Free Patch Research Articles

Testing the effectiveness of a virtual sustained tobacco treatment: Initial reporting of findings from the EAQ171CD randomized clinical trial conducted by ECOG-ACRIN within the NCI Community Oncology Research Program (NCORP).

376 Background: Persistent smoking among patients diagnosed with cancer is associated with adverse clinical outcomes, yet clinical guidelines for tobacco use interventions have not been integrated into community oncology settings. We conducted a trial of a virtual sustained tobacco treatment intervention across community oncology settings nationally. Methods: This randomized clinical trial, conducted through ECOG-ACRIN, compared the effectiveness of sustained telehealth counseling plus medication (Virtual Sustained Treatment; VST) to referral to the NCI quitline (Enhanced Usual Care; EUC) in assisting recently diagnosed cancer patients to quit smoking. The VST group received up to 11 synchronous telehealth sessions (4 weekly, 4 biweekly, 3 monthly) of motivational counseling and up to 12-weeks of free NRT patch and/or lozenge. Eligibility criteria included adults within 4 months of a new cancer diagnosis, cigarette use in the past 30 days, English/Spanish speaking, and access to an internet-enabled device. The primary outcome is 6-month self-reported 7-day point prevalence abstinence. Results: From 08/2019 to 12/2022, 306 patients were randomized from 30 NCORP Community Sites and 7 Minority/Underserved NCORP sites. Participants were 70.9% female; 86.3% White; 8.8% Black; and 2.9% Hispanic; median age 57 years; 25.5% completed a college degree; 50.3% stages 0-2; 46.4% had non-smoking-related tumors. Median cigarettes per day was 12.0; 72.2% (n = 221/306) smoked within 30 minutes of waking; 49.0% (n = 150/306) were in precontemplation/contemplation stage of readiness to quit. 73.8% (222/301) and 72.2% (210/291) completed the 3 and 6-month outcome assessments. Classifying missing smoking status as smokers, 6-month abstinence rates were 28.4% (42/148) in the VST group vs. 14.7% (21/143) in the EUC group (p<.005). For secondary outcomes, there were no significant differences when adjusted for multiple comparisons (α = 0.0025); abstinence at 3-months was 24.7% (38/154) in the VST group vs. 15.0% (22/147) in the EUC group (p=.035); continuous abstinence at 6 months was 18.9% (28/148) in the VST vs 9.1% (13/143) in the EUC (p=.016). 80.8% (126/156) of individuals randomized to VST participated in counseling; of those, 59.5% (75/126) completed at least 6 sessions, 46.0% (58/126) completed at least one monthly booster session, and 85.7% (108/126) were dispensed 4 weeks of NRT. Conclusions: Among recently diagnosed cancer patients, sustained remotely delivered telehealth counseling and free NRT produced a significantly higher 6-month quit rate than a quitline referral. Findings support adopting a policy of widespread sustained tobacco treatment and implementation of tobacco treatment into community oncology care settings nationwide. Clinical trial information: NCT03808818 .

Diagnosis and Treatment of an Unusual Maxillary Gingiva Malignant Melanoma Arising Around Dental Implant.

Oral mucosal malignant melanoma (OMMM) arises from malignant melanocytes, and the most affected age, sex, and site are 20 to 83 years, male, and the mucosa of hard palate and maxillary gingiva, respectively. Despite several cases of OMMM have been published in the literature, cases of malignant melanoma arising around the dental implant are rarely reported. A 59-year-old male was admitted to our Department with the complain of gingival black pigmentations following dental implant treatment for 3 years. Intraoral examination revealed a painless black lobulated mass around maxillary gingiva and alveolar fossa of dental implant (first molar). CBCT revealed bone destruction around the implant. Positron emission tomography/computed tomography confirmed the presence of tumoral lesion, which was diagnosed as right maxillary gingiva malignant melanoma (T4aN0M0). Partial maxillectomy+buccal fat pad transfer+free tissue patch repair were carried out. Pathologic analyses confirmed the diagnosis of malignant melanoma. The postoperative course was uneventfully, the patient is undergoing follow-up without any evidence of recurrence. Our report showed that an ill-fitting dental implant may cause OMMM. Excisional biopsy with sufficient surgical margins allows complete removal and final diagnosis of OMMM. Early diagnosis and treatment are recommended.

Key Transdermal Patch Using Cannabidiol-Loaded Nanocarriers with Better Pharmacokinetics in vivo.

Cannabidiol (CBD) is a promising therapeutic drug with low addictive potential and a favorable safety profile. However, CBD did face certain challenges, including poor solubility in water and low oral bioavailability. To harness the potential of CBD by combining it with a transdermal drug delivery system (TDDS). This innovative approach sought to develop a transdermal patch dosage form with micellar vesicular nanocarriers to enhance the bioavailability of CBD, leading to improved therapeutic outcomes. A skin-penetrating micellar vesicular nanocarriers, prepared using nano emulsion method, cannabidiol loaded transdermal nanocarriers-12 (CTD-12) was presented with a small particle size, high encapsulation efficiency, and a drug-loaded ratio for CBD. The skin permeation ability used Strat-M™ membrane with a transdermal diffusion system to evaluate the CTD and patch of CTD-12 (PCTD-12) within 24 hrs. PCTD-12 was used in a preliminary pharmacokinetic study in rats to demonstrate the potential of the developed transdermal nanocarrier drug patch for future applications. In the transdermal application of CTD-12, the relative bioavailability of the formulation was 3.68 ± 0.17-fold greater than in the free CBD application. Moreover, PCTD-12 indicated 2.46 ± 0.18-fold higher relative bioavailability comparing with free CBD patch in the ex vivo evaluation. Most importantly, in the pharmacokinetics of PCTD-12, the relative bioavailability of PCTD-12 was 9.47 ± 0.88-fold higher than in the oral application. CTD-12, a transdermal nanocarrier, represents a promising approach for CBD delivery, suggesting its potential as an effective transdermal dosage form.

Diet Outcome in Patients With Hypopharyngeal Defects Repaired With Different Reconstruction Flaps: A Comparative Study.

To assess potential risk factors influencing diet outcomes after reconstruction of subtotal hypopharyngeal defects using free patch- or tube-shaped anterolateral thigh (ALT) fasciocutaneous flaps. Retrospective cohort study. First-level referral hospital. Between January 2011 and December 2020, we studied hypopharyngeal cancer patients who underwent the reconstruction of hypopharyngeal defects using free patch- or tube-shaped ALT fasciocutaneous flaps. The choice between patch- or tube-shaped ALT flaps depended on the defect's nature, favoring patch-shaped for subtotal defects and tube-shaped for circumferential defects. A restricted diet was characterized by a history of enterostomy or endoscopic esophageal dilation treatment postreconstruction. We analyzed patients with restricted diets at 1- and 3-year follow-up visits. Ninety-eight patients were enrolled; 39 patch-shaped flaps, and 59 tube-shaped flaps. No significances were noted in demographics, postoperative radiotherapy (RT) or chemotherapy, rates of free flap reoperation/salvage, or complications. However, a significant difference emerged in diet outcomes at the 1-year follow-up (P = .005). The rate of a restricted diet was 6.08 times higher in patients with tube-shaped flaps compared to patch-shaped flaps (95% confidence interval [CI]: 1.95-18.94). Stratifying based on postoperative RT revealed a 5.47 times higher rate of a restricted diet in tube-shaped flap recipients compared to patch-shaped flap recipients (95% CI: 1.44-20.48). No significances were observed in 5-year survival rates. Concerning postoperative RT, patch-shaped flaps exhibited a lower incidence of a restricted diet compared to tube-shaped flaps. Preservation of the posterior mucosa may play a crucial role in preventing RT-induced esophageal stricture.

Reconstruction using a free jejunal patch flap in salvage head and neck surgery after radiotherapy

Background Chemoradiotherapy is a standard treatment for functional preservation in patients with advanced head and neck carcinoma. However, chemoradiotherapy increases the risk of postoperative complications. Aims/objectives We report the usefulness of reconstruction using a free jejunal patch flap in treating recurrence or residual head and neck carcinoma after radiotherapy. Furthermore, we investigated the factors for the occurrence of postoperative complications in patients who underwent salvage surgery using a free flap transfer. Material and methods This study included 41 patients with head and neck carcinoma who underwent salvage surgery using a free flap transfer, including 11 patients who underwent reconstruction using a free jejunal patch flap. Prognostic analysis was performed for the development of complications. Results Ten jejunal patch flaps survived without microvascular problems. One patient underwent revision reconstructive surgery because of flap failure. However, no patient had a pharyngocutaneous fistula. Oral intake could be resumed in all patients at a median 14 days postoperatively. Multivariate logistic regression analysis indicated that the use of cutaneous flaps was significantly associated with the development of complications. Conclusions and significance Free jejunal patch flaps can be considered useful for head and neck reconstruction after radiotherapy for early intake resumption and complication prevention.

Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment.

To define the anatomic and functional outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole (MH) without retinal detachment. Sixty-four eyes of 64 patients who underwent PPV for myopic MH were included. Group 1 consists of patients underwent ILM peeling (n=26), and Groups 2 and 3 consists of patient underwent free ILM patch graft (n=20) and inverted ILM flap procedure (n=18) respectively. Outcomes following surgery were MH closure and best corrected visual acuity (BCVA) in logMAR at 6mo. Closure of MH was obtained in 20 eyes (76.9%) of the Group 1, in 16 eyes (80%) of the Group 2 and in 16 eyes (88.9%) of the Group 3. The mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR, respectively (P<0.05). There was no significant difference in the postoperative BCVA and anatomical closure rates in the three groups. Although the anatomical closure rate did not differ significantly in the groups, closure of MH tended to be better in the inverted ILM flap technique group at 6mo. Different surgical techniques may provide favorable visual and anatomical results for myopic MH surgery. ILM flap techniques offer higher closure rates compared to ILM peeling technique. However, in terms of visual outcomes, the study reveals no difference in three surgical techniques.

The effect of free peritoneal patch on bursting pressure in primary gastric suturing with peritonitis conditions (study on New Zealand White rabbits)

Link of Video Abstract: https://youtu.be/L5cB4oIP45U Background: perforated peptic ulcer is still a challenge for surgeons and requires a strategy to provide a good outcome. Currently, research on protective biomaterials still has limitations. Free peritoneal patch has growth factors, is antimicrobial, and increases angiogenesis and progenitor properties, which is useful for wound healing. This study examines the healing of primary gastric suturing with peritoneal patches in peritonitis conditions by measuring bursting pressure. Methods: Researchers conducted an experimental study using 30 New Zealand White Rabbits induced by fecal peritonitis. An artificial perforation with a diameter of 1 cm in the gastric corpus was performed, and primary suturing was performed using 5/0 silk thread with 2 simple sutures. In the treatment group, a free peritoneal patch was added. The bursting pressure examination was carried out on the 7th postoperative day. Results: Changes in the body weight of the rabbits before and after surgery reflecting the nutritional status of the sample did not significantly affect the value of bursting pressure (p&gt;0.05). Meanwhile, the value of bursting pressure in the primary gastric suturing group with a free peritoneal patch was significantly higher than in the primary gastric suturing group without adding a free peritoneal patch (p&lt;0.05). Conclusion: A free peritoneal patch can be used as a biological dressing to prevent leakage in gastric primary suturing in conditions of peritonitis, as shown by higher bursting pressure values.

V06-09 ROBOT-ASSISTED NEPHRON-SPARING MANAGEMENT OF URETERAL TUMORS: PATIENT-TAILORED APPROACH WITH DEMONSTRATION OF FOUR DIFFERENT TECHNIQUES

You have accessJournal of UrologyCME1 Apr 2023V06-09 ROBOT-ASSISTED NEPHRON-SPARING MANAGEMENT OF URETERAL TUMORS: PATIENT-TAILORED APPROACH WITH DEMONSTRATION OF FOUR DIFFERENT TECHNIQUES Sumit Saini, Timothy O'Rourke, and Ashok Hemal Sumit SainiSumit Saini More articles by this author , Timothy O'RourkeTimothy O'Rourke More articles by this author , and Ashok HemalAshok Hemal More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003274.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Need for renal function preservation may influence the decision to take a nephron sparing approach of segmental ureterectomy for localized ureteral tumors, as an alternative to radical nephroureterectomy. In this video we demonstrate four different individualized surgical techniques tailored according to patient’s disease. METHODS: All the surgeries were performed by single surgeon (AKH) using da Vinci (Si/Xi) robotic surgical system. For distal ureteral tumors, distal ureterectomy with bladder cuff excision/partial cystectomy with pelvic lymph node dissection (PLND) and uretero-neo-cystostomy was performed in 11 patients. Proximal ureteral tumors were addressed with segmental ureterectomy and uretero-ureterostomy in 5 patients and another patient underwent augmented anastomotic ureteroplasty using free circumferential ileal patch. Regardless of the surgical approach adopted, complete preoperative evaluation was carried out with cross sectional imaging and other investigations (renogram, retrograde pyelogram & nephrostogram) as indicated. These procedures were considered in carefully selected patients with unifocal disease associated with medical co-morbidities, advancing age, and compromised renal function. Intraoperative fluoroscopy guided navigation and/or molecular imaging using indocyanine green (intraluminal or intravascular) are also helpful. RESULTS: In this video, we have demonstrated four such techniques, including our novel approach of augmented anastomotic ureteroplasty with free circumferential ileal patch to bridge a significant defect following segmental ureterectomy. We have also highlighted our novel technique of intra-corporeal JJ stent placement. No intra or post operative complications were noted, and all the surgical margins were negative. JJ Stents was removed in about 4 weeks post-operatively. CONCLUSIONS: Robot-assisted patient-tailored approach for ureteral tumors may be effectively employed in appropriately selected patients of ureteral tumors with excision and end to end anastomosis, augmented anastomosis or uretero-neo-cystotomy with psoas hitch as an alternative to radical nephroureterectomy to salvage the ipsilateral kidney. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e511 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sumit Saini More articles by this author Timothy O'Rourke More articles by this author Ashok Hemal More articles by this author Expand All Advertisement PDF downloadLoading ...

Quitline Promotion to Medicaid Members Who Smoke: Effects of COVID-19–Specific Messaging and a Free Patch Offer

People who smoke are at increased risk of serious COVID-19-related disease but have had reduced access to cessation treatment during the pandemic. This study tested 2 approaches to promoting quitline services to Medicaid members who smoke at high rates: using COVID-19-specific messaging and offering free nicotine patches. The hypotheses were that both would increase enrollment. A California Medicaid mailing from October 2020 to January 2021 (N=7,489,093) included 4 versions of a flyer following a 2×2 design comparing generic with COVID-19-specific messaging and a no-patch with free-patch offer. The main outcome measure was quitline enrollments. Quit outcomes (attempted quitting, quit ≥7 days, quit ≥30 days) were assessed at 2 months. A subsequent free-patch offer was sent to all members (N=7,577,198) from April 2021 to June 2021. Data were collected in 2020-2021 and analyzed in 2022. The first mailing generated 1,753 enrollments. Response rates were 0.023% and 0.024% for generic and COVID-19-specific messaging, respectively (p=0.538), and 0.006% and 0.041% for no-patch and free-patch offers, respectively, the latter being 6.7 times more effective than the former (p<0.0001). Quit outcomes were comparable across conditions. The subsequent free-patch offer generated 3,546 enrollments at $40.28 per enrollee. In a Medicaid mailing during COVID-19, offering free patches generated more than 6 times as many quitline enrollments as offering generic help. COVID-19-specific messaging was no more effective than generic messaging. Offering free patches was highly cost-effective. Medicaid programs partnering with quitlines should consider using similar strategies, especially during a pandemic when regular health care is disrupted.

Effect of a free peritoneal patch on bursting pressure in primary colonic anastomosis with intraperitoneal infection conditions

Anastomotic leakage following colorectal resection is reported to have a significant mortality and morbidity. Various surgical technologies have been developed to improve the outcome of colonic anastomotic, including biomaterial protective agent which has limitations in expensive price and rejection risk. The free peritoneal graft contains growth factors, antimicrobial agent and progenitor or stem cell nature by Mesothelial-Mesenchymal transition mechanism for wound healing process. Examining the healing of colonic anastomotic treated with free peritoneal graft in the presence of intraperitoneal infection by measuring the bursting pressure of the colonic tissue after surgery. We conducted an experimental study using 30 fecal peritonitis-induced New Zealand White Rabbit in 2 sample groups. Both of them have half circumferential diameter colonic resection treated with primary anastomotic using 5/0 silk braided suture material. In the treatment group, free peritoneal auto-graft was harvested and applicated. Bursting pressure was measured on the colonic tissue treated with anastomosis on day-7. The changes in the rabbits’ body weight before and after surgery which describe the nutritional status did not significantly affect the bursting pressure value (P = 0.745).

Changes in Rat Scleral Collagen Structure Induced by UVA-Riboflavin Crosslinking at Various Tissue Depths in Whole Globe Versus Scleral Patch.

PurposeTo investigate structural changes in scleral collagen fibers at various tissue depths before and after photosensitized crosslinking (CXL) both isolated scleral patch versus whole globe using second-harmonic generation (SHG) imaging.MethodsScleral tissues were harvested from Sprague–Dawley rats and separated into three groups: untreated sclera (control), full-thickness scleral patch for CXL (Free Scleral CXL group), and sclera in intact globe for CXL (Globe CXL group). The CXL groups were soaked in 0.1% riboflavin and irradiated with 365 nm ultraviolet-A light (power, 0.45 mW/cm2) for 30 minutes. SHG images were acquired every 5 µm between 10 and 60 µm from the outer scleral surface. Collagen fiber waviness was calculated as the ratio of the total length of a traced fiber and the length of a straight path between the fiber ends.ResultsIn the Free Scleral CXL group, collagen waviness was significantly increased compared to the control group at 35 to 50 µm (P < 0.05). In the Globe CXL group, collagen waviness was decreased compared to control at all depths with statistical significance (P < 0.05) achieved from 10 to 45 µm.ConclusionsDepending upon its initial state (i.e., free scleral patch versus mechanically loaded intact globe under pressure), collagen may experience different structural changes after CXL. In addition, the extent of the CXL effects may vary at different depths away from the surface.Translational RelevanceUnderstanding the CXL effects on collagen structure may be important in optimizing the scleral crosslinking protocol for future clinical applications such as preventing myopic progression.

Development and Evaluation of a Remote Patient Monitoring System in Autologous Breast Reconstruction.

Background:Flap monitoring after a deep inferior epigastric perforator flap breast reconstruction is crucial to detect complications in time. A novel and innovative wireless device has been developed and tested in a feasibility study. This study describes our experience with remote patient monitoring via this device in postoperative monitoring of deep inferior epigastric perforator flaps.Methods:Following a deep inferior epigastric perforator breast reconstruction, the “Free Flap Patch” was adhered to the flap, continuously measuring temperature and tissue saturation. Data were stored locally on the patch and analyzed in a retrospective manner. Raw analog-digital-conversion values from the red- and infrared sensors, delta muscle saturation (dSmO2), and estimated tissue oxygenation (StO2) were assessed and compared with clinical records.Results:No adverse events related to the device were recorded. One patient suffered flap loss; a decrease in estimated tissue oxygenation was measured with the device in situ. No deviations in clinical variables were recorded in the uncompromised flaps.Conclusions:A wearable patient monitoring device was successfully utilized in clinical practice. In one patient, a flap failure was recorded where the PPG-derived StO2 parameter was indicatory for this event. The Free Flap Patch has the potential of automatically predicting blood supply issues in an early stage. More data are needed for clinical validation.

Experimental Evaluation of Miniature Impedance Board for Loosening Monitoring of the Threaded Pipe Connection

Electromechanical impedance (Electromechanical impedance)-based methods as potential nondestructive evaluation (NDT) techniques have been widely used in the field of structural health monitoring (SHM), especially for the civil, mechanical, and aerospace engineering fields. However, it is still difficult to apply in practical applications due to the limitations of the impedance measurement hardware, which is usually expensive, bulky, and heavy. In this paper, a small, lightweight, and low power consumption EMI-based structural health monitoring system combined with the low-cost miniature impedance board AD5933 was studied experimentally to investigate its quantifiable performance in impedance measurement and structural damage identification. At first, a simple impedance test with a free PZT patch was introduced to present the impedance calibration and measurement procedure of AD5933, and then its calibration performance was validated by comparing the signature with the one measured by a professional impedance analyzer (WK6500B). In order to further validate the feasibility and effectiveness of the AD5933 board in practical applications, a threaded pipe connection specimen was assembled in the laboratory and then connected with the AD5933 to acquire its impedance signatures under different loosening severities. The final results demonstrated that the impedance measured by the AD5933 show a good consistency with the measurements by the WK6500B, and the evaluation board could be successfully utilized for the loosening severities identification and quantitatively evaluation.

A Spurious Free Dual Band Microstrip Patch Antenna for Radio Frequency Energy Harvesting

Objectives: To design high gain square slots loaded dual-band rectangular microstrip patch antenna having harmonic suppression capability and rectifier circuit (Rectenna (Antenna + Rectifier) for Radio Frequency Energy Harvesting (RFEH). Methods: To achieve the objectives, the square slots are loaded on the four corners of the rectangular microstrip patch in order to enhance the current distribution which resulted in improved impedance matching at desired frequencies with dual isolated bands. The proposed antenna is simulated in Computer Simulation Technology (CST) Studio Suite Three- Dimensional Electromagnetic Simulation (3DEM) software. A rectifier with an LC impedance matching network is designed, simulated, and optimized in Agilent Advanced Design System (ADS) software. Findings: The overall size of the proposed antenna operating at 2.49 GHz and 3.73 GHz (WiMax) is 57482.5 mm3. The proposed antenna is assessed in terms of its simulated performance parameters: Return loss (S1,1), Impedance (Z1,1), Voltage Standing Wave Ratio (VSWR), Gain, Directivity, and Efficiency. The proposed antenna exhibits improved performance over the conventional rectangular patch antenna, in terms of (S1,1), Impedance (Z1,1) and Gain. The results obtained from the simulation indicate -35.47 dB and -37.42 dB of S1,1 at 2.49 GHz and 3.73 GHz respectively with the Gain of 4.74 dBi and 3.62 dBi respectively. Further, a rectifier circuit is proposed at 2.45 GHz. The complete rectenna system is simulated over a range of input power levels (1dBm-10dBm) for 4.7 kOhm load resistance. The simulated rectenna result presents the maximum output voltage of 3.34 V. Novelty and Applications: The proposed rectenna design with its harmonic suppression capability can be used for RFEH to drive the Internet of Things-Sensor Network (IoT-SN) and Wireless Sensor Network (WSN). The novelty of the proposed work is harmonic suppression capability. harmonic suppression capability is achieved by inserting the square slots at the four corners of the conventional square patch. Keywords: Radio Frequency; Energy Harvesting; Efficiency; Gain; Rectifier; Schottky diode

LANDING ASSISTANCE AND EVALUATION USING IMAGE PROCESSING

Most of the landing systems are based on GPS and radar altimeter, sonar, infrared. But in urban environments buildings and other obstacles disturb the GPS signal and can even cause loss of signal. In such case it will be beneficial to have independent control of navigation and landing assistance system. So the main aim is to design a software system that will assist helicopter or Unmanned Aerial Vehicle accurately under all-weather. The software system takes height parameter and images from helicopter or Unmanned Aerial Vehicle as an input. After applying number of processing techniques like edge detection, RGB to Gray scale on the image, the image is compared with the HSV dataset to find the free space. For edge detection Canny edge detection algorithm is used. From the number of free spaces nearest patch is selected by taking vehicle dimension and landing orientation of the vehicle into consideration. Performance of the system depends on the accuracy and the speed of the system. This system also resolves the potentially dangerous problem of GPS denial.

Microstrip Patch Antenna Miniaturization Using Magneto-Dielectric Substrates for Electromagnetic Energy Harvesting

A mathematical modelling, and a derivation of the main parameters of the Magneto – Dielectric materials (substrate) and their effect on microstrip patch antenna design is shown. The Magneto – Dielectric materials (substrate) is shown to miniaturize the antenna size and enhance the bandwidth when used in the design of the microstrip patch antenna. The progression of the foundational modelling starts with laying out the concepts of the ferrimagnetic materials in terms of their permeability and permittivity, the components of antenna miniaturization. First, a ground free elliptical microstrip patch antenna (GFDSEPA) is simulated for miniaturization purposes at the 900MHz cellular band. A size reduction of almost 50% as well as bandwidth enhancement (100%) is achieved by utilizing the GFDSEPA. More size reduction is achieved by employing the magneto – dielectric structure; in this case the commercially available Rogers MAGTREX 555 substrate is used. Other performance parameters show comparable results between the antenna simulated based on dielectric only substrate and the one based on magneto–dielectric substrate. A comparison of the main parameters between the results of this work and other results in the literature is shown. The application of the microstrip patch antenna design in energy harvesting, by using a rectifier circuit, is shown. Layout scenarios of the energy harvester are proposed. The proposed layout of the energy harvester ensures practicality of the proposed design and assures correlation between simulation results and experimental results.

Dinâmica espacial da paisagem do Parque Estadual do Jalapão (TO) de 2000 a 2015

A modificação da paisagem e a fragmentação do habitat tornaram-se grandes temas de pesquisa, uma vez que são consideradas ameaças graves para a biodiversidade. Considerando o histórico de perturbação da área do Parque Estadual do Jalapão (PEJ), dado sua característica de Unidade de Conservação (UC) de proteção integral inserida no bioma Cerrado, o objetivo desta pesquisa é atualizar o mapa de uso e cobertura do solo dessa UC e analisar as métricas que quantificam a conectividade do habitat e a fragmentação da ecologia da paisagem para o ano de 2015, tendo como base o mapa de uso e ocupação do solo do ano 2000. Para elaborar o mapa de uso do solo do PEJ de 2015, utilizou-se a cena 221/67 (órbita/ponto) de 8 de agosto de 2015 do satélite Landsat 8, sensor OLI, por abranger toda a área de estudo e por não ter cobertura de nuvens. No processamento digital das imagens foram realizadas a correção radiométrica, a pré-classificação e a associação das classes de uso do solo, e, posteriormente, classificação supervisionada por meio de interpretação visual. Para verificar a precisão do mapa foi calculado o coeficiente de Kappa, cujo valor foi de 0,92. A partir do mapa atualizado foram realizados os cálculos de índices de ecologia da paisagem referentes à área, tamanho, forma, borda e proximidade dos fragmentos. Os procedimentos foram realizados no software SIG ArcGIS 10.4 por meio da extensão gratuita Patch Analyst 5.2. Com base nos mapas de uso e cobertura do solo e nos índices de ecologia da paisagem, pode-se constatar que houve mudanças na paisagem. Quanto às métricas, conclui-se que a UC se encontra fragmentada, apresenta 564 fragmentos e possui alta heterogeneidade espacial e forma complexa e irregular em razão dos valores de MPS, PSCoV e MSI.

The use of an autologous right atrial free wall as a patch for closure of atrial septal defects.

Various patch materials to close large atrial septal defects (ASDs) are autologous pericardium or a large of prosthetic patches which may be associated with infrequent but definite problems. We describe our experience with the use of the right atrial free wall patch over the last two decades. Between July 1998 and December 2017, 157 patients (mean age 14.7 ± 13.9 years), underwent ASD closure using the right atrial free wall patch. Associated lesions were severe mitral regurgitation (n = 24), partial anomalous pulmonary venous drainage (n = 15), ASD closure occurring after myxoma excision (n = 12) total anomalous pulmonary venous drainage (n = 2) and tricuspid regurgitation (n = 2). Surgery was uneventful in all patients. All patients underwent serial electrocardiography and echocardiography. Follow-up in 140 of 155 survivors was 103.6 ± 0.6 months. One hundred forty of one hundred fifty-five survivors are in sinus rhythm and three have persistent atrial fibrillation. Twenty-four hours of Holter monitoring (n = 19) revealed normal sinus rhythm in all but three patients, with occasional atrial ectopics in one patient; four were lost to follow-op. Electrophysiological studies in seven consenting patients, 9 to 16 months following ASD closure showed normal atrial potentials from the site of the patch. The autologous right atrial free wall is a safe patch material for ASD closure. Its advantages are that it is autologous, endothelialized, probably viable, and carries a low risk of thromboembolism. Studies with a larger number of patients with longer follow are needed to further confirm these findings.

A COMPARATIVE STUDY OF THE FIGURE OF 8 SUTURING REINFORCED WITH FREE PARIETAL PERITONEAL PATCH VERSUS DIRECT SUTURING WITH OMENTAL PLUG/FALCIFORM PLUG IN PATIENTS WITH GASTRO-INTESTINAL PERFORATION.

Objectives: This present study was to compare the figure of 8 suturing reinforced with free parietal peritoneal patch versus direct suturing with omental plug/falciform plug in patients with gastro-intestinal perforation.&#x0D; Methods: A detail history, clinical examinations and relevant investigations were performed to all patients. All patients were anaesthetized: After painting and draping the operation site, right paramedian incision was made. Peritoneum was opened. Whole GIT and intra-abdominal organs were examined properly. Edges of perorated site were debrided. Then, the perforation firstly was stitched by a Figure of 8 stitch with vicryl 3-0 and then a free parietal peritoneal patch taken from lateral abdominal wall was applied and held in position with interrupted/continuous seromuscular sutures. Then, central tucking was also be done to keep the patch firmly fixed.&#x0D; Results: Data was analyzed by using SPSS version 26 software. One sample t test was applied. Mean and standard deviation were observed. P value was taken less than or equal to 0.05 for significant differences.&#x0D; Conclusions: Reinforcement of free parietal peritoneal patch over figure of 8 suturing is effective method for the closure of gastrointestinal tract perforations, with early evidence of gastrointestinal motility with oral intake allowed on an average 4th - 5th postoperative day was significant statistical difference with regards to complications like anastomotic leakage. Hence, the figure of 8 stitch reinforced with free parietal peritoneal patch is a simple and easy procedure with less hospital stay which does not require significant expertise and can even be performed in very short time by a trained general surgeon in a seriously ill patient in an emergency situation.&#x0D; Keywords: Gastrointestinal perforation, Figure of 8 stitch, parietal peritoneal patch, omental plug, direct suturing

Reconstruction of esophageal stenosis that had persisted for 40 years using a free jejunal patch graft with virtual endoscopy assistance: A case report.

In this report, we present a case in which good results were achieved by treatment using a free jejunal patch graft with virtual endoscopy (VE) assistance in a patient whose swallowing had failed to improve for 40 years after he mistakenly swallowed sulfuric acid, despite pectoralis major myocutaneous flap grafting and frequent balloon dilatation surgery. During the last 20 years, virtual computed tomography imaging has improved remarkably and continues to be used to address new challenges. For reconstructive surgeons, the greatest advantage of VE is that it is a noninvasive modality capable of visualizing areas inaccessible to a flexible endoscope. Using VE findings, we were able to visualize the 3-dimensional shape beyond the stenosis. VE can also help predict the area of the defect after contracture release.