Submitral aneurysm in children: A rare entity with varied presentation!

AbstractWe present echocardiographic images in two children with a diagnosis of submitral aneurysm. Both had absolutely different presentations. The diagnosis was established on echocardiography and no advanced imaging techniques were used

Quantification of temporal fault trees based on fuzzy set theory

© Springer International Publishing Switzerland 2014. Fault tree analysis (FTA) has been modified in different ways to make it capable of performing quantitative and qualitative safety analysis with temporal gates, thereby overcoming its limitation in capturing sequential failure behaviour. However, for many systems, it is often very difficult to have exact failure rates of components due to increased complexity of systems, scarcity of necessary statistical data etc. To overcome this problem, this paper presents a methodology based on fuzzy set theory to quantify temporal fault trees. This makes the imprecision in available failure data more explicit and helps to obtain a range of most probable values for the top event probability

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Sustainability aspects in the warm forming of tailor welded blanks

Tailor welded blank (TWB) technology has been used in the manufacture of automobile body-in-white components since a long time. These components consist of different materials/thicknesses. Researchers and manufacturers involved with production of warm formed TWB components failed to address the sustainable issues related to warm forming. Rather they concentrated more on reducing the weld line movement (WLM). The WLM if not arrested shall lead to fracture, due to wrinkles, produced during forming. In this paper, the sustainability aspects involved in the warm forming of TWB were discussed with respect to energy and material savings. The results show a reduction of about 50% punch load in a hydraulic press during deep drawing under warm forming conditions. This paper addresses the questions related to the implications of thickness ratio on the weld line movement and further shows how material savings of nearly 33% has been obtained. It also discusses about the carbon emissions during manufacturing of raw materials and the recycling benefits of stainless steel, so as to minimize emissions at the production stage itself during raw materials production

Subsidence in the Kathmandu Basin, before and after the 2015 Mw 7.8 Gorkha Earthquake, Nepal Revealed from Small Baseline Subset-DInSAR Analysis

Land subsidence in densely urbanized areas is a global problem that is primarily caused by excessive groundwater withdrawal. The Kathmandu Basin is one such area where subsidence due to groundwater depletion has been a major problem in recent years. Moreover, on 25 April 2015, this basin experienced large crustal movements caused by the Gorkha earthquake (Mw 7.8). Consequently, the effects of earthquake-induced deformation could affect the temporal and spatial nature of anthropogenic subsidence in the basin. However, this effect has not yet been fully studied. In this paper, we applied the SBAS-DInSAR technique to estimate the spatiotemporal displacement of land subsidence in the Kathmandu Basin before and after the Gorkha earthquake, using 16 ALOS-1 Phased Array L-band Synthetic Aperture Radar (PALSAR) images during the pre-seismic period and 26 Sentinel-1 A/B SAR images during the pre- and post-seismic periods. The results showed that the mean subsidence rate in the central part of the basin was about −8.2 cm/year before the earthquake. The spatial extents of the subsiding areas were well-correlated with the spatial distributions of the compressible clay layers in the basin. We infer from time-series InSAR analysis that subsidence in the Kathmandu basin could be associated with fluvio-lacustrine (clay) deposits and local hydrogeological conditions. However, after the mainshock, the subsidence rate significantly increased to −15 and −12 cm/year during early post-seismic (108 days) and post-seismic (2015–2016) period, respectively. Based on a spatial analysis of the subsidence rate map, the entire basin uplifted during the co-seismic period has started to subside and become stable during the early-post-seismic period. This is because of the elastic rebound of co-seismic deformation. However, interestingly, the localized areas show increased subsidence rates during both the early-post- and post-seismic periods. Therefore, we believe that the large co-seismic deformation experienced in this basin might induce the local subsidence to increase in rate, caused by oscillations of the water table level in the clay layer

Match beam inversion of geoacoustic parameters from towed hydrophone streamer array data

183-194<span style="font-size:9.0pt;font-family: " times="" new="" roman","serif";mso-fareast-font-family:"times="" roman";mso-ansi-language:="" en-us;mso-fareast-language:en-us;mso-bidi-language:ar-sa"="" lang="EN-US">The study estimates geoacoustic parameters of the sediment by inversion of acoustic data acquired from seismic hydrophone streamer array.  Inversion is performed by beamforming technique as the data is pertaining to shallow water and there is no prior information on the sediment type and the profiles of subbottom sediment layers. Initially, the estimates of sediment speed are obtained from critical angle derived from beamformer output by conventional beamforming. The sediment speed is used to set the parameter search bounds for further inversion by beamforming technique. The search bounds for density and compressional attenuation coefficient is set accordingly. The feasibility of inversion is understood by undertaking synthetic runs followed by inversion of field data. The beam cutoff angles are determined from the beampattern and the arrivals pertaining to the sea bottom.  The geoacoustic model comprises of a water column, two sediment layers and a sediment half space.  The inversion results of field data sets are compared with results obtained by modal inversion. The results show negligible variation in estimated sound speed indicating similar sediment type. The sediment density and compressional attenuation coefficient exhibits lesser sensitivity toward inversion process<span style="font-size: 11.0pt;font-family:" times="" new="" roman","serif";mso-fareast-font-family:"times="" roman";="" mso-ansi-language:en-us;mso-fareast-language:en-us;mso-bidi-language:ar-sa"="" lang="EN-US">.</span

A New Species of Brachystelma R.Br. (Apocynaceae: Asclepiadoideae – Ceropegieae) from India

Brachystelma pullaiahi Ravi Prasad Rao, Prasad, Sadasivaiah, Suresh Babu and Prasanna, a new species of Brachystelma R. Br. (Apocynaceae: Asclepiadoideae - Ceropegieae) is described and illustrated. This species located in the hills of Eastern Ghats of Southern Andhra Pradesh is similar to B. maculatum Hook. f. but differs in having long stems, solitary flowers, ash-coloured corolla base, very long and non-keeled, pale yellow corolla lobes with white hairs and biseriate yellow corona