Investigation of aerosol indirect effects on monsoon clouds using ground-based measurements over a high-altitude site in Western Ghats

The effect of aerosols on cloud droplet number concentration and droplet effective radius is investigated from ground-based measurements over a high-altitude site where clouds pass over the surface. First aerosol indirect effect (AIE) estimates were made using (i) relative changes in cloud droplet number concentration (AIEn) and (ii) relative changes in droplet effective radius (AIEs) with relative changes in aerosol for different cloud liquid water contents (LWCs). AIE estimates from two different methods reveal that there is systematic overestimation in AIEn as compared to that of AIEs. Aerosol indirect effects (AIEn and AIEs) and dispersion effect (DE) at different LWC regimes ranging from 0.05 to 0.50 g m−3 were estimated. The analysis demonstrates that there is overestimation of AIEn as compared to AIEs, which is mainly due to DE. Aerosol effects on spectral dispersion in droplet size distribution play an important role in altering Twomey's cooling effect and thereby changes in climate. This study shows that the higher DE in the medium LWC regime offsets the AIE by 30 %

Case report: Thoracoscopic repair of renal ectopia associated with congenital diaphragmatic hernia: Report of two cases

Renal ectopia is a rare anomaly which may occur due to an abnormal ascent of the kidney. It is usually  asymptomatic and does not require treatment. Intrathoracic renal ectopia with concomitant congenital diaphragmatic hernia (CDH) is extremely rare. All symptomatic CDH cases must be treated with open or thoracoscopic repair. During plication of the diaphragm, care must be taken to avoid renal injury. Following, we present two rare variants of CDH with concomitant renal ectopia managed thoracoscopically.  Postoperative recovery was uneventful. Doppler ultrasound study performed one month after surgery confirmed normal vascularity of the kidneys and the absence of urinary outflow obstruction.KEYWORDS: Congenital diaphragmatic hernia; Renal ectopia; Thoracoscopic repai

Aggregation Bias: A Proposal to Raise Awareness Regarding Inclusion in Visual Analytics

Data is a powerful tool to make informed decisions. They can be used to design products, to segment the market, and to design policies. However, trusting so much in data can have its drawbacks. Sometimes a set of indicators can conceal the reality behind them, leading to biased decisions that could be very harmful to underrepresented individuals, for example. It is challenging to ensure unbiased decision-making processes because people have their own beliefs and characteristics and be unaware of them. However, visual tools can assist decision-making processes and raise awareness regarding potential data issues. This work describes a proposal to fight biases related to aggregated data by detecting issues during visual analysis and highlighting them, trying to avoid drawing inaccurate conclusions

Feasibility of the porous zone approach to modelling vegetation in CFD

Vegetation within stormwater ponds varies seasonly and its presence affects the flow field, which in turn affects the pond’s Residence Time Distribution and its effectiveness at pollutant removal. Vegetated flows are complex and, as a result, few suitable tools exist for evaluating realistic stormwater pond designs. Recent research has suggested using a porous zone to represent vegetation within a CFD model, and this paper investigates the feasibility of this approach using ANSYS Fluent. One of the main benefits of using a porous zone is the ability to derive the relevant parameters from the known physical characteristics of stem diameter and porosity using the Ergun equation. A sensitivity analysis on the viscous resistance factor 1/α1/α and the inertial resistance factor C2C2 has been undertaken by comparing model results to data collected from an experimental vegetated channel. Best fit values of C2C2 were obtained for a range of flow conditions including emergent and submerged vegetation. Results show the CFD model to be insensitive to 1/α1/α but very sensitive to values of C2C2. For submerged vegetation, values of C2C2 derived from the Ergun equation are under-predictions of best-fit C2C2 values as only the turbulence due to the shear layer is represented. The porous zone approach does not take into account turbulence generated from stem wakes such that no meaningful predictions for emergent vegetation were obtained. C2C2 values calculated using a force balance show better agreement with best-fit C2C2 values than those derived from the Ergun equation. Manually fixing values of kk and εε within the porous zone of the model shows initial promise as a means of taking stem wakes into account

Comparison of glottic views and intubation times in the supine and 25 degree back-up positions

Background: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views and ease of intubation. Methods: In the first part of the study, patients were intubated in the standard supine sniffing position. In the second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score. The number of attempts at both laryngoscopy and tracheal intubation, together with the use of ancillary equipment and manoeuvres were recorded. The ease of intubation was indirectly assessed by recording the time interval between beginning of laryngoscopy and insertion of the tracheal tube. Results: Seven hundred eighty one unselected surgical patients scheduled for non-emergency surgery were included. In the back-up position, ancillary laryngeal manoeuvres, which included cricoid pressure, backwards upwards rightward pressure and external laryngeal manipulation, were required less frequently (19.6 % versus 24. 6 %, p = 0.004). The time from beginning of laryngoscopy to insertion of the tracheal tube was 14 % shorter (median time 24 versus 28 s, p = 0.031) in the back-up position. There was no significant difference in glottic views. Conclusions: The 25° back-up position improved the ease of intubation as judged by the need for fewer ancillary manoeuvres and shorter time for intubation. Trial registration: ClinicalTrials.gov Identifier: NCT02934347 registered retrospectively on 14th Oct 2016

Bio-nanotechnology application in wastewater treatment

The nanoparticles have received high interest in the field of medicine and water purification, however, the nanomaterials produced by chemical and physical methods are considered hazardous, expensive, and leave behind harmful substances to the environment. This chapter aimed to focus on green-synthesized nanoparticles and their medical applications. Moreover, the chapter highlighted the applicability of the metallic nanoparticles (MNPs) in the inactivation of microbial cells due to their high surface and small particle size. Modifying nanomaterials produced by green-methods is safe, inexpensive, and easy. Therefore, the control and modification of nanoparticles and their properties were also discussed

Innovations in total knee replacement: new trends in operative treatment and changes in peri-operative management

The human knee joint can sustain damage due to injury, or more usually osteoarthritis, to one, two or all three of the knee compartments: the medial femorotibial, the lateral femorotibial and the patellofemoral compartments. When pain associated with this damage is unmanageable using nonsurgical techniques, knee replacement surgery might be the most appropriate course of action. This procedure aims to restore a pain-free, fully functional and durable knee joint. Total knee replacement is a well-established treatment modality, and more recently, partial knee replacement—more commonly known as bi- or unicompartmental knee replacement—has seen resurgence in interest and popularity. Combined with the use of minimally invasive surgery (MIS) techniques, gender-specific prosthetics and computer-assisted navigation systems, orthopaedic surgeons are now able to offer patients knee replacement procedures that are associated with (1) minimal risks during and after surgery by avoiding fat embolism, reducing blood loss and minimising soft tissue disruption; (2) smaller incisions; (3) faster and less painful rehabilitation; (4) reduced hospital stay and faster return to normal activities of daily living; (5) an improved range of motion; (6) less requirement for analgesics; and (7) a durable, well-aligned, highly functional knee. With the ongoing advancements in surgical technique, medical technology and prosthesis design, knee replacement surgery is constantly evolving. This review provides a personal account of the recent innovations that have been made, with a particular emphasis on the potential use of MIS techniques combined with computer-assisted navigation systems to treat younger, more physically active patients with resurfacing partial/total implant knee arthroplasty

A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia

<p>Abstract</p> <p>Background</p> <p>The C-MAC^®(Karl Storz, Tuttlingen, Germany) has recently been introduced as a new device for videolaryngoscopy guided intubation. The purpose of the present study was to compare for the first time the C-MAC with conventional direct laryngoscopy in 150 patients during routine induction of anaesthesia.</p> <p>Methods</p> <p>After approval of the institutional review board and written informed consent, 150 patients (ASA I-III) with general anaesthesia were enrolled. Computer-based open crossover randomisation was used to determine the sequence of the three laryngoscopies: Conventional direct laryngoscopy (HEINE Macintosh classic, Herrsching, Germany; blade sizes 3 or 4; <it>DL </it>group), C-MAC size 3 (<it>C-MAC3 </it>group) and C-MAC size 4 (<it>C-MAC4 </it>group) videolaryngoscopy, respectively. After 50 patients, laryngoscopy technique in the C-MAC4 group was changed to the straight blade technique described by Miller (C-MAC4/SBT).</p> <p>Results</p> <p>Including all 150 patients (70 male, aged (median [range]) 53 [20-82] years, 80 [48-179] kg), there was no difference of glottic view between DL, C-MAC3, C-MAC4, and C-MAC4/SBT groups; however, worst glottic view (C/L 4) was only seen with DL, but not with C-MAC videolaryngoscopy. In the subgroup of patients that had suboptimal glottic view with DL (C/L≥2a; n = 24), glottic view was improved in the C-MAC4/SBT group; C/L class improved by three classes in 5 patients, by two classes in 2 patients, by one class in 8 patients, remained unchanged in 8 patients, or decreased by two classes in 1 patient. The median (range) time taken for tracheal intubation in the DL, C-MAC3, C-MAC4 and C-MAC4/SBT groups was 8 sec (2-91 sec; n = 44), 10 sec (2-60 sec; n = 37), 8 sec (5-80 sec; n = 18) and 12 sec (2-70 sec; n = 51), respectively.</p> <p>Conclusions</p> <p>Combining the benefits of conventional direct laryngoscopy and videolaryngoscopy in one device, the C-MAC may serve as a standard intubation device for both routine airway management and educational purposes. However, in patients with suboptimal glottic view (C/L≥2a), the C-MAC size 4 with straight blade technique may reduce the number of C/L 3 or C/L 4 views, and therefore facilitate intubation. Further studies on patients with difficult airway should be performed to confirm these findings.</p

Tissue sparing surgery in knee reconstruction: unicompartmental (UKA), patellofemoral (PFA), UKA + PFA, bi-unicompartmental (Bi-UKA) arthroplasties

Recently mini-invasive joint replacement has become one of the hottest topics in the orthopaedic world. However, these terms have been improperly misunderstood as a “key-hole” surgery where traditional components are implanted with shorter surgical approaches, with few benefits and several possible dangers. Small implants as unicompartmental knee prostheses, patellofemoral prostheses and bi-unicompartmental knee prostheses might represent real less invasive procedures: Tissue sparing surgery, the Italian way to minimally invasive surgery (MIS). According to their experience the authors go through this real tissue sparing surgery not limited only to a small incision, but where the surgeons can respect the physiological joint biomechanics