Reduce Recovery Time Research Articles

Rapid and Efficient NO2 Sensing Performance of TeO2 Nanowires.

Gas sensors play a pivotal role in environmental monitoring, with NO2 sensors standing out due to their exceptional selectivity and sensitivity. Yet, a prevalent challenge remains: the prolonged recovery time of many sensors, often spanning hundreds of seconds, compromises efficiency and undermines the precision of continuous detection. This paper introduces an efficient NO2 sensor using TeO2 nanowires, offering significantly reduced recovery times. The TeO2 nanowires, prepared through a straightforward thermal oxidation process, exhibit a unique yet smooth surface. The structural characterizations confirm the formation of pure-phase TeO2 after the anneal oxidation. TeO2 nanowires are extremely sensitive to NO2 gas, and the maximum response (defined as the ratio of resistance in the air to that under the target gas) to NO2 (10 ppm) is 1.559. In addition, TeO2 nanowire-based sensors can return to the initial state in about 6-7 s at 100 °C. The high sensitivity can be attributed to the length-diameter rate, which adsorbs more NO2 to facilitate the electron transfer. The fast recovery is due to the smooth surface without pores on TeO2 nanowires, which may release NO2 quickly after stopping the gas supply. The present approach for sensing TeO2 nanowires can be extended to other sensor systems as an efficient, accurate, and low-priced tactic to enhance sensor performance.

20 Examining the Recovery Course of Pediatric Concussion Patients with Protracted Recovery Referred to a Specialty Concussion Clinic

Objective:The purpose of this study was to explore overall recovery time and post-concussive symptoms (PCSS) of pediatric concussion patients who were referred to a specialty concussion clinic after enduring a protracted recovery (>28 days). This included patients who self-deferred care or received management from another provider until recovery became complicated. It was hypothesized that protracted recovery patients, who initiated care within a specialty concussion clinic, would have similar recovery outcomes as typical acute injury concussion patients (i.e., within 3 weeks).Participants and Methods:Retrospective data were gathered from electronic medical records of concussion patients aged 6-19 years. Demographic data were examined based on age, gender, race, concussion history, and comorbid psychiatric diagnosis. Concussion injury data included days from injury to initial clinic visit, total visits, PCSS scores, days from injury to recovery, and days from initiating care with a specialty clinic to recovery. All participants were provided standard return-to-learn and return-to-play protocols, aerobic exercise recommendations, behavioral health recommendations, personalized vestibular/ocular motor rehabilitation exercises, and psychoeducation on the expected recovery trajectory of concussion.Results:52 patients were included in this exploratory analysis (Mean age 14.6, SD ±2.7; 57.7% female; 55.7% White, 21.2% Black or African American, 21.2% Hispanic). Two percent of our sample did not disclose their race or ethnicity. Prior concussion history was present in 36.5% of patients and 23.1% had a comorbid psychiatric diagnosis. The patient referral distribution included emergency departments (36%), local pediatricians (26%), neurologists (10%), other concussion clinics (4%), and self-referrals (24%).Given the nature of our specialty concussion clinic sample, the data was not normally distributed and more likely to be skewed by outliers. As such, the median value and interquartile range were used to describe the results. Regarding recovery variables, the median days to clinic from initial injury was 50.0 (IQR=33.5-75.5) days, the median PCSS score at initial visit was 26.0 (IQR=10.0-53.0), and the median overall recovery time was 81.0 (IQR=57.0-143.3) days.After initiating care within our specialty concussion clinic, the median recovery time was 21.0 (IQR=14.0-58.0) additional days, the median total visits were 2.0 (IQR=2.0-3.0), and the median PCSS score at follow-up visit was 7.0 (IQR=1-17.3).Conclusions:Research has shown that early referral to specialty concussion clinics may reduce recovery time and the risk of protracted recovery. Our results extend these findings to suggest that patients with protracted recovery returned to baseline similarly to those with an acute concussion injury after initiating specialty clinic care. This may be due to the vast number of resources within specialty concussion clinics including tailored return-to-learn and return-to-play protocols, rehabilitation recommendations consistent with research, and home exercises that supplement recovery. Future studies should compare outcomes of protracted recovery patients receiving care from a specialty concussion clinic against those who sought other forms of treatment. Further, evaluating the influence of comorbid factors (e.g., psychiatric and/or concussion history) on pediatric concussion recovery trajectories may be useful for future research.

Advancements in Minimally Invasive Surgical Techniques: A Comprehensive Review

Introduction: Minimally Invasive Surgical (MIS) techniques have revolutionized the field of surgery, offering significant benefits over traditional open surgery. This narrative review examines the historical evolution, current advancements, and prospects of MIS, with a focus on its impact on patient outcomes, surgical training, and healthcare systems.Objective: To provide a comprehensive overview of the advancements in MIS, highlighting technological innovations, changes in clinical practice, and the evolution of surgical education. The review also aims to discuss the challenges and future directions of MIS.Methods: The review included 24 articles published from 2004 to 2023. Criteria for inclusion were relevance to MIS development and impact, with exclusion for non-English and unrelated articles. Data were synthesized to outline the progression, current state, and future trends in MIS.Results: Key findings include significant advancements in surgical technologies such as robotics and enhanced imaging, the expansion of MIS across various specialties, and improved patient outcomes like reduced recovery times and lower complication rates. Challenges identified include the steep learning curve for surgeons and disparities in global access to MIS. Future trends indicate a move towards AI integration, personalized surgical approaches, and further refinement of robotic systems.Conclusions: MIS represents a paradigm shift in surgical practice, characterized by technological innovation and improved patient care. Despite challenges, its future is promising, with continuous advancements expected to further reshape surgical procedures.

Advancements in Minimally Invasive Surgical Techniques: A Comprehensive Review

Introduction: Minimally Invasive Surgical (MIS) techniques have revolutionized the field of surgery, offering significant benefits over traditional open surgery. This narrative review examines the historical evolution, current advancements, and prospects of MIS, with a focus on its impact on patient outcomes, surgical training, and healthcare systems.Objective: To provide a comprehensive overview of the advancements in MIS, highlighting technological innovations, changes in clinical practice, and the evolution of surgical education. The review also aims to discuss the challenges and future directions of MIS.Methods: The review included 24 articles published from 2004 to 2023. Criteria for inclusion were relevance to MIS development and impact, with exclusion for non-English and unrelated articles. Data were synthesized to outline the progression, current state, and future trends in MIS.Results: Key findings include significant advancements in surgical technologies such as robotics and enhanced imaging, the expansion of MIS across various specialties, and improved patient outcomes like reduced recovery times and lower complication rates. Challenges identified include the steep learning curve for surgeons and disparities in global access to MIS. Future trends indicate a move towards AI integration, personalized surgical approaches, and further refinement of robotic systems.Conclusions: MIS represents a paradigm shift in surgical practice, characterized by technological innovation and improved patient care. Despite challenges, its future is promising, with continuous advancements expected to further reshape surgical procedures.

Internet of Things Based Fault Detection in Underground Cables

In recent days, power systems are very complicated to deal with load requires raises and environmental check curbs the network. With the development of urban scale and creation of energy infrastructure, more cities build underground cables to substitute overhead lines from the view point of environment and safety. But it is facing few troubles like installation cost and fault area detection. Finding the precise spot of the error is tougher. In our proposed project, our objective is to improve the trustworthiness of a distribution system and accurate recognition of a faulted location and time of fault. In this work, the three phase voltage and current were monitored. It is IOT based technique where we collect the database and utilize it for monitoring purpose. If the error is located precisely is updated in cloud to facilitate the delay in recovery time reduction. The fault location is displayed through LCD. In addition, it also displays the voltage value at faulty cable and the current consumption through the line is displayed and monitored.

Preparation and Optimization of Mesoporous SnO2 Quantum Dot Thin Film Gas Sensors for H2S Detection Using XGBoost Parameter Importance Analysis

Tin oxide (SnO2) is a traditional gas-sensitive semiconductor with excellent response to various gases. However, its sensor performances are attenuated by the utility factor during gas diffusion in the sensing body. Therefore, the rational design of microstructure of devices is attractive and necessary because it may provide a sensible and controllable microstructure, which facilitates gas diffusion and inhibits the utility factor. Herein, the mesoporous tin oxide (MPTD) quantum dot thin film for H2S gas sensors is prepared by a facile route, which creates a mesoporous microstructure for thin films by the thermal decomposition of NH4Cl. The pore size of the thin films is controlled to be 19.36–40.13 nm. The mesoporous microstructure exhibits enhanced gas-sensing properties amounting to a 30-fold increase in response and 1/3 reduction in recovery time in H2S detection at room temperature (25 °C), with a limit of detection of 0.4 ppm. To determine the importance of sensor parameters such as pore size, film thickness, and grain size, an eXtreme Gradient Boosting (XGBoost) algorithm model was developed to examine the feature importance of each parameter on the gas-sensing performance of the MPTD sensors. The visual illustration of parameter importance is revealed to facilitate the optimization of technical preparation parameters as well as the rational design of semiconductor gas sensors.

Improving recovery performance of graphene oxide humidity sensors through pore modulation by intercalating TiO2 nanoparticles

A strategy is proposed to construct nano-porous channels inside graphene oxide (GO) layers through pore modulation by intercalating TiO2 nanoparticles of different amounts and sizes, which can significantly improve the recovery performance of GO humidity sensors. Typical device prepared by laser direct writing on the GO/TiO2 film shows a high sensitivity to a broad humidity range of 2 ∼ 85% and a significantly reduced recovery time of 40.5 s from 95.7 s for the one prepared on sole GO film. The intercalation of TiO2 nanoparticles constructs nano-porous channels effectively, which afford spaces to promote water molecule desorption and diffusion.

Posterior Fossa Tumors Special Edition. Celebrating 4 years!

Posterior fossa tumors account for approximately half of the central nervous system tumors in children. Major technological advances, mainly in the fields of molecular biology and neuroimaging, have modified their classification, leading to a more detailed description of these entities. Certain modifications in the general nomenclature introduced by the 2021 WHO classification of tumors of the CNS have an impact on how we approach the posterior fossa tumors described in this study. The focus of this annual special issue is posterior fossa tumors in children. There were several emerging technologies and approaches in the diagnosis and treatment of posterior fossa tumors in children. It's important to note that medical technology and research are continually evolving, so there may have been further advancements in this field since then. Here are some promising technologies and strategies that were being explored: Advanced Imaging Techniques: Functional MRI (fMRI): This technology helps in mapping the brain's functional areas, allowing surgeons to plan their approach more accurately and minimize damage to critical brain regions. Diffusion Tensor Imaging (DTI): DTI provides information on the brain's white matter tracts, aiding surgeons in preserving essential neural pathways during surgery. Spectroscopy: It helps in identifying tumor types and differentiating between tumor tissue and healthy brain tissue. Surgical Navigation Systems: The use of advanced navigation systems during surgery allows for precise tumor localization and safer tumor removal, minimizing damage to surrounding healthy tissue. Brain Ultrasound and iMRI: Some hospitals are equipped with iMRI suites that allow real-time imaging during surgery. Most common brain ultrasound helps a lot during the posterior fossa surgery and can use simultaneously with neuronavigation system. Minimally Invasive Techniques: Minimally invasive procedures, such as endoscopic surgery, are being explored for certain types of posterior fossa tumors. These techniques can reduce recovery times and complications. Intraoperative monitoring (IOM), also known as intraoperative neurophysiological monitoring (IONM), is a critical technique used during certain surgeries to monitor the nervous system's function in real-time. It helps surgeons and medical teams assess the integrity of neural structures, particularly the brain and spinal cord, during surgical procedures. Genomic and Molecular Analysis: Advances in genomic and molecular analysis of tumors can provide insights into the specific genetic mutations driving the tumor's growth. This information can help guide treatment decisions, including targeted therapies. Radiation Therapy Advancements: Techniques like proton therapy and stereotactic radiosurgery are being used to precisely target tumors while minimizing damage to surrounding healthy tissue, which is especially important in pediatric cases. Immunotherapy: Immunotherapy approaches, such as checkpoint inhibitors, are being investigated for their potential in treating certain types of posterior fossa tumors in children. These therapies aim to harness the body's immune system to fight the tumor. Personalized Medicine: Tailoring treatment plans to the individual characteristics of each patient's tumor is becoming increasingly important. This includes considering factors such as tumor genetics, location, and the child's overall health. Telemedicine and Remote Consultations: Telemedicine technologies enable pediatric neuro-oncologists to collaborate with experts worldwide, improving the quality of care, especially in regions with limited access to specialized healthcare. This special issue covers the different aspects of posterior fossa tumors surgery. We wish to thank all the authors for their tremendous contributions, and we hope that you will have the same interest and pleasure to read this special issue as we have had to edit it.

The Effect of Stem Cells on Ankle Injuries

Ankle injuries lead to joint pain, limitation of movement, occasional effusion, and quality of life impairment. It is estimated that one injury occurs for every 10,000 people each day due to inversion of the ankle. 7-10% of all admissions to hospital emergency departments are a result of ankle injuries. It was found that 70% of acute ankle sprains and fractures display some osteochondral defects (OCD) of the talus. Twenty five percent of all injuries of the musculoskeletal system are related to inversion injuries. About 50% of these injuries are related to sports. Full thickness focal chondral defects in athletes have an overall prevalence of 36%. The ankle is the most injured area of the body for 24 of 70 sports that were studied. Basketball, soccer, football, volleyball, running, and dancing are the sports in which these athletic injuries are most common. Individuals under 35 years of age demonstrate majority of these ankle injuries. The most common age group is for those are between the ages of 15 and 19 years. Etiology of ankle OCDs can either be non-traumatic or traumatic. Seventy percent of acute ankle sprains and fractures occur in the OCD of talus. Potential side effects or medical complications may result from OCD surgeries. Animal and human subjects are commonly used by researchers to investigate the overall effectiveness of stem cells for OCD injuries. Mesenchymal stem cells (MSC) are often the source of preference for orthopedic procedures as they have the ability to differentiate into a variety of tissues. These tissues include bone, muscle, cartilage, and fat. Stem cell transplantation has shown improved tissue quality and rate of healing, sustained gains functionally, decreased pain, and enhanced clinical outcomes. Researchers believed the use of stem cells may offer choices for patients with orthopedic injuries including OCD to reduce recovery time and osteoarthritis as well as enhance function.

Enhancing of the power system resilience through the application of micro power systems (microgrid) with renewable distributed generation

The power sector plays a critical role in the functioning of the economy and the security of a country, being closely interconnected with other vital infrastructures, such as gas supply, water supply, transportation, and telecommunications. Ensuring a stable power supply is crucial for the uninterrupted operation of these systems. One way to enhance the resilience of the power system is by integrating local networks with distributed renewable generation into the overall energy infrastructure. The flexibility, stability, controllability, and self-healing capabilities of microgrids make them an effective solution for improving the resilience of the power system. The power grid is susceptible to disturbances and disruptions that can cause large-scale power outages for consumers. Statistical data indicates that approximately 90% of outages occur due to issues in the distribution system, thus research focuses on local microgrids with distributed renewable generation. This study analyzed the role of microgrids with renewable generation in enhancing the resilience of power systems. Additionally, functions of microgrids that contribute to enhancing power system resilience, such as service restoration, network formation strategies, control and stability, as well as preventive measures, were summarized. It was found that local microgrids have significant potential to enhance power system resilience through the implementation of various strategies, from emergency response planning to providing reliable energy supply for quick responses to military, environmental, and human-induced crises. The concept of local distributed energy generation, storage, and control can reduce reliance on long-distance power transmission lines, reduce network vulnerabilities, and simultaneously improve its resilience and reduce recovery time. It has been determined that the most necessary and promising approaches to enhance the resilience of the power system include developing appropriate regulatory frameworks, implementing automatic frequency and power control systems, ensuring resource adequacy (including the reservation of technical components), promoting distributed generation, integrating energy storage systems into the energy grid, and strengthening cyber security. Keywords: resilience, local power systems, MicroGrid, distributed generation, renewable energy sources.

191 Minimally Invasive General Surgery Landmark Trials and Lessons Learned - A Narrative Review

Abstract Aims The aim of this review is to explore the history of minimally invasive (MI) surgery and landmark trials that guide modern practice. Methods A narrative review was conducted according to the four steps outlined by Demiris et al. Results MI surgery has become the gold-standard for many operations. Laparoscopic surgery has equivalent operative outcomes to open surgery with reduced recovery time and hospital stay. Randomised controlled trials (RCTs) investigating complex laparoscopic upper gastrointestinal oncological resections demonstrate reduced blood loss and postoperative pain. Within colorectal surgery, the CLASSIC and COREAN trials described comparable mortality and oncological clearance in MI colorectal cancer resections versus open surgery. Conversely, ALaCaRT and ACOSOG raised concerns about oncological results. Robotic surgery provides a high degree of instrument freedom and stabilises hand tremors, however substantial associated costs remain a barrier. Robotic cholecystectomy (RC) is a safe and effective tool, and RC outcomes are comparable to laparoscopic surgery in the elective setting; although more evidence is required for more complex disease outcomes. For rectal cancer, the ROLARR trial found no difference in complications, conversion rate, or circumferential margin positivity for robotic-assisted versus laparoscopic surgery. Recently, the Smart Tissue Autonomous Robot performed the first autonomous intestinal anastomosis on porcupines, outperforming expert surgeons for both consistency and accuracy, demonstrating the potential future of robotic surgery. Conclusion This review gives an overview of MI general surgery; demonstrating the advantages as well as some concerns for the different surgical techniques, and raises suggestions for future uses.

Resilience enhancement of using prefabrication technology for post-accident restoration of coastal infrastructure

Severe weather or man-made accidents often cause serious damage to coastal infrastructure. A long-term suspension of coastal infrastructure under severe accidents always trigger a significant resilience degradation. Rapid restoration techniques are hence essential for the post-accident resilience of coastal infrastructure. However, current research on post-accident resilience assessment and technology enhancement for coastal infrastructure restoration is still inadequate. Therefore, this study proposed the application of prefabrication technology to enhance the coastal infrastructure resilience to fill this knowledge gap. First, accident-oriented simulation was performed to quantitatively assess the damage of port structure. Next, a precast component database was constructed to establish restoration schemes. Finally, a resilience assessment process considering the restoration process, time and cost was developed. The process formed an essential tool for coastal resilience assessment and produced the following key results. (1) freighter impacts can trigger a significant resilience degradation of coastal infrastructure. Such accidents cause enormous restoration work, long recovery times and high restoration costs. (2) The application of prefabrication technology for port structure restoration is significantly advantageous. The resilience of prefabrication restoration is about 38% higher than cast-in-situ restoration, and the recovery time reduction is more than twice. (3) Perpetual restoration is an advantage of prefabrication restoration. Compared with cast-in-situ restoration, the resilience of perpetual restoration is improved by 75.6%. Perpetual restoration shortens major restoration recovery time by 60.8%, and achieves 46.1% cost optimization. (4) Prefabrication technology demonstrates adaptability to large-scale and long-term operating coastal infrastructure. The application of prefabrication technology for major restoration saves local resources by more than twice compared to cast-in-situ restoration, and achieves up to 54% restoration cost optimization. In summary, prefabrication technology has demonstrated green and efficient features for post-accident restoration of port structures. The proposed resilience assessment process establishes a theoretical foundation for resilience assessment of post-disaster restoration of coastal infrastructure and develops a strategy for post-disaster resilience.

Multi-layer film surface functionalized PMF sensor for real-time humidity measurement

Real-time monitoring of environmental relative humidity (RH) plays a crucial role in ensuring both the quality of industrial production and the quality of life. In this work, polarization maintaining fiber (PMF) was used as carriers to creatively constructed multi-layer film surface functionalization on its cladding surface. The indium tin oxide (ITO) film and polyvinyl alcohol (PVA) doped graphite oxide (GO) composite polymer constitute multi-layer humidity sensitive film, which has the effect of dual absorption of water and improves the humidity sensitivity. Microporous composite polymer films created by laser processing increase the area for water evaporation and absorption, which improve response speed, and reduce recovery time. The surface functionalized PMF sensor exhibits high sensitivity and rapid response to humidity, achieving bidirectional repeated measurement of 0.28 nm/% within 10 s in the measurement range of 30%-90%, rendering it a reliable means for real-time monitoring of humidity.

Orthogonalization of the Sensing Matrix Through Dominant Columns in Compressive Sensing for Speech Enhancement

This paper introduces a novel speech enhancement approach called dominant columns group orthogonalization of the sensing matrix (DCGOSM) in compressive sensing (CS). DCGOSM optimizes the sensing matrix using particle swarm optimization (PSO), ensuring separate basis vectors for speech and noise signals. By utilizing an orthogonal matching pursuit (OMP) based CS signal reconstruction with this optimized matrix, noise components are effectively avoided, resulting in lower noise in the reconstructed signal. The reconstruction process is accelerated by iterating only through the known speech-contributing columns. DCGOSM is evaluated against various noise types using speech quality measures such as SNR, SSNR, STOI, and PESQ. Compared to other OMP-based CS algorithms and deep neural network (DNN)-based speech enhancement techniques, DCGOSM demonstrates significant improvements, with maximum enhancements of 42.54%, 62.97%, 27.48%, and 8.72% for SNR, SSNR, PESQ, and STOI, respectively. Additionally, DCGOSM outperforms DNN-based techniques by 20.32% for PESQ and 8.29% for STOI. Furthermore, it reduces recovery time by at least 13.2% compared to other OMP-based CS algorithms.

Patient preferences for stress urinary incontinence treatments: a discrete choice experiment

ObjectivesTo elicit and value patient preferences for the processes and outcomes of surgical management of stress urinary incontinence in women.DesignA discrete choice experiment survey to elicit preferences for type of...

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> .

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.