Types of colorectal cancer and dysplasia associated with inflammatory bowel disease

Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.

Multi-Robot Formation Control Based on CVT Algorithm and Health Optimization Management

In view of the low formation redundancy in the traditional rigid formation algorithm and its difficulty in dynamically adapting to the external environment, this study considers the use of the CVT (centroidal Voronoi tessellation) algorithm to control multiple robots to form the desired formation. This method significantly increases the complexity of the multi-robot system, its structural redundancy, and its internal carrying capacity. First, we used the CVT algorithm to complete the Voronoi division of the global map, and then changed the centroid position of the Voronoi cell by adjusting the density function. When the algorithm converged, it could ensure that the position of the generated point was the centroid of each Voronoi cell and control the robot to track the position of the generated point to form the desired formation. The use of traditional formations requires less consideration of the impact of the actual environment on the health of robots, the overall mission performance of the formation, and the future reliability. We propose a health optimization management algorithm based on minor changes to the original framework to minimize the health loss of robots and reduce the impact of environmental restrictions on formation sites, thereby improving the robustness of the formation system. Simulation and robot formation experiments proved that the CVT algorithm could control the robots to quickly generate formations, easily switch formations dynamically, and solve the formation maintenance problem in obstacle scenarios. Furthermore, the health optimization management algorithm could maximize the life of unhealthy robots, making the formation more robust when performing tasks in different scenarios.

Pedicle flap reconstruction for treatment of infected median sternotomy wounds after cardiac surgery in overweight and obese patients: proposal of a management algorithm based on a case series analysis

Background A relationship between obesity and adverse outcomes in patients with post-sternotomy wounds undergoing pedicle flap reconstruction is not well-documented. In this study, we present a single-centre retrospective case series analysis of early postoperative outcomes of patients with infected post-sternotomy wounds undergoing pedicle flap reconstruction. We also propose a management algorithm for such patients, based on BMI and wound width. Methods We retrospectively analyzed all patients, who underwent pedicle flap reconstruction for major sternal wound infections after sternotomy for cardiac surgery in a tertiary hospital in Germany during a 5-year period. Exclusion criteria included patients younger than 18 years of age and patients with BMI < 18.5 kg/m2. Patients were divided into 2 groups according to BMI: normal-weight (NW; BMI < 25 kg/m2) and overweight/obese (OB/OW; BMI > 25 kg/m2). Both groups were compared in terms of preoperative parameters and early postoperative outcomes. Preoperative parameters included demographics, wound bacteria and comorbidities. Postoperative outcomes included duration of surgery time (from incision to skin closure), transfusion requirement (during surgery and entire hospital stay), onset of flap and donor-site complications, length of stay and 30-day mortality. We employed the two-tailed t-test to compare continuous variables and the two-sided Fischer’s exact test to compare categorical variables. Statistical significance was set at p < 0.05. Results The total sample consisted of 48 patients. Overall mean BMI was 28.4 (6.1) kg/m2. Mean age was 67 (12) years. The study group consisted of 28 patients with BMI > 25 kg/m2, who were compared with 20 normal-weight patients. There was a significant difference amongst both groups regarding duration of surgery (120 vs. 174 min, p < 0.05). Donor-site complications requiring intervention were observed in 30% of patients in both groups. Flap-related complications were recorded in 16 (57%) cases in the study group and 7 cases in the control group (35%, p = 0.15). Conclusions We conclude that wound width and BMI can aid the decision-making process for patients with infected sternal wounds after cardiac surgery requiring pedicle flap reconstruction. However, in our case series analysis, OB/OW patients were not found to be at statistically significantly increased risk for worse postoperative outcomes, but were associated with a longer duration of surgery.

Design, Control, Management, and Performance Analysis of PV-Battery Supercapacitor DC-System Using Buck Converter

The intermittent nature of photovoltaic energy necessitates the incorporation of storage devices to ensure the continuality of loads feeding. In addition, it is important to model, control, and verify the operating of the designed system before implementation. Furthermore, the integration of power electronic interfaces plays a significant role in protecting the system and benefiting from solar energy. To this end, a buck converter is chosen to charge the battery and supply the supercapacitor. The control strategy is based on the maximum power point tracking techniques when the management algorithm recommends MPPT function mode. Otherwise, a feedback constant voltage PI controller is designed. Indeed, perturb and observe and incremental conductance are implemented and compared to analyze the system efficiency within the management strategy to charge the battery, switch between the controllers, and feed a supercapacitor in case of full battery charge. The obtained results using MATLAB/SIMULINK platform confirm the behaviour of the proposed strategy.

Sliding Mode Control for PV Grid-Connected System With Energy Storage

We need to solve the problem due to the nonlinearity and power fluctuation in the photovoltaic (PV) connected storage system and grid; for that, the authors develop an algorithm to obtain the maximum power point tracking (MPPT) via control of the duty cycle of DC/DC boost converter. Consequently, they design an MPPT based on the second-order sliding mode control. Next, generating the law control founded on the Lyapunov theory can augment the robustness and stability of the PV connected grid. Then, they add a battery energy storage system (BESS) with a control management algorithm in the DC/DC side to eliminate any fluctuation of the output power of the PV system because of the temperature and irradiation variation. On the grid side, they control the DC/AC inverter side by the three-phase voltage source inverter control (VSIC) as a charge controller for the grid parameters.

Acquaintance Management Algorithm Based on the Multi-Class Risk-Cost Analysis for Collaborative Intrusion Detection Network

The collaborative intrusion detection network (CIDN) framework provides collaboration capability among intrusion detection systems (IDS). Collaboration selection is done by an acquaintance management algorithm. A recent study developed an effective acquaintance management algorithm by the use of binary risk analysis and greedy-selection-sort based methods. However, most algorithms do not pay attention to the possibility of wrong responses in multi-botnet attacks. The greedy-based acquaintance management algorithm also leads to a poor acquaintance selection processing time when there is a high number of IDS candidates. The growing number of advanced distributed denial of service (DDoS) attacks make acquaintance management potentially end up with an unreliable CIDN acquaintance list, resulting in low decision accuracy. This paper proposes an acquaintance management algorithm based on multi-class risk-cost analysis and merge-sort selection methods. The algorithm implements merge risk-ordered selection to reduce computation complexity. The simulation result showed the reliability of CIDN in reducing the acquaintance selection processing time decreased and increasing the decision accuracy.