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This chapter discusses the anaesthetic management of neurosurgery. It begins with general principles of neurosurgery, including management of intracranial pressure. Surgical procedures covered include craniotomy (including awake craniotomy); insertion of ventriculo-peritoneal (VP) shunt; evacuation of traumatic intracranial haematoma; pituitary surgery; posterior fossa surgery; and interventional radiology treatment of intracranial vascular lesions (with particular attention to subarachnoid haemorrhage (SAH)). The management of venous air embolism is described, along with a discussion of the particular circumstance of resuscitation during neurosurgery.

In this paper, we present a coupling of homotopy perturbation technique and sumudu transform known as homotopy perturbation sumudu transform method (HPSTM). We show applicability of this method by solving fractional equal width (EW) equation, fractional modified equal width (MEW) equation and variant of fractional modified equal width (VMEW) equation. The fractional equal width equations play a key role in describing hydro-magnetic waves in cold plasma. Our aim is to study the nonlinear behavior of plasma system and highlight the important points. We examine the ability of HPSTM to study the fractional nonlinear systems and show its supremacy over other available numerical techniques. The other key point of this investigation is to examine two important fractional equations with different nonlinearity. The HPSTM gives excellent accuracy in analogous with the numerical solution. The numerical solutions indicate that the HPSTM is a powerful technique for studying the nonlinear behavior of plasma system very precisely and accurately.

Two-dimensional (2D) molybdenum disulfide (MoS2)–based materials are of great interest because of their capacity to efficiently absorb electromagnetic spectrum in the visible region. Starting from the structural and electronic properties, this review discusses the synthesis strategies of 2D MoS2. The major photocatalytic applications of 2D MoS2 such as hydrogen evolution, pollutant degradation, self-cleaning, photoelectrochemical water splitting, and microbial disinfection are summarized. The mechanistic understanding of various photocatalytic applications of 2D MoS2 is summarized through schematic diagrams. In addition, this review outlines the methodologies for improving the 2D MoS2 photocatalysts and recapitulates the research directions in this area of semiconductor photocatalysis.

STUDY DESIGN Digitally reconstructed radiograph-based study. OBJECTIVE Using a computer-based method to determine what degree of pelvic rotation is acceptable for measuring the pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). The effectiveness of a geometrical formula used to calculate the angle of pelvic rotation proposed in a previous article was assessed. SUMMARY OF BACKGROUND DATA It is unclear whether PI, PT, and SS are valid with pelvic rotation while acquiring a radiograph. MATERIALS AND METHODS Ten 3-dimensionally reconstructed models were established with software and placed in a neutral orientation to orient all of the bones in a standing position. Next, 140 digitally reconstructed radiographs were obtained by rotating the models around the longitudinal axis of each pelvis in the software from 0 to 30 degrees at 2.5-degree intervals. PI, PT, and SS were measured. The rotation angle was considered to be acceptable when the change in the measured angle (compared with the "correct" position) was

Condensation is of paramount importance in numerous technological applications where phase change processes take place. The physical nature of condensation from vapor to liquid can impose limits on the speed of the process, especially at the interface of the vapor, surface, and liquid. However, the nature of the surfaces themselves, especially those with low wettability, have been shown to enhance and promote condensation. This review is focused on the advances in surface wettability related to enhancement of condensation processes and while both filmwise and dropwise modes are addressed, emphasis is given to the enhancement of drop-wise condensation which produces higher heat transfer. Fundamental theoretical models governing surface wetting characteristics and heat transfer in condensation are presented. Methods to reduce wetting including coatings of low surface energy materials such as polymers, noble metals, rare-earth oxides, organic monolayers, switchable wettability surfaces, and ion-implantation are discussed. Certain surface features along with low surface energy coatings can enable droplet removal at much smaller sizes and can even control the droplet movements during condensation. Special emphasis is given to characteristics of these surface features including roughness, porous structures, hybrid surfaces, micro-grooved surfaces, and lubricant infused surfaces. Additionally, challenges and opportunities associated with the use of these surfaces in condensation are discussed. It is noted that dropwise condensation is prone to surface flooding at higher subcoolings. Moreover, the surface design is critical to choice of working fluid and further developments are required to achieve dropwise condensation of working fluids of low surface tension. The current review focusses on recent technological advances that may assist with the development of dropwise condensation for industrial, domestic and consumer related heat transfer devices, along with the concomitant superior heat transfer capabilities over the filmwise mode.

STUDY DESIGN A prospective study of anterior transarticular screw (ATS) fixation patients. OBJECTIVE To develop a method to determine screw tip position through plain radiography after percutaneous ATS fixation to prevent occipitocervical joint (OCJ) violation. SUMMARY OF BACKGROUND DATA No studies using plain radiography to prevent OCJ violation during percutaneous ATS fixation have been performed. METHODS In total, 34 subjects (with 68 screws) who had undergone percutaneous ATS fixation were enrolled. To evaluate the screw tip location in relation to the C1 lateral mass (LM), the screw tip positions were graded 1, 2, or 3 on anteroposterior (AP) radiographs, and I, II, or III on lateral radiographs. OCJ violation was analyzed by postoperative computed tomography (CT). RESULTS Screws with tips located lower (tip I) in the LM did not result in OCJ violation. Only one tip in the tip 3 position showed OCJ perforation, and this screw was also located in tip III. Screw perforation rates of tip 1-tip II, tip 1-tip III, and tip 2-tip III were the highest (100%), followed by tip 2-tip II (10.5%) and tip3-tip III (10%). CONCLUSION This study provides insights into OCJ violation during percutaneous ATS fixation. According to AP radiography, a percutaneous ATS with the screw tip located in the lateral part of the LM resulted in a lower rate of OCJ perforation, whereas screws located in the medial LM resulted in the highest rate of perforation. Percutaneous ATS with the screw tip located in the neutral part of the LM should ensure that the screw tip is below the upper part of the LM, preventing OCJ violation. These findings may help surgeons assess screw positioning both during and after the operation. LEVEL OF EVIDENCE 3.

Our aim was to evaluate the results of short-segment pedicle instrumentation with screw insertion in the fracture level and find factors predicting kyphosis recurrence in thoracolumbar burst fractures. We retrospectively analysed 122 patients with thoracolumbar burst fracture who were divided into two groups: kyphosis recurrence and no kyphosis recurrence. Pre-operative radiographic data comprising Cobb angle (CA), regional angle, anterior vertebra height (AVH), upper intervertebral angle, vertebral wedge angle (VWA), pre-anteroposterior A/P approach, superior endplate fracture, load-sharing classification (LSC) score and clinical data including age, visual analogue scale (VAS) score, thoracolumbar injury classification and severity score were compared between groups. T test, Pearson's chi-square and multivariate logistic regression were calculated for variables. CA, VWA and AVH were significantly corrected after surgery. CA changed from 23.7 to 3.0 (p

The aim of the present work is to propose a simple and reliable algorithm namely homotopy perturbation transform method (HPTM) for KdV equations in warm plasma. The homotopy perturbation transform method is a combined form of the Laplace transform method with the homotopy perturbation method. In this method, the solution is calculated in the form of a convergent series with an easily computable compact. To illustrate the simplicity and reliability of the method, several examples are provided. In this paper, the homotopy perturbation transform method has been applied to obtain the solution of the KdV, mKdV, K(2, 2) and K(3,3) equations. We compared our solutions with the exact solutions. Results illustrate the applicability, efficiency and accuracy of HPTM to solve nonlinear equations despite needlessness to any linearization or perturbation. It is predicted that the proposed algorithm can be widely applied to other nonlinear problems in science and engineering.

In this paper, an effective analytical scheme based on Sumudu transform known as homotopy perturbation Sumudu transform method (HPSTM) is employed to find numerical solutions of time fractional Schrödinger equations with harmonic oscillator.These nonlinear time fractional Schrödinger equations describe the various phenomena in physics such as motion of quantum oscillator, lattice vibration, propagation of electromagnetic waves, fluid flow, etc. The main objective of this study is to show the effectiveness of HPSTM, which do not require small parameters and avoid linearization and physically unrealistic assumptions. The results reveal that proposed scheme is a powerful tool for study large class of problems. This study shows that the results obtained by the HPSTM are accurate and effective for analysis the nonlinear behaviour of complex systems and efficient over other available analytical schemes.

The Earth life is dependable upon infinite source of green energy. There is an increasing trends for the use of solar cells in industry and domestic appliances because cosmic energy is expected to play significant role in future grids as non-conventional resources. The Large- scaled integration of non-conventional sources into the grid is possible by the computer simulations so there is extreme growing demand for computer simulation of non- conventional resources. The Electrical energy gained by the photon energy of the sun technically named as Photovoltaic (PV). The proposed model is based upon the maximised electric power extraction from the solar cell radiation and electrical driver interface for implementing electrical characteristic of power limited systems in power simulations. This paper gives us details steps of one-by-one procedures for the simulation of photovoltaic (PV) modules with Matlab/Simulink. Single diode equivalent circuit is processed in order to examine I-V and P-V properties are obtained for the typical 72W PV module. The suggested model is designed using a user-friendly idol and a communication box like simulink section libraries. The model is dynamic in computational multiplicity and it is easy to build for representing wide-range of photovoltaic (PV) installations.

Today latest technologies have been used to reduce the losses of the existing system and slow down the rate of occurrence of global warming. Most of the designs and researches aim to improve the power quality of the system. Purpose to design this circuit for the power factor improvement single inductor dual output circuit used single source in input side with the dual or multiple output system. Now days the consumers uses electronic equipments in large amount that shows utilization of maximum or multiple output through the minimum input source. In this the PI controller circuit is reconstructed with the help of Artificial Neural Network as a controller with fly-back converter. The design also shows the comparison between the both (PI & ANN) controllers. Through output gives the regulated output supply, here this study about the artificial neural network is efficiently remove problems to improve the power factor and reduce more THD (i.e. total harmonic distortion). The Artificial neural network helps oscillation, overshooting and undershooting and provides light weight, less settling time, small size. Main purpose to design this circuit improving the power factor with ANN controller MATLAB simulation is used to design the circuit. This design is shows that the ANN controller is more accurate when compared to the conventional system.

Cardiovascular events are an important group of critical incidents in anaesthesia. They include hypotension, hypertension, myocardial ischaemia/infarction, arrhythmias and cardiac arrest. These incidents require prompt recognition to stabilise the patient.

Dr. Goswámí, a Theoretical Quantum Physicist, shows how science and spirituality can be integrated by connecting between quantum physics and transpersonal psychology. Dr. Goswámí touches three concepts from quantum physics: unity consciousness, quantum self and purposiveness. 1. There are two domains of reality: that of possibility which is represented by waves of unity consciousness and that of actuality which is represented by particles. 2. The self has also two versions: the quantum self, the original self which holds direct connection to the unity consciousness, and the ego self, based on memories which generate conditioned behaviours thus it is disconnected from reality. 3. Consciousness as a representation of vitality is purpose driven. In its evolution it goes thorough three types of purposive movements: the movement of feelings (expressed through physical organs and the chakras), the movement of meaning (thinking) and the movement of archetypes (intuition). Now, it is true that unity consciousness is only potentiality, but by working on ourselves, developing our creativity and intuition, expending our consciousness, we can reestablish the freedom of choice the original self had and create satisfying kind of life which is full of joy and in flow with reality. The text of this contribution is taken from the International Transpersonal Conference 2017 - Prague. KEY WORDS Quantum physics, science, spirituality, consciousness

The aim of this study was to develop a novel method for observing the morphology of the blood vessels in the rabbit endplate. Twenty 6-month-old rabbits were used in this study. The blood vessels in the L5 endplate in Group A were injected with iohexol and Group B with barium sulfate. Group C was the control group with saline. To optimize the study, Group B was divided into two subgroups: Group B-1 was injected with 100% (w/v) barium sulfate and Group B-2 with 50% (w/v). After injection, the L4–L5 vertebral body was excised and the cranial endplate of L5 was scanned using a micro-CT scanner. Models of the vertebral endplate and vessels were reconstructed using the 3D reconstruction software (Mimics 16.0) by calculating a bone threshold value, and then merged these two models to create a superimposed model. The 3D vessel models could not be created in Groups A and C, but they were clearly visualized in Group B. In the 3D model, the blood vessels extended from the subchondral bone to the endplate, and the density of the blood vessels in the area of the nucleus pulposus (NP) was higher than in the annulus fibrosus. The results of this study suggest that the blood vessels in the rabbit endplate can be clearly observed by the method described using barium sulfate [the 50% (w/v) gave better results compared with the 100% (w/v)]. The information from the 3D vessel structure could provide essential data to help us understand the nutrient pathways within the vertebral endplate.

The best training method in laparoscopic surgery has not been defined. We evaluated the efficacy of laparoscopic skills acquisition in a short-term focused program. Two hundred fifty-six participants undergoing training on a phantom model were divided into 2 groups. Group 1 had no exposure and group 2 had performed a few laparoscopic surgeries. Acquisition of laparoscopic skills was assessed by operation time and the modified Global Operative Assessment of Laparoscopic Skills (GOALS) scale. A questionnaire was sent to the participants after 3 to 6 months for assessment of impact of training. There was a statistically significant improvement in the assessed parameters and in the mean score of all 5 domains of GOALS. The participants in group 2 performed better than those in group 1 in the first case. The difference between both the groups disappeared after the training. Participants who responded to the questionnaire felt that training helped them in improving their performance in the operation theater.

This study suggests that training improves laparoscopic suturing skills in experienced as well as inexperienced laparoscopic surgeons., Background: Laparoscopic suturing is a difficult skill to master but can be acquired with extensive training outside the operating room. This study was done with the primary aim of assessing whether prior exposure to laparoscopic surgery helped trainees in acquiring laparoscopic suturing skills more quickly than trainees with no prior exposure to laparoscopic surgery. Materials and Methods: Twenty laparoscopy-exposed and 20 laparoscopy-naïve surgeons performed 5 laparoscopic gastrojejunostomies each on a phantom porcine model. The performance was evaluated for operation time, overall anastomotic score (calculated by adding scores of anastomotic leak, size of the anastomosis, suture placement, and mucosal approximation), and the level of difficulty. The performance at the beginning of training (baseline) was compared to the performance at the end of training. Results: All participants showed statistically significant improvement in operation time, overall anastomotic score, and difficulty level. Laparoscopy-exposed surgeons had a significantly better operation time than laparoscopy-naïve surgeons at the beginning of training; however, the difference became insignificant by the end of training. The difference in overall anastomotic score was not significant between laparoscopy-exposed and naïve-surgeons. Laparoscopy-exposed surgeons showed significant improvements in anastomotic leak rate and size of the anastomosis, whereas laparoscopy naïve surgeons showed improvements in all the parameters, although these were not significant statistically. Conclusion: Training improves the laparoscopic suturing skills of laparoscopy-exposed as well as laparoscopy-naïve surgeons. Prior experience in laparoscopic surgery does not seem to influence the acquisition of laparoscopic suturing skills as laparoscopic-naïve surgeons manage to catch up with the skills of the laparoscopy-exposed surgeons.

Background: Incomplete gallbladder removal following open and laparoscopic techniques leads to residual gallbladder stones. The commonest presentation is abdominal pain, dyspepsia and jaundice. We reviewed the literature to report diagnostic modalities, management options and outcomes in patients with residual gallbladder stones after cholecystectomy. Materials And Methods: Medline, Google and Cochrane library between 1993 and 2013 were reviewed using search terms residual gallstones, post-cholecystectomy syndrome, retained gallbladder stones, gallbladder remnant, cystic duct remnant and subtotal cholecystectomy. Bibliographical references from selected articles were also analyzed. The parameters that were assessed include demographics, time of detection, clinical presentation, mode of diagnosis, nature of intervention, site of stone, surgical findings, procedure performed, complete stone clearance, sequelae and follow-up. Results: Out of 83 articles that were retrieved between 1993 and 2013, 22 met the inclusion criteria. In most series, primary diagnosis was established by ultrasound/computed tomography scan. Localization of calculi and delineation of biliary tract was performed using magnetic resonance imaging/magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography. In few series, diagnosis was established by endoscopic ultrasound, intraoperative cholangiogram and percutaneous transhepatic cholangiography. Laparoscopic surgery, endoscopic techniques and open surgery were the most common treatment modalities. The most common sites of residual gallstones were gallbladder remnant, cystic duct remnant and common bile duct. Conclusion: Residual gallbladder stones following incomplete gallbladder removal is an important sequelae after cholecystectomy. Completion cholecystectomy (open or laparoscopic) is the most common treatment modality reported in the literature for the management of residual gallbladder stones.

The straightforward approach, of course, is to consider all these as real dualitiesthis is the philosophy of dualism. However, the philosophy of dualism is not considered tenable if we take a scientific, explanatory, and verifiable approach. Take the dualism of consciousness and matter, for example. If consciousness and matter are truly dualistic, that is, made of two entirely different substances, then how do they interact? Their interaction requires a mediator. The obvious absence of a mediator speaks in favor of a monism. According to many physicists, scientists, and philosophers, physics must be carried out on the basis of the philosophy of material or scientific realism-the philosophy that only matter is real; all else, including consciousness, is an epiphenomenon of matter. It is assumed that such an approach serves to establish monism, based on material supremacy, over dualism. But material monism is a pseudomonism. In truth, material-realistic models of consciousness are unable to explain the hard questions of consciousness such as the subject/object split nature of experience (Chalmers 1995). Similarly, there are holistic approaches within the basic materialist ontology (Capra 1996) that try to resolve the consciousness/matter and transcendent/ immanent dualisms by regarding consciousness as a holistic aspect of matter (the whole is greater than the parts), but this completely ignores the transcendent aspect of consciousness (Wilber 1996). The philosopher Daniel Dennet (1991) agrees that materialist cognitive-science models of consciousness in the brain do succumb to an underlying dualism, the implicit idea that a homunculus is looking at the computer output that the brain

In a previous article (Goswami, 1997), it was suggested that an application of quantum measurement theory under the auspices of a monistic idealist ontology (that consciousness is the ground of being) can solve many difficult problems of neo-Darwinism, e.g., alternating rapid creativity and homeostasis observed in evolution and the directionality, origin, and nature of life. In this article, we propose an epigenetic quantum mechanism to explain the connection of developmental processes and evolution, as has been evidenced in such controversial phenomena as directed mutation and phenocopies. *** DIRECT SUPPORT *** A31BB026 00003

Biological order is discussed within the context of the idealist interpretation of quantum mechanics. A quantum mechanism is proposed for quantum speciation and for quantum evolution, in general. It is shown that an extension of neo-Darwinism to include quantum evolution via a quantum mechanism can resolve some of the recent controversies that have rattled evolution theory. It is pointed out that the quantum approach has the further benefit of giving a straightforward insight into the nature of life itself. Experimental support for some aspects of the theory is discussed.

Creativity theories are as diverse as the worldviews in which they are wrapped. Recently, an integrative science and an integrated worldview have been founded on two giant pillars of human thought—the philosophy of monistic idealism and quantum physics. In this article, a unification of the theories of creativity is accomplished based on this integrative science and worldview. New definitions for the phenomenon are proposed and justified. A theory of the creative process is formulated, and applications of the unified theory are briefly discussed.

Various models of postmaterialist science are introduced with a brief exposition of the quantum physics and primacy-of-consciousness-based model that integrates all the various approaches.