Analysis of Human Gait Cycle with Body Equilibrium based on leg Orientation

Gait analysis identifies the posture during movement in order to provide the correct actions for a normal gait. A person\u27s gait may differ from others and can be recognized by specific patterns. Healthy individuals exhibit normal gait patterns, while lower limb amputees exhibit abnormal gait patterns. To better understand the pitfalls of gait, it is imperative to develop systems capable of capturing the gait patterns of healthy individuals. The main objective of this research was to introduce a new concept in gait analysis by computing the static and dynamic equilibrium in a real-world environment. A relationship was also presented among the parameters stated as static \& dynamic equilibrium, speed, and body states. A sensing unit was installed on the designed metal-based leg mounting assembly on the lateral side of the leg. An algorithm was proposed based on two variables: the position of the leg in space and the angle of the knee joint measured by an IMU sensor and a rotary encoder. It was acceptable to satisfy the static conditions when the body was in a fixed position and orientation, whether lying down or standing. While walking and running, the orientation is determined by the position and knee angle variables, which fulfill the dynamic condition. High speed reveals a rapid change in orientation, while slow speed reveals a slow change in orientation. The proposed encoder-based feedback system successfully determined the flexion at 47$^\circ$, extension at 153$^\circ$, and all seven gait cycle phases were recognized within this range of motion. Body equilibrium facilitates individuals when they are at risk of falling or slipping

Evaluation of Phyllanthus niruri L. from Malaysia for In-vitro Anti-Urolithiatic properties by different solvent extraction

The Phyllanthus niruri is traditionally used for curing of kidney disorders and urinary stones in Malaysia. Hence the current work was aimed to evaluate the effect of different solvents extract (n- hexane, ethyl acetate, methanol and water) of P. niruri for in vitro anti-urolithiatic properties in terms of inhibition activity on CaOx by using the rate of CaOx aggregation assay and dissolution of calcium oxalate (CaOx) crystal by using titrimetry method. Cystone was used as positive control. The effects of cystone on slope of nucleation and aggregation as well as growth of CaOx were evaluated spectrophotometrically. The highest yield percentage of P.niruri was occupied by methanol (5.74 %). The maximum inhibition against aggregation of CaOx crystals was also occupied by methanol (66.67 % ± 1.61) and was comprised with alkaloid, steroid, terpenoid and tannin. Dissolution effect on calcium oxalate crystals indicates that the aqueous extracts of P. niruri was found to be more effective in dissolution of CaOx with 63.33 % ± 1.44. P. niruri significantly (P < 0.05) inhibited the slope of nucleation and aggregation of CaOx crystallization, and reduced the crystal density. The results of the present study confirmed that P. niruri leaves can be used as remedial mediator for urolithiasis. However, further studies are required for isolation and identification of active constituents and their in-vivo confirmation

Yield of esophagogastroduodenoscopy and colonoscopy in cancer of unknown primary

Objectives: Carcinoma of unknown primary origin (CUP) is heterogeneous group of cancers. Role of gastrointestinal (GI) endoscopy in this entity is under investigated. Aim of this study was to evaluate yield of Colonoscopy and Esophagogastroduodenoscopy (EGD) in localizing primary tumor in patients with CUP. METHODOLOGY: Patients with histopathologically proven CUP who underwent colonoscopy / EGD to find the primary tumor from December 2009 to December 2011 were included in the study. Abdominal symptoms and cytokeratin (CK) 7 and 20 markers were correlated with presence of primary in GI tract. Results: After giving informed consent 86 patients were included in final analysis. All patients underwent colonoscopy while 60(70%) got EGD along with colonoscopy. Mean age was 55.10 +/-11.94 years with 52(60%) male. Abdominal symptoms were present in 50%. CK7+/CK20- in 34(40%); CK7-/CK20+ in 2(2%) while CK7+/20+ in 7(8%) of metastatic tumor samples. Liver was metastatic site in 47(55%), Lymph node 12(14%) and Ascites in 8(9%). Endoscopy detected primary in 6 (7%) patients with 3 each in stomach and colon. No association of abdominal symptoms and cytokeratin markers was found with presence of GI primary site. CONCLUSION: Yield of localizing primary lesion in the GI tract by pan-endoscopy was limited. Abdominal symptoms and cytokeratin markers do not predict presence of gastrointestinal malignancies

Composite model predictive control for the boost converter and two-phase interleaved boost converter

This article compares the conventional model predictive control (MPC) and active disturbance rejection control (ADRC) with a novel MPADRC technique for controlling a non-minimum phase behavior in the DC–DC boost converter. The control of the boost converter is challenging as it is nonlinear, and it shows non-minimum phase behavior in a continuous conduction mode (CCM). Moreover, in this article, the comparison is presented for the boost converter and the two-phase interleaved boost converter using MPC and ADRC, and the effectiveness of the interleaving technique is shown. Finally, it is proved that the interleaving method has much more efficiency and less output ripple than the simple boost converter. To conclude, a novel technique has been introduced that combines both the techniques, that is, MPC and ADRC, in the outer and inner loop with a boost converter, respectively, and the response is clearly the best when compared to the said techniques individually. The overall impact of this technique includes the advantages of both the techniques, that is, the use of MPC allows us to optimize the current value by predicting the future values, and the use of ADRC ensures that the disturbance factor is well tackled and cancels the effect caused by all the disturbances including ignored quantities as well

National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.Peer reviewe

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

Abstract 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

Technical Considerations and Complication of Percutaneous Transhepatic Biliary Drainage: A Single Center Retrospective Study

Introduction: With comparable outcomes, percutaneous transhepatic biliary drainage (PTBD) is the preferred method for relieving biliary obstruction when the gold standard endoscopic retrograde cholangiopancreaticography (ERCP) fails or is not practicable. Aims & Objectives: To evaluate the technical success rate, clinical success rate, and complications of PTBD. Place and duration of study: This study was carried out in Radiology Department of Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan from 29th February 2020 to 1st November 2021. Material & Methods: In this study, consecutive PTBD procedures performed from 29th February 2020 to 1st November 2021 were retrospectively reviewed. We collected data including patients' age, gender, diagnosis, indications, prior ERCP performance, preoperative and post operative bilirubin, and complications. Technical success, clinical success, and complications were documented. SPSS Version 26 was used for data entry and analysis, P-value<0.05 was taken as significant. Results: A total of 96 procedures were performed in 64 patients with the mean age of 52 years (range: 20 - 91 years). Out of 96, 66 (68.8%) procedures were performed in malignant obstruction with most common cause being cholangiocarcinoma (24%). Technical success was achieved in100% of the cases while clinical success rate was 90.6%. In total 96 procedures, 7 complications were reported. Major complication rate was 5.2%. These included 2 cases of post-procedure cholangitis (2.1%), 2 cases of acute pancreatitis (2.1%), and a case of bilio-venous fistula (1%). Minor complication rate (including 2 cases of pericatheter leakage) was 2.1%. Conclusion: PTBD is a reliable and effective procedure. In general, complication rate after PTBD is not high, and the patients having malignant disease were more prone to the complications

Load Frequency Control and Automatic Voltage Regulation in Four-Area Interconnected Power Systems Using a Gradient-Based Optimizer

Existing interconnected power systems (IPSs) are being overloaded by the expansion of the industrial and residential sectors together with the incorporation of renewable energy sources, which cause serious fluctuations in frequency, voltage, and tie-line power. The automatic voltage regulation (AVR) and load frequency control (LFC) loops provide high quality power to all consumers with nominal frequency, voltage, and tie-line power deviation, ensuring the stability and security of IPS in these conditions. In this paper, a proportional integral derivative (PID) controller is investigated for the effective control of a four-area IPS. Each IPS area has five generating units including gas, thermal reheat, hydro, and two renewable energy sources, namely wind and solar photovoltaic plants. The PID controller was tuned by a meta-heuristic optimization algorithm known as a gradient-based optimizer (GBO). The integral of time multiplied by squared value of error (ITSE) was utilized as an error criterion for the evaluation of the fitness function. The voltage, frequency, and tie-line power responses of GBO-PID were evaluated and compared with integral–proportional derivative (GBO-I-PD), tilt integral derivative (GBO-TID), and integral–proportional (GBO-I-P) controllers with 5% step load perturbation (SLP) provided in each of the four areas. Comprehensive comparisons between GBO-PID and other control methodologies revealed that the proposed GBO-PID controller provides superior voltage, frequency, and tie-line power responses in each area. The reliability and efficacy of GBO-PID methodology were further validated with variations in the turbine time constant and speed regulation over a range of  ± 25%. It is evident from the outcomes of the sensitivity analysis that the proposed GBO-PID control methodology is very reliable and can successfully stabilize the deviations in terminal voltage, load frequency, and tie-line power with a shorter settling time in a four-area IPS

Concurrent acute pancreatitis, pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum following ERCP-related perforation: A rare and insightful case study

This case report details an extraordinary occurrence following endoscopic retrograde cholangiopancreatography (ERCP) in a 42-year-old woman. Despite ERCP being a commonly performed procedure, this case presented an unusual combination of acute pancreatitis, pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum resulting from a Stapfer type III perforation. The patient managed conservatively with nil per os, nasogastric tube, intravenous fluids, pain relief, and antibiotics, exhibited clinical improvement. Remarkably, resolution of complications occurred without surgical intervention. This case underscores the significance of vigilance in diagnosing and appropriately managing ERCP-related complications, contributing to the broader understanding of these rare events and fostering improved patient outcomes

Investigating the drinking and surface water quality and associated health risks in a semi-arid multi-industrial metropolis (Faisalabad), Pakistan

Urban areas under the influence of multi-industrial activities with arid and semi-arid environments witness the significant increase in environmental pollution especially in the water sector. The present study evaluated the water quality and associated health risk assessment through heavy metal pollution. Drinking (n = 48) and surface (n = 37) water samples were collected from semi-arid multi-industrial metropolis, Faisalabad, Pakistan. Physio-chemical and biological parameters and different metals (Al, As, Ba, Cd, Cr, Cu, Fe, Pb, Ni and Zn) were investigated using standard procedures and multivariate water quality assessments. Many physio-chemical and biological parameters and metals especially arsenic were exceeding the permissible limit of Punjab environmental quality standards and the World Health Organization. The results from water quality index showed that 1) and carcinogenicity was found in case of arsenic and chromium (1 x 10(-4)) in adults and children. Semi-arid weather combined with different anthropogenic activities and unusual water features provoked metal contamination. Results of the present study can deliver basic information for effective management of water in the most populous and industrial areas