Reliable Asynchronous Image Transfer Protocol in Wireless Multimedia Sensor Networks

In the paper, we propose a reliable asynchronous image transfer protocol, RAIT. RAIT applies a double sliding window method to node-to-node transfer, with one sliding window for the receiving queue, which is used to prevent packet loss caused by communication failure between nodes, and another sliding window for the sending queue, which prevents packet loss caused by network congestion. The routing node prevents packet loss between nodes by preemptive scheduling of multiple packets for a given image. RAIT implements a double sliding window method by means of a cross-layer design between the RAIT layer, routing layer, and queue layer. We demonstrate that RAIT guarantees a higher reliability of image transmission compared to the existing protocols

Risk Assessment and Mitigation Model for Overseas Steel-Plant Project Investment with Analytic Hierarchy ProcessFuzzy Inference System

This paper presents an analytic hierarchy process (AHP)-fuzzy inference system (FIS) model to aid decision-makers in the risk assessment and mitigation of overseas steel-plant projects. Through a thorough literature review, the authors identified 57 risks associated with international steel construction, operation, and transference of new technologies. Pairwise comparisons of all 57 risks by 14 subject-matter experts resulted in a relative weighting. Furthermore, to mitigate human subjectivity, vagueness, and uncertainty, a fuzzy analysis based on the findings of two case studies was performed. From these combined analyses, weighted individual risk soring resulted in the following top five most impactful international steel project risks: procurement of raw materials; design errors and omissions; conditions of raw materials; technology spill prevention plan; investment cost and poor plant availability and performance. Risk mitigation measures are also presented, and risk scores are re-assessed through the AHP-FIS analysis model depicting an overall project risk score reduction. The model presented is a useful tool for industry performing steel project risk assessments. It also provides decision-makers with a better understanding of the criticality of risks that are likely to occur on international steel projects.11sciessciscopu

Wolff-Parkinson-White syndrome in young people, from childhood to young adulthood: relationships between age and clinical and electrophysiological findings

PurposeThe aim of the present study was to evaluate the characteristics of electrophysiologic studies (EPS) and radiofrequency ablation (RFA) performed in subjects aged less than 30 years with Wolff-Parkinson-White (WPW) syndrome, particularly pediatric patients under 18 years of age, based on our experience.MethodsTwo hundred and one consecutive patients with WPW syndrome were recruited and divided to 3 groups according to age: group 1, 6 to 17 years; group 2, 18 to 29 years; and group 3, 30 to 60 years. The clinical, electrophysiological, and therapeutic data for these patients were evaluated by a retrospective medical record review.ResultsA total of 73 (36%) of these patients were <30 years of age. Although there were more males than females in group 2 (male:female, 31:11), there was no sex difference in group 1 (male:female, 16:15). Left accessory pathway was detected less frequently in group 1 (32%, 10/31) than in group 2 (57%, 24/42) and group 3 (63%, 81/128) (P=0.023 and P=0.002, respectively).ConclusionThe present study describes several different electrophysiological characteristics in children and adolescents with WPW syndrome. Therefore, when EPS and RFA are performed in children and adolescence with WPW syndrome, we recommend that these characteristics be considered

Differences of Upper Airway Morphology According to Obesity: Study with Cephalometry and Dynamic MD-CT

ObjectivesWe investigated difference of parameters of polysomnography, cephalometry and dynamic multi-detector computerized tomography (MD-CT) in wake and sleep states according to obesity.MethodsWe evaluated 93 patients who underwent polysomnography and cephalometry. MD-CT was performed in 68 of these 93 patients. Fifty-nine and 34 patients were classified as obese and non-obese, with obesity defined as BMI ≥25. Cephalometry results were analyzed for 12 variables. Using the MD-CT, we evaluated dynamic upper airway morphology in wake and sleep states and divided the upper airway into four parts named as high retropalatal (HRP), low retropalatal (LRP), high retroglossal (HRG), and low retroglossal (LRG). A minimal cross sectional area (mCSA) and collapsibility index (CI) were calculated for each airway level.ResultsDiastolic blood pressure (P=0.0005), neck circumference (P<0.0001), and apnea-hypopnea index (P<0.0001) were statistically significantly different between the obese and non-obese group. Among 12 cephalometric variables, there was a significant difference in only the distance from mandibular plane to hyoid bone (P=0.003). There was statistical difference in CI of HRG and LRG in sleep state (P=0.0449, 0.0281) but no difference in mCSA in wake and sleep states.ConclusionThe obese group had more severe sleep apnea than the non-obese group. We believe that the increased severity of apnea in the obese group may be have been due to increased collapsibility of the upper airway rather than decreased size of the upper airway

A Comparison of Tracheal Intubation Using Direct Laryngoscope and Video Laryngoscope in the Sellick and Trendelenburg Position with That Using Direct Laryngoscope in the Supine Sniffing Position: A Randomized Controlled Trial

Background: Tracheal intubation in the Sellick and Trendelenburg position (ST position) can prevent pulmonary aspiration but increase the difficulty of tracheal intubation. We compared tracheal intubation using video and direct laryngoscopy in the ST position with direct laryngoscopy in the supine sniffing position to evaluate the overall intubation performance. Methods: One hundred and twenty patients were randomly assigned to three groups: direct laryngoscope in the supine sniffing position (control), direct laryngoscope in the ST position (ST direct), and video laryngoscope in the ST position (ST video). The primary outcome was the intubation time; secondary outcomes included the first attempt success rate of tracheal intubation, intubation difficulty scale score, operator’s subjective assessment of intubation difficulty, and modified Cormack–Lehane grades. Results: The median intubation times were greater in the ST direct (36.0 s) and video (34.5 s) than the control (28.0 s) groups. The first attempt success rate decreased in the ST direct (77.5%) but not the video (95.0%) group compared with the control group (100%). Conclusions: The challenges of tracheal intubation in the ST position, aimed at reducing the risk of pulmonary aspiration, can be mitigated by using a video laryngoscope, despite slightly longer intubation times

The impact of sequential versus single anastomoses on flow characteristics and mid-term patency of saphenous vein grafts in coronary bypass grafting

ObjectiveTo assess the influence of bypass grafting technique on the flow characteristics and mid-term patency of saphenous vein coronary bypass grafts.MethodsIn the present study, 309 patients who underwent either sequential (group A, N = 84 grafts) or individual (group B, N = 244 grafts) saphenous vein coronary bypass grafting between February 2002 and September 2007 were investigated. Individual bypassing only was performed in 212 patients, and sequential bypassing only was performed in 78 patients. The remaining 19 patients received both. A total of 436 distal anastomoses were performed with 328 saphenous vein grafts. The intraoperative flow characteristics and the graft patency were assessed with the transit time flow meter and serial multi-detector computed tomography coronary angiograms, respectively.ResultsGroup A showed a higher mean flow compared with group B at 49.4 ± 27.4 mL/min versus 37.1 ± 20.1 mL/min, respectively (P = .001). The mean flow increased linearly as the number of anastomoses increased per graft (P < .001). Graft patency at 3 years was 93.3% ± 3.4% in group A and 86.5% ± 3.1% in group B (P = .048). After adjustment for baseline characteristics, group A showed a tendency for superior mid-term patency than group B (hazard ratio 0.362; 95% confidence interval, 0.129–1.017; P = .0538).ConclusionsSequential bypass grafts were associated with higher mean flows and superior mid-term patency compared with individual grafts. These findings suggest the more favorable results of sequential bypass grafting to be attributed to the enhanced flow hemodynamics

Surgical repair of descending thoracic and thoracoabdominal aortic aneurysm involving the distal arch: Open proximal anastomosis under deep hypothermia versus arch clamping technique

BackgroundSurgical repair of a descending thoracic and thoracoabdominal aortic aneurysm (DTA/TAAA) involving the distal arch is challenging and requires either deep hypothermic circulatory arrest (DHCA) or crossclamping of the distal arch. The aim of this study was to compare these 2 techniques in the treatment of DTA/TAAA involving the distal arch.MethodsFrom 1994 to 2012, 298 patients underwent open repair of DTA/TAAA through a left thoracotomy. One hundred seventy-four patients with distal arch involvement who were suitable for either DHCA (n = 81) or arch clamping (AC; n = 93), were analyzed. In-hospital outcomes were compared using propensity scores and inverse-probability-of-treatment weighting adjustment to reduce treatment selection bias.ResultsEarly mortality was 11.1% in the DHCA group and 8.6% in the AC group (P = .58). Major adverse outcomes included stroke in 16 patients (9.2%), low cardiac output syndrome in 15 (8.6%), paraplegia in 10 (5.7%), and multiorgan failure in 10 (5.7%). After adjustment, patients who underwent DHCA were at similar risk of death (odds ratio [OR], 1.14; P = .80) and permanent neurologic injury (OR, 0.95; P = .92) to those who underwent AC. Although prolonged ventilator support (>24 hours) was more frequent with DHCA than with AC (OR, 2.60; P = .003), DHCA showed a tendency to lower the risk of paraplegia (OR, 0.15; P = .057).ConclusionsCompared with AC, DHCA did not increase postoperative mortality and morbidity, except for prolonged ventilator support. However, DHCA may offer superior spinal cord protection to AC during repair of DTA/TAAA involving the distal arch

Rudder Gap Flow Control for Cavitation Suppression

For the suppression of rudder cavitation, especially within and around the gap between the stationary and movable parts, flow control devices were developed. In the present study, both experimental and computational analyses of the flow control devices were carried out. The new rudder system is equipped with cam devices, which effectively close the gap between the stationary horn/pintle and movable flaps. Model scale experiments of surface pressure measurements, flow field visualization near the gap using PIV, and cavitation behavior observation were conducted in a cavitation tunnel. The experiments were simulated using a computational fluid dynamics tool and the results are compared for validation. It is confirmed that the flow control devices effectively suppresses the rudder gap cavitation and, at the same time, augments lifthttp://deepblue.lib.umich.edu/bitstream/2027.42/84266/1/CAV2009-final70.pd

Development of Laser Ruler in Rigid Laryngoscope

ObjectivesThe objective of this study was to develop a new device that provides a simple, noninvasive method of measuring accurate lesion size while using an endoscope.MethodsWe developed a rigid laryngoscope with a built-in laser-ruler using a one-light emitting diode and an acrylic plate. The invention incorporates a built-in laser diode that projects an auto-parallel beam into the optical path of the rigid laryngoscope to form two spots in the field of view.ResultsWhile the interspot distance remains consistent despite changes in focal plane, magnification, or viewing angle of the laryngoscope, projection to an uneven surface introduces certain variations in the shape, and size of the spots, and the distance between the two spots.ConclusionThe device enables a laryngologist to easily measure the distance between landmarks, as well as the change in real size, and the progressive change of vocal fold lesions in an outpatient setting