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ObjectiveThe aim of this study was to provide an interim safety analysis of the first 30 surgical procedures performed using the Versius Surgical System.BackgroundRobot-assisted laparoscopy has been developed to overcome some of the important limitations of conventional laparoscopy. The new system is currently undergoing a first-in-human prospective clinical trial to confirm the safety and effectiveness of the device when performing minimal access surgery (MAS).MethodsProcedures were performed using Versius by a lead surgeon supported by an operating room (OR) team. Male or female patients aged between 18 and 65 years old and requiring elective minor or intermediate gynaecological or general surgical procedures were enrolled. The primary endpoint was the rate of unplanned conversion of procedures to other MAS or open surgery.ResultsThe procedures included nine cholecystectomies, six robot-assisted total laparoscopic hysterectomies, four appendectomies, five diagnostic laparoscopy cases, two oophorectomies, two fallopian tube recanalisation procedures, an ovarian cystectomy and a salpingo-oophorectomy procedure. All procedures were completed successfully without the need for conversion to MAS or open surgery. No patient returned to the OR within 24 h of surgery and readmittance rate at 30 and 90 days post-surgery was 1/30 (3.3%) and 2/30 (6.7%), respectively.ConclusionsThis first-in-human interim safety analysis demonstrates that the Versius Surgical System is safe and can be used to successfully perform minor or intermediate gynaecological and general surgery procedures. The cases presented here provide evidence that the Versius clinical trial can continue to extend recruitment and begin to include major procedures, in alignment with the IDEAL-D Framework Stage 2b: Exploration.

Some have suggested that trabeculae within the transverse sinuses (chordae Willisii) might restrict flow and potentially contribute to thrombus organization. In addition, these structures might be encountered with endovascular procedures within the transverse sinus and are now readily seen on imaging. Therefore as anatomic studies of these structures are scant, the current study aimed to better elucidate these structures within the transverse sinus via a morphologic study in cadavers.Thirty fresh-frozen, cadaveric transverse sinuses were dissected, and their detailed morphology was recorded. Classification schemes were applied based on the anatomy and orientation of each chordae.Chordae were found on 70% of sides and were statistically more likely to be found on right sides (86.6%) (P0.01). Three types and 3 classes of chordae were identified. There was a statistically significant difference between sides regarding type of chordae (P = 0.02).To date, a comprehensive anatomic evaluation of the intraluminal chordae of the transverse sinuses has been lacking. Knowledge of these bands is also essential to those performing endovascular procedures of the dural venous sinuses and for those interpreting imaging of these structures.

The Surgical Pleth Index (SPI) is a multivariate index derived noninvasively from finger plethysmographic signal. It has been demonstrated to correlate with surgical stress intensity. So, we examined these beneficial effects of SPI guided anaesthesia to determine the amount of intraoperative fentanyl consumption and haemodynamic stability in laparoscopic surgeries under general anaesthesia. After obtaining institutional ethical clearance and patient informed consent, A total of 100 Patients (20-65yrs) posted for laparoscopic surgeries under general anaesthesia were randomly allocated to the SPI and conventional analgesia group (50 patients each). In SPI group, SPI value >50; In conventional group, rise in heart rate(HR), mean arterial pressure (MAP) 20% above baseline were the criteria for fentanyl administration. Fentanyl 0.5 µg/kg is administered in each group for an event persisting for 5 min. Intraoperative fentanyl consumption, hemodynamic stability and postoperative pain for 1 hour were observed. Comparison analysis was performed for total intraoperative fentanyl consumption using t-test. Correlation analysis performed using the Pearson test and p- value Total intraoperative fentanyl consumption was lower in SPI group than in the conventional group (108.30±21.84 µg vs 125.70±24.87 µg; p=0.0003) and it was statistically significant with good haemodynamic stability. Postoperative pain scores were comparable in both the groups. The postoperative fentanyl consumption in SPI group was 14.4 ± 1.7 µg and in conventional group was 19.4± 7.0 µg.Compared with conventional analgesia, SPI guided analgesia resulted in lower intraoperative fentanyl consumption and more stable haemodynamics.

Anjing merupakan hewan peliharaan yang memiliki hubungan paling dekat dengan manusia.Pemeriksaan kesehatan yang rutin harus ada untuk menjaga stamina anjing supaya tetap dalam kondisi prima. Salah satu indikator untuk mengetahui kondisi kesehatan melalui pemeriksaan darah. Populasi anjing di Kota Denpasar pada tahun 2019 menurut Dinas Pertanian Kota Denpasar adalah sekitar 97.522 ekor. Berbagai analisis gambaran darah pada anjing dapat digunakan untuk mengetahui pengaruh lingkungan lokal terhadap faktor fisiologi. Penelitian ini bertujuan untuk mengetahui gambaran darah dari anjing peliharaan yang diberi pakan secara rumahan. Objek penelitian yang digunakan adalah anjing yang dipelihara masyarakat di Kota Denpasar dengan jumlah 47 ekor. Pengambilan sampel darah dilakukan pada anjing-anjing yang dipelihara oleh masyarakat Kota Denpasar. Lokasi penelitian dilaksanakan di Labolatorium Diagnosis Klinik, Patologi Klinik, Radiologi Veteriner, Fakultas Kedokteran Hewan dan di Balai Besar Veteriner Denpasar. Hasil menunjukkan bahwa anjing di Kota Denpasar banyak yang tidak sehat. Kemungkinan yang menyebabkan anjing tidak sehat yaitu dalam hal pemberian gizi yang kurang baik, dan lingkungan yang terinfestasi penyakit. Perlu adanya peningkatan pemantauan pemeliharaan maupun kesehatan anjing di Kota Denpasar, terutama mengenai pemeriksaan laboratorium kemudian peningkatan kebersihan lingkungan supaya anjing terhindar dari serangan penyakit dan pemberian pakan yang memiliki nutrisi yang baik untuk anjing.

Study Design: Cadaver study. Objective: The retropharyngeal space’s (RPS’s) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation. Methods: Five fresh-frozen cadavers were dissected in the supine position. A digital manometer and a 20 Fr Foley catheter were inserted into the RPS via an anterolateral approach. While inflating the Foley catheter, the position of the esophagus/trachea was documented using fluoroscopy, and the retropharyngeal pressure was measured. We quantified the volume required to deviate the esophagus/trachea >1 cm from its original position using fluoroscopy. We also recorded the volume required to cause a visible change to the normal neck contour. Results: A mean volume of 12.5 mL (mean pressure 1.50 mm Hg) was needed to cause >1 cm of esophageal deviation. Tracheal deviation was encountered at a mean volume of 20.0 mL (mean pressure of 2.39 mm Hg). External visible clinical neck contour changes were apparent at a mean volume of 39 mL. Conclusion: A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.

Thermal through silicon via (TTSV) and heat spreaders plays a vital role in heat management in 3-Dimentional IC integration. However in recent years FIN to TTSV and heat spreaders has proposed to detects and spread heat in any one direction which leads to the damage of an integration circuit (IC). This paper proposes a FIN with optimal directions and heat spreaders to spread the heat in various directions and finally the heat absorb towards heat sink effectively. In this work, we have also demonstrated various thermal cooling effects and its impact on the distribution of potential across IC at different conditions. We have studied these using FEM Simulator for (1) 3D IC architecture with FIN and heat spreaders using Graphene and CNT material, (2) TTSV with FIN and heat spreaders of Graphene, (3) TTSV with fin and heat spreaders of CNT, (4) TTSV with FIN direction towards heat source made of Graphene and CNT, and (5) TTSV with FIN direction towards TSV made of CNT and Graphene. Our result shows that CNT has better thermal cooling management towards heat source as well TSVs than Graphene with order greater than 100 Kelvin.

Background: Eczema of foot adversely impacts daily activities, work productivity, and interpersonal relationships. Materials and Methods: This cross-sectional, questionnaire-based study collated epidemiological data of 70 outpatients of foot eczema, evaluated their quality of life by 10-item dermatology life quality index (DLQI) questionnaire, and undertook the correlation thereof. Results: Cases were predominantly males (48; 68.5%); 26 (37.1%) belonged to fifth decade of life and 47 (67%) presented within 12 months of onset. Dorsa of feet was involved in most (59; 84.2%) cases. Itching was a universal complaint followed by scaling (51; 72.9%), dryness (22; 31.4%), and oozing (21; 30%). History of atopy was reported by 15 (21.4%) patients; tobacco and/or alcohol abuse 32 (45.7%) patients; past treatment was received by 37 (52.9%) patients; and winter aggravation in 9 (12.3%) patients. Mean DLQI score was 13.64; with very large effect (11–20) on QoL in 38 (54.3%) patients; moderate (6–10) in 15 (21.4%) patients; extremely large (21–30) in 9 (12.9%) patients; and small (2–5) in 8 (11.4%) patients. Mean scores of questions of DLQI tool were 2.46 in first question (symptoms), 1.99 in fifth (social activities); 1.81 in seventh (working/studying); and 0.17 in fourth (clothes) question. Significant (P < 0.05) impairment of quality of life emerged with respect of burning, scaling, oozing, history of atopy, seasonal variation, and past treatment. Conclusion: Our study reports significant association of atopy, winter aggravation, past treatment, burning, scaling, and oozing with adverse quality of life in our study on cases of foot eczema and appears to be first study from India.

With the introduction of damage tolerance-based design philosophies, the demand for reliable and robust structural health monitoring (SHM) procedures for aerospace composite structures is increasing rapidly. The performance of supervised learning algorithms for SHM depends on the amount of labeled and balanced datasets. Apart from this, collecting datasets accommodating all possible damage scenarios is cumbersome, costly, and inaccessible for aerospace applications. In this paper, we have proposed two different unsupervised-feature learning approaches where the algorithms are trained only on the baseline scenarios to learn the distribution of baseline signals. The trained unsupervised feature learner is used for delamination prediction with an anomaly detection philosophy. In the first approach, we have combined dimensionality reduction techniques (principal component analysis and independent component analysis) with a one-class support vector machine. In another approach, we have utilized deep learning-based deep convolutional autoencoders (CAE). These state-of-the-art algorithms are applied on three different guided wave-based experimental datasets. The raw guided wave signals present in the datasets are converted into wavelet-enhanced higher-order representations for training unsupervised feature-learning algorithms. We have also compared different techniques, and it is seen that CAE generates better reconstructions with lower mean squared error and can provide higher accuracy on all the datasets.

A new prenylated kaempferol, conglomeratin (1), alongside 7 known compounds including flavonoids (2 and 3), ellagic acid derivatives (4 and 5), triterpenoids (6 and 7), and a coumarin (8) were isolated from the leaves (1 − 5) and stem bark (6 − 8) of Macaranga conglomerata. Their structures were elucidated using spectroscopic and spectrometric techniques. The antibacterial assay was performed using disc diffusion method against Gram-positive and Gram-negative microorganisms. Compound 1 was significantly active against Pseudomonas aeruginosa ATCC 27853 (MIC = 7.8 µg/mL) and moderately active towards Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922 and Klebsiella pneumoniae ATCC 31488 (MIC = 62.5 µg/mL). Compound 2 showed potency against P. aeruginosa ATCC 27853 (MIC = 1.0 µg/mL) while 4 and 7 were selective towards K. pneumoniae ATCC 31488 (MIC = 7.8 and 1.0 µg/mL, respectively). These findings suggest that prenylation of flavonoids may contribute to improving their broad-spectrum antimicrobial activities.

Laminated composite materials are widely used in most fields of engineering. Wave propagation analysis plays an essential role in understanding the short-duration transient response of composite structures. The forward physics-based models are utilized to map from elastic properties space to wave propagation behavior in a laminated composite material. Due to the high-frequency, multi-modal, and dispersive nature of the guided waves, the physics-based simulations are computationally demanding. It makes property prediction, generation, and material design problems more challenging. In this work, a forward physics-based simulator such as the stiffness matrix method is utilized to collect group velocities of guided waves for a set of composite materials. A variational autoencoder (VAE)-based deep generative model is proposed for the generation of new and realistic polar group velocity representations. It is observed that the deep generator is able to reconstruct unseen representations with very low mean square reconstruction error. Global Monte Carlo and directional equally-spaced samplers are used to sample the continuous, complete and organized low-dimensional latent space of VAE. The sampled point is fed into the trained decoder to generate new polar representations. The network has shown exceptional generation capabilities. It is also seen that the latent space forms a conceptual space where different directions and regions show inherent patterns related to the generated representations and their corresponding material properties.

Splenic rupture is rarely seen in neonates these days. This is because traumatic deliveries rarely occur. However rarely splenic rupture can take place spontaneously and can present with life threatening haemorrhagic shock. A case of spontaneous and delayed rupture of the spleen in a neonate that was managed with conservative approach with good outcome has been described in this case report.

Disruption of axonal transport causes a number of rare, inherited axonopathies and is heavily implicated in a wide range of more common neurodegenerative disorders, many of them age-related. Acetylation of α-tubulin is one important regulatory mechanism, influencing microtubule stability and motor protein attachment. Of several strategies so far used to enhance axonal transport, increasing microtubule acetylation through inhibition of the deacetylase enzyme histone deacetylase 6 (HDAC6) has been one of the most effective. Several inhibitors have been developed and tested in animal and cellular models, but better drug candidates are still needed. Here we report the development and characterization of two highly potent HDAC6 inhibitors, which show low toxicity, promising pharmacokinetic properties, and enhance microtubule acetylation in the nanomolar range. We demonstrate their capacity to rescue axonal transport of mitochondria in a primary neuronal culture model of the inherited axonopathy Charcot-Marie-Tooth Type 2F, caused by a dominantly acting mutation in heat shock protein beta 1.

Statistical courses are mandatory for students to take to assist in solving research problems. The purpose of this study was to determine student perceptions of the level of understanding of all statistical material indicators after attending statistics lectures and to prove that the average student perception was not in the low category. The research method used is quantitative research. The sample used was 31 samples from students of Early Childhood Education Teacher Education, Universitas Negeri Medan in 2021. The data collection technique used a questionnaire technique. Data were analyzed using descriptive statistics and one sample t-test. The results showed that Student perceptions of mastery of statistical lecture indicators fall into two categories, namely the high category of 61% and the medium category of 39%. The perception of the sample's ability to master the lecture indicators is divided into four categories, namely the very high category of 19%, the high category of 42%, the medium category of 32%, and the low category of 7%. The mean score of perceived mastery of statistical indicators is greater than 31.5, which means that students' perceptions of ability are not in the Low category.

Objectives: This case report aims to identify fractures that occur through panoramic radiographs and evaluated by CBCT after being given treatment. Case Report: A 12-year-old male patient came with his older brother to the emergency room (ER) RSKGM/Bandung Dental Hospital due to the trauma of a fall by an iron football goalpost while playing soccer which caused the patient to fall onto the grass field. The patient was experiencing continuous bleeding. Systemic and allergic history was denied. Extraoral examination showed bruising with no facial asymmetry. Intraoral examination revealed a vertical gap between teeth 42 and 43, the jaw within the site was mobile, and active bleeding especially from lingual lacerations. After consulting with Dental Surgery Specialist, the emergency room doctor gave interdental wiring. After 2 months post wiring, a CBCT photo evaluation was carried out. Conclusion: The mandibular fracture in this case report was well identified by clinical examination and supported by panoramic radiography. After that the patient was given treatment and evaluated through CBCT. CBCT provides a clearer and better picture.

During COVID-19 pandemic, Healthcare Workers (HCWs) were at increased risk for exposure to SARS-CoV-2 virus and prioritized for early administration of COVID-19 vaccines in India. Real-life scenario information among vaccinated HCWs acquiring COVID-19 infection, is scarce. We retrospectively analyzed COVID-19 infection frequency, severity, and associated mortality among healthcare workers, immunized with either Covishield or Covaxin vaccines at 27 Fortis Hospitals across 11 Indian states. Positive cases were identified based on RT-PCR or rapid antigen tests for SARS-CoV-2 between 16th January 2021 till 15th May 2021. 20034 HCWs received vaccination. 3971 received 1 dose, 16063 received 2 doses. Post-vaccination, 1139 HCWs acquired COVID-19 infection, 180 (4.53%) and 959 (5.97%) among partially and fully vaccinated category, respectively. Breakthrough infection occurred among 913 (5.68%) HCWs. Concurrently, Case Positivity Rate was 11.9%, among general population (control). Among 1139 positive cases, mild, moderate, and severe infections were 1059 (93%), 71 (6.2%) and 9 (0.8%), respectively with Case Fatality Rate of 0.18%, compared to 0.92% among general population (p=0.0043). The Case Fatality Rate in vaccinated HCWs was found to be 80% less than that in general population (control). Hence, COVID-19 vaccines available in India seem to be effective against SARS-CoV-2 virus.

The recruitment of new employees and allocation of suitable work has always been a random approach for many multinational companies [MNC]. With the use of the data obtained from the submitted resumes, this research work aims to separate the resume levels by analyzing the expertise data from the resumes. To accomplish this, the proposed research work has used machine learning and Naive-Bayes methodology and it also attempts to find which process provides best possible result for the segregation using one vs. rest classifier. Furthermore, this research work attempts to find the accuracy and performance of the proposed methodology and incorporate it in the IT firms and other regulations for the prevention of manual screening and establish a safe allocation of resources for the companies.

Background: Laparoscopy is an established method to perform major surgeries, with many advantages over open surgeries. Hysterectomy is a common procedure performed with increased use of laparoscopy, having postoperative pain management is a major issue. Effective pain management promotes early ambulation, lowering the risk of DVT and PE.Methods: The present study aimed to assess effect of bupivacaine intraperitoneally during laparoscopic hysterectomy to reduce postoperative pain. 48 women undergoing laparoscopic hysterectomy under ASA I and II general anesthesia were included, divided into 2 groups, group A receiving 0.25% bupivacaine intraperitoneally; group B receiving saline. A blind observer observed both groups for 6 hours post-surgery or until the VAS was 4, whichever came first, need for rescue analgesia, side-effects, and total dose of analgesia required in 24 hours. Diclofenac sodium and paracetamol was used as rescue analgesia for both groups.Results: There was no significant difference reported in demographic parameters between two study groups. The VAS scores at 6, 12 and 24 hours after laparoscopy was significantly lower in group A than group B. There was significant increase in the time required for 1st analgesia, while amount of analgesia required was significantly low in group A as compared to group B. There were significantly more number of patients in group B who needed opioids than group A.Conclusions: Peritoneal bupivacaine instillation after laparoscopic hysterectomy was found to be useful to reduce the pain as compared to use of saline (placebo), significant reduction in need for analgesics in the postoperative period.