Laparoscopic Ventral Mesh Fixation in Patients with Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a condition with a high incidence rate and often creates difficulties in surgical coloproctology and gynecology. The aim of this study was to evaluate the effectiveness of laparoscopic ventral reticular sacrocolporectopexy and sacrorectopexi in women and men with POP, respectively. This study was conducted at the Educational-Surgical Clinic of Azerbaijan Medical University and Department of Surgery of the Faculty of Medicine of Ankara University (2016-2019) on 21 patients with POP (15 women and 6 men). Results of diagnostics and surgical treatment of POP were studied with preferences towards endoscopic, radiation, and functional methods. The surgical methods used in these patients included laparoscopic fixation methods (sacrocolpopexy, sacrocolporectopexy) of protruding organs (uterus, vaginal vault/vaginal cuff, rectum) and simultaneous vaginal (colporrhaphy, colpolevatoroplasty, vaginal plastic surgery) and proctological surgeries (circulatory resection, hemorrhoidectomy, sphincteroplasty). The findings demonstrated that the most progressive POP mostly occurred in women of premenopausal age and during menopause. Based on the results of the long-term evaluation of the surgical treatment (6-12 months), the rates of recurrence of prolapse and complications were low (up to 4.8% and 9.5%, respectively) with favorable long-term functional results,  such as a decrease in the degree of fecal incontinence and constipation, observed in the evaluation. Due to the concomitant weakness of the ligamentous apparatus of the pelvic floor in these patients, there is the need for intra-abdominal apical support of organs. In conclusion, that laparoscopic sacrocolpopexy in women and sacrorectopexy in men are reliable surgical method to treat POP. However, specific skills need to be acquired by both gynecologist and coloproctologist to be able to do these laparoscopic surgery techniques

Femtosecond laser fabrication of fiber based optofluidic platform for flow cytometry applications

Miniaturized optofluidic platforms play an important role in bio-analysis, detection and diagnostic applications. The advantages of such miniaturized devices are extremely low sample requirement, low cost development and rapid analysis capabilities. Fused silica is advantageous for optofluidic systems due to properties such as being chemically inert, mechanically stable, and optically transparent to a wide spectrum of light. As a three dimensional manufacturing method, femtosecond laser scanning followed by chemical etching shows great potential to fabricate glass based optofluidic chips. In this study, we demonstrate fabrication of all-fiber based, optofluidic flow cytometer in fused silica glass by femtosecond laser machining. 3D particle focusing was achieved through a straightforward planar chip design with two separately fabricated fused silica glass slides thermally bonded together. Bioparticles in a fluid stream encounter with optical interrogation region specifically designed to allocate 405nm single mode fiber laser source and two multi-mode collection fibers for forward scattering (FSC) and side scattering (SSC) signals detection. Detected signal data collected with oscilloscope and post processed with MATLAB script file. We were able to count number of events over 4000events/sec, and achieve size distribution for 5.95μm monodisperse polystyrene beads using FSC and SSC signals. Our platform shows promise for optical and fluidic miniaturization of flow cytometry systems. © 2017 SPIE

LCrowdV: Generating Labeled Videos for Simulation-based Crowd Behavior Learning

We present a novel procedural framework to generate an arbitrary number of labeled crowd videos (LCrowdV). The resulting crowd video datasets are used to design accurate algorithms or training models for crowded scene understanding. Our overall approach is composed of two components: a procedural simulation framework for generating crowd movements and behaviors, and a procedural rendering framework to generate different videos or images. Each video or image is automatically labeled based on the environment, number of pedestrians, density, behavior, flow, lighting conditions, viewpoint, noise, etc. Furthermore, we can increase the realism by combining synthetically-generated behaviors with real-world background videos. We demonstrate the benefits of LCrowdV over prior lableled crowd datasets by improving the accuracy of pedestrian detection and crowd behavior classification algorithms. LCrowdV would be released on the WWW

Boundary element method for optical force calibration in microfluidic dual-beam optical trap

The potential use of optical forces in microfluidic environment enables highly selective bio-particle manipulation. Manipulation could be accomplished via trapping or pushing a particle due to optical field. Empirical determination of optical force is often needed to ensure efficient operation of manipulation. The external force applied to a trapped particle in a microfluidic channel is a combination of optical and drag forces. The optical force can be found by measuring the particle velocity for a certain laser power level and a multiplicative correction factor is applied for the proximity of the particle to the channel surface. This method is not accurate especially for small microfluidic geometries where the particle size is in Mie regime and is comparable to channel cross section. In this work, we propose to use Boundary Element Method (BEM) to simulate fluid flow within the micro-channel with the presence of the particle to predict drag force. Pushing experiments were performed in a dual-beam optical trap and particlea's position information was extracted. The drag force acting on the particle was then obtained using BEM and other analytical expressions, and was compared to the calculated optical force. BEM was able to predict the behavior of the optical force due to the inclusion of all the channel walls. © 2015 SPIE

Sympathetic Skin Response and Boston Questionnaire in Carpal Tunnel Syndrome

We aimed to determine relations between the sudomotor efferent nerve fiber function and Boston questionnaire (BQ) in idiopathic carpal tunnel syndrome (CTS). Median nerve-induced sympathetic skin responses (SSRs) evoked by wrist stimulation were recorded in 108 CTS patients and compared with those in 88 healthy volunteers. The Boston questionnaire form (BQF) was applied to the subjects. All patients and healthy individuals were questioned about the autonomic symptoms in the hand (red or purple skin coloration, excessive sweating, and feeling cold). The average SSR latencies of the patients with CTS were significantly longer than those in the control group (P < 0.001). Positive significant, while weak, correlations were found between the SSR latency, autonomic symptoms, and total sympathetic system scores. No statistically significant relationship was found between the Boston symptom severity, functional capacity scores, and SSR latency. The latter obtained through wrist stimulation was sensitive to support the sudomotor sympathetic dysfunction in patients with CTS. No relationship between the BQF and SSR can be related to the fact that these indices evaluate different aspects of CTS.Ми намагалися встановити взаємовідносини судомоторної функції еферентного нерва та показників Бостонського опитувальника (BQ) у випадках ідіопатичного синдрому зап’ястного каналу (СЗК). Шкірні симпатичні відповіді (ШСВ) відводилися після стимуляції медіанного нерва на рівні зап’ястка у 108 пацієнтів із діагностованим СЗК; ці характеристики порівнювались із такими у 88 здорових добровольців. Усім суб’єктам пропонували форму BQF. Усі пацієнти та здорові особи опитувалися щодо вегетативних симптомів, які проявлялися на кисті (червоне або пурпурове забарвлення шкіри, надмірне потовиділення та відчуття холоду). Середнє значення латентного періоду ШСВ у пацієнтів із СЗК вірогідно перевищувало таке в контрольній групі (P < 0.001). Істотна позитивна, хоча й слабка, кореляція була виявлена між латентним періодом ШСВ, вегетативними симптомами та бальною загальною оцінкою стану симпатичної системи. Не було встановлено вірогідних відносин між показником тяжкості симптомів (згідно з BQF), оцінкою функціональної здатності та латентним періодом ШСВ. Останній параметр, отриманий при стимуляції на рівні зап’ястка, був чутливим щодо судомоторної симпатичної дисфункції у пацієнтів із цим синдромом. Відсутність зв’язку між оцінками BQF та ШСВ може бути зумовлена тим, що дані показники оцінюють різні аспекти ШСВ

Potential Cost-Effectiveness of RSV Vaccination of Infants and Pregnant Women in Turkey:An Illustration Based on Bursa Data

BackgroundWorldwide, respiratory syncytial virus (RSV) is considered to be the most important viral cause of respiratory morbidity and mortality among infants and young children. Although no active vaccine is available on the market yet, there are several active vaccine development programs in various stages. To assess whether one of these vaccines might be a future asset for national immunization programs, modeling the costs and benefits of various vaccination strategies is needed. Objectives To evaluate the potential cost-effectiveness of RSV vaccination of infants and/or pregnant women in Turkey.MethodsA multi-cohort static Markov model with cycles of one month was used to compare the cost-effectiveness of vaccinated cohorts versus non-vaccinated cohorts. The 2014 Turkish birth cohort was divided by twelve to construct twelve monthly birth cohorts of equal size (111,459 new-borns). Model input was based on clinical data from a multicenter prospective study from Bursa, Turkey, combined with figures from the (inter) national literature and publicly available data from the Turkish Statistical Institute (TUIK). Incremental cost-effectiveness ratios (ICERs) were expressed in Turkish Lira (TL) per quality-adjusted life year (QALY) gained.ResultsVaccinating infants at 2 and 4 months of age would prevent 145,802 GP visits, 8,201 hospitalizations and 48 deaths during the first year of life, corresponding to a total gain of 1650 QALYs. The discounted ICER was estimated at 51,969 TL (26,220 US $in 2013) per QALY gained. Vaccinating both pregnant women and infants would prevent more cases, but was less attractive from a pure economic point of view with a discounted ICER of 61,653 TL (31,106 US$ in 2013) per QALY. Vaccinating only during pregnancy would result in fewer cases prevented than infant vaccination and a less favorable ICER.ConclusionRSV vaccination of infants and/or pregnant women has the potential to be cost-effective in Turkey. Although using relatively conservative assumptions, all evaluated strategies remained slightly below the threshold of 3 times the GDP per capita.</p

CO2 polishing of femtosecond laser micromachined microfluidic channels

The CO2 polishing of femtosecond laser micromachined channels is studied. The surface quality before and after polishing is observed with naked eye and optical microscope. The method improves imaging of microspheres. © 2016 OSA

Sheathless microflow cytometry using viscoelastic fluids

Microflow cytometry is a powerful technique for characterization of particles suspended in a solution. In this work, we present a microflow cytometer based on viscoelastic focusing. 3D single-line focusing of microparticles was achieved in a straight capillary using viscoelastic focusing which alleviated the need for sheath flow or any other actuation mechanism. Optical detection was performed by fiber coupled light source and photodetectors. Using this system, we present the detection of microparticles suspended in three different viscoelastic solutions. The rheological properties of the solutions were measured and used to assess the focusing performance both analytically and numerically. The results were verified experimentally, and it has been shown that polyethlyene oxide (PEO) and hyaluronic acid (HA) based sheathless microflow cytometer demonstrates similar performance to state-of-the art flow cytometers. The sheathless microflow cytometer was shown to present 780 particles/s throughput and 5.8% CV for the forward scatter signal for HA-based focusing. The presented system is composed of a single capillary to accommodate the fluid and optical fibers to couple the light to the fluid of interest. Thanks to its simplicity, the system has the potential to widen the applicability of microflow cytometers. © 2017 The Author(s)

CO2 laser polishing of microfluidic channels fabricated by femtosecond laser assisted carving

In this study, we investigate the effects of CO2 laser polishing on microscopic structures fabricated by femtosecond laser assisted carving (FLAC). FLAC is the peripheral laser irradiation of 2.5D structures suitable for low repetition rate lasers and is first used to define the microwell structures in fused silica followed by chemical etching. Subsequently, the bottom surface of patterned microwells is irradiated with a pulsed CO2 laser. The surfaces were characterized using an atomic force microscope (AFM) and scanning electron microscope (SEM) in terms of roughness and high quality optical imaging before and after the CO2 laser treatment. The AFM measurements show that the surface roughness improves more than threefold after CO2 laser polishing, which promises good channel quality for applications that require optical imaging. In order to demonstrate the ability of this method to produce low surface roughness systems, we have fabricated a microfluidic channel. The channel is filled with polystyrene bead-laden fluid and imaged with transmission mode microscopy. The high quality optical images prove CO2 laser processing as a practical method to reduce the surface roughness of microfluidic channels fabricated by femtosecond laser irradiation. We further compared the traditional and laser-based glass micromachining approaches, which includes FLAC followed by the CO2 polishing technique. � 2016 IOP Publishing Ltd

ALACA: A platform for dynamic alarm collection and alert notification in network management systems

Mobile network operators run Operations Support Systems that produce vast amounts of alarm events. These events can have different significance levels and domains and also can trigger other ones. Network operators face the challenge to identify the significance and root causes of these system problems in real time and to keep the number of remedial actions at an optimal level, so that customer satisfaction rates can be guaranteed at a reasonable cost. In this paper, we propose a scalable streaming alarm management system, referred to as Alarm Collector and Analyzer, that includes complex event processing and root cause analysis. We describe a rule mining and root cause analysis solution for alarm event correlation and analyses. The solution includes a dynamic index for matching active alarms, an algorithm for generating candidate alarm rules, a sliding window–based approach to save system resources, and a graph-based solution to identify root causes. Alarm Collector and Analyzer is used in the network operation center of a major mobile telecom provider. It helps operators to enhance the design of their alarm management systems by allowing continuous analysis of data and event streams and predict network behavior with respect to potential failures by using the results of root cause analysis. We present experimental results that provide insights on performance of real-time alarm data analytics systems. Copyright © 2017 John Wiley & Sons, Ltd