b) simplifies transformation complexities and data association ambiguities usually experienced in fusing sub-maps together. A Monte Carlo analysis of the system is presented as a means of demonstrating the consistency and efficacy of the proposed technique.

Development of a novel continuous statistical modelling technique for detecting the adulteration of extra virgin olive oil with hazelnut oil by using spectroscopic data

The adulteration of extra virgin olive oil with other vegetable oils is a certain problem with economic and health consequences. Current official methods have been proved insufficient to detect such adulterations. One of the most concerning and undetectable adulterations with other vegetable oils is the addition of hazelnut oil. The main objective of this work was to develop a novel dimensionality reduction technique able to model oil mixtures as a part of an integrated pattern recognition solution. This final solution attempts to identify hazelnut oil adulterants in extra virgin olive oil at low percentages based on spectroscopic chemical fingerprints. The proposed Continuous Locality Preserving Projections (CLPP) technique allows the modelling of the continuous nature of the produced in house admixtures as data series instead of discrete points. This methodology has potential to be extended to other mixtures and adulterations of food products. The maintenance of the continuous structure of the data manifold lets the better visualization of this examined classification problem and facilitates a more accurate utilisation of the manifold for detecting the adulterants.

Gastroretentive Extended-Release Floating Granules Prepared Using a Novel Fluidized Hot Melt Granulation (FHMG) Technique

The objective of this work was to investigate the feasibility of using a novel granulation technique, namely, fluidized hot melt granulation (FHMG), to prepare gastroretentive extended-release floating granules. In this study we have utilized FHMG, a solvent free process in which granulation is achieved with the aid of low melting point materials, using Compritol 888 ATO and Gelucire 50/13 as meltable binders, in place of conventional liquid binders. The physicochemical properties, morphology, floating properties, and drug release of the manufactured granules were investigated. Granules prepared by this method were spherical in shape and showed good flowability. The floating granules exhibited sustained release exceeding 10 h. Granule buoyancy (floating time and strength) and drug release properties were significantly influenced by formulation variables such as excipient type and concentration, and the physical characteristics (particle size, hydrophilicity) of the excipients. Drug release rate was increased by increasing the concentration of hydroxypropyl cellulose (HPC) and Gelucire 50/13, or by decreasing the particle size of HPC. Floating strength was improved through the incorporation of sodium bicarbonate and citric acid. Furthermore, floating strength was influenced by the concentration of HPC within the formulation. Granules prepared in this way show good physical characteristics, floating ability, and drug release properties when placed in simulated gastric fluid. Moreover, the drug release and floating properties can be controlled by modification of the ratio or physical characteristics of the excipients used in the formulation.

The influence of high air entry filter on the testing of unsaturated soils using the axis translation technique

Suction is an important stress variable that is required for reliable predictions of the likely performance of unsaturated soils. The axis translation technique is the best established method of measuring or controlling suction; however, the success of this application is heavily dependent on the rating of the high air entry filter (HAF) and how it is incorporated into the testing system. This paper reports some basic experiments in which samples of unsaturated kaolin were brought to saturation in stages using 5 bar and 15 bar HAFs. The results have shown that the water equilibrium in unsaturated soils is greatly affected by the rating of filters. The findings also suggest that the flow through unsaturated soils is not necessarily governed by the one-dimensional consolidation theory that was developed for saturated soils, and this may be attributed to the bimodal pore size distribution of unsaturated soils.

Semiconductor photocatalysis: an environmentally acceptable alternative production technique and effluent treatment process

New environmentally acceptable production methods are required to help reduce the environmental impact of many industrial processes. One potential route is the application of photocatalysis using semiconductors. This technique has enabled new environmentally acceptable synthetic routes for organic synthesis which do not require the use of toxic metals as redox reagents. These photocatalysts also have more favourable redox potentials than many traditional reagents. Semiconductor photocatalysis can also be applied to the treatment of polluted effluent or for the destruction of undesirable by-products of reactions. In addition to the clean nature of the process the power requirements of the technique can be relatively low, with some reactions requiring only sunlight. 

Critical evaluation of pulse-echo ultrasonic test method for the determination of setting and mechanical properties of acrylic bone cement: Influence of mixing technique

Currently there is no reliable objective method to quantify the setting properties of acrylic bone cements within an operating theatre environment. Ultrasonic technology can be used to determine the acoustic properties of the polymerising bone cement, which are linked to material properties and provide indications of the physical and chemical changes occurring within the cement. The focus of this study was the critical evaluation of pulse-echo ultrasonic test method in determining the setting and mechanical properties of three different acrylic bone cement when prepared under atmospheric and vacuum mixing conditions. Results indicated that the ultrasonic pulse-echo technique provided a highly reproducible and accurate method of monitoring the polymerisation reaction and indicating the principal setting parameters when compared to ISO 5833 standard, irrespective of the acrylic bone cement or mixing method used. However, applying the same test method to predict the final mechanical properties of acrylic bone cement did not prove a wholly accurate approach. Inhomogeneities within the cement microstructure and specimen geometry were found to have a significant influence on mechanical property predictions. Consideration of all the results suggests that the non-invasive and non-destructive pulse-echo ultrasonic test method is an effective and reliable method for following the full polymerisation reaction of acrylic bone cement in real-time and then determining the setting properties within a surgical theatre environment. However the application of similar technology for predicting the final mechanical properties of acrylic bone cement on a consistent basis may prove difficult.

Printability of calcium phosphate: Calcium sulphate powders for the application of tissue engineered bone scaffolds using the 3D printing technique

In this study, calcium phosphate (CaP) powders were blended with a three-dimensional printing (3DP) calcium sulfate (CaSO4)-based powder and the resulting composite powders were printed with a water-based binder using the 3DP technology. Application of a water-based binder ensured the manufacture of CaP:CaSO4 constructs on a reliable and repeatable basis, without long term damage of the printhead. Printability of CaP:CaSO4 powders was quantitatively assessed by investigating the key 3DP process parameters, i.e. in-process powder bed packing, drop penetration behavior and the quality of printed solid constructs. Effects of particle size, CaP:CaSO4 ratio and CaP powder type on the 3DP process were considered. The drop penetration technique was used to reliably identify powder formulations that could be potentially used for the application of tissue engineered bone scaffolds using the 3DP technique. Significant improvements (p < 0.05) in the 3DP process parameters were found for CaP (30-110 μm):CaSO4 powders compared to CaP (< 20 μm):CaSO4 powders. Higher compressive strength was obtained for the powders with the higher CaP:CaSO4 ratio. Hydroxyapatite (HA):CaSO4 powders showed better results than beta-tricalcium phosphate (β-TCP):CaSO4 powders. Solid and porous constructs were manufactured using the 3DP technique from the optimized CaP:CaSO4 powder formulations. High-quality printed constructs were manufactured, which exhibited appropriate green compressive strength and a high level of printing accuracy.

Studio Craft and Technique: The Architecture Student's Handbook

This is a second edition of the very successful book originally published in 2010. This second edition is published by new publisher Laurence King Publishers which will include an increased international distribution.

A low-cost digital image correlation technique for characterising the shear deformation of fabrics for draping studies

A novel digital image correlation (DIC) technique has been developed to track changes in textile yarn orientations during shear characterisation experiments, requiring only low-cost digital imaging equipment. Fabric shear angles and effective yarn strains are calculated and visualised using this new DIC technique for bias extension testing of an aerospace grade, carbon-fibre reinforcement material with a plain weave architecture. The DIC results are validated by direct measurement, and the use of a wide bias extension sample is evaluated against a more commonly used narrow sample. Wide samples exhibit a shear angle range 25% greater than narrow samples and peak loads which are 10 times higher. This is primarily due to excessive yarn slippage in the narrow samples; hence, the wide sample configuration is recommended for characterisation of shear properties which are required for accurate modelling of textile draping.