677 research outputs found

    Feasibility study of a hand guided robotic drill for cochleostomy

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    The concept of a hand guided robotic drill has been inspired by an automated, arm supported robotic drill recently applied in clinical practice to produce cochleostomies without penetrating the endosteum ready for inserting cochlear electrodes. The smart tactile sensing scheme within the drill enables precise control of the state of interaction between tissues and tools in real-time. This paper reports development studies of the hand guided robotic drill where the same consistent outcomes, augmentation of surgeon control and skill, and similar reduction of induced disturbances on the hearing organ are achieved. The device operates with differing presentation of tissues resulting from variation in anatomy and demonstrates the ability to control or avoid penetration of tissue layers as required and to respond to intended rather than involuntary motion of the surgeon operator. The advantage of hand guided over an arm supported system is that it offers flexibility in adjusting the drilling trajectory. This can be important to initiate cutting on a hard convex tissue surface without slipping and then to proceed on the desired trajectory after cutting has commenced. The results for trials on phantoms show that drill unit compliance is an important factor in the design

    Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition: A case report

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    Although the pathological relationship between parathyroid and thyroid diseases is common, an association between parathyroid adenoma and thyroid cancer is rare. Concomitant thyroid cancer in patients with primary hyperparathyroidism (pHPT) has been reported at varying frequencies. WE present here a 23-year-old man who had papillary thyroid carcinoma in the right thyroid lobe and a parathyroid adenoma in the left thyroid lobe, which were confirmed surgically. Copyright © 2012 Via Medica

    Complete improvement in a patient with multiple irreversible defects of the left ventricle on 99m technetium-sestamibi SPECT after percutaneous coronary intervention.

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    99mTc-sestamibi has been investigated as a potential viability marker; initial studies have shown good concordance between 201Tl and 99mTc-sestamibi activities in both viable and nonviable myocardium. However, assessment of myocardial viability by 99mTc-sestamibi remains controversial for tissue recovery after revascularization. Here, we present a patient with several regions of severely diminished and irreversible (defect persisting in both early and delay images of each set scanning) defects on initial scan which were dissolved completely on the follow up scan after an intervention. In a 75 year-old Asian woman with acute myocardial infarction who received thrombolytic therapy and subjected to percutaneous coronary angiography (PCI) on day 28 after acute myocardial infarction(MI), resting 99mTc-sestamibi SPECT was applied on day 4 (initial scan) and 138 (follow up scan) after acute MI at 30 and 180 min after injection of tracer (740 MBq); Two-dimensional echocardiography was carried out at the same time. On the initial image set, there was irreversible defects in the apex, anteroapical, inferoapical, anteroseptal, septal and also anterior walls, while the follow up image was normal in all regions.The angiography intervention showed just significant stenosis on left anterior descending (LAD) vessel (95). This may highlight the failure of 99mTc-sestamibi as a marker of myocardial viability and also mandate further validating of the procedure with follow up scan or other modalities for myocardial viability investigation

    The Minimum Shared Edges Problem on Grid-like Graphs

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    We study the NP-hard Minimum Shared Edges (MSE) problem on graphs: decide whether it is possible to route pp paths from a start vertex to a target vertex in a given graph while using at most kk edges more than once. We show that MSE can be decided on bounded (i.e. finite) grids in linear time when both dimensions are either small or large compared to the number pp of paths. On the contrary, we show that MSE remains NP-hard on subgraphs of bounded grids. Finally, we study MSE from a parametrised complexity point of view. It is known that MSE is fixed-parameter tractable with respect to the number pp of paths. We show that, under standard complexity-theoretical assumptions, the problem parametrised by the combined parameter kk, pp, maximum degree, diameter, and treewidth does not admit a polynomial-size problem kernel, even when restricted to planar graphs

    The Complexity of Routing with Few Collisions

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    We study the computational complexity of routing multiple objects through a network in such a way that only few collisions occur: Given a graph GG with two distinct terminal vertices and two positive integers pp and kk, the question is whether one can connect the terminals by at least pp routes (e.g. paths) such that at most kk edges are time-wise shared among them. We study three types of routes: traverse each vertex at most once (paths), each edge at most once (trails), or no such restrictions (walks). We prove that for paths and trails the problem is NP-complete on undirected and directed graphs even if kk is constant or the maximum vertex degree in the input graph is constant. For walks, however, it is solvable in polynomial time on undirected graphs for arbitrary kk and on directed graphs if kk is constant. We additionally study for all route types a variant of the problem where the maximum length of a route is restricted by some given upper bound. We prove that this length-restricted variant has the same complexity classification with respect to paths and trails, but for walks it becomes NP-complete on undirected graphs

    Data-Feedthrough Faults in Circuits using Unclocked Storage Elements

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    Some faults in storage elements (SEs) do not manifest as stuck-at-0/1 faults. These include data-feedthrough faults that cause the SE cell to exhibit combinational behaviour. The authors investigate the implications of such faults on the behaviour of circuits using unclocked SEs. It is shown that effects of data-feedthrough faults at the behavioural level are different from those due to stuck-at faults, and therefore tests generated for the latter may be inadequat

    Lime Cake as an Alternative Stabiliser for Loose Clayey Loams

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    Lime Cake (precipitated calcium carbonate PCC), a by-product of sugar production, is proposed as a stabiliser for improvement of loose silty clayey loams. Two inorganic pedogenic and organic precipitated calcium carbonate polymorphs are artificially synthesized into a base loosely compacted loamy soil. Formation, micromorphology, quality of cementing bonds, and physiochemical interactions in the interlayer are modelled at molecular level and verified by a suite of micro-analytical spectrometry techniques. Emphasis is put into determining the impacts of polysaccharides on soil strength and implications on soil pore anatomy. Erodibility, compressibility, volumetric change, and hydro-mechanical behaviour of base, and modified soils at yield and post-yield states are studied. Anomalies in suction-controlled post-yield stress–strain behaviour of modified soils are discussed and explained within the tenets of mechanics of composite soils with double porosity. PCC-reinforcement offers the closest possible packing at optimum water content. Desiccation cracking remains likely, but at relatively higher lower-bound water contents. Under low confinement levels and unsaturated state, strain-hardening prevails. Loss of shear strength on saturation is minimal. When saturated, PCC-reinforced soil develops substantially high levels of shear strength at all strain levels. Higher levels of confinement are needed for organic fibrous and onion-skin coating matters to effectively encrust the soil pore network; such high levels, however, leads to formation of an unwelcomed brittle, strain–softening stress–stress behaviour

    Hypothetical Reasoning via Provenance Abstraction

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    Data analytics often involves hypothetical reasoning: repeatedly modifying the data and observing the induced effect on the computation result of a data-centric application. Previous work has shown that fine-grained data provenance can help make such an analysis more efficient: instead of a costly re-execution of the underlying application, hypothetical scenarios are applied to a pre-computed provenance expression. However, storing provenance for complex queries and large-scale data leads to a significant overhead, which is often a barrier to the incorporation of provenance-based solutions. To this end, we present a framework that allows to reduce provenance size. Our approach is based on reducing the provenance granularity using user defined abstraction trees over the provenance variables; the granularity is based on the anticipated hypothetical scenarios. We formalize the tradeoff between provenance size and supported granularity of the hypothetical reasoning, and study the complexity of the resulting optimization problem, provide efficient algorithms for tractable cases and heuristics for others. We experimentally study the performance of our solution for various queries and abstraction trees. Our study shows that the algorithms generally lead to substantial speedup of hypothetical reasoning, with a reasonable loss of accuracy

    Vitamin D supplementation lowers thrombospondin-1 levels and blood pressure in healthy adults

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    Introduction: Vitamin D insufficiency, defined as 25-hydroxyvitamin D (25(OH)D) levels < 75nmol/L is associated with cardio-metabolic dysfunction. Vitamin D insufficiency is associated with inflammation and fibrosis, but it remains uncertain whether these anomalies are readily reversible. Therefore, we aimed to determine the effects of vitamin D supplementation on markers of: 1) nitric oxide (NO) signaling, 2) inflammation, and 3) fibrosis, in healthy volunteers with mild hypovitaminosis. Methods: Healthy volunteers (n = 35) (mean age: 45 ± 11 years) with 25(OH)D levels <75nmol/L, received vitamin D supplementation (Ostelin ® capsules 2000IU) for 12 weeks. Resting systolic and diastolic blood pressures (BP) were assessed. Routine biochemistry was examined. Plasma concentrations of asymmetric dimethylarginine (ADMA), thrombospondin-1 (TSP-1), plasminogen activator inhibitor-1 (PAI-1), hs-CRP, activin-A, and follistatin-like 3 (FSTL3) were quantitated. Results: Vitamin D administration for 12 weeks significantly increased 25-(OH)D levels (48.8 ± 16 nmol/L to 100.8 ± 23.7 nmol/L, p<0.001). There was significant lowering of systolic and diastolic BP, while there was no significant change in lipid profiles, or fasting insulin. Plasma concentrations of ADMA, hs-CRP, PAI-1, activin A, and FSTL-3 did not change with vitamin D supplementation. However, there was a marked reduction of TSP-1 (522.7 ± 379.8 ng/mL vs 206.7 ± 204.5 ng/mL, p<0.001). Conclusions: Vitamin D supplementation in vitamin D insufficient, but otherwise healthy individuals markedly decreased TSP-1 levels and blood pressure. Since TSP-1 suppresses signaling of NO, it is possible that the fall in BP is engendered by restoration of NO effect.Anjalee T. Amarasekera, Bahador Assadi-Khansari, Saifei Liu, Marilyn Black, Greer Dymmott, Natasha M. Rogers, Aaron L. Sverdlov, John D. Horowitz, Doan T. M. Ng
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