454 research outputs found

    ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

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    Abstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

    Further Results on (a, d) -total Edge Irregularity Strength of Graphs

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    ليكن  رسمًا بيانيًا بسيطًا على رؤوس l وحواف m مع إجمالي h -  وضع العلامات  . فان   تسمى (ا,د)- وسم غير منتظم للحافة الإجمالية إذا وجد تطابق متقابل وليكن   معرفة بواسطة   لكل   , حيث  . كذلك قيمة  يقال لها وزن الحافة . يشار الى (ا,د)-اجمالي قوة عدم انتظام الحواف للرسم البياني G ب  وهي اقل h التي يقبلها G   للحافة -(ا,د) الغير منتظمة للعلامة-h . في هذه المقالة تم فحص,  لبعض عائلات الرسم البياني الشائعة. بالاضافة الى ذلك تم حل المسالة المفتوحة  بشكل ايجابي. م تسمى ρ (أ ، د) - وسم غير منتظم للحافة الإجمالية إذا كان هناك تطابق واحد لواحد ، قل ψ: E (G) → {a ، a + d ، a + 2d ،… + a + (m- 1) د} محدد بواسطة ψ (uv) = ρ (u) + ρ (v) + ρ (uv) لجميع uv∈E (G) ، حيث a≥3 ، d≥2. أيضًا ، يُقال إن القيمة ψ (uv) هي وزن حافة الأشعة فوق البنفسجية. يشار إلى قوة عدم انتظام الحافة الإجمالية (أ ، د) للرسم البياني G بواسطة (a ، d) -tes (G) وهي أقل h التي يقبلها G (أ ، د) - علامة h غير منتظمة للحافة. في هذه المقالة ، يتم فحص (أ ، د) -tes (G) لبعض عائلات الرسم البياني الشائعة. بالإضافة إلى ذلك ، يتم حل المشكلة المفتوحة (3،2) - tes (K_ (m ، n)) ، m ، n> 2 بشكل إيجابي.Consider a simple graph   on vertices and edges together with a total  labeling . Then ρ is called total edge irregular labeling if there exists a one-to-one correspondence, say  defined by  for all  where  Also, the value  is said to be the edge weight of . The total edge irregularity strength of the graph G is indicated by  and is the least  for which G admits   edge irregular h-labeling.  In this article,   for some common graph families are examined. In addition, an open problem is solved affirmatively

    Assessing spatial variability of soil and drawing location-specific management zones for coastal saline soils in Ramanathapuram District, Tamil Nadu

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    The production of crops in saline and alkali-degraded areas is difficult due to the heterogeneous and spatial variation of soil fertility.  First, their spatial variability was analyzed and maps of the spatial distribution were created using Geostatistical techniques.  The fuzzy k-mean clustering analysis was then used to define Management zones in the coastal saline soils of Ramanathapuram district in Tamil Nadu.  One hundred and fifty geo-referenced soil samples  (30 cm depth) were taken and analyzed for pH, electrical conductivity (ECe) in the saturated paste extract (USSL method), organic carbon (OC) (Walkley-Black chromic acid wet oxidation method), calcium carbonate (CaCO3) (Rapid titration method) and available phosphorus and extractable micronutrients (Multinutrients extraction method), revealing significant variation in soil characteristics throughout the coastal saline soils of Ramanathapuram district.  The most significant factors, which together accounted for four principal components and 69% of the overall variability, were pH, electrical conductivity (ECe), calcium Carbonate and available zinc.  According to Geostatistical analysis, the Exponential (pH, OC (organic carbon), P, Fe, Mn and Zn) and Stable (ECe) was the best fit semivariogram ordinary kriging model with weak to moderate spatial dependence.  Fuzzy k-mean clustering was also used to identify zone 1, zone 2 and zone 3.  For every soil property, there was a significant difference between MZ1(zone 1), MZ2(zone 2) and MZ3(zone 3).  These results also showed that cluster analysis gave farmers a chance to use location-specific nutrient management strategies by minimizing variability within the zone. The management zones can decrease agricultural inputs and environmental pollutants while increasing crop productivity.

    Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

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    ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

    No full text
    Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

    Fidelity and adherence to a liquefied petroleum gas stove and fuel intervention: The multi-country Household Air Pollution Intervention Network (HAPIN) trial

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    Background: Reducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels. Methods: The Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n = 1,590), with controls expected to continue cooking with biomass fuels (n = 1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant’s first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs). Results: Fidelity and adherence to the HAPIN intervention were high. Median time required to refill LPG cylinders was 1 day (interquartile range 0–2). Although 26% (n = 410) of intervention participants reported running out of LPG at some point, the number of times was low (median: 1 day [Q1, Q3: 1, 2]) and mostly limited to the first four months of the COVID-19 pandemic. Most repairs were completed on the same day as problems were reported. Traditional stove use was observed in only 3% of observation visits, and 89% of these observations were followed up with behavioral reinforcement. According to SUMs data, intervention households used their traditional stove a median of 0.4% of all monitored days, and 81% used the traditional stove < 1 day per month. Traditional stove use was slightly higher post-COVID-19 (detected on a median [Q1, Q3] of 0.0% [0.0%, 3.4%] of days) than pre-COVID-19 (0.0% [0.0%, 1.6%] of days). There was no significant difference in intervention adherence pre- and post-birth. Conclusion: Free stoves and an unlimited supply of LPG fuel delivered to participating homes combined with timely repairs, behavioral messaging, and comprehensive stove use monitoring contributed to high intervention fidelity and near-exclusive LPG use within the HAPIN trial

    A mixed-methods study to define Textbook Outcome for the treatment of patients with uncomplicated symptomatic gallstone disease with hospital variation analyses in Dutch trial data

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    Background: International consensus on the ideal outcome for treatment of uncomplicated symptomatic gallstone disease is absent. This mixed-method study defined a Textbook Outcome (TO) for this large group of patients. Methods: First, expert meetings were organised with stakeholders to design the survey and identify possible outcomes. To reach consensus, results from expert meetings were converted in a survey for clinicians and for patients. During the final expert meeting, clinicians and patients discussed survey outcomes and a definitive TO was formulated. Subsequently, TO-rate and hospital variation were analysed in Dutch hospital data from patients with uncomplicated gallstone disease. Results: First expert meetings returned 32 outcomes. Outcomes were distributed in a survey among 830 clinicians from 81 countries and 645 Dutch patients. Consensus-based TO was defined as no more biliary colic, no biliary and surgical complications, and the absence or reduction of abdominal pain. Analysis of individual patient data showed that TO was achieved in 64.2% (1002/1561). Adjusted-TO rates showed modest variation between hospitals (56.6-74.9%). Conclusion: TO for treatment of uncomplicated gallstone disease was defined as no more biliary colic, no biliary and surgical complications, and absence or reduction of abdominal pain.TO may optimise consistent outcome reporting in care and guidelines for treating uncomplicated gallstone disease

    System decomposition method-based global stability criteria for T-S fuzzy Clifford-valued delayed neural networks with impulses and leakage term

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    This paper investigates the global asymptotic stability problem for a class of Takagi-Sugeno fuzzy Clifford-valued delayed neural networks with impulsive effects and leakage delays using the system decomposition method. By applying Takagi-Sugeno fuzzy theory, we first consider a general form of Takagi-Sugeno fuzzy Clifford-valued delayed neural networks. Then, we decompose the considered -dimensional Clifford-valued systems into -dimensional real-valued systems in order to avoid the inconvenience caused by the non-commutativity of the multiplication of Clifford numbers. By using Lyapunov-Krasovskii functionals and integral inequalities, we derive new sufficient criteria to guarantee the global asymptotic stability for the considered neural networks. Further, the results of this paper are presented in terms of real-valued linear matrix inequalities, which can be directly solved using the MATLAB LMI toolbox. Finally, a numerical example is provided with their simulations to demonstrate the validity of the theoretical analysis

    Neutron-induced fission cross sections of <math><mmultiscripts><mi>Th</mi><mprescripts/><none/><mn>232</mn></mmultiscripts></math> and <math><mmultiscripts><mi mathvariant="normal">U</mi><mprescripts/><none/><mn>233</mn></mmultiscripts></math> up to 1 GeV using parallel plate avalanche counters at the CERN n_TOF facility

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    International audienceThe neutron-induced fission cross sections of Th232 and U233 were measured relative to U235 in a wide neutron energy range up to 1 GeV (and from fission threshold in the case of Th232, and from 0.7 eV in case of U233), using the white-spectrum neutron source at the CERN Neutron Time-of-Flight (n_TOF) facility. Parallel plate avalanche counters (PPACs) were used, installed at the Experimental Area 1 (EAR1), which is located at 185 m from the neutron spallation target. The anisotropic emission of fission fragments were taken into account in the detection efficiency by using, in the case of U233, previous results available in EXFOR, whereas in the case of Th232 these data were obtained from our measurement, using PPACs and targets tilted 45∘ with respect to the neutron beam direction. Finally, the obtained results are compared with past measurements and major evaluated nuclear data libraries. Calculations using the high-energy reaction models INCL++ and ABLA07 were performed and some of their parameters were modified to reproduce the experimental results. At high energies, where no other neutron data exist, our results are compared with experimental data on proton-induced fission. Moreover, the dependence of the fission cross section at 1 GeV with the fissility parameter of the target nucleus is studied by combining those (p,f) data with our (n,f) data on Th232 and U233 and on other isotopes studied earlier at n_TOF using the same experimental setup

    Neutron-induced fission cross sections of Th 232 and U 233 up to 1 GeV using parallel plate avalanche counters at the CERN n_TOF facility

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    The neutron-induced fission cross sections of 232^{232}Th and 233^{233}U were measured relative to 235^{235}U in a wide neutron energy range up to 1 GeV (and from fission threshold in the case of 232^{232}Th, and from 0.7 eV in case of 233^{233}U), using the white-spectrum neutron source at the CERN Neutron Time-of-Flight (n_TOF) facility. Parallel plate avalanche counters (PPACs) were used, installed at the Experimental Area 1 (EAR1), which is located at 185 m from the neutron spallation target. The anisotropic emission of fission fragments were taken into account in the detection efficiency by using, in the case of 233^{233}U, previous results available in EXFOR, whereas in the case of 232^{232}Th these data were obtained from our measurement, using PPACs and targets tilted 45∘ with respect to the neutron beam direction. Finally, the obtained results are compared with past measurements and major evaluated nuclear data libraries. Calculations using the high-energy reaction models INCL++ and ABLA07 were performed and some of their parameters were modified to reproduce the experimental results. At high energies, where no other neutron data exist, our results are compared with experimental data on proton-induced fission. Moreover, the dependence of the fission cross section at 1 GeV with the fissility parameter of the target nucleus is studied by combining those (p,f) data with our (n,f) data on 232^{232}Th and 233^{233}U and on other isotopes studied earlier at n_TOF using the same experimental setup
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