General Versus Spinal Anesthesia: Which is a Risk Factor for Octogenarian Hip Fracture Repair Patients?

SummaryBackgroundMost studies have shown no difference between the two types of anesthesia administered to hip fracture patients. This study compared postoperative morbidity and mortality in octogenarian patients who received either general or spinal anesthesia for hip fracture repair.MethodsWe retrospectively analyzed the hospital records of 335 octogenarian patients who received hip fracture repair in our teaching hospital between 2002 and 2006. A total of 167 and 168 patients received general and spinal anesthesia, respectively. Morbidity, mortality, and intraoperative and preoperative variables were compared between groups.ResultsThere were no mortality differences between spinal and general anesthesia groups. However, the overall morbidity was greater in the general anesthesia group than in the spinal anesthesia group (21/167 [12.6%] vs. 9/168 [5.4%]; p = 0.02). Respiratory system-related morbidity was also higher in the general anesthesia group than in the spinal anesthesia group (11/167 [6.6%] vs. 3/168 [1.8%]; p = 0.03). Logistic regression analysis revealed two significant predictors of postoperative morbidity: anesthesia type (general; odds ratio, 2.39) and preexisting respiratory diseases (odds ratio, 3.38).ConclusionGeneral anesthesia increased the risk of postoperative morbidity in octogenarian patients after hip fracture repair, and patients with preexisting respiratory diseases were especially vulnerable. Spinal anesthesia is strongly recommended in such individuals

Experiences with a simple laparoscopic gastric tube construction

BACKGROUND: Minimally invasive esophagectomy (MIE) is a complex operation, and the detailed optimal surgical procedure has not been well described. Our aim was to evaluate use of a simple method of laparoscopic gastric tube construction as minimally invasive surgery for patients with esophageal cancer. METHODS: We performed a retrospective review of 26 consecutive patients who underwent MIE for esophageal cancer in the Koo Foundation Sun Yat-Sen Cancer Center between September 2009 and August 2011. Perioperative data and postoperative complications were statistically analyzed. RESULTS: The patient group consisted of 22 men and 4 women. MIE was performed successfully in all patients. The mean operative time was 430.4 ± 60.6 minutes, and the mean estimated operative blood loss was 135.0 ± 97.8 mL. There were no cases of conversion to open surgery during the procedure. The postoperative complication rate was 53.8%, and there was no surgical mortality. CONCLUSIONS: We recommend this novel method of total laparoscopic staplized formation of gastric tube to facilitate gastric pull-up

Solving The Flexible Job Shop Problem using Multi-Objective Optimizer with Solution Characteristic Extraction

It is difficult to find optimal scheduling solutions for abstract scheduling problems with mass parallel tasks on multiprocessors because they are NP-complete. In this paper, a solution searching strategy called solution characteristic extraction is proposed as a multi-objective optimizer for solving flexible job shop problems (FJSP). These problems are concerned with finishing assigned jobs with minimal critical machine workload, total workload, and completion times. A suitable job assignment must consider processor performance, job complexity, and job suitability for each individual processor simultaneously. To test the efficiency and robustness of the proposed method, the experiments will contain two groups of benchmarks; with, and without release time constraints. Each benchmark includes numbers of heterogeneous processors and different jobs for execution. The results indicate the proposed method can find more potential solutions, and outperform related methods

Comparison of the Prevalence of Metabolic Syndrome Between the Criteria for Taiwanese and Japanese and the Projected Probability of Stroke in Elderly Hypertensive Taiwanese

SummaryBackgroundThe cutoff of abdominal circumference for metabolic syndrome (MS) defined by the Bureau of Health Promotion (BHP) of Taiwan for Taiwanese (men, 90cm; women, 80cm) and by the International Diabetes Federation (IDF) for Japanese (men, 85cm; women, 90cm) differs. This study aimed to examine the impact of this difference on the prevalence of MS and the impact of an MS diagnosis on the projected risk of stroke in hypertensive Taiwanese.MethodsMS was examined in a sample of 3,472 hypertensive patients (aged 55–80 years; 1,709 women) across Taiwan. The 10-year probability of stroke estimated from the Framingham equation was compared between MS and non-MS patients.ResultsThe prevalence of MS using the BHP criteria was 59.2% using the BHP criteria (95% confidence interval, CI, 57.6–60.8%; men, 52.5%; women, 66.1%) and 48.9% by the IDF criteria (95% CI, 47.2–50.5%; men, 61.3%; women, 36.1%). Both criteria showed that, compared with non-MS, MS has higher predicted 10-year probability of stroke (BHP, 0.153 ± 0.115 vs. 0.133 ± 0.105; IDF, 0.159 ± 0.109 vs. 0.132 ± 0.112; both p < 0.001) because of the difference in women (BHP, 0.143 ± 0.124 vs. 0.102 ± 0.091; IDF, 0.147 ± 0.121 vs. 0.118 ± 0.110; both p < 0.001) rather than men (BHP, p = 0.21; IDF, p = 0.29).ConclusionBoth criteria demonstrate that MS is highly prevalent in elderly hypertensive patients in Taiwan. Additionally in women, but not men, the predicted probability of stroke is higher in MS than in non-MS patients. The diagnosis of MS is potentially useful for identifying elderly hypertensive females with an elevated risk of stroke in Taiwan

Tutorial: A guide to techniques for analysing recordings from the peripheral nervous system

The nervous system, through a combination of conscious and automatic processes, enables the regulation of the body and its interactions with the environment. The peripheral nervous system is an excellent target for technologies that seek to modulate, restore or enhance these abilities as it carries sensory and motor information that most directly relates to a target organ or function. However, many applications require a combination of both an effective peripheral nerve interface and effective signal processing techniques to provide selective and stable recordings. While there are many reviews on the design of peripheral nerve interfaces, reviews of data analysis techniques and translational considerations are limited. Thus, this tutorial aims to support new and existing researchers in the understanding of the general guiding principles, and introduces a taxonomy for electrode configurations, techniques and translational models to consider

Preparation, characterization, and application of titanium nano-tube array in dye-sensitized solar cells

The vertically orientated TiO2 nanotube array (TNA) decorated with TiO2 nano-particles was successfully fabricated by electrochemically anodizing titanium (Ti) foils followed by Ti-precursor post-treatment and annealing process. The TNA morphology characterized by SEM and TEM was found to be filled with TiO2 nano-particles interior and exterior of the TiO2 nano-tubes after titanium (IV) n-butoxide (TnB) treatment, whereas TiO2 nano-particles were only found inside of TiO2 nano-tubes upon titanium tetrachloride (TiCl4) treatment. The efficiency in TNA-based DSSCs was improved by both TnB and TiCl4 treatment presumably due to the increase of dye adsorption

Scalable photonic sources using two-dimensional lead halide perovskite superlattices

Miniaturized photonic sources based on semiconducting two-dimensional (2D) materials offer new technological opportunities beyond the modern III-V platforms. For example, the quantum-confined 2D electronic structure aligns the exciton transition dipole moment parallel to the surface plane, thereby outcoupling more light to air which gives rise to high-efficiency quantum optics and electroluminescent devices. It requires scalable materials and processes to create the decoupled multi-quantum-well superlattices, in which individual 2D material layers are isolated by atomically thin quantum barriers. Here, we report decoupled multi-quantum-well superlattices comprised of the colloidal quantum wells of lead halide perovskites, with unprecedentedly ultrathin quantum barriers that screen interlayer interactions within the range of 6.5 Å. Crystallographic and 2D k-space spectroscopic analysis reveals that the transition dipole moment orientation of bright excitons in the superlattices is predominantly in-plane and independent of stacking layer and quantum barrier thickness, confirming interlayer decoupling

QoS routing with link stability in mobile ad hoc networks

Abstract. In this paper, in accordance with requirements of different users and supplying effective usage of limited network resources, we propose a stable QoS routing mechanism to determine a guaranteed route suited for mobile ad hoc wireless networks. The manner exploits the received signal strength (RSS) techniques to estimate the distance and the signal change of the velocity to evaluate the breakaway. To ensure the QoS it chooses a steady path from the source to the destination and tries to reserve the bandwidth. Ultimately, it is clear to find that the performance never decrease even the growth of the overhead and the movement of users via the simulated by ns-2. Introduction Mobile Ad Hoc Wireless Networks (MANET), also called the Ad hoc network, is lots of moving nodes (mobile hosts) communicating with their adjacent mobile node by radio wave. Every node can contact each other without existence infrastructural network. In the Ad hoc network, it differs from cellular wireless networks that need base stations to deliver and receive the packets. Each node plays the role as a router. When one of them wants to deliver packets to destination out of its coverage, intermediate nodes will forward this packet to the next node till the destination node receive it. In traditional cellular wireless networks, generally we need to establish base stations in advance. Fixed nodes far and near connect to the backbone and become a wireless network environment. In this network the customer who wants to communicate with another must locate in the base station coverage. If user moved out of base station&apos;s service scope, he can&apos;t take the communication. Consequently, we need to establish enough base stations to achieve the objective. Ad hoc networks do not demand fixed network infrastructures and centralized management mechanisms, as well as can be built anytime, anywhere rapidly. Ad hoc networks also have the feature of self-creating, self-organization and elf-management as well as deploy and remove network easily. Ad hoc network has above advantages. However, the Ad hoc network environment has the following restricts [1], including of Network topology instable, Limited energy constrained and Limited network bandwidth-constrained QoS Routing with Link Stability in Mobile A