Laparoscopic nephrectomy in crossed fused kidney ectopia with severe hydronephrosis in 2 year-old child

Introduction: There are no specific recommendations for the surgical management of crossed fused renal ectopia (CFRE), but a laparoscopy has been proposed in a limited number of children. We report the case of a complex CFRE with severe hydronephrosis in a child treated by laparoscopic nephrectomy. Case report: A 2-year-old boy was admitted for hip and abdominal pain. A CFRE was diagnosed. Laparoscopic nephrectomy was suggested. The right crossed ectopic kidney appeared fused at its upper pole to the lower pole of the left kidney. The left kidney was in total rotation postero superiorly The left ureter crossing over the ectopic dilated right pelvis deliniated the fusion line between both kidneys. The right ureter was dissected distally. The right artery and vein were dissected and the right kidney pelvis opened making the separation of the kidneys easier and so reducing the danger of damaging the lower pole of the left kidney. During the dissection an aberrant vein arising from the left iliac vein and draining from both kidneys was identified. The right vein was dissected preserving the left vein, and the nephrectomy completed. Conclusions: Laparoscopy is a recommended option to treat CFRE, offering all advantages of this approach

Altered Metabolic Profile in Congenital Lung Lesions Revealed by1H Nuclear Magnetic Resonance Spectroscopy

Congenital lung lesions are highly complex with respect to pathogenesis and treatment. Large-scale analytical methods, like metabolomics, are now available to identify biomarkers of pathological phenotypes and to facilitate clinical management. Nuclear magnetic resonance (NMR) is a unique tool for translational research, as in vitro results can be potentially translated into in vivo magnetic resonance protocols. Three surgical biopsies, from congenital lung malformations, were analyzed in comparison with one control sample. Extracted hydrophilic metabolites were submitted to high resolution 1H NMR spectroscopy and the relative concentration of 12 metabolites was estimated. In addition, two-dimensional NMR measurements were performed to complement the results obtained from standard monodimensional experiments. This is one of the first reports of in vitro metabolic profiling of congenital lung malformation. Preliminary data on a small set of samples highlights some altered metabolic ratios, dealing with the glucose conversion to lactate, to the relative concentration of phosphatidylcholine precursors, and to the presence of myoinositol. Interestingly some relations between congenital lung lesions and cancer metabolic alterations are found

Smart Operations of Air-Conditioning and Lighting Systems in a Government Buildings for Peak Power Reduction

This paper presents the achievements of implementing smart operations strategies for air-conditioning (A/C) and lighting systems in Justice Palace Complex (JPC), Kuwait during the summer 2007. The peak load of this building was 3700 kW. The achievements are summarized as direct savings between 13:00 and 22:00 h by closing supply and return air fans of 52 air-handling units with a connected load 400 kW, and an additional saving of 550 kW during the same period by optimizing the cooling production and distribution. Also an all time saving of 22 kW by de-lamping, and additional saving of 27 kW through TDC of lighting were achieved. In conclusion project achieved an overall reduction in power demand of around 20% between 13:00 to 17:00 h and reduction ranging from 7% to 15% between 17:00 to 20:00 h

A Digital Currency Architecture for Privacy and Owner-Custodianship

Objective: to present the new approach to perform monetary transactions with digital currency.Methods: abstract-logical, analytical methods.Results: in recent years, electronic retail payment mechanisms, especially e-commerce and card payments at the point of sale, have increasingly replaced cash in many developed countries. As a result, societies are losing a critical public retail payment option, and retail consumers are losing important rights associated with using cash. To address this concern, we propose an approach to digital currency that would allow people without banking relationships to transact electronically and privately, including both e-commerce purchases and point-of-sale purchases that are required to be cashless.The article shows the advantages of cash payments compared to non-cash ones and defines the possibility to transform these advantages into the central bank digital currencies. The disputable issues of commercial banks development under the spread of digital currencies are discussed. The architecture of digital currencies is described, including distributed ledgers technology. It was shown that, for the digital currency to function effectively, it is necessary to include the privacy of end-users into its architecture; measures to achieve that are determined.Scientific novelty: the approached proposed in the article should be used to develop the digital currencies infrastructure. It should be government-backed, privately-operated and ensure that every transaction is registered by a bank or money services business, relying upon non-custodial wallets backed by privacy-enhancing technology, such as blind signatures or zero-knowledge proofs, to ensure that transaction counterparties are not revealed. This approach can also facilitate more efficient and transparent clearing, settlement, and management of systemic risk. We argue that our system can restore and preserve the salient features of cash, including privacy, owner-custodianship, fungibility, and accessibility, while also preserving fractional reserve banking and the existing two-tiered banking system.Practical significance: the proposed approach can be applied in the practical organization of perform monetary transactions using digital currencies.The article was first published in English language by Future Internet. For more information please contact the editorial office.For original publication: Goodell G., Al-Nakib H. D., Tasca P. A Digital Currency Architecture for Privacy and Owner-Custodianship, Future Internet, 2021, 13, 130. https://doi.org/10.3390/fi13050130Publication URL: https://www.mdpi.com/1999-5903/13/5/13

Peak Power Reduction Strategies for the Lighting Systems in Government Buildings

Lighting systems are the second major contributor to the peak power demand and energy consumption in buildings after A/C systems. They account for nearly 20% of the peak power demand and 15% of the annual energy consumption. Thus energy efficient lighting systems and their smart operation can be very effective in reducing the national peak power and energy consumption, particularly for a country like Kuwait where power demand grew from 6750 MW in 2001 to 9075 MW in 2007 (MEW, 2002- 2008). This paper presents an approach developed to reduce the peak power demand in the lighting. The approach included optimum use of daylight, time of day control and delamping. The implementation of this approach for eight government buildings with occupancy of between 7:30 and 2:30 and peak power demand of 29.3 MW achieved a reduction of 2 MW in the peak power demand (around 7%). More importantly this 7% in peak load reduction and 10,628 MWh reduction in the annual energy consumption was achieved without any added cost. Also, the paper includes recommendations for retrofitting cost effective energy efficient lighting systems and implementation of more effective control

Metabolomic profile of amniotic fluid to evaluate lung maturity: the diaphragmatic hernia lamb model

Background: Tracheal occlusion (TO) stimulates lung growth in fetuses affected with congenital diaphragmatic hernia (CDH) although the processes involved in lung maturation still remain unknown. The objective of this study was to evaluate the metabolomic profile of amniotic fluid (AF) following TO in fetal lamb model in order to obtain an indirect view of mechanisms involved in pulmonary reversal hypoplasia and biochemical maturity in response to fetal TO. Methods: Liquid Chromatography Mass Spectrometry was performed on lamb AF samples at: age I (70 days' gestation); age II (102 days' gestation); age III (136 days' gestation). CDH was induced at age I and TO at age II. Results: Betaine, choline, creatinine were found significantly increased during gestation in the control group. The CDH group showed choline (p =0.007) and creatinine (p =0.004) decreases during pregnancy. In the TO group choline and creatinine profiles were restored. Conclusions: Alveolar tissue and fetal global growth ameliorated after TO. Metabolomics provided usefu information on biochemical details during lung maturation. Metabolomic profiling would help to identify the best time to perform TO, in order to increase survival of CDH affected patients

Cesarean section deliveries in Egypt: Trends, practices, perceptions, and cost

In Egypt, the past decade has witnessed a sharp increase in the prevalence of cesarean section (CS) with the most recent Egypt Demographic and Health Survey documenting a CS rate of 52 percent, suggesting that cesarean delivery might be overused or used for inappropriate indications. This study aimed to explore trends, practices, and costs associated with CS deliveries to women, their families, and the health system, as well as factors that may contribute to increased use of CS in Egypt. Participating physicians and key informants unanimously agreed that the CS mode of delivery was over-used in Egypt. Perceived reasons underlying increased CS deliveries were: financial incentive, doctors’ desire to have better control over their time, doctors’ fear of medical litigation, vagueness of medical protocols regarding indications for use of CS, limited opportunities for junior doctors to practice vaginal deliveries, shortage of pain relief drugs in public hospitals, and shortage of anesthesiologists who are trained in administration of epidural anesthesia which could be used to relieve pain in vaginal deliveries. Recommendations are proposed for rationalizing the use of CS deliveries in Egyp

Implementation of Smart Operation Strategies for Air-Conditioning and Lighting Systems for Ministries Complex in the State of Kuwait

The smart operation strategies were implemented for Air-Conditioning (A/C) and lighting systems to reduce the national load at Ministries Complex (MC) in the state of Kuwait. The A/C system in MC is a district cooling system that comprises of 8 chillers with water-cooled condensers and four circuits of chilled water distribution with their independent pumps feeding to 184 air-handling units (AHUs), including 26 independent fresh air units. Total connected load of A/C systems is 8,867 kW, while fan motors of AHUs account for 2,390 kW. Lighting system in MC comprises mostly of energy efficient T12 fluorescent tubes and compact fluorescent lamps with a total connected load of 2,254 kW. Pre Closing Treatment (PCT) between 13:00 and 14:00 h, when the building was still occupied, was explored. Fresh-air AHUs were closed at 13:00 h instead of 14:30. Also, Time-of-Day Control (TDC) for AHUs and lighting systems along with the cooling production and cooling distribution systems was applied between 14:00 and 15:30 h, in line with the building occupancy for each building at MC. PCT and TDC schemes for chillers, AHUs and lighting systems were carried out through the Building Automation System (BAS). Implementation of the smart operation strategies for A/C and lighting systems was successful at MC. The temperature build up did not exceed 1°C during PCT scheme and the temperature did not exceed 28°C during TDC scheme. The savings in peak load demand were 610 kW between 13:00 and 14:00 h, 4,500 kW between 14:00 and 15:00 h, and 6,897 after 15:30 h. The reduction of 4,500 kW at 15:00 h is equivalent to $7.6 million towards constructing power plant and distribution network. Savings of 13,720 kWh in daily energy consumption was achieved due the implementation of the smart operation strategies. These savings led to a reduction of$1,500 per typical summer day of the MEW fuel bill and 8,918 kg/day of CO2 emissions. To make MC building more energy efficient, it is recommended to retrofit AHUs and secondary chilled water pumps with variable frequency drives (VFDs)

Smart Operations of Air-Conditioning and Lighting Systems in a Government Buildings for Peak Power Reduction

This paper presents the achievements of implementing smart operations strategies for air-conditioning (A/C) and lighting systems in Justice Palace Complex (JPC), Kuwait during the summer 2007. The peak load of this building was 3700 kW. The achievements are summarized as direct savings between 13:00 and 22:00 h by closing supply and return air fans of 52 air-handling units with a connected load 400 kW, and an additional saving of 550 kW during the same period by optimizing the cooling production and distribution. Also an all time saving of 22 kW by de-lamping, and additional saving of 27 kW through TDC of lighting were achieved. In conclusion project achieved an overall reduction in power demand of around 20% between 13:00 to 17:00 h and reduction ranging from 7% to 15% between 17:00 to 20:00 h

Smart Operations of Air-Conditioning and Lighting Systems in Government Buildings for Peak Power Reduction

During the summer 2007 smart operation strategies for air-conditioning (A/C) and lighting systems were developed and tested in a number of governmental buildings in Kuwait as one of the solutions to reduce the national peak demand for electrical power that commonly occur around 15:00 h. The working hours for these building are generally between 07:00 and 14:00 h and their peak demand exceeds 600 MW. The smart operation strategies implemented in these buildings included pre-closing treatment (PCT) between 13:00 and 14:00 h and time-of-day control (TDC) after 14:00 h. Also de-lamping was carried out in some of the buildings to readjust the higher than recommended illumination levels. This paper presents the achievements of implementing these smart operations strategies in Justice Palace Complex (JPC) as a case study. The peak load of this building was 3700 kW. The achievements are summarized as an all time saving of 22 kW by de-lamping, an additional saving of 27 kW through TDC of lighting, direct savings between 13:00 and 22:00 h by closing supply and return air fans of 52 air-handling units with a connected load 400 kW, and an additional saving of 550 kW during the same period by optimizing the cooling production and distribution. In conclusion project achieved an overall reduction in power demand of around 20% between 13:00 to 17:00 h and reduction ranging from 7% to 15% between 17:00 to 20:00 h