Study of the Stress State of a Dissimilar Metal Weld Due to Manufacturing and Operational Conditions

Welding is accompanied by the presence of weld residual stresses, which in case of dissimilar metal welds even with post weld heat treatment cannot be removed completely therefore they should be considered when assessing possible welding defects. The measurement of residual stress in metal weld is a very complex procedure and also in the investigated case could not be carried out as it is the part of a working plant. However, by modelling these processes, the residual stresses and deformation of the components caused by this manufacturing method can be determined. It is important to calculate these values as accurately as possible to determine the maximum load capacity of the structure. The structure under examination was the dissimilar metal weld of a VVER-440 steam generator. 2D simulations were performed, where temperature and phase-dependent material properties were implemented. Different loading scenarios were considered in the numerical analysis. The results can be useful to determine the real loading conditions of a given component and can be used to predict stress corrosion crack initiation locations, as well as to evaluate the lifetime and failure mode prediction of welded joints.

Patient Safety in Hemodialysis

Patient safety addresses the risks involved in health care, simplifying or eliminating adverse events, these are defined as incidents that occur during the provision of health care and that result in harm to the patient. Health care is increasingly complex and can increase the potential for incidents, errors or failures to occur. Hemodialysis is a technically complex procedure, with many potential sources of error and which can cause harm to patients. Dialysis is a therapy that in recent years has benefited many patients, but it is a care process that involves important dangers and risks. Hemodialysis is a hospital sector with a great risk potential for the occurrence of adverse events, this occurs for several reasons such as complex procedures, the use of high technology, the characteristic of chronic kidney disease, the high use of medications. Strategies need to be taken to reduce the occurrence of adverse events, thus ensuring the quality of dialysis, consequently the quality of life of patients with chronic kidney disease undergoing dialysis treatment.

Successful Multidisciplinary Repair of Severe Bilateral Uretero-Enteric Stricture with Inflammatory Reaction Extending to the Left Iliac Artery, after Robotic Radical Cystectomy and Intracorporeal Ileal Neobladder

Uretero-enteric anastomotic strictures (UES) after robot-assisted radical cystectomy (RARC) represent the main cause of post-operative renal dysfunction. The gold standard for treatment of UES is open uretero-ileal reimplantation (UIR), which is often a challenging and complex procedure associated with significant morbidity. We report a challenging case of long severe bilateral UES (5 cm on the left side, 3 cm on the right side) after RARC in a 55 years old male patient who was previously treated in another institution and who came to our attention with kidney dysfunction and bilateral ureteral stents from the previous two years. Difficult multiple ureteral stent placement and substitutions had been previously performed in another hospital, with resulting urinary leakage. An open surgical procedure via an anterior transperitoneal approach was performed at our hospital, which took 10 h to complete, given the massive intestinal and periureteral adhesions, which required very meticulous dissection. A vascular surgeon was called to repair an accidental rupture that had occurred during the dissection of the external left iliac artery, involved in the extensive periureteral inflammatory process. Excision of a segment of the external iliac artery was accomplished, and an interposition graft using a reversed saphenous vein was performed. Bilateral ureteroneocystostomy followed, which required, on the left side, the interposition of a Casati-Boari flap harvested from the neobladder, and on the right side a neobladder-psoas-hitching procedure with intramucosal direct ureteral reimplantation. The patient recovered well and is currently in good health, as determined at his recent 24-month follow-up visit. No signs of relapse of the strictures or other complications were detected. Bilateral ureteral reimplantation after robotic radical cystectomy is a complex procedure that should be restricted to high-volume centers, where multidisciplinary teams are available, including urologists, endourologists, and general and vascular surgeons.

DEVELOPMENT OF A BIM INFRASTRUCTURE WORKFLOW ADAPTED TO FACILITIES OF LAND SUBDIVISION PROJECTS IN MOROCCO

Land subdivision represents a complex procedure which leads to the construction of a set of buildings and utilities necessary for the viability of the project: Roads, sewerage network, water network, electricity network and telecommunication networks. The techniques adopted so far to carry out land subdivision projects in Morocco have certain limitations. Several stakeholders are necessary for the realization of a land subdivision and many 2D plans and documents are used. These plans and documents are independently produced and carried out by the various trades involved in the project. If a change is made to one element of the project, which often happens, several documents and plans are affected and must be updated. This can be a source of errors and conflicts and can lead to an increase in the time and cost of the hall project. This study proposes the development of a Building Information Modelling (BIM) infrastructure workflow adapted to land subdivision projects in Morocco. The integration of BIM in this type of project is an innovation in the Moroccan context. It will improve the design, simplify communication and collaboration between the various stakeholders and facilitate the management and the monitoring of the project. The resulting digital BIM model can be used to produce 2D and 3D construction plans, take measurements and plan work. It constitutes the basic platform to perform calculations and simulations at any stage of the infrastructure life cycle and to detect and resolve interferences in a collaborative environment.

General principles governing record taking in patients with cleft lip and palate

(WHO meetings on International Collaborative Research on Craniofacial Anomalies).One of the most common congenital anomaly we come across is the Cleft Lip and palate where affected children suffer from range of functional as well as aesthetic problems. Cleft lip and palate is a multifunctional disease associated with environmental factors. Management of cleft is a complex procedure and demands co-operation among experts from different fields. Clinical treatment procedure extends from beginning of birth, to achieving skeletal maturity effectively.

Mali’s participation in the West Africa’s integration processes

The first ever integration bloc in Africa was formed back in the colonial era in 1910, when a number of British colonies were integrated. Modern integration processes in the African countries in the south of the Sahara began much later, from the early 1960s, when most of the former colonies gained independence, and it was during this period that the construction of a number of economic blocks began. The article reveals integration processes in West Africa and sub-Saharan African countries features. Integration as such is viewed as a complex procedure, with the success way which depends on many factors. On the experience of the Republic of Mali, the authors demonstrated how an irrational socio-economic policy can lead to deformation of integration processes, which inevitably threatens with deep financial and socio-political crises.

Do People Trust in Robot-Assisted Surgery? Evidence from Europe

(1) Background: The goal of the paper was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. (2) Methods: Data were obtained from a 2017 Flash Eurobarometer (number 460) of the European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, using experience and sociodemographic independent variables. (3) Results: The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude, and perception of robots become more negative. Furthermore, sociodemographic variables played an important predictive role. The effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. (4) Conclusions: The results show that trust in robots goes beyond rational decision-making, since the final decision about whether it should be a robot that performs a complex procedure like a surgical intervention depends almost exclusively on the patient’s wishes.

AN INNOVATIVE APPROACH IN THE MANAGEMENT OF ALVEOLAR CLEFTS WITH BONE GRAFT HARVEST FROM MAXILLARY TUBEROSITY AND MANDIBULAR WISDOM MOLAR ODONTECTOMY SITES- A CASE REPORT

Alveolar bone grafting is a complex procedure utilized in alveolar cleft repair, however, the ideal site of bone graft material remains highly debated. In this paper, we describe the management of a 14 year old female with bilateral alveolar clefts using alternative intra-oral donor sites for bone graft harvest.

The ‘excess gas’ method for laboratory formation of methane hydrate-bearing sand: geotechnical application

Over recent years, there has been a growing interest in producing methane gas from hydrate-bearing sands (MHBS) located below the permafrost in arctic regions and offshore within continental margins. Geotechnical stability of production wellbores is one of the significant challenges during the gas extraction process. The vast majority of geotechnical investigations of MHBS have been conducted on laboratory-formed samples due to the complex procedure of undisturbed sample extraction. One of the most commonly used hydrate laboratory-formation methods is the excess-gas method. This work investigates fundamental aspects in the excess-gas formation of MHBS that are affecting the geotechnical interpretation and modeling. The work finds that (1) the measured temperature in the experimental system may be quite different from the in-sample temperature, and can reach 4 $$^\circ$$ ∘ C difference during thermodynamic processes. This potential difference must be considered in investigation of hydrate formation or dissociation, (2) various calculation approaches may yield different hydrate saturation values of up to tens of percentages difference in high hydrate saturations. The calculation formulas are specified together with the fundamental difference between them, (3) the water mixture method during the sample assembling is critical for homogeneous MHBS laboratory formation, in which a maximum initial water content threshold of 9.1 to 1.3 % are obtained for a minimal fraction size of 0.01 to 0.8 mm, respectively, (4) the hydrate formation duration may influence the MHBS properties, and should be rigorously estimated according to the real-time gas consumption convergence. The outcomes of this work may contribute to the integration of data sets derived from various experiments for the study of MHBS mechanical behavior.

A Safe Start Laparoscopic-assisted Pancreaticoduodenectomy in Songklanagarind Hospital, Thailand: Case Report

Total laparoscopic pancreaticoduodenectomy (PD) is a highly complex procedure. Evidence suggests laparoscopic-assisted PD (LAPD) might be an important link in the process of transition from open PD to total laparoscopic PD. We present the first successful LAPD in a female patient with distal cholangiocarcinoma at Songklanagarind Hospital, Thailand in July 2018. The postoperative course was satisfactory without the clinical relevance of complications. No evidence of recurrence was found after 35 months of follow-up. The results ensured the feasibility and safety of LAPD in the initial phase; regarding both complications and oncological outcomes in a high-volume center for open PD.