Technical Considerations Research Articles

Sustainable Personalized Home Care for Pandemic Management: A Service-Oriented Approach

The COVID-19 pandemic has shown us how a viral disease originating in one part of the world rapidly spread the entire globe in just a few weeks, causing a complete shutdown of socio-economic activities in almost all countries. We have seen that during vaccine unavailability, social distancing, rigorous contact tracing, and case isolation are found to be the most effective strategies to contain the disease outbreak. For effective management of home-based isolation, patient care should not be limited to the illness but should also take into account other factors that are related to the needs and sustenance of patients and their dependents. In this paper, we first present retrospective case studies of South Asian countries, discuss the strategies and technological interventions employed to fight the pandemic, and underscore the significant issues that persist and require action. Second, building upon the insights from these case studies, we propose an integrated service-oriented system that supports seamless interfacing and information sharing with the functional systems of service providers/ caregivers to develop, manage, and monitor care plans for patients undergoing home isolation. The viability of our proposed framework is demonstrated by providing a proof-of-concept implementation. Further, we discuss the technical issues and policy considerations for practical and sustainable deployment of such system(s).

The INDEPSO-ISPSM Consensus on Peritoneal Malignancies: General Principles of Cytoreductive Surgery and Technical Considerations

The INDEPSO-ISPSM Consensus on Peritoneal Malignancies: General Principles of Cytoreductive Surgery and Technical Considerations

Biogas potential estimation and geospatial decision-making: a hybrid MCDA approach to optimizing biogas facility locations

Abstract Biogas stands out among renewable energy sources with its environmental and economic advantages that support sustainable development. Despite Turkey’s rich biomass resources, the underutilization of biogas potential has resulted in insufficient investments in this field. The main objective of this study is to determine the most suitable locations for establishing biogas energy facilities in Şanlıurfa province, which is in the Southeastern Anatolia Region of Turkey. The total biogas potential of Şanlıurfa province, calculated from plant and animal waste, means that 4 biogas plants with an installed capacity of 40 MW can be built. Using an integrated approach that combines Remote Sensing, Geographical Information Systems, and Multi-Criteria Decision-Analysis methods, the study assessed 24 alternative locations for facility establishment. The Fuzzy Analytic Hierarchy Process was used to weight 13 criteria reflecting environmental, economic, and technical considerations. Then, the obtained criteria weights were analyzed by the Technique for Order Preference Ranking Technique by Similarity to Ideal Solution method, and the most suitable alternative areas for biogas facilities were ranked. As a result of the study, the four most suitable areas for establishing biogas facilities were identified out of 24 alternative areas based on environmental sustainability, economic efficiency, and technical feasibility. These results can guide the decision-making processes of local governments and investors in the strategic planning of biogas facilities and contribute to the effective utilization of Şanlıurfa's biogas potential. Thus, the region's energy supply security will be strengthened, and a sustainable contribution will be made to Turkey's overall energy policies.

Effects of sulphuric-acid attack and chloride-ion penetration on cement mortar with copper tailings: mechanical properties and technical considerations for uses in shotcrete

Effects of sulphuric-acid attack and chloride-ion penetration on cement mortar with copper tailings: mechanical properties and technical considerations for uses in shotcrete

Distributed Systems in Modern Enterprise Architecture: Challenges and Solutions

This comprehensive article examines the evolution and implementation of distributed systems in modern enterprise architecture, focusing on critical aspects, including data consistency, transaction management, performance optimization, fault tolerance, and security. The article investigates how organizations leverage various architectural patterns and technologies such as Event Sourcing, Saga Pattern, CQRS, and zero-trust security principles to address challenges in distributed environments. Through a detailed examination of implementation strategies across multiple industry sectors, the article demonstrates how these patterns contribute to improved system resilience, scalability, and operational efficiency. The article encompasses technical implementation considerations and practical operational outcomes, providing insights into how organizations can effectively manage the complexities of distributed systems while maintaining performance, reliability, and security requirements.

AI-Driven Cloud Optimization : Transforming Modern Infrastructure Management

This article explores how AI-driven cloud optimization is transforming modern infrastructure management by enabling organizations to maximize their cloud investments while maintaining optimal performance. The convergence of artificial intelligence, machine learning, and cloud computing technologies has created systems capable of analyzing operational patterns, predicting resource requirements, and automatically adjusting cloud configurations without human intervention. It examines five key benefits of AI-driven optimization: cost reduction through intelligent resource allocation, performance enhancement via dynamic resource management, intelligent scalability through predictive capacity planning, operational automation that reduces IT burden, and environmental sustainability through efficient resource utilization. The article further analyzes three implementation approaches—cloud provider native tools, third-party optimization platforms, and custom AI solutions—while discussing critical technical considerations including data collection infrastructure, AI/ML model selection, integration requirements, and governance frameworks. The article concludes by examining emerging trends such as autonomous operations, cross-layer optimization, and quantum-enhanced optimization that will shape the future of cloud resource management and deliver even greater efficiency, performance, and business value.

Reversal of Roux-en-Y Gastric Bypass to Normal Anatomy-Experience of 70 Patients.

A limited subset of patients undergoing Roux-en-Y gastric bypass (RYGB) may develop intractable symptoms that ultimately require reversal to normal anatomy. Existing literature on this subject is characterized by small cohort sizes, substantial variation in surgical techniques, and limited follow-up durations. However, this study presents the largest single-center series to date, comprising seventy patients. A prospective analysis was conducted on clinical data from patients who underwent laparoscopic reversal of Roux-en-Y gastric bypass (RYGB). The study evaluated the indications for the procedure, technical considerations, clinical outcomes, and associated complications. Patients were stratified into two groups based on their primary symptoms: Group 1 (abdominal pain; n = 47) and Group 2 (hypoglycemia, malnutrition, or other symptoms; n = 23). Seventy patients were included in the study, with a mean follow-up period of 2.4years. The majority of patients (93%, 65/70) were female, and the mean age was 44 ± 11.45years. The mean body mass index (BMI) at baseline was 28.7 ± 6.3kg/m2. In Group 1, 85% of patients experienced either complete or partial resolution of symptoms, while in Group 2, 96% achieved complete symptom resolution. Thromboembolic complications occurred in 7.1% of patients, and 13% required reoperation. At 12months post-reversal, mean weight and BMI had increased by 9.1kg and 3.2kg/m2, respectively. At the most recent follow-up, the total weight gain (Δkg) was 14.9kg, and the BMI increase (ΔBMI) was 5.1kg/m2. Reversal of Roux-en-Y gastric bypass (RYGB) is an effective intervention for patients experiencing chronic complications. Patients with hypoglycemia and malnutrition experienced higher rates of symptom resolution compared to those with abdominal pain or small bowel adhesions. The implementation of pyloroplasty, combined with high-dose subcutaneous anticoagulant therapy, was associated with a reduction in complication rates. Given the expected weight regain following reversal, it is essential for both surgeons and patients to align their expectations with anticipated outcomes.

Interdural Spinal Arachnoid Cyst Case Study and Review of Literature with Operative Technical Considerations

Interdural Spinal Arachnoid Cyst Case Study and Review of Literature with Operative Technical Considerations

Transforming Healthcare with Salesforce CRM and MuleSoft Integration: A Technical Perspective

This article explores the transformative potential of integrating Salesforce CRM with MuleSoft in healthcare environments. This integration creates a unified ecosystem that enhances patient care while streamlining operations by addressing the persistent challenges of data fragmentation and system isolation. The technical architecture combines Salesforce Health Cloud's patient relationship capabilities with MuleSoft's API-led connectivity to bridge disparate clinical, administrative, and financial systems. Key implementation use cases examined include comprehensive patient 360 views, automated engagement workflows, and revenue cycle optimization. The article details technical considerations for successful deployment, including security requirements, performance optimization strategies, and structured development methodologies. Through real-world examples and industry data, the article demonstrates how this integration delivers improved patient experiences, operational efficiencies, and regulatory compliance while positioning healthcare organizations for future technological evolution.

Voice-Driven Code Navigation & Search: Revolutionizing Developer Workflows with NLP

This article explores the evolution and challenges of code navigation and search tooling in modern software development environments, focusing on the transformative potential of voice-driven systems and AI-powered smart assistants for this use case. The article examines the limitations of traditional navigation and search methods, presenting voice-driven alternatives that leverage natural language processing and advanced AI capabilities. Through analysis of multiple research studies, the article investigates developer behavior patterns, cognitive load implications, and the effectiveness of voice-based interfaces in programming environments. The article demonstrates how voice-driven navigation and NLP-based code search systems can address common challenges in code comprehension, context management, and development workflow efficiency. Furthermore, the article explores how AI-enhanced voice assistants could extend these capabilities through sophisticated debugging assistance, contextual code explanations, multi-turn interactions, and proactive suggestions—creating a collaborative development experience. The article highlights both the immediate benefits of voice-driven tools and the future potential of AI integration, along with technical considerations and implementation requirements for successful adoption in modern Integrated Development Environments (IDEs).

Prevalence Of Popliteal Artery Variants in Free Tissue Transfer for Limb Salvage: A 12-Year Vasculo-Plastic Experience.

Popliteal artery variants (PAVs) are anatomical deviations of the popliteal artery's branching pattern and should be considered in microsurgical planning for patients undergoing lower extremity (LE) free tissue transfer (FTT). However, there is a significant lack of FTT literature in this patient population. Thus, this study presents our 12-year experience with LE FTT in patients with PAV. Patients receiving LE FTT reconstruction from July 2011 to March 2024 were reviewed. Preoperative angiograms were reviewed by a single vascular surgeon, and the presence of PAV was identified and classified as IIIA, IIIB, or IIIC. Primary outcomes were flap success and limb salvage. A total of 339 LE FTT were performed in 331 patients. 32 patients (9.4%) had PAV, accounting for a total of 34 LE FTT. Class III-A was the most common category (n=20, 58.8%) followed by III-B (n=8, 23.5%) and III-C (n=6, 11.7%). Median age and BMI were 63.5 (IQR: 22.5) years and 27.4 (IQR: 10.3) kg/m2. The median Charlson Comorbidity Index was 5 (IQR: 2.5), with prevalent rates of diabetes (n=18/32, 56.3%) and peripheral artery disease (n=16/32, 50.0%). Median wound area was 71.0 (IQR: 80.0) cm2. Flap success rate was 100% (n=34/34). At a median follow-up of 12.8 (IQR: 22.6) months, limb salvage was 97.1% (n=33/34) and mortality was 6.3% (n=2/32). In this large population of LE FTT, PAV occurs in almost one out of ten patients. Essential to flap success and limb salvage is appropriate preoperative vascular imaging with arteriography, as the presence of PAV changes microsurgical intraoperative planning and technical considerations.

Enhancing District Heating System Efficiency: A Review of Return Temperature Reduction Strategies

This review paper provides a comprehensive examination of current strategies and technical considerations for reducing return temperatures in district heating (DH) systems, aiming to enhance the utilization of available thermal energy. Return temperature, a parameter indirectly influenced by various system-level factors, cannot be adjusted directly but requires careful management throughout the design, commissioning, operation, and control phases. This paper explores several key factors affecting return temperature, including DH network, heat storage, and control strategies as well as the return temperature effect on the heat source. This paper also considers the influence of non-technical aspects, such as pricing strategies and maintenance practices, on system performance. The discussion extends to the complex interplay between low return temperatures and temperature differences, and between operational temperature schemes and economic considerations. Concluding remarks emphasize the importance of adopting a holistic approach that integrates technical, operational, and economic factors to improve DH system efficiency. This review highlights the need for comprehensive system-level optimization, effective management of system components, and consideration of unique heat production characteristics. By addressing these aspects, this study provides a framework for advancing DH system performance through optimized return temperature management.

Hybrid Storage Integration: Bridging On-Premises and Cloud through APIs

This comprehensive article explores the evolution, implementation, and benefits of API-driven hybrid storage architectures in modern enterprise environments. The article examines how organizations increasingly adopt hybrid approaches that blend on-premises infrastructure with cloud capabilities to address complex storage challenges. It investigates market trends driving this transition, including cloud-first strategies, performance requirements, and regulatory considerations. The article details key components of successful API-driven hybrid storage implementations, including unified API frameworks, data orchestration services, storage virtualization, metadata management, and comprehensive security controls. Implementation benefits are quantified across multiple dimensions, including operational consistency, flexible resource allocation, cost optimization, migration efficiency, enhanced data protection, and performance optimization. The article concludes with critical technical implementation considerations necessary for successful deployments, providing organizations with a roadmap for implementing effective hybrid storage strategies.

Measuring the openness of AI foundation models: competition and policy implications

ABSTRACT This paper provides the first comprehensive evaluation of AI foundation model licenses as drivers of innovation commons. We introduce our analysis by outlining how AI licenses regulate access privileges to the fundamental inputs of AI innovation commons. We show that AI licenses operate as a bottleneck, as their level of openness directly influences the flow of knowledge and information into the commons. We then introduce a new methodology for evaluating the openness of AI foundation models. Our methodology extends beyond purely technical considerations to more accurately reflect AI licenses’ contribution to innovation commons. We proceed to apply it to today’s most prominent models—including OpenAI’s GPT-4, Meta’s Llama 3, Google’s Gemini, Mistral’s 8×7B, and MidJourney’s V6—and find significant differences from existing AI openness rankings. We conclude by proposing concrete policy recommendations for regulatory and competition agencies interested in fostering AI commons based on our findings.

Factors influencing obstetricians’ acceptance of termination of pregnancy beyond the first trimester: a qualitative study

BackgroundIn Belgium, termination of pregnancy after the first trimester is exclusively allowed on medical grounds. When faced with fetal or maternal health complications during pregnancy, patients typically turn to obstetricians for guidance on the diagnosis, prognosis, and available options. Patients’ decisions and their actual access to termination of pregnancy can be profoundly influenced by the quality of this counselling and the willingness of professionals to present termination as an acceptable option. This paper aims to explore the factors influencing obstetricians’ acceptance of TOP requests after the first trimester of pregnancy. We subsequently analyze these acceptance dynamics from a multidisciplinary angle, incorporating ethical perspectives and a socio-legal exploration into how the interviewed health professionals experience, interpret, and apply the law.MethodsWe conducted an interview study with 23 hospital obstetricians who had prior experience with termination of pregnancy decision-making beyond the first trimester in Flanders, Belgium. Interviews, on average, lasted 1h30 and followed a semi-structured format guided by a topic guide. The transcripts were coded with NVivo software and subsequently thematically analyzed by a multidisciplinary research team to provide a comprehensive understanding of obstetricians’ acceptance of termination of pregnancy after the first trimester.ResultsObstetricians’ acceptance of termination of pregnancy after the first trimester mainly depends on the presence of compelling clinical factors. Secondary factors, including patient/couple preferences, institutional and collegial processes, timing and viability, technical considerations, obstetricians’ ethical and professional values, the wider background of the patient/couple, and perception of alternatives, could sway decisions in the absence of compelling clinical factors.ConclusionsSecondary factors help sway obstetricians’ decisions in favor of or against termination of pregnancy after 12 weeks when a request is characterized by inconclusive clinical factors. The multifactorial acceptance dynamics of obstetricians illustrate the limits of a strong emphasis on fetal interest argumentation. Moreover, they exhibit a degree of divergence and complexity absent from the Belgian Abortion Law. The presented typology of factors could stimulate and guide debates on legal reform and the importance that should be attributed to various factors in professional decision-making on termination of pregnancy.

Telehealth for the study of palliative care communication: opportunities, methodological challenges, and recommendations

BackgroundWhile telehealth may offer promise for accessible, efficient palliative care delivery, leveraging telehealth technologies as an opportunity to better understand and advance the science of palliative care communication has been less well explored. Without identifying solutions to overcome challenges to conducting research in the virtual environment, we are unable to conduct the foundational work to offer evidence-based recommendations for high-quality telehealth, particularly in the context of palliative care. Our objective is to highlight methodological challenges in the use of telehealth for the study of palliative care communication and share lessons learned from using these methods.MethodsThis paper is the result of a reflective process and experience across three ongoing observational communication research studies focused on the use of telehealth during serious illness. These research datasets have been collected from multiple sites and represent rural and urban telehealth palliative care consultations for patients receiving dialysis (n = 34), patients with cancer (n = 13), and seriously ill, home-bound patients (n = 9). We illustrate challenges, insights, and recommendations with case studies from these studies.ResultsWe identify key challenges, and offer recommendations to address them, in telehealth palliative care communication research. Key insights fall within three themes: 1) addressing accessibility barriers to enrollment in telehealth research; 2) technical considerations regarding how software and hardware choices have implications for data collection and analysis; and 3) ethical considerations regarding the nuances of consent and privacy in telehealth encounters.ConclusionsOverall, our approach demonstrates possibilities for the use of telehealth to study palliative care communication and provides a “how-to” example for unique telehealth considerations from data collection through analysis. These strategies can facilitate success with large-scale health communication research studies in the telehealth context.

AI in Financial Services: Revolutionizing Fraud Detection and Risk Management

This comprehensive article examines the transformative impact of artificial intelligence and machine learning technologies on financial institutions' approaches to fraud detection, risk management, and regulatory compliance. The article explores how cloud-powered AI solutions are revolutionizing security measures and operational efficiency in the financial sector. From advanced fraud detection systems to automated regulatory compliance, the article demonstrates how AI-driven solutions are enabling financial organizations to enhance their security posture while streamlining operations. The article covers the evolution of financial security systems, core components of AI-driven security, technical implementation considerations, and regulatory compliance integration, concluding with an examination of emerging trends shaping the future of AI-powered financial security.

Minimally Invasive Lateral Approach for Calcified Thoracic Disc Herniations: Technical Considerations and Outcomes Review.

Symptomatic thoracic disc herniation (TDH) is relatively uncommon, and surgical management poses significant challenges owing to restricted anatomic corridors, limited space within the spinal canal, tenuous blood supply, and proximity to vital organs and vasculature. Calcified TDH adds further complexity, necessitating meticulous preoperative planning to determine the safest and most effective approach. Although various techniques have been described for managing TDH, many are associated with high complication rates, increased blood loss, and extended hospitalizations. Recent studies suggest that the minimally invasive lateral retropleural approach for calcified TDH offers notable advantages, improving clinical and operative outcomes. However, research specifically focusing on the efficacy of this technique remains limited. This narrative review examines the existing literature on the lateral retropleural approach, discussing reported outcomes, technical considerations, and potential challenges.

Cone Beam CT assisted Radiologically Inserted Gastrostomy. Technical considerations and impact on radiation dose.

Cone Beam CT assisted Radiologically Inserted Gastrostomy. Technical considerations and impact on radiation dose.

Single Position Lateral Anterior Lumbar Interbody Fusion at L5/S1.

Anterior lumbar interbody fusion (ALIF) is an established surgical approach for spinal fusion, offering distinct advantages in restoring lumbar lordosis, indirectly decompressing neural elements, and facilitating high fusion rates because of the increase in the fusion surface area. Traditionally, ALIF is performed with the patient in a supine position, necessitating repositioning for additional posterior interventions, which increases operative time, anesthetic time, and complexity. The recent development of single position lateral ALIF (SPL-ALIF) enables anterior and posterior access without repositioning, enables gravity facilitated retroperitoneal access, and optimizes surgical efficiency, particularly in cases necessitating multilevel anterior column fusion. The current review comprehensively examines SPL-ALIF at the L5-S1 level, presenting technical considerations and comparative benefits over traditional techniques. The approach has demonstrated significant reductions in operative time, blood loss, and postoperative ileus, with equivalent radiographic outcomes compared with supine ALIF. Furthermore, SPL-ALIF has been evidenced to have a similar safety profile to supine ALIF with equivalent vascular, abdominal, and neurological complications, as well as comparable revision rates between the two procedures. However, SPL-ALIF is not without limitations. The technique may be less effective in cases requiring direct decompression or in patients with complex vascular anatomy or extensive retroperitoneal scarring. These challenges necessitate careful patient selection to optimize outcomes and minimize intraoperative risks. Future studies are warranted to validate the clinical benefits of SPL-ALIF, particularly concerning fusion rates, patient-reported outcomes, and complication profiles, thereby solidifying its role in the evolving landscape of minimally invasive spine surgery.