Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications
Flexible joint robot (FJR) manipulators can offer many attractive features over rigid manipulators, including light weight, safe operation, and high power efficiency. However, the tracking control of the FJR is challenging due to its inherent problems, such as underactuation, coupling, nonlinearities, uncertainties, and unknown external disturbances. In this article, a terminal sliding mode control (TSMC) is proposed for the FJR system to guarantee the finite-time convergence of the systems output, and to achieve the total robustness against the lumped disturbance and estimation error. By using two coordinate transformations, the FJR dynamics is turned into a canonical form. A cascaded finite-time sliding mode observer (CFTSMO) is construct
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Fetal growth restriction is a significant contributor to fetal morbidity and mortality. In addition, there are heightened maternal risks associated with surgical operations and their accompanying dangers. Monitoring fetal development is a crucial objective of prenatal care and effective methods for early diagnosis of Fetal growth restriction, allowing prompt management and timely intervention to improve the outcomes. Screening for Fetal growth restriction can be achieved via many modalities; it can be medical, biochemical, or radiological. Some recommended combining more than one for better outcomes. Currently, there is inconsistency about the best method of Fetal growth restriction screening. In this review, a comprehensive
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In many applications such as production, planning, the decision maker is important in optimizing an objective function that has fuzzy ratio two functions which can be handed using fuzzy fractional programming problem technique. A special class of optimization technique named fuzzy fractional programming problem is considered in this work when the coefficients of objective function are fuzzy. New ranking function is proposed and used to convert the data of the fuzzy fractional programming problem from fuzzy number to crisp number so that the shortcoming when treating the original fuzzy problem can be avoided. Here a novel ranking function approach of ordinary fuzzy numbers is adopted for ranking of triangular fuzzy numbers with simpler an
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The flexible joint robot (FJR) typically experiences parametric variations, nonlinearities, underactuation, noise propagation, and external disturbances which seriously degrade the FJR tracking. This article proposes an adaptive integral sliding mode controller (AISMC) based on a singular perturbation method and two state observers for the FJR to achieve high performance. First, the underactuated FJR is modeled into two simple second-order fast and slow subsystems by using Olfati transformation and singular perturbation method, which handles underactuation while reducing noise amplification. Then, the AISMC is proposed to effectively accomplish the desired tracking performance, in which the integral sliding surface is designed to reduce cha
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Leading edge serration is now a well-established and effective passive control device for the reduction of turbulence–leading edge interaction noise, and for the suppression of boundary layer separation at high angle of attack. It is envisaged that leading edge blowing could produce the same mechanisms as those produced by a serrated leading edge to enhance the aeroacoustics and aerodynamic performances of aerofoil. Aeroacoustically, injection of mass airflow from the leading edge (against the incoming turbulent flow) can be an effective mechanism to decrease the turbulence intensity, and/or alter the stagnation point. According to classical theory on the aerofoil leading edge noise, there is a potential for the leading edge blowi
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In this paper, three approximate methods namely the Bernoulli, the Bernstein, and the shifted Legendre polynomials operational matrices are presented to solve two important nonlinear ordinary differential equations that appeared in engineering and applied science. The Riccati and the Darcy-Brinkman-Forchheimer moment equations are solved and the approximate solutions are obtained. The methods are summarized by converting the nonlinear differential equations into a nonlinear system of algebraic equations that is solved using Mathematica®12. The efficiency of these methods was investigated by calculating the root mean square error (RMS) and the maximum error remainder (𝑀𝐸𝑅n) and it was found that the accuracy increases with increasi
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The research aims to reveal the impact of media policy in Iraqi media outlets on the level of objectivity in these outlets. A study from the communicators’ point of view where the researcher used a survey method on the communicators in media outlets to reveal the extent of media policies knowledge as well as the pressures exerted by this policy on communicators in media outlets. It also reveals the extent of their commitment to objectivity, neutrality in dealing with information and the way used to transfer it.
The research sample included (179) respondents from communicators in a range of Media outlets such as (Press, Radio, and Television), The researcher was careful with the diversity of the sample, and