A Multi-Level World Comprehensive Neural Network Model for Maximum Annual Solar Irradiation on a Flat Surface

With the growing demand for clean and economically feasible renewable energy, solar photovoltaic (PV) system usage has increased. Among many factors, the tilt and azimuth angles are of great importance and influence in determining the photovoltaic panel’s efficiency to generate electricity. Although much research was conducted related to solar PV panels’ performance, this work critically determined the tilt and azimuth angles for PV panels in all countries worldwide. The optimum tilt and azimuth angles are estimated worldwide by the photovoltaic geographic information system (PVGIS). Also, annual and average daily solar irradiation incident on the tilted and oriented plate optimally (AR1 and DR1) are calculated. Besides, annual and average daily solar irradiation incident on plate tilt optimally and oriented because of the south in the northern hemisphere and because of the north in the southern hemisphere (AR2 and DR2) are estimated. PVGIS is also used to calculate the annual and average daily solar irradiation incident on the horizontal plate (AR3 and DR3). The data collected from PVGIS are used to develop an efficient and accurate artificial neural network model based on feed-forward neural network approach. This model is an essential subpart that can be used in an embedded system or an online system for further PV system analysis and optimization. The developed neural model reflected very high accuracy in predicting the PV panels’ optimal tilt and azimuth angles worldwide. The benefit of tilting is generally increased by increasing the latitude. As the latitude increases, the tilt factor (F) increases because of the increase in the optimum tilt angle by increasing the latitude. The optimal orientation is due to the north in the southern hemisphere and due to the south in the northern hemisphere for most cities worldwide. In sum, it can be concluded that the optimum tilt angle is equal to or greater than the latitude until the latitude 30°. The optimum tilt angle becomes less than the latitude, and the difference is increased until it reaches more than 20°. Hence in this study the aim is to develop a simple neural network model which can accurately predict the annual radiation and optimum tilt and azimuth angle in any region of the world and can be easily implemented in a low-cost microcontroller

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Carcterísticas topográficas del queratocono en nuestro medio Topographic characteristics of the keratoconus in our environment

Objetivos: Conocer los patrones topográficos del queratocono en nuestro medio, valorando los índices topográficos obtenidos a partir de ellos. Métodos: el universo de estudio fue de 100 ojos de pacientes con diagnóstico de esta enfermedad, los cuales fueron sometidos a un estudio de topografía corneal donde se analizaron diferentes variables como: poder dióptrico en el ápex del cono y su eje, poder dióptrico central del ojo y del ojo adelfo, la diferencia entre el poder dióptrico corneal superior e inferior, y el astigmatismo. Resultados: se encontró que el queratocono central asimétrico fue el predominante. Los valores topográficos y la diferencia del ápex del cono entre ambos ojos resultaron más elevados en el queratocono central y periférico, igualmente el astigmatismo resultó elevado en estos patrones; mientras que los valores del ápex del cono y su eje, poder dióptrico central del ojo y del ojo adelfo y la diferencia entre el poder dióptrico corneal superior e inferior resultaron menores en el queratocono central. Con relación al eje se evidenció el predominio a nivel temporal inferior. Conclusiones: En este medio, el queratocono es una patología con escasos estudios, y este trabajo trata de establecer los patrones topográficos predominantes donde se encontraron 3 tipos básicos como son el queratocono central, central asimétrico y el periférico, con valores topográficos significativos.<br>Objectives: To know the topographic patterns of the keratoconus in our environment by assessing the topographic indexes obtained from them. Methods: the universe of study was composed of 100 eyes from patients who had been diagnosed this disease. They underwent a corneal topography study where different variables, such as dioptric power in the apex of the cone and its axis, dioptric central power of the eye and of the adelphos eye, the difference between the upper and lower corneal dioptric power, and astigmatism, were analyzed. Results: it was found that the central asymmetric keratoconus is the predominant.The topographic values and the difference of the apex of the cone between both eyes were higher in the central and peripheral keratoconus. Likewise, astigmatism was elevated in these patterns, whereas the values of the apex of the cone and its axis, the central dioptric power of the eye, of the adelphos eye and the difference between the upper and lower corneal dioptric power were lower in the central keratoconus. As regards the axis, it was evidenced the predominance at the lower temporary level. Conclusions: In this setting, the keratoconus is a poorly studied pathology and this paper tries to establish the prevailing topographic patterns where 3 basic types were found: the central, the central asymmetric and the peripherical keratoconus with significant topographic values

Measurement of Entropy Level in Comparison between Remifentanil and Propofol in Open Heart Surgery

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; There is a high rate of awareness during open heart surgery, which causes severe complications that endanger the patient's life and potentially lead posttraumatic stress disorder. Various techniques have been employed to measure the depth of anesthesia and awareness by Entropy (EEG, EMG monitoring) autonomic response (H.R, B.P), Bispectral index (EEG monitoring) skin conductance (change in sweat production), lower esophageal contractility. &lt;strong&gt;Aims:&lt;/strong&gt; In our study we try to compare the incidence of awareness by measuring the difference in level of entropy) EEG) in these two groups of anesthetic drugs ,1st group Remifentanil, 2nd group propofol. &lt;strong&gt;Patients and methods:&lt;/strong&gt; A randomized prospective comparative clinical trial, of 44 adult patients were undergone open heart surgery,22 of them received Remifentanil, the other 22 patients received propofol both as maintenance of anesthesia. Before induction of anesthesia, we apply three forehead entropy leads to measure the depth of anesthesia in the pre cardiopulmonary bypass period. &lt;strong&gt;Results:&lt;/strong&gt; There was significant decrease in awareness (state entropy) in R group, P value 0. 016m.The H. R significantly decrease in P Group P value 0. 046.While there is no significant difference in blood pressure in both groups. &lt;strong&gt;Conclusion:&lt;/strong&gt; The use of Remifentanil for maintenance of anesthesia in open heart surgery is more suitable than propofol maintenance because it has shown less awareness and more hemodynamic stability&lt;/p&gt

Implantes orbitarios de HAP-200: Experiencia en 100 casos Orbital implants of HAP-200: Experience in 100 cases

Exponemos nuestra experiencia en los primeros 100 casos, en los cuales utilizamos implantes orbitarios confeccionados en Cuba con hidroxiapatita porosa coralina (HAP-200), en el período comprendido entre 1995-2000. Nuestra casuística estuvo enmarcada entre los 5 y 65 años de edad, predominando los grupos de edades de 15 a 35 años con 63 casos, el 72 % correspondió al sexo masculino. Los traumatismos primaron como causa de pérdida del globo ocular (80 %). Efectuamos 5 tipos de técnicas quirúrgicas, 22 enucleaciones, 46 evisceraciones (26 con y 9 sin conservación corneal respectivamente, 11 con cuadrisección escleral) y 32 reconstrucciones de cavidades antiguas (implantes secundarios). En la mayoría de los pacientes operados los síntomas y signos posoperatorios fueron locales y catalogados de ligeros, que desaparecieron en la primera semana. Observamos dentro de las complicaciones 12 dehiscencias conjuntivales, 10 exposiciones de los implantes, 2 hipercorrecciones, 1 hipocorrección y 1 quiste conjuntival. La gammagrafía orbitaria demostró crecimiento fibrovascular en la totalidad de los pacientes sometidos a dicha investigación. Los resultados cosméticos evaluados fueron la conservación del surco orbitario y la motilidad del muñón que se consideraron satisfactorios, así como la tolerancia al material implantado que fue buena en el 93 % de los casos al cabo de los 2,5 años.We explain our experience with the first 100 cases in whom orbital implants made in Cuba with coralline porous hydroxyapatite (PHA-200) were placed between 1995 and 2000. Our casuistics comprised patients aged 5-65. It was observed a predominance of the age groups 15-35 with 63 cases. 72 % were males. Traumas prevailed as the main cause of eyeball loss (80 %). 5 types of surgical techniques were performed: 22 enucleations, 46 eviscerations (26 with and 9 without corneal conservation, respectively, 11 with scleral cuadrisection) and 32 reconstructions of old cavities (secondary implants).The postoperative symptoms and signs were local and mild in most of the patients that were operated on and they disappeared during the first week. 12 conjunctival deshicences, 10 implant exposures, 2 hypercorrections, 1 hypocorrection and 1 conjunctival cyst were observed among the complications. The orbital scintigraphy showed fibrovascular growth in all the patients under study. The evaluated cosmetic results were the conservation of the orbital sulcus and the motility of the strump that were considered as satisfactory, as well as the tolerance to the implanted material that was good in 93 % of the cases after 2.5 years

Maternal and Neonatal Outcomes Post Bariatric Surgery: A Population-Based Study

Objectives  This study had two primary objectives. First, to evaluate the incidence, risk factors, and maternal and neonatal outcomes among pregnant women post-BS (the exposed group). Second, to evaluate these outcomes among pregnant women without a history of BS, these include women who are obese, overweight, and with normal weight (non-exposed groups). Design This population-based study was conducted using 12-month retrospective registry data from the PEARL-Peristat Study at the Women's Wellness and Research Center (WWRC) in Qatar. Methods: We examined 6,212 parturient women and their offspring. Participants were classified into exposed (post-BS) (N=315) and non-exposed (N=5897). Statistical analysis was conducted using SPSS 28 software. We analyzed the risk factors and outcomes using univariate and multivariable regression. Results were reported as odds ratios (cOR) and adjusted aOR with 95% confidence intervals (CI), while incidences were reported as percentages. P value was regarded as significant at Results Qatari, advanced maternal age, Parity >1, diabetes, and hypertension were found to be significant risk factors for women with post-BS. In addition, women in the post-BS group were found to be significantly more likely to have a cesarean delivery (37.5% vs. 24%, aOR=1.59, CI 1.18-2.14), preterm babies (10% vs. 7%, aOR=1.66, CI 1.06-2.59), and stillbirth (1.6% vs. 0.4%, aOR=4.53, CI 1.33-15.50) compared to the normal weight women group. Moreover, post-BS women had a higher risk of low-birth-weight neonates than obese (15% vs. 8%, aOR= 1.77, CI 1.153-2.73), overweight (15% vs. 7%, aOR=1.63, CI:1.09-2.43), and normal weight (15% vs. 8%, aOR=1.838, CI 1.23-2.75) women. Finally, women in the post-BS group were more likely to have low-birth weight neonates ( In contrast, post-BS had a lower risk of gestational diabetes than obese (19% vs. 40%, aOR=0.39, CI: 0.29-0.54) overweight (19% vs. 32%, aOR= 0.57, CI 0.42-0.79) women. Similarly, compared to the overweight group, post-BS had a lower incidence and risk of assisted birth (4% vs. 9%, aOR=0.46, CI 0.21-0.99). On the other hand, obesity significantly increased the risk of gestational diabetes, cesarean deliveries, and labor induction in comparison to the other groups. Conclusion  Pregnancies with post-BS should be considered a high-risk group for some outcomes and should be monitored closely. These findings may guide the future clinical decisions of antenatal and postnatal follow-up for post-BS women. </p