30 research outputs found
Leveraging wireless network virtualizaton for flexible sharing of WLANs
No full textProviding air-time guarantees across a group of clients forms a fundamental building block in sharing an access point (AP) across different virtual network service providers. Though this problem has a relatively simple solution for downlink group scheduling through traffic engineering at the AP, solving this problem for uplink (UL) traffic presents a challenge for fair sharing of wireless hotspots. Among other issues, the mechanism for uplink traffic control has to scale across a large user base, and provide flexible operation irrespective of the client channel conditions and network traffic loads. In this thesis the SplitAP architecture is proposed that addresses the problem of sharing uplink airtime across groups of users by extending the idea of network virtualization. The architecture discussed in this thesis allows different algorithms to be deployed on it for enforcing UL airtime fairness across different client groups. In this thesis, the design features of the SplitAP architecture are highlighted followed by results from evaluation on a prototype deployed with the two algorithms for controlling UL group fairness like: (1) Linear Proportional Feedback Control (LPFC) and (2) Linear Proportional Feedback Control plus (LPFC+). Performance comparisons on the ORBIT testbed show that the proposed algorithms are capable of providing group air-time fairness across wireless clients irrespective of the network volume, and traffic type. The algorithms show up to 40% improvement with a modified Jain fairness index.M.S.Includes bibliographical referencesby Dipti Vet
Changes in electromyographic amplitudes but not latencies occur with endotracheal tube malpositioning during intraoperative monitoring for thyroid surgery: Implications for guidelines
No full textObjectives/Hypothesis: During intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery, endotracheal
(ET) tube migration can result in a decrease in vocalis electromyographic (EMG) amplitude without a concordant latency
elevation during stimulation of the recurrent laryngeal nerve (RLN).
Study Design: Retrospective review.
Methods: Data were reviewed retrospectively for thyroid and parathyroid surgery patients with IONM of the laryngeal
nerves from January 2015 to December 2015. Recordings of vocalis EMG amplitudes and latencies with RLN stimulation
were obtained with the neuromonitoring ET tube surface electrodes in optimal baseline position, with vertical displacement
away from the vocalis, and with rotational change away from baseline.
Results: ET tube surface electrode EMG recordings were obtained with stimulation of seven left and three right RLNs in
a total of 10 patients. Mean vocalis EMG amplitudes were reduced with vertical displacement 1 and 2 cm both inferior and
superior to baseline and with rotational change (458 and 908 clockwise and counterclockwise, 1808), although amplitude
change with 458 clockwise and 1808 rotation did not meet statistical significance. Mean EMG latency values did not change
significantly from baseline with either rotation or vertical displacement of the ET tube.
Conclusions: An isolated decrease in EMG amplitude without concordant latency elevation should warrant re-evaluation
of ET tube position during thyroid and parathyroid surgery and is in contrast to a combined event, with both EMG amplitude
decrease and concordant latency increase, which is more suggestive of a true neuropraxic injury.
Key Words: Thyroid and parathyroid surgery, intraoperative neural monitoring, electromyography, recurrent laryngeal
nerve, combined event, amplitude change.
Level of Evidence: 4.
Laryngoscope, 00:000–000, 201
Routine versus selective use of episiotomy in primigravida: a prospective non-randomized case-control study
No full textBackground: Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labour. It is an inflicted second-degree perineal tear. Objective of this study was to determine the possible benefits and risks of the use of selective episiotomy versus routine episiotomy during delivery in primigravida.Methods: This is a prospective non-randomized case-control study designed to analyze and compare the maternal outcomes following routine versus selective use of episiotomy in primigravida. In control group, 122 patients were recruited and mediolateral episiotomy was given in all patients; while in study group, 61 patients were recruited, in whom episiotomy was given selectively.Results: In study group 61 patients were recruited, out of which episiotomy can be avoided in 23 (37.7%) of cases. There was no 3rd or 4th degree perineal tear found in any group. Perineal pain score on 3rd day postpartum was less in study group, as compared to control group on bed rest, sitting, walking and defecation.Conclusions: Selective use of episiotomy can improve maternal outcome by reducing perineal lacerations and those having intact perineum can have the best outcome when episiotomy is given selectively
Predicting traction return current in electric railway systems through physics-informed neural networks
No full textThis paper addresses the problem of determining the distribution of the return current in electric railway traction systems. The dynamics of traction return current are simulated in all three space dimensions by informing the neural networks with the Partial Differential Equations (PDEs) known as telegraph equations. In addition, this work proposes a method of choosing optimal activation functions for training the physics-informed neural network to solve higher-dimensional PDEs. We propose a Monte Carlo based framework to choose the activation function in lower dimensions, mitigating the need for ensemble training in higher dimensions. To further strengthen the applicability of the Monte Carlo based framework, experiments are presented under two loss functions governed by L2 and L∞ norms. The presented method efficiently simulates the traction return current for electric railway systems, even for three-dimensional problems.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Railway Engineerin
A prospective study of intrauterine death cases at a tertiary care hospital
No full textBackground: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise
Fetomaternal outcome in pregnancy with oligohydramnios: a prospective study
No full textBackground: Oligohydramnios is defined as amniotic fluid index <5th percentile or 2 standard deviation below the normal amniotic fluid volume. It affects 4% of all the pregnancy. The aim of this study is to evaluate the etiological risk factor of oligohydramnios and to assess their clinical significance and mode of delivery and maternal and perinatal outcome.Methods: This study was conducted at a tertiary health care centre, SSG Hospital, Baroda, from 1st September 2019 to 30th August 2020. It is a prospective study of 200 cases of oligohydramnios with gestational age > 30 weeks.Results: The most common risk factor associated with oligohydramnios was hypertensive disorder of pregnancy (35%) followed by intra uterine growth restriction (31%), preterm rupture of membranes (17%), post-datism (5%) and about 12% were due to idiopathic causes. Among cases majority were primigravida (43%). Lower segment caesarean section was done in 86 cases (43%), and main indication was fetal distress. There was no maternal mortality in the study. NICU admission for low birth weight (26%), pre-maturity (20%), meconium aspiration syndrome (8%), congenital anomalies (8%). Among congenital anomalies, posterior urethral valve had highest incidence (50%) followed by renal agenesis (25%). The neonatal mortality was 5%.Conclusions: Oligohydramnios adversely affects the perinatal outcome. Therefore, it requires meticulous assessment, prompt detection, timely management and treating underlying condition. However, a favourable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care
Fetomaternal outcome in sickle cell disease in a tertiary care centre
No full textBackground: Sickle cell disease is a hereditary haematological disorder prevalent in tribal regions of India. Sickle cell disease can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the tertiary centre S.S.G. Hospital, Baroda, Gujarat. Hence this study was conducted to assess complications in pregnancy and maternal and perinatal outcome among women with Sickle cell disease.Methods: It was a retrospective observational study including all pregnant women with sickle cell disease after 20 weeks of gestation who delivered at S.S.G. Hospital, Baroda from August 2019 to August 2020.Results: There were 43 antenatal women with Sickle cell disease during the study period. There was increased risk of obstetric complications like gestational hypertension (11.62%), preeclampsia (9.3%), eclampsia (6.97%), HELLP syndrome (4.65%), intrauterine growth retardation (23.25%), and oligohydramnios (11.62%). Medical complications observed were mainly anaemia (53.48%), vaso-occlusive crisis (18.16%), acute chest syndrome (4.65%) and infections like urinary tract infection (6.97%) and pneumonia (4.65%). The incidence of low birth weight babies (56.94%), low APGAR score (11.62%) and neonatal ICU admissions (23.25%) was high. 6.5% cases of maternal mortality and 4.65% cases of perinatal mortality was observed.Conclusions: Pregnancy in Sickle cell disease is associated with an increased maternal morbidity and high perinatal mortality due to obstetric and medical complications
The International RLN Anatomic Classification System
No full textWith this chapter we offer an anatomy-based classification system of recurrent laryngeal nerve (RLN); a classification that embraces normal anatomy as well as embryological and acquired sources of variation in the trajectory of the right and left RLN in human neck. We endeavor to put forth a classification system that encompasses all of the above sources of variations and is simple and surgically relevant so that it is maximally valuable to the surgeon during thyroidectomy.
This classification system relates to the path/trajectory of the main trunk of the RLN. We appreciate that specific interactions between the nerve and the thyroid gland occur at the tubercle of Zuckerkandl (described in Chap. 9), ligament of Berry (described in Chap. 10) and with the inferior thyroid artery (described in Chap. 7). The surgical approach to the nerve can be conceptualized in a number of different ways and this is detailed in Chap. 13. In this chapter both the basic classification of RLN surgical anatomic path in the neck base as it relates to the thyroid surgery as well as vagal carotid sheath anatomy are described
Collected Papers (Papers of Mathematics or Applied Mathematics), Volume V
No full textThis volum includes 37 papers of mathematics or applied mathematics written by the author alone or in collaboration with the following co-authors: Cătălin Barbu, Mihály Bencze, Octavian Cira, Marian Niţu, Ion Pătraşcu, Mircea E. Şelariu, Rajan Alex, Xingsen Li, Tudor Păroiu, Luige Vlădăreanu, Victor Vlădăreanu, Ştefan Vlăduţescu, Yingjie Tian, Mohd Anasri, Lucian Căpitanu, Valeri Kroumov, Kimihiro Okuyama, Gabriela Tonţ, A. A. Adewara, Manoj K. Chaudhary, Mukesh Kumar, Sachin Malik, Alka Mittal, Neetish Sharma, Rakesh K. Shukla, Ashish K. Singh, Jayant Singh, Rajesh Singh, V.V. Singh, Hansraj Yadav, Amit Bhaghel, Dipti Chauhan, V. Christianto, Priti Singh, and Dmitri Rabounski
Head Start and child care providers' feeding practices: a potential avenue for obesity prevention in young children
No full textThe Academy of Nutrition and Dietetics released a position statement in 2012 regarding benchmarks for nutrition in child care to establish healthful eating behaviors in early childhood and prevent obesity in young children. Further, recent publications by the Institute of Medicine and national organizations have recommended specific feeding practices for child care providers to be implemented at the state-level to prevent early childhood obesity in preschool children. Although over 12 million US children in child care consuming up to 5 meals and snacks per day in such settings, little is known about child care providers’ feeding practices.
The purpose of this dissertation was to examine provider’s feeding practices in Head Start and child care programs with the following aims 1) To assess whether providers met the Academy’s benchmarks and if attainment of benchmarks varied across child care contexts (Head Start [HS], Child and Adult Care Food Program [CACFP] and non-CACFP). 2) To identify determinants of child care providers’ healthful and controlling feeding practices for 2-5y-old children. 3) To identify Head Start and child care provider’s motivators, barriers and facilitators for using family style meal service (FSMS) during child care mealtimes.
Cross-sectional data was collected in 2011 and 2012 where 118 child care providers from 24 center-based programs (6 Head Start [HS], 11 Child and Adult Care Food Program [CACFP] funded, 7 non-CACFP) completed self-administered surveys regarding their feeding practices for 2-5-year-old children. Chi-square tests and Analysis of variance were used to determine variation in meeting benchmarks across contexts. Multi-level multivariate linear regression models were used to predict seven feeding practices- healthful (allowing children to control their food intake, role modeling healthy eating and teaching children about nutrition) and controlling (pressuring children to eat and restricting access to food for health or weight control). For aim 3, qualitative semi-structured interviews were conducted with a subset of providers based on maximum variation purposive sampling. The interviews were lead until saturation was reached and the data was coded using thematic analysis by NVivo qualitative software.
It was found that HS providers had greater compliance with the Academy’s benchmarks compared to CACFP and non-CACFP providers. HS providers sat more frequently with children during meals (P=0.01), ate the same foods as children (P=0.001) and served meals family-style (P<0.0001) more often, compared to CACFP and non-CACFP providers. HS providers (P=0.002), parents (P=0.001) and children (P=0.01) received more nutrition education opportunities compared to CACFP and non-CACFP. HS providers encouraged more balance and variety of foods (P<0.05), offered healthier foods (P<0.05), modeled healthy eating (P<0.001), and taught children about nutrition (P<0.001) compared to CACFP and non-CACFP providers. Providers across all three contexts used significantly more non-internal than internal mealtime verbal comments (P<0.0001).
Regarding predictors of provider’s feeding practices; working in a HS center predicted teaching children about nutrition and modeling healthy eating; that may be attributed to the HS performance standards which require HS providers to practice healthful feeding. Providers who reported being concerned about children’s weight, responsible for feeding children and had an authoritarian feeding style were more likely to pressure children to eat, restrict intake, and control food intake to decrease or maintain children’s weight. Providers with non-White race, who were trying to lose weight, perceived nutrition as important in their own diet, and had greater number of nutrition training opportunities were more likely to use restrictive feeding practices. Findings suggest that individual and child care level factors, particularly provider race, education, training, feeding attitudes and styles and the child care context may influence providers’ feeding practices with young children.
A qualitative investigation of the motivators, barriers and facilitators for using family style meal service (FSMS) from the perspective of 18 child care providers revealed that HS and CACFP providers were motivated to use FSMS because it created pleasant mealtimes, opportunities to role model healthy eating, and healthful child development. CACFP and non-CACFP providers reported not using FSMS because it was resource intensive, messy, unhygienic, and seemed to violate CACFP policy. HS and CACFP providers recommended strategies to overcome these barriers. They suggested that FSMS becomes easier with practice and teaching children self-help skills during play time can avoid messes during mealtimes.
Possible reasons for an increased compliance of HS providers to the Academy’s benchmarks may be attributed to HS federal performance standards for child nutrition and increased nutrition training opportunities for HS staff. HS programs can serve as a model in implementing the Academy’s benchmarks. Considering the predictors of providers feeding practices identified by this study when developing interventions, may add to the efficacy of childhood obesity prevention programs. The present research offers new insights not only regarding providers’ barriers to FSMS, but also strategies from providers to help overcome these barriers and allow for effective implementation of FSMS in child care settings. Providers should be encouraged to adopt FSMS, because the long-term health consequences and learning opportunities of FSMS outweigh any barriers related to its practical implementation. By strengthening policies and training that are more aligned with the Academy’s benchmarks, child care providers can be in a unique position to prevent childhood obesity by instilling positive eating behaviors related to self-regulation of the preschool-aged children in their care.Item withdrawn by Laura Spradlin ([email protected]) on 2013-11-25T23:14:56Z
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