Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: A cost analysis

Background: Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70-95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods: 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or "open" under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient's satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student's, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. Results: 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 \u20ac for the MIVAP group (51 patients) and 836,11 \u20ac for the OMIP group (p<0,001); for the Team, 122,93 \u20ac (group A) and 90,02 \u20ac (group B) (p<0,001); the other operative costs were 1388,32 \u20ac (group A) and 928,23 \u20ac (group B) (p<0,001). The patient's satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). Conclusions: MIVAP is more expensive compared to the "open" parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration

Description beyond the mean field approximation of an electrolyte confined between two planar metallic electrodes

We study an electrolyte confined in a slab of width $W$ composed of two grounded metallic parallel electrodes. We develop a description of this system in a low coupling regime beyond the mean field (Poisson--Boltzmann) approximation. There are two ways to model the metallic boundaries: as ideal conductors in which the electric potential is zero and it does not fluctuate, or as good conductors in which the average electric potential is zero but the thermal fluctuations of the potential are not zero. This latter model is more realistic. For the ideal conductor model we find that the disjoining pressure is positive behaves as $1/W^3$ for large separations with a prefactor that is universal, i.e. independent of the microscopic constitution of the system. For the good conductor boundaries the disjoining pressure is negative and it has an exponential decay for large $W$. We also compute the density and electric potential profiles inside the electrolyte. These are the same in both models. If the electrolyte is charge asymmetric we find that the system is not locally neutral and that a non-zero potential difference builds up between any electrode and the interior of the system although both electrodes are grounded.Comment: 16 pages, 5 figures, added a new appendix B and a discussion on ideal conductors vs. good conductor

Investigative study on the angiotensin converting enzyme (ACE) inhibiting properties of the terpenoid extract of Crataegus monogyna using in silico models

Crataegus monogyna is mainly used in the treatment of cardiac and circulatory system disorders. In vitro and clinical studies are indicative of the fact that the hydroethanolic extract of C. monogyna has angiotensin converting enzyme (ACE) inhibitory activity. This study sought to support these claims through the use of in silico modelling techniques. Possible binding conformations for β-amyrin, oleanolic acid and ursolic acid were generated using captopril, as well as enalaprilat and lisinopril, as template ligands. The ligand binding affinity (LBA) of each was calculated and the best binding conformation of each triterpene was established. Results indicate that these naturally occuring terpenes possess in silico predicted ligand binding affinities that are superior to both the small molecule captopril and the larger molecules enalaprilat and lisinopril.peer-reviewe

Charge-Fluctuation-Induced Non-analytic Bending Rigidity

In this Letter, we consider a neutral system of mobile positive and negative charges confined on the surface of curved films. This may be an appropriate model for: i) a highly charged membrane whose counterions are confined to a sheath near its surface; ii) a membrane composed of an equimolar mixture of anionic and cationic surfactants in aqueous solution. We find that the charge fluctuations contribute a non-analytic term to the bending rigidity that varies logarithmically with the radius of curvature. This may lead to spontaneous vesicle formation, which is indeed observed in similar systems.Comment: Revtex, 9 pages, no figures, submitted to PR

Modernisation of furrow irrigation in the sugar industry: final report 2014/079

Automated furrow irrigation systems have been successfully installed and operated on 160 ha of furrow irrigation, on three farms located across the Burdekin sugarcane growing region. The once labour intensive manual irrigation management has been transformed by allowing growers to control, schedule and monitor the behaviour of the pumps, pipeline and valves remotely from a computer, tablet or smartphone. Significant reductions of energy, water, labour and travel associated with irrigation management were seen across all three, large-scale demonstration sites. Reduced labour and travel was seen at each site, with one site registering an annual saving of at least 11,000 km travel. At two of the sites, reduced water usage of around 10% of annual usage was obtained and corresponded to a direct saving in water costs; and for one of these sites, the reduced water usage directly results in a reduced energy cost, while for the other, offers the potential to sell the saved water on the open market. Irrigation events can be scheduled to occur when they are required or to suit off peak electricity tariffs rather than when they suit labour availability. All three farmers recognised the quality of life improvements, and notably their ability to have more time for their family and improved sleeping habits. While assessing improvements to off-site impacts was not part of the project, they are expected as a direct result of the reduction in excess irrigation flowing through to a reduction of irrigation-induced run-off and/or deep drainage and the dissolved agri-chemicals it may contain

Smarter irrigation scheduling in the sugarcane farming system using the Internet of Things

Better irrigation practices can lead to improved yields through less water stress and reduced water usage to deliver economic benefits for farmers. More and more sugarcane growers are transitioning to automated irrigation in the Burdekin and other regions. Automated irrigation systems can save farmers a significant amount of time by remotely turning on and off pumps and valves. However, the system could be improved if it could be integrated with tools that factor in the weather, crop growing conditions, water deficit, and crop stress, to improve irrigation use efficiency. IrrigWeb is a decision-support tool that is turned to as a solution to this problem. IrrigWeb uses CANEGRO to help farmers decide when to irrigate and how much to apply. Farmers can then use this information to plan their irrigation management. However, managing irrigation is a considerable time investment for Burdekin farmers. A tool is needed to integrate the auto-irrigation system (e.g., WiSA) and IrrigWeb to provide a smarter irrigation solution. An uplink program (WiSA to IrrigWeb) has been successfully developed and implemented as part of a pilot study. It saves farmers a significant amount of time by uploading irrigation and rainfall data automatically instead of the farmer having to input them manually. This paper focuses on developing a smarter irrigation-scheduling tool that connects IrrigWeb to WiSA. A downlink program was developed to download, calculate and apply irrigation schedules automatically. In this process, sugarcane irrigators will spend less time manually setting up irrigation schedules as it will happen automatically. The simulation results demonstrated that the downlink program could improve the scheduling by incorporating practical limitations, such as pumping capacity or pumping time constraints, that are found on the farm

Critical Casimir forces for O(n){\cal O}(n) systems with long-range interaction in the spherical limit

We present exact results on the behavior of the thermodynamic Casimir force and the excess free energy in the framework of the $d$-dimensional spherical model with a power law long-range interaction decaying at large distances $r$ as $r^{-d-\sigma}$, where $\sigma<d<2\sigma$ and $0<\sigma\leq2$. For a film geometry and under periodic boundary conditions we consider the behavior of these quantities near the bulk critical temperature $T_c$, as well as for $T>T_c$ and $T<T_c$. The universal finite-size scaling function governing the behavior of the force in the critical region is derived and its asymptotics are investigated. While in the critical and under critical region the force is of the order of $L^{-d}$, for $T>T_c$ it decays as $L^{-d-\sigma}$, where $L$ is the thickness of the film. We consider both the case of a finite system that has no phase transition of its own, when $d-1<\sigma$, as well as the case with $d-1>\sigma$, when one observes a dimensional crossover from $d$ to a $d-1$ dimensional critical behavior. The behavior of the force along the phase coexistence line for a magnetic field H=0 and $T<T_c$ is also derived. We have proven analytically that the excess free energy is always negative and monotonically increasing function of $T$ and $H$. For the Casimir force we have demonstrated that for any $\sigma \ge 1$ it is everywhere negative, i.e. an attraction between the surfaces bounding the system is to be observed. At $T=T_c$ the force is an increasing function of $T$ for $\sigma>1$ and a decreasing one for $\sigma<1$. For any $d$ and $\sigma$ the minimum of the force at $T=T_c$ is always achieved at some $H\ne 0$.Comment: 13 pages, revtex, 8 figure

Multilevel examination of diabetes in modernising China: what elements of urbanisation are most associated with diabetes?

Aims/hypothesis: The purpose of this study was to examine the association between urbanisation-related factors and diabetes prevalence in China. Methods: Anthropometry, fasting blood glucose (FBG) and community-level data were collected for 7,741 adults (18–90 years) across 217 communities and nine provinces in the 2009 China Health and Nutrition Survey to examine diabetes (FBG ≥7.0 mmol/l or doctor diagnosis). Sex-stratified multilevel models, clustered at the community and province levels and controlling for individual-level age and household income were used to examine the association between diabetes and: (1) a multicomponent urbanisation measure reflecting overall modernisation and (2) 12 separate components of urbanisation (e.g., population density, employment, markets, infrastructure and social factors). Results: Prevalent diabetes was higher in more-urbanised (men 12%; women 9%) vs less-urbanised (men 6%; women 5%) areas. In sex-stratified multilevel models adjusting for residential community and province, age and household income, there was a twofold higher diabetes prevalence in urban vs rural areas (men OR 2.02, 95% CI 1.47, 2.78; women, OR 1.94, 95% CI 1.35, 2.79). All urbanisation components were positively associated with diabetes, with variation across components (e.g. men, economic and income diversity, OR 1.42, 95% CI 1.20, 1.66; women, transportation infrastructure, OR 1.18, 95% CI 1.06, 1.32). Community-level variation in diabetes was comparatively greater for women (intraclass correlation [ICC] 0.03–0.05) vs men (ICC ≤0.01); province-level variation was greater for men (men 0.03–0.04; women 0.02). Conclusions/interpretation: Diabetes prevention and treatment efforts are needed particularly in urbanised areas of China. Community economic factors, modern markets, communications and transportation infrastructure might present opportunities for such efforts. Electronic supplementary material The online version of this article (doi:10.1007/s00125-012-2697-8) contains peer-reviewed but unedited supplementary material, which is available to authorised users