Conversion from Laparoscopic to Open Cholecystectomy

Introductions: With the advent of newer technology, the era of open surgery for gall bladder diseases has been preferably taken over by laparoscopic cholecystectomy. However, certain cases still require conversion to open surgery. In this review we aim to analyze the reason for conversion.Methods: This retrospective study was conducted at Patan Hospital, Patan Acdemy of Health Sciences, Nepal. All patients who underwent laparoscopic cholecystectomy from February 2009 to July 2012 were included in the study. File numbers of all the patients were obtained from operation room register. The patient files were analyzed for age, sex, duration of symptoms, liver function tests, ultrasound findings and the description in operation note for reason for conversion.Results: The age ranged from 12 to 81 years with mean age of patients 32.76 years and male to female ratio 1:2.9. The mean operating time was 65 minutes and average post operative hospital stay was 1.61 days. Out of 305 patients, 34 (11.14%) required open conversion. Factors esponsible for open conversion were dense fibrosis at Calots in 11 (3.6%), adhesions due to previous abdominal surgery in 6 (1.9%), uncontrollable bleeding in 5 (1.6%), bile duct injury in 4 (1.3%) cholecystoenteric fistula in 3 (0.9%), Mirizzi’s syndrome 2(0.6%).Conclusions: Adhesions at the calot’s triangle was the common reason for conversion from laparoscopic to open cholecystectomy.Keywords: adhesions, conversion, gallstone, laparoscopic cholecystectom

Deployment of Available Rail Steels to Reduce Life Cycle Costs

The rate of rail degradation and hence its expected life is not uniform throughout any railway network and is governed by a combination of track, traffic and operating characteristics in addition to the metallurgical attributes of the steel. Consequently, it is suggested that any route or network is not a single linear asset but is a compilation of individual segments with different track characteristics, degradation rates and expected life spans. Thus, the choice of rail steel grade to maximise life span needs to combine the knowledge of the metallurgical attributes of the available rail steels with the conditions prevailing at the wheel-rail and vehicle-track interfaces. This approach has been the focus of research at the University of Huddersfield Institute of Railway Research (IRR) and this paper describes some of the results from the EPSRC/RSSB/DfT sponsored project entitled “Designing Steel Composition and Microstructure to Better Resist Degradation during Wheel-Rail Contact”. The paper is focussed on: - Classification of the susceptibility to rail degradation in various parts of a mixed-traffic network. - Metallurgical attributes of the currently available rail steel

Stability at the half pin-frame interface on external fixation constructs

Abstract A mechanical study investigating the use of two different methods (grub and bolt screws) to secure external fixation half pins to circular frames. A four part experiment: (1) Grub and bolt screws were used to secure half pins in Taylor Spatial frames. Loosening torques were measured using a calibrated torque wrench. (2) Using universal testing machine (UTM), axial loading was applied to establish thresholds for loosening in grub and bolt screw constructs. (3) We established the application torque to produce failure at the head–driver interface using these two methods. (4) Grub and bolt screw constructs were created controlling torque. Using UTM, axial loading was applied to establish thresholds for loosening. Statistical analysis was conducted using SPSS v20.0.0. (1) Higher torque is employed when bolt rather than grub screws is used to secure half pins on Rancho cubes (p < 0.05). (2) Loading threshold for loosening is higher in bolt screw constructs when the torque applied to secure the constructs is not controlled (p < 0.05). (3) Torque required for failure at the head–driver interface was 5.3 Nm for grub screws and 9.9 Nm for bolts. (4) Loading threshold for loosening is higher in grub screw constructs when the same torque was applied to secure them (p < 0.05). Bolt screws can be employed to secure the half pin–frame interface. They offer good stability and reduce failure at the head–driver interface. Further research is needed to determine the mechanical properties of such constructs in vivo

Longitudinal rail weld geometry control and assessment criteria

This study covers the parametric variations of vehicle and track characteristics to inform on the requirements for an optimum and yet pragmatic control of longitudinal rail weld profile. A statistical study has been carried out using a large set of measured weld profiles (arbitrary mix of flash butt welds and aluminothermic welds) in order to establish relationships between degradation mechanisms and the longitudinal geometry of the finished weld. The potential benefits which would be expected from improved controls over the welded profile, with respect to not only rail running surface damage but also susceptibility to rail breaks and ballast degradation, are demonstrated. Finally, recommendations for the review of the geometric controls of finished weld geometry in the relevant Euro Norms are made

Characterization and Screening of Thermophilic Bacillus Strains for Developing Plant Growth Promoting Consortium From Hot Spring of Leh and Ladakh Region of India

In the present investigation, the main aim is to identify and characterize the potential drought tolerant plant growth promoting consortium for agricultural productivity. Three bacterial isolates were isolated from hot spring of Chumathang area of Leh district. Bacillus species (BHUJP-H1, BHUJP-H2, and BHUJP-H3) were done some biochemical tests including catalase, cellulase, amylase, indole-3-acetic acid, phosphate solubilisation, production of ammonia, siderophore, and hydrogen cyanide. Molecular characterization of isolates was done by 16S rDNA sequencing, e.g., Bacillus subtilis BHUJP-H1 (KU312403), Bacillus sp. BHUJP-H2 (KU312404) and B. licheniformis BHUJP-H3 (KU312405). The genetic diversity of the isolates was assessed by seven inter simple sequence repeat, all primer shows high polymorphism. The highest polymorphism efficiency and polymorphism information content showed by UBC-809 and UBC-836 which were 100% and 0.44 respectively, the lowest is by UBC-807 75% and 0.28 respectively. On an average 90.69% polymorphism efficiency and 0.40 polymorphism information contents obtained by used markers. The highest, 11.08 and the lowest, 4.50 effective multiplex ratios obtained for primer UBC-823 and UBC-807, on an average 7.99 effective multiplex ratio obtained. The highest, 4.89 and the lowest, 1.25 marker indexes obtained by UBC-836 and UBC-807 respectively and on an average 3.24 obtained. The UPGMA cluster analysis divided a population into two clusters I and II, in which BHUJP-H1 and BHUJP-H2 grouped under same while BHUJP-H3 grouped under another cluster. The treatment combination of Bacillus subtilis BHUJP-H1, B. subtilis BHUJP-H1+ B. licheniformis BHUJP-H3 and B. subtilis BHUJP-H1+ Bacillus sp. BHUJP-H2+ B. licheniformis BHUJP-H3 were recorded better combination for enhancing plant growth attributes of Vigna radiata as compared to control and others. The plant growth promoting consortium, e.g., Bacillus subtilis BHUJP-H1, Bacillus subtilis BHUJP-H1+ B. licheniformis BHUJP-H3 and B. subtilis BHUJP-H1+ Bacillus sp. BHUJP-H2+ B. licheniformis BHUJP-H3 can be further used as effective microbial inoculant for enhancing the production of mungbean in field conditions. Bacillus sp. BHUJP-H1 and Bacillus sp. BHUJP-H2 may use as drought tolerant plant growth promoting consortium for enhancing the sustainable agricultural productivity

A systems approach to evaluating rail life

Corus Rail Technologies (CRT) has undertaken a major project involving track studies of Rolling Contact Fatigue (RCF), with support from Manchester Metropolitan University (MMU). The work takes a systems approach and involves the development and application of a suite of numerical models used to investigate the in-service conditions of track components with particular emphasis on RCF. The suite of models, called the Track System Model (TSM), comprises of vehicle dynamics models, developed by MMU, a Global Track model and a rail-wheel Contact model, developed by CRT. The modelling is being complemented through the monitoring of a number of RCF affected sites on the UK network to provide essential empirical data. A total of seven vehicle models have been developed using ADAMS/Rail, including two locomotives, two DMUs, two passenger coaches, and a freight wagon. Vehicle simulations were conducted for a range of UK sites and provided results such as wheel-rail contact forces and contact patch positions. The vehicle models have been validated using track measurements. The results were then used as inputs for the CRT Global Track and Contact models. The Global Track model is a finite element (FE) model that represents a length of railway track and includes the rails, sleepers and ballast. Forces from the vehicle simulations were applied to the Global model in order to predict the bending stresses in the rail head. This was conducted for a number of vehicles at seven sites and the predicted values showed good comparison with track measurements. The Contact FE model is a 3 dimensional (3D) representation of a wheel section rolling on a short length of rail. Wheel loads calculated from the vehicle dynamics simulations were applied to the contact model in order to predict surface and subsurface stresses, including directional and shear, in the rail head. Subsurface stress distribution is of primary importance for understanding the development of RCF and crack growth. The TSM successfully integrates the vehicle and track aspects of the railway system and provides an accurate method of predicting stresses in rails. When used in conjunction with the practical understanding of RCF, through site monitoring, it will enable the development of analytical fatigue life models that can be used by the track engineer to support future decision making for an optimum rail grinding strategy and rail renewal programme

Biogenic factors explain soil carbon in paired urban and natural ecosystems worldwide

12 páginas.- 4 figuras.- 49 referencia.- Supplementary information The online version contains supplementary material available at https://doi.org/10.1038/s41558-023-01646-z .- Full-text access to a view-only version (Acceso a texto completo de sólo lectura en este enlace) https://rdcu.be/c8vZiUrban greenspaces support multiple nature-based services, many of which depend on the amount of soil carbon (C). Yet, the environmental drivers of soil C and its sensitivity to warming are still poorly understood globally. Here we use soil samples from 56 paired urban greenspaces and natural ecosystems worldwide and combine soil C concentration and size fractionation measures with metagenomics and warming incubations. We show that surface soils in urban and natural ecosystems sustain similar C concentrations that follow comparable negative relationships with temperature. Plant productivity’s contribution to explaining soil C was higher in natural ecosystems, while in urban ecosystems, the soil microbial biomass had the greatest explanatory power. Moreover, the soil microbiome supported a faster C mineralization rate with experimental warming in urban greenspaces compared with natural ecosystems. Consequently, urban management strategies should consider the soil microbiome to maintain soil C and related ecosystem services.This study was supported by a 2019 Leonardo Grant for Researchers and Cultural Creators, BBVA Foundation (URBANFUN), and by BES Grant Agreement No. LRB17\1019 (MUSGONET). M.D-B., P.G-P., J.D. and A.R. acknowledge support from TED2021-130908B-C41/AEI/10.13039/501100011033/ Unión Europea NextGenerationEU/PRTR. M.D.-B. also acknowledges support from the Spanish Ministry of Science and Innovation for the I + D + i project PID2020-115813RA-I00 funded by MCIN/AEI/10.13039/501100011033. M.D.-B. was also supported by a project of the Fondo Europeo de Desarrollo Regional (FEDER) and the Consejería de Transformación Económica, Industria, Conocimiento y Universidades of the Junta de Andalucía (FEDER Andalucía 2014-2020 Objetivo temático ‘01 - Refuerzo de la investigación, el desarrollo tecnológico y la innovación’) associated with the research project P20_00879 (ANDABIOMA). D.J.E. was supported by the Hermon Slade Foundation. J.P.V. thanks the Science and Engineering Research Board (SERB) (EEQ/2021/001083, SIR/2022/000626) and the Department of Science and Technology (DST), India (DST/INT/SL/P-31/2021) and Banaras Hindu Univeristy-IoE (6031)-incentive grant for financial assistance for research in plant-microbe interaction and soil microbiome. J.D. and A. Rodríguez acknowledge support from the FCT (2020.03670.CEECIND and SFRH/BDP/108913/2015, respectively), as well as from the MCTES, FSE, UE and the CFE (UIDB/04004/2021) research unit financed by FCT/MCTES through national funds (PIDDAC).Peer reviewe