Impact of a global pandemic on surgical education and training- review, response, and reflection

The catastrophic effects of the coronavirus disease-2019 global pandemic have revolutionised human society. The unprecedented impact on surgical training needs to be analysed in detail to achieve an understanding of how to deal with similar situations arising in the foreseeable future. The challenges faced by the surgical community initiated with the suspension of clinical activities and elective practice, and included the lack of appropriate personal protective equipment, and the self-isolation of trainees and reassignment to coronavirus patient-care regions. Together, all these elements had deleterious effects on the psychological health of the professionals. Surgical training irrespective of specialty is equally affected globally by the pandemic. However, the global crisis inadvertently has led to a few constructive adaptations in healthcare systems, including the development of tele-clinics, virtual academic sessions and conferences, and increased usage of simulation. The current review article was planned to highlight the impact of corona virus disease on surgical training and institutions\u27 response to the situation in order to continue surgical training, and lessons learnt from the pandemic

A novel adaptive PD-type iterative learning control of the PMSM servo system with the friction uncertainty in low speeds

High precision demands in a large number of emerging robotic applications strengthened the role of the modern control laws in the position control of the Permanent Magnet Synchronous Motor (PMSM) servo system. This paper proposes a learning-based adaptive control approach to improve the PMSM position tracking in the presence of the friction uncertainty. In contrast to most of the reported works considering the servos operating at high speeds, this paper focuses on low speeds in which the friction stemmed deteriorations become more obvious. In this paper firstly, a servo model involving the Stribeck friction dynamics is formulated, and the unknown friction parameters are identified by a genetic algorithm from the offline data. Then, a feedforward controller is designed to inject the friction information into the loop and eliminate it before causing performance degradations. Since the friction is a kind of disturbance and leads to uncertainties having time-varying characters, an Adaptive Proportional Derivative (APD) type Iterative Learning Controller (ILC) named as the APD-ILC is designed to mitigate the friction effects. Finally, the proposed control approach is simulated in MATLAB/Simulink environment and it is compared with the conventional Proportional Integral Derivative (PID) controller, Proportional ILC (P-ILC), and Proportional Derivative ILC (PD-ILC) algorithms. The results confirm that the proposed APD-ILC significantly lessens the effects of the friction and thus noticeably improves the control performance in the low speeds of the PMSM

Comparative analysis of leaf spot disease in Rice Belt of Punjab, Pakistan

Background: Brown leaf spot (BLS) caused by Bipolaris oryzae (Breda de Haan) Shoemaker, is a chronic disease of rice that infects millions of hectares worldwide each year. In this study, a total of 18 rice growing districts of Punjab, Pakistan were surveyed during cropping season in 2014-17 for the incidence of BLS disease. Methods: The survey method was used to gather the data of BLS incidence during 2014-2017 in 18 districts of rice growing areas of Punjab, Pakistan. Meteorological data was collected from the weather stations of each surveyed district and co-related with BLS incidence. Results: The findings of the study revealed that quantitative relationship exists between meteorological variables and BLS incidence. The incidence of disease in the field was at peak during the month of October. The disease incidence varied from 1.12% to 14.37% over a period of study i.e. from 2014-2017. However, the role of relative humidity (RH) was highly positively correlated with the incidence of disease. Relative humidity showed a positive correlation with the incidence of disease as indicated by the year in which it was towards the high values. The highest disease incidence was observed in district Sargodha whereas the minimum in district Okara. The highest incidence of BLS disease was found in variety Basmati Super (51.43%) and the minimum in Basmati 386 (6.57%). Conclusion: Our study revealed that the fluctuations in temperature did not depict an appreciable impact on the incidence of BLS as indicated by the statistical coefficient, whereas RH strongly influenced the incidence of BLS incidence.

An innovative approach based on meta-learning for real-time modal fault diagnosis with small sample learning

The actual multimodal process data usually exhibit non-linear time correlation and non-Gaussian distribution accompanied by new modes. Existing fault diagnosis methods have difficulty adapting to the complex nature of new modalities and are unable to train models based on small samples. Therefore, this paper proposes a new modal fault diagnosis method based on meta-learning (ML) and neural architecture search (NAS), MetaNAS. Specifically, the best performing network model of the existing modal is first automatically obtained using NAS, and then, the fault diagnosis model design is learned from the NAS of the existing model using ML. Finally, when generating new modalities, the gradient is updated based on the learned design experience, i.e., new modal fault diagnosis models are quickly generated under small sample conditions. The effectiveness and feasibility of the proposed method are fully verified by the numerical system and simulation experiments of the Tennessee Eastman (TE) chemical process

Cholangiocarcinoma in a Resected Biliary Cyst: Importance of Follow-up

Biliary cysts are rare cystic dilatations of the biliary tree. Biliary cysts are positively associated with several significant complications, amongst them, cholangiocarcinoma befalls the most dreadful one. The elevated incidence is 20-30% in the unresected cyst and 0.7% in resected cysts. Magnetic resonance imaging (MRI) scan, magnetic resonance cholangiopancreatography (MRCP) or a contrast-enhanced computed tomography (CECT) is applied for the initial diagnostic study but the ultimate diagnosis ordinarily requires the tissue biopsy. Currently, the sole curative option involves the complete surgical resection of the lesion, with standard chemotherapy and active radiation applied as an alternative for the unresectable tumors. Despite the curative surgery the percentage of eternal recurrence of the tumor indefinitely persists, and effective post-surgical surveillance is reasonably demanded. We report a case of 29-year-old female with local recurrence of cholangiocarcinoma in a previously resected biliary cyst type I. The curative resection of the choledochal cyst only minimizes the considerable risk of the possible development of future cholangiocarcinoma but it does not completely prevent it. The appropriate follow-up for potential patients who have been typically treated for a biliary cyst is unclear. The lethal course of cholangiocarcinoma is believed due to its slow asymptomatic growing phase. Therefore, to adequately screen for malignancy, periodic imaging along with annual liver tests represents a reasonable approach to prevent the possible development of this appalling complication.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Impact of Parental Involvement on Achievement Score of Students at Elementary Level

The aim of this research was to investigate the impact of parental involvement on the achievement score of elementary-level students. Parental involvement was the independent variable and the achievement scores of students were the dependent variable. Whereas, demographic variables like school status, SES, and parents’ qualifications were also important. This study was comparative in nature and all elementary-level schools were taken as population. Elementary campuses of boys and girls were conveniently selected from the public sector in Faisalabad and taken as accessible population. From this accessible population, a sample of 376 students (307 male and 69 female) were drawn who have passed the elementary exams. Demographic sheets, copies of elementary result cards, and questionnaires were collected in order to find out the impact of parental involvement on the achievement scores of students at the elementary level. Descriptive statistics (mean, standard deviation, frequency) was employed along with ANOVA, and t-test for data analysis. Keeping in view the results taken from Punjab Examination Commission, significant differences between the academic performance of the children belonging to the businessmen class and the job holders’ class were noticed. Further, it was also determined from the dished-out results that the difference in academic achievement level is significant when more involvement of parents was there

Situational analysis of antimicrobial stewardship program (ASP) among public and private sector tertiary care hospitals in Karachi, Pakistan: A qualitative case study

Abstract Objective: To assess the current status of implementation of the Antimicrobial Stewardship Program (ASP) across Tertiary Care Hospitals in Karachi, Pakistan. Design: Exploratory qualitative case study. Setting: Public and private tertiary care hospitals in Karachi, Pakistan Participants and Methods: The study data were collected from 3 public and 4 private tertiary care hospitals. Twenty-eight in-depth interviews were conducted from the Chief Executive Officer, Chief Medical Officer, Medical Superintendent, and departmental heads of internal medicine, general surgery, and pediatric, respectively. Purposive sampling was done to include higher and middle managers, whereas the infectious diseases consultant, infectious diseases/clinical pharmacist, and clinical microbiologist were interviewed through snowball sampling methodology. Analysis was done using NVivo. Data were source-triangulated within and among the study setting and study participants. Results: We found that more than two-thirds (n = 5, 71%) of tertiary care hospitals in Karachi do not have a structured ASP which includes major public sector hospitals (n = 3, 43%) and half of the private sector hospitals (n = 4, 29%). The study results led to four broad themes, (1) ASP structure, (2) ASP interventions, (3) hospital medical record-keeping system, and (4) structured way for analyzing and reporting mechanism of data related to the ASP. At H1 and H2, there was a consistency in ASP structure and interventions, whereas paucity seen among remaining tertiary care hospitals. Conclusion: There is an alarming need for ASP in the public and private sector hospitals in Karachi. This study can inform future stakeholders regarding ASP and strategies for structural change at hospitals