Operation Of Stage Research Articles

Clinical analysis of 5-year survival and recurrence in giant retroperitoneal liposarcoma after surgery.

Clinical analysis of 5-year survival and recurrence in giant retroperitoneal liposarcoma after surgery.

Comparative Study of Pre-operative, Operative, and Post-operative Parameters of Single and Staged Bilateral Total Hip Replacement

Objectives Total Hip replacement (THR) is now emerging as the most successful surgery that can drastically improve the quality of life of an arthritis patient. Bilateral (B/L) hip involvement is seen in many cases where there is a treatment option of operation on both hips in a single operation under single anesthesia or a staged operation. The present study aims to compare the pre-operative, operative, and post-operative parameters of single operation Bilateral Total Hip Replacement (B/L THR) and staged B/L THR (two operations in stages; second operation done after 6–7 days). Material and Methods 97 B/L THR cases were included in a retrospective cohort study operated Delete conducted 2017–2021 under a single surgeon in a tertiary care hospital. The age, sex, and Body Mass Index (BMI) - matched cases were divided into Group 1-single B/L THR and Group 2-staged B/L THR. The patients were assessed on blood loss during surgery and post-surgery up to 24 h, time to reach visual pain analog score of baseline 3, pre and post-operative Harris Hip score, post-operative hemoglobin (Hb) level, infection, dislocation, deep vein thrombosis and duration of hospital stay. Results Thirty-seven cases of Group 1 Single B/L THR and 60 cases of Group 2-Staged B/L THR were analyzed. The time taken for pain to decrease was more in Single B/L THR which was statistically significant. Even though the intra-operative and post operative blood loss was not statistically significant, still more number of cases showed greater blood loss in Staged B/L THR. The pre-operative and post-operative hip functionality outcome was statistically same in both groups. Complications like deep vein thrombosis (DVT) showed lower incidence in Single B/L THR; and equal incidence of infection in both groups. The duration of hospital stay was more in Staged B/L THR. The statistical significance of longer duration of pain in Staged B/L THR can be explained on basis of two injuries inflicted by two operations 6–7 days apart. Harris Hip score for assessing hip functionality did not show statistical significance indicating that both single and staged show similar improvement of hip function. Lower incidence of DVT in Staged B/L THR can be attributed to early mobilization and physiotherapy. Conclusion On the basis of the above study, we conclude that Single B/L THR is feasible, safe and cost-effective with similar functional outcomes and early return to the society. Therefore, it should be encouraged in tertiary care hospitals.

Primary squamous cell carcinoma of the ovary accompanied by transition of a mucinous borderline ovarian tumor

This report describes a woman with a rare primary squamous cell carcinoma of the ovary accompanied by transition of a mucinous borderline ovarian tumor. A woman in her late 40s was referred for abdominal discomfort, which worsened during defecation. Pelvic magnetic resonance imaging showed a multiloculated cystic lesion in the left adnexa measuring approximately 7.5 × 9.5 × 7.0 cm. An intraoperatively obtained frozen biopsy sample of the mass in the left ovary was positive for malignancy, resulting in a surgical staging operation. The tumor was composed of squamous cell carcinoma and mucinous borderline tumor. There was no evidence of capsular invasion or invasion of other internal organs, including pelvic and para-aortic lymph nodes (0/41). Immunohistochemistry showed that the tumor was diffusely positive for cytokeratin 7, cytokeratin 20, Ki-67, and P40 but negative for P16. After a debulking operation, the patient has been monitored regularly without adjuvant therapy owing to final surgical staging of the tumor as stage IA.

Signal Processing with Machine Learning for Context Awareness in 5G Communication Technology

To meet users’ expectations for speed and reliability, 5th Generation (5G) networks and other forms of mobile communication of the future will need to be highly efficient, flexible, and nimble. Because of the expected density and complexity of 5G networks, sophisticated network control across all layers is essential. In this context, self-organizing network (SON) is among the essential solutions for managing the next generation of mobile communication networks. Self-optimization, self-configuration, and self-healing (SH) are typical SON functions. This research creates a framework for analyzing SH by exploring the impact of recovery measures taken in precarious stages of health. For this reason, our suggested architecture takes into account both detection and compensating operations. The system is broken down into some faulty states and the “fuzzy c-means” (FCM) approach is used to conduct the classifying. In the compensation process, the network is characterized as the Markov decision model (MDM), and the linear programming (LP) technique is implemented to find the most effective strategy for reaching a goal. Numerical findings acquired from a variety of situations with varying objectives show that the suggested method with optimized operations in the compensation stage exceeds the approach with randomly chosen actions.

Effect of Training Program on Midwife's Knowledge and Practice Regarding Evidence Based Practice for Active Management of Third Stage of Labor in Al Tahreer Maternity Hospital in Gaza strip, Palestine.

The third stage of labor is considered to be the most dangerous stage for the bearing woman due to the threat of bleeding. Midwife is frontline to give care, by using active operation of third stage of labor which as evidence based technique. This study was aimed to evaluate the effect of training program on midwives’ knowledge and practice regarding evidence based practice of active management of third stage of labor in Al Tahreer maternity hospital. This study was aimed to estimate the effect of training program on midwives ’ knowledge and practice regarding evidence based practice of active operation of third stage of labor in Al Tahreer maternity hospital. Keywords: Midwife, Knowledge, practice, Evidence, Active management, Third stage.

Impact of Retinal Vessel Image Coherence on Retinal Blood Vessel Segmentation

Retinal vessel segmentation is critical in detecting retinal blood vessels for a variety of eye disorders, and a consistent computerized method is required for automatic eye disorder screening. Many methods of retinal blood vessel segmentation are implemented, but these methods only yielded accuracy and lack of good sensitivity due to the coherence of retinal blood vessel segmentation. Another main factor of low sensitivity is the proper technique to handle the low-varying contrast problem. In this study, we proposed a five-step technique for assessing the impact of retinal blood vessel coherence on retinal blood vessel segmentation. The proposed technique for retinal blood vessels involved four steps and is known as the preprocessing module. These four stages of the pre-processing module handle the retinal image process in the first stage, uneven illumination and noise issues using morphological operations in the second stage, and image conversion to grayscale using principal component analysis (PCA) in the third step. The fourth step is the main step of contributing to the coherence of retinal blood vessels using anisotropic diffusion filtering and testing their different schemes and get a better coherent image on the optimized anisotropic diffusion filtering. The last step included double thresholds with morphological image reconstruction techniques to produce a segmented image of the vessel. The performances of the proposed method are validated on the publicly available database named DRIVE and STARE. Sensitivity values of 0.811 and 0.821 on STARE and DRIVE respectively meet and surpass other existing methods, and comparable accuracy values of 0.961 and 0.954 on STARE and DRIVE databases to existing methods. This proposed new method for retinal blood vessel segmentations can help medical experts diagnose eye disease and recommend treatment in a timely manner.

Improved Progression-Free Survival Associated with Tumor-Infiltrating Lymphocytes in High-Grade Endometrial Cancer.

Tumor-infiltrating lymphocytes (TILs) have emerged as a prognostic marker in endometrial cancer (EC). However, the role of TILs in EC with distinct histology grades and molecular types (such as mismatch repair [MMR] deficiency) has not yet been made clear. We retrospectively included 237 patients with primary EC who underwent a standard staging operation of laparoscopic or laparotomy total hysterectomy and bilateral salpingo-oophorectomy for analyses. An independent pathologist who was blind to the study patients' information reviewed the pathologic slides to assess TILs according to the method introduced by the International Immuno-Oncology Biomarkers Working Group in 2017. The outcomes of interest included both progression-free survival (PFS) and overall survival (OS). The Kaplan-Meier method was used to determine the curves of PFS and OS according to TILs, and also in the relevant subgroups (low-grade vs. high-grade, MMR-proficient vs. MMR-deficient). After a median follow-up duration of 1.82 years, 18 patients had experienced either disease progression or death. Overall, TILs (+) were not associated with PFS or OS. We did observe, however, that TILs (+) were associated with a better PFS (p = 0.045) in patients with high-grade EC, but not in those with low-grade tumors (p = 0.733). The effect of TILs on PFS was not observed in patients with MMR-proficient (p = 0.347) or MMR-deficient (p = 0.168) EC. TILs were associated with a better PFS in patients with high-grade EC. Our results suggest that TILs may be a potential prognostic marker in these patients.

A reasoning diagram based method for fault diagnosis of railway point system

Railway Point System (RPS) is an important infrastructure in railway industry and its faults may have significant impacts on the safety and efficiency of train operations. For the fault diagnosis of RPS, most existing methods assume that sufficient samples of each failure mode are available, which may be unrealistic, especially for those modes of low occurrence frequency but with high risk. To address this issue, this work proposes a novel fault diagnosis method that only requires the power signals generated under normal RPS operations in the training stage. Specifically, the failure modes of RPS are distinguished through constructing a reasoning diagram, whose nodes are either binary logic problems or those that can be decomposed into the problems of the binary logic. Then, an unsupervised method for the signal segmentation and a fault detection method are combined to make decisions for each binary logic problem. Based on the results of decisions, the diagnostic rules are established to identify the failure modes. Finally, the data collected from multiple real-world RPSs are used for validation and the results demonstrate that the proposed method outperforms the benchmark in identifying the faults of RPSs.

THE PECULIARITIES OF OPTIMAL GROUPAGE CARGO ARRANGEMENT IN A SEMITRAILER ALGORITHM

This article dwells upon the peculiarities of optimal groupage cargo arrangement in a semitrailer algorithm. Nowadays it is quite important to optimize logistics processes due to high demand of this kind of service. The author describes a developing and designing process of special application that automatically arranges cargos in a semitrailer. The text gives valuable information referred to a semitrailer structure and logistics. It is spoken in detail about eight steps explaining the whole process of development. Much attention is given to one particular step explaining application operation in stages. Such an application is rather user friendly, so any logistics manager can use it without instructions. The solution is applicable to real use case with some final improvements towards compatibility with other systems and also this solution helps in speeding up some workflows in logistics services, so some funds can be saved. The exact amount of savings can differ from company to company due to individual internal structure. Summing up the results, it can be concluded that the solution is rather multipurpose, in other terms it can be applicable to multiple companies with some refinements due to specific company's requests.

Disgerminom u trudnoći - prikaz slučaja

Introduction: Malignant germ cell tumors (MGCTs), as a subtype of rare non-epithelial ovarian cancers (NOEC), are most commonly found in pregnancy. Of all MGCTs, 38% are dysgerminoma. Considering the rarity of these entities, the aim of this paper is to show a rare case of ovarian dysgerminoma presented in pregnancy and its influence on course and outcome of the pregnancy. Patient Review: Patient aged 26, gravida 2, para 1, with one vaginal delivery five years before, was admitted to the Clinic for Gynecology and obstetrics in term pregnancy because of uterine contractions accompanied by left thigh pain and tingling sensation in the left leg. Solid hypoechogenic mass with regular borders, 125x90 mm in diameter adjacent to the left side of the uterus was seen by ultrasound, without free fluid in pelvic cavity. Since regular uterine contractions started, the decision was made to terminate pregnancy by Caesarean section (CS) because of tumor previa. Histopathological examination confirmed ovarian dysgerminoma, but after staging operation which was performed two months after CS, following imaging diagnostics, ovarian dysgerminoma was confirmed with FIGO stage IA, meaning that patient's specific oncological treatment was finished. Conclusion: Diagnosis of ovarian dysgerminoma is in general challenging since up to 50% are asymptomatic or symptoms are non-specific. The management of ovarian cancer in pregnancy should be multidisciplinary and individualized in the best interest of the mother and the fetus. The overall five-year survival rate for ovarian dysgerminoma is favorable in more than 90% of cases. Women diagnosed with dysgerminoma in pregnancy are young and in general have good feto-maternal outcome.

НОВЫЕ МЕТОДОЛОГИЧЕСКИЕ ПОДХОДЫ К РАСЧЕТУ СКВОЗНОЙ СЕБЕСТОИМОСТИ КЛАСТЕРА В ЕДИНОМ ТЕХНОЛОГИЧЕСКОМ ПРОЦЕССЕ

Within the framework of the law on industrial policy of the Russian Federation, economic entities to which the state potentially guarantees financial support are identified. One of these entities is an industrial cluster. The authors of this article believe that the sign of territorial proximity, as well as the geographical location of the cluster entities specified in the law, are not essential features of this concept. The key features that distinguish a cluster from any other set of legal entities are their technological dependence on each other and the presence of a single control center. The cluster can produce products for both civil and defense purposes. The fundamental economic indicators of the state defense order are its price and cost. To correctly calculate the cost of a state defense order, it is necessary to distinguish fixed and variable costs as part of the cost; for this, the authors have introduced definitions of the end-to-end cost of a cluster and the intermediate product of a cluster. Methodological principles for the formation of the end-to-end cost of a cluster are proposed, subject to the consumption of the intermediate product of the cluster in the technological and servicing operation of the next stage. Formulas for calculating the cost of a cluster are given. The combination of these formulas and methodological principles for the formation of the end-to-end cost of a cluster is a new method of calculating the cost - cluster-costing, which will make it possible to more accurately formulate the cost of state defense orders and make calculations between the state and contractors more fair.

An Automatic Threshold Selection Using ALO for Healthcare Duplicate Record Detection with Reciprocal Neuro-Fuzzy Inference System

ESystems based on EHRs (Electronic health records) have been in use for many years and their amplified realizations have been felt recently. They still have been pioneering collections of massive volumes of health data. Duplicate detections involve discovering records referring to the same practical components, indicating tasks, which are generally dependent on several input parameters that experts yield. Record linkage specifies the issue of finding identical records across various data sources. The similarity existing between two records is characterized based on domain-based similarity functions over different features. De-duplication of one dataset or the linkage of multiple data sets has become a highly significant operation in the data processing stages of different data mining programmes. The objective is to match all the records associated with the same entity. Various measures have been in use for representing the quality and complexity about data linkage algorithms, and many other novel metrics have been introduced. An outline of the problem existing in the measurement of data linkage and de-duplication quality and complexity is presented. This article focuses on the reprocessing of health data that is horizontally divided among data custodians, with the purpose of custodians giving similar features to sets of patients. The first step in this technique is about an automatic selection of training examples with superior quality from the compared record pairs and the second step involves training the reciprocal neuro-fuzzy inference system (RANFIS) classifier. Using the Optimal Threshold classifier, it is presumed that there is information about the original match status for all compared record pairs (i.e., Ant Lion Optimization), and therefore an optimal threshold can be computed based on the respective RANFIS. Febrl, Clinical Decision (CD), and Cork Open Research Archive (CORA) data repository help analyze the proposed method with evaluated benchmarks with current techniques.

Retracted: Application of Laparoscopy in Comprehensive Staging Operation of Ovarian Cancer Based on Electronic Medical Blockchain Technology.

[This retracts the article DOI: 10.1155/2021/6649640.].

Intelligentization of wheel loader shoveling system based on multi-source data acquisition

To effectively reduce the operation intensity of drivers, it is essential to research the intelligent operation for various stages of loaders. The traditional operation mode of the loader requires the driver to manually complete the high repeatability and frequency operation of various stages, which makes the energy-saving characteristics of the loader particularly affected by the driver. Hence, this paper proposes intelligent operation methods for various stages of loaders based on the extraction and analysis of multi-sourced data characteristics of the experiment. Specifically, the automatic adjustment of the working device attitude in the shoveling stage is achieved. During the loading and unloading stages, the working device can be automatically lifted to the memorized angle, and the bucket can also be automatically leveled. The intelligent operation method solves the problem that the loader requires the driver to work with high intensity for various stages and improves the economic aspects.

Minimisation of Construction Waste Using the Principles of Waste Management

Construction waste especially material waste is one major concern for the construction projects and has important implications in terms of socioeconomic and environmental aspects for the country. Construction industry being largest consumer of raw materials derived from natural resources also produces high amount of material waste that negatively impacts the environment. The building industry alone in Malaysia has reportedly generated approximately 25,600 tonnes of construction and demolition wastes daily due to rapid development. Therefore, any means of reducing material waste will not only result in significant cost savings within the projects but also reducing the pressure on the landfills and ease environmental concerns dealing with such waste conversion and recycling; and reduction. This study examines the causes and prevention of material waste in the construction specifically the building industry through the principles of waste management available. Questionnaires survey is the main tool deployed for data collection. The average and relative index were used to analyse the various aspects of the data collected. Stages of works used for the study include the material handling and storage stage; procurement of material stage; usage and operation of the material stage; and the design and documentation stage. The results indicate that respondents are aware of the concept of waste management but lack of awareness on the availability of such guidelines. It is hopeful that this study can improve on waste management implementation in order to uptake the principle of reduce, recycle and reuse material waste so as to reduce construction costs, provide good savings to the end users and improve the level of productivity of the nation.

Volume–Outcome Relationship in Cancer Survival Rates: Analysis of a Regional Population-Based Cancer Registry in Japan

There is limited data on the relationship between hospital volumes and outcomes with respect to cancer survival in Japan. The primary objective of this study was to evaluate the effect of hospital volume on cancer survival rate using a population-based cohort database. Using the Kanagawa cancer registry, propensity score matching was employed to create a dataset for each cancer type by selecting 1:1 matches for cases from high- and other-volume hospitals. The 5-year survival rate was estimated and the hazard ratio (HR) for hospital volume was calculated using a Cox proportional hazard model. Additional analyses were performed limited to cancer patients who underwent surgical operation, chemotherapy, and other treatments in each tumor stage and at the time of diagnosis. The number of cases with complete data, defined as common cancers (prostate, kidney, bladder, esophagus, stomach, liver, pancreas, colon, breast, and lung), was 181,039. Adjusted HR differed significantly among hospital volume categories for the most common cancers except bladder, and the trends varied according to cancer type. The HR ranged from 0.76 (95%CI, 0.74-0.79) for stomach cancer to 0.85 (0.81-0.90) for colon cancer. This study revealed that a relationship may exist between hospital volume and cancer survival in Japan.

LET’S PLAY TOGETHER: INTERGENERATIONAL EDUCATION BY CO-DESIGN ESCAPE GAME WITH OLDER ADULTS

Abstract People always think that the older adults are only suitable for participating in activities and games suitable for older adults, and cannot complete games with young people, such as escape game. However, if we can understand the characteristics and needs of the elderly, we find that the older adults still have mobility and vitality to participate in games with young people. Through the intergenerational learning of university’s students and the older adults, we use design thinking and PDCA as class frameworks, and let two groups can jointly together to design escape game for the older adults. During the planning stage, the survey and interview of older adults, game design training; the practical operation in the implementation stage; the team discussion and correction in the reflection stage; and the sharing with older adults in the re-action stage (celebration). As a result, these processes allow students and older adults to communicate and share life experiences and wisdom. In one hand, students have a better understanding and concerns about older adults, and they find that the older adults also have vitality and enthusiasm; on the other hand, older adults also more understand the life of students, and feel the creativity and investment of students. In other words, both groups have changed their cognition to each other, and discovered the possibility of mutual cooperation and communication.

Mathematical simulation and experimental verification of a novel control strategy for a single stage PN/A (partial nitrification/Anammox) SBR (sequencing batch reactor)

The single reactor PN-A process offers a cost-effective solution for nitrogen removal. The successful startup and operation of the PN/A reactor requires the enrichment and balanced growth of AOB (Ammonium oxidizing bacteria) and AMX (AMAMMOX bacteria). The precise aeration supply or DO (dissolved oxygen) control was regarded to be the key for successful operation of the PN/A reactor. However, due to the low DO concentration requirement for the PN/A reactor, it is not practical to apply the precise aeration or DO concentration control. In this study, a new control strategy for the rapid startup and operation of the single stage PN/A (partial nitrification) SBR (sequencing batch reactor) was put forward. The control strategy relies on the periodic measurement of effluent NH4+, NO2-, and NO3- concentration to determine the nitrogen loading rate and aeration pump speed (i.e., not exact air supply volume). It does not require precise oxygen supply or DO (dissolved oxygen) control. This feature makes the control strategy easily applicable for practical application. A calibrated mathematical model was used to evaluate the control strategy, which was shown to be effective in achieving satisfactory nitrogen removal and NOB suppression. The control strategy was tested in a lab PN/A batch reactor, in which TN removal efficiency of 80% was achieved under low influent NH4+ concentration of 100 mg N/L and nitrogen loading rate of 0.12 Kg N/(m3•d) within 60 days of the experiment.

Analytical model of deformation of reinforced concrete columns based on fracture mechanics

When conducting seismic calculations of reinforced concrete buildings and structures, it is quite important to use nonlinear models of structural performance, including those taking into account the overcritical operation in the fracture stage. The application of such models is especially important if the structures have an initial damage from fire or corrosion, as well as mechanical damage caused by force factors. The purpose of this study is to develop an analytical model of the deformation of eccentrically compressed reinforced concrete columns considering the stage of failure, which includes such processes as spelling of the protective layer, loss of stability of compressed reinforcement, and softening of confined concrete after reaching the design resistance. The existing models describing hysteresis behavior of reinforced concrete structures under low-cycle loading have been reviewed. The models have been analyzed in terms of considering the defining monotone curves, which are the boundaries of cyclic deformation. The model proposed in the research is constructed by analyzing the stages of the stress-strain state of a reinforced concrete column. At each stage, formulas are found for determining moment and curvature by solving equations of equilibrium of internal forces. Calculations based on the obtained model for a particular reinforced concrete column are carried out, monotonous diagrams are obtained, and a conclusion about the significant influence of the level of axial load on the character of deformation is made. On the basis of the obtained model, the construction of hysteresis diagrams under low-cycle loading is expected in the future.

Blade Drag Resistance in Windage Operating of Low Pressure Steam Turbines

On the basis of previous experimental and numerical studies, the windage operation of low-pressure turbine rear stage is investigated. The state of the steam within the rotor channel was correlated to measurements carried out downstream of the blades for different ventilation regimes. Considering very-low-volume flow conditions, the ventilation power was related to the drag force acting on the moving blades. A correlation was identified between the drag coefficient and a Reynolds number relative to the reverse flow height. This correlation can be used in order to predict the power loss of a last-stage moving blade operating at low load.