Analysis of Energy Harvesting Enhancement in Piezoelectric Unimorph Cantilevers

Environmental energy harvesting is a major operation in research and industries. Currently, researchers have started analyzing small-scale energy scavengers for the supply of energy in low-power electrical appliances. One area of interest is the use of piezoelectric materials, especially in the presence of mechanical vibrations. This study analyzed a unimorph cantilever beam in different modes by evaluating the effects of various parameters, such as geometry, piezoelectric material, lengths of layers, and the proof mass to the energy harvesting process. The finite element method was employed for analysis. The proposed model was designed and simulated in COMSOL Multiphysics, and the output parameters, i.e., natural frequencies and the output voltage, were then evaluated. The results suggested a considerable effect of geometrical and physical parameters on the energy harvesters and could lead to designing devices with a higher functional efficiency.

Nigeria's north-east military strategy is failing

Significance This marks the highest-ranking combat casualty suffered by the Nigerian army to date and is part of a series of recent ISWAP attacks as the group transitions into another fighting season following the end of the rainy season. Impacts The military will soon look to launch another major operation into ISWAP-held territory. Absent more robust and flexible ground capabilities, newly delivered A-29 Super Tucano aircraft will have limited effect against ISWAP. Humanitarian services will be confronted by increasing risks.

Influence of methodological choices on maintenance and replacement in building LCA

Purpose Previous life cycle assessments (LCAs) of buildings and building components show a broad range of values for the impact of maintenance and replacement, some highlighting these operations as major hotspots while others consider them insignificant. This article highlights methodological aspects explaining this discrepancy. The influence of three aspects is investigated further in a case study of façade materials: the reference study period (RSP), service life data, and the use of a round-up number of operations or annualized impacts. Methods A comparative LCA of seven façade alternatives is carried out as an illustrative case study. For each alternative, global warming potential (GWP) is calculated using three possible RSPs, four possible material service lives (one from industry practitioners and low, standard and high values from a generic database), and two possible calculation methods (round-up or annualized impacts). Results and discussion While the same façade alternative had the lowest GWP in all cases, different methodological choices significantly affected the GWP and respective ranking of other alternatives. Some alternatives showed a significant increase in GWP over longer RSPs, while others were still dominated by the impact of initial production after 200 years. In nearly all cases, generic service life data lead to a higher GWP than data from industry practitioners. Major discrepancies were found between generic and practitioner data in some cases, e.g., for the brick façade. In most cases, annualized impacts led to a slightly lower (or equal) GWP than using a round-up number of operations. However, when a major operation happens shortly before the end of the RSP, the annualized method leads to considerably lower GWP. Conclusions Maintenance and replacement are rarely significant over a 50-year RSP but sometimes become hotspots over longer RSPs. Using round-up operations or annualized impacts does not make much difference in average, but leads to significantly different results in specific cases. As building LCA enters certification and regulation, there is a need to harmonize such methodological choices, as they affect LCA results, hotspot identification, and recommendations. Discrepancies in service life data also call for the gathering of reliable data.

OPERATING ROOM TIME ANALYSIS IN A TERTIARY CARE HOSPITAL : TO FIND BOTTLENECKS FOR IMPROVEMENT

BACKGROUND: rd Operating rooms (ORs) cost constitute a major investment of healthcare resources, approximating 1/3 of the total hospital budget and are among the most important areas of the hospital, contributing to both the workload and the revenue. OR efficiency is dened functionally in terms of underutilized and overutilized hours of ORtime. METHOD: A two p art study containing a prospective analysis time motion study of the operating room (OR) database to retrieve only the cases involving ve major operation theatres followed by a dichotomous open formal questionnaire with yes or no options to take the opinion of the operating room staff i.e., consultants, residents (both surgeons and anesthetists) and nurses RESULTS: Based on the time motion study the delays were mostly identied in T1-Wheel in time, T2- Anesthesia induction T6-cleaning of OR. In part 2 of the study it was evident that 65 % of the staff were of an opinion that OR is currently underutilized, 45% of the staff opined that signicant time is wasted between two surgeries and 75 % opined that they couldn't complete the scheduled list. CONCLUSIONS : Proper scheduling of regular cases and clarity in preparation of OT list, augmenting the man power, establishment good supply chain by providing sub stores in operation operating room, arrangement of sterile supplies and other equipment for the OR adequately by nursing staff could possibly lead in effective utilization of the Operating room time

Kidney to Share

This book tells the story of the author's decision to donate a kidney to a stranger. The book takes readers through the complex process by which such donors are vetted to ensure that they are physically and psychologically fit to take the risk of a major operation. The story is also placed in the larger context of the history of kidney transplantation and the ethical controversies that surround living donors. The book helps readers understand the discoveries that made transplantation relatively safe and effective as well as the legal, ethical, and economic policies that make it feasible. The book explores the steps involved in recovering and allocating organs. It analyzes the differences that arise depending on whether the organ comes from a living donor or one who has died. It observes the expertise — and the shortcomings — of doctors, nurses, and other professionals and describes the burdens that we place on people who are willing to donate. It asks us to consider just how far society should go in using one person's healthy body parts in order to save another person. The book provides an account of organ donation that is both personal and analytical. A combination of perspectives leads to a profound and compelling exploration of a largely opaque practice. The book pulls back the curtain to offer readers a more transparent view of the fascinating world of organ donation.

Outcomes of critically ill end-stage kidney disease patients who underwent major surgery

Purpose End-stage kidney disease (ESKD) is a major worldwide health problem. Patients with ESKD are thought to have a significant risk for development of complications following an operation. However, the study of ESKD and its outcomes following major operations remains rare, particularly in critical illness. Therefore, this study aimed to demonstrate how the outcomes of ESKD patients were affected when they underwent a major operation and were admitted to the intensive care unit (ICU), compared with non-ESKD patients. Methods A retrospective matched case cohort study was conducted in 122 critically ill surgical patients who underwent a major operation and were admitted to the ICU, during 2013 and 2016. Sixty-one ESKD patients who required long-term dialysis were enrolled and compared with 61 matched non-ESKD patients. The matching criteria were the same age interval (±5 years), gender, and type of operation. The ICU mortality was compared to the primary outcome of the study. Results Patients’ baseline characteristics between ESKD and non-ESKD were similar to a priori matching criteria and other demographics, except for pre-existing diabetes mellitus and hypertension, which were found significantly more in ESKD (p = 0.03 and 0.04, respectively). For operations, ESKD showed a higher grade of the American Society of Anesthesiologist (ASA) physical status (p < 0.001), but there were no differences for emergency surgery (p = 0.71) and duration of operation (p = 0.34). At ICU admission, the severity of illness measured by the Sequential Organ Failure Assessment (SOFA) score was greater in ESKD (8.9 ± 2.6 vs 5.6 ± 2.5; p < 0.001). However, after eliminating renal domain, SOFA non-renal score was equivalent (5.7 ± 2.2 vs 5.2 ± 2.3, p = 0.16). The ICU mortality was significantly higher in critically-ill surgical patients with ESKD than non-ESKD (23% vs 5%, p=0.007), along with hospital mortality rates (34% vs 10%, p = 0.002). The multivariable logistic regression analyses adjusted for age and SOFA non-renal score demonstrated that ESKD had a significant association with ICU and hospital mortality (adjOR = 5.59; 95%CI [1.49–20.88], p = 0.01 and adjOR = 4.55; 95%CI[1.67–12.44], p = 0.003, respectively). Conclusion Patients who underwent a major operation and needed intensive care admission with pre-existing ESKD requiring long-term dialysis were associated with greater mortality than patients without ESKD. More careful assessment before, during, and after major surgical procedures should be performed in this group of patients to improve post-operative outcomes.

Review of Unsafe Changes in the Practice of Cesarean Section with Analysis of Flaws in the Interpretation of Statistics and the Evidence

Cesarean section is the commonest major operation. Unfortunately, many recent practice-changes have been rushed based on flawed interpretation limited data that are debated in this review. The discussion includes non-closure of the peritoneum, the 39-week rule for elective cesarean, incorrect implementation of four-category urgency classification, and abdominal entry with excessive blunt force. It took NASA two fatal space-shuttle disasters over 18 years to change its culture of dismissing reasoning and observations in addition to numerical data. Reasoning becomes even more important when there is emerging data, especially in soft sciences like medicine. This review discusses flawed science behind the change to “non-closure of peritoneum” in details (and other changes briefly). This practice change was based on narrow mistaken considerations and solely on statistical significance, studying irrelevant short-term outcomes like increased requirement of analgesia. Several statistical mistakes in interpreting this evidence with wider applications are discussed. This weak/flawed evidence has been subsequently disproven by large randomized controlled trials. Small reduction in operating time should never have been a consideration. The merit of hypothesis favoring peritoneal closure to prevent adhesions is very strong to begin with. More importantly, the meta-analysis of available studies shows that closing peritoneum significantly reduces the formation of adhesions, particularly the severe ones. Extensive adhesion of uterus to the abdominal wall is relatively rare to reach statistical significance in small studies but is clinically highly significant due to operative complications. The rushed mistaken recommendation of non-closure of peritoneum should not have been made. However, reversing these changes is perceived as admitting errors, and there is simply no interest in doing so with detriment of the patients. Guidelines should now change their advice on many important aspects of cesarean, as discussed in this review.

Understanding the apprehension and concern haunting patients before a total knee arthroplasty

Purpose The aim of this prospective study was to understand the fear and apprehension factors that play on patient’s mind before total knee arthroplasty. Methods This retrospective cohort study included 500 consecutive patients (375 females and 125 males) who were scheduled to undergo total knee arthroplasty the next day. The patients were asked to list the most important fear in their mind regarding the operation in descending order of importance. They were given a questionnaire form which contained several capture points, including age, gender, educational background, occupation, and provision of help at home. Preoperative pain was measured by using the visual analog score, and its influence on the patients’ fear and apprehension factors was also measured. Results In this study, 58% of patients (50 males, 40%; 240 females, 64%) were fearful of the pain that they would experience after surgery and during the postoperative physiotherapy. The female patients showed more fear of pain than their male counterparts (P < 0.05). 18% of the patients (40 males, 32%; 50 females, 13%) listed whether they will be able to walk and perform activities of daily living after surgery as the most important fear. The male patients had more fear of returning to normal walking (P < 0.05). 20% of the patients (30 males, 24%; 70 females, 19%) were fearful about getting adequate home help after discharge from hospital (P > 0.05). 4% of patients were concerned about withstanding such a major operation. There was no difference between male and female patients (P > 0.05). Conclusion The majority of the patients experience apprehension of pain in the perioperative period of TKA. Preoperative counseling benefits pain management by alleviating the patient’s concerns about the fear of postoperative pain and apprehension of returning to normal walking.

Investigation on Power, Delay and Area optimization of XOR Gate

Nowadays a mobile computing and multimedia applications are need for high-performance reduced size and low-power devices. The multiplication is major operation in any signal processing applications. In any multiplier architecture, adder is one of the major processing elements. In which XOR is the basic block of an adder and multiplier. In this paper, a various design styles of XOR Gate have been surveyed and simulated using Microwind tool. In that XOR gate was analyzed the power using the different styles. They are conventional XOR gate, Pass transistor logic based EX-OR gate, Static inverter based EX-OR gate, Transmission Gate based EX-OR Gate, EX-OR Gate based on 8 & 6 Transistor & and Modified version of EX-OR Gate The CMOS circuit layout was created and simulated in Microwind software. In that the proposed XOR-based circuit has 40.17% of power consumption has improved &14.28 % of area in-terms of number of transistor improved as compare to modified version of EX-OR Gate design.

Development of Device for Dentist Implant Orientation

Doctors have always wondering the new technology and improvement in the up gradation of the current technology; Dental Procedures and Surgery is always critical as it is the major operation which everybody experiences once in the entire life span. To resolve the complexity of the dental surgery on Implant device like brackets, this device is developed to pre-define the angular disposition based on structure of the teeth and also location and direction where to implant the bracket for braces and help to locate the exact position on the teeth were the surgery is to be executed were parts can mounted at a perfect angle in the human mouth.