Reduce Recovery Time Research Articles

The Sensing Mechanism of PdNPs-Decorated Silicon Nanobelt Devices for H2 Sensing at Room Temperature

This study reports the sensing mechanism of Pd nanoparticles (PdNPs) decorated n+/n-/n+ double-junction silicon nanobelt (SNB) device as hydrogen (H <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) gas sensor. The SNB devices are prepared via CMOS process. Plasma-enhanced atomic layer deposition (PEALD) is adopted for PdNPs deposition as sensing material on the Al <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> O <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">3</sub> dielectric of SNB devices. The PdNPs-decorated SNB devices working at room temperature are characterized at H <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> concentration ranging from 10 to 1000 ppm. Instead of using the traditional steady-state response, the slope of response is presented to estimate concentration and shorten the response time. More than 60% improvement in response time has been achieved for 10 to 1000 ppm H <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> detection. To reduce recovery time, device localized Joule heating (DLJH) with a bias of 11 V for 240 s is demonstrated to restore the device back to the baseline. At a bias of 1 V, H <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> sensing at room temperature consumes only 68.39 μW.

Mechanism of Recovery Performance Improvement With Porous-Stabilized REBCO Tape for Resistive-Type Superconducting Fault Current Limiters

Resistive-type superconducting fault current limiters (R-SFCLs) utilizing rare-earth barium copper oxide (REBCO) tapes have been developed to limit fault currents. To balance recovery and current-limiting performances, a porous-stabilized REBCO tape was proposed. The experimental results showed that using a porous stabilizer with the REBCO tape and insulating epoxy reduced recovery time to 25%. However, the underlying mechanisms of this improvement in recovery performance are not yet clear. The aim of the present study is to understand these mechanisms. To do so, a vapor-film-collapse model was proposed to clarify the impact of the insulating epoxy on vapor film collapse. This model suggests that when liquid nitrogen (LN <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) comes into contact with the insulating epoxy, it causes a rapid decrease in the temperature of the insulating epoxy surface, leading to the collapse of the vapor film. Additionally, a liquid-retention model was proposed to investigate the effect of the porous stabilizer. This model indicates that if the porous stabilizer can retain LN <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> , the equivalent heat flux observed in experiments can be achieved through evaporation of the retained LN <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> .

A Randomized Controlled Study on the Timing of Furosemide for Reducing Operative Hysteroscopy Intravascular Absorption Syndrome (OHIAS) during Hysteroscopic Leiomyoma Surgery

Background: The purpose of this study was to compare the effect of pre- and post-treatment furosemide on reducing intravascular absorption syndrome in complex hysteroscopic leiomyoma surgery. Methods: This randomized controlled study enrolled 62 patients who underwent hysteroscopic leiomyoma surgery in Fuxing Hospital, Capital Medical University. Patients were randomly allocated to pre- and post-treatment furosemide groups. Information on patient age, body mass index, sum of the three diameters of the uterus, sum of diameter of submucosal myoma, and intimal thickness were recorded. The mean arterial pressure and heart rate were recorded at entry to the operating room, after anesthesia induction, at the end of operation, and after laryngeal mask pulled out. The duration of anesthesia, recovery time after withdrawal of anesthetic drug, amount of sufentanil, amount of propofol, amount of uterine perfusion fluid, the amount of perfusion fluid flowing out, the actual amount of fluid intake, the proportion of pulmonary diffuse B-line in perioperative period, and uterine perfusion pressure during operation were also recorded, together with postoperative adverse reactions (drowsiness, nausea, vomiting, chills). Results: No significant differences were observed between the pre- and post-treatment groups in terms of patient age, body mass index, sum of the three diameters of the uterus, sum of diameter of submucosal myoma, and intimal thickness. The mean arterial pressure and heart rate at the four different time points were not significantly different between the two groups, nor were there any significant differences in the duration of anesthesia, the amount of sufentanil, the amount of propofol, the amount of intrauterine perfusion fluid, the amount of perfusion fluid flowing out, the actual amount of fluid intake, the intrauterine perfusion pressure, or the incidence of postoperative drowsiness, nausea and vomiting. However, pre-treatment with furosemide was associated with a significantly reduced recovery time (p = 0.037) and incidence of postoperative chills (p = 0.032) compared to the post-treatment group. Furosemide significantly reduces the number of B-lines. Conclusions: Furosemide preconditioning can reduce the recovery time and occurrence of postoperative chills, both of which are conducive to better postoperative recovery. Clinical Trial Registration: The study was registered at https://www.chictr.org.cn (registration number ChiCTR2200062840).

Neural network based patient recovery estimation of a PAM-based rehabilitation robot

Rehabilitation robots have shown a promise in aiding patient recovery by supporting them in repetitive, systematic training sessions. A critical factor in the success of such training is the patient’s recovery progress, which can guide suitable treatment plans and reduce recovery time. In this study, a neural network-based approach is proposed to estimate the patient’s recovery, which can aid in the development of an assist-as-needed training strategy for the gait training system. Experimental results show that the proposed method can accurately estimate the external torques generated by the patient to determine their recovery. The estimated patient recovery is used for an impedance control of a 2-DOF robotic orthosis powered by pneumatic artificial muscles, which improves the robot joint compliance coefficients and makes the patient more comfortable and confident during rehabilitation exercises.

Lines of Efforts in Order to Improve the Military Supply Chains Performance in Military Operations

Abstract Supply chain resilience plays a critical role in maintaining operational readiness and effectiveness in military operations. However, the unique challenges faced by military supply chains necessitate tailored approaches to enhance resilience. This paper presents a comprehensive framework for optimizing supply chain resilience in military operations. The proposed framework incorporates key elements such as risk assessment, contingency planning, information sharing, and resource allocation. It leverages advanced analytics techniques, including simulation modeling, optimization algorithms, and real-time data integration, to support decision-making and improve resilience. Results demonstrate that the optimized supply chain resilience strategy significantly enhances the military's ability to respond to disruptions, reduce recovery time, and minimize operational downtime. Moreover, the framework identifies critical vulnerabilities and recommends proactive measures to enhance system robustness. By adopting this framework, military organizations can better prepare for and respond to a wide range of supply chain disruptions, ultimately improving operational efficiency and mission success. The findings of this study contribute to the emerging field of military logistics by providing a systematic approach to optimize supply chain resilience and offering valuable insights for military decision-makers.

Transoral incisionless fundoplication and open hiatal hernia repair: A case report

IntroductionTransoral incisionless fundoplication is a new procedure that has recently emerged as a potential alternative to traditional anti-reflux surgeries. It is a less invasive option with fewer complications and reduced recovery time. Hiatal hernia repair is also commonly performed in conjunction with transoral incisionless fundoplication to improve outcomes. In this case, it details a successful transoral incisionless fundoplication and hiatal hernia repair procedure in a patient with long standing gastroesophageal reflux disease (GERD). The case is unique as it involved a patient with an uncharacteristically large hiatal hernia measuring above 5cm, which is a size that is generally not considered suitable for transoral incisionless fundoplication. The hiatal hernia was repaired with a gastrectomy instead of laparoscopically due to the size and adhesions present.Case detailsThis case report presents an 86 year old female patient with a history of long-standing GERD symptoms from the past 10 years who had failed to respond to medical therapy. Endoscopic imaging revealed a hernia of more than 5cm in size, which was confirmed by a bravo study. A DeMeester score of 446 was reported. The patient was referred for surgery and underwent transoral incisionless fundoplication with hiatal hernia repair. Despite the large size of the hiatal hernia, it was decided to proceed with a transoral incisionless fundoplication (TIF) procedure combined with hiatal hernia repair. The gastrectomy was chosen due to significant adhesions and anatomical distortion, making it difficult to continue laparoscopically. The esophagus was fibrosed to the pericardium, and the stomach was stuck in a retrocardiac position. Laparoscopic removal of the adhesions proved difficult since the patient had friable tissues, and there was a high risk of injury to surrounding organs. The surgery was therefore converted to an open approach, and the hernia was repaired with a gastrectomy. The TIF procedure was performed successfully, and the patient had no complications postoperatively.ConclusionThis case details a successful transoral incisionless fundoplication procedure for GERD in a patient with an uncharacteristically large hiatal hernia. Despite the challenges posed by the hernia’s size and anatomical distortion, the TIF procedure combined with hiatal hernia repair was successful in providing relief from GERD symptoms, with no postoperative complications. The case highlights the potential suitability of TIF as an alternative to laparoscopic fundoplication in patients with large hiatal hernias, although gastrectomy may be necessary in cases with significant adhesions or anatomical distortion.

The 2018 west-central European drought projected in a warmer climate: how much drier can it get?

Abstract. Projections of changes in extreme droughts under future climate conditions are associated with large uncertainties, owing to the complex genesis of droughts and large model uncertainty in the atmospheric dynamics. In this study we investigate the impact of global warming on soil moisture drought severity in west-central Europe by employing pseudo global warming (PGW) experiments, which project the 1980–2020 period in a globally warmer world. The future analogues of present-day drought episodes allow for investigation of changes in drought severity conditional on the historic day-to-day evolution of the atmospheric circulation. The 2018 west-central European drought is the most severe drought in the 1980–2020 reference period in this region. Under 1.5, 2 and 3 ∘C global warming, this drought episode experiences strongly enhanced summer temperatures but a fairly modest soil moisture drying response compared to the change in climatology. This is primarily because evaporation is already strongly moisture-constrained during present-day conditions, limiting the increase in evaporation and thus the modulation of the temperature response under PGW. Increasing precipitation in winter, spring and autumn limits or prevents an earlier drought onset and duration. Nevertheless, the drought severity, defined as the cumulative soil moisture deficit volume, increases considerably, with 20 % to 39 % under 2 ∘C warming. The extreme drought frequency in the 1980–2020 period strongly increases under 2 ∘C warming. Several years without noticeable droughts under present-day conditions show very strong drying and warming. This results in an increase in 2003-like drought occurrences, compounding with local summer temperature increases considerably above 2 ∘C. Even without taking into account a (potentially large) dynamical response to climate change, drought risk in west-central Europe is strongly enhanced under global warming. Owing to increases in drought frequency, severity and compounding heat, a reduction in recovery times between drought episodes is expected to occur. Our physical climate storyline provides evidence complementing conventional large-ensemble approaches and is intended to contribute to the formulation of effective adaptation strategies.

Au modified Nd-doped In2O3 hollow microspheres for high performance triethylamine gas sensor

The Au-modified Nd-doped In2O3 hollow microspheres were prepared by hydrothermal method as well as UV irradiation reduction. Their microstructure and phase structure were characterized by SEM, TEM and XRD. The effect of Nd3+ doping and Au loading were discussed based on the results of XPS, UV–vis, BET. The gas-sensitive measurement reveal the In2O3 loaded with 2 wt% Au and doped with 3 mol% Nd3+ (2 wt% Au/3 mol% Nd–In2O3) exhibited the optimal sensing performance among Au-modified Nd-doped In2O3 nanocomposites. Compared with unmodified In2O3, its sensing properties are improved. The response to 100 ppm triethylamine is 61, 4 times of pure In2O3, along with improved selectivity, declined optimum operation temperature, reduced recovery time and good stability. Using Nd–In2O3 and Au/In2O3 as control samples, the synergetic roles of Nd doping and Au loading in sensing process were discussed. By the cooperation of Nd and Au, more oxygen vacancies, raised electric resistance and increased specific surface area are triggered, which improve the gas-sensitive performance of the sensor. The excellent sensing performance of Au-modified Nd-doped In2O3 nanocomposites makes it a potential sensing material for triethylamine detection.

Model-based observer for vehicle proton exchange membrane fuel cell humidity based on adaptive sliding mode estimation technique

Real-time humidity acquisition for vehicle proton exchange membrane fuel cell (PEMFC) facilitates humidity control to avoid membrane flooding or drying, improving its efficiency and stability. However, due to the frequent changes of actual vehicle conditions and expensive as well as unreliable humidity sensors, it is difficult to obtain real-time water content in PEMFC, which brings obstacles to closed-loop control of humidity. To this end, a model-based observer is proposed to obtain real-time humidity. Specifically, a dimensionless third-order model of relative humidity for PEMFC was established, which includes the dynamic of membrane water content. Based on the proposed model, an adaptive sliding mode convergence algorithm was designed to approach real-time humidity using measurable signals (voltage, current, pressure, flow rate, and temperature). The exploration of proposed adaptive sliding mode observer (ASMO) performance was compared with non-adaptive sliding mode observer (SMO) and classical ASMO by using a real 80 kW commercial fuel system experimental data. The experimental results show that compared with second-order humidity model, proposed third-order humidity model reduced recovery time under small step condition, where 250 s for cathode humidity estimation and 200 s for anode humidity estimation. In addition, under the small step condition, the average error of the three observers was less than 3%, which is accurate for engineering application. Moreover, proposed ASMO had the minimum static error, with 4% for cathode humidity estimation and 9% for anode humidity estimation under large step conditions as well as MAE, MSE, RMSE with 4%, 1.90%, 4.39% for cathode relative humidity estimation, 8.19%, 0.89%, 9.44% for anode relative humidity estimation respectively. The comprehensive results indicate that the proposed ASMO with adaptive parameters tuning has better dynamic performance than non-adaptive SMO as well as classical ASMO in terms of robustness and estimated accuracy.

Concurrent daytime and nighttime heatwaves in the late 21st century over the CORDEX‐East Asia phase 2 domain using multi‐GCM and multi‐RCM chains

AbstractThe adverse impacts of extreme heat on human health when a concurrent daytime and nighttime heatwave (CDNHW) occurs are greater than when daytime or nighttime heatwaves occur individually, because of the reduced recovery time from heat exposure. This study projects increases in CDNHW over the whole of East Asia under two Representative Concentration Pathway scenarios (RCP2.6 and RCP8.5) and two Shared Socioeconomic Pathway scenarios (SSP1‐2.6 and SSP5‐8.5). The daily maximum and minimum temperatures, which are used to define a CDNHW, are calculated of 3‐hourly temperatures of 25 km horizontal resolution produced by 12 general circulation model and regional climate model chains participating in the Coordinated Regional Climate Downscaling Experiment East Asia phase 2 project. In Historical simulation (1981–2005), occurrence period and occurrence rate of CDNHW from April to September area‐averaged in East Asia are 10.9 days and 0.9%, respectively. In projections for the future (2071–2100), occurrence period and occurrence rate of CDNHW will be 3 weeks and 3.7% (RCP2.6), 2 months and 20.5% (RCP8.5), 2 months and 15.6% (SSP1‐2.6), and 3 months and 45.7% (SSP5‐8.5). In addition, it is expected that the CDNHW intensity will increase, and the spatial extent of CDNHW will be extended. Although a CDNHW lasting less than 3 days is the most common, the proportion of CDNHWs lasting more than 10 days, compared to the total CDNHW frequency, will increase to 1.2% (RCP2.6), 7.2% (RCP8.5), 6.1% (SSP1‐2.6), and 17.3% (SSP5‐8.5) from 0.2% (Historical). Both occurrence rate and intensity of CDNHW will increase to a relatively large extent in Indochina, East and West China, and India. If the current greenhouse gas emissions continue, East Asia will experience unprecedented heat stress because the frequency and intensity of CDNHWs, which rarely occur during present‐day, will increase significantly over all regions by the end of the 21st century.

A Comparative Study of Post-Operative Outcomes for Off-Pump and On-Pump Coronary Artery Bypass Grafting

Introduction: Coronary artery bypass grafting (CABG) is a common surgical procedure for the management of coronary artery disease. Off-pump (OPCAB) and on-pump (ONCAB) CABG have been compared in various studies, but limited data exists for the Bangladeshi population. The present study was conducted to shed further light on the topic relative to the Bangladeshi demographic. Methods: This retrospective observational study conducted at the Department of Cardiac Surgery, National Institute of Cardiovascular Disease, Dhaka, Bangladesh, over a 1.5-year period from April 2019 to September 2020 compared the outcomes of OPCAB and ONCAB in a Bangladeshi population, analyzing the demographic and clinical characteristics, operative characteristics, early postoperative outcomes, and recovery parameters of 34 patients undergoing either OPCAB (n=17) or ONCAB (n=17). Result: The two groups were well-matched in terms of demographic and clinical characteristics, with no significant differences in age, gender, BMI, or comorbidities. The OPCAB group had a significantly shorter total operative time (180.4 ± 26.8 min vs. 195.3 ± 31.2 min, P &lt; 0.05). Early postoperative outcomes were similar between the two groups (P &gt; 0.05 for all comparisons), while the OPCAB group had a significantly shorter hospital stay (7.8 ± 1.8 days vs. 9.2 ± 2.1 days, P &lt; 0.05), mechanical ventilation time (9.1 ± 3.8 hours vs. 12.6 ± 4.5 hours, P &lt; 0.05), and time to ambulation (3.8 ± 0.9 days vs. 4.5 ± 1.0 days, P &lt; 0.05). Conclusion: Our study suggests that OPCAB may be a viable alternative to ONCAB for selected patients in the Bangladeshi population, offering potential benefits in terms of reduced recovery times and resource utilization. Further large-scale, randomized controlled trials are needed to confirm these findings and assess the long-term outcomes and cost-effectiveness of OPCAB compared to ONCAB.

Injury prevention strategies at the 2019 FIFA Women's World Cup display a multifactorial approach and highlight subjective wellness measurements

ObjectiveTo report the injury prevention programs utilised by top-level female footballers competing internationally. MethodsAn online survey was administered to physicians of the 24 competing national teams at the 2019 Federation Internationale de Football Association (FIFA) Women's World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies, and (4) reflection on their World Cup experience. ResultsFollowing responses from 54% of teams, the most common injuries encountered included muscle strains, ankle sprains, and anterior cruciate ligament ruptures. The study also revealed the most important injury risk factors during the FIFA 2019 World Cup. Intrinsic risk factors include accumulated fatigue, previous injury, and strength endurance. Extrinsic risk factors include reduced recovery time between matches, congested match schedule, and the number of club team matches played. The 5 most used tests for risk factors were flexibility, joint mobility, fitness, balance, and strength. Monitoring tools commonly used were subjective wellness, heart rate, minutes/matches played, and daily medical screening. Specific strategies to limit the risk of an anterior cruciate ligament injury included the FIFA 11+ program and proprioception training. ConclusionThe present study revealed multifactorial approaches to injury prevention strategies for women's national football teams at the FIFA 2019 World Cup. Challenges to injury prevention program implementation reflect time limitations, schedule uncertainties, and varying club team recommendations. Level of evidenceIV.

PO-01-090 ABLATION OF TYPICAL RIGHT ATRIAL FLUTTER THROUGH THE ARM: EVALUATION OF SAFETY, FEASIBILITY, AND EFFICACY – THE ARM AFLUTTER STUDY

Typical atrial flutter ablation (AFLA) has become a common procedure usually performed through the femoral vein. Case reports have described ablation via the arm which may allow for a safer procedure and reduced recovery time. We aimed to evaluate the safety, feasibility, and efficacy of AFLA via the Arm approach (AA) vs Femoral approach (FA). Patients were randomly assigned 1:1 to either FA or AA for EP study and AFLA. The primary endpoint was length of recovery time after the procedure. The secondary endpoints were success rates for achieving bidirectional block across the cavotricuspid isthmus, procedure complications, and recurrence rates of atrial flutter at 1 month follow-up. Outcomes with continuous variables were compared between groups using a Mann Whitney U test. Categorical outcomes were compared between groups using a chi-square analysis or Fisher’s exact test. Patients (N=16; aged 64.4±11.3yr; 81.3% Male) were randomized to either AA (n=7) or FA (n=9). There were no significant differences in baseline patient characteristics or medications at the time of ablation. With regard to the primary endpoint, recovery time was significantly less in AA (median, IQR=137.0, 27.0 min) compared to FA (median, IQR=265.0, 49.0 min; P=.004, U=4.00). Bidirectional block was achieved for all patients in both groups, however time to achieve bidirectional block was longer in AA (median, IQR=73.0, 65.0 min) compared to FA (median, IQR=37.0, 31.0 min; P=.026, U=10.50). There were no complications in either group, and there were no recurrences of atrial flutter at 1 month follow-up. In a small sample, AFLA from the arm was a feasible, safe approach with shorter recovery time to discharge without recurrence at 1 month. Achieving bidirectional block required more time in AA compared to FA likely due to operator learning curve, and lack of appropriately designed sheaths and catheters for use in the arm. Results from these data will be confirmed in a larger, adequately powered study with 6 and 12 month follow-up.

Research on Triode Based High Re-Frequency Ultrafast Electrical Pulse Generation Technology

The high-repeat frequency ultrafast electrical pulse generation technology is mainly based on ultrafast switching devices combined with ultrafast circuits to generate electrical pulses with repetition frequencies of several kilohertz and a rise-time of nanoseconds or even picoseconds. This technology is the basis for several research studies and is one of the key technologies that has received wide attention from various countries. The problems to be solved are high re-frequency ultrafast high-voltage pulse generation and ultra-broadband ultrafast pulse transport and circuit stability applicability, which include circuit conduction mechanism research, pulse generation time improvement and recovery time reduction. By studying the avalanche transistor high-voltage transient conduction characteristics and reducing the loss in the carrier transport process, the influence of each parameter on the output is determined, and the key factors to enhance the circuit performance are identified. This paper designs a new high-repetition frequency ultrafast electric pulse generation (UPG) circuit using pure electronics components, which consists of combining avalanche transistor model 2N2222 with a hybrid Marx structure at the same time in the pulse circuit to add filtering, fast recovery diodes and pulse cutoff and other matching techniques to make its output more stable, which can obtain higher output frequency, faster rise-time and narrower pulse widths. It has been tested that a high re-frequency ultrafast high-voltage electrical pulse signal with a pulse repetition frequency of 200 kHz, a leading edge of 800 ps, a half-high pulse width of 5 ns, an amplitude of 1.2 kV and jitter of less than 5% can be generated at the load with a 50 Ω load at the output. The signal can be applied in the fields of ultrafast diagnosis, information countermeasures and nuclear electromagnetic radiation research.

Adolescents With More Oculomotor and Vestibular Signs of Sport-Related Concussion Benefit from Aerobic Exercise: An Exploratory Analysis.

Abstract Early targeted heart rate (HR) aerobic exercise has been shown to reduce the duration of recovery from sport-related concussion (SRC) as well as the incidence of persistent post-concussive symptoms (PPCS). It is not known, however, if more severe oculomotor and vestibular presentations of SRC benefit from a prescription of aerobic exercise. The current study is an exploratory analysis of two published randomized controlled trials that compared aerobic exercise within 10 days of injury with a placebo-like stretching intervention. Combining the two studies yielded a larger sample size to stratify severity of concussion based on the number of abnormal physical examination signs present at the initial office evaluation, which were confirmed with self-reported symptoms and recovery outcomes. The most discriminant cut-off was between those who had ≤3 oculomotor and vestibular signs and those who had >3 signs. Aerobic exercise (hazard ratio = 0.621 [0.412, 0.936], p = 0.023) reduced recovery times even when controlling for site (hazard ratio = 0.461 [0.303, 0.701], p < 0.001), severity (hazard ratio = 0.528 [0.325, 0.858], p = 0.010) and the interaction term of intervention and severity (hazard ratio = 0.972 [0.495, 1.909], p = 0.935). Adolescents who presented with >3 signs and were assigned to the placebo-like stretching group had a PPCS incidence of 38%, which was the highest of all subgroups (aerobic exercise and ≤3 findings: 8%; stretching and ≤3 findings: 11%; aerobic exercise and >3 findings: 21%). This exploratory study provides pilot evidence that prescribed sub-symptom threshold aerobic exercise treatment early after SRC may be effective for adolescents with more oculomotor and vestibular physical examination signs and should be validated in future adequately powered trials.

Design of the Novel Single Incision, Free Motion Laparoscopic Surgical System

Abstract Laparoscopic surgery is a common minimally invasive surgery that uses specialized tools to access the abdominal cavity and pelvic regions via small incisions called ports. Compared to open surgery, laparoscopy's small incision size better protects a patient's health and reduces recovery time. However, restricted rotation of the tools around chosen port locations can limit a surgeon's mobility while operating. To address this, the novel single incision, free motion (SIFM) laparoscopic surgical system was created, and its design was explored through three experiments. Experiment 1 analyzed different permanent magnetic configurations to optimize the magnetic force between a tool on the inside of the abdominal wall and an external tool. The chosen configuration was a single-pole external magnet, coupled to an axially magnetized internal magnet. Experiment 2 analyzed the experimental and theoretical forces applied by the internal tool. The tool was able to provide sufficient cutting forces at 26.1 mm of separation between the tools. Experiment 3 measured the precision of the tool's end effector which was controlled by a stepper motor-powered cable system. The tool's end effector rotates no more than 1 deg about the y-axis and no more than 2 deg about the x-axis. The SIFM system combines the health benefits of minimally invasive laparoscopic surgery, with the free motion and ease of open surgery.

Cache-Based Matrix Technology for Efficient Write and Recovery in Erasure Coding Distributed File Systems

With the development of various information and communication technologies, the amount of big data has increased, and distributed file systems have emerged to store them stably. The replication technique divides the original data into blocks and writes them on multiple servers for redundancy and fault tolerance. However, there is a symmetrical space efficiency problem that arises from the need to store blocks larger than the original data. When storing data, the Erasure Coding (EC) technique generates parity blocks through encoding calculations and writes them separately on each server for fault tolerance and data recovery purposes. Even if a specific server fails, original data can still be recovered through decoding calculations using the parity blocks stored on the remaining servers. However, matrices generated during encoding and decoding are redundantly generated during data writing and recovery, which leads to unnecessary overhead in distributed file systems. This paper proposes a cache-based matrix technique that uploads the matrices generated during encoding and decoding to cache memory and reuses them, rather than generating new matrices each time encoding or decoding occurs. The design of the cache memory applies the Weighting Size and Cost Replacement Policy (WSCRP) algorithm to efficiently upload and reuse matrices to cache memory using parameters known as weights and costs. Furthermore, the cache memory table can be managed efficiently because the weight–cost model sorts and updates matrices using specific parameters, which reduces replacement cost. The experiment utilized the Hadoop Distributed File System (HDFS) as the distributed file system, and the EC volume was composed of Reed–Solomon code with parameters (6, 3). As a result of the experiment, it was possible to reduce the write, read, and recovery times associated with encoding and decoding. In particular, for up to three node failures, systems using WSCRP were able to reduce recovery time by about 30 s compared to regular HDFS systems.

Moving Microgrid Hierarchical Control to an SDN-Based Kubernetes Cluster: A Framework for Reliable and Flexible Energy Distribution

Software Defined Networking (SDN) is a communication alternative to increase the scalability and resilience of microgrid hierarchical control. The common architecture has a centralized and monolithic topology, where the controller is highly susceptible to latency problems, resiliency, and scalability issues. This paper proposes a novel and intelligent control network to improve the performance of microgrid communications, solving the typical drawback of monolithic SDN controllers. The SDN controller's functionalities are segregated into microservices groups and distributed through a bare-metal Kubernetes cluster. Results are presented from PLECS hardware in the loop simulation to validate the seamless transition between standard hierarchical control to the SDN networked microgrid. The microservices significantly impact the performance of the SDN controller, decreasing the latency by 10.76% compared with a monolithic architecture. Furthermore, the proposed approach demonstrates a 42.23% decrease in packet loss versus monolithic topologies and a 53.41% reduction in recovery time during failures. Combining Kubernetes with SDN microservices can eliminate the single point of failure in hierarchical control, improve application recovery time, and enhance containerization benefits, including security and portability. This proposal represents a reference framework for future edge computing and intelligent control approaches in networked microgrids.

Endoscopic Resection for Vascular Anomalies in Children: A New Standard.

To report an innovative endoscopic surgery for subcutaneous vascular malformations and intramuscular fibro-adipose vascular anomaly (FAVA) at our center. Historically, open surgical resection has been the treatment of choice. Recent advances in minimally invasive surgery have led to the successful application of endoscopic resection techniques for the surgical management of diseases of soft tissue. Patients who underwent endoscopic resection of vascular anomalies were included in this retrospective review. Data were extracted from our Vascular Anomalies Center database between September 2019 and October 2022, including sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up. There were 13 females and 15 males in the current study, with ages ranging from 1 to 17 years. The diagnoses included microcystic lymphatic malformation (LM) (n = 8), Klippel-Trénaunay syndrome (n = 7), venous malformation (n = 6), FAVA (n = 6), and mixed cystic LM (n = 1). Surgical sites included the lower extremity (n = 24), abdominal wall (n = 2), upper extremity (n = 1), and thoracic wall (n = 1). Five patients had an intramuscular lesion (FAVA). The endoscopic technique used 2 or 3 small ports in a gas inflation manner. Surgery included thrombectomy, radical resection, and debulking of vascular anomalies. Postoperative sclerotherapy with bleomycin was performed through a drainage tube in 6 patients with microcystic LM. Technical success was obtained in 27 patients. The conversion to open surgery was performed in one patient owing to the deep location of the lesion. No wound-related complication was observed. Endoscopic surgery is a minimally invasive, effective, and safe treatment for subcutaneous vascular malformations and intramuscular FAVA. This approach can set a new standard that minimizes wound complications and reduces recovery time in patients undergoing resection for benign soft-tissue lesions.

Advances in Endoscopic Ultrasound (EUS)-Guided Liver Biopsy.

Recent years have seen the emergence of endoscopic-ultrasound-guided liver biopsy (EUS-LB) as an effective alternative to traditional (percutaneous or transjugular) liver biopsy techniques. Comparative studies have demonstrated that both endoscopic and non-endoscopic approaches are similar in terms of diagnostic adequacy, accuracy, and adverse events; however, EUS-LB offers the advantage of reduced recovery time. Additionally, EUS-LB enables the sampling of both lobes of the liver as well as the advantage of portal pressure measurements. However, EUS-LB may be argued to have a high cost, although this procedure can be cost-effective if bundled with other endoscopic procedures. Approaches utilizing EUS-guided liver therapy, such as the administration of chemotherapeutic agents and EUS elastography, are in development, and their optimal integration into clinical care is likely to emerge in the coming years. In the present review, we evaluate the available literature on EUS-LB indications, contraindications, variations in needle biopsy techniques, comparative outcomes, advantages and disadvantages, and future trends and perspectives.