Common Mode Research Articles

Mode and Associated Injury among the Patients Presented with Acute Subdural Hematoma

Background: Different mode of injuries are responsible for the formation of acute subdural hematoma. Objective: The purpose of the present study was to mode and associated injury among the patients presented with acute subdural hematoma. Methodology: This cross-sectional study was carried out in the Neurosurgery Department of Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2011 to August 2012 for a period of one year and eight months. Patients with acute subdural hematoma who fulfil the inclusion criteria for surgery and got admitted into the Hospital were selected as study population. Acute Subdural hematoma patient of any age, both sexes with GCS 5 to 13, thickness of hematoma more than l0 mm, midline shift more than 5 mm, pupil reacting to light and patient presented within 72 hours of injury were included for this study. At admission, a detailed history of the illness was taken from the patient or attendant, thorough general and neurological examinations were carried out and were recorded. Results: A total number of 48 patients presented with acute subdural hematoma who were operated in the Department of Neurosurgery of Dhaka Medical College & Hospital, Dhaka, Bangladesh were included in current study. Majority of the patients were in the age group of 10 to 30 years which was 25(52.1%) cases. In this study, majority of patients 26(54.2%) had history of road traffic accidents. Other causes of injury were fall from height 9(18.75%), physical assault 7(14.58%), industrial accident 2(4.16%). No associated injury was found in 18(37.5%) patients and 15(31.2%) cases were hemorrhagic contusion. In this study 3(6.5%) cases were presented with intra-cerebral hemorrhage (ICH) and 4(8.3%) cases were associated EDH. SAH was found in 3(6.5%) cases. Conclusion: In conclusion the most common mode of injury is road traffic accidents which is associated with hemorrhagic contusion. Journal of National Institute of Neurosciences Bangladesh, January 2024;10(1):8-11

Interactive 3D visualisation technique used in pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled study evaluating quality of life, compliance and use of health care.

A pulmonary rehabilitation (PR) programme, including exercise training, education, and behaviour change, is highly recommended in treatment guidelines for chronic obstructive pulmonary disease (COPD). A new PR educational material for PR using an interactive three-dimensional (3D) visualisation technique was developed. There is little known regarding using 3D in this setting. The aim was to evaluate, within a PR programme setting, differences between outcomes of education through interactive 3D compared with education by means of 2D visualisation in patients with COPD regarding health-related quality of life (HRQL), physical capacity, exercise self-efficacy, compliance to exercise training, compliance to medication, and the use of health care and to describe learning styles. Patients were cluster randomised to PR at the University Hospital clinic, including exercise training, for 10 weeks with education by 3D (n = 27) or education by traditional 2D technique (n = 17). At follow-ups, HRQL, physical capacity, self-efficacy, handgrip strength, compliance to exercise training, compliance to medication and health care utilisation were assessed. No significant differences were observed in HRQL in relation to COPD between the groups after 10 weeks. Differences were found in handgrip strength at baseline and at 10 weeks (p < 0.01). The 3D group had improved scores in HRQL assessed with the Leicester Cough Questionnaire (LCQ-S) psychological domain (p = 0.022). In the 2D group, the LCQ-S social domain (p = 0.028), psychological domain (p = 0.021) and the St George's Respiratory Questionnaire total (p = 0.050) were increased. The most common learning mode and learning style in both groups was reflective observation and divergent style. An interactive education in 3D technique used in a PR programme for patients with COPD yielded no significant differences compared to conventional techniques. Three-dimensional techniques can be used in PR for COPD as an alternative to conventional techniques. ClinicalTrials.gov (identifier:NCT02802618).

When Disaster Strikes: Conversion of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty

ObjectivesTo investigate the causes of failure in unicompartmental knee arthroplasty (UKA), types of implants used in the revision, evaluate the need to use tibial stems, metal block augmentations and bone grafts during conversion to total knee arthroplasty (TKA) MethodsIn a 10-year retrospective analysis, focusing on cases of UKA failure, our study aimed to categorize early and late failures, determine the primary failure modes, and assess the utilization of bone augmentations and grafts during conversion to TKA. We evaluated patient data, diagnoses, procedure intervals, and follow-up periods to provide a comprehensive understanding of the conversion process. ResultsDuring the past decade, 301 UKA procedures were performed, with 36 knees (11.96%) requiring conversion to TKA. Patient ages averaged 64.3 years, with varied diagnoses, including osteoarthritis and avascular necrosis. The most common failure mode was component loosening or sinking (52.78%), followed by progression of arthritis (25%). Of the 31 cases with mobile-bearing UKA, 9 (29.03%) developed instability and displacement of the polyethylene. Of the 36 cases converted from UKA to TKA, in 31 (86.11%) a revision tibial component with a tibial stem was used. Metal block augmentation was performed in 19 knees (52,78%). All revised UKAs were converted to cemented TKA, with a focus on addressing tibial side issues, which constituted 72.22% of the revisions. ConclusionThis study highlights the challenges associated with UKA failure, particularly early failures linked to displaced bearings. Converting from UKA to TKA presents technical hurdles, including rod alignment and utilization. Management of proximal tibial defects with metal block augmentation proves to be a viable approach. The use of modular metal augmentation simplifies the reconstruction process. Although the study has limitations, it contributes valuable information about the complexities of knee arthroplasty conversion. Level of evidenceTherapeutic study, level IV (case series).

Using Therapeutic Play to Increase the Oral Administration Adherence Rate of Preschool Pediatric Inpatients

Oral administration is the most common mode of medical treatment for pediatric patients. Although over 98% of the patients in the targeted pediatric unit require oral medication, the oral administration adherence rate in 2022 was 43.9%. The reasons for this low rate were identified as: (1) no relevant oral administration educational materials, (2) no relevant continued nursing education provided, and (3) lack of assistive tools and feeding aids to help administer oral medication to young children. This project was developed to increase the adherence rate of oral administration of preschool pediatric inpatients in our hospital. The improvement strategies included the design of patient-centered oral medication care guidance leaflets and QR code (quick response code) video links, the development of therapeutic play aids, adding cartoon characters to medicine feeders, and the creation of a "Rescue the Forest" picture book and video and reward stickers. The oral medication adherence rate increased from 43.9% pretest to 91.9% posttest. This project and its positive effect on the rate of oral medication adherence may be referenced by other pediatric units.

HEPATITIS B. IN PREGNANCY

Hepatitis B virus (HBV) infection has widespread implications and has already generated 350 million chronic carriers which can further progress to liver cirrhosis &amp; hepatocellular carcinoma1. Out of total pool of chronic carriers, half have got infected vertically from their mothers, i.e. through mother - to - child transmission (MTCT). Vertically - acquired HBV infections become chronic in 90% of cases2.HBV can be transmitted Vertically during pregnancy, delivery or postpartum. HBV has the ability of placental transfer and reach the fetus but the exact impact of this mode is unclear. Transmission during delivery is the most common mode of MTCT, thus, the neonatal administration of HBIG with vaccination is able to prevent newborn HBV infection in more than 85 % of cases. In postpartum period the close contact between mother and baby is responsible for HBV transmission and includes breastfeeding which has potential either through ingestion of the virus or by contact with skin lesions on the mothers breastAll Pregnant women should undergo mandatory screening for Hepatitis B.If HBV viral load or HbeAg is found to be significantly high, then antiviral treatment tenofovir 300 mg should be started. Caesarean section should be performed only for obstetric indications only and not solely due to HBV infection. Every new born of hepatitis B mother should be mandatory given 0.5 ml hepatitis B immunoglobulin, along with zero dose Hepatitis B vaccination within twelve hours of birth and later on full course of HBV should be completed. Breast feeding is allowed for the new born.

Imaging Single Particle Profiler to Study Nanoscale Bioparticles Using Conventional Confocal Microscopy.

Single particle profiling (SPP) is a unique methodology to study nanoscale bioparticles such as liposomes, lipid nanoparticles, extracellular vesicles, and lipoproteins in a single particle and high throughput manner. The initial version requires the single photon counting modules for data acquisition, which limits its adoptability. Here, we present imaging-based SPP (iSPP) that can be performed by imaging a spot over time in the common imaging mode with confocal detectors. We also provide user-friendly software with a graphical user interface to analyze such data and give quantitative insights on the content and properties of nanoscale bioparticles. We use iSPP to decipher lipid-protein interactions, membrane modifications by drugs, and the heterogeneity of extracellular vesicles isolated from cell lines and human urine. This easily applicable modality of the single particle profiler will facilitate nanoscale bioparticle research in laboratories with access to any confocal microscope.

Constructive Strategies for Enhancing Public Engagement in County Governance: A Focus on Nandi, Kenya, 2024.

Abstract: This article examined the effectiveness of constructive strategies for engaging the public in county governance in Nandi County, Kenya, 2024. It highlighted that the legal and institutional framework has not ensured public participation as intended by the Kenya 2010 constitution. The study’s objectives included examining the effectiveness of constructive strategies for engaging the public in county governance in Nandi County. It utilised Adam Smith’s Rational Choice Model and employed a concurrent mixed research design, incorporating purposive sampling. Data was collected through questionnaires and interviews, with secondary data from document analysis. Analysis was done using a statistical package for the social sciences for descriptive statistics, and qualitative data was processed through thematic analysis. Devolution in Kenya, implemented in 2013, shifted responsibilities to county governments to enhance transparency and public participation. It allowed citizens to elect local leaders and engage in decision-making, promoting responsive governance. The County Government Act (2012) emphasises timely access to information and the role of non-state actors in fostering citizen involvement. The findings revealed that the most common mode of collaboration was electing project leaders. However, many individuals were unaware of the importance of participation, leading to low engagement, especially in project identification and implementation. The primary source of information on development projects was barazas (public meetings). The study concluded that public participation in development projects is below desired levels as per the County Government Act and recommended that Nandi County should improve public engagement across all sectors for a more significant impact on constructive strategies.

Research on Optimized Multi‐Objective FCS‐MPC Without Weighting Factors of NPC Three‐Level Inverter

ABSTRACTTo address a series of issues in the application of finite control set model predictive control (FCS‐MPC) strategy for neutral point clamped (NPC) three‐level inverters, such as large amount of rolling optimization calculation, poor midpoint voltage balance effect, high common mode voltage, and complex design of weighting coefficients, this paper proposes an optimized multi‐objective FCS‐MPC strategy without weighting factors. First, the method applies the idea of space vector region division, to obtain the optimal region based on Lyapunov function, and combines with delay compensation, reducing the system's optimization time and enhancing the control precision of the system. Second, aiming at the issue of multi‐objective control for inverters, by constructing the objective function to control tracking reference current, midpoint voltage balance, and reduce common mode voltage, a hierarchical optimization control method is adopted. This approach eliminates the need to design complex weighting coefficients constrained in the objective function as constraints, thereby improving the accuracy of predicted currents. Finally, the optimized multi‐objective FCS‐MPC control strategy is validated through simulation and experimentation to achieve a better balance of midpoint voltage and reduce common mode voltage and harmonic content, thereby enhancing the control precision and dynamic/static performance of the system.

Development of a Tool for Verifying Leakage Detection in Microfluidic Systems

While submissions of microfluidic-based medical devices to the Food and Drug Administration (FDA) have increased in recent years, leakage remains a common but difficult failure mode to detect in microfluidic systems. Here, we have developed a sensitive tool to measure and verify leakages ranging from 0.1% to 10% in leakage detection systems, which can then be used to detect leak in microfluidic devices. Our methodology includes an analytical model that applies hydrodynamic resistance using different fluid-contacting elements (e.g., tubing, junctions, and connectors) to tune the leakage rate based on the application-specific acceptance criteria. We then used three polymer-based microfluidic systems to target leakage rates of approximately 0.1, 1.0, and 10%. The experimental uncertainties in Polyether Ether Ketone (PEEK) tubing were 23.08%, 13.64%, and 1.16%, respectively, while the PEEK-Coated Fused Silica (PEEKsil) tubing system had errors of 0.00%, 0.72%, and 1.59%, respectively, relative to the theoretical values for the same target leak rates. The commonly used commercial grade Cyclic Olefin Copolymer (COC) microfluidic chips produced errors of 7.69% and 5.05%, respectively, for target leakage rates of 0.24% and 1.88%. We anticipate that the proposed bench test method can be useful for device developers as a verification tool for leakage detection systems before assessing flow-mediated leakage failure modes in microfluidic medical devices.

Evaluation Method and Modeling Analysis of the Common Mode Noise Suppression Capability of Full-Bridge Transformers

Evaluation Method and Modeling Analysis of the Common Mode Noise Suppression Capability of Full-Bridge Transformers

Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study

BackgroundSepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention. Globally, sepsis is common, with an estimated 31.5 million cases per year. Sepsis accounts for a significant in-hospital mortality rate of 17% in high-income countries, while in Malawi, it ranges from 17 to 50%. For Malawi, the trend can be reversed with improvements in patient referral system within the healthcare system. The study sets out to establish factors associate with delay referral of patients with sepsis from primary healthcare to tertiary hospitals and to understand healthcare workers and patients’ perspectives on barriers associated with delayed referral of patients with sepsis from primary to tertiary healthcare.MethodsA qualitative descriptive study in six health centres within Blantyre District health office. In-depth interviews were conducted with 22 respondents: healthcare providers [n = 12]; patients [n = 10] using semi-structured interview guides. Purposive sampling techniques were used in selecting healthcare providers (health centre in charges) and patients.ResultsThe study demonstrating that the main referral pathways for patients with sepsis include community-to-facility and facility-to-facility referrals. Ambulances and personal transport are common transportation mode used during referrals. Primary care facilities face several challenges that delay referrals from primary to tertiary health facility of patients with sepsis, such as lack of referral transport, poor communication, poor road network, shortage of skilled healthcare workers, patient preferences, delayed treatment-seeking action, and ambulances prioritising maternal conditions.ConclusionsPatients’ delay and failure to access prompt and timely referral services result from the healthcare system’s lack of transport, communication problems, bad road networks and shortage of well-trained personnel. Referral delays have deleterious effects on patient-care outcomes.

Association of gestational day with antenatal management and the mortality and respiratory outcomes of extremely preterm infants

ObjectivePerinatal epidemiological studies and outcomes are often reported on gestational week thresholds. This study aims to quantify and investigate the association of each gestational day at birth on antenatal management,...

Influence of Calcium Silicate-Based vs. Resin-Based Sealers on Pull-Out Bond Strength of Two Universal Adhesive/Resin Cement Combinations for Fiber Posts Cementation

This in vitro study investigated the influence of root canal sealer type (calcium silicate-based vs. resin-based) on the pull-out bond strength of two universal adhesive/resin cement combinations. Forty-eight human premolars were prepared, obturated with either Ceraseal™ (calcium-silicate based) (C) or AH Plus™ (resin-based) (A), and stored at 37°C, 100% humidity for 24 hours. Two adhesive/resin cement combinations were used for fiber post cementation: Single Bond Universal/RelyX™ Ultimate (UT) and ScotchbondTM Universal Plus/RelyX™ Universal (UN). Pull-out bond strength values (Newton) were measured after seven days using a universal testing machine. Then all fiber posts were observed for mode of failure using a stereomicroscope. AH PlusTM and ScotchbondTM Universal Plus/RelyXTM Universal (AUN) had the highest bond strength (263.50 ± 46.47 N), while CeraSealTM and Single Bond Universal Adhesive/RelyXTM Ultimate (CUT) had the lowest (202.88± 38.21 N). The results of the two-way ANOVA indicated a significant main effect for root canal sealer types (P = 0.025); a significant main effect for resin cement types (P = 0.015); and no significant interaction effect between root canal sealer types and resin cement types (P = 0.068). Post hoc Tukey HSD testing revealed significant differences between CUT and CUN (p = 0.008), CUT and AUN (P = 0.003), and CUT and AUT (P = 0.024). The most common failure mode was the mixed type. The type of root canal sealer and the combination of adhesive/resin cements influence pull-out bond strength values. Using the calcium-silicated base sealer may decrease the pull-out bond strength values in certain adhesive/resin cement combinations.

Data fusion by T3-PCA: A global model for the simultaneous analysis of coupled three-way and two-way real-valued data.

In various areas of science, researchers try to gain insight into important processes by jointly analysing different datasets containing information regarding common aspects of these processes. For example, to explain individual differences in personality, researchers collect, for the same set of persons, data regarding behavioural signatures (i.e., the reaction profile of a person across different situations), on the one hand, and traits or dispositions, on the other hand. To uncover the processes underlying such coupled data, to all N-way -mode data blocks simultaneously a global model is fitted, in which each data block is represented by an -way -mode decomposition model (e.g., principal component analysis [PCA], Parafac, Tucker3) and the parameters underlying the common mode are required to be the same for all data blocks this mode belongs to. To estimate the parameters underlying the common mode, a simultaneous strategy is used that pools the information present in all data blocks (i.e., data fusion). In this paper, we propose the T3-PCA model, which represents three- and two-way data with Tucker3 and PCA respectively. This model is less restrictive than the already proposed LMPCA model in which the three-way data block is decomposed according to a Parafac model. To estimate the T3-PCA model parameters, an alternating least-squares algorithm is proposed. The superior performance of the simultaneous T3-PCA strategy over a sequential strategy (i.e., estimating common parameters using information from the three-way data block only) is demonstrated in an extensive simulation study and an application to empirical coupled anxiety data.

Applications and Challenges of Oral Peptide Drug Delivery in Diabetes Treatment

Peptide drugs, an important class of biopharmaceuticals, have been studied and applied in the field of diabetes treatment for decades. In recent years, with a deeper understanding of the physiological mechanisms of diabetes, efforts by developers to improve therapeutic efficacy have increased. Although oral administration is the most common mode of drug delivery, many peptide drugs still need to be administered by injection due to their unique chemical structures and biological properties. The paper aims to summarize the research literature related to diabetes and analyze the major barriers to the development of oral peptide drugs, such as the stability and low bioavailability of peptides in the GI tract, as well as technological coping strategies to address these barriers, including novel delivery systems and formulation optimization. In addition, it assesses the current progress in the development of oral peptide drugs and their clinical applications, mainly with reference to relevant literature from 2015 onwards. The results indicate that although some oral peptide drugs have been approved, the possibility of their popularization is still relatively small in the short term. Thus, future research should focus on overcoming the technical challenges of oral drug delivery in order to enhance their clinical application potential and ultimately provide patients with more convenient and effective treatment options

All-polarization-maintaining dual-comb Er-fiber laser with combined figure-8 and figure-9 architectures.

We propose and demonstrate, for the first time to the best of our knowledge, an all-polarization-maintaining (all-PM) dual-comb Er-fiber laser based on combined figure-8 and figure-9 architectures. The opposite signs of the non-reciprocal phase shifts required for figure-8 and figure-9 architectures in the shared nonlinear amplifying loop mirror (NALM) are achieved using a single non-reciprocal phase shifter (NRPS) that operates in two orthogonal polarizations. The capability of common mode noise cancellation, environmental stability, long-term reliability, and the tunable range of the repetition rate difference Δf rep between two combs has been investigated and characterized. In addition, the dual-comb spectroscopy measurement with our dual-comb fiber laser is demonstrated to resolve the transmission spectrum of a flat-top DWDM (dense wavelength division multiplexer) demultiplexer, with a passband of ∼50 GHz at 1564.5 nm. Our experimental results indicate that the combined-architecture all-PM fiber laser, with its large tunable range of 100 kHz in Δf rep , shows significant potential for dual-comb applications in precise and rapid metrology outside the laboratory.

A Novel Balanced Nonreciprocal Bandpass Filter Based on Stub‐Loaded Ring Time‐Modulated Resonator

ABSTRACTIn this paper, a novel balanced nonreciprocal bandpass filter based on stub‐loaded ring time‐modulated resonators (TMRs) is proposed, which is co‐designed to integrate the feed circuits and common‐mode (CM) suppression circuits. The design employs the fewest TMRs necessary, which is at least two, to achieve a reverse isolation level of larger than 20 dB. This configuration also ensures the presence of two reverse isolation poles, thereby maximizing the reverse isolation bandwidth. Even‐ and odd‐mode analysis elucidates the isolation of signals under differential mode (DM) and the suppression of noise under common mode. This approach eliminates the need for separate feed lines and complex CM noise suppression circuit designs. Furthermore, parameterization analysis is adopted to verify the modulation parameters on the impact of the circuit. A balanced microstrip nonreciprocal bandpass filter, centered at 1.5 GHz, has been designed, simulated, and experimentally verified. The measured DM forward insertion loss is 3.9 dB, and the reverse isolation is greater than 20 dB with a bandwidth of 48 MHz. The measured CM noise suppression exceeds 26.6 dB within the frequency range of 1.2 to 1.8 GHz.

Surveillance of Dual-Mobility Hip Systems: Damage Mode and Clinical Data Analysis.

Hip instability following total hip arthroplasty (THA) is among the most common indications for revision surgery. The implantation of dual-mobility (DM) systems, designed to improve stability, continues to rise, and thus, characterizing in vivo implant damage modes is paramount. Under an implant retrieval protocol, 51 DM THA systems were analyzed. Each component was examined for macroscopic damage and microscopically graded for fretting corrosion at the trunnion interface. Clinically relevant data were collected from medical records. Revision indications included mechanical complications (n = 15, 27%), infection (n = 12, 22%), and dislocation (n = 9, 16%). The average duration of implantation was 12 months, which significantly correlated with summed femoral head taper corrosion (P = 0.044). Average summed fretting and corrosion scores were 2.9 and 3.0 for heads (two regions, two to eight summed scores possible) and 7.6 and 7.1 for trunnions (four quadrants, 4 to 16 summed scores possible), respectively. Scratching (n = 26, 65.4%) was the most common damage mode on articular surfaces of acetabular cups, burnishing (n = 29, 55.2%) on metal liners, and edge deformation (n = 22, 45.5%) on polyethylene liners. Screw-liner corrosion was noted on 10.3% (n = 3) of available acetabular liners; an increased incidence of acetabular and femoral osteolysis was noted when this damage mode was present (P = 0.019 and P = 0.022, respectively). This series demonstrated in vivo damage of DM THA components following short-to-midterm (zero to five years) implantation, with overall mild-to-moderate fretting and corrosion scores. Femoral head taper corrosion correlated with longer implantation, and amplified trunnion corrosion was observed in the setting of infection. Screw-liner corrosion may be related to acetabular and femoral osteolysis. This study indicates trends that merit further evaluation.

High frequency modeling and optimization design of common mode inductance for electromagnetic interference suppression of valve cooling system sensors

High frequency modeling and optimization design of common mode inductance for electromagnetic interference suppression of valve cooling system sensors

On the common mode current reduction in induction motor fed by three-level NPC inverter for pumping photovoltaic application

On the common mode current reduction in induction motor fed by three-level NPC inverter for pumping photovoltaic application