Instrument Alignment Research Articles

Risk-based maintenance strategy for oil transfer pipelines using an intuitionistic fuzzy computational approach

The safety and reliability of oil transfer pipelines are crucial, as pipeline failures can severely affect the environment. As pipeline risk management is dynamic and uncertain, traditional maintenance approaches often fall short. This research paper proposes an Intuitive Fuzzy Computational Approach (IFCA) for oil transfer pipeline maintenance (RBM). To develop a targeted and nuanced maintenance plan, Failure Modes and Effects Analysis (FMEA) is employed. Pipeline equipment is hierarchically organised according to their failure mode criticality, which guides maintenance design. This paper leverages the context of an Interval Valued Intuitionistic Fuzzy (IVIF) environment to streamline the hierarchical classification of oil transmission pipeline instruments. The objectives are threefold: (1) to develop an intuitionistic fuzzy risk assessment model, (2) to design a modified algorithm for maintenance prioritisation, and (3) to develop a decision support system. Additionally, the research incorporates the IVIF-SWARA method to enable flexible adjustments in the alignment of the pipeline instruments. By addressing the specific challenges of oil transfer pipelines, this research aims to contribute to advancing the field of pipeline maintenance and risk management. The proposed RBM strategy, underpinned by the IFCA framework, is expected to enhance pipeline reliability and mitigate the risks associated with pipeline failures. Abbreviations: RBM: Risk-Based Maintenance; IFCA: Intuitionistic Fuzzy Computational Approach; FMEA: Failure Modes and Effects Analysis; IVIF: Interval Valued Intuitionistic Fuzzy; SWARA: Stepwise Weight Assessment Ratio Analysis; RCM: Reliability-Centered Maintenance; RBI: Risk-Based Inspection; CBM: Condition-Based Maintenance; IFS: Intuitionistic Fuzzy Set; HFPR: Hesitant Fuzzy Preference Relation; IVIFPHA: Interval-Valued Intuitionistic Fuzzy Power Heronian Aggregation; MCDM: Multi-Criteria Decision-Making; S C O i : Accuracy Function of Occurrence; S C S i : Accuracy Function of Severity; K ( a ~ ) : Failure Probability Index; L W D : Minimum Allowable Weight of The Failure Detection Index; WS, WO, WD: Weight Assigned to The Failure Outcome; RP V j : Relative Priority Value; OREDA: The Offshore Reliable Data Handbook; IVIFPWHA: Interval-Valued Intuitionistic Fuzzy Power Weight Heronian Aggregation

SUSTAINABLE FINANCE IN ACTION: EXPLORING GREEN LOANS IN PROMOTING ENVIRONMENTAL RESPONSIBILITY

In the evolving landscape of finance, the imperative to address environmental concerns and promote sustainable development has given rise to innovative financial instruments, notably green loans and sustainable linked loans. This comprehensive study delves into the key features and characteristics of green loans, assessing their role in fostering positive environmental impact through targeted funding for eco-friendly projects. Additionally, it explores the novel concept of sustainable linked loans, which tie loan terms to specific sustainability performance targets, offering a nuanced approach to promoting environmental and social sustainability. The research examines adoption patterns globally, evaluates the impact of Green Loan Principles (GLP), analyzes financial incentives, and explores the alignment of these financial instruments with Sustainable Development Goals (SDGs). The findings contribute to a deeper understanding of the dynamics surrounding green loans and sustainable linked loans, shedding light on their effectiveness in driving positive change towards a sustainable global economy.

Micromanipulator Set-up - Taking Control of This System

Embryo biopsy is a precise procedure, demanding adept manipulation skills and the finest instruments to ensure high-quality results. One of the most crucial elements to gain mastery over is the micromanipulator system. In this session attendees will delve into the practical facets of setting up and controlling a micromanipulator within the context of a blastocyst biopsy. The session will also cover the important aspects of system set-up, instrument alignment, and objective positioning, aimed to maximize control, precision, and stability during the biopsy procedure. Moreover, the discussion will touch on the common challenges faced during the set-up process, offering practical solutions, and troubleshooting tips to manage these effectively.

Validitas Isi Instrumen TPACK pada Calon Guru Kimia menggunakan Aplikasi Model Rasch

This research aims to assess the content validity of the instrument used to measure Technological Pedagogical Content Knowledge (TPACK) in prospective chemistry teachers. The evaluation encompasses a thorough analysis of the instrument's alignment with the knowledge domains being measured, ensuring that the instrument covers key aspects of TPACK that are relevant to the context of teaching chemistry. Content validity reflects the representation and relevance of a set of items used to measure a concept carried out through rational analysis of the contents of the test through an expert panel assessment. This validity refers to the accuracy of the measurement based on the contents of the instrument to ensure that the scale of the items used has fulfilled the entire concept of the item or the suitability of the item. The instrument used in this study was assessed by nine validators consisting of two chemistry education experts and seven chemistry teachers. The assessment is done by determining the appropriateness or relevance of the test contents to be used through rational analysis by a competent panel or through expert judgment. The instrument validations in this study were 20 multiple choice questions. The assessment is done by giving a score of 1-4 on each item. This research is a quantitative descriptive study using Rasch model analysis. The analysis showed that the exact agreement was 71.4% and the expected agreement was 73.8%. Based on measurements showing relevant items in this research instrument, there are 17, among others number 1, 10, 11, 14, 5, 8, 19, 20, 18, 3, 6, 12, 13, 15, 17, 4 and 9. While there are 3 items that are irrelevant and need to be corrected, including number 16, 2 and 7.

Functional positioning principles for image-based robotic-assisted TKA achieved a higher Forgotten Joint Score at 1 year compared to conventional TKA with restricted kinematic alignment.

Few comparative studies assessed the current concept of individualised alignment for total knee arthroplasty (TKA) and their outcomes at mid-term. This study aimed to evaluate the functional outcomes at 1 year of primary TKA performed with a functional positioning technique based on an image-based robotic-assisted system, compared to conventional TKA performed with a restricted kinematic alignment technique. This retrospective comparative study included 100 primary TKAs performed with functional positioning principles using an image-based robotic-assisted system. A control group included 100 primary TKAs with the same posterior-stabilised implant as the robotic group but performed with manual instrumentation and restricted kinematic alignment technique. In the robotic group, the mean age was 69.2years old ± 7.9; the mean body mass index was 29.7kg/m2 ± 4.6. The demographic characteristics were similar between both groups. Kujala score, Forgotten Joint Score (FJS), Knee Society Score (KSS) knee and KSS function were collected 12months postoperatively. Normally distributed continuous variables were compared using the Student t test. For non-normally distributed continuous variables, the Mann-Whitney test was used. FJS was significantly higher in the robotic group (76.3 ± 13 vs. 68.6 ± 16.9 in the conventional group; p = 0.026). At a 1-year follow-up, there was no significant difference in the KSS knee and KSS function scores and the Kujala score between both groups. The mean KSS knee score was 90.8 ± 11.4 in the robotic group versus 89.4 ± 9.6 in the conventional group (p = 0.082). The mean KSS function score was 91.4 ± 12.3 versus 91.3 ± 12.6, respectively (p = 0.778). Functional positioning principles using an image-based robotic-assisted system achieved a higher Forgotten Joint Score 1year after TKA compared to restricted kinematic alignment. Personalised alignment and implant positioning are interesting paths to improve the functional outcomes after TKA. III.

Initial validation of a closed loop filter and controller approach for active stabilization of thermomechanical distortions

Increasing technological progress in space technology is accompanied by an increased demand for accuracy. The alignment of optical instruments or antennas on the satellite platform requires structural stability that can no longer be achieved with traditional, passive methods, such as the use of materials with high stiffness or low coefficient of thermal expansion. Within the Infrared Astronomy Satellite Swarm Interferometry (IRASSI) project, an approach to actively stabilizing structures against low-frequency periodic heat induced deformations has been developed and simulated. In this study, the basic functionality of that thermomechanical FEM model is demonstrated by means of the thermal transfer functions between the changes in the applied heat and the resulting temperature changes, as well as a closed loop filter and controller approach consisting of a Linear Quadratic Regulator (LQR) and a Kalman filter. For this purpose, an experimental setup consisting of an aluminum plate with 14 temperature sensors, four heating elements for controlling the structure and one heating element for simulating the perturbation is used. The evaluation of the thermal transfer functions in the model compared to the experimental setup shows a deviation of the phase shift of less than 0.6% and an amplitude shift of less than 3.5% on average. A Kalman filter processes the temperature measurement in order to obtain an optimal estimate for the LQR controller, which then calculates the necessary change in the heating power of the four control heating elements to minimize the displacements at the desired two positions in x- and y-direction. The verification is performed by a camera system as an external validation tool, which is able to resolve micron-scale displacements by measuring the spatial displacement of a speckle pattern applied to the structure using sub-pixel accurate image correlation algorithms. While the range of values of the amplitudes of the displacements is 8.93 μ in the uncontrolled case, an improvement of more than 4.6dB could be achieved by applying the filter and controller system. Thus, it is demonstrated that this method has the potential to further improve already highly stable structures or to make lighter and cheaper materials with poorer passive stability values usable through active structural stabilization.

<em>Ex ante</em> analysis of circular built environment policy coherence

As European governments adopt new circular built environment policies to cope with the socio-ecological crisis, the need for evaluating such policies gains in urgency. Ex post evaluation is, however, difficult as these policies have not been in place long enough to have had significant effects. Nonetheless, ex ante policy evaluation may be possible by assessing policy coherence or the alignment and synergies of policy goals, instruments and implementation practices. This paper proposes a framework to analyse circular built environment policies. This framework is based on a combination of two existing analytical frameworks: circular city development and policy coherence analysis. The framework is tested for the case of a circular built environment in campus development at Delft University of Technology in the Netherlands, which is regarded as an urban development proxy. Policy documents and semi-structured interviews were analysed and coded. Results confirm previous findings about a prevailing focus on looping actions and indicates limited policy instrumentalisation across governance levels. Identified multilevel (in)coherence in circular city policy is pointed out as consequence of siloed-led and supply chain-based thinking and underdeveloped circular policy frameworks. Finally, the analytical benefits of circular city development and policy coherence frameworks are discussed. Policy relevance Circular economy policies are conceptually limited in delivering a more circular city and built environment. By proposing and testing a circular city policy coherence framework, this article reveals the limited effect of circular economy policies in coping with unsustainable urbanisation. Policymaking and implementation for circularity in the built environment require frameworks that embrace urban complexities instead of reductionist approaches seeing the built environment as a mere agglomeration of supply-chains. Policymakers may use the proposed circular city policy coherence framework as a tool for ex ante policy evaluation in diverse areas of urban development, and specifically for built environment interventions. The combination of both content- and process-based frameworks enables the identification of possible (in)coherence in current and future policy goals, instruments and implementation practices. This can improve policy in early stages of implementation and create more effective policy outputs and outcomes in the long term.

Simultaneous Multicolor Multifocal Scanning Microscopy.

Super-resolution fluorescence microscopy has revolutionized cell biology over the past decade, enabling the visualization of subcellular complexity with unparalleled clarity and detail. However, the rapid development of image-scanning-based super-resolution systems still restrains convenient access to commonly used instruments such as epi-fluorescence microscopes. Here, we present multifocal scanning microscopy (MSM) for super-resolution imaging with simultaneous multicolor acquisition and minimal instrumental complexity. MSM implements a stationary, interposed multifocal multicolor excitation by exploiting the motion of the specimens, realizing super-resolution microscopy through a general epi-fluorescence platform without compromising the image-scanning mechanism or inducing complex instrument alignment. The system is demonstrated with various phantom and biological specimens, and the results present effective resolution doubling, optical sectioning, and contrast enhancement. We anticipate MSM, as a highly accessible and compatible super-resolution technique, to offer a promising methodological pathway for broad cell biological discoveries.

Development of a project assessment instrument to measure skills using historical sources for history study program students at the University of Riau

The goal of this study is to create a project evaluation tool that can be used to evaluate students' knowledge of how to use historical sources at the University of Riau's History Study Program. The three steps of the employed instrument development approach are: (i) problem analysis and instrument development needs; (ii) development of a framework for project evaluation instruments; and (iii) validation tests, instrument trials, and instrument changes by experts. 54 randomly chosen students from the history education study program at Riau University made up the research subjects. Research data was gathered through surveys and literature reviews. The SPSS version 25.0 application is used to do statistical analysis as part of the data analysis approach. 4.416. This demonstrates the instrument's excellent design and alignment with the intended use of the measurement. With an average score of 4.24, the test results further demonstrate this instrument's capacity to deliver reliable assessments. The instrument's validity and reliability scored highly. Based on these results, it can be said that the project evaluation tool created in this study has strong validity and reliability in assessing students in the University of Riau's History Study Program's capacity to use historical materials. This test is a useful tool for determining how well students can examine and comprehend historical sources. In the subject of historical education, this study has a significant impact on the creation of project assessment tools and can serve as the foundation for future advancements.

Determining the error in measuring the spherical concave mirror radius of curvature with a laser rangefinder

An instrument and technique for assessing errors of measuring optical surface radius of curvature with a laser rangefinder are presented. Errors of optical instrument alignment with a wave-front sensor are shown to influence the accuracy of measuring the mirror radius. Errors of the rangefinder-aided technique for measuring the surface radius are estimated. A computer analysis shows that the developed scheme of misalignment measurement allows a relative error of 0.02 – 0.3 % to be attained for mirrors ranging in radius from 1 m to 10 m. The choice of the accuracy characteristics of the rangefinders used for measuring the optical surface radius of curvature is justified.

IMPLEMENTASI DAN ASESMEN PEMBELAJARAN BERDIFERENSIASI PADA MATERI ANEKDOT UNTUK SISWA SMA

This study aims to describe the implementation and assessment of differentiated learning on anecdotal material for high school students by reviewing the alignment of predetermined learning instruments. The design in this study is a mix method. The data collection procedure was carried out by researchers by distributing questionnaires and interviewing Indonesian language teachers in class X as respondents. Respondents filled out the prepared questionnaire using the Google Form format. Data analysis was carried out descriptively. The findings of the differentiated learning assessment research on content differentiation components are well implemented. The assessment of the process differentiation component was implemented well in two aspects, namely the implementation of the way in which the material was delivered varied according to students' understanding abilities and there were variations in activities to understand the material based on the container. Three aspects of the assessment indicators are still experiencing differentiation. Differentiated learning assessment on product differentiation components is well implemented. The results of the research on the implementation of differentiated learning assessments on anecdotal material for high school students serve as a guideline for Indonesian teachers in conducting assessments in favor of learning profiles.

Freehand Pre-drilling Technique for Lateral Mass Screw Fixation Is More Efficient and Reliable Versus Sequential Drilling Technique: A Sawbone Analysis.

Background Since posterior cervical fixation with lateral mass screws was introduced in 1979, multiple techniques have been described in the literature. However, no study to date has determined whether pre-drilling all lateral masses prior to screw insertion has a benefit over the traditional sequential drilling and screw insertion on the alignment of the screw-rod construct. This study sought to determine the efficacy and efficiency in achieving alignment with a novel pre-drilling technique compared to the traditional sequential drilling technique. The authors hypothesized that the novel pre-drilling technique could be applied more quickly and precisely than the traditional sequential drilling technique. Methods Eight cervical spine sawbones models were utilized to place 64 lateral mass screws by two surgeons. The pre-drilling technique was utilized to place 32 screws in four models, and the sequential drilling technique was utilized to place the 32 screws in the remaining four models. In the traditional sequential drilling technique, each lateral mass underwent screw tract preparation and insertion before proceeding to the subsequent vertebra. In the pre-drilling technique, all lateral masses were marked and drilled sequentially before screw placement. CT imaging with 3D reconstructions was generated for all models. Variability in screw placement and time taken to fully instrument the models were compared. Results The mean time to completion of the pre-drilling technique was 337 ± 22 seconds compared to 490 ± 22 seconds with the traditional technique (p<0.01). There was a significantly higher variability in the coronal plane within the traditional group between C5 and C6 compared to other adjacent vertebrae (p<0.05). There was no significant difference in the start point variability and the overall tightness of line fit between the techniques. Conclusions Our study suggests that a novel pre-drilling technique for lateral mass screw insertion may be more efficient and reliable than the traditional sequential drilling technique. In addition, this technique may reduce the need for rod contouring or additional implants to optimize the alignment of cervical instrumentation. However, further clinical studies are necessary to validate the potential clinical and radiologic benefits of this described technique.

Optimizing column-to-column retention time alignment in high-speed gas chromatography by combining retention time locking and correlation optimized warping

We examine and then optimize alignment of chromatograms collected on nominally identical columns using retention time locking (RTL), an instrumental alignment tool, and software-based alignment using correlation optimized warping (COW). For this purpose, three samples are constructed by spiking two sets of analytes into a base test mixture. The three samples are analyzed by high-speed gas chromatography with four nominally identical columns and identical separation conditions. The data is first analyzed without alignment, then using COW alone, then RTL alone, and finally with RTL followed by COW to correct the severe column-to-column misalignment. Principal component analysis (PCA) is used to investigate how well each alignment method clustered the chromatograms into the three sample classes via a scores plot without being compromised by the specific column(s) used. The degree-of-class separation (DCS) is used as a classification metric, measured as the Euclidian distance between the centroids of two clusters in PC space in the scores plot, normalized by their pooled variance. With no alignment, the average DCS between sample classes (DCSsam) was 3.0, while the average DCS between the four nominally identical columns, i.e., column classes (DCScol) was 76.1 (ideally the DCScol should be 0), indicating the chromatograms were initially classified by the columns used. Using either COW or RTL alone also produced unsatisfactory results, with COW alone incorrectly aligning many peaks, leading to a DCSsam of only 1.9 and DCScol of 1.7, while RTL alone provided a DCSsam of 4.7 and DCScol of 4.2. Finally, using RTL followed by COW alignment, DCSsam increased to 32.5, indicating successful classification by chemical differences between sample classes, while the DCScol decreased to 0.4, indicating virtually no classification due to column-to-column differences, as desired. Thus, RTL provided a “first-order” correction of the initial retention mismatch observed for the nominally identical columns, while additional alignment via COW was required to optimize sample classification by PCA.

Outcome of Image-Guided Surgical Biopsy of Brain Lesions: A Single Centre Experience

Abstract AIMS The aim of this study was to quantify the accuracy of surgical biopsy for brain lesions using different image-guidance techniques, in our tertiary neurosurgical centre. METHOD Retrospective data was collected from electronic and paper patient notes. Data collected included: age, sex, comorbidities, pre-operative functional images, surgeon grade, biopsy method, number of targets, number of samples, result from frozen section and fixed sample histopathology, complications, and length of stay. Methods of biopsy included: ultrasound-guided, frame-based biopsy and frameless Brainlab guided biopsy (free-hand, Varioguide and registration tool -guided). RESULTS A percentage of 11.5% of cases (total = 52) were US-guided biopsy. Navigated frameless biopsies comprised 76.9% of all cases. In these cases, 42.3% of cases were guided by the registration tool, 23% used a fixed “Varioguide” instrument alignment tool and 11.5% were completed using the free-hand method. Overall accuracy of biopsy for all cases was 82.69%. Accuracy rates of different frameless methods were: 81.8% for Brainlab registration- guided biopsy, 66.7% for Brainlab Varioguide biopsy and 100% for Brainlab free-hand frameless biopsies. The percentage of complications was 5.8%. CONCLUSION In our centre, the accuracy of image-guided surgical biopsy for brain lesions was as high as 82.69% with a low complication rate of 5.8%. The Brain lab free-hand technique had the highest diagnostic yield and safety amongst all frameless stereotactic techniques.

Applying 3-Dimensional Printing and Modeling for Preoperative Reconstruction and Instrumentation Placement Planning in Complex Deformity Surgery.

Advances in three-dimensional (3D) printing technology have enabled the development of customized instrumentation and surgical training platforms. However, no existing studies have assessed how patient-specific 3D-printed spine models can facilitate patient education and operative planning in complex spinal deformity correction. To present a cost-effective technique for constructing personalized 3D-printed spine models for patients with severe spinal deformities and to outline how these models can promote informed consent, trainee education, and planning for instrumentation placement and alignment correction. We present 2 patients who underwent surgical correction of progressive thoracolumbar deformities. Full-scale 3D-printed models of each patient's spine were produced preoperatively and used during clinic evaluations, surgical planning, and as intraoperative references. Each model took 9 days to build and required less than 60 US dollars of material costs. Both patients were treated with a posterior approach and contiguous multilevel osteotomies. Postoperatively, their alignment parameters and neurological deficits improved. Personalized 3D-printed spine models can aid in patient education, surgical training, visualization, and correction of complex spinal deformities.

High pressure neutron diffraction on WAND2 with a Paris-Edinburgh press

ABSTRACT The Paris-Edinburgh press is a widely available, highly adaptable pressure cell commonly used while collecting neutron scattering data. Here, we detail the use of the VX3 and VX5 Paris-Edinburgh presses on the Wide-Angle Neutron Diffractometer (WAND) at the High Flux Isotope Reactor at Oak Ridge National Laboratory. We first give a detailed overview of the instrument setup and alignment capabilities used at WAND. We then demonstrate the high pressure capabilities through three examples. The first example focuses on diffraction data obtained from a lithium-diamond mixture to 10 GPa with the use of single toroidal cubic boron nitride anvils. Other examples include the room temperature compressions of germanium (up to 16 GPa) and the mineral malachite with double toroidal sintered diamond anvils. This work thereby represents the first studies above 10 GPa at the High Flux Isotope Reactor and opens the door for future user experiments at these elevated pressures.

Uniportal VATS Approach in Esophageal Cancer - How to Do It Update.

The adoption of minimally invasive esophagectomy has been used for over a decade, and the chest part is evolving into a uniportal video-assisted thoracoscopic surgery (VATS) approach. Uniportal esophageal mobilization and anastomosis have many peculiar aspects, which include placement of the incision, alignment of instruments, and anastomosis. The incision is placed over the sixth intercostal space posterior axillary line. The esophagus is usually encircled at the level of the inferior pulmonary vein. The use of curved suction helps in the retraction of the esophagus and the exposure of the left main bronchus deep in the mediastinum. For intrathoracic anastomosis in Ivor Lewis esophagectomy, a completely side-to-side linear-stapled anastomosis is preferred. This anastomotic technique results in a long stapler line. The correct alignment of tissues and adequate anastomotic circumference are of utmost importance to prevent leaks or strictures. Perioperative and oncologic results in several series with uniportal VATS, esophageal mobilization, and anastomosis are comparable with open or other types of minimally invasive esophagectomy. Uniportal VATS for esophagectomy is feasible and fast with good results.

An automated structural health monitoring system developed for Ekaterinburg Arena

Introduction. The paper presents those essential Structural Health Monitoring (SHM) implementation details that have not been sufficiently documented in Russian national guides or regulations. The study aims to systematize and share the experience of applying the previously developed SHM theoretical principles to the existing large-span unique sports facility Ekaterinburg Arena. The paper provides information about determining monitored structural elements, instrumentation alignment, and monitoring parameters’ threshold value.&#x0D; Materials and methods. The long-term SHM system of the large-span structure of the Arena is organized around hardware and software for processing the data constantly incoming from tiltmeters, strain gauges, accelerometers, a motorized total station, and a weather station.&#x0D; Results. A unified information system for automated SHM of the Arena has been created. It comprised modules for data acquisition, high-performance databases for storing metrics, metadata, and the project information, services for evaluating and visualizing structural parameters, components for the instrumentation self-diagnosis, an application development interface for sophisticated data analysis, and a 3D model of the structure. Engineering methods for evaluating the initial values of the controlled parameters and their thresholds acceptable for regular operation are proposed. The technique of calculating internal forces based on the strain gauge data with a redundant measurement pattern has been tested.&#x0D; Conclusions. The obtained monitoring results have become a valuable source of initial data for developing automated methods for detecting and locating damages in structures, improving structural analysis and design methods, predictive maintenance, surveys, and solving other knowledge-intensive tasks. Applying the SHM theoretical principles to the real structure can significantly contribute to developing the current immature scientific and regulatory framework for implementing similar monitoring systems at complicated construction facilities.

Governance of Fragmented Compliance and Voluntary Carbon Markets Under the Paris Agreement

Over the past two decades, the emergence of multiple carbon market segments has led to fragmentation of governance of international carbon markets. International baseline-and-credit systems for greenhouse gas mitigation have been repeatedly expected to wither away, but show significant resilience. Still, Parties to the Paris Agreement have struggled to finalize rules for market-based cooperation under Article 6, which are still being negotiated. Generally, there is tension between international top-down and bottom-up governance. The former was pioneered through the Clean Development Mechanism under the Kyoto Protocol and is likely to be utilized for the Article 6.4 mechanism, while the latter was used for the first track of Joint Implementation and will be applied for Article 6.2. Voluntary carbon markets governed bottom-up and outside the Kyoto Protocol by private institutions have recently gained importance by offering complementary project types and methodological approaches. The clear intention of some Parties to use market-based cooperation in order to reach their nationally determined contributions to the Paris Agreement have led to an ongoing process of navigating the alignment of these fragmented carbon market instruments with the implementation of nationally determined contributions and Paris Agreement’s governance architecture. We discuss emerging features of international carbon market governance in the public and private domain, including political and technical issues. Fragmented governance is characterized by different degrees of transparency, centralization, and scales. We assess the crunch issues in the Article 6 negotiations through the lens of these governance features and their effectiveness, focusing on governance principles and their operationalization to ensure environmental integrity and avoid double counting.

Outcomes of Single-Incision Thoracoscopic Surgery Using the Spinal Needle Anchoring Technique for Primary Spontaneous Pneumothorax.

BackgroundAlthough classical multi-port video-assisted thoracic surgery has been widely performed, single-incision thoracoscopic surgery (SITS) is a popular surgical technique for the treatment of primary spontaneous pneumothorax (PSP). However, the inconvenient alignment of instruments and the limited field of view occasionally make surgeons convert from SITS to multi-port surgery or extend the incision. This study aimed to present an easy and safe SITS technique for PSP using a spinal needle.MethodsIn total, 139 patients underwent SITS between May 2011 and December 2017. We used a spinal needle to hook the bulla or bleb, and wedge resection was performed through a small incision. Patients’ medical records were reviewed retrospectively, and a telephone survey was conducted to investigate the recurrence rate.ResultsThe mean age of the 139 patients was 23.62±9.60 years. The mean operative time was 36.69±14.64 minutes, and multi-port conversion was not performed. The mean postoperative hospital stay was 3.00±0.78 days, and the mean indwelling chest tube duration was 1.97±0.77 days. No complications were observed. In the mean follow-up period of 86.75±23.20 months, recurrence of pneumothorax was found in 3 patients.ConclusionWe suggest that SITS for PSP with the aid of a spinal needle to replace a grasper is a safe and easy technique that only requires a small incision.