Simulation model as a tool for handling equipment operation diagnostics

Efficiency of handling equipment reduces the service time of vehicles arriving at the container terminal. A simulation model of the operation of handling equipment allows reducing the time for diagnosis handling technique with its failure. The model constructed by means of apparatus of Petri Nets the formalism of Petri Nets provides the precision of definitions and reflects the structural and logical connection of the simulated events. The visualization and simplicity of Petri Nets allows the technician has no special training to use these models. This paper examines the reach stacker model, these types of machines that used in container terminals. A Petri Net simulating the operation of the reach stacker – hierarchical, has a built-in network positions. Hierarchy of networks identified position to ensure secure operation techniques, conflict situation, and analyzed solutions. Position having the chips are nodes, which can cause failures.

A case report of fractured guidewire removal by rotational atherectomy

Background Fractures occur in association with manipulation and because of the complexity of the coronary artery, and they can cause a series of serious complications, such as myocardial infarction and secondary thrombosis. Common treatments for fractured guidewires include conservative, interventional and surgical methods. Case presentations A 67-year-old male was admitted to our institute. He had recurrent chest tightness and chest pain for half a month, which worsened in one day. He was diagnosed with acute non-ST-segment elevation myocardial infarction. Guidewire fracture was caused by improper manipulation during percutaneous coronary intervention. We successfully performed rotational atherectomy to remove the fractured guidewire. His symptoms, and condition improved 6 weeks after the removal of fractured guidewire. Conclusion Physicians should have higher requirements for the quality of the guidewires and operation techniques.

Composite Line Designs and Accuracy Measurements for Tactile Line Tracing on Touch Surfaces

Eyes-free operation of mobile devices is critical in situations where the visual channel is either unavailable or attention is needed elsewhere. In such situations, vibrotactile tracing along paths or lines can help users to navigate and identify symbols and shapes without visual information. In this paper, we investigated the applicability of different metrics that can measure the effectiveness of vibrotactile line tracing methods on touch screens. In two user studies, we compare trace Length Error, Area Error, and Fréchet Distance as alternatives to commonly used trace Time. Our results show that a lower Fréchet distance is correlated better with the comprehension of a line trace. Furthermore, we show that distinct feedback methods perform differently with varying geometric features in lines and propose a segmented line design for tactile line tracing studies. We believe the results will inform future designs of eyes-free operation techniques and studies.

The investigation survey of inguinal hernia operation techniques preferred by pediatric surgeons in Turkey

In inguinal hernia, standard procedure has been considered open repair for a long time, the number of pediatric surgeons who prefer laparoscopic techniques is increasing day by day. In this study, it was aimed to determine how pediatric surgeons in our country approach patients with inguinal hernia and manage the treatment process. Controversial issues on inguinal hernia repair were identified and a questionnaire was prepared to reveal the current situation. The questionnaire was delivered to members of Turkish Association of Pediatric Surgery on the official website of the association. The survey was directed to 420 people, 92 people returned with the answers to the questionnaire. Thirty-six of the surgeons prefer the laparoscopic method for inguinal hernia repair. The reason for choosing open surgery was questioned, the most frequent answer was to be more experienced and to have more cumulative knowledge on open repair method. According to survey, the greatest advantage of laparoscopy was stated to be the better evaluation of the contralateral inguinal canal (n=16, %44.4). Twelve of surgeons who performed laparoscopic treatment in the selection of patients stated that gender is important and prefer laparoscopic surgery for female patients. Thirty percent (n = 11) of the participants stated that they prefer laparoscopy in patients between 3 months and 13 years old, while the rest prefer laparoscopy at all ages. In conclusion thirty nine percent of surgeons in Turkey prefer laparoscopic repair. Open repair is still preferred in our country. There is still no consensus on perfect method and patient selection yet.

Split Lateral Forehead Flap for Reconstruction of Upper and Lower Eyelids

Background: Eyelids reconstruction after tumor resection has be one of the most challenging procedures in reconstructive plastic surgery. Small defects may be closed by primary suture or covered by small local flaps or skin graft. But in large eyelids defects, we need to find a bigger source of color and texture matching tissue that will ensure functional and aesthetical outcomes. Many techniques have been described, but in this case, the author suggest a split lateral forehead flap designed to cover upper and lower eyelids. Patient and Operation Techniques: A Male 51 years-old-patient, presented himself in our clinic with a basal cell carcinoma involving the right upper and lower eyelids. The tumor had a history of 7 years, without any pain or vision disorders involved. Tumor was widely excised, leaving a full thickness on upper and lower eyelids. The inner lining palpebral was replaced by composite auricular graft following by lateral cantophexy. A lateral forehead flap raised with a right temporal pedicle, and the distal part of flap was split in half, and inset into the upper and lower eyelids defect. The donor region was closed with an STSG from Femur Dextra. After 14 days the flap was divided, the functional result was excellent. Discussion: At first, surgeons were worried of raising forehead flaps beyond the midline, fearing that by splitting the distal flap would cause its compropmise. However, rich anastomostic plexus exists between the major forehead angiosomes lined by the smaller calibre “choke” vessels. Conclusions: Periorbital Basal cell carcinoma resection may leave great defect to the underlying tissue. The need to provide adequate support to this structure requires complex techniques with minimum two flaps. In our case, we performed a split lateral forehead flap with a good functional and cosmetic outcome.

Postcoital cystitis: surgical management

Introduction. Urinary tract infection is one of the most common urological infectious diseases. An important risk factor for uncomplicated urinary tract infection in women is sexual intercourse. Post-coital cystitis is a special form of recurrent cystitis, associated with a low location of the external urethral orifice. This condition is called vestibulo-vaginal dislocation of the urethra. Materials and methods. PubMed and Elibrary (Scientific Electronic Library) databases were searched for studies describing surgical treatment of recurrent post-coital cystitis in women. Based on the relevance and reliability of the sources, 23 articles in peer-reviewed medical journals were selected. All of the selected studies contained data on evolution of surgical treatment approaches for post-coital cystitis. Results. In the middle of the 20th century the interest of medical community in surgical treatment of post-coital cystitis has gradually faded. Such trend was caused by imperfect surgical techniques of existing procedures (O'Donnell and Hirschhorn operations). Subsequent accumulation of experience, over several decades, allowed to establish possible mistakes in diagnosis and operation techniques. Furthermore, a constant search for new techniques and improvement of existing ones minimized potential risk of complications. Great hopes are pinned on the works of B.K. Komyakov et al., who proposed extravaginal transposition of the urethra, that implies the transposition of the urethra and its external orifice as high as possible toward the clitoris. The technique is characterized by high efficacy and a low number of complications, as demonstrated by the treatment results of 228 patients diagnosed with post-coital cystitis. Conclusions. Various curative procedures for post-coital cystitis show the need to determine and standardize the optimal amount of surgical intervention for urethral dystopia in women.

Potential adaptation strategies for climate change impact among flood-prone fish farmers in climate hotspot Uganda

Climate-induced floods are increasing in Africa. The need to evolve framework for adaptation to climate change impact (CCI) among flood-prone fish farmers necessitated this study. Based on availability, 60 farming active flood-experienced fish farmers were purposively selected from flood-prone (Gulu and Kibuku) regions in climate hotspot Uganda. These were assessed for CCI adaptation tendencies in their socioeconomics and farming operation/techniques (FOI) indices, CCI awareness, CCI adaptation strategies, and perceived required interventions (RIs) using structured questionnaire. Data were analyzed through descriptive and multivariate regression tools. Respondents were mostly male, adults, educated, Christian, married, medium-sized family, social group members, 1–5 years’ experience, medium-sized farms, and government trained. Income was 1.0–6.0 million Ugx/year. In FOI, semi-intensive culture system, use of rainwater plus groundwater, small-sized (< 0.5 ha) ponds, ponds possession of inlets and outlets, seasonal farming and mixed culture/farming dominated. Most respondents were aware of CCI, while erratic rainfall with floods and prolonged drought mostly impacted farming. AS-Adaptation Strategy were changed stocking time and livelihood diversification. Communication technology and social group’s membership enhanced adaptation, while inadequate awareness constrains adaptation. Respondents’ RI(s) were tree planting, irrigation and pond perimeter trenching. Gender, government training, farm size, water sources and presence of inlet and outlets in ponds (FOI) predicted adaptation (R = 0.802, R2 = 0.64, P < 0.05). Some socioeconomic, technical and awareness indices could assist CCI flexibility. However, the statistically significant predictors of adaptation, identified adaptive strategies, constraints to adaptation and required interventions could be integrated into a framework for effective CCI adaptation for sustainable fish farming in flood-prone scenarios.

Assessment of testes with two-dimensional Shear Wave Elastography in patients with operated inguinal hernia

Aim: We compared the two-dimensional shear-wave elastography (2D-SWE) values between the testes with same side operated inguinal hernia (IH) and the contralateral testes, as well as the testes of healthy volunteers without IH. Material and methods: A total of 189 participants (117 unilateral [117 testes] and 8 bilateral operated IH patients [16 testes] and 64 healthy volunteers [128 testes]), providing a total of 378 testicles, were investigated prospectively. All patients underwent B-mode ultrasonography (US) and 2D-SWE examinations. Operation type, the period between diagnosis and operation, the period since the operation, testes volumes, and 2D-SWE values were compared. Results: The B-mode US finding of the testes were normal in all participants. The mean testes’ volume of same side operated IH was significantly lower comparing to contralat-eral testes and the healthy group (p<0.001). The 2D-SWE values of the testes with same side operated IH were significantly higher comparing to the contralateral testes and the healthy group (p<0.001). There was a statistically significant correlation between 2D-SWE values and IH severity, as well as the duration of the hernia (p=0.001). There was no significant correlation between the IH severity and testes volume (p=0.285). No significant difference was found between the direct and indirect IH in terms of testicular volume and SWE values and between the duration of the hernia, the time after sugery, testicular volume and SWE values according to operation techniques(p>0.005). Conclusions: The 2D-SWE can be used as an effective imag-ing method to evaluate testicular stiffness with objective numerical values, to estimate the severity of histologic damage in patients with operated IH.