Preoperative paracetamol infusion reduces sevoflurane consumption during thyroidectomy under general anesthesia with spectral entropy monitoring

AbstractBackgroundIntravenous (IV) paracetamol has a significant opioid-sparing effect. We investigated the effect of paracetamol infusion on sevoflurane consumption during entropy monitored general anesthesia.MethodsSixty-two ASA I and II patients undergoing thyroidectomy under general anesthesia were included in a prospective, randomized, double-blind and placebo controlled study. The patients were randomized to receive a slow infusion of either 1g paracetamol (paracetamol group, n=31) or saline (control group, n=31) just before induction of anesthesia. Sevoflurane concentration was titrated to keep the state entropy value between 40 and 50. End-tidal sevoflurane concentration, sevoflurane consumption, recovery characteristics, time to first analgesic request and meperidine consumption during the first 6 postoperative hours were recorded.ResultsThe mean±SD estimated sevoflurane consumption was significantly lower in the paracetamol treated patients (36.2±15 vs 44.9±13.9ml, in the control group; p=0.021). Patients receiving paracetamol had a faster post-anesthetic recovery profile (extubation time, time to eye opening to command and time to state name and mention his/her home address) than the other group (p<0.05). Mean±SD time to first analgesic request was significantly prolonged in paracetamol group compared to control group (48.4±14.0 vs 40.7±11.5min, respectively; p=0.021). Meperidine consumption was higher in control group than in paracetamol group (28.7±10.2 vs 23.1±9.0mg, respectively; p=0.025).ConclusionPreoperative IV paracetamol infusion improved consumption and emergence from entropy monitored sevoflurane anesthesia with enhancement of the early postoperative analgesia

Development of a Novel and Dynamic Shear Rheometer Based Extensional Deformation Test to Replace Force Ductility Test

Modification of asphalt binders is essential to improve the physical and rheological properties of asphalt and to reduce the aging effect. The use of polymers to modify asphalt is the most common approach in asphalt modification. Force ductility test has been a challenging topic as an indicator of asphalt performance, especially for the modified asphalt binders. The significance of the force ductility test as a measure of fatigue and thermal cracking has been debated because of its low reproducibility, empirical nature and the unclear relationship with the fundamental asphalt properties, especially with modified asphalt binders [1]. Extensional deformations tests where converging flows occur have been used by many for polymer characterizations (2). In this study, the extensional deformation behavior of binders Performance Graded 58-28, PG 64-22, and PG 76-22 and its parameters including geometry and temperature were investigated through an extensional rheological approach using a DSR-based Sentmanat Extensional Rheometer (SER). Furthermore, a test method and a sample preparation procedure especially for asphalt binders were developed as a replacement to the conventional force ductility test. The sample preparation method has been simplified and detailed in a way that it can be performed in all asphalt labs. A detailed analysis indicates that the average second peak and first peak elongation forces increase due to the increase of the sample’s area, with ܴ ଶ values of 0.85 and 0.84, respectively. However, the same areas with different dimensions derived different values of elongation force that is due to the dominant role of the width. The elongation force of all samples with the same area but different dimensions increases due to the width’s increment even though the thickness decreases. Based on this study, the recommended test specifications are as follows: the selected geometry is 9 mm x 0.72 mm (width x thickness). The second peak elongation force F2 value was chosen as a recommended force ductility parameter. The minimum ܨଶ value recommended is 14 N, which was lower than the lowest limit of 99% confidence interval (14.45N – 15.99 N). Also, the minimum ratio of the second peak elongation force over the first peak elongation force ܨଶ/ܨଵ of 1.25 is recommended for PG 76-22. This is also lower than the lowest value of 99% confidence interval (1.29-1.51). The recommended temperature is 4ºC, the recommended strain rate is 0.1ݏ ିଵ , and the recommended final strain is 3.4 rad. Therefore, with a more reproducible, significantly less material and time consuming, and with a more mechanistic approach, the developed novel method can help improve the durability of modified asphalt pavements

Evaluation of yolk sac size and embryonic heart rate in first trimester and pregnancy outcome

Background: Accurate differentiation between normal pregnancy and pregnancy loss in early gestation remains a clinical challenge-previous studies have described the association between embryonic well-beings and the characteristics of gestational sac. The aim of the study was to evaluate the yolk sac size and embryonic heart rate as a prognostic factor for the first trimester pregnancy outcome.Methods: This was a prospective cohort observesional study. It included 52 pregnant women in their first trimester from 6 week till 12 weeks gestation. Transvaginal sonographic examination after explanation and agreement of each patient. All pregnancies were followed for their pregnancy outcome after completion of 12 weeks. The adverse outcome was spontaneous miscarriage occurring before or at 12 weeks of gestation. These patients allocated into four study groups: according to gestational age at presentation and pregnancy outcome. Group I included women who were examined during (6-7 weeks+6 days). Group II included women who were examined during (8-9 weeks+6 days). Group III included women who were examined during (10-12 weeks). Group IV included women who had their pregnancies resulted into first trimester spontaneous miscarriage.Results: The validity of YS diameter regarding the prognosis of first trimester pregnancy outcome shows that; YSD had 100% specificity and 97.8% sensitivity in prediction of miscarriage. Regarding embryonic heartbeat, there was a statistically significant difference between group IV and the other groups. There was embryonic bradycardia in the miscarriage group. EHR had a sensitivity of 97.5% and specificity of 100% in prediction of first trimester pregnancy outcome.Conclusions: Abnormal yolk sac diameter, in the form of small, enlarged, absent or irregular yolk sac, and embryonic bradycardia are associated with poor pregnancy outcome

Weakly-supervised localization of diabetic retinopathy lesions in retinal fundus images

Convolutional neural networks (CNNs) show impressive performance for image classification and detection, extending heavily to the medical image domain. Nevertheless, medical experts are sceptical in these predictions as the nonlinear multilayer structure resulting in a classification outcome is not directly graspable. Recently, approaches have been shown which help the user to understand the discriminative regions within an image which are decisive for the CNN to conclude to a certain class. Although these approaches could help to build trust in the CNNs predictions, they are only slightly shown to work with medical image data which often poses a challenge as the decision for a class relies on different lesion areas scattered around the entire image. Using the DiaretDB1 dataset, we show that on retina images different lesion areas fundamental for diabetic retinopathy are detected on an image level with high accuracy, comparable or exceeding supervised methods. On lesion level, we achieve few false positives with high sensitivity, though, the network is solely trained on image-level labels which do not include information about existing lesions. Classifying between diseased and healthy images, we achieve an AUC of 0.954 on the DiaretDB1.Comment: Accepted in Proc. IEEE International Conference on Image Processing (ICIP), 201

Corporate Boards and Ownership Structure as Antecedents of Corporate Governance Disclosure in Saudi Arabian Publicly Listed Corporations

We investigate whether and to what extent publicly listed corporations voluntarily comply with and disclose recommended good corporate governance (CG) practices, and distinctively examine whether the observed cross-sectional differences in such CG disclosures can be explained by ownership and board mechanisms with specific focus on Saudi Arabia. Our results suggest that corporations with larger boards, a big-four auditor, higher government ownership, a CG committee and higher institutional ownership disclose considerably more than those that are not. By contrast, we find that an increase in block ownership significantly reduces CG disclosure. Our results are generally robust to a number of econometric models that control for different types of disclosure indices, firm-specific characteristics and firm-level fixed-effects. Our results have important implications for policy-makers, practitioners and regulatory authorities, especially those in developing countries across the globe

An Assessment of Portfolio Managers' Awareness of Big Data Analytics (BDA) Role in Achieving Portfolio Management (PFM) Success: A Qualitative Study

As big data analytics become the most valuable resource held by all administrations, every huge organization will be investing in initiatives of big data in a succession of Portfolio Management at the next level (Grover et al., 2018). This research aims to study the extent to which portfolio managers are aware of the role of big data in the efficiency of portfolio management.This study includes a qualitative research method to assess portfolio managers' awareness of the role of big data analytics (BDA) in portfolio management success. The researcher followed a theoretical, descriptive approach. The researcher applied the onion analysis methods. The researcher surveyed many portfolio managers in several companies in the Kingdom of Saudi Arabia. Only portfolio managers were chosen because they are more concerned with achieving strategic goals than program and project managers. The researcher conducted a qualitative study by interviewing 38 company portfolio managers.The concept of BDA in this study contains four components (Volume – Veracity- velocity- variety). In this research, five main questions have been extracted to link big data analytics with portfolio management methodology as per PMI standard guidelines for managing business portfolios. The central themes and sub-themes have been extracted for conducting the interview.The results indicated that the portfolio managers' awareness of the (PMI) Portfolio Management (PFM) methodology is very high and compatible with the directions of the Kingdom of Saudi Arabia 2030. The researcher recommends future research to apply another quantitative study for a specific sector to investigate clear awareness regarding the value of using BDA in managing several portfolios. Keywords: Big Data Analytics (BDA)- Portfolio Management (PFM)- Portfolio Decision Support (PDS). DOI: 10.7176/EJBM/14-24-07 Publication date: December 31st 202

Evanescent single-molecule biosensing with quantum limited precision

Sensors that are able to detect and track single unlabelled biomolecules are an important tool both to understand biomolecular dynamics and interactions at nanoscale, and for medical diagnostics operating at their ultimate detection limits. Recently, exceptional sensitivity has been achieved using the strongly enhanced evanescent fields provided by optical microcavities and nano-sized plasmonic resonators. However, at high field intensities photodamage to the biological specimen becomes increasingly problematic. Here, we introduce an optical nanofibre based evanescent biosensor that operates at the fundamental precision limit introduced by quantisation of light. This allows a four order-of-magnitude reduction in optical intensity whilst maintaining state-of-the-art sensitivity. It enable quantum noise limited tracking of single biomolecules as small as 3.5 nm, and surface-molecule interactions to be monitored over extended periods. By achieving quantum noise limited precision, our approach provides a pathway towards quantum-enhanced single-molecule biosensors.Comment: 17 pages, 4 figures, supplementary informatio

Fault interpretation and reservoir characterization of the Farewell Formation within Kerry Field, Taranaki Basin, New Zealand

The Kerry Field, located in the southern offshore Taranaki Basin, is a large liquid-rich gas accumulation with a thin (20 m) oil rim. The field was discovered by the New Zealand Oil & Gas in 1986 (well Kupe South-1). The gas and oil are trapped within a 9.2 km2 fault-dependent three-way dip closure in the Paleocene Farewell Formation reservoir. Pressure, volume, and temperature (PVT) data indicate that the gas and oil columns in the field are in equilibrium with one another and are saturated at current reservoir conditions. The Farewell Formation is the uppermost formation of the Kapuni Group and is producing gas and oil in the Kerry Field. The Farewell Formation is one of the oldest reservoirs in the Taranaki Basin. The Kupe South-1 well penetrates two sequence boundaries. One is an unconformity beneath the Late Miocene Urenui Formation, and the other is beneath the Oligocene Otaraoa Formation, which appears to be in fault contact with the Paleocene Farewell Formation. The Farewell Formation was deposited in the fluvio-deltaic environment, and consists primarily of sandstone, interbedded with carbonaceous mudstone. The thickness of the formation ranges from 261 to 382 m. A time structure map, depth map, isochron map, edge detection map, and coherence map were produced to identify the structures, especially the faults the study area. A correlation across three wells along 19,089 m was generated to support the interpretation the maps. Several faults are mapped that display seismic attributes. The water-oil contact was found at a depth of 3,300 m. The density of the Farewell Formation ranges between 2.2 and 2.6 g/cm3. The average porosity of the Farewell Formation ranges between 20 -24 present. The prospective areas for oil production are located in the north and the south-west parts of the formation --Abstract, page iii

An elegant operational matrix based on harmonic numbers: Effective solutions for linear and nonlinear fourth-order two point boundary value problems

This paper analyzes the solution of fourth-order linear and nonlinear two point boundary value problems. The suggested method is quite innovative and it is completely different from all previous methods used for solving such kind of boundary value problems. The method is based on employing an elegant operational matrix of derivatives expressed in terms of the well-known harmonic numbers. Two algorithms are presented and implemented for obtaining new approximate solutions of linear and nonlinear fourth-order boundary value problems. The two algorithms rely on employing the new introduced operational matrix for reducing the differential equations with their boundary conditions to systems of linear or nonlinear algebraic equations which can be efficiently solved by suitable solvers. For this purpose, the two spectral methods namely, Petrov-Galerkin and collocation methods are applied. Some illustrative examples are considered aiming to ascertain the wide applicability, validity, and efficiency of the two proposed algorithms. The obtained numerical results are satisfactory and the approximate solutions are very close to the analytical solutions and they are more accurate than those obtained by some other existing techniques in literature