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A comparison of financial and operational efficiency between smart and traditional insufflation for laparoscopic surgery: A granular analysis

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Laparoscopic, Endoscopic and Robotic Surgery 2023年第3期6卷 97-102页

作者： Aazad Abbas Imran Saleh Graeme Hoit Gurjovan Sahi Sam Park Jihad Abouali Cari Whyne jay toor Division of Orthopaedic Surgery University of Toronto149 College Street Room 508-ATorontoONM5T 1P5Canada Orthopaedic Biomechanics Lab Sunnybrook Research Institute2075 Bayview AvenueTorontoONCanada Department of Mechanical and Industrial Engineering University of Toronto5 King's College RoadTorontoONM5S 3G8Canada Faculty of Medicine University of Toronto1 King's College CircleTorontoONM5S 1A8Canada University of Toronto Orthopaedics Sports Medicine Women's College Hospital76 Grenville StTorontoONCanada Division of Orthopaedic Surgery Michael Garron Hospital825 Coxwell AvenueTorontoONM4C 3E7Canada Division of Orthopaedic Surgery Sunnybrook Health Science Centre2075 Bayview AvenueTorontoONCanada Department of Orthopaedic Surgery University of Manitoba820 Sherbrook StreetWinnipegMBCanada

Objective:Smart insufflation(SI)techniques relying on valve and membrane-free insufflation are increasing in *** considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes,there remains a paucity describing the financial impact of these *** purpose of this study was to determine the financial and efficiency impact of these devices on the operating room and inpatient wards of a ***:A discrete event simulation model representing a typical mid-sized North American hospital comparing SI to traditional insufflation(TI)was *** National Surgical Quality Improvement database from 2015 to 2019 was used to populate the model with data supplemented from the *** included length of stay(LOS),duration of surgery(DOS),annual procedure volume,profit,return on investment(ROI),and gross profit margin(GPM).From the literature review,DOS savings were 10e32 minutes/case,while LOS savings were 0e3 days/***:Implementation of an SI led to an increase in annual throughput of 42e346(4.4%e36.6%)cases for all procedures and 38 to 297(4.3%e33.3%)cases for complex *** was found to be decreased by 175e614(18.3%e64.2%)days for all procedures and 231 to 614(35.6%e77.9%)cases for complex procedures with the implementation of an ***,this resulted in an increase in net profit of$104,685 per *** ROI of SI over the TI device was>1000%,and the GPM for the TI was 90.0%,while the GPM for the SI was 71.7%.Conclusion:Despite the initial financial investment being greater,the implementation of SI offsets these expenses and yields significant financial *** study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analyses of technologies are essential to aid in sound healthcare procurement decision making.

关键词： Insufflation Airseal Surgical efficiency Financial impact

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Evolutionarily Stable Strategies in Quantum Hawk-Dove Game

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Chinese Physics Letters 2010年第5期27卷 12-15页

作者： Ahmad Nawaz A. H. toor National Centre for Physics Quaid-i-Azam University Campus Islamabad Pakistan Department of Physics Quaid-i-Azam University Islamabad 45320 Pakistan

We quantize the Hawk-Dove game by using the most general form of a pure initial state to investigate the existence of pure and mixed evolutionarily stable strategies （ESS）. An example is considered to draw a comparison between the classical and quantum version of the game. Our choice of the most general initial quantum state enables us to make the game symmetric or asymmetric. We show that for a particular set of game parameters where there exists only mixed ESS in the classical version of the game, quantization allows even a pure strategy to be an ESS for the symmetric game in addition to mixed ESS. On the other hand only pure strategy ESS can exist for the asymmetric quantum version of the Hawk-Dove game.

关键词： Dove game game pure

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Stability of Mixed Nash Equilibria in Symmetric Quantum Games

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Communications in Theoretical Physics 2004年第3X期42卷 335-338页

作者： A.Iqbal A.H.toor DepartmentofElectronics Quaid-i-AzamUniversityIslamabad45320Pakistan

In bimatrix games the Bishop-Cannings theorem of the classical evolutionary game theory does not permitpure evolutionarily stable strategies (ESSs) when a mixed ESS exists. We find the necessary form of two-qubit initialquantum states when a switch-over to a quantum version of the game also changes the evolutionary stability of a mixedsymmetric Nash equilibrium.

关键词：量子博弈论混合策略展开稳定性策略纳什平衡

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Changes in heavy metal contents in animal feeds and manures in an intensive animal production region of China

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Journal of Environmental Sciences 2013年第12期25卷 2435-2442页

作者： Hui Wang Yuanhua Dong Yunya Yang Gurpal S.toor Xumei Zhang Key Laboratory of Soil Environment and Pollution Remediation Institute of Soil ScienceChinese Academy of Sciences Soil and Water Quality Laboratory Gulf Coast Research and Education CenterUniversity of Florida Taicang Soil Management Station

The 360 feed and manure samples were collected from 150 animal farms in Jiangsu Province, China and analyzed for heavy metals. Concentrations of Zn and Cu in animal feeds were 15.9-2041.8 and undetected-392.1 mg/kg respectively, while Hg, As, Pb, Cd, and Cr in all feeds were below 10 mg/kg. Concentrations of Cu, Zn, and Cr in animal manures were 8.4-1726, 39.5-11379, and 1.0-1602 mg/kg respectively, while As, Cd, Hg, and Pb were 〈 10 mg/kg. The concentration of Cu, Zn, As and Cr in animal feed and manure were positively correlated （p 〈 0.001）, but the Cd, Hg, and Pb were not statistically correlated between the feed and the manure. Concentrations of Cu and Zn were highest in pig feed and manure, followed by poultry and dairy feeds and manures. During 1990- 2008, Cu, Zn, As, Cr, Cd contents increased by 771%, 410%, 420%, 220%, and 63% in pig manure, 212%, 95%, 200%, 791%, and -63% in dairy manure, and 181%, 197%, 1500%, 261, and 196% in poultry manure. Most of the increases occurred from 2002 to 2008, which reflects the extensive use of feed additives after 2002. In contrast, Pb and Hg in manures continuously decreased from 1990 to 2008. The results suggest that the heavy metal contents in animal manure have been greatly increased over 18 years and the contribution of manures to soil should be considered.

关键词： animal manures heavy metal change

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Sensitivity of Labile Soil Organic Carbon Pools to Long-Term Fertilizer, Straw and Manure Management in Rice-Wheat System

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Pedosphere 2015年第4期25卷 534-545页

作者： Dinesh K.BENBI Kiranvir BRAR Amardeep S.toor Shivani SHARMA Department of Soil Science Punjab Agricultural University

Labile soil organic carbon （SOC） pools, estimated through chemical fractionation techniques, are considered sensitive indicators of management-induced changes in quality and composition of soil organic matter. Although the impacts of organic manure and crop residue applications on C sequestration in rice-wheat system are fairly well documented, their influence on labile SOC pools is relatively less known. Impacts of organic manure, rice straw, and inorganic fertilizer nitrogen （N） applications on soil total organic carbon （TOC） and SOC pools including water-extractable organic C （WEOC）, hot water-soluble organic C （HWOC）, potassium permanganate- oxidizable organic C （KMnO4-C）, microbial biomass C （MBC）, mineralizable organic C （Cmin）, and the oxidizable fractions of decreasing oxidizability （easily-oxidizable, oxidizable, and weakly-oxidizable） were investigated in an ll-year field experiment under rice-wheat system. The field experiment included treatments of different combinations of farmyard manure, rice straw, and fertilizer N application rates, with C inputs estimated to be in the range from 23 to 127 Mg ha-1. After 11 years of experiment, WEOC, HWOC, and KMnO4-C were 0.32%-0.50%, 2.2%-3.3%, and 15.0%-20.6% of TOC, respectively. The easily-oxidizable, oxidizable, and weakly-oxidizable fractions were 43%-57%0, 22%-27%, and 10%-19% of TOC, respectively. The applications of farmyard manure and rice straw improved WEOC, HWOC, KMnO4-C, easily-oxidizable fraction, Cmin, and MBC, though the rates of change varied considerably from -14% to 145% and -1170 to 83% of TOC, respectively. At the C input levels between 29 and 78 Mg C ha-1 during the ll-year period, the greatest increase was observed in WEOC and the minimum in KMnO4-C. Water-extractable organic C exhibited a relatively greater sensitivity to management than TOC, suggesting that it may be used as a sensitive indicator of management-induced changes in soil organic matter under rice-wheat system. All the other la

关键词： metabolic quotient mineralizable C organic amendments oxidizable C soil microbial biomass soil organic matter water-soluble C

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Experimental Investigation of Performance Characteristics of PZT-5A with Application to Fault Diagnosis

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Structural Durability & Health Monitoring 2022年第4期16卷 307-321页

作者： Saqlain Abbas Zulkarnain Abbas Yanping Zhu Waqas Tariq toor Xiaotong Tu Department of Mechanical Engineering University of Engineering and Technology LahoreNarowal CampusNarowal51600Pakistan Institute of Vibration Shock and NoiseState Key Laboratory of Mechanical System and VibrationShanghai Jiao Tong UniversityShanghai200240China Department of Mechanical Engineering National Fertilizer Cooperation(NFC)Institute of Engineering and TechnologyMultan61000Pakistan Institute of Refrigeration and Cryogenics Shanghai Jiao Tong UniversityShanghai200240China Department of Electrical Engineering University of Engineering and Technology LahoreNarowal CampusNarowal51600Pakistan The School of Informatics Xiamen UniversityXiamen361005China

In the previous couple of decades,techniques to reap energy and empower low voltage electronic devices have received outstanding *** of the methods based on the piezoelectric effect to harvest the energy from ambient vibrations have been ***’s an absence of experiment-based investigation which incorporates the microstructure analysis and crystal morphology of those energy harvest home ***,the impact of variable mechanical and thermal load conditions has seldom been studied within the previous literature to utilize the effectiveness of those materials in several practical applications like structural health monitoring(SHM),*** the proposed research work,scanning electron microscope(SEM)and energy dispersive x-ray(EDX)analysis are performed to examine the inside crystal morphology of PZT-5A and ensure the quality of the piezoelectric ***,the performance of piezoelectric vibration-based energy harvester has been investigated in the second phase of current research work under the variable mechanical and thermal load conditions through a regular series of ***’s been found that the output voltage of piezoelectric sensors will increase by increasing the applied load,whereas a decreasing trend in output voltage is noticed by increasing the applied temperature,resistance and *** the third part,a measuring setup is developed in the laboratory to further investigate the effectiveness of PZT-5A in practical applications such as electromechanical impedance(EMI)based structural health monitoring under the controlled heating ***,this analysis not only evaluates the performance of PZT sensors under the variable operating conditions but also encourages developing a temperature compensation approach in EMI-based SHM.

关键词： Piezoelectric energy harvester crystal morphology scanning electron microscope structural health monitoring electromechanical impedance

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Mixed neuroendocrine-non-neuroendocrine neoplasms of the digestive system:A mini-review

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World Journal of Gastroenterology 2022年第19期28卷 2076-2087页

作者： Deepak toor Jonathan M Loree Zu-Hua Gao Gang Wang Chen Zhou Department of Pathology and Laboratory Medicine BC CancerVancouver V5Z 1H5Canada Department of Pathology and Laboratory Medicine University of British ColumbiaVancouver V5Z 1H5Canada Department of Medicine BC CancerVancouver V5Z 4E6Canada

Mixed neuroendocrine-non-neuroendocrine neoplasms(MiNENs)are rare mixed tumors containing both neuroendocrine(NE)and non-NE *** component must occupy at least 30%of the tumor volume by *** molecular evidence suggests MiNENs are clonal neoplasms and potentially harbor targetable mutations similar to conventional *** have been multiple changes in the nomenclature and classification of MiNENs which has created some confusion among pathologists on how to integrate the contributions of each component in a MiNEN,an issue which in turn has resulted in confusion in communication with front-line treating *** mini review summarizes our current understanding of MiNENs and outline diagnosis,prognosis,and management of these *** authors emphasize the importance of treating the most aggressive component of the tumor regardless of its percentage volume.

关键词： Mixed neuroendocrine non-neuroendocrine neoplasms Mixed adenoneuorendocrine carcinoma Mixed neuroendocrine neoplasms Neuroendocrine Non-neuroendocrine

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Xen45 Gel Stent implant: patient reported outcomes

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International Journal of Ophthalmology(English edition) 2019年第9期12卷 1503-1506页

作者： Faaiq Hassan Luke Thomas Middleton Thomson Gurpal toor Qusay Alfahad Department of Ophthalmology South Warwickshire NHS foundation trust

Our aim was to report quality of life(QOL) outcomes following Xen45 Gel Stent implantation surgery in patients suffering with primary open angle glaucoma(POAG). A retrospective analysis was performed on all patients who had Xen45 implantation surgery during a 2-year period(Jun, 2016-Apr, 2018). Of 52 consecutive patients were included with a total of 58 eyes being operated on. QOL was compared both pre-operatively and 6 weeks postoperatively using the GQL-15 questionnaire. There was an overall improvement in GQL-15 summary scores for our patient group. All item scores showed either no change or some degree of improvement. The Xen45 Gel Stent Implant is a promising new intervention which has shown improved QOL scores in our patient group. Further, higher power studies are now needed to compare the Xen45 to trabeculectomy(TE), which is currently the gold standard.

关键词： glaucoma minimally invasive glaucoma surgery Xen45 Gel Stent implant

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Genome tuning through HLA and KIR gene clusters impact susceptibility to dengue

Infectious Medicine

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Infectious Medicine 2023年第3期2卷 167-177页

作者： Neha Sharma Gaurav Sharma Uma Kanga Devinder toor Department of Biosciences School of Basic and Applied SciencesGalgotias UniversityGreater Noida 203201India Department of Translational and Regenerative Medicine Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Department of Transplant Immunology and Immunogenetics All India Institute of Medical SciencesNew Delhi 110029India Amity University Uttar Pradesh Amity Institute of Virology and ImmunologyAmity UniversityNoida 201301India

Dengue is amongst the most prevalent viral diseases which globally affects millions of individuals annually and renders billions at risk,particularly in tropical and sub-tropical *** estimated 100-400 mil-lion infections each year and reported 4.2 million active cases in 2019 *** infection is caused by arthropod-transmitted dengue virus which is known to have 5 serotypes(DENV1-5).Most of the cases show mild clinical symptoms;though others may develop severe forms viz;dengue hemorrhagic fever and dengue shock *** limited literature suggests the population-specific genetic influence on susceptibility and the clinical course of dengue;the genetic propensity of dengue is largely unknown in most *** this context,the human leukocyte antigen(HLA)system represents the most polymorphic region of the human genome and is crucial for the initiation of an appropriate immune *** most of the genome-wide association studies,the HLA complex is the most significantly linked genetic region with susceptibility or protection towards vari-ous infectious and noninfectious *** immunoglobulin-like receptors represent another highly variable system present on the surface of natural killer(NK)cells which regulate the activity of NK cells through inter-actions with their cognate HLA *** is conceivable that the interaction of HLA-Killer immunoglobulin-like receptors systems influences the host susceptibility towards dengue infection as well the disease *** we attempt to review these parameters in dengue infection and disease *** detailed investigations are warranted towards the identification of novel susceptibility markers and targeted therapeutic interventions.

关键词： DENV Human leukocyte antigen Killer immunoglobulin receptor Pathogenesis and genetic susceptibility

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TAK1 is essential for MAIT cell development and the differentiation of MA/T1 and MA/T17

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Cellular & Molecular Immunology 2023年第7期20卷 854-856页

作者： Rachel Krevh Jie Wang Bobby Zuniga Jugmohit toor Kalpana Subedi Li Zhou Qing-Sheng Mi Center for Cutaneous Biology and Immunology Research Department of DermatologyHenry Ford HealthDetroitMUSA Immunology Research Program Henry Ford Cancer InstituteHenry Ford HealthDetroitMIUSA Department of Internal Medicine Henry Ford HealthDetroitMIUSA Department of Medicine College of Human MedicineMichigan State UniversityEast LansingMI 48824USA

Mucosal-associated invariant T(MAIT)cells are unconventional T cells that have been conserved throughout mammalian evolution,displaying innate and effector-like qualities[1,2].MAIT cells express a semi-invariant T-cell receptor,which recognizes vitamin B metabolites produced by various bacteria and yeast organisms,presented on the restriction molecule major histocompatibility complex(MHC)-related protein-1(MR1)[3].In mice,MAIT cells undergo three developmental stages in the thymus,giving rise to two subsets,MAIT1 and MAIT17,which secrete IFN-and IL-17 to combat infections[4,5].

关键词： vitamin invariant giving

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