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There is a paucity of utility and cost data regarding the launch of 3D printing in a hospital. The objective of this project is to benchmark utility and costs for radiology-based in-hospital 3D printing of anatomic models in a single, adult academic hospital.All consecutive patients for whom 3D printed anatomic models were requested during the first year of operation were included. All 3D printing activities were documented by the 3D printing faculty and referring specialists. For patients who underwent a procedure informed by 3D printing, clinical utility was determined by the specialist who requested the model. A new metric for utility termed Anatomic Model Utility Points with range 0 (lowest utility) to 500 (highest utility) was derived from the specialist answers to Likert statements. Costs expressed in United States dollars were tallied from all 3D printing human resources and overhead. Total costs, focused costs, and outsourced costs were estimated. The specialist estimated the procedure room time saved from the 3D printed model. The time saved was converted to dollars using hospital procedure room costs.The 78 patients referred for 3D printed anatomic models included 11 clinical indications. For the 68 patients who had a procedure, the anatomic model utility points had an overall mean (SD) of 312 (57) per patient (range, 200-450 points). The total operation cost was $213,450. The total cost, focused costs, and outsourced costs were $2,737, $2,180, and $2,467 per model, respectively. Estimated procedure time saved had a mean (SD) of 29.9 (12.1) min (range, 0-60 min). The hospital procedure room cost per minute was $97 (theoretical $2,900 per patient saved with model).Utility and cost benchmarks for anatomic models 3D printed in a hospital can inform health care budgets. Realizing pecuniary benefit from the procedure time saved requires future research.

Gastrointestinal tract (GIT) epithelial cells detect nutrients in the lumen via G-protein coupled receptors (GPRs) located in the gut epithelial cells especially in enteroendocrine cells. Dietary free fatty acids (FFA) are the major energy source and also acts as signalling molecules for FFA receptors. Long chain fatty acids (LCFA) activate LCFA receptors, GPR40/FFAR1 and GPR120/FFAR4 which trigger intracellular signalling and release gut hormones or modifies gene expression that facilitate fat digestion and absorption. However, there is a paucity of information on chemosensing of nutrients and digestion in ruminants. Hence, present study was aimed to evaluate chemosensing of fat digestion and absorption by the expression pattern of GPR40, GPR120, chylomicron forming genes, fatty acid translocase (CD36/FAT), microsomal triglyceride transfer protein (MTTP) and apolipoprotein B (APOB) in the various segments of GIT in sheep supplemented with calcium salts of long chain fatty acids (CSLCFAs) along with the secretory patterns of gut peptides cholecystokinin (CCK) and peptide tyrosine tyrosine (PYY). The study was carried out for a period 60 days with eighteen adult ewes of 8-12 months of age and they were divided into three groups with six animals each as group-I, group-II and group-III. All the experimental animals were stall fed with a basal diet and maintained as per animal husbandry standards. Group-II and group-III were supplemented additionally with 3% and 5% CSLCFAs, respectively on dry matter intake. The results from the study indicated that the supplementation of CSLCFAs upregulated (P 0.05) the relative mRNA expression of GPR40 and GPR120 in the various segments of GIT of sheep in correspondence to level of dietary fat. Abundance of mRNA expression of CD36, MTTP and APOB increased (P 0.05) in the GIT of sheep in accordance to quantity of LCFAs in the diet where these genes facilitate fatty acid uptake. Feeding of CSLCFAs enhanced (P 0.05) pre-feeding level of CCK from day 15 onwards, whereas, post-feeding CCK and PYY increased in all the experimental sheep. However, the increase was higher (P 0.05) in sheep supplemented with CSLCFAs by 10.80 ± 1.45% and 14.25 ± 1.17%, respectively in comparison to group-I. The comprehensive results of the study concluded that feeding of additional CSLCFAs upregulated the expression of GPR40, GPR120, CD36, and chemosensing of LCFAs by these genes triggered the signalling transduction that enhanced CCK and PYY levels to facilitate fat digestion and absorption in accordance with quantity of dietary fat. This was further evident from the significant upregulation of MTTP and APOB in the various segments of GIT supported the high content of dietary fat at cellular fat metabolism in the gut that regulates the fatty acid uptake.

Cluster bean (Cyamopsis tetragonoloba L. Taub.), commonly known as guar, is a member of the family Papilionaceae, cultivated in the Indian Sub-continent since time immemorial. It is a drought-hardy leguminous annual crop used variously for vegetables, forage and green manure. There is tremendous variability available in Indian cluster bean germplasm. Genetic resources with their enormous variability for different characters provide the base for the improvement of crop plants. Within genetic resources, genetic stocks are expected to play a major role in future crop improvement programmes. One promising unbranched, single-stemmed and flower determinate growth habit bearing accession IC-140784P1, developed through single plant selection at ICAR-NBPGR Regional Station Jodhpur starts flowering at 23 days after sowing and flowers 50% at 32 days after sowing. This accession does mature only 82 days after sowing. These accessions mature about 10-15 days early compared to normal existing improved cultivars, which take 90-95 days for maturity. Another accession IC 569315 has been characterized as leaf determinate (in which the stem terminates into the leaf) with alternate cluster-bearing habit. The majority of the cluster bean crop is grown under rainfed conditions in the drier parts of the country. Therefore, maturity is an important trait, especially for cluster bean.

When providers are forced to address the growing oral healthcare needs of an aging and sick population, full mouth extractions (FMEs) are often sought as a solution. The purpose of this observational study was to evaluate mortality rates, mortality timeline, and to identify associated risk factors.A single-center retrospective cohort study was conducted at the University of Cincinnati Medical Center. All patients who underwent FMEs at the Oral and Maxillofacial Surgery clinic from July 1, 2012 to December 31, 2019 due to caries or periodontal disease were included. Predictor variables recorded included a medical history, social history, and patient demographics. The main outcome variable was post-FME death, including the elapsed time from procedure to death. Deaths were identified using the National Death Index. Data were analyzed using simple descriptive statistics and Cox proportional hazard models. Deceased FME patients were compared to living FME patients to identify potential risk factors. Mortality risk index was derived from multivariable logistic regression.One thousand eight hundred twenty nine patients were included in the study. Nine hundred seventy six were female with a median age of 49 years (interquartile range 38-58). One thousand seven hundred nine were diagnosed with more than 1 comorbidity and 89% were on medicaid or medicare insurance. One hundred seventy patients (9.3%) were identified as deceased as of December 31, 2019. Of those who died, 87 patients were deceased within 2 years of the procedure and 147 within 5 years of the procedure. Statistically significant factors associated with mortality (P value.01) included age (hazards ratio [HR] 1.01, 95% confidence interval [CI] 1.01-1.03), ASA score3 (HR 3.12, 95% CI 2.2-4.42), nursing home residence (HR 2.66, 95% 1.67-4.28), hepatic disease (HR 1.81, 95% CI 1.18-2.78), and oncologic disease (HR 1.91, 95% 1.32-2.77).Approximately 1 in 10 patients died within 5 years of FME at our center. These patients may be medically and socially compromised. More research is needed to develop FME-specific mortality indices, which may serve useful for clinical decision-making and surgical palliative care.

Reinforcement learning is a well-proven and powerful algorithm for robotic arm manipulation. There are various applications of this in healthcare, such as instrument assisted surgery and other medical interventions where surgeons cannot find the target successfully. Reinforcement learning is an area of machine learning and artificial intelligence that studies how an agent should take actions in an environment so as to maximize its total expected reward over time. It does this by trying different ways through trial-and-error, hoping to be rewarded for the results it achieves. The focus of this paper is to use a deep reinforcement learning neural network to map the raw pixels from a camera to the robot arm control commands for object manipulation.

PurposeIndia is a rapidly urbanizing developing country with a population of 1.4 Billion. Indian governments have invested USD 50 Billion) in metro rail projects in 18 cities. Metro constructions are multi-stakeholder mega-projects and are prone to a variety of risks. The purpose of this paper is to analyze the risks involved in metro rail construction projects in a densely populated developing country for two types of systems and from two perspectives. Current literature lacks an understanding of similarities and differences in the risks involved in underground and elevated metro projects from clients' and contractors' perspectives, which the paper highlights.Design/methodology/approachA total of twenty-five risks were identified, categorized and assessed through experts' opinions about the impact and probability of occurrence of the risks through a questionnaire-based survey. The survey respondents included experts in metro rail construction from client and contractor sides. Paper uses a Fuzzy Inference System to calibrate risk magnitude from occurrence probability and impact.FindingsA notable difference was observed in the views of clients and contractors, except for certain common risks. Both stakeholders had different risk perceptions for the underground and elevated metro rail systems.Practical implicationsThis study contributes to the risk assessment for different types of metro systems. This research can help policymakers as well as consultants in prioritizing their risk management strategies in developing countries like India.Originality/valueHighlighting the critical aspects of risks in metro projects in a developing country, this paper also provides system-based and stakeholder-based comparative aspects of risk analysis.

Percentage of somatic variants based on 6 mutation types in Asian lung cancers.

Clinical and tissue information on 30 lung cancer patients (S1); Recurrent somatic variants based on presence of the same variant in the COSMIC database or presence of the same variant within the dataset (S2); Variants of the category 'three or more different variants with predicted functional impact within a gene' (S3); Somatic structural variations (S4); Summary of the sequencing statistics by Complete Genomics for 30 tumor/normal paired samples (S5); Validation of somatic variants by Ion Torrent or Sanger sequencing (S6); Validation of EGFR mutations by Sanger sequencing (S7).

Asian nonsmoking populations have a higher incidence of lung cancer compared with their European counterparts. There is a long-standing hypothesis that the increase of lung cancer in Asian never-smokers is due to environmental factors such as second-hand smoke. We analyzed whole-genome sequencing of 30 Asian lung cancers. Unsupervised clustering of mutational signatures separated the patients into two categories of either all the never-smokers or all the smokers or ex-smokers. In addition, nearly one third of the ex-smokers and smokers classified with the never-smoker–like cluster. The somatic variant profiles of Asian lung cancers were similar to that of European origin with G.C>T.A being predominant in smokers. We found EGFR and TP53 to be the most frequently mutated genes with mutations in 50% and 27% of individuals, respectively. Among the 16 never-smokers, 69% had an EGFR mutation compared with 29% of 14 smokers/ex-smokers. Asian never-smokers had lung cancer signatures distinct from the smoker signature and their mutation profiles were similar to European never-smokers. The profiles of Asian and European smokers are also similar. Taken together, these results suggested that the same mutational mechanisms underlie the etiology for both ethnic groups. Thus, the high incidence of lung cancer in Asian never-smokers seems unlikely to be due to second-hand smoke or other carcinogens that cause oxidative DNA damage, implying that routine EGFR testing is warranted in the Asian population regardless of smoking status. Cancer Res; 74(21); 6071–81. ©2014 AACR.

Legend for Supplementary Figures S1-S2.

The focus of the paper is the internal structure of the verbal spine. Our aim is to show, using data from Malayalam, how verbal structures can be built, allowing for a new understanding of verb alternations as well as the verbal spine. The paper provides a novel analysis of the various v/Voice features, and proposes the adjunction of a √AGENT to the functional heads v and Voice. The difference in the loci of adjunction of the √AGENT is shown to be directly correlated with the differences in the semantics of the verb with consequences for the argument structure, specifically, the external argument at Spec, VoiceP. This analysis not only unpacks the verbal spine to help build a uniform account of verb alternations, but also provides for a clear understanding of the complex past tense morphology in the language. The contextually driven allomorphy of the past tense is shown to be directly linked to the morphosyntactic features and the expression of the exponents at v/Voice. The paper also proposes that the feature specifications on the verbal spine are becoming synchronically opaque for a variety of reasons, and are often only indirectly recoverable via the past tense morphology.

Introduction Effective pain management in the immediate postoperative period is a crucial first step in the treatment of shoulder arthroplasty patients. Previous studies suggested that local infiltrative analgesia (LIA), specifically with Liposomal Bupivacaine (LB), is equivalent to interscalene nerve block (ISNB) for postoperative pain management. This prospective, randomized, double-blinded study seeks to measure the difference in efficacy between the 3 widely-used LIA cocktail formulations: Bupivacaine, LB, and Ropivacaine. Methods Between 2018 and 2019, 179 consecutive patients underwent reverse total shoulder arthroplasty for end-stage shoulder arthropathy. Patients were enrolled and randomized in a prospective, double-blind clinical trial to receive one of 3 LIA injections before skin incision and after skin closure: 0.25% Bupivacaine ±Epinephrine, 1.3% LB, or 0.5% Ropivacaine cocktail with Ketorolac. There were 67 patients excluded due to preoperative comorbidities or consent refusal. The eligible 112 patients were monitored for 24 hours after surgery. Mean age was 67.9 years (range: 40-90 years). The primary outcome measure was the mean preoperative Visual Analog Scale (VAS) pain score, mean postoperative VAS score during the 24-hour postoperative period, and change in mean VAS score. The secondary outcome measure was total Morphine Milligram Equivalents (MMEs) used, antiemetic use, and laxative use during the same period. Pre-hoc power analysis found a total sample size of 219 (73 per group) was estimated to detect a significant difference at 80% power and 0.05 Type I error rate. Results Use of Bupivacaine, LB, and Ropivacaine resulted in 1.2±2.9, 0.6±3.2, and 0.1±2.8 change in VAS scores, respectively (P=.32). Total postoperative MMEs used were 124.1±115.1, 116±84.5, and 105±96.7 milligrams, respectively (P=.71). There were no statistically significant differences amongst the 3 cocktails for postoperative pain relief or rate of antiemetic/laxatives used.There was a nonsignificant trend toward superior analgesic effect of Ropivacaine compared to Bupivacaine. Ad-hoc power analysis found that the estimated sample sizes required to detect a difference between the Ropivacaine and Bupivacaine treatment for change in VAS score and total MMEs use, were 321 and 1593 patients, respectively. Because of the non-clinically significant differences, continued patient enrollment was terminated. The cost of Bupivacaine was comparable to Ropivacaine ($13.43 and $21.95, respectively), whereas LB cost ($434.96) was 20-30 times higher. Conclusion There were no differences in clinical efficacy amongst Bupivacaine, LB, and Ropivacaine cocktails for perioperative pain management in shoulder arthroplasty. LB was not clinically advantageous compared to the other two medications and did not justify the increase in cost. Level of evidence Level I

Morphological modification in materials aids multi-channel electron access sites for easier electrolyte ion access for many electrochemical devices including energy storage devices. Controlled synthesis of such multichannel morphologies of metal oxides offers significant challenges. Herein, we report a template-assisted electrodeposition technique for the synthesis of Cu nanowires, which are transformed into either CuO nanotubes by controlled annealing or CuO hierarchical nanospikes using a simple hydroxyl ion impregnation technique and subsequent annealing. These materials are tested as electrodes in charge storage systems in 6 M KOH electrolyte in a three-electrode system; both electrodes have shown battery-type charge storage behaviour. Despite the chemical similarity between the two materials, the CuO nanospikes electrodes showed improved charge transport between electrode-electrolyte interface compared to the CuO nanotubes. With the cost-effectiveness, easy availability, and multi-channel morphology of CuO nanospikes along with the promising performance of the electrode in a three-electrode system, the present research offers future potential in developing low cost and high performing energy storage devices.

Hierarchically porous crystalline nanoporous aerogels of syndiotactic polystyrene (sPS) received much attention because of their unique nanoporous structures along with meso- and macroporosity. Dep...

The purpose of this study was to conduct a systematic review for understanding the availability and limitations of artificial intelligence (AI) approaches that could automatically identify and quantify computed tomography (CT) findings in traumatic brain injury (TBI).Systematic review, in accordance with PRISMA 2020 and SPIRIT-AI extension guidelines, with a search of 4 databases (Medline, Embase, IEEE Xplore, and Web of Science) was performed to find AI studies that automated the clinical tasks for identifying and quantifying CT findings of TBI-related abnormalities.A total of 531 unique publications were reviewed, which resulted in 66 articles that met our inclusion criteria. The following components for identification and quantification regarding TBI were covered and automated by existing AI studies: identification of TBI-related abnormalities; classification of intracranial hemorrhage types; slice-, pixel-, and voxel-level localization of hemorrhage; measurement of midline shift; and measurement of hematoma volume. Automated identification of obliterated basal cisterns was not investigated in the existing AI studies. Most of the AI algorithms were based on deep neural networks that were trained on 2- or 3-dimensional CT imaging datasets.We identified several important TBI-related CT findings that can be automatically identified and quantified with AI. A combination of these techniques may provide useful tools to enhance reproducibility of TBI identification and quantification by supporting radiologists and clinicians in their TBI assessments and reducing subjective human factors.

In this article, we present an analysis of the complexity of grammatical constraints and their impact on early language acquisition of inflectional morphemes in Malayalam. We use the natural speech production data of two monolingual children acquiring Malayalam between the ages 1;9–2;10 and 2;3–3;0 and three bilingual children acquiring Malayalam-English between the ages 1;9–2;8, 2;0–3;0 and 1;10–2;11 to recover the underlying grammatical constraints that govern the correct productions as well as errors across monolingual and bilingual contexts. We find rules that reference lexico-semantic properties to be particularly challenging to young children.

Artificial intelligence has become ubiquitous with modern technology. Digital transformations are occurring in every field including medicine, surgery, and education. Computers and computer programs are getting sophisticated to form neural networks globally. These algorithms allow for sophisticated and complex pattern recognitions and make accurate predictions. This allows for both accurate diagnosis and prognostication in medicine and opens opportunities for medical and surgical education. Oral and Maxillofacial surgeons and OMS education like all of the surgery are adapting well to the world of AI, incorporating machine learning into simulation, and attaching sensors to master surgeons to understand motion economy.

The US Health and Human Services Pain Management Best Practices Inter-Agency Task Force initiated a public–private partnership which led to the publication of its report in 2019. The report emphasized the need for individualized, multimodal, and multidisciplinary approaches to pain management that decrease the over-reliance on opioids, increase access to care, and promote widespread education on pain and substance use disorders. The Task Force specifically called on specialty organizations to work together to develop evidence-based guidelines. In response to this report’s recommendations, a consortium of 14 professional healthcare societies committed to a 2-year project to advance pain management for the surgical patient and improve opioid safety. The modified Delphi process included two rounds of electronic voting and culminated in a live virtual event in February 2021, during which seven common guiding principles were established for acute perioperative pain management. These principles should help to inform local action and future development of clinical practice recommendations.

Introduction Reverse total shoulder arthroplasty (RTSA) is reportedly an effective option in the treatment of glenohumeral arthritis and severe comminuted proximal humeral fractures. To date, RTSA failures and their subsequent revisions are significant issues that have not been well studied. In revision RTSA cases with severe proximal humeral bone loss (PHBL), there is increased risk of early failure [ 4 , 10 , 28 , 30 ]. In this series, the authors evaluate the short-term results of a novel custom-made, patient-specific Deltoid Lateralization Sleeve (DLS) with an adjustable humeral RTSA component for revision of failed arthroplasty with severe bone loss. Methods Patients treated with a custom, adjustable DLS system for revision RTSA between 2012 and 2019 at one institution were identified using medical health records and included in the study. Each patient had undergone multiple previously failed surgeries before the current salvage procedure was performed. Revision RTSAs with less than 5 centimeters (cm) of bone loss, precluding DLS use, were excluded. Data was retrospectively collected and included demographics, surgical history, amount of bone loss in centimeters, preoperative and postoperative range of motion (ROM), patient-reported outcome scores, and postoperative complications. Results From 2012 to 2019, fifteen patients with a mean PHBL of 8.3 cm (range 5-12.5cm) underwent revision RTSA with DLS. Median age was 66.0 years (range 25-81 years). Median clinical and radiographic follow-up was 30 months (range: 23-77 months). Median preoperative active anterior elevation (AE), active external rotation (ER), and active internal rotation (IR) improved from 10° to 120°, 0° to 35°, and 0° to 40°, respectively. Median Visual Analog Scale (VAS) pain score improved from 5 to 0, American Shoulder and Elbow Surgeons (ASES) score improved from 25 to 65, Simple Shoulder Test (SST) score improved from 0 to 46, and Single Assessment Numeric Evaluation (SANE) score improved from 20% to 68%. There were 9 (60%) complications, including 5 major complications requiring revision surgery (33.3%). One patient (6.7%) was lost to follow-up. Discussion/Conclusion Revision RTSA for excessive PHBL with severe tuberosity deficiency can be surgically challenging. Irrespective of the high complication rate, DLS use in patients with severe PHBL and severe tuberosity deficiency may provide favorable long-term glenohumeral reconstruction viability. Level of evidence Level IV

Introduction: Diabetes affects 88 million people in south-east Asia with a regional prevalence of8.8%, and of them, 77 million live in India. Diabetic Foot Disease is an important complication thataccounts for significant morbidity and mortality in a diabetic individual. Aim: This study wasconducted to study the presentation stage of diabetic foot disease during the pandemic period asseen at a tertiary care hospital in North Kerala. Methods: This was a retrospective cohort studycarried out on patients diagnosed with diabetic foot and admitted to the Department of Surgery of atertiary care hospital in North Kerala during the study period of 6months from July 2020 toDecember 2020. A sample size of 63 was calculated. Data were collected from the case records ofthe patients, and the stages of presentation, relevant blood investigations, culture reports,radiological imaging and arterial doppler ultrasound findings were noted. Results: In this study, atotal of 63 patients were included. Of the 63 patients, 51(80.9%) were males, and 12 (19.0%) werefemales with a male to female ratio of 4.25:1. The mean age of the patients was 57.74 years. In thisstudy, as per the Wagner-Meggitt Classification of diabetic foot, the most common stage ofpresentation of diabetic foot encountered was Grade III (42.9%) followed by Grade IV (28.6%),Grade II (19.0%) and Grade V (9.5%).Conclusion: This is in part may be due to financialconstraints of the patient's families due to lack of job, transportation difficulties, shortage ofmedicines, shutting down of small scale health care facilities and pharmacies, prolonged neglect ofwounds, discontinuing of regular medications and poor home wound care which in turn are due tothe frequent regional lockdowns as a result of the covid pandemic.

Promising strategies to stabilize gelatin or collagen include glutaraldehyde-based chemical cross-linking or dehydrothermal treatment at different temperatures (120-180 °C). However, these procedures require 24-48 h for complete cross-linking to occur. The present study aims to evaluate the role of wheat gluten on enhancing thermal cross-linking of silica-nanohydroxyapatite (nanoHA)-gelatin composite scaffolds within a shorter period (2 h). Changes in properties were evaluated by varying the ratio of gelatin and gluten in silica-nanoHA matrix (60 wt% ceramic: 40 wt% polymer). The results showed that the scaffolds cross-linked at 170 °C were stable in phosphate-buffered saline for 21 days. It was crystalline and porous in nature. However, the scaffolds with high weight percentage of wheat gluten were brittle, while those with low gluten degraded fast in vitro. The mesenchymal stem cells could adhere, proliferate and differentiate into osteogenic lineage on wheat gluten-containing scaffolds for 21 days (mainly medium concentration). The scaffold also supported new bone formation in critical-sized rat calvarial defect, showing its osteoconductive and osteointegrative nature. In short, this study showed the potential of wheat gluten on improving thermal cross-linking within a shorter period and its suitability to use as a biomimetic bone graft for bone tissue engineering.

To carry out a comprehensive critical appraisal of image-guided intensity-modulated proton therapy practice for craniospinal irradiation (CSI).An image-guided intensity-modulated proton therapy database of 45 consecutive paediatric patients with central nervous system embryonal malignancies treated between January 2019 and April 2022 were critically appraised for demography, diagnosis, treatment planning strategy and treatment delivery accuracy.Most patients (median age: 7.5 years; male:female ratio: 34:11) had medulloblastoma (56%), followed by recurrent ependymoma (19%), pinealoblastoma (5%), germ cell (5%) and others (15%). The dose to the planning target volume-craniospinal (PTV-CS; length 39.06-79.59 cm) varied from 21 to 35 GyRBE, whereas the combined median dose to craniospinal and boost was 54 GyRBE. In all patients, the 95% isodose line covered the cribriform plate completely and optic nerves mostly, with a median V95% of 100% and 82.96%, keeping Dmax to the lens3.9 GyRBE. In skeletally immature patients (88.38%), the anterior vertebral body was completely covered in 18.18% and underdosed in 70.15% of the cases, resulting in a median Dmean of 10.11 GyRBE to the oesophagus. Lateral spine coverage was maintained on the edges of the vertebral body in 52.2%, whereas it extended beyond in 48.8%. The median V98% for clinical target volumes and V95% for PTVs of the brain, spine and craniospinal were97%, with excellent conformity (0.89) and homogeneity (0.07) indices for PTV-CS. All neurological organs at risk received a median Dmax ranging from 36 to 44 GyRBE from the combined CSI and boost regimens. Analysis of patient-specific quality assurance results revealed that 545 (97.67%) planar dosage verification had gamma (3% at 3 mm) values95%. The online patient set-up verification showed translational and rotational deviation within 2 mm and 0.5° in 88-94% and 97% of the cases. Systematic and random error were within 0.90 mm and 1.71 mm in translation and 0.1° and 0.2° in rotation.A change in practice pattern was observed. The findings from our comprehensive critical appraisal add to the growing library of CSI practice and may serve as a reference for inter-institutional comparison.

Ternary nanocomposites synergistically combine the material characteristics of three materials, altering the desired charge storage properties such as electrical conductivity, redox states, and surface area. Therefore, to improve the energy synergistic of SnO

Significant knowledge gaps exist in the perioperative pain management of patients with a history of chronic pain, substance use disorder, and/or opioid tolerance as highlighted in the US Health and Human Services Pain Management Best Practices Inter-Agency Task Force 2019 report. The report emphasized the challenges of caring for these populations and the need for multidisciplinary care and a comprehensive approach. Such care requires stakeholder alignment across multiple specialties and care settings. With the intention of codifying this alignment into a reliable and efficient processes, a consortium of 15 professional healthcare societies was convened in a year-long modified Delphi consensus process and summit. This process produced seven guiding principles for the perioperative care of patients with chronic pain, substance use disorder, and/or preoperative opioid tolerance. These principles provide a framework and direction for future improvement in the optimization and care of ‘complex’ patients as they undergo surgical procedures.

This paper investigates the performance of neural networks in positioning an industrial robot manipulator based on image feedback. Visual servoing regulates the pose of the robot manipulat...