Role of infrainguinal bypass in Buerger's disease: An eighteen-year experience

Objectives:The role of bypass to the distal arteries for patients with Buerger's disease (thromboangiitis or TAO) remains controversial because of the high incidence of graft failure. We retrospectively reviewed the results of 71 bypasses to evaluate their efficacy.Materials and methods:We performed 71 autogenous vein bypasses in 61 patients with TAO. Of the patients, 97% were heavy smokers. The indications for surgery were claudication in 41%, and ischaemic ulcer or gangrene in 59%. Of the bypasses 85% were to the crural arteries or to the arteries below the ankle. The grafts used were 53 single saphenous veins, and 18 venovenous composite grafts.Results:There were 38 graft failures, the main causes including anastomosis to a diseased artery, disease progression (which occurred in smokers after surgery), and vein graft stenosis. Of 38, 10 were restored to patency by revision surgery. Primary and secondary patency rates were 48.8% and 62.5% at 5 years, and 43.0% and 56.3% at 10 years, respectively. The patency rates of the postoperative non-smoking group was significantly higher than that of the smoking group (66.8% vs. 34.7%, p < 0.05). Thirty-six patients (59%) had successful revascularisation and returned to full-time work. However, of 28 with secondary failure, 11 underwent amputation, while 14 had persistent disabling claudication.Conclusion:Bypass to the distal arteries is an effective treatment for TAO patients, and the long-term patency is quite satisfactory as long as patients stop smoking

Symptoms versus problems (SVP) in household high speed broadband (HSBB): regaining momentum for Unifi, Malaysia

Problem identification is a talent and skill set required in all leaders. The objective of this study is to reveal an improved research method by integrating mixed-method research combined with problem identification method (using symptoms versus problems (SVP) framework) for telco service providers. The SVP framework discovers the primary causes to the decrease in revenue growth rates. Malaysia’s household broadband penetration rate grew from 15.2% (2007) to 67.1% (2013). Meanwhile, the growth rate for Unifi, offered by Telekom Malaysia (TM), decreased from 104% (2012) to 30% (2013). Why? There are eight causes, specifically; not prioritizing 4G LTE license; obligating social services to rural areas; providing 20-30 Mbps wireless broadband packages by the competitors; offering less competitive price; not covering all zones; offering less favorable service contracts; offering limited packages; and receiving customer complaints. The sequential methodology process began with semi-structured interviews, analysis of unpublished company data, customer survey on 164 respondents and field observation which were all summarized into a root-cause analysis tool called symptoms versus problems framework (SVP). The SVP indicates TM acquired Packed One to overcome HSBB issues; revamp its strategies to product content offering instead of head-on price war; establishing bureaucracy busting team, competitors busting teams on product innovation; collaborating with local broadcasting companies; and developing talent. Interestingly, this study discovers another framework on critical success factors for telco service providers through development of “House of Pillars for Rapid Growth” of TM in Malaysia

Probing Spin-Charge Relation by Magnetoconductance in One-Dimensional Polymer Nanofibers

Polymer nanofibers are one-dimensional organic hydrocarbon systems containing conducting polymers where the non-linear local excitations such as solitons, polarons and bipolarons formed by the electron-phonon interaction were predicted. Magnetoconductance (MC) can simultaneously probe both the spin and charge of these mobile species and identify the effects of electron-electron interactions on these nonlinear excitations. Here we report our observations of a qualitatively different MC in polyacetylene (PA) and in polyaniline (PANI) and polythiophene (PT) nanofibers. In PA the MC is essentially zero, but it is present in PANI and PT. The universal scaling behavior and the zero (finite) MC in PA (PANI and PT) nanofibers provide evidence of Coulomb interactions between spinless charged solitons (interacting polarons which carry both spin and charge)

Nanofiltration of aerobically-treated palm oil mill effluent: Characterization of the size of colour compounds using synthetic dyes and polyethylene glycols

Membrane-based separation is one of the emerging technologies that have garnered significant interest in recent years for the treatment process of palm oil mill effluent (POME). As documented in the literature, different types of membrane processes such as ultrafiltration (UF), nanofiltration (NF) and reverse osmosis (RO) were used for the POME treatment and the efficiency of separation varied depending on the membrane properties. Unlike the previous works that used membranes to treat POME, the main focus of this current work is to utilize NF membrane to characterize the size of colour compounds in the aerobically-treated POME (AT-POME). Two different markers, i.e., synthetic dyes and polyethylene glycols (PEGs) with molecular weight (MW) in the range of 200-1000 g/mol were used to characterize the colour compounds in the AT-POME. Results showed that dyes are more suitable compared to PEGs for the characterization because dyes possessed negative charge similar as the colour compounds in the AT-POME. By using dyes as the markers, it was found that the size of the colour compounds in the AT-POME was at MW of 300-400 g/mol. Precise determination of the size of colour compounds in the AT-POME is of importance as it could provide useful information on the selection of ideal membrane properties (in particular pore size or molecular weight cut-off) to achieve complete solute separation

Dialogue based interfaces for universal access.

Conversation provides an excellent means of communication for almost all people. Consequently, a conversational interface is an excellent mechanism for allowing people to interact with systems. Conversational systems are an active research area, but a wide range of systems can be developed with current technology. More sophisticated interfaces can take considerable effort, but simple interfaces can be developed quite rapidly. This paper gives an introduction to the current state of the art of conversational systems and interfaces. It describes a methodology for developing conversational interfaces and gives an example of an interface for a state benefits web site. The paper discusses how this interface could improve access for a wide range of people, and how further development of this interface would allow a larger range of people to use the system and give them more functionality

Impacts of hydrophilic nanofillers on separation performance of thin film nanocomposite reverse osmosis membrane

The membrane technology is still considered a costly method to produce potable water. In view of this, RO membrane with enhanced water permeability without trade-off in salt rejection is desirable as it could further reduce the cost for water desalination. In this study, thin film nanocomposite (TFN) membranes containing 0.05 or 0.10 w/v% hydrophilic nanofillers in polyamide layer were synthesized via interfacial polymerization of piperazine and trimesoyl chloride monomers. The resultant TFN membranes were characterized and compared with a control thin film composite (TFC) membrane. Results from the filtration experiments showed that TFN membranes exhibited higher water permeability, salt rejection and fouling resistance compared to that of the TFC membrane. Excessive amount of nanofillers incorporated in the membrane PA layer however negatively affected the cross-linking in the polymer matrix, thus deteriorating the membrane salt rejection. TFN membrane containing 0.05 w/v% of nanofillers showed better performances than the TFC membrane, recording a pure water flux of 11.2 L/m2∙he membsalt rejection of 95.4%, 97.3% and 97.5% against NaCl, Na2SO4 and MgSO4, respectively

Effects of biomaterials keratin-gelatin and basic fibroblast growth factor-gelatin composite film on wound healing in dogs

Eighteen clinically healthy dogs weighing 10-15 kg body weight were used in this study over a 20-day period. They were allocated randomly into 3 groups of 6 animals each. After the creation of 5 cm x 5cm open wound, Group I was control treated with Gentamycin ointment. Groups II and ill were treated with keratin-gelatin and basic fibroblast growth factor (bFGF)-gelatin composite film respectively. On application, the keratin-gelatin and bFGF-gelatin composite film were well accepted by the animals without any adverse reaction. On clinical examination, Group II showed bright beefy red color granulation tissue with angiogenesis when compared to Groups I and ill. On bacteriological examination, Staphylococcus aureus, Pseudomonas, Escherichia coli, Proteus and Klebsiella species were isolated from all the groups. Mean percentage of epithelialisation, wound contraction and total healing were significantly better in Group II (P<0.05). Keratin is a biocompatible protein which does not interfere with the body's normal immunologic response and therefore it can be used in extensive wounds and also in non healing chronic wounds which need a trigger to stimulate the normal healing process. In extensive wounds when there is lack of autologous tissue, biomaterials like keratin-gelatin may be beneficial and can be used

Synthetic RNA Silencing of Actinorhodin Biosynthesis in Streptomyces coelicolor A3(2)

We demonstrate the first application of synthetic RNA gene silencers in Streptomyces coelicolor A3(2). Peptide nucleic acid and expressed antisense RNA silencers successfully inhibited actinorhodin production. Synthetic RNA silencing was target-specific and is a new tool for gene regulation and metabolic engineering studies in Streptomyces.Peer reviewe