Part II: an evaluation of an integrated systems approach using diffusion-weighted, image-guided, exoscopic-assisted, transulcal radial corridors

2015 ◽  
Vol 3 (1-2) ◽  
Author(s):  
Amin B. Kassam ◽  
Mohamed A. Labib ◽  
Mohammed Bafaquh ◽  
Diana Ghinda ◽  
Melanie B. Fukui ◽  
...  
Keyword(s):  
Systems Approach ◽  
Core Competencies ◽  
Image Interpretation ◽  
High Definition ◽  
Surgical Access ◽  
Sensorimotor Area ◽  
Dynamic Navigation ◽  
High Degree ◽  
Functional Morbidity

AbstractSubcortical injury resulting from the surgical access and management of lesions in the sensorimotor area is associated with a high degree of cognitive and functional morbidity.We used a systems approach integrating the six core competencies of the 6 Pillar approach: 1) image interpretation and trajectory planning; 2) dynamic navigation; 3) radial transulcal access and cannulation; 4) exoscopic high-definition optics; 5) resection with automated nonthermal mechanical instrumentation; and 6) regenerative medicine. We describe the application of the 6 Pillar approach to 13 consecutive patients with lesions in the sensorimotor area.Eight females and five males with lesions in the sensorimotor area were treated using the 6 Pillar approach. There were eight tumors, one abscess, and four primary intracranial hemorrhages. Fifteen procedures were performed. Postoperatively, seven patients improved neurologically (three tumors, one abscess, and three ICHs), five remained unchanged, and one patient died. There was no worsening of pre-existing deficits.The integration of the 6 Pillar approach provides a safe and effective parafascicular minimally invasive corridor to subcortical lesions involving the sensorimotor area. Future studies will be needed to determine long-term efficacy, durability, and degree of resection within each category.

Part I: The challenge of functional preservation: an integrated systems approach using diffusion-weighted, image-guided, exoscopic-assisted, transulcal radial corridors

2015 ◽  
Vol 3 (1-2) ◽  
Author(s):  
Amin B. Kassam ◽  
Mohamed A. Labib ◽  
Mohammed Bafaquh ◽  
Diana Ghinda ◽  
Joseph Mark ◽  
...  
Keyword(s):  
Systems Approach ◽  
Integrated Approach ◽  
Illustrative Case ◽  
Low Grade ◽  
Fiber Tracts ◽  
Surgical Access ◽  
Sensorimotor Region ◽  
Sensorimotor Area ◽  
White Matter Fiber Tracts ◽  
Functional Preservation

AbstractSurgical access to subcortical lesions in the sensorimotor area can lead to a high degree of cognitive and functional morbidity through injury to white matter fiber tracts. Inherent technological challenges limit resection of lesions in the sensorimotor area. A systematic and integrated approach to address these challenges termed the six-pillar approach has been developed. While individual elements of these pillars have been reported elsewhere, the authors hypothesize that the consistent adoption of standardized imaging, navigation, access, optics and resection technologies as a system identifies and protects eloquent tissue. In addition, this approach allows for the targeted harvest of viable cells to serve as the substrate for molecular regenerative therapy. An illustrative case with resection of a low-grade glioma in the sensorimotor region using the six-pillar approach is included to highlight the strengths of this approach.

Major Approaches to Assessing the Fiscal Sustainability of the Constituent Entities of the Russian Federation

2020 ◽  
Vol 26 (6) ◽  
pp. 577-583
Author(s):  
L. A. Tuaeva ◽  
I. Z. Toguzova ◽  
S. K. Tokaeva
Keyword(s):  
Russian Federation ◽  
Systems Approach ◽  
Fiscal Sustainability ◽  
Qualitative Assessment ◽  
Universal System ◽  
Russian Scientific ◽  
Analysis And Synthesis ◽  
The Russian Federation ◽  
State And Local

The presented study develops theoretical and methodological foundations for assessing the fiscal sustainability of the constituent entities of the Russian Federation in perspective.Aim. The study aims to develop a systems approach to assessing the fiscal sustainability of the constituent entities of the Russian Federation in the medium and long term.Tasks. The authors analyze the major approaches to assessing the fiscal sustainability of federal subjects and determine the significance of quantitative and qualitative assessment methods in the development of a methodology for assessing the fiscal sustainability of federal subjects in the medium and long term.Methods. This study uses scientific methods of cognition, analysis and synthesis, comparison and analogy, systems and institutional approaches to assess the fiscal sustainability of federal subjects.Results. The authors examine the major approaches to assessing the fiscal sustainability of federal subjects developed by Russian scientific schools and disciplines; approaches used by state and local authorities; approaches to assessing the fiscal sustainability of federal subjects used by international and national rating agencies; foreign experience. In general, this implies the development of a universal system of indicators for assessing the fiscal sustainability of federal subjects.Conclusions. It is substantiated that under the current conditions of new challenges, particularly in the context of the coronavirus pandemic, it is necessary to assess the long-term balance and sustainability of the budgets of federal subjects using a systems approach based on quantitative and qualitative methods, making allowance for the medium- and long-term prospects to make efficient management decisions at different levels of the economic system.

SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

2017 ◽  
Vol 63 (1) ◽  
pp. 146-152
Author(s):  
Mikhail Ter-ovanesov ◽  
Aleksandr Levitskiy ◽  
E. Lesnidze ◽  
Aram Gaboyan ◽  
Mariya Kukosh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Esophageal Reconstruction ◽  
Gastroesophageal Cancer ◽  
Colonic Interposition ◽  
Simultaneous Application ◽  
High Involvement ◽  
Surgical Access ◽  
Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

Hate Crime and Place: The Spatial and Temporal Concentration of Bias-Motivated Crime in Washington, D.C.

2021 ◽  
pp. 088626052098781
Author(s):  
Marin R. Wenger ◽  
Brendan Lantz
Keyword(s):  
Hate Crime ◽  
Hate Crimes ◽  
Temporal Perspective ◽  
Spatial Stability ◽  
Units Of Analysis ◽  
Crime Types ◽  
High Degree ◽  
Block Groups ◽  
Street Segments

Prior research suggests that many crime types are spatially concentrated and stable over time. Hate crime, however, is a unique crime type that is etiologically distinct from others. As such, examination of hate crime from a spatial and temporal perspective offers an opportunity to understand hate crime and the spatial concentration of crime more generally. The current study examines the spatial stability of hate crimes reported to the police in Washington, D.C., from 2012 through 2018 using street segments, intersections, and block groups as units of analysis. Findings reveal that hate crime is spatially concentrated, with less than 4% of street segments and intersections experiencing hate crime over the study period. Results reveal a high degree of spatial stability, both year-to-year and over the long term even when restricting the analysis to units that experienced at least one hate crime.

scholarly journals Influence of the Share of Renewable Energy Sources on the Level of Energy Security in EECCA Countries

Energies ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 903 ◽  
Author(s):  
Ivan Trifonov ◽  
Dmitry Trukhan ◽  
Yury Koshlich ◽  
Valeriy Prasolov ◽  
Beata Ślusarczyk
Keyword(s):  
Renewable Energy ◽  
Energy Security ◽  
Structural Characteristics ◽  
Renewable Energy Sources ◽  
Energy Resource ◽  
Energy Sources ◽  
Structural Content ◽  
High Degree

In this study we aimed to determine the extent to which changes in the share of renewable energy sources, their structural complex, and the level of energy security in Eastern Europe, Caucasus and Central Asia (EECCA) countries in the medium- and long-term are interconnected. The study was performed through modeling and determination of the structural characteristics of energy security in the countries. The methodology of the approach to modeling was based on solving the problem of nonlinear optimization by selecting a certain scenario. For the study, the data of EECCA countries were used. The ability of EECCA countries to benefit from long-term indirect and induced advantages of the transformation period depends on the extent to which their domestic supply chains facilitate the deployment of energy transformation and induced economic activity. This study provides an opportunity to assess the degree of influence of renewable energy sources on the level of energy security of countries in the context of energy resource diversification. The high degree of influence of renewable energy sources on energy security in the EECCA countries has been proven in the implementation of the developed scenarios for its increase. Energy security is growing. At the same time, its level depends not only on an increase in the share of renewable sources but also on the structure of energy resources complex of countries, and the development of various renewable energy sources. Therefore, today the EECCA countries are forced not only to increase the share of renewable energy sources but also to attach strategic importance to the structural content of their energy complex.

scholarly journals A Novel Highly Durable Carbon/Silver/Silver Chloride Composite Electrode for High-Definition Transcranial Direct Current Stimulation

Nanomaterials ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1962
Author(s):  
Lingjun Li ◽  
Guangli Li ◽  
Yuliang Cao ◽  
Yvonne Yanwen Duan
Keyword(s):  
Service Life ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Silver Chloride ◽  
Cycling Performance ◽  
High Definition ◽  
Silver Silver ◽  
Sintered Ag ◽  
Silver Silver Chloride

High-definition transcranial direct current stimulation (HD-tDCS) is a promising non-invasive neuromodulation technique, which has been widely used in the clinical intervention and treatment of neurological or psychiatric disorders. Sintered Ag/AgCl electrode has become a preferred candidate for HD-tDCS, but its service life is very short, especially for long-term anodal stimulation. To address this issue, a novel highly durable conductive carbon/silver/silver chloride composite (C/Ag/AgCl) electrode was fabricated by a facile cold rolling method. The important parameters were systematically optimized, including the conductive enhancer, the particle size of Ag powder, the C:Ag:PTFE ratio, the saline concentration, and the active substance loading. The CNT/Ag/AgCl-721 electrode demonstrated excellent specific capacity and cycling performance. Both constant current anodal polarization and simulated tDCS measurement demonstrated that the service life of the CNT/Ag/AgCl-721 electrodes was 15-16 times of that of sintered Ag/AgCl electrodes. The much longer service life can be attributed to the formation of the three-dimensional interpenetrating conductive network with CNT doping, which can maintain a good conductivity and cycling performance even if excessive non-conductive AgCl is accumulated on the surface during long-term anodal stimulation. Considering their low cost, long service life, and good skin tolerance, the proposed CNT/Ag/AgCl electrodes have shown promising application prospects in HD-tDCS, especially for daily life scenarios.

Development of a Performance-Related Framework for Asphalt Mixture Design for the Illinois Tollway

2021 ◽  
pp. 036119812110148
Author(s):  
Behnam Jahangiri ◽  
Punyaslok Rath ◽  
Hamed Majidifard ◽  
William G. Buttlar
Keyword(s):  
Asphalt Mixture ◽  
Field Performance ◽  
Compact Tension ◽  
T Test ◽  
Novel Approach ◽  
Final Adjustment ◽  
Development And Validation ◽  
High Degree ◽  
Selection Of

Various agencies have begun to research and introduce performance-related specifications (PRS) for the design of modern asphalt paving mixtures. The focus of most recent studies has been directed toward simplified cracking test development and evaluation. In some cases, development and validation of PRS has been performed, building on these new tests, often by comparison of test values to accelerated pavement test studies and/or to limited field data. This study describes the findings of a comprehensive research project conducted at Illinois Tollway, leading to a PRS for the design of mainline and shoulder asphalt mixtures. A novel approach was developed, involving the systematic establishment of specification requirements based on: 1) selection of baseline values based on minimally acceptable field performance thresholds; 2) elevation of thresholds to account for differences between short-term lab aging and expected long-term field aging; 3) further elevation of thresholds to account for variability in lab testing, plus variability in the testing of field cores; and 4) final adjustment and rounding of thresholds based on a consensus process. After a thorough evaluation of different candidate cracking tests in the course of the project, the Disk-shaped Compact Tension—DC(T)—test was chosen to be retained in the Illinois Tollway PRS and to be presented in this study for the design of crack-resistant mixtures. The DC(T) test was selected because of its high degree of correlation with field results and its excellent repeatability. Tailored Hamburg rut depth and stripping inflection point thresholds were also established for mainline and shoulder mixes.

China’s evolving humanitarian diplomacy: Evidence from China’s disaster-related aid to Nepal

2021 ◽  
pp. 205789112110192
Author(s):  
Peng Lin
Keyword(s):  
Humanitarian Assistance ◽  
Underdeveloped Countries ◽  
The Past ◽  
Belt And Road ◽  
High Degree ◽  
The Belt And Road ◽  
Post Disaster ◽  
Effective Channel ◽  
India And China

Engaging in disaster relief and, more recently, post-disaster reconstruction in developing countries with critical geoeconomic and geopolitical interests has become an increasingly regular and institutionalized component of China’s evolving humanitarian diplomacy over the past decade. Drawn upon novel evidence from China’s growing disaster-related humanitarian assistance to Nepal and unprecedented engagement in Nepal’s long-term post-earthquake rebuild since 2015, this article explores the dynamics behind China’s transforming humanitarian diplomacy. The findings of this article suggest that: 1) geopolitical and geoeconomic interests, represented by the Belt-and-Road Initiative, serve as a critical driver for the development of China’s bilateral partnership with other countries in the disaster sector; 2) long-term cooperation with underdeveloped countries like Nepal provides China, both government and non-state actors (NSAs), with an effective channel to engage with the international humanitarian community and to internalize humanitarian norms; 3) although humanitarian missions remain contingent and instrumental in China’s international relations, they are laying the foundations for a specialized humanitarian policy area with more relevant normative assets, more professional actors, and more sophisticated institutions; 4) NSAs, represented by private foundations and civil NGOs, have played active roles in the state-dominant cooperation in disaster management. This article also suggests that intensified geopolitical confrontations, such as military clashes between India and China along their disputed borders over the past year, would lead to a high degree of politicization of humanitarian missions and partnerships counter-conducive to humanitarian goals.

scholarly journals Calculating the True Costs of Food Service in Long-Term Care: Development of a Costing Methodology

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 88-88
Author(s):  
Mikaela Wheeler ◽  
Karen Abbey ◽  
Sandra Capra
Keyword(s):  
Long Term Care ◽  
Systems Approach ◽  
Food Service ◽  
Term Care ◽  
Oral Nutrition ◽  
Total Cost ◽  
Real Cost ◽  
Future System ◽  
Care Development

Abstract As population’s age and the need for long term care (LTC) increases, so too does the focus on the costs to provide that care. Providing food, oral nutrition supplements and meals, can be a considerable expense to a home. The objective of this research was to develop a valid foodservice costing tool (FCT), to calculate the real cost of providing foods and meals in LTC. Current costing methodologies are not specific to LTC and do not account for all costs of a foodservice, including staff, procurement and nutrition supplements. An initial tool was developed using the systems approach in conjunction with literature and professional knowledge. This was piloted in real world contexts, using volunteer LTC homes. Four iterations of the tool were completed to assess its feasibility in calculating costs and useability. Managers were interviewed after completing the tool to gather an understanding of how the tool was interpreted and to refine completion. Following feedback, the resulting tool consists of nine sections, measuring both costs incurred in meal production and service as well as analysis of staff workloads. Preliminary results show consistency between homes within Australia, indicating that the true cost is much higher than that reported in the literature to date. The development of a comprehensive, usable tool which captures the total cost of foodservice allows homes to accurately report and understand costs from a systems level. This information can be used to demonstrate cost effectiveness of a foodservice and the potential to justify and plan future system changes.

scholarly journals Microscale Heterogeneous Distribution and Speciation of Phosphorus in Soils Amended with Mineral Fertilizer and Cattle Manure Compost

Minerals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 121
Author(s):  
Noriko Yamaguchi ◽  
Toshiaki Ohkura ◽  
Atsuko Hikono ◽  
Yohey Hashimoto ◽  
Aomi Suda ◽  
...  
Keyword(s):  
Hot Spots ◽  
Mineral Fertilizer ◽  
Chemical Extraction ◽  
Heterogeneous Distribution ◽  
Edge Structure ◽  
Soil P ◽  
Macro Scale ◽  
Cattle Manure Compost ◽  
High Degree

Global concerns for the sustainability of agriculture have emphasized the need to reduce the use of mineral fertilizer. Although phosphorus (P) is accumulated in farmland soils due to the long-term application of fertilizer, most soil P is not readily available to plants. The chemical speciation of P in soils, which comprise heterogeneous microenvironments, cannot be evaluated with a high degree of specificity using only macroscopic analyses. In this study, we investigated the distribution and speciation of P accumulated in soils by using both macro- and microscopic techniques including chemical extraction, solution and solid-state 31P NMR, bulk- and micro- P K-edge X-ray absorption near edge structure (XANES), and electron probe microanalysis (EPMA). Soil samples were collected from a field in which cabbage was cultivated under three amendment treatments: i) mineral fertilizer (NPK), ii) mineral fertilizer and compost (NPK + compost), and iii) mineral fertilizer plus compost but without nitrogen fertilizer (PK + compost). Macro-scale analyses suggested that accumulated P was predominantly inorganic P and associated with Al-bearing minerals. The repeated application of compost to the soils increased the proportion of P associated with Ca which accounted for 17% in the NPK + compost plot and 40% in the PK + compost plot. At the microscale, hot spots of P were heterogeneously distributed, and P was associated with Fe and Ca in hot spots of the NPK + compost (pH 6) and PK + compost (pH 7) treated samples, respectively. Our results indicate that application of compost contributed to creating diverse microenvironments hosting P in these soils.

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