Total Time Research Articles

Colorectal procedures with the novel Hugo™ RAS system: training process and case series report from a non-robotic surgical team.

The landscape of robotic surgery is evolving with the emergence of new platforms. However, reports on their applicability in different surgical fields are still limited and come from teams with robotics experience. This study aims to describe the training process for colorectal surgery with the Hugo™ RAS system of a robotics-inexperienced surgical team and present the initial patient series. The training process is depicted, and data from the first 10 consecutive patients operated on for colorectal conditions with the Hugo™ RAS system by a surgical team with no prior experience in robotic surgery were prospectively recorded and analysed. The team received intensive training in robotic surgery and specifically in the Hugo™ RAS system previously to the first case. Between May 2023 and December 2023, 10 patients underwent colorectal procedures: 5 right colectomies, 3 sigmoid resections, 1 high rectal resection and 1 ventral mesh rectopexy. The first case was proctored by an expert. Median docking time was 14 min and median total operative time was 185 min. The only technical difficulty during the procedures was occasional clashing of robotic arms. None had to be converted, and no intraoperative or postoperative morbidity was recorded. Hospital stays ranged from 2 to 4 days. A median of 21 lymph nodes were yielded in the operations for malignant conditions. Common colorectal procedures can be safely performed using the Hugo™ RAS platform. Prior experience in robotic surgery is not a necessary requirement, but following a structured training program is essential.

The utility of fetal heart rate deceleration's descending slope in searching for a non-National Institute of Child Health and Human Development parameter for the detection of fetal acidosis.

To identify new parameters predicting fetal acidemia. A retrospective case-control study in a cohort of deliveries from a tertiary referral hospital-based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non-NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC). A total of 10 362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC = 0.727). The non-NICHD parameters measured during the 30-min fetal monitoring, total deceleration area (AUC = 0.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC = 0.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC = 0.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%). The slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility.

Behavioural therapy for shift work disorder improves shift workers' sleep, sleepiness and mental health: A pilot randomised control trial.

The present study evaluates the efficacy of behavioural therapy adapted for shift work disorder with a randomised control design in a healthcare population. Forty-three night shift workers (m. age: 34 years; 77% women) experiencing shift work disorder were randomised to either the behavioural therapy for shift work disorder (BT-SWD) or a waiting-list control group offered after the waiting period. Participants completed questionnaires on insomnia, sleepiness and mental health pre- and post-treatment, pre- and post-waiting, and at follow-up, and a sleep diary. As night shift workers alternate between sleeping during the day after their night shifts and transitioning to nighttime sleep on days off, insomnia severity and sleep variables were analysed for daytime and nighttime sleep. The BT-SWD involved sleep restriction therapy, stimulus control and fixed sleep periods in the dark. Statistical analyses were performed under intent-to-treat and per-protocol approaches. Repeated-measures two-way ANCOVA analysis, controlling for age, sex and pre-treatment daytime total sleep time, was performed with Bonferroni corrections, and between-group effect sizes computed. Fourteen participants dropped out after randomisation. Under the intent-to-treat analysis, BT-SWD participants had a significant greater decrease in daytime insomnia severity and an increase in daytime total sleep time at post-treatment than the control group, with large between-group effect sizes (-1.25 and 0.89). These corresponding results were also significant with large effect sizes under the per-protocol analysis. Sleepiness, anxiety and depression levels improved at post-treatment and maintained at follow-up when the BT-SWD treated controls were added to the BT-SWD group. The behavioural therapy for shift work disorder can be used to improve the sleep and mental health of healthcare night workers.

Associations of objectively measured physical activity and sleep in preschoolers aged 3 to 6 years

Research has demonstrated various negative effects of poor sleep on overall health in children. Engaging in physical activity during the day is often recommended to help children sleep better. Limited research has examined this recommendation for preschool children, although physical activity is generally supported as a healthy sleep practice. When measuring physical activity and sleep, objective measures (e.g., accelerometers) are recommended as opposed to subjective measures (e.g., parental reports). The purpose of the current study was to examine the relationship between objectively measured sleep (key variables included sleep efficiency, sleep onset latency, and sleep duration) and physical activity (operationalized as mean daily total physical activity) among preschool-aged children in Nova Scotia, Canada. Children (n = 29) wore a wrist accelerometer to objectively measure sleep and wore an accelerometer on their waist to measure physical activity for nine consecutive days. Overall, linear regression analyses demonstrate physical activity as a predictor of sleep efficiency but not total sleep time or sleep onset latency among preschool-aged children. Future research should examine the causal relationships between sleep efficiency and physical activity by conducting interventions to increase physical activity and determining the impact on sleep efficiency.

Effect of intravenous lidocaine on the ED50 of propofol induction dose in elderly patients undergoing painless gastroscopy: a prospective, randomized, double-blinded, controlled study

BackgroundIntravenous lidocaine could be a potential alternative adjuvant to propofol-based sedation for gastroscopy in elderly patients. This study aimed to evaluate the effect of intravenous lidocaine on the median effective dose (ED50) of propofol induction dose in elderly patients undergoing painless gastroscopy.MethodsThe study included 70 patients aged ≥ 60 years undergoing painless gastroscopy with 64 randomly assigned to either group L (2% lidocaine 1.5 mg/kg, n = 31) or group N (equal volume normal saline, n = 33). All patients received propofol induction following 0.1 μg/kg intravenous sufentanil. The Dixon “up-and-down” sequential method was used, with a 1.5 mg/kg initial induction dose of propofol followed by a 0.1 mg/kg sequential variable dose. The primary endpoint was the ED50 of the propofol induction dose. The total propofol dose, recovery time, adverse events, and local anesthetic intoxication reactions were also recorded.ResultsThe ED50 of propofol induction dose was 0.670 (95% confidence interval [CI] 0.216–0.827) mg/kg in group L and 1.118 (95% CI 0.803–1.232) mg/kg in group N. There was a statistically significant difference between the two groups (p < 0.001). The incidence of hypotension and propofol injection pain were lower in group L than in group N (p < 0.05). Furthermore, the orientation recovery time in group L was shorter compared to group N (p < 0.05). None of the participants in group L observed local anesthetic intoxication reactions after receiving lidocaine.ConclusionsThe administration of intravenous lidocaine to elderly patients undergoing painless gastroscopy resulted in a significant 40% reduction in the ED50 of propofol induction dose, which may be related to the decreased incidence of hypotension and injection pain, as well as the improved post-gastroscopy orientation recovery.Trial registrationChiCTR, ChiCTR2200065530. Registered on 08 November 2022.

Patient Factors and Their Effect on Operating Room Time for Urologic Procedures

Patient Factors and Their Effect on Operating Room Time for Urologic Procedures

Investigating the design, participation and experience of teaching and learning facilitated by user-generated microgames on an open educational platform

Investigating the design, participation and experience of teaching and learning facilitated by user-generated microgames on an open educational platform

Assessing the impact of ride-sourcing vehicles on HOV-lane efficacy and management strategies

High-occupancy vehicle (HOV) lanes, which exclusively allow vehicles with two or more travelers on board to enter, has been recognized as a promising and practical way to motivate travelers to carpool. However, in the presence of ride-sourcing services, ride-sourcing vehicles with one driver and one (or more) passenger on board also meet the vehicle requirements of HOV lanes. So instead of encouraging travelers to carpool, HOV lanes may benefit ride-sourcing users and stimulate ride-sourcing demand. In this paper, in a single-corridor network with both HOV lanes and general purpose (GP) lanes, we model travelers’ mode choices among transit, driving alone, ride-sourcing, and carpool, and delineate travelers’ lane choices at user equilibrium, with the travel time of GP/HOV lanes and the carpool price being endogenously determined. With numerical examples, we show that the occupation of HOV lanes by ride-sourcing vehicles will greatly reduce the time saving on HOV lanes, thus lower the attractiveness of carpool, and increase the total travel time cost on the corridor. To solve this problem, we propose to implement an additional tolling scheme on HOV lanes, so that carpool users can split the toll evenly, while ride-sourcing riders have to pay the toll alone. As shown by numerical examples, the optimal tolling scheme can effectively reduce the occupancy of ride-sourcing vehicles on the HOV lane and encourage users to carpool. And the impacts of the ride-sourcing price, driving car cost and the HOV lane capacity ratio on the effectiveness of the proposed hybrid toll and HOV strategies are examined through sensitivity analysis.

Quantification of surgical workflow during robotic proctectomy.

Surgical workflow assessments offer insight regarding procedure variability. We utilised an objective method to evaluate workflow during robotic proctectomy (RP). We annotated 31 RPs and used Spearman's correlation to measure the correlation of step time and step visit frequency with console time (CT) and total operative time (TOT). Strong correlations were seen with CT and step times for inferior mesenteric vein dissection and ligation (ρ=0.60, ρ=0.60), lateral-to-medial splenic flexure mobilisation (SFM) (ρ=0.63), left rectal dissection (ρ=0.64) and mesorectal division (ρ=0.71). CT correlated strongly with medial-to-lateral (ρ=0.75) and supracolic SFM visit frequency (ρ=0.65). TOT correlated strongly with initial exposure time (ρ=0.60), and medial-to-lateral (ρ=0.67) and supracolic SFM visit frequency (ρ=0.65). This study correlates surgical steps with CT and TOT through standardised annotation, providing an objective approach to quantify workflow.

EXTINGUISHING TIME OF OIL PRODUCT TANK FIRES WITH SELF-EXPANDING GAS-AEROSOL-FILLED FOAM

EXTINGUISHING TIME OF OIL PRODUCT TANK FIRES WITH SELF-EXPANDING GAS-AEROSOL-FILLED FOAM

Comparison of the short-term surgical outcomes of lateral lymph node dissection for low rectal cancer using a robotic-assisted transabdominal approach alone or supported by a transanal approach.

Lateral lymph node metastases are a major cause of local recurrence after surgery for advanced low rectal cancer. Lateral lymph node dissection (LLND) may reduce the risk of local recurrence in patients with suspected lateral lymph node metastasis. Recent reports have shown that robotic-assisted LLND can help to reduce the postoperative complication rate, such as urinary disturbance. Furthermore, with the advent of transanal total mesorectal excision, a novel LLND procedure that combines a transabdominal approach with a transanal approach has been reported. This study aimed to clarify the safety and feasibility of robotic-assisted LLND supported by a transanal approach for advanced low rectal cancer. Thirty-nine patients diagnosed to have low rectal cancer between June 2019 and May 2023 were retrospectively enrolled and divided according to whether they underwent LLND via a robotic-assisted transabdominal approach alone (transabdominal group, n = 19) or in combination with a transanal approach (2team group, n = 20). The patient characteristics and short-term surgical outcomes were compared between the two groups. The total operation time was significantly shorter in the 2team group than in the transabdominal group (366min vs. 513min, P < 0.001), as was the time taken to perform unilateral LLND (64min vs. 114min, P < 0.001). Furthermore, there was significantly less intraoperative bleeding in the 2team group (30mL vs. 80mL, P = 0.004). There was no significant between-group difference in postoperative complications. The incidence of postoperative urinary disturbance was satisfactory at 5% in both groups. The operation time for LLND performed by a robotic-assisted transabdominal approach was shortened when supported by a transanal approach. The frequency of postoperative urinary disturbance was low in both groups. Therefore, robotic-assisted abdominal LLND supported by a transanal approach can be considered a promising treatment option for advanced low rectal cancer.

Abstract A032: Preliminary evaluation of sleep-related patient-reported outcomes (pros), morningness-eveningness chronotype, &amp; objective sleep measures using smart wearables in a primary brain tumor patient population

Abstract Introduction: Sleep is vitally important for the improvement of cancer outcomes, but evaluation of sleep in the primary brain tumor (PBT) population is limited. This analysis aims to provide preliminary data on the consistency/reliability of sleep-related patient-reported outcomes (PROs) and to assess sleep symptom severity with both PROs and objective sleep measurements. Methods: PBT patients ³ 18 years wore a Fitbit smart-wearable device for 4 weeks, which captured objective sleep measures (total sleep time, sleep latency, nap odds/number/duration, and wake after sleep onset (WASO)). The Morningness-Eveningness Questionnaire (MEQ) was completed at baseline, PROMIS Sleep-Related Impairment (SRI) and Sleep Disturbance (SD) Short-Forms were completed at baseline and at the end of the study, and daily sleep diaries were done during the final week. Descriptive statistics were used to describe patient demographics/clinical characteristics, Cronbach’s alpha to test consistency, McNemar’s tests for change in PRO severity, and Pearson’s correlations for relationships between PROs and objective sleep measures at week 1 and week 4. Results: 54 patients (median 46 years (24-71), 56% male, 85% white non-Hispanic, 81% KPS ≥ 90) completed the study. Most had anaplastic astrocytoma (20%) or glioblastoma (17%), had received radiation therapy (83%), had prior tumor recurrence (32%), and were not on active treatment (80%) during the study. PROMIS SRI/SD and MEQ were all consistent and reliable (Cronbach’s alpha 0.74-0.92). Fifty-six percent of patients had an intermediate sleep chronotype, 35% moderate-morning, 4% definite-morning, and only 6% moderate-evening (0% definite-evening). Moderate-severe SD and SRI were reported in 13% and 17% at baseline, and 4% (p=0.06) and 13% (p=0.69) at study exit. Co-occurrence of SD and SRI decreased from 11% to 2% (p=0.06). Fitbit-recorded measures showed a correlation at week 4 between WASO and SD (r=0.35, p=0.009), and a trend with SRI (r=0.24, p=0.08). Conclusions: This investigation shows initial evidence that sleep-related PROs are consistent and reliable in PBT patients, &amp;gt;10% of participants had significant SD and SRI, and the majority had intermediate and morningness chronotypes. Surprisingly, significant improvement in SD was reported during the study, which may be related to increased awareness of sleep patterns by the participants. Lack of sleep improvement (high SD/SRI) was associated with increased WASO, suggesting greater sleep fragmentation and potentially greater circadian vs. homeostatic sleep drive dysregulation in this population, warranting further investigation. Citation Format: Maeve M. Pascoe, Elizabeth Vera, Hope Miller, Alex Wollet, Dorela Shuboni-Mulligan, Amanda L. King, Terri S. Armstrong. Preliminary evaluation of sleep-related patient-reported outcomes (pros), morningness-eveningness chronotype, &amp; objective sleep measures using smart wearables in a primary brain tumor patient population [abstract]. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_1):Abstract nr A032.

Association Between Augmentation Index and Total Sleep Time in Night Shift Workers.

Augmentation index and pulse wave velocity are markers of vascular compromise and independent predictors of cardiovascular risk and mortality. While the link between shift work and heightened cardiovascular risk is established, the intricate genesis of early cardiovascular outcomes in shift workers remains incompletely understood. However, there is evidence that sleep duration plays a role in this regard. Here we evaluate the association of total sleep time with pulse wave velocity, augmentation index, and central blood pressure in night shift workers. This study cross-sectionally evaluated the association of total sleep time evaluated by 10-day monitoring actigraphy with augmentation index, pulse wave velocity, and brachial and central blood pressure evaluated by oscillometry in nursing professionals, 63 shift workers (89% women; age = 45.0 ± 10.5 years), and 17 (100% women; age = 41.8 ± 15.6) day workers. There were no differences in the studied variables between shift workers and day workers. Results of correlation analysis demonstrated that pulse wave velocity, central systolic blood pressure, central diastolic blood pressure, brachial systolic blood pressure, and brachial diastolic blood pressure tended to have significant correlation with each other, while these measures did not have a significant relationship with augmentation index in both groups. However, results of adjusted restricted cubic spline analysis showed a U-shaped-curve association between total sleep time and augmentation index (p < 0.001 for trend) with a nadir at 300-360 min of total sleep time in shift workers. The present study showed that total sleep time, assessed by actigraphy, had a U-shaped association with augmentation index in shift workers, which indicated better characteristics of vascular functionality when sleep time was 5-6 h in the workers studied.

Numerical simulation and experimental investigation on Phase Change Materials based energy storage system for cooling the water in process industries towards water conservation and environmental sustainability

Water conservation is one of the significant concerns in the industrial sector in cooling processes. Water is lost predominantly in the cooling towers by evaporation, drift, and blowdown. A new Phase Change Material (PCM) based cooling system is proposed as a replacement for cooling towers to eliminate water losses completely. In the current research, the temperature drop of water known as range in the cooling tower is investigated in the proposed system by varying the process parameters such as water velocity, tube materials and tube lenght. In the present study, OM50, an organic PCM with a melting temperature of 500 C is chosen for experimental and numerical analysis as the normal operating temperature of water in the cooling towers is in this range. Based on the experiment, it is observed that the temperature range of water almost remains constant for the melt fraction values of PCM from about 0.1 to 0.8 and taking about 35 % of the total time required for completely melting the PCM. However the cooling range steeply decreases for the melt fraction variation from 0.8 to 1. Hence the designing of PCM based cooling system will be effective for the melting of the PCM from 0.1 to 0.8 leading to constant cooling range of temperature. The experimental results obtained are also validated by CFD simulation using ANSYS 18.1 and the results obtained are in close agreement with each other. The range obtained in the present research is almost in the same range of cooling tower used in the chiller plant presented in the case study. The proposed system may be able to replace cooling towers towards conservation of water and environmental sustainability.

The effect of quiet eye training on golf putting performance in pressure situation

To explores the effect and mechanism of quiet eye training on the accuracy of golfers´ putts in pressure situations and provides methods and basis for targeted attention training and control. 22 young golfers in China golf team aged from 13 to 18 were randomly assigned to the experimental group (quiet eye training group) and the control group (technical guidance group) according to gender. Both groups of participants underwent two consecutive weeks of push training (3 sets per day, 20 golf putts per set, rest for 3 min between sets) separately in accordance with the guidance of a professional psychological research group and an expert coach. Eye tracking technology, biofeedback technology, and subjective evaluation methods were used to test and analyze the push process of the two groups of participants before and after training under pressure situations (Eye movement behaviors and the heart rate were recorded by ASL Mobile Eye-XG and NeXus-2 biofeedback, pressure and state anxiety were evaluated by self-rating pressure scale and S-AI. Golf putting performance was recorded by a research graduate assistant). A higher hit ratio as well as lower pressure and SAI level was founded in quiet eye training group in the pressure situation, the quiet eye movement time and total fixation time was longer than technical group. The quiet eye training group has a better putting performance. Quiet eye training can improve the golf putting performance in pressure situations. After quiet eye training, the state anxiety decreased, the quiet eye movement time and the total fixation time increased in pressure situations.

Carbohydrate counting knowledge and ambulatory glucose profile in persons living with type 1 diabetes

Context.The amount of consumed carbohydrates is the strongest factor influencing glucose levels during the four hours following a meal.Our aim was to evaluate the association between carbohydrate counting knowledge and continuous glucose monitoring (CGM) parameters in patients with type 1 diabetes (T1D) using different insulin regimens. MethodIn this multicenter prospective study, the GluciQuizz questionnaire was used to evaluate carbohydrate knowledge. CGM data for the 14 days preceding completion of the questionnaire were analyzed.The primary endpoint was evaluation of the correlation between the GluciQuizz total score and time in range (TIR) in the study population. ResultsThe mean age of the 170 participants was 40.7 ± 14.8 years and duration of T1D 18.8 ± 12.1 years. The mean GluciQuizz total score for all participants was 66 ± 13 %. Mean TIR was 58.6 ± 18.7 %. GluciQuizz total score positively correlated with TIR (r = 0.3001; p < 0.0001). This correlation was observed in CSII users (r = 0.2526; p < 0.05) but not in MDI (r = 0.2510; p = 0.1134) and HCL users (r = -0.1065; p = 0.4914). TIR was also negatively correlated with the mean carb count error in all study participants (r = -0.2317; p < 0.01). ConclusionIn conclusion, as the Gluciquizz score was associated with metabolic control, this easy-to-use self-administered questionnaire could be used widely on a routine basis to assess the carbohydrate knowledge of T1D patients and to offer them targeted education tailored to their needs.

Magnesium-calcium thin films at low calcium concentrations for anode materials in biodegradable implantable primary batteries

A Mg–Ca thin film combinatorial library was produced by thermal co-evaporation targeting a compositional spread of Ca from 0.2 to 3 at.%. Microstructure characterizations proved all alloys to have single-phase microstructures, displaying a gradual refinement with increasing Ca concentration. Electrochemical characterizations conducted using scanning droplet cell microscopy (SDCM), showed that the incorporation of Ca resulted in an improvement of the corrosion resistance of Mg thin films. The Mg-1.2 at.% Ca thin film alloy screened from the library showed an optimal initial cell potential and total discharge time.

137 Impacts of heat stress on the accuracy of an ear-tag sensor for detection of eating and rumination behavior in cattle

Abstract Ear-tag accelerometers are used for precision livestock management, but little is known regarding effects of varying environmental conditions on sensor performance. The objective was to evaluate accuracy of a commercially available ear-tag sensor (CowManager SensOor, Agis Automatisering BV, Harmelen, the Netherlands) in quantifying feeding behaviors under varying temperature-humidity indices (THI). RumiWatch System (RW) noseband sensors (Itin+Hoch GmbH, Liestal, Switzerland) were utilized as a benchmark. Nine Holstein-Angus steers (body weight: 488 ± 9 kg) were fitted with CowManager (CM) sensors and RW halters, with continuous monitoring during two 14-d phases: thermoneutral (TN: 21.0 ˚C, 64.0% humidity, THI = 67) and heat stress (HS: cyclical daily temperatures to mimic diurnal patterns; HS: 23.2 ˚C – 33.6 ˚C, 39.5 – 70.0% humidity, THI = 70.3 – 83.5). Steers were individually-housed (3×3 m) and provided ad libitum access to a mixture of corn silage and dried distillers grains with solubles. Hourly summaries of eating time (ET) recorded by CM were compared with EAT1TIME (head down) and EAT2TIME (head up) parameters from RW (v.7.3.36) as well as total ET (EAT1TIME + EAT2TIME); rumination time (RT) was also compared. Agreement was evaluated (R; v.4.3.1) over the full 24-h day (FULL) and a 6-h period from afternoon to early evening (AFT; 1400 – 2000 h) when HS effects would be most pronounced. Across both 14-d phases, agreement between CM and EAT1TIME was moderate to high (concordance correlation coefficient [CCC] = 0.69 to 0.77), whereas agreement with EAT2TIME and total ET was poor to moderate (CCC = 0.41 – 0.61). Bland-Altman analysis demonstrated significant underestimation of total ET by CM, with biases of -8.98 (-10.88, -7.09) to -6.44 (-7.51, -5.38) min h-1. Agreement for EAT1TIME was high for TN (CCC = 0.74), but only moderate during HS (CCC = 0.69) for the FULL dataset. Similarly, agreement for total ET was moderate for TN but poor for HS over FULL and during AFT, respectively (CCC: TN – 0.53, 0.54; HS – 0.47, 0.41). CowManager significantly underestimated EAT1TIME during HS (bias: FULL = -1.45 [-2.60, -0.30]; AFT = -2.14 [-3.93, -0.35] min h-1), but not TN (bias: FULL = -1.38 [-2.82, 0.06]; AFT = -1.83 [-3.68, 0.02] min h-1). Agreement for RT was high regardless of environmental conditions and time period analyzed (CCC = 0.74 – 0.81). However, during the critical AFT period, CM significantly overestimated RT under HS (bias: 4.42 [2.06, 6.79] min h-1) but not TN conditions (bias: -0.47 [-2.42, 1.47] min h-1). These results indicate that ET reported by CM is more reflective of time eating with the head down than the total time engaged in eating behaviors. Results of this study also suggest accuracy of ear-tag accelerometers may be impaired when cattle are subjected to heat stress.

Boosting thermal regulation of phase change materials in photovoltaic-thermal systems through solid and porous fins

This study explores the integration of porous fins with phase-change materials (PCM) to enhance the thermal regulation of photovoltaic-thermal (PVT) systems. Computational simulations are conducted to evaluate the impacts of different porous fin configurations on PCM melting dynamics, PV cell temperatures, and overall PVT system effectiveness. The results demonstrate that incorporating optimized porous fin arrays into the PCM region can significantly improve heat dissipation away from the PV cells, enabling more effective thermal control. Specifically, the optimized staggered porous fin design reduces the total PCM melting time and decreases peak cell temperatures by about 5°C . This is achieved by creating efficient heat transfer pathways that accelerate the onset of natural convection during the PCM melting process. Further comparisons with traditional solid metallic fins indicate that while solid fins enable 12.2% faster initial melting, they provide inferior long-term temperature regulation capabilities compared to the optimized porous fins. Additionally, inclining the PV module from 0° to 90° orientation can further decrease the total PCM melting time by 13 minutes by harnessing buoyancy-driven convection. Overall, the lightweight porous fin structures create highly efficient heat transfer pathways to passively regulate temperatures in PVT systems, leading to quantifiable improvements in thermal efficiency of 16% and electricity output of 2.9% over PVT systems without fins.

Endovascular aneurysm repair under local anesthesia through bilateral percutaneous femoral access is a safe strategy to improve early outcomes and reduce hospital stay.

To estimate the impact of anesthetic conduct, alone and in combination with the type of femoral access, on early results after endovascular aneurysm repair (EVAR). A retrospective multicenter analysis on patients undergoing elective standard EVAR at four academic centers was performed. Patients undergoing the procedure through either local or general anesthesia were compared. Comparative subanalyses of the two groups were performed for the type of femoral access to evaluate further impact on outcomes. Five hundred twenty-four patients underwent elective standard EVAR, of which 207 (39.5%) under general anesthesia and 317 (60.5%) under local anesthesia. Patients who underwent general anesthesia had higher 30-day mortality rates (3.4% vs. 0.3%, P=0.005), as well as slightly worse 30-day major systemic complication rates (8.2% vs. 5.4%, P=0.195). There were no differences in terms of reinterventions (2.1% vs. 2.5%, P=0.768) and aneurysm-related mortality (0% vs. 0.4%, P=0.422) at one year. Total intervention times were significantly longer in the general anesthesia group (126 vs. 89 minutes, P=0.001), as well as the total length of hospital stay (7.6 vs. 5.3 days, P=0.007). At subanalyses, the combination of local anesthesia with bilateral percutaneous femoral access further improved 30-day outcomes and determined an additional reduction in total intervention times and ICU stays. EVAR performed under local anesthesia has a significantly better impact on early results when compared to general anesthesia. Combining percutaneous bilateral femoral access to local anesthesia reduced procedural times, ICU stays and consequently improved early results.