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This work presents an experimentally measured, implemented, openly-available programmable analog standard cell library in Skywater’s 130nm CMOS process. Programmability enables standard-cell components, eliminating the need for large number of device geometries required in classic analog design. This effort presents the methodology in developing these analog standard cell library and integrating synthesis with these cells.

The study of biorealistic neuron circuits has been limited by the efficiency of digital implementations. Efficient digital approaches generally use I&F variants, losing important neural properties for network computation. In contrast, accurate neuron ODEs tend to utilize computationally intensive operations, causing the overhead to become prohibitive for large spiking neural network applications. This effort presents efficient digital approximations for coupled HH neurons derived from transistor-channel neural modeling. Neuron models are implemented in C using floating-point and 32-bit fixed-point arithmetic, and small networks are simulated using a fixed-step ODE solver. Our approach enables large network simulation of HH-like neurons, facilitating scalable digital modeling while also providing a direct path towards a framework for analog computation.

Background: Drain practices in minimally invasive retromuscular ventral hernia repairs have largely been transferred over from open surgery without significant review. We wished to evaluate the role of drains in these repairs. Methods: Using the Abdominal Wall Reconstruction Surgical Collaborative (AWRSC) registry, patients with ventral hernias who underwent enhanced-view totally extraperitoneal (eTEP) repairs between February 2016 and September 2019 were evaluated. Patients with contamination or active infection within the surgical field, those who underwent an emergent or hybrid repair, or received a concomitant procedure were excluded. Propensity score matching based on the defect size, previous hernia repair status, and the use of posterior component separation (PCS) was used to match patients with drains to patients without drains. We evaluated 180-day outcomes in terms of SSIs, SSOs, and recurrence. Results: 308 patients met the inclusion criteria. After propensity score matching, 48 patients with drains and 72 without drains were included in the analysis cohort. Those with drains were older with a greater likelihood of an incisional hernia, but were broadly similar for other relevant demographic and hernia-related variables. While there was no difference in the incidence of SSOs and SSIs between the two groups, we report a higher risk of SSOs needing procedural intervention (SSOPI) and recurrence, with a lengthened hospital stay in the cohort that received surgical drains. Conclusion: The use of surgical drains in “clean” eTEP repairs of ventral hernias appears to be common, with a selection bias for more complex cases. Based on our analysis, we found the use of drains was associated with longer hospital stays. The use of drains did not change the likelihood of suffering an SSI or SSO. However, the incidence of SSOPIs was higher despite the use of drains, which raises questions about their protective role in these repairs.

Background: Laparoscopy for ventral hernia repair is now an established technique with its proven benefits of less pain, early recovery, low-recurrence rate as compared to open repair. Several techniques have been described such as IPOM, MILOS, TES, EMILOS, SCOLA, e-TEP. e-TEP was originally conceptualized as an alternative approach to inguinal hernia in difficult cases (obese, previous scars) and for training surgery residents. Application of this approach for ventral hernia repair has recently been reported by few surgeons. We present our experience of e-TEP approach for ventral hernia from a tertiary care center in South India over one year duration. Materials and methods: Electronically maintained data of patients who underwent e-TEP for ventral hernia during a period of November 2017 to November 2018 was reviewed retrospectively. Their demographic data, intraoperative details, postoperative complications and follow up data for a period of 6 months was noted. Results: 171 patients underwent e-TEP approach ventral hernia repair. Mean age was 49.34 ± 10.75 years with hypertension being most common comorbidity. Mean BMI was 29.2 ± 4.1 kg/m2. Mean defect area was 51.35 ± 45.09 cm2and mean mesh size used was 397.56 ± 208.83 cm2. Fifty patients required TAR. Mean duration of surgery was 176.75 ± 62.42 min and blood loss was 78.7 ± 24.4 ml. Mean length of stay was 2.18 ± 1.27 days. Seven cases had paralytic ileus, 5 cases had surgical site infection, and 3 cases had recurrence at 6 months follow up. Conclusion: e-TEP is a minimally invasive approach which is safe, feasible and also avoids placement of mesh in peritoneal cavity. Since it is a relatively new approach it requires further studies for standardization of techniques, criteria for patient selection and to study long-term outcomes.

Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction is generally accepted as first line management for common bile duct (CBD) stones. CBD exploration, either by open or laparoscopic approach nowadays, is usually reserved for ERCP failures, complicated stone locations, along with altered anatomical situations. The aim of this study was to highlight the increasing role of laparoscopic choledochoduodenostomy which is not only a reliable but also as a rescue procedure for those failed ERCP cases due to complicated bile duct stones. It is a retrospective review of the database, from a tertiary care teaching institution from India, from Jan 2012 up to December 2016. Out of total 30 patients who underwent laparoscopic choledochoduodenostomy, 28 had failed ERC stone clearance while two patients were directly offered drainage in view of unfavorable anatomy. The major reasons for failed ERC stone clearance were as follows—multiple large calculi (42.8%), recurrent stones (21.4%), and associated stricture (21.4%). Mean operating time was 130 (± 27) minutes with mean blood loss of 60 (± 19) ml. Stone extraction was successful, primarily by milking in 13 (43.33%) patients, rest required augmentation by Dormia basket/balloon. Two patients (6.66%) developed controlled bile leak which resolved with conservative treatment. The median length of hospital stay was 5 days (IQR 3–9). Mean duration of follow-up was 17 (± 3.2) months. Laparoscopic common bile duct exploration with choledochoduodenostomy has been shown to be a safe, reliable, and efficient method for treating complex CBDS, especially after failed ERCP procedures.

Industrial or Trade effluent defines, in legal term, any liquid, gaseous or solid substance discharged from industry premises. The discharge of untreated effluents is injurious to public health besides to the life and health of animals or plants or of aquatic organisms. Effluent treatment involves mechanical, physical, chemical and biological processes; in majority of non-natural processes, mechanical equipment is used to breakdown the wastes into environmentally stable components, and their suitability depends on the type of the generated waste, process, efficiency of equipment used, etc. A few of these include – diffusers, fixed and floating aerators for injecting compressed air, Bio-discs which rotate on shafts for biological treatment, incinerators for burning solid wastes, cyclones and wet/dry Scrubbers for air treatment, Filter press, Centrifuge to remove water/moisture. Petrochemical product manufacturing activity is a highly polluting industry. The effect of mechanical equipments in such a petrochemical unit, manufacturing Phthalic Anhydride, Maleic Anhydride, Fumaric Acid and Maleic Acid, at Tamil Nadu has been studied and the performance of the equipment in the aeration components of the ETP system evaluated; the study concludes with suggestions for supplementary improvement.

Abstract: Background: Bariatric surgeries are now redefined as metabolic surgeries given the excellent resolution of metabolic derangements accompanying obesity. Duodenojejunal bypass (DJB) is a novel metabolic surgery based on foregut hypothesis. Reports describe DJB as a stand-alone procedure for the treatment of diabetes in nonobese subjects. For obese subjects, DJB is combined with sleeve gastrectomy. This combination of DJB and sleeve gastrectomy is proposed as an ideal alternative to Roux-en-Y gastric bypass (RYGB) with these advantages: (1) easy postoperative endoscopic surveillance, (2) preservation of the pyloric mechanism, which prevents dumping syndrome, and (3) reduced alimentary limb tension. This study aimed to analyze the short-term outcomes of laparoscopic DJB with sleeve gastrectomy for morbidly obese patients. Methods: At our institution, 38 patients who underwent laparoscopic DJB with sleeve gastrectomy were followed up. The inclusion criteria for the study were according to the Asian Pacific Bariatric Surgery Society guidelines. Sleeve gastrectomy was performed over a 36-Fr bougie, with the first part of the duodenum mobilized and transected. The jejunum was divided 50 cm distal to duodenojejunal flexure. A 75- to 150-cm alimentary limb was fashioned and brought in a retrocolic manner. End-to-end hand-sewn duodenojejunostomy was performed. Intestinal continuity was restored with a stapled jejunojejunostomy, and mesenteric rents were closed. Results: The study population consisted of 38 patients (15 men and 23 women) ranging in age from 31 to 48 years. During a mean follow-up period of 17 months, the excess body weight loss was 72%, with a 92% resolution of diabetes. One patient presented with internal herniation through the retrocolic window 1 month after the operation and was managed surgically without any complication. No other minor or major complications occurred, and there was no mortality. Conclusion: Laparoscopic DJB with sleeve gastrectomy is safe and effective in achieving durable weight loss and excellent resolution of comorbidities. Long-term follow-up studies are needed.

The present study aimed to assess the impact of municipal solid waste dumpsite on groundwater bodies at Hyderabad, India. Leachate and groundwater samples collected through pre- and post-monsoon analyzed the physicochemical, microbiological, biological and heavy metals. The analytical data were compared with Bureau of Indian Standards (BIS) drinking water quality standards. Water quality index (WQI), heavy metal pollution indices like heavy metal evaluation index (HEI) and degree of contamination (Cd) are calculated for groundwater samples. High total dissolve solids values in leachates revealed that they were highly contaminated with organic and inorganic salts. Biological oxygen demand values indicated that dumpsite was “old and stabilized” with decreasing biodegradability from time to time. According to WQI, about 75% of the water samples identified as “Poor” category that is not suitable for neither drinking nor domestic purposes as per BIS standards. Similarly, HEI and Cd results indicated that majority of the samples are labeled with low-metal pollution status. Spatial patterns obtained through geographic information systems using inverse distance weighted interpolation technique revealed that the concentrations of various parameters are high due to increased degradation of solid wastes during rainfall, especially during the post-monsoon. The study suggested that leachates have treated prior to disposal on land, and continuous monitoring of groundwater wells is required to minimize the pollution and potential health hazards.