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Sample records for two-stage palatal repair

  1. One-stage (Warsaw) and two-stage (Oslo) repair of unilateral cleft lip and palate: Craniofacial outcomes.

    Science.gov (United States)

    Fudalej, Piotr Stanislaw; Wegrodzka, Ewa; Semb, Gunvor; Hortis-Dzierzbicka, Maria

    2015-09-01

    The aim of this study was to compare facial development in subjects with complete unilateral cleft lip and palate (CUCLP) treated with two different surgical protocols. Lateral cephalometric radiographs of 61 patients (42 boys, 19 girls; mean age, 10.9 years; SD, 1) treated consecutively in Warsaw with one-stage repair and 61 age-matched and sex-matched patients treated in Oslo with two-stage surgery were selected to evaluate craniofacial morphology. On each radiograph 13 angular and two ratio variables were measured in order to describe hard and soft tissues of the facial region. The analysis showed that differences between the groups were limited to hard tissues – the maxillary prominence in subjects from the Warsaw group was decreased by almost 4° in comparison with the Oslo group (sella-nasion-A-point (SNA) = 75.3° and 79.1°, respectively) and maxillo-mandibular morphology was less favorable in the Warsaw group than the Oslo group (ANB angle = 0.8° and 2.8°, respectively). The soft tissue contour was comparable in both groups. In conclusion, inter-group differences suggest a more favorable outcome in the Oslo group. However, the distinctiveness of facial morphology in background populations (ie, in Poles and Norwegians) could have contributed to the observed results. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair.

    Science.gov (United States)

    Morén, Staffan; Mani, Maria; Lilian, Stålhammar; Lindestad, Per Åke; Holmström, Mats

    2017-11-01

      To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.   Cross-sectional study with long-term follow-up.   All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.   Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.   Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.   The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.

  3. Influence of timing of hard palate repair in a two-stage procedure on early language development in Danish children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

    2012-01-01

    Objective: to investigate the influence of timing of hard palate closure on early language development from 18 months to 3 years of age. Design: a prospective, randomized clinical trial. Participants: thirty-four children with UCLP with velum closure at 4 months of age, and hard palate closure...... language development in cleft palate children. Key words: cleft palate, phonological development, lexical development, surgical timing....... at 12 months (EarlyHPR (Early hard palate repair)) or 36 months (LateHPU (Late hard palate Unrepaired)) by random assignment. Thirty-five control children matched for gender and age. Methods: all children were video recorded during a play interaction with a parent at 18 months of age. These recordings...

  4. One-stage (Warsaw) and two-stage (Oslo) repair of unilateral cleft lip and palate: Craniofacial outcomes

    NARCIS (Netherlands)

    Fudalej, P.S.; Wegrodzka, E.; Semb, G.; Hortis-Dzierzbicka, M.

    2015-01-01

    The aim of this study was to compare facial development in subjects with complete unilateral cleft lip and palate (CUCLP) treated with two different surgical protocols. Lateral cephalometric radiographs of 61 patients (42 boys, 19 girls; mean age, 10.9 years; SD, 1) treated consecutively in Warsaw

  5. Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

    Directory of Open Access Journals (Sweden)

    Simona Stoicescu

    2013-12-01

    Full Text Available Introduction: Although cleft lip and palate (CLP is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66% and twenty-seven (34% patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery

  6. Hypospadias repair: Byar's two stage operation revisited.

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    Arshad, A R

    2005-06-01

    Hypospadias is a congenital deformity characterised by an abnormally located urethral opening, that could occur anywhere proximal to its normal location on the ventral surface of glans penis to the perineum. Many operations had been described for the management of this deformity. One hundred and fifteen patients with hypospadias were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur, Malaysia between September 1987 and December 2002, of which 100 had Byar's procedure performed on them. The age of the patients ranged from neonates to 26 years old. Sixty-seven patients had penoscrotal (58%), 20 had proximal penile (18%), 13 had distal penile (11%) and 15 had subcoronal hypospadias (13%). Operations performed were Byar's two-staged (100), Bracka's two-staged (11), flip-flap (2) and MAGPI operation (2). The most common complication encountered following hypospadias surgery was urethral fistula at a rate of 18%. There is a higher incidence of proximal hypospadias in the Malaysian community. Byar's procedure is a very versatile technique and can be used for all types of hypospadias. Fistula rate is 18% in this series.

  7. Cleft lip and palate repair

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002979.htm Cleft lip and palate repair To use the sharing features on this ... Cheiloplasty; Cleft rhinoplasty; Palatoplasty; Tip rhinoplasty Patient Instructions Cleft lip and palate repair - discharge Images Cleft lip repair - series References ...

  8. Influence of different palate repair protocols on facial growth in unilateral complete cleft lip and palate.

    Science.gov (United States)

    Xu, Xue; Kwon, Hyuk-Jae; Shi, Bing; Zheng, Qian; Yin, Heng; Li, Chenghao

    2015-01-01

    To address the question of whether one- or two-stage palatal treatment protocol has fewer detrimental effects on craniofacial growth in patients aged 5 years with unilateral complete cleft lip and palate. Forty patients with non-syndromic unilateral complete cleft lip and palate (UCCLPs) who had received primary cleft lip repair at age 6-12 months and cleft palate repair at age 18-30 months were selected in this study. Eighteen UCCLP patients who received two-stage palate repair were selected as group 1, and 22 UCCLP patients who received one-stage palate repair were selected as group 2. The control group consisted of 20 patients with unilateral incomplete cleft lip (UICL patients) whose age and gender matched with UCCLP patients. A one-sample Kolmogorov-Smirnov test was used to analyze the nature of data distribution. Bonferroni test and Kruskal-Wallis H tests were used for multiple comparisons. Both case groups showed reduced maxillary sagittal length (ANS-PMP, A-PM, p palate repair had a reduced posterior maxillary vertical height (R-PMP, p palate repair. Vomer flap repair inhibited maxilla vertical growth. Delayed hard palate repair showed less detrimental effects on maxillary growth compared to early hard palate repair in UCCLP patients aged 5 years. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Two-stage palatoplasty, is it still a valuable treatment protocol for patients with a cleft of lip, alveolus, and palate?

    Science.gov (United States)

    Gundlach, Karsten K H; Bardach, Janusz; Filippow, Daniel; Stahl-de Castrillon, Franka; Lenz, Jan-Hendrik

    2013-01-01

    Speech development is of utmost importance and requires early closure of a palatal cleft. On the other hand, it is well known that all types and timings of surgical repair of facial clefts are detrimental to maxillary growth. Nevertheless, these days one is more and more confronted with a world-wide tendency in favour of the one-in-all operation to close clefts of the lip, alveolus, and palate. Therefore, a three-centre study was performed for testing - once more - the value of two-stage palatoplasty as a means to reduce the detrimental effects of surgery on palatal growth and at the same time to also enable early speech development. Plaster casts from 85 patients have been re-evaluated. All of them had a complete unilateral cleft of lip, alveolus, and palate. They had been treated according to the old therapy protocols followed in either one of the three different cleft centres many years ago, namely in Hamburg, (Western) Germany, Iowa City, IO, USA, and Rostock, (in those days still Eastern) Germany. The impressions had been taken already in 1987 from patients being either 8 years (36 pts.) or 16 years of age (49 pts.). Three different treatment protocols had been followed for these patients in those centres in those days: The main difference was that in centres A and B the palates were closed in two stages whilst in centre C palatoplasty was performed in just one operation. The most interesting results regarding the palatal growth were that: 1. In centre C (one-stage palatoplasty) the patients had more constricted palates. 2. In centre A (two-stage palatoplasty) the patients had least often an anterior cross-bite. It appears that it was possible to show once more that closing the palate in one stage at age 1 year or less is interfering most with maxillary growth. This study leads us to conclude that two-stage palatoplasty is still a valuable treatment protocol for patients with a complete unilateral cleft of lip, alveolus, and palate, especially as apparently

  10. Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review.

    Science.gov (United States)

    Reddy, Rajgopal R; Gosla Reddy, Srinivas; Vaidhyanathan, Anitha; Bergé, Stefaan J; Kuijpers-Jagtman, Anne Marie

    2017-06-01

    The number of surgical procedures to repair a cleft palate may play a role in the outcome for maxillofacial growth and speech. The aim of this systematic review was to investigate the relationship between the number of surgical procedures performed to repair the cleft palate and maxillofacial growth, speech and fistula formation in non-syndromic patients with unilateral cleft lip and palate. An electronic search was performed in PubMed/old MEDLINE, the Cochrane Library, EMBASE, Scopus and CINAHL databases for publications between 1960 and December 2015. Publications before 1950-journals of plastic and maxillofacial surgery-were hand searched. Additional hand searches were performed on studies mentioned in the reference lists of relevant articles. Search terms included unilateral, cleft lip and/or palate and palatoplasty. Two reviewers assessed eligibility for inclusion, extracted data, applied quality indicators and graded level of evidence. Twenty-six studies met the inclusion criteria. All were retrospective and non-randomized comparisons of one- and two-stage palatoplasty. The methodological quality of most of the studies was graded moderate to low. The outcomes concerned the comparison of one- and two-stage palatoplasty with respect to growth of the mandible, maxilla and cranial base, and speech and fistula formation. Due to the lack of high-quality studies there is no conclusive evidence of a relationship between one- or two-stage palatoplasty and facial growth, speech and fistula formation in patients with unilateral cleft lip and palate. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Dental arch relationship outcomes in one- and two-stage palatoplasty for Japanese patients with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Mikoya, Tadashi; Shibukawa, Toyoko; Susami, Takafumi; Sato, Yoshiaki; Tengan, Toshimoto; Katashima, Hirotaka; Oyama, Akihiko; Matsuzawa, Yusuke; Ito, Yumi; Funayama, Emi

    2015-05-01

    To compare dental arch relationship outcomes following one- and two-stage palatal repair. Nonrandomized, clinical trial with concurrent control. Hokkaido University Hospital. Sixty-eight consecutively treated Japanese patients with complete unilateral cleft lip and palate. Thirty-one of the 68 patients underwent two-stage palatoplasty with delayed hard palate closure, and 37 patients underwent one-stage pushback palatoplasty. Dental casts were taken at 4.9 to 6.3 (mean: 5.2) years of age in the two-stage group and at 4.0 to 6.3 (mean: 5.1) years of age in the one-stage group, and dental arch relationships were assessed using the 5-Year-Olds' Index (5-Y) by four raters and the Huddart/Bodenham Index (HB) by two raters. Intrarater and interrater reliabilities evaluated using weighted kappa statistics were good or better for the 5-Y and HB ratings. The mean 5-Y score was 2.94 in the two-stage group and 3.13 in the one-stage group (P value was not significant). However, there was a significant difference in distributions between the groups (P < .05). The HB scores of molars were significantly greater in the two-stage group than in the one-stage group (P < .05). The rank correlation coefficients between the 5-Y and total HB score (ρ = -0.840, P < .01) and between the 5-Y and the score of the incisors in the HB (ρ = -0.814, P < .01) were significantly increased. These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.

  12. Lingual mucosal graft two-stage Bracka technique for redo hypospadias repair

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    Ahmed Sakr

    2017-09-01

    Conclusion: Lingual mucosa is a reliable and versatile graft material in the armamentarium of two-stage Bracka hypospadias repair with the merits of easy harvesting and minor donor-site complications.

  13. Influence of timing of two-stage palate closure on early phonological and lexical development in children with cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth

      BACKGROUND AND PURPOSE Numerous studies have indicated that early closure of the palatal cleft has a positive influence on the phonological development in children with cleft palate. So far, however, substantial evidence for this assumption has been lacking due to a variety of weaknesses...... of the studies conducted, including the lack of randomized clinical trials (RCT) (Peterson-Falzone 1996). A  prospective RCT was conducted to add to the knowledge of the influence of timing of hard palate closure on early phonological and lexical development from 1 to 3 years. METHODS Fourty-one children...... were video-recorded during a play interaction with a parent, and the video-recordings were transcribed in IPA. At 36 months, a naming test was administered. RESULTS At 18 months, the phonological development in the early group was more similar to that of the control group, than that of the late group...

  14. Rapid Two-stage Versus One-stage Surgical Repair of Interrupted Aortic Arch with Ventricular Septal Defect in Neonates

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    Meng-Lin Lee

    2008-11-01

    Conclusion: The outcome of rapid two-stage repair is comparable to that of one-stage repair. Rapid two-stage repair has the advantages of significantly shorter cardiopulmonary bypass duration and AXC time, and avoids deep hypothermic circulatory arrest. LVOTO remains an unresolved issue, and postoperative aortic arch restenosis can be dilated effectively by percutaneous balloon angioplasty.

  15. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

    Science.gov (United States)

    Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom FJMC; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-01-01

    Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence. PMID:28573094

  16. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

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    Isabelle Francisca Petronella Maria Kappen

    2017-05-01

    Full Text Available BackgroundNo consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP.MethodsThis was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.ResultsForty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years. Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001. In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry.ConclusionsThe present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  17. Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes.

    Science.gov (United States)

    Kappen, Isabelle Francisca Petronella Maria; Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom Fjmc; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

    2017-05-01

    No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (Pspeech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

  18. Strategies to Improve Regeneration of the Soft Palate Muscles After Cleft Palate Repair

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    Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne Marie; Wagener, Frank A.D.T.G.

    2012-01-01

    Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. These patients are unable to separate the nasal from the oral cavity leading to air loss during speech. Although surgical repair ameliorates soft palate function by joining the clefted muscles of the soft palate, optimal function is often not achieved. The regeneration of muscles in the soft palate after surgery is hampered because of (1) their low intrinsic regenerative capacity, (2) the muscle properties related to clefting, and (3) the development of fibrosis. Adjuvant strategies based on tissue engineering may improve the outcome after surgery by approaching these specific issues. Therefore, this review will discuss myogenesis in the noncleft and cleft palate, the characteristics of soft palate muscles, and the process of muscle regeneration. Finally, novel therapeutic strategies based on tissue engineering to improve soft palate function after surgical repair are presented. PMID:22697475

  19. [Cleft palate repair with a combined method of mucosal flap pushback of the hard palate].

    Science.gov (United States)

    Zhao, Z; Li, S; Xu, J

    1996-03-01

    From January of 1992, we applied a combined method to repair cleft palate in 20 patients and received satisfactory results. The method is characterized by pushing back the mucosal flap of the hard palate, a Z-plasty on the nasal mucosa, repositioning the levator muscle to lengthen the palate, circumferential pharyng oplasty using denervated extensor hallucis brevis muscle, without making relaxing incisions and elevating the mucoperiosteal flap, avoiding interference to the greater and lesser palatine vessels and nerves, without relaxing palatal aponeurosis. The advantages of this method are preserving the normal anatomy and function of the palate and nasopharyngeal cavity, improving the function of velopharyngeal closure and minimizing secondary deformities.

  20. Variations in Velopharyngeal Structure in Adults With Repaired Cleft Palate.

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    Perry, Jamie L; Kotlarek, Katelyn J; Sutton, Bradley P; Kuehn, David P; Jaskolka, Michael S; Fang, Xiangming; Point, Stuart W; Rauccio, Frank

    2018-01-01

    The purpose of this study was to examine differences in velopharyngeal structures between adults with repaired cleft palate and normal resonance and adults without cleft palate. Thirty-six English-speaking adults, including 6 adults (2 males and 4 females) with repaired cleft palate (M = 32.5 years of age, SD = 17.4 years) and 30 adults (15 males and 15 females) without cleft palate (M = 23.3 years of age, SD = 4.1 years), participated in the study. Fourteen velopharyngeal measures were obtained on magnetic resonance images and compared between groups (cleft and noncleft). After adjusting for body size and sex effects, there was a statistically significant difference between groups for 10 out of the 14 velopharyngeal measures. Compared to those without cleft palate, participants with repaired cleft palate had a significantly shorter hard palate height and length, shorter levator muscle length, shorter intravelar segment, more acute levator angles of origin, shorter and thinner velum, and greater pharyngeal depth. Although significant differences were evident in the cleft palate group, individuals displayed normal resonance. These findings suggest that a wide variability in velopharyngeal anatomy can occur in the presence of normal resonance, particularly for those with repaired cleft palate. Future research is needed to understand how anatomic variability impacts function, such as during speech.

  1. Extent of palatal lengthening after cleft palate repair as a contributing factor to the speech outcome.

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    Bae, Yong-Chan; Choi, Soo-Jong; Lee, Jae-Woo; Seo, Hyoung-Joon

    2015-03-01

    Operative techniques in performing cleft palate repair have gradually evolved to achieve better speech ability with its main focus on palatal lengthening and accurate approximation of the velar musculature. The authors doubted whether the extent of palatal lengthening would be directly proportional to the speech outcome. Patients with incomplete cleft palates who went into surgery before 18 months of age were intended for this study. Cases with associated syndromes, mental retardation, hearing loss, or presence of postoperative complications were excluded from the analysis. Palatal length was measured by the authors' devised method before and immediately after the cleft palate repair. Postoperative speech outcome was evaluated around 4 years by a definite pronunciation scoring system. Statistical analysis was carried out between the extent of palatal lengthening and the postoperative pronunciation score by Spearman correlation coefficient method. However, the authors could not find any significant correlation. Although the need for additional research on other variables affecting speech outcome is unequivocal, we carefully conclude that other intraoperative constituents such as accurate reapproximation of the velar musculature should be emphasized more in cleft palate repair rather than palatal lengthening itself.

  2. Spread and Control of Mobile Benign Worm Based on Two-Stage Repairing Mechanism

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    Meng Wang

    2014-01-01

    Full Text Available Both in traditional social network and in mobile network environment, the worm is a serious threat, and this threat is growing all the time. Mobile smartphones generally promote the development of mobile network. The traditional antivirus technologies have become powerless when facing mobile networks. The development of benign worms, especially active benign worms and passive benign worms, has become a new network security measure. In this paper, we focused on the spread of worm in mobile environment and proposed the benign worm control and repair mechanism. The control process of mobile benign worms is divided into two stages: the first stage is rapid repair control, which uses active benign worm to deal with malicious worm in the mobile network; when the network is relatively stable, it enters the second stage of postrepair and uses passive mode to optimize the environment for the purpose of controlling the mobile network. Considering whether the existence of benign worm, we simplified the model and analyzed the four situations. Finally, we use simulation to verify the model. This control mechanism for benign worm propagation is of guiding significance to control the network security.

  3. Perioperative adverse airway events in cleft lip and palate repair ...

    African Journals Online (AJOL)

    Background: Airway-related problems account for the majority of anaesthetic morbidity in paediatric anaesthesia, but more so for cleft lip and palate repair. The aim of this study was to assess the frequency, pattern, management and outcome of adverse airway events during the perioperative period in cleft lip and palate ...

  4. Economic Analysis of Cleft Palate Repair in International Adoptees.

    Science.gov (United States)

    Tomlinson-Hansen, Sandra; Paliga, J Thomas; Tahiri, Youssef; Paine, Kaitlyn M; Bartlett, Scott P; Taylor, Jesse A

    2016-09-01

    Retrospective cohort study. Major international tertiary care referral center for cleft palate repair. One hundred thirty-eight patients at the Children's Hospital of Philadelphia who had palate repair performed between 2010 and 2013, excluding syndromic patients, patients undergoing palate revision, and patients with incomplete payment information. None. Fees and charges for procedures. Surgeon payment was significantly higher for international adoptees (Δ = $2047.51 [$128.35 to $3966.66], P = .038). Medicaid-adjusted surgeon payments averaged $1006 more for adoptees ([-$394.19 to $2406.98], P = .158). Hospital and anesthesiology costs for adoptee palate repair were highly variable but did not differ significantly from those for nonadoptees. Partly due to payer mix, surgeon reimbursement was somewhat higher for international adoptees. No difference in total payment was found.

  5. Improving Informed Consent for Cleft Palate Repair

    Science.gov (United States)

    2017-03-07

    Cleft Palate; Jaw Abnormalities; Maxillofacial Abnormalities; Mouth Abnormalities; Congenital Abnormalities; Jaw Diseases; Musculoskeletal Diseases; Craniofacial Abnormalities; Musculoskeletal Abnormalities; Stomatognathic Diseases; Stomatognathic System Abnormalities

  6. Frequency of oronasal fistulae in complete cleft palate repair

    International Nuclear Information System (INIS)

    Aslam, M.

    2015-01-01

    To determine the frequency of oro-nasal fistula in patients undergoing complete cleft palate repair by two flappalatoplasty. Study Design: Case series. Place and Duration of Study: Department of Plastic Surgery, Services Hospital, Lahore, from January to December 2013. Methodology: Patients admitted to the study place for repair of cleft palate after informed consent obtained were included. Cleft palate was repaired by two-flap palatoplasty, using Bardach technique. Patients were discharged on the second postoperative day and followed-up at third week postoperatively. During follow-up visits, fistulae formation and their sites were recorded on pre-designed proforma. Results: Among the total 90 patients, 40 patients (44.4%) were male and 50 patients (55.6%) were female. The mean age was 6.4 +- 5.7 years ranging from 9 months to 20 years. At third week follow-up, 5 patients (5.6%) had fistulae formation. Four patients (80%) had anterior fistulae and one patient (20%) had posterior fistula. Conclusion: With two-flap palatoplasty Bardach procedure for repair of cleft palate, the complication of fistula formation was uncommon at 5.6%, provided the repair was tension free and multi-layered. (author)

  7. Cleft Palate Repair Using a Double Opposing Z-Plasty.

    Science.gov (United States)

    Moores, Craig; Shah, Ajul; Steinbacher, Derek M

    2016-07-01

    Cleft palate is a common congenital defect with several described surgical repairs. The most successful treatment modality remains a controversy. The goals of repair focus on achievement of normal speech and optimizing velopharyngeal function while minimizing both fistula formation and facial growth restriction. In this video, the authors demonstrate use of the double opposing Z-plasty technique in the repair of a Veau II type cleft palate. The video demonstrates the marking, incisions, dissection, and repair of the cleft. It also examines the use of von Langenbeck-type relaxing incisions and demonstrates a specific approach to the repair of this particular cleft. The authors believe that the Furlow double opposing Z-plasty with the von Langenbeck relaxing incision can provide the best postoperative outcome by combining the benefits of each individual operation. The Z-plasty technique works to correct the aberrant muscle of the soft palate while increasing the length of the palate. The authors believe that this results in better velopharyngeal function.

  8. Asymmetric Anterior Distraction for Transversely Distorted Maxilla and Midfacial Anteroposterior Deficiency in a Patient With Cleft Lip/Palate: Two-Stage Surgical Approach.

    Science.gov (United States)

    Hirata, Kae; Tanikawa, Chihiro; Aikawa, Tomonao; Ishihama, Kohji; Kogo, Mikihiko; Iida, Seiji; Yamashiro, Takashi

    2016-07-01

    The present report describes a male patient with a unilateral cleft lip and palate who presented with midfacial anteroposterior and transverse deficiency. Correction involved a two-stage surgical-orthodontic approach: asymmetric anterior distraction of the segmented maxilla followed by two-jaw surgery (LeFort I and bilateral sagittal splitting ramus osteotomies). The present case demonstrates that the asymmetric elongation of the maxilla with anterior distraction is an effective way to correct a transversely distorted alveolar form and midfacial anteroposterior deficiency. Furthermore, successful tooth movement was demonstrated in the new bone created by distraction.

  9. Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push-back method: preliminary results.

    Science.gov (United States)

    Kitagawa, Taiji; Kohara, Hiroshi; Sohmura, Taiji; Takahashi, Junzo; Tachimura, Takashi; Wada, Takeshi; Kogo, Mikihiko

    2004-09-01

    This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

  10. Long-term effects of palate repair on craniofacial morphology in patients with unilateral cleft lip and palate.

    Science.gov (United States)

    Liao, Yu-Fang; Mars, Michael

    2005-11-01

    To identify the long-term effects of palate repair on craniofacial growth in patients with unilateral cleft lip and palate (UCLP). Retrospective cross-sectional study. Sri Lankan Cleft Lip and Palate Project. Forty-eight adults with nonsyndromic unilateral cleft lip and palate, 29 men and 19 women, had lip repair only (LRO group). Fifty-eight adults with nonsyndromic unilateral cleft lip and palate, 35 men and 23 women, had lip and palate repairs by the age of 9 (LPR group). Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine craniofacial morphology. In the lip and palate repair group, the depth of the bony pharynx (Ba-PMP), the maxillary length at the alveolar level (PMP-A), the effective length of the maxilla (Ar-IZ, Ar-ANS, Ar-A), the maxillary protrusion (S-N-ANS, SNA), the anteroposterior jaw relation (ANS-N-Pog, ANB), and the overjet were smaller than in the lip repair only group. There were no significant differences in the maxillary length at the basal level (PMP-IZ, PMP-ANS) and the anterior and posterior maxillary heights (N-ANS and R-PMP, respectively) in the two groups. Palate repair inhibits the forward displacement of the basal maxilla and anteroposterior development of the maxillary dentoalveolus in patients with unilateral cleft lip and palate. Palate repair has no detrimental effects on the downward displacement of the basal maxilla or on palatal remodeling in patients with unilateral cleft lip and palate.

  11. Changes in maxillofacial morphology and velopharyngeal function with two-stage maxillary distraction-mandibular setback surgery in patients with cleft lip and palate.

    Science.gov (United States)

    Susami, T; Mori, Y; Ohkubo, K; Takahashi, M; Hirano, Y; Saijo, H; Takato, T

    2018-03-01

    Maxillary distraction is increasingly used for the correction of severe maxillary retrusion in patients with cleft lip and palate. However, control of the maxillary movement is difficult, and the need to wear visible distractors for a long period of time causes psychosocial problems. A two-stage surgical approach consisting of maxillary distraction and mandibular setback was developed to overcome these problems. In this study, changes in maxillofacial morphology and velopharyngeal function were examined in 22 patients with cleft lip and palate who underwent this two-stage approach. Lateral cephalograms taken just before the first surgery, immediately after the second surgery, and at completion of the active post-surgical orthodontic treatment were used to examine maxillofacial morphology. Velopharyngeal function was evaluated by speech therapists using a 4-point scale for hypernasality. The average forward movement of the maxilla with surgery at point A was 7.5mm, and the average mandibular setback at pogonion was 8.6mm. The average relapse rate during post-surgical orthodontic treatment was 25.2% for the maxilla and 11.2% for the mandible. After treatment, all patients had positive overjet, and skeletal relapse was covered by tooth movement during postoperative orthodontics. Velopharyngeal function was not changed by surgery. This method can shorten the period during which the distractors have to be worn and reduce the patient burden. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis.

    Science.gov (United States)

    Pollack, Daniel

    2018-01-01

    A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.

  13. Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair.

    Science.gov (United States)

    Luyten, Anke; D'haeseleer, Evelien; Budolfsen, Dorte; Hodges, Andrew; Galiwango, George; Vermeersch, Hubert; Van Lierde, Kristiane

    2013-01-01

    The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. One-stage vs two-stage cartilage repair: a current review

    Directory of Open Access Journals (Sweden)

    Daniel Meyerkort

    2010-10-01

    Full Text Available Daniel Meyerkort, David Wood, Ming-Hao ZhengCenter for Orthopaedic Research, School of Surgery and Pathology, University of Western Australia, Perth, AustraliaIntroduction: Articular cartilage has a poor capacity for regeneration if damaged. Various methods have been used to restore the articular surface, improve pain, function, and slow progression to osteoarthritis.Method: A PubMed review was performed on 18 March, 2010. Search terms included “autologous chondrocyte implantation (ACI” and “microfracture” or “mosaicplasty”. The aim of this review was to determine if 1-stage or 2-stage procedures for cartilage repair produced different functional outcomes.Results: The main procedures currently used are ACI and microfracture. Both first-generation ACI and microfracture result in clinical and functional improvement with no significant differences. A significant increase in functional outcome has been observed in second-generation procedures such as Hyalograft C, matrix-induced ACI, and ChondroCelect compared with microfracture. ACI results in a higher percentage of patients with clinical improvement than mosaicplasty; however, these results may take longer to achieve.Conclusion: Clinical and functional improvements have been demonstrated with ACI, microfracture, mosaicplasty, and synthetic cartilage constructs. Heterogeneous products and lack of good-quality randomized-control trials make product comparison difficult. Future developments involve scaffolds, gene therapy, growth factors, and stem cells to create a single-stage procedure that results in hyaline articular cartilage.Keywords: autologous chondrocyte implantation, microfracture, cartilage repair

  15. Important points for primary cleft palate repair for speech derived from speech outcome after three different types of palatoplasty.

    Science.gov (United States)

    Funayama, Emi; Yamamoto, Yuhei; Nishizawa, Noriko; Mikoya, Tadashi; Okamoto, Toru; Imai, Satoko; Murao, Naoki; Furukawa, Hiroshi; Hayashi, Toshihiko; Oyama, Akihiko

    2014-12-01

    This study was performed to investigate speech outcomes after three different types of palatoplasty for the same cleft type. The objective of this study was to investigate the surgical techniques that are essential for normal speech on the basis of each surgical characteristic. Thirty-eight consecutive nonsyndromic patients with unilateral complete cleft of the lip, alveolus, and palate were enrolled in this study. Speech outcomes, i.e., nasal emission, velopharyngeal insufficiency, and malarticulation after one-stage pushback (PB), one-stage modified Furlow (MF), or conventional two-stage MF palatoplasty, were evaluated at 4 (before intensive speech therapy) and 8 (after closure of oronasal fistula/unclosed hard palate) years of age. Velopharyngeal insufficiency at 4 (and 8) years of age was present in 5.9% (0.0%), 0.0% (0.0%), and 10.0% (10.0%) of patients who underwent one-stage PB, one-stage MF, or two-stage MF palatoplasty, respectively. No significant differences in velopharyngeal function were found among these three groups at 4 and 8 years of age. Malarticulation at 4 years of age was found in 35.3%, 10.0%, and 63.6% of patients who underwent one-stage PB, one-stage MF, and two-stage MF palatoplasty, respectively. Malarticulation at 4 years of age was significantly related to the presence of a fistula/unclosed hard palate (P<0.01). One-stage MF palatoplasty that was not associated with postoperative oronasal fistula (ONF) showed significantly better results than two-stage MF (P<0.01). Although the incidences of malarticulation at 8 years of age were decreased in each group compared to at 4 years of age, the incidence was still high in patients treated with two-stage MF (45.5%). On the whole, there was a significant correlation between ONF/unclosed hard palate at 4 years of age and malarticulation at 8 years of age (P<0.05). Appropriate muscle sling formation can compensate for a lack of retropositioning of the palate for adequate velopharyngeal closure

  16. The effects of palatal lengthening on the functional and speech outcomes after submucous cleft palate repair.

    Science.gov (United States)

    Ezzat, Abdelrahman E M; El-Begermy, Marwa M; Eid, Mustafa I; Akel, Mabrouk M

    2016-02-29

    This study was designed to compare intravelar veloplasty with and without V-Y pushback palatoplasty regarding postoperative functional and speech outcomes. is to find out the importance and influence of palatal lengthening on the functional and speech outcomes after SMCP repair. This is a prospective randomized comparative study of 20 patients divided into 2 equal groups. The study was conducted between February 2008 and January 2015. Radical Intravelar Veloplasty (RIVVP group): included 10 patients with a mean age of 5.539±1.335 years and V-Y Pushback Pharyngoplasty and Radical Intravelar Veloplasty (VYP+RIVVP group): included 10 patients with a mean age of 5.688±1.341 years for non-syndromic SMCP. Academic tertiary care medical centres. In both groups there was a significant change in Eustachian tube function, nasal emission and nasal tone of voice postoperatively than preoperatively, while there was no significant difference between both groups in the postoperative outcomes as regards the same parameters (ET function, nasal emission and resonance) (p=0.558, 0.563 and 0.164 respectively). However, there was a significant difference between both groups as regards palatal lengthening, no statistically significant difference was present between both groups as regards the postoperative mean pharyngeal gap, using videoendoscopic analysis. In conclusion, RIVVP and VYP+RIVVP are both effective methods to repair non-syndromic SMCP. Moreover, the lengthening of the palate in non-syndromic SMCP is an unnecessary process.

  17. Two-stage anatomical repair of “simple” transposition of great arteries in neonates with extracardiac perinatal complications

    Directory of Open Access Journals (Sweden)

    O. Yu. Kornoukhov

    2017-07-01

    Full Text Available Aim. This study was designed to analyse the results of two-stage arterial switch operation (ASO of “simple” transposition of great arteries in patients with infection, neurological problems or necrotizing enterocolitis, which preclude neonatal surgery. Methods. Transthoracic echocardiography data and outcomes of surgery were investigated in 19 patients (study group; #1 after two-stage ASO and 67 patients (control group; #2 after a single-stage ASO. Age of patients at the first stage was 27 (8–55 days and at the second stage 172 (92–256 days. Patients in group 2 were 7 (2–53 days old. All of them were followed up for 21 (4–49 months (group 1 and 40 (7–79 months (group 2 after arterial switch operation. Results. There was no operative mortality at both stages in group 1. The duration of ventilation, length of intensive care unit and hospital stay after surgery were considerably lower in group 1. Actuarial sur-vival and freedom from reoperation at 4 years in group 1 accounted for 100%, while in the con-trol group those indicators at 6 years ran to 98.5% and 94%, respectively. The only difference detected by echocardiography was the aortic valve hinge points Z-score (3.9±1.44 vs 3.1±1.27; p=0.025 and sinuses of Valsalva (3.8±1.41 vs 2.8±1.19; p=0.03, which were higher in the 1st group. There was no aortic regurgitation >1 grade in both groups. Conclusion. Two-stage repair of “simple” transposition of great arteries, when it’s necessary to delay arterial switch operation on the clinical grounds, can be performed with excellent clinical outcomes. The tendency of group 1 patients to have a larger neo-aortic root does not appear to bear any clinical significance in mid-term follow-up.Received 21 December 2016. Accepted 8 May 2017.Funding: The study had no sponsorship.Conflict of interest: The authors declare no conflict of interest. Author contributions Study concept and design: Kornoukhov O.Yu., Ilyin V.N.Data collection and

  18. Cleft Lip and Palate Repair Using a Surgical Microscope.

    Science.gov (United States)

    Kato, Motoi; Watanabe, Azusa; Watanabe, Shoji; Utsunomiya, Hiroki; Yokoyama, Takayuki; Ogishima, Shinya

    2017-11-01

    Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Surgical microscopy was demonstrated to be useful during cleft operations.

  19. One-Stage Cleft Lip and Palate Repair in an Older Population.

    Science.gov (United States)

    Guneren, Ethem; Canter, Halil Ibrahim; Yildiz, Kemalettin; Kayan, Resit Burak; Ozpur, Mustafa Aykut; Baygol, Emre Gonenc; Sagir, Haci Omer; Kuzu, Ismail Melih; Akman, Onur; Arslan, Serap

    2015-07-01

    In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients. A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique. The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents' and patients' expectations. The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors' experience.

  20. Nasalance Scores of Children with Repaired Cleft Palate Who Exhibit Normal Velopharyngeal Closure during Aerodynamic Testing

    Science.gov (United States)

    Zajac, David J.

    2013-01-01

    Purpose: To determine if children with repaired cleft palate and normal velopharyngeal (VP) closure as determined by aerodynamic testing exhibit greater acoustic nasalance than control children without cleft palate. Method: Pressure-flow procedures were used to identify 2 groups of children based on VP closure during the production of /p/ in the…

  1. Techniques and outcome of repair of cleft of the secondary palate at ...

    African Journals Online (AJOL)

    Background: The technique adopted in the repair of cleft of the secondary palate must not just be based on the choice of the surgeon but on several factors which include the width of the cleft, length of palate and age of the patient. The aim of the article was to document our 4-year experience of the techniques and outcome ...

  2. One-flap Palatoplasty: A Cohort Study to Evaluate a Technique for Unilateral Cleft Palate Repair

    Directory of Open Access Journals (Sweden)

    Percy Rossell-Perry, PhD, FACS

    2015-04-01

    Conclusions: Use of a 1-flap technique for unilateral cleft palate repair allowed us to achieve results comparable to those of a 2-flap technique in terms of postoperative fistula development and hypernasal speech. Additional studies are required to evaluate the effect of this technique on palatal growth.

  3. Cleft palate repair with the use of osmotic expanders: a preliminary report.

    Science.gov (United States)

    Kobus, Kazimierz F

    2007-01-01

    A new method of cleft palate repair by expansion of tissue by means of osmotic expanders implanted in the first stage of treatment is described. Self-expanding expanders manufactured by OSMED (Ilmenau, Germany) were implanted under the mucoperiosteal layer of the hard palate, on purpose to generate more tissue and provide facility for palate repair performed 24-48h later. Nineteen children aged from 2 to 3 years were operated from January 2004 to 15 April 2005. In clefts10mm, cleft palate repair was more difficult and the outcomes were less favourable. Despite more generous dissection of the neurovascular bundles and other adjunctive measures such as mucosal V-Y plasty [Bardach J, Salyer K. Surgical techniques in cleft lip and palate. Chicago, London: Year Book Medical Publishers, Inc.; 1987.] and suturing of the mucosal grafts at the border of the hard and soft palate, seven 2-4mm fistulae were noted, however. Concluding, in spite of some shortcomings and unacceptable rate of fistula in wide clefts, the above-presented method seems to be an attractive concept. Despite some technical problems related mostly to still tested optimal filling phase, tissue expansion makes palate repair easier, probably without relaxing incisions and bone denudation. Consequently, some adverse effects on facial growth may be reduced. So far, there is no evidence for it, however, and since this is a preliminary report, there is a need for longer observations and larger material.

  4. Barriers to Cleft Lip and Palate Repair Around the World.

    Science.gov (United States)

    Massenburg, Benjamin B; Jenny, Hillary E; Saluja, Saurabh; Meara, John G; Shrime, Mark G; Alonso, Nivaldo

    2016-10-01

    Cleft lip and/or palate (CLP) is estimated to occur in 1 out of every 700 births, but for many people residing in low- and middle-income countries this deformity may be repaired late in life or not at all. This study aims to analyze worldwide provider-perceived barriers to the surgical repair of CLP in low- and middle-income countries. From 2011 to 2014, Smile Train distributed a multiple-choice, voluntary survey to healthcare providers to identify areas of need in CLP care worldwide. Data on provider-reported barriers to care were aggregated by year, country, and larger world regions. A total of 1997 surveys were completed by surgeons and healthcare providers (60.7% response rate). The most commonly reported barriers were "patient travel costs" (60.7%), "lack of patient awareness" (54.1%), and "lack of financial support" (52.8%). "Patient travel costs" was the most commonly reported barrier in sub-Saharan Africa, the Middle East and North Africa, and South and Southeast Asia. "Lack of financial support" was the most commonly reported barrier in the Americas, Eastern Europe, and East Asia. This is the largest intercontinental study on healthcare provider-identified barriers to care, representing the limitations experienced by healthcare professionals in providing corrective surgery for CLP around the world. Financial risk protection from hidden costs, such as patient travel costs, is essential. Community health workers and nurses are critical for communication and linking CLP care to the rest of the community. Recognition of these barriers can inform future policy decisions, targeted by region, for surgical systems delivering care for patients with CLP worldwide.

  5. Speech and Speech-Related Quality of Life After Late Palate Repair: A Patient's Perspective.

    Science.gov (United States)

    Schönmeyr, Björn; Wendby, Lisa; Sharma, Mitali; Jacobson, Lia; Restrepo, Carolina; Campbell, Alex

    2015-07-01

    Many patients with cleft palate deformities worldwide receive treatment at a later age than is recommended for normal speech to develop. The outcomes after late palate repairs in terms of speech and quality of life (QOL) still remain largely unstudied. In the current study, questionnaires were used to assess the patients' perception of speech and QOL before and after primary palate repair. All of the patients were operated at a cleft center in northeast India and had a cleft palate with a normal lip or with a cleft lip that had been previously repaired. A total of 134 patients (7-35 years) were interviewed preoperatively and 46 patients (7-32 years) were assessed in the postoperative survey. The survey showed that scores based on the speech handicap index, concerning speech and speech-related QOL, did not improve postoperatively. In fact, the questionnaires indicated that the speech became more unpredictable (P reported that their self-confidence had improved after the operation. Thus, the majority of interviewed patients who underwent late primary palate repair were satisfied with the surgery. At the same time, speech and speech-related QOL did not improve according to the speech handicap index-based survey. Speech predictability may even become worse and nasal regurgitation may increase after late palate repair, according to these results.

  6. Speech outcomes of early palatal repair with or without intravelar veloplasty in children with complete unilateral cleft lip and palate.

    Science.gov (United States)

    Doucet, Jean-Charles; Herlin, Christian; Captier, Guillaume; Baylon, Hélène; Verdeil, Mélanie; Bigorre, Michèle

    2013-12-01

    We compared the early speech outcomes of 40 consecutive children with complete unilateral cleft lip and palate (UCLP) who had been treated according to different 2-stage protocols: the Malek protocol (soft palate closure without intravelar veloplasty at 3 months; lip and hard palate repair at 6 months) (n=20), and the Talmant protocol (cheilorhinoplasty and soft palate repair with intravelar veloplasty at 6 months; hard palate closure at 18 months) (n=20). We compared the speech assessments obtained at a mean (SD) age of 3.3 (0.35) years after treatment by the same surgeon. The main outcome measures evaluated were acquisition and intelligibility of speech, velopharyngeal insufficiency, and incidence of complications. A delay in speech articulation of one year or more was seen more often in patients treated by the Malek protocol (11/20) than in those treated according to the Talmant protocol (3/20, p=0.019). Good intelligibility was noted in 15/20 in the Talmant group compared with 6/20 in the Malek group (p=0.010). Assessment with an aerophonoscope showed that nasal air emission was most pronounced in patients in the Malek group (p=0.007). Velopharyngeal insufficiency was present in 11/20 in the Malek group, and in 3/20 in the Talmant group (p=0.019). No patients in the Talmant group had an oronasal fistula (ppalate, early speech outcomes were better in the Talmant group because intravelar veloplasty was successful and there were no fistulas after closure of the hard palate in 2 layers. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  7. Repair of large palatal fistula using tongue flap

    Directory of Open Access Journals (Sweden)

    Fejjal Nawfal

    2014-01-01

    Full Text Available Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap.

  8. Repair of large palatal fistula using tongue flap | Nawfal | African ...

    African Journals Online (AJOL)

    Large palatal fi stulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue fl ap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fi stula closure with anteriorly based tongue fl ap. Key words: Cleft surgery, ...

  9. Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

    Science.gov (United States)

    Chen, Qi; Li, Yang; Shi, Bing; Yin, Heng; Zheng, Guang-Ning; Zheng, Qian

    2013-12-01

    The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. A lining vomer flap for palate pushback in unilateral cleft palate repair.

    Science.gov (United States)

    Clavin, H D; Owsley, J Q

    1978-01-01

    A combinaation vomer mucoperiosteal flap and nasal floor mucoperiosteal flap is described which is used to achieve nasal coverage in unilateral cleft palate patients requiring pushbacks. A posteriorly based readily accessible vomer flap is raised on the cleft side and used as nasal lining for the palatal mucoperiosteal flap on the non-cleft side. On the cleft side, a symmetrically sized nasal floor flap is easily elevated under direct vision and used to cover the nasal aspect of the corresponding mucoperiosteal palatal flap.

  11. The Effects of Age at Cleft Palate Repair on Middle Ear Function and Hearing Level.

    Science.gov (United States)

    Lou, Qun; Zhu, Hongping; Luo, Yi; Zhou, Zhibo; Ma, Lian; Ma, Xiaoran; Fu, Yuan

    2018-05-01

    To investigate the age effects of cleft palate repair on middle ear function and hearing level in patients who underwent cleft palate repair at different ages by audiologic examination. Medical histories were gathered in detail, and audiologic tests (ie, tympanometry and pure tone hearing threshold) were conducted in 126 patients after palatoplasty. The patients were divided into the following 4 groups according to their ages when they underwent cleft palate repair: group I (0-3 years, 73 patients), group II (4-7 years, 29 patients), group III (8-11 years, 16 patients), and group IV (12 years and older, 8 patients). The data regarding tympanograms, hearing levels, and the average hearing thresholds of each group were analyzed using chi-square tests. The prevalence of middle ear dysfunction and hearing loss in the patients who underwent palatoplasty before 3 years old (27.4% and 2.0% respectively) was significantly lower than that in patients who underwent palatopalsty at 12 years or older (75.0% and 43.7%, respectively). Linear-by-linear association revealed that the prevalences of middle ear dysfunction and hearing loss among the 4 groups were significantly different ( P cleft palate repair. From an audiologist's perspective, palatoplasty at an early age is very beneficial in helping children with cleft palates acquire better middle ear function and hearing level.

  12. Current surgical practices in cleft care: cleft palate repair techniques and postoperative care.

    Science.gov (United States)

    Katzel, Evan B; Basile, Patrick; Koltz, Peter F; Marcus, Jeffrey R; Girotto, John A

    2009-09-01

    The purpose of this study was to objectively report practices commonly used in cleft palate repair in the United States. This study investigates current surgical techniques, postoperative care, and complication rates for cleft palate repair surgery. All 803 surgeon members of the American Cleft Palate-Craniofacial Association were sent online and/or paper surveys inquiring about their management of cleft palate patients. Three-hundred six surveys were received, a 38 percent response rate. This represented responses of surgeons from 100 percent of American Cleft Palate-Craniofacial Association registered cleft teams. Ninety-six percent of respondents perform a one-stage repair. Eighty-five percent of surgeons perform palate surgery when the patient is between 6 and 12 months of age. The most common one-stage repair techniques are the Bardach style (two flaps) with intravelar veloplasty and the Furlow palatoplasty. After surgery, 39 percent of surgeons discharge patients within 24 hours. Another 43 percent discharge patients within 48 hours. During postoperative management, 92 percent of respondents implement feeding restrictions. Eighty-five percent of physicians use arm restraints. Surgeons' self-reported complications rates are minimal: 54 percent report a fistula in less than 5 percent of cases. The reported need for secondary speech surgery varies widely. The majority of respondents repair clefts in one stage. The most frequently used repair techniques are the Furlow palatoplasty and the Bardach style with intravelar veloplasty. After surgery, the majority of surgeons discharge patients in 1 or 2 days, and nearly all surgeons implement feeding restrictions and the use of arm restraints. The varying feeding protocols are reviewed in this article.

  13. Perceptual Speech Assessment after Maxillary Advancement Osteotomy in Patients with a Repaired Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2012-05-01

    Full Text Available BackgroundMaxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients.MethodsEighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B.ResultsNo patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B.ConclusionsRepaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

  14. Perceptual speech assessment after maxillary advancement osteotomy in patients with a repaired cleft lip and palate.

    Science.gov (United States)

    Kim, Seok-Kwun; Kim, Ju-Chan; Moon, Ju-Bong; Lee, Keun-Cheol

    2012-05-01

    Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

  15. Unilateral cleft lip and palate: Simultaneous early repair of the nose, anterior palate and lip

    Science.gov (United States)

    Laberge, Louise Caouette

    2007-01-01

    Unilateral cleft lip and palate is a defect involving the lip, nose and maxilla. These structures are inter-related, and simultaneous early correction of all the aspects of the defect is necessary to obtain a satisfactory result that will be maintained with growth. The surgical technique combining various procedures is presented and compared with previously published reports. PMID:19554125

  16. Speech Analysis of Bengali Speaking Children with Repaired Cleft Lip & Palate

    Science.gov (United States)

    Chakrabarty, Madhushree; Kumar, Suman; Chatterjee, Indranil; Maheshwari, Neha

    2012-01-01

    The present study aims at analyzing speech samples of four Bengali speaking children with repaired cleft palates with a view to differentiate between the misarticulations arising out of a deficit in linguistic skills and structural or motoric limitations. Spontaneous speech samples were collected and subjected to a number of linguistic analyses…

  17. Post-operative outcomes after cleft palate repair in syndromic and non-syndromic children: a systematic review protocol.

    Science.gov (United States)

    Zhang, Zach; Stein, Michael; Mercer, Nigel; Malic, Claudia

    2017-03-09

    There is a lack of high-level evidence on the surgical management of cleft palate. An appreciation of the differences in the complication rates between different surgical techniques and timing of repair is essential in optimizing cleft palate management. A comprehensive electronic database search will be conducted on the complication rates associated with cleft palate repair using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Two independent reviewers with expertise in cleft pathology will screen all appropriate titles, abstracts, and full-text publications prior to deciding whether each meet the predetermined inclusion criteria. The study findings will be tabulated and summarized. The primary outcomes will be the rate of palatal fistula, the incidence and severity of velopharyngeal insufficiency, and the rate of maxillary hypoplasia with different techniques and also the timing of the repair. A meta-analysis will be conducted using a random effects model. The evidence behind the optimal surgical approach to cleft palate repair is minimal, with no gold standard technique identified to date for a certain type of cleft palate. It is essential to appreciate how the complication rates differ between each surgical technique and each time point of repair, in order to optimize the management of these patients. A more critical evaluation of the outcomes of different cleft palate repair methods may also provide insight into more effective surgical approaches for different types of cleft palates.

  18. Improving speech outcomes after failed palate repair: evaluating the safety and efficacy of conversion Furlow palatoplasty.

    Science.gov (United States)

    Nayar, Harry S; Cray, James J; MacIsaac, Zoe M; Argenta, Anne E; Ford, Matthew D; Fenton, Regina A; Losee, Joseph E; Grunwaldt, Lorelei J

    2014-03-01

    Velopharyngeal insufficiency occurs in a nontrivial number of cases following cleft palate repair. We hypothesize that a conversion Furlow palatoplasty allows for long-term correction of VPI resulting from a failed primary palate repair, obviating the need for pharyngoplasty and its attendant comorbidities. A retrospective review of patients undergoing a conversion Furlow palatoplasty between 2003 and 2010 was performed. Patients were grouped according to the type of preceding palatal repair. Velopharyngeal insufficiency was assessed using Pittsburgh Weighted Speech Scale (PWSS). Scores were recorded and compared preoperatively and postoperatively at 3 sequential visits. Sixty-two patients met inclusion criteria and were grouped by preceding repair (straight-line repair (n = 37), straight-line repair with subsequent oronasal fistula (n = 14), or pharyngeal flap (n = 11). Median PWSS scores at individual visits were as follows: preoperative = 11, first postoperative = 3 (mean, 114.0 ± 6.7 days), second postoperative = 1 (mean, 529.0 ± 29.1 days), and most recent postoperative = 3 (mean, 1368.6 ± 76.9 days). There was a significant difference between preoperative and postoperative PWSS scores in the entire cohort (P the exception of the second to the most recent visit. There were no differences between postoperative PWSS scores in the operative subgroupings (P > 0.05). Eight patients failed to improve and showed no differences in PWSS scores over time (P > 0.05). Patients with a PWSS score of 7 or greater (n = 8) at the first postoperative visit (0-6 months) displayed improvement at the most recent visit (Pspeech. Future studies should elucidate which factors predict the success of this technique following failed palate repair.

  19. Factors prognostic for phonetic development after cleft palate repair.

    Science.gov (United States)

    Lee, Joon Seok; Kim, Jae Bong; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

    2015-10-01

    Palatoplasty is aimed to achieve normal speech, improve food intake, and ensure successful maxillary growth. However, the velopharyngeal function is harder to control than other functions. Therefore, many studies on the prognostic factor of velopharyngeal insufficiency have been conducted. This study aimed to evaluate the relationships between speech outcomes and multimodality based on intraoral and preoperative three-dimensional computerized tomographic (CT) findings. Among 73 children with cleft palate who underwent palatoplasty between April 2011 and August 2014 at Kyungpook National University Hospital (KNUH), 27 were retrospectively evaluated. The 27 cases were non-syndromic, for which successful speech evaluation was conducted by a single speech-language pathologist (Table 1). Successful speech evaluation was defined as performing the test three times in 6-month intervals. Three intraoral parameters were measured before and immediately after operation (Fig. 1). On axial- and coronal-view preoperative facial CT, 5 and 2 different parameters were analyzed, respectively (Figs. 2 and 3). Regression analysis (SPSS IBM 22.0) was used in the statistical analysis. Two-flap palatoplasty and Furlow's double opposing Z-plasty were performed in 15 and 12 patients, respectively. The operation was performed 11 months after birth on average. Children with a higher palatal arch and wider maxillary tuberosity distance showed hypernasality (p palate width and height, rather than initial diagnosis, treatment method, or palate length. Therefore, a more active intervention is needed, such as orthopedic appliance, posterior pharyngeal wall augmentation, or early speech training. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. The Implications of Nasal Substitutions in the Early Phonology of Toddlers With Repaired Cleft Palate.

    Science.gov (United States)

    Hardin-Jones, Mary A; Chapman, Kathy L

    2018-01-01

    To examine the implications of nasal substitutions in the early words of toddlers with cleft palate. Retrospective. Thirty-four toddlers with nonsyndromic cleft palate and 20 noncleft toddlers, followed from ages 13 to 39 months. The groups were compared for the percentage of toddlers who produced nasal substitutions in their early words. The percentage of toddlers with repaired cleft palate who produced nasal substitutions and were later suspected of having velopharyngeal dysfunction (VPD) was also examined. Seventy-six percent of the toddlers in the cleft group (n = 26) and 35% of toddlers in the noncleft group (n = 7) produced nasal substitutions on one or more of their early words. Only 38% (10/26) of the toddlers with cleft palate who produced nasal substitutions in their early words were later diagnosed as having moderate-severe hypernasality and suspected VPD. The presence of nasal substitutions following palatal surgery was not always an early sign of VPD. These substitutions were present in the early lexicon of children with and without cleft palate.

  1. The impact of cleft lip and palate repair on maxillofacial growth.

    Science.gov (United States)

    Shi, Bing; Losee, Joseph E

    2015-03-23

    Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau's pushback palatoplasty and Langenbeck's palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.

  2. The impact of cleft lip and palate repair on maxillofacial growth

    Science.gov (United States)

    Shi, Bing; Losee, Joseph E

    2015-01-01

    Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau's pushback palatoplasty and Langenbeck's palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not. PMID:25394591

  3. Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair.

    Science.gov (United States)

    Abdel-Aziz, Mosaad; Khalifa, Badawy; Shawky, Ahmed; Rashed, Mohammed; Naguib, Nader; Abdel-Hameed, Asmaa

    2016-01-01

    Adenoid hypertrophy may play a role in velopharyngeal closure especially in patients with palatal abnormality; adenoidectomy may lead to velopharyngeal insufficiency and hyper nasal speech. Patients with cleft palate even after repair should not undergo adenoidectomy unless absolutely needed, and in such situations, conservative or partial adenoidectomy is performed to avoid the occurrence of velopharyngeal insufficiency. Trans-oral endoscopic adenoidectomy enables the surgeon to inspect the velopharyngeal valve during the procedure. The aim of this study was to assess the effect of transoral endoscopic partial adenoidectomy on the speech of children with repaired cleft palate. Twenty children with repaired cleft palate underwent transoral endoscopic partial adenoidectomy to relieve their airway obstruction. The procedure was completely visualized with the use of a 70° 4mm nasal endoscope; the upper part of the adenoid was removed using adenoid curette and St. Claire Thompson forceps, while the lower part was retained to maintain the velopharyngeal competence. Preoperative and postoperative evaluation of speech was performed, subjectively by auditory perceptual assessment, and objectively by nasometric assessment. Speech was not adversely affected after surgery. The difference between preoperative and postoperative auditory perceptual assessment and nasalance scores for nasal and oral sentences was insignificant (p=0.231, 0.442, 0.118 respectively). Transoral endoscopic partial adenoidectomy is a safe method; it does not worsen the speech of repaired cleft palate patients. It enables the surgeon to strictly inspect the velopharyngeal valve during the procedure with better determination of the adenoidal part that may contribute in velopharyngeal closure. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.

    Science.gov (United States)

    Friede, H; Lilja, J

    1994-06-01

    Dentofacial morphology was evaluated in 94 adolescent or early adult patients born with unilateral or bilateral cleft lip and palate. As well as lip closure, the primary treatment included vomer flap surgery and pushback palatal repair. Roentgencephalometric measurements as well as classification of the patients into different classes of dentofacial deformity indicated development of bimaxillary retrognathia with severe midfacial deficiency in about a quarter of the cases. Our results were similar to those reported by other teams who used similar surgical regimen.

  5. Repair of Primary Cleft Palate and Oronasal Fistula With Acellular Dermal Matrix: A Systematic Review and Surgeon Survey.

    Science.gov (United States)

    Simpson, Andrew; Samargandi, Osama A; Wong, Alison; Graham, M Elise; Bezuhly, Michael

    2018-01-01

    The current review and survey aim to assess the effectiveness of acellular dermal matrix (ADM) in the repair of cleft palate and oronasal fistula and to evaluate the current trends of ADM use in palate surgery. A systematic review of English articles was conducted using MEDLINE (1960 to July 1, 2016), the Cochrane Controlled Trials Register (1960 to July 1, 2016), and EMBASE (1991 to July 1, 2016). Additional studies were identified through a review of references cited in initially identified articles. Search terms included "cleft palate," "palatal," "oronasal fistula," "acellular dermal matrix," and "Alloderm®." An online survey was disseminated to members of the American Cleft Palate-Craniofacial Association to assess current trends in ADM use in palate surgery. All studies evaluating the outcome of primary palate repair or repair of oronasal fistula with the use of aceullar dermal matrix products were included in the review. Twelve studies met inclusion criteria for review. Studies were generally of low quality, as indicated by methodological index for non-randomized studies (MINORS) scores ranging from 7 to 14. The pooled estimate for fistula formation after primary palatoplasty following ADM use was 7.1%. The pooled estimate for recurrence of fistula after attempted repair using ADM was 11%. Thirty-six cleft surgeons responded to the online survey study. Of these, 45% used ADM in primary cleft palate repair, while 67% used ADM for repair of oronasal fistulae. Use of ADM products is commonplace in palate surgery. Despite this, there is a paucity of high-quality data demonstrating benefit. Further randomized controlled trials examining ADM in palate surgery are required to help develop structured guidelines and improve care.

  6. Use of autologous platelet-rich plasma in complete cleft palate repair.

    Science.gov (United States)

    El-Anwar, Mohammad Waheed; Nofal, Ahmed Abdel Fattah; Khalifa, Mohamed; Quriba, Amal Saeed

    2016-07-01

    Evaluate the effect of topical application of autologous platelet-rich plasma (PRP) in primary repair of complete cleft palate and then compare the result with another group of patients using the same surgical technique, without application of PRP with regard to the incidence of oronasal fistula, velopharyngeal closure, and grade of nasality. Case control study. This study was carried on 44 children with complete cleft palate with age range from 12 to 23 months. The children were divided into two age- and gender-matched groups: All children were subjected to the same technique of V-Y pushback repair of the complete cleft palate. In group A (22 children), the PRP prepared from the patient was topically applied between the nasal and oral mucosa layer during palatoplasty, whereas in group B (22 children) the PRP was not applied. All cases were recovered smoothly without problems. In group A, no oronasal fistula was reported, whereas in group B three patients (13.6%) had postoperative fistulae and two patients (9.1%) needed revision palatoplasty. At 6 months postoperative assessment, group A (with PRP application) showed significantly better grade of nasality (P = 0.024) and better endoscopic velopharyngeal closure (P = 0.016) than group B. Usage of autologous PRP in complete cleft palate repair is simple; effective; can decrease the incidence of oronasal fistula; and also significantly improves the grade of nasality and velopharyngeal closure, which decreases the need of further surgical intervention in cleft palate patients. 3b. Laryngoscope, 126:1524-1528, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Effect of cleft palate repair on the susceptibility to contraction-induced injury of single permeabilized muscle fibers from congenitally-clefted goat palates.

    Science.gov (United States)

    Despite cleft palate repair, velopharyngeal competence is not achieved in ~ 15% of patients, often necessitating secondary surgical correction. Velopharyngeal competence postrepair may require the conversion of levator veli palatini muscle fibers from injury-susceptible type 2 fibers to injury-resi...

  8. The need for orthognathic surgery in nonsyndromic patients with repaired isolated cleft palate.

    Science.gov (United States)

    Antonarakis, Gregory S; Watts, Guy; Daskalogiannakis, John

    2015-01-01

    To determine the frequency of need for orthognathic surgery among nonsyndromic patients with isolated cleft palate repaired during infancy at The Hospital for Sick Children in Toronto, Canada. Retrospective cohort study. PATIENTS with nonsyndromic isolated cleft palate born between 1970 and 1997 with available records including a lateral cephalometric radiograph taken at ≥15 years of age. PATIENTS who had undergone or were being prepared for orthognathic surgery were automatically counted as requiring surgery. For the remaining patients, lateral cephalometric radiographs were traced and analyzed. Arbitrarily set cephalometric criteria were used to identify the "objective" need for orthognathic surgery. Of the 189 patients identified with nonsyndromic isolated cleft palate and for whom records were available, 25 (13.2%) were deemed to require orthognathic surgery. Of the surgical cohort, 92% required surgical correction for a Class III malocclusion. Similar percentages of males and females required orthognathic surgery. An apparently greater proportion of patients of Asian background (18.5%) than of white background (10.6%) required surgery, but this difference was not significant (P = .205). The current results suggest that approximately one in eight patients at our institution with nonsyndromic isolated cleft palate requires orthognathic surgery. There is a tendency for this to be higher in patients of Asian descent and lower in patients of white descent. Variability in extent, severity, and phenotype of the cleft, which may be attributed largely to genetics, may play an important role in dictating the need for orthognathic surgery.

  9. Herpes simplex 1 stomatitis after cleft palate repair: a case report and guidelines for management.

    Science.gov (United States)

    Evangelista, Maristella S; Tracy, Lauren; Wells, James H

    2015-05-01

    Herpes simplex virus (HSV) primary infection and reactivation has been associated with the inflammation and transient decrease in immunocompetence after surgery and local trauma. In addition, HSV infection is known to impair wound healing, increase risk of scarring, and impede connective tissue graft transplantation. To our knowledge, this is the first case of HSV infection complicating cleft palate repair presented in literature. In this report, we present a case of primary HSV infection occurring in a healthy 26-month-old patient after repair of the secondary cleft palate with mucoperichondrial flaps and V-Y pushback. The patient developed high fever on postoperative day 1, which was followed by perioral vesicular lesions and multiple intraoral ulcerations involving the lips, palate, and posterior pharynx. Unknown to the surgeons, the patient was exposed to HSV before surgery by a sibling with orolabial HSV infection. The infective cause was ascertained via polymerase chain reaction for HSV-1 DNA, and the infection was treated with topical and intravenous acyclovir for 1 week. The patient recovered well with adequate flap healing, good aesthetic outcome, and no complications on 1-month follow-up. This report underscores the importance of prompt recognition of herpetic infections in the patient with craniofacial surgery and reviews the association and complications of HSV infection in surgical healing. Early identification with prompt antiviral therapy and meticulous wound care are essential to ameliorate the scarring and delayed wound healing associated with HSV infection.

  10. Assessing an avoidable and dispensable reoperative entity: Self-referred flawed cleft lip and palate repair.

    Science.gov (United States)

    Foroglou, Pericles; Tsimponis, Antonis; Goula, Olga-Christina; Demiri, Efterpi

    2015-01-01

    aesthetically improved outcome. Indications for surgery include widened scars, lip contour deformities, shortened lips, poorly defined and flattened nasal tip, short columella and irregularities of the nostrils (narrow or high-riding) and cartilages. Wound dehiscence, contractures, vermilion notching, white roll malalignment and orovestibular fistulas are possible unfavourable results after cleft lip repair. The psychological status of children and adults with repaired cleft lip and palate has been the subject of extensive research especially regarding the way of their evaluation facial appearance, satisfaction and need for secondary corrective surgical procedures in the hope of increasing their self-esteem and self-confidence. The aim of this study was to assess secondary CLP deformity management in an accredited present-day tertiary hospital facility with an existing infrastructure of a specialist teams however not formed in a multidisciplinary group. Equally, to answer questions of specific operation indications and choice as related to prior surgeries, hospitalization time and cost, provision of adequate preoperative information, correlation between paediatric and plastic surgeons and effect of post-plastic surgical care on patients' health and well-being. It also aims at presenting, beyond our current primary cleft lip and palate repair approach, appropriate indications and timing of secondary repair and achieved results.

  11. Comparison of the fistula risk associated with rotation palatoplasty and conventional palatoplasty for cleft palate repair.

    Science.gov (United States)

    Kahraman, Ahmet; Yuce, Serdar; Kocak, Omer Faruk; Canbaz, Yasin; Guner, Sukriye Ilkay; Atik, Bekir; Isik, Daghan

    2014-09-01

    The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula. Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V-Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R). One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011). The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V-Y pushback technique.

  12. Palate Fracture Repair With Light-Cured Resin Splint: Technical Note.

    Science.gov (United States)

    Waldrop, Jimmy; Dale, Elizabeth L; Halsey, Jordan; Sargent, Larry A

    2015-10-01

    Palate fractures are rare, and their treatment is a matter of debate. Although some investigators have favored rigid plate fixation, others have reported successful treatment without it. Sagittal split and comminuted fractures can require rigid fixation to reduce the maxillary width; however, additional stabilization is needed. Also, palate repair without a splint is complicated by prolonged intermaxillary fixation (IMF), causing stiffness to the temporomandibular joint. We introduce a technique using a rapid light-cured resin (TRIAD TranSheet) frequently used by orthodontists for making dental retainers. Its use is similar to the splints traditionally created preoperatively, but obviates the need for making impressions, a model, and a molded splint. A series of 13 patients treated with this technique during a 5-year period is presented. The average duration of IMF was 4.7 weeks (range 3 to 6). The average duration of the palate splint was 8.4 weeks (range 5 to 12). One patient had malocclusion, but none had malunion, infection, or oronasal fistula. Our series has demonstrated a simple, cost-effective, and successful technique. It can be used alone or combined with rigid fixation and allows for a shortened duration of maxillomandibular fixation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. [STUDY ON WOUND HEALING AFTER Sommerlad TECHNIQUE REPAIR OF ISOLATED CLEFT PALATE].

    Science.gov (United States)

    Lu, Yong; Shi, Bing; Wang, Zhiyong; Zhan, Xin

    2014-07-01

    To study the inhibitory effect of Sommerlad technique on the growth of the maxilla by comparing the wound healing between Sommerlad and Von Langenbeck techniques in repair of isolated cleft palate. A retrospective cohort study was conducted on 54 patients with isolated cleft palate who received palatoplasty with levator veli palatini retropositioning according to Sommerlad between June 2005 and August 2011 as trial group; 89 cleft patients received Von Langenbeck technique repair between June 2003 and September 2006 as control group. There was no significant difference in gender and age between 2 groups (P > 0.05). The operation time, intraoperative blood loss, body temperature, and fever were recorded and compared; the wound healing was observed, and the palatal mucosa was graded according to Karsten standard. The operation time of trial group [(72.2 ± 5.5) minutes] was significantly longer than that of control group [(58.1 ± 6.8) minutes] (t = 4.494, P = 0.000); the intraoperative blood loss of trial group [(18.6 ± 6.5) mL] was significantly less than that of control group [(34.2 ± 10.2) mL] (t = 2.447, P = 0.000). Within postoperative 48 hours, the highest body temperature was 36.6-37.6°C (mean, 36.9°C) in trial group, and was 36.8-38.2°C (mean, 37.3°C) in control group; fever occurred in 5 patients (9.3%) of trial group and 21 patients (23.6%) of control group, showing significant difference (χ2 = 4.640, P = 0.030). The patients were followed up 3-18 months (mean, 9 months) in the trial group, and 3-6 years (mean, 4 years) in the control group. Scar was rated as level 0, level 1, and level 2 in 38, 13, and 3 cases of trial group, and in 6, 35, and 48 cases of control group, showing significant difference (Z = -7.785, P = 0.000). The isolated cleft palate repair using Sommerlad technique has the advantages of less injury and less scar tissue, indicating no inhibitory effect on the growth of the maxilla.

  14. The Effect of Cleft Palate Repair on Contractile Properties of Single Permeabilized Muscle Fibers From Congenitally Cleft Goats Palates

    Science.gov (United States)

    A cleft palate goat model was used to study the contractile properties of the levator veli palatini (LVP) muscle which is responsible for the movement of the soft palate. In 15-25% of patients that undergo palatoplasty, residual velopharyngeal insufficiency (VPI) remains a problem and often require...

  15. Craniofacial morphology in complete unilateral cleft lip and palate patients consecutively treated with 1-stage repair of the cleft.

    NARCIS (Netherlands)

    Fudalej, P.S.; Surowiec, Z.; Offert, B.; Dudkiewicz, Z.; Katsaros, C.

    2010-01-01

    OBJECTIVE: To retrospectively evaluate the craniofacial morphology of children with a complete unilateral cleft lip and palate treated with a 1-stage simultaneous cleft repair performed in the first year of life. METHODS: Cephalograms and extraoral profile photographs of 61 consecutively treated

  16. Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate

    Science.gov (United States)

    Othman, Siti Adibah; Aidil Koay, Noor Airin

    2016-08-01

    We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra- and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions.

  17. Repair of a submucous cleft palate by W-pushback and levator repositioning without incision to the nasal mucosa.

    Science.gov (United States)

    Hwang, Kun

    2012-03-01

    The author created an innovative method of W-pushback and levator repositioning without having to make an incision to the nasal mucosa for submucous cleft palate repair.The W-shaped mucoperiosteal flap is outlined where the 2 peaks of W are the alveolar processes of both canine teeth and the midpoint of W is the anterior limit of the cleft notch of the hard palate. A short incision, medial to and behind the maxillary tuberosity and curved forward onto the palate and extended forward just medial to the alveolar process, is joined by a second incision from the apex of the cleft to the region of the canine tooth. The W-shaped mucoperiosteal flap is raised until the midline notch of the hard palate is exposed. The nasal mucosa and abnormally inserted levator veli palatini muscle to the posterior border of the hard palate bone are detached. By leaving the nasal mucosa intact, the detached levator veli palatini muscle is approximated at the midline and so the zona pellucida is obliterated. The cleft uvulas are cut in half and closed. The approximated W-flap is joined to the small anterior flap by 1 or more sutures (the W-pushback).Three patients were operated on with this technique without serious complications.The author believes that this method can make the levator sling and increase the length of the soft palate without making an incision to the nasal mucosa.

  18. The Effect of Cleft Lip and Palate, and the Timing of Lip Repair on Mother-Infant Interactions and Infant Development

    Science.gov (United States)

    Murray, Lynne; Hentges, Francoise; Hill, Jonathan; Karpf, Janne; Mistry, Beejal; Kreutz, Marianne; Woodall, Peter; Moss, Tony; Goodacre, Tim

    2008-01-01

    Background: Children with cleft lip and palate are at risk for psychological problems. Difficulties in mother-child interactions may be relevant, and could be affected by the timing of lip repair. Method: We assessed cognitive development, behaviour problems, and attachment in 94 infants with cleft lip (with and without cleft palate) and 96…

  19. Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

    Directory of Open Access Journals (Sweden)

    M. Elsonbaty

    2017-01-01

    Conclusion: Co-administration of intravenous magnesium sulphate or dexamethasone with to sevoflurane anesthesia during primary cleft palate repair provides more vital hemodynamic state and decrease in postoperative vomiting and delirium when compared with control group.

  20. A Comparison of the Need for Speech Therapy After 2 Palatal Repair Techniques.

    Science.gov (United States)

    Yen, Debra W; Nguyen, Dennis C; Skolnick, Gary B; Naidoo, Sybill D; Patel, Kamlesh B; Grames, Lynn Marty; Woo, Albert S

    2017-03-01

    Reconstruction of the levator musculature during cleft palate repair has been suggested to be important in long-term speech outcomes. In this study, we compare the need for postoperative speech therapy between 2 intravelar veloplasty techniques. Chart review was performed for patients with nonsyndromic cleft palate who underwent either primary Kriens or overlapping intravelar veloplasty before 18 months of age. All subjects completed a follow-up visit at approximately 3 years of age. Data obtained included documentation of ongoing or recommended speech therapy at age 3 years and reasons for speech therapy, which were categorized as cleft-related and non-cleft-related by a speech-language pathologist. One surgeon performed all Kriens procedures (n = 81), and the senior author performed all overlapping procedures (n = 25). Mean age at surgery (Kriens = 13.5 ± 1.4 months; overlapping = 13.1 ± 1.5 months; P = 0.188) and age at 3-year follow-up (Kriens = 3.0 ± 0.5 years; overlapping = 2.8 ± 0.5 years; P = 0.148) were equivalent in both groups. Cleft severity by Veau classification (P = 0.626), prepalatoplasty pure tone averages, (P = 0.237), pure tone averages at 3-year follow-up (P = 0.636), and incidence of prematurity (P = 0.190) were also similar between the 2 groups. At 3 years of age, significantly fewer overlapping intravelar veloplasty patients required cleft-related speech therapy (Kriens = 47%; overlapping = 20%; P = 0.015). The proportions of patients requiring non-cleft-related speech therapy were equivalent (P = 0.906). At 3 years of age, patients who received overlapping intravelar veloplasty were significantly less likely to need cleft-related speech therapy compared with patients who received Kriens intravelar veloplasty. Cleft severity, hearing loss, and prematurity at birth did not appear to explain the difference found in need for speech therapy.

  1. Morphological evaluation of changes in velopharyngeal function following maxillary distraction in patients with repaired cleft palate during mixed dentition.

    Science.gov (United States)

    Satoh, Koichi; Nagata, Junko; Shomura, Kenji; Wada, Takeshi; Tachimura, Takashi; Fukuda, Jinichi; Shiba, Ryosuke

    2004-07-01

    To describe the morphological changes of nasopharyngeal components after maxillary distraction and clarify whether the morphological characteristics are related to velopharyngeal function (VPF). Perceptual judgments of hypernasality and nasendoscopy were performed before and after treatment. Lateral cephalograms were obtained to describe the morphological changes. Department of Oral and Maxillofacial Surgery, Miyazaki Medical College, Miyazaki, Japan. Nine patients with repaired cleft palate in the mixed dentition stage underwent maxillary distraction using a face mask and an intraoral fixed appliance system. The severity of hypernasality, velopharyngeal insufficiency, and measurements such as pharyngeal depth, velar length, and the rotation of the palatal plane were evaluated. Increase in pharyngeal depth was not always proportional to the amount of advancement. It depended on the posture of the posterior pharyngeal wall and the rotation of palatal plane. Cephalometric measurements of the nasopharynx before and after surgery confirmed subsequent changes in VPF. These were suggested to be useful in predicting future VPF. When performing maxillary distraction in patients with cleft palate in the mixed dentition stage, and when velopharyngeal closure is found to occur by velar contact against the hypertrophied adenoid, patients should be counseled about risks of subsequent deterioration in their speech before surgery.

  2. Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 1. Nasal changes.

    LENUS (Irish Health Repository)

    Ayoub, Ashraf

    2010-08-11

    Abstract Objective: To evaluate 3D nasal morphology following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous non-cleft data Design: Prospective, cross-sectional, controlled study. Setting: Glasgow Dental Hospital & School, Faculty of Medicine, Glasgow University Patients and Participants: Two groups of 3-year old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a 3D vision based capture technique. Methods: 3D images of the face were reflected so the cleft was on the left side to create a homogenous group for statistical analysis. Three-dimensional co-ordinates of anthropometric landmarks were extracted from facial images by a single operator. A set of linear measurements was utilised to compare cleft and control subjects on right and left sides, adjusting for sex differences Results: the mean nasal base width and the width of the nostril floor on right and left sides differed significantly between control and Unilateral Cleft Lip and Palate (UCLP) groups. The measurements were greater in UCLP children. The difference in the mean nasal height and mean nasal projection between the groups were not statistically significant. Mean columellar lengths were different between the left and right sides in UCLP cases. Conclusions: There were significant nasal deformities following the surgical repair of UCLP. Keywords: child, cleft lip and palate, three-dimensional imaging.

  3. Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 2. Lip Changes.

    LENUS (Irish Health Repository)

    Ayoub, Ashraf

    2010-09-08

    Abstract Objective: To evaluate 3D lip morphology, following primary reconstruction in children with unilateral cleft lip and palate (UCLP) relative to contemporaneous non-cleft data Design: Prospective, cross-sectional, controlled study Setting: Glasgow Dental Hospital & School, University of Glasgow, The UK. Patients and Participants: Two groups of 3-year old children (21 with unilateral cleft lip and palate and 96 controls) with facial images taken using a 3D vision based capture technique. Methods: 3D images of the face were reflected so the cleft was on the left side to create a homogenous group for statistical analysis. Three-dimensional co-ordinates of anthropometric landmarks were extracted from facial images. 3D generalised Procustes superimposition was employed and a set of linear measurements were utilised to compare between cleft and control subjects for right and left sides, adjusting for sex differences. Results: Christa philteri on both the cleft and non-cleft sides were displaced laterally and posteriorly; there was also a statistically significant increase in philtrum width. No significant differences between cleft and control regarding the cutaneous height of the upper lip. The lip in the cleft cases was flatter than in the non-cleft cases with less prominence of labialis superioris. Conclusions: Stereophotogrammetry allows detection of residual dysmorphology following cleft repair. There was significant increase of the philtrum width. The lip appeared flatter and more posterior displaced in Unilateral Cleft Lip and Palate (UCLP) cases compared with control. Keywords: child, cleft lip and palate, lip repair, three-dimensional imaging.

  4. Palatalization and glide strengthening as competing repair strategies: Evidence from Kirundi

    Directory of Open Access Journals (Sweden)

    Alexei Kochetov

    2016-07-01

    Full Text Available Alternations involving place-changing palatalization (e.g. t+j → ʧ in spirit – spiritual are very common and have been a focus of much generative phonological work since Chomsky & Halle’s (1968 ‘Sound Pattern of English’. The interest in palatalization and its mechanisms (see e.g. Sagey 1990; Chen 1996; Bateman 2007 has somewhat obscured the question of how these processes fit into a wider typology of segmental alternations. What happens when palatalization fails to apply? Do other processes take its place and apply under the same circumstances? In this paper, I argue for a close functional and formal affinity between place-changing palatalization and one such process, palatal glide strengthening (e.g. p+j → pc. As evidence I present data from Kirundi (Bantu on the realization of consonant + palatal and velar glide sequences within and across morphemes. As will be shown, palatalization and glide strengthening in Kirundi work in parallel, affecting different subsets of consonants. Specifically, palatalization targets C+j sequences with laryngeals, velars, nasal coronals, and – across morpheme boundaries – non-nasal coronals. In contrast, glide strengthening targets C+j sequences with labials and – within morphemes – non-nasal coronals. In addition, glide strengthening applies to within- and across-morpheme consonant + velar glide sequences, producing a set of outputs (e.g. m+w → mŋ similar to C+j sequences. I further present a unified Optimality Theoretic (Prince & Smolensky 1993/2004 account of these seemingly disparate phenomena as both arising from different rankings of constraints prohibiting consonant + glide sequences (parameterized by place and/or manner and various feature-specific agreement and faithfulness constraints. Finally, I explore typological predictions of this account, reviewing several remarkably similar cases of C + glide resolution patterns from other languages, and outlining questions for further

  5. Primary Cleft Lip and Palate Repair in Assam, India: Does Preoperative Anthropometric Analysis Help Identify Patients With Increased Surgical Risk in a Clinically Prescreened Population?

    Science.gov (United States)

    Jerome, Mairin A; Gillenwater, Justin; Laub, Donald R; Osler, Turner; Allan, Anna Y; Restrepo, Carolina; Campbell, Alex

    2017-11-01

      To compare anthropometric z-scores with incidence of post-operative complications for patients undergoing primary cleft lip or palate repair.   This was a retrospective observational analysis of patients from a surgical center in Assam, India, and includes a cohort from a single surgical mission completed before the opening of the center.   Patients included in the study underwent surgery during an Operation Smile mission before the opening of Operation Smile's Guwahati Comprehensive Cleft Care Center in Guwahati, India. The remaining cohort received treatment at the center. All patients received preoperative assessment and screening; surgery; and postoperative care, education, and follow-up.   Our sample size included 1941 patients and consisted of all patients with complete information in the database who returned for follow-up after receiving primary cleft lip repair or primary cleft palate repair between January 2011 and April 2013.   Preoperative anthropometric measurements.   Postoperative complications.   Anthropometric z-scores were not a significant predictor of adverse surgical outcomes in the group analyzed. Palate surgery had increased risk of complication versus lip repair, with an overall odds ratio of 5.66 (P < .001) for all patients aged 3 to 228 months.   Anthropometric z-scores were not correlated with increased risk of surgical complications, possibly because patients were well screened for malnutrition before surgery at this center. Primary palate repair is associated with an approximate fivefold increased risk of developing postoperative complication(s) compared with primary lip repair.

  6. A novel computer system for the evaluation of nasolabial morphology, symmetry and aesthetics after cleft lip and palate treatment. Part 2: Comparative anthropometric analysis of patients with repaired unilateral complete cleft lip and palate and healthy individuals.

    Science.gov (United States)

    Pietruski, Piotr; Majak, Marcin; Pawlowska, Elzbieta; Skiba, Adam; Antoszewski, Boguslaw

    2017-04-01

    The aim of this study was to use a novel system, 'Analyse It Doc' (A.I.D.) for a complex anthropometric analysis of the nasolabial region in patients with repaired unilateral complete cleft lip and palate and in healthy individuals. A set of standardized facial photographs in frontal, lateral and submental view have been taken in 50 non-cleft controls (mean age 20.6 years) and 42 patients with repaired unilateral complete cleft and palate (mean age 19.57 years). Then, based on linear, angular and area measurements taken from the digital photographs with the aid of the A.I.D. system, a photogrammetric analysis of intergroup differences in nasolabial morphology and symmetry was conducted. Patients with cleft lip and palate differed from the controls in terms of more than half of analysed angular measurements and proportion indices derived from linear and area measurements of the nasolabial region. The findings presented herein imply that despite primary surgical repair, patients with unilateral complete cleft lip and palate still show some degree of nasolabial dysmorphology. Furthermore, the study demonstrated that the novel computer system is suitable for a reliable, simple and time-efficient anthropometric analysis in a clinical setting. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Roberts-SC syndrome, a rare syndrome and cleft palate repair

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2008-01-01

    Full Text Available Roberts SC syndrome is a rare syndrome with only 17 previously recognized patients reported in medical literature. The syndrome is characterized by multiple malformations, particularly, symmetrical limb reduction, craniofacial anomalies such as bilateral cleft lip and palate, micrognathia, and severe growth and mental retardation. Our patient, a young child of five years having Roberts-SC, was successfully operated for cleft palate under general anesthesia. The main features of the syndrome and the technical problems of anesthesia and surgery are discussed in this report.

  8. Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... health conditions > Cleft lip and cleft palate Cleft lip and cleft palate E-mail to a friend Please fill in ... repair cleft lip and palate. What are cleft lip and cleft palate? Cleft lip is a birth defect in which ...

  9. Dental arch relationship in children with complete unilateral cleft lip and palate following warsaw (one-stage repair) and oslo protocols.

    NARCIS (Netherlands)

    Fudalej, P.S.; Hortis-Dzierzbicka, M.; Dudkiewicz, Z.; Semb, G.

    2009-01-01

    OBJECTIVE: To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. MATERIAL: Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP

  10. [Simultaneous repairing defects of orbital floor and palate with the modified temporalis muscle flap after the maxillectomy].

    Science.gov (United States)

    Zhong, Q; Huang, Z G; Fang, J G; Chen, X J; Chen, X H; Hou, L Z; Li, P D; Ma, H Z; He, S Z

    2016-09-07

    Objective: To evaluate the outcome of one-stage reconstruction of maxillary and orbital defects with modified temporalis muscle flap (TMF) following the removal of malignant neoplasms. Methods: In this retrospective study, 15 patients underwent the reconstruction of defects of orbital floor and palate after maxillectomy for malignant tumor were included from June 2008 to June 2014. The modified temporalis muscle flap was used to repair the defects after surgery, and functional outcomes were analyzed. Results: All the patients were followed up for 12-81 months. Three cases of them received preoperative radiotherapy and 12 cases underwent postoperative radiotherapy. All flaps were survived. Epithelization of the tissues in oral and nasal cavity was completed in 4-6 weeks. Good functional reconstruction on swallowing and speaking functional results were achieved with maxillary and orbital reconstruction and no secondary deformity of external nose was observed. The eye positions in all cases were normal. Diplopia, diminution and loss of vision were not found. Conclusion: The modified TMF can be used for simultaneous reconstruction for the defects of orbital floor and palate after maxillectomy in patients whom free tissue flap can not be applied to, showing better cosmetic and functional results.

  11. Two stages of economic development

    OpenAIRE

    Gong, Gang

    2016-01-01

    This study suggests that the development process of a less-developed country can be divided into two stages, which demonstrate significantly different properties in areas such as structural endowments, production modes, income distribution, and the forces that drive economic growth. The two stages of economic development have been indicated in the growth theory of macroeconomics and in the various "turning point" theories in development economics, including Lewis's dual economy theory, Kuznet...

  12. Five surgical maneuvers on nasal mucosa movement in cleft palate repair: A cadaver study.

    Science.gov (United States)

    Nguyen, Dennis C; Patel, Kamlesh B; Parikh, Rajiv P; Skolnick, Gary B; Woo, Albert S

    2016-06-01

    This biomechanical study aims to characterize the nasal mucosa during palatoplasty, thereby describing the soft tissue attachments at different zones and quantifying movement following their release. Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosa off the maxilla, (2) dissection of nasal mucosa from soft palate musculature, (3) separation of nasal mucosa from palatine aponeurosis, (4) release of mucosa at the pterygopalatine junction, and (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate (MP) and posterior nasal spine (PNS) following each maneuver were measured. At the MP, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p = 0.72). At the PNS, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p < 0.001). Maneuver 4 yielded the greatest amount of movement of the lateral nasal mucosa at both MP (4.2 mm, 40.8%) and PNS (7.2 mm, 55.8%). At the MP, complete release of the lateral nasal mucosa achieves as much movement as the vomer flap. At the hard-soft palate junction, the maneuvers progressively add to the movement of the lateral nasal mucosa. The most powerful step is release of attachments along the posterior aspect of the medial pterygoid. Published by Elsevier Ltd.

  13. A Relationship between nasolabial appearance and self-esteem in adolescent with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center.

    Science.gov (United States)

    Patjanasoontornm, Niramol; Wongniyom, Kusalapom; Pradubwong, Suteera; Piyavhakul, Navanant; Chowchuen, Bowornsilp

    2014-10-01

    To examine levels of self-esteem of adolescents with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center and its correlation with nasolabial appearance. Across-sectional survey of 93 adolescents with repaired cleft lip and palate. A total nasolabial appearance score was 2.8 +/- 0.36 (fair to good). The mean of the total self-esteem score for all respondents was 20.11 +/- 3.27 (maximum 30). There was no-significant correlation between nasolabial appearance and self esteem (Pearson product-moment correlation coefficiency (r) = 0.18, p = 0.08. The self-esteem scores of good, fair and poor appearance were 20.5 +/- 0.98, 19.8 +/- 0.32, 19 +/- 2.09 respectively. The nasolabial appearance of repaired cleft lip and palate not be the only factor but other psychosocialfactors also may play a role in their self-esteem. The analysis of this study found no relationship between self-esteem and appearance.

  14. Two-stage implant systems.

    Science.gov (United States)

    Fritz, M E

    1999-06-01

    Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

  15. Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair.

    Science.gov (United States)

    Lorot-Marchand, A; Guerreschi, P; Pellerin, P; Martinot, V; Gbaguidi, C C; Neiva, C; Devauchelle, B; Frochisse, C; Poli-Merol, M L; Francois-Fiquet, C

    2015-07-01

    Cleft lip-palate (CLP) is a "social" pathology because of its impact on the child's facial appearance and speech. School is the first place where children are confronted to others and when they start socializing. Taunting and bullying are common and their psychological impact remains hard to assess. The aim of this study was to evaluate the importance of taunting in school and its impact in CLP patients who had surgical repair. We conducted a multicenter prospective study where we consecutively included patients ≥ 12 years who had CLP repair. During a multidisciplinary consultation they were asked to complete a questionnaire (3 parts: surgical outcomes, taunting and its impact, socio-economic status) previously approved by our psychologists. 55 patients were included (37 B, 18 G) (mean age 15.5 years): 11 CL, 13 CP and 31 CLP. 69% of patients reported having suffered from taunting and peer victimization in school. In 84% of the cases, taunting was linked to the CLP defect itself. The teasing started in primary school to reach a peak of aggressiveness in middle school. 42% of patients reported that bullying occurred at least once a day (16/38). Regarding the psychological impact of taunting, 50% of patients reported sadness, 31% depression and 26.3% were marked for life. At one time or another 29% of patients did not want to attend school because of the teasing. The grade retention rate amounted to 37.7% (20/53), and 2 patients were in special education classes. As a matter of fact, 50% of these children repeated their 1st or 2nd year of primary school. Furthermore, 47% of patients wanted to change something to their face, but 63% of them never spoke to their surgeon about additional surgeries even though they were teased in school. Taunting is common in children with CLP. This study highlights the high frequency and impact of taunting on the daily lives and self-perception of patients with CLP or CLP repair. It is important for healthcare professionals to be

  16. Evolution of my philosophy in the treatment of unilateral cleft lip and palate.

    Science.gov (United States)

    Brusati, Roberto

    2016-08-01

    At the end of 50-year-long clinical activity, the evolution of my approach to the treatment of unilateral cleft of the lip and palate is discussed. I had several teachers in this field (Rusconi, Reherman, Perko, Delaire, Talmant, Sommerlad and others) and I introduced in my approach what I considered to be improvements from all of them. My current protocol is related to the anatomy of the cleft: for wide clefts a two-stage protocol is applied (1° step: soft palate and lip and nose repair; 2° step: hard palate repair with gingivoalveoloplasty); for narrow cleft (less than 1 cm at the posterior border of hard palate) an "all in one" protocol is performed with or without gingivoalveoloplasty (in accordance to the presence or absence of contact between the stumps at alveolar level). The most important details regarding surgery of the lip and palate are discussed. Robust data collection on speech and skeletal growth is still needed to determine whether the "all in one" approach can be validated as the treatment of choice for unilateral complete lip and palate cleft in selected cases. Copyright © 2016. Published by Elsevier Ltd.

  17. The use of SymNose for quantitative assessment of lip symmetry following repair of complete bilateral cleft lip and palate.

    Science.gov (United States)

    Russell, James H B; Kiddy, Harriet C; Mercer, Nigel S

    2014-07-01

    The SymNose computer program has been proposed as an objective method for the quantitative assessment of lip symmetry following unilateral cleft lip repair. This study aims to demonstrate the use of SymNose in patients with complete bilateral cleft lip and palate (BCLP), a group previously excluded from computer-based analysis. A retrospective cohort study compared several parameters of lip symmetry between BCLP cases and non-cleft controls. 15 BCLP cases aged 10 (±1 year) who had undergone primary repair were recruited from the patient database at the South West Cleft Unit, Frenchay Hospital. Frontal facial photographs were selected for measurement. 15 age-matched controls were recruited from a local school. Lip symmetry was expressed as: percentage mismatch of left vermillion border and upper lip area over the right, horizontal lip tilt and lateral deviation of the lip. A significant increase in lip asymmetry was found in the BCLP group expressed as upper vermillion border mismatch across computer-defined and user-defined midlines (mean difference was 16.4% (p lip asymmetry remains in BCLP patients even after primary repair. This challenges previous assumptions that those with bilateral defects would be relatively symmetrical. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Congenital Palatal Fistula Associated with Submucous Cleft Palate

    Science.gov (United States)

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H. Wolfgang

    2016-01-01

    Background: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and management. Methods: Two cases of children with congenital palatal fistulae and a submucous cleft palate are presented who were treated in different settings by different surgeons. Cases are discussed along with a thorough review of the available literature. Results: Patient 1 presented at 4 years of age with “a hole in the palate” since birth and abnormal speech. His palatal fistula and submucous cleft were repaired with a modified von Langenbeck technique in Ethiopia. At a 2-year follow-up, the palate remained closed, but hypernasal speech persisted. Patient 2 was a 1-year-old presenting with failure to thrive and nasal regurgitation, who underwent a Furlow palatoplasty in the United States with good immediate results. She was unfortunately lost to follow-up. Conclusions: A congenital fenestration of the palate is rare. Reports reveal suboptimal speech at follow-up, despite various types of repair, especially when combined with a submucous cleft. Available literature suggests that repair should not focus on fistula closure only but instead on providing adequate palate length to provide good velopharyngeal function, as in any cleft palate repair. PMID:27014542

  19. Evaluation of Facial Appearance among Patients With Repaired Unilateral Cleft Lip and Palate: Comparison of Patient- and Clinician-Ratings of Satisfaction.

    Science.gov (United States)

    Thittiwong, Rungkarn; Manosudprasit, Montian; Wangsrimongkol, Tasanee; Kongsomboon, Supaporn; Pitiphat, Waranuch; Chowchuen, Bowornsilp; Uttaravichien, Akasith; Pisek, Poonsak

    2015-08-01

    The objective of this study was to determine the levels of patient-satisfaction on facial and dental appearance compared with clinician ratings. Participants included 61 patients with repaired unilateral cleft lip and palate (UCLP), aged 14-25 years. Raters comprised three cleft team clinicians. A Likert scale was used to assess the levels of satisfaction of the patients themselves and the clinicians. The results revealed that the patients were moderately satisfied with their appearance. Nose was the least satisfactory feature, followed by lip appearance. When compared to the clinician ratings, the patients were less satisfied with their own nose and lip, but more satisfied with teeth. Concerning age, self-assessment did not differ between adolescents and young adults. Females were less likely to be satisfied compared to males, but the difference was not statistically significant. In conclusion, patients with repaired UCLP were moderately satisfied with their facial and dental appearance. Clinician- and patient-opinions were different in some aspects. This study highlights the importance of patient satisfaction as a meaningful treatment outcome assessment, which could lead to an improvement in cleft care to meet the patient expectations.

  20. Penatalaksanaan Repair Palatoplasty dengan Teknik Furlow Double Opposing Z Plasty

    Directory of Open Access Journals (Sweden)

    Pingky Krisna Arindra

    2015-06-01

    metode Furlow double opposing z plasty dengan kombinasi insisi lateral, dan didapatkan hasil menutupnya celah di palatum mole sampai dengan uvula. Telah dilakukan operasi repair palatoplasi dengan metode Furlow double opposing z plasty. Teknik ini dilakukan untuk menghindari insisi yang terlalu luas dikarenakan terdapatnya jaringan fibrous yang tebal pada mukosa palatum pasca operasi sebelumnya. Tujuan studi kasus adalah untuk mengetahui kemampuan teknik Furlow Double Opposing Z Plasty sebagai prosedur repair palatoplasty.   Repair Palatoplasty Management with Furlow Double Opposing Z Plasty Technique. Cases of cleft lip and palate are one of the deformity disorders that often occur. There are variety of clinical appearance ranging from incomplete to complete cases. Clinical appearance with different width requires proper surgical technique. Patients with cleft lip and palate had undergone surgical intervention, so that they needed surgical correction to repair the result or failure of the previous surgery. A Four year old boy complain there was cleft on the soft palate. The patient was diagnosed with labiognatopalatoscisis. The patient had undergone two stages of cleft lip surgery and twice of cleft palate surgery with pushback method and repair with z plasty, however the result was unsatisfactory. Further, the patient underwent repair palatoplasty surgery with Furlow double opposing z plasty method combined with lateral relaxing insicion. The result in the post surgery was the closure of cleft soft palate up to uvula. Repair palataplasty surgery has been done with Furlow double opposing z plasty method. This technique could avoid extended incision due to thick fibrous tissue on the palatum mucosa as the result of serial previous surgery. The aim of this case case study is to determine the technical capabilities of Furlow Double Opposing Z Plasty as palatoplasty repair procedure.

  1. Two Stages repair of proximal hypospadias: Review of 33 cases

    African Journals Online (AJOL)

    HussamHassan

    Background/Purpose: Proximal hypospadias with chordee is the most challenging variant of hypospadias to reconstruct. During the last 10 years, the approach to sever hypospadias has been controversial. Materials & Methods: During the period from June 2002 to December 2009, I performed 33 cases with proximal.

  2. Sensitivity Analysis in Two-Stage DEA

    Directory of Open Access Journals (Sweden)

    Athena Forghani

    2015-07-01

    Full Text Available Data envelopment analysis (DEA is a method for measuring the efficiency of peer decision making units (DMUs which uses a set of inputs to produce a set of outputs. In some cases, DMUs have a two-stage structure, in which the first stage utilizes inputs to produce outputs used as the inputs of the second stage to produce final outputs. One important issue in two-stage DEA is the sensitivity of the results of an analysis to perturbations in the data. The current paper looks into combined model for two-stage DEA and applies the sensitivity analysis to DMUs on the entire frontier. In fact, necessary and sufficient conditions for preserving a DMU's efficiency classiffication are developed when various data changes are applied to all DMUs.

  3. Sensitivity Analysis in Two-Stage DEA

    Directory of Open Access Journals (Sweden)

    Athena Forghani

    2015-12-01

    Full Text Available Data envelopment analysis (DEA is a method for measuring the efficiency of peer decision making units (DMUs which uses a set of inputs to produce a set of outputs. In some cases, DMUs have a two-stage structure, in which the first stage utilizes inputs to produce outputs used as the inputs of the second stage to produce final outputs. One important issue in two-stage DEA is the sensitivity of the results of an analysis to perturbations in the data. The current paper looks into combined model for two-stage DEA and applies the sensitivity analysis to DMUs on the entire frontier. In fact, necessary and sufficient conditions for preserving a DMU's efficiency classiffication are developed when various data changes are applied to all DMUs.

  4. Two-stage precipitation of plutonium trifluoride

    International Nuclear Information System (INIS)

    Luerkens, D.W.

    1984-04-01

    Plutonium trifluoride was precipitated using a two-stage precipitation system. A series of precipitation experiments identified the significant process variables affecting precipitate characteristics. A mathematical precipitation model was developed which was based on the formation of plutonium fluoride complexes. The precipitation model relates all process variables, in a single equation, to a single parameter that can be used to control particle characteristics

  5. Two-Stage Series-Resonant Inverter

    Science.gov (United States)

    Stuart, Thomas A.

    1994-01-01

    Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

  6. Dental arch relationship in children with complete unilateral cleft lip and palate following Warsaw (one-stage repair) and Oslo protocols.

    Science.gov (United States)

    Fudalej, Piotr; Hortis-Dzierzbicka, Maria; Dudkiewicz, Zofia; Semb, Gunvor

    2009-11-01

    To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP consecutively treated with one-stage closure of the cleft at 9.2 months (range, 6.0 to 15.8 months; SD, 2.0) by the Warsaw Cleft Team at the Institute of Mother and Child, Poland, were compared with a sample drawn from a consecutive series of patients with UCLP treated by the Oslo Cleft Team and matched for age, gender, and soft tissue band. The study models were given random numbers to blind their origin. Four examiners rated the dental arch relationship using the GOSLON Yardstick. The strength of agreement of rating was assessed with weighted Kappa statistics. An independent t-test was carried out to compare the GOSLON scores between Warsaw and Oslo samples, and Fisher's exact tests were performed to evaluate the difference of distribution of the GOSLON scores. The intrarater and interrater agreements were high (K > or = .800). No difference in dental arch relationship between Warsaw and Oslo groups was found (mean GOSLON score = 2.68 and 2.65 for Warsaw and Oslo samples, respectively). The distribution of the GOSLON grades was similar in both groups. The dental arch relationship following one-stage repair (Warsaw protocol) was comparable with the outcome of the Oslo Cleft Team's protocol.

  7. Incisor and molar overjet, arch contraction, and molar relationship in the mixed dentition in repaired complete unilateral cleft lip and palate: A qualitative and quantitative appraisal.

    Science.gov (United States)

    Disthaporn, Suteeta; Suri, Sunjay; Ross, Bruce; Tompson, Bryan; Baena, Diogenes; Fisher, David; Lou, Wendy

    2017-07-01

    To compare the mixed dentition incisor and molar overjet, severity of contraction of the dental arch, and the sagittal molar relationship on the cleft side vs the noncleft side in children with repaired complete unilateral cleft of the lip and palate (UCLP). Orthodontic records taken prior to orthodontic preparation for alveolar bone grafting were screened to select study casts from patients with nonsyndromic repaired complete UCLP who did not have mandibular skeletal or dental asymmetry. The study sample comprised dental casts from 74 children aged 8.9 ± 1 years. Standardized digital photographs were acquired at 1:1 magnification. A coordinate system was developed using digital image-processing software (Photoshop CS4 and Adobe Illustrator). Incisor and molar overjet, Angle's classification, and arch contraction were recorded. Descriptive statistics, paired t-tests, and kappa statistics were used to compare the cleft and noncleft sides. A negative overjet of -1 to -5 mm was often present at the incisors, with greater frequency and magnitude on the cleft side. Class II molar relation was more frequent on the cleft side (61.1%) than on the noncleft side (47.2%). Significantly greater contraction of the cleft side deciduous canine and deciduous first molar was noted, while the difference was very minor at the first permanent molar. Cleft side maxillary arch contraction was most severe in the deciduous canine and first deciduous molar region and progressively less severe in the posterior region of the arch. A greater frequency and severity of negative overjet and Class II molar relationship was seen on the cleft side.

  8. Condensate from a two-stage gasifier

    DEFF Research Database (Denmark)

    Bentzen, Jens Dall; Henriksen, Ulrik Birk; Hindsgaul, Claus

    2000-01-01

    Condensate, produced when gas from downdraft biomass gasifier is cooled, contains organic compounds that inhibit nitrifiers. Treatment with activated carbon removes most of the organics and makes the condensate far less inhibitory. The condensate from an optimised two-stage gasifier is so clean...... that the organic compounds and the inhibition effect are very low even before treatment with activated carbon. The moderate inhibition effect relates to a high content of ammonia in the condensate. The nitrifiers become tolerant to the condensate after a few weeks of exposure. The level of organic compounds...... and the level of inhibition are so low that condensate from the optimised two-stage gasifier can be led to the public sewer....

  9. Two-stage nonrecursive filter/decimator

    International Nuclear Information System (INIS)

    Yoder, J.R.; Richard, B.D.

    1980-08-01

    A two-stage digital filter/decimator has been designed and implemented to reduce the sampling rate associated with the long-term computer storage of certain digital waveforms. This report describes the design selection and implementation process and serves as documentation for the system actually installed. A filter design with finite-impulse response (nonrecursive) was chosen for implementation via direct convolution. A newly-developed system-test statistic validates the system under different computer-operating environments

  10. Evidence-Based Medicine: Cleft Palate.

    Science.gov (United States)

    Woo, Albert S

    2017-01-01

    After studying this article, the participant should be able to: 1. Describe the incidence of cleft palate and risk factors associated with development of an orofacial cleft. 2. Understand differences among several techniques to repair clefts of both the hard and soft palates. 3. Discuss risk factors for development of postoperative fistulas, velopharyngeal insufficiency, and facial growth problems. 4. Establish a treatment plan for individualized care of a cleft palate patient. Orofacial clefts are the most common congenital malformations of the head and neck region, and approximately three-quarters of these patients have some form of cleft palate deformity. Cleft palate repair is generally performed in children between 6 and 12 months of age. The goals of palate repair are to minimize the occurrence of fistulas, establish a normal velopharyngeal mechanism, and optimize facial growth. This Maintenance of Certification review discusses the incidence and epidemiology associated with cleft palate deformity and specifics associated with patient care, including analgesia, surgical repair techniques, and complications associated with repair of the cleft palate.

  11. Two stage-type railgun accelerator

    International Nuclear Information System (INIS)

    Ogino, Mutsuo; Azuma, Kingo.

    1995-01-01

    The present invention provides a two stage-type railgun accelerator capable of spiking a flying body (ice pellet) formed by solidifying a gaseous hydrogen isotope as a fuel to a thermonuclear reactor at a higher speed into a central portion of plasmas. Namely, the two stage-type railgun accelerator accelerates the flying body spiked from a initial stage accelerator to a portion between rails by Lorentz force generated when electric current is supplied to the two rails by way of a plasma armature. In this case, two sets of solenoids are disposed for compressing the plasma armature in the longitudinal direction of the rails. The first and the second sets of solenoid coils are previously supplied with electric current. After passing of the flying body, the armature formed into plasmas by a gas laser disposed at the back of the flying body is compressed in the longitudinal direction of the rails by a magnetic force of the first and the second sets of solenoid coils to increase the plasma density. A current density is also increased simultaneously. Then, the first solenoid coil current is turned OFF to accelerate the flying body in two stages by the compressed plasma armature. (I.S.)

  12. Two-stage free electron laser research

    Science.gov (United States)

    Segall, S. B.

    1984-10-01

    KMS Fusion, Inc. began studying the feasibility of two-stage free electron lasers for the Office of Naval Research in June, 1980. At that time, the two-stage FEL was only a concept that had been proposed by Luis Elias. The range of parameters over which such a laser could be successfully operated, attainable power output, and constraints on laser operation were not known. The primary reason for supporting this research at that time was that it had the potential for producing short-wavelength radiation using a relatively low voltage electron beam. One advantage of a low-voltage two-stage FEL would be that shielding requirements would be greatly reduced compared with single-stage short-wavelength FEL's. If the electron energy were kept below about 10 MeV, X-rays, generated by electrons striking the beam line wall, would not excite neutron resonance in atomic nuclei. These resonances cause the emission of neutrons with subsequent induced radioactivity. Therefore, above about 10 MeV, a meter or more of concrete shielding is required for the system, whereas below 10 MeV, a few millimeters of lead would be adequate.

  13. Internationally adopted children with cleft lip and/or palate: A retrospective cohort study.

    Science.gov (United States)

    Werker, C L; de Wilde, H; Mink van der Molen, A B; Breugem, C C

    2017-12-01

    The treatment approach for internationally adopted children with cleft lip and/or palate differs from locally born children with cleft lip and/or palate. They are older at initial presentation, may have had treatment abroad of different quality, and are establishing new and still fragile relationships with their adoptive parents. The aim of this study was to describe the characteristics and initial care and treatment of this group. A retrospective cohort study was performed including all internationally adopted children with cleft lip and/or palate presenting to the cleft team outpatient clinic in the Wilhelmina Children's Hospital between January 1994 and December 2014. Medical records of all patients were reviewed; information concerning demographic characteristics, characteristics at initial presentation, and treatment were obtained. A total number of 132 adopted patients were included: 15% had cleft lip, 7% had cleft palate, and 78% had cleft lip and palate. The average age at the time of adoption was 26.5 months. In most cases, China was the country of origin. Seventy-eight percent had surgery in their country of origin, primarily lip repair. Fistulae in need of revision surgery were found in 8% of the patients. Pharyngoplasty was needed in 48% of the patients. No significant differences were found for mean age at adoption, gender, cleft type, and one- or two-stage palatal closure. Internationally adopted children with cleft lip and/or palate are a very diverse group of patients with challenging treatment. These children undergo surgery late and frequently need additional surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Nasal Glial Heterotopia with Cleft Palate.

    Science.gov (United States)

    Chandna, Sudhir; Mehta, Milind A; Kulkarni, Abhishek Kishore

    2018-01-01

    Congenital midline nasal masses are rare anomalies of which nasal glial heterotopia represents an even rarer subset. We report a case of a 25-day-old male child with nasal glial heterotopia along with cleft palate suggesting embryonic fusion anomaly which was treated with excision and primary closure for nasal mass followed by palatal repair at later date.

  15. Nasal glial heterotopia with cleft palate

    Directory of Open Access Journals (Sweden)

    Sudhir Chandna

    2018-01-01

    Full Text Available Congenital midline nasal masses are rare anomalies of which nasal glial heterotopia represents an even rarer subset. We report a case of a 25-day-old male child with nasal glial heterotopia along with cleft palate suggesting embryonic fusion anomaly which was treated with excision and primary closure for nasal mass followed by palatal repair at later date.

  16. Maxillary Arch Dimensions and Spectral Characteristics of Children with Cleft Lip and Palate Who Produce Middorsum Palatal Stops

    Science.gov (United States)

    Zajac, David J.; Cevidanes, Lucia; Shah, Sonam; Haley, Katarina L.

    2012-01-01

    Purpose: The purpose of this study was twofold: (a) to determine maxillary arch dimensions of children with repaired cleft lip and palate (CLP) who produced middorsum palatal stops and (b) to describe some spectral characteristics of middorsum palatal stops. Method: Maxillary arch width, length, and height dimensions and first spectral moments of…

  17. Calvarial periosteal graft for second-stage cleft palate surgery: a preliminary report.

    Science.gov (United States)

    Neiva, Cecilia; Dakpe, Stephanie; Gbaguidi, Cica; Testelin, Sylvie; Devauchelle, Bernard

    2014-07-01

    The objectives of cleft palate surgery are to achieve optimal outcomes regarding speech development, hearing, maxillary arch development and facial skull growth. Early two-stage cleft palate repair has been the most recent protocol of choice to achieve good maxillary arch growth without compromising speech development. Hard palate closure occurs within one year of soft palate surgery. However, in some cases the residual hard palate cleft width is larger than 15 mm at the age of two. As previously reported, integrated speech development starts around that age and it is a challenge since we know that early mobilization of the mucoperiosteum interferes with normal facial growth on the long-term. In children with large residual hard palate clefts at the age 2, we report the use of calvarial periosteal grafts to close the cleft. With a retrospective 6-year study (2006-2012) we first analyzed the outcomes regarding impermeability of hard palate closure on 45 patients who at the age of two presented a residual cleft of the hard palate larger than 15 mm and benefited from a periosteal graft. We then studied the maxillary growth in these children. In order to compare long-term results, we included 14 patients (age range: 8-20) treated between 1994 & 2006. Two analyses were conducted, the first one on dental casts from birth to the age of 6 and the other one based on lateral cephalograms following Delaire's principles and TRIDIM software. After the systematic cephalometric analysis of 14 patients, we found no evidence of retrognathia or Class 3 dental malocclusion. In the population of 45 children who benefited from calvarial periosteal grafts the rate of palate fistula was 17% vs. 10% in the overall series. Despite major advances in understanding cleft defects, the issues of timing and choice of the surgical procedure remain widely debated. In second-stage surgery for hard palate closure, using a calvarial periosteal graft could be the solution for large residual clefts

  18. Meta-analysis of Gaussian individual patient data: Two-stage or not two-stage?

    Science.gov (United States)

    Morris, Tim P; Fisher, David J; Kenward, Michael G; Carpenter, James R

    2018-04-30

    Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis. Arguments for one-stage analysis have typically noted that a wider range of models can be fitted and overall estimates may be more precise. The two-stage side has emphasised that the models that can be fitted in two stages are sufficient to answer the relevant questions, with less scope for mistakes because there are fewer modelling choices to be made in the two-stage approach. For Gaussian data, we consider the statistical arguments for flexibility and precision in small-sample settings. Regarding flexibility, several of the models that can be fitted only in one stage may not be of serious interest to most meta-analysis practitioners. Regarding precision, we consider fixed- and random-effects meta-analysis and see that, for a model making certain assumptions, the number of stages used to fit this model is irrelevant; the precision will be approximately equal. Meta-analysts should choose modelling assumptions carefully. Sometimes relevant models can only be fitted in one stage. Otherwise, meta-analysts are free to use whichever procedure is most convenient to fit the identified model. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  19. One-stage and two-stage penile buccal mucosa urethroplasty

    African Journals Online (AJOL)

    G. Barbagli

    2015-12-02

    Dec 2, 2015 ... there also seems to be a trend of decreasing urethritis and an increase of instrumentation and catheter related strictures in these countries as well [4–6]. The repair of penile urethral strictures may require one- or two- stage urethroplasty [7–10]. Certainly, sexual function can be placed at risk by any surgery ...

  20. Comparison of dental arch dimensions in models of preschool children with cleft lip/palate repaired by means of surgery alone versus controls.

    Science.gov (United States)

    Burhan, Ahmad S; Nawaya, Fehmieh R

    2016-09-01

    Cleft lip and palate (CLP) anomaly is one of the most prevalent congenital defects causing disturbances of dental arch dimensions. This study aimed at investigating differences in these dimensions between preschool children with cleft lip/palate and a matched control group representing healthy individuals with normal occlusion (NO). The sample of this cross-sectional analytical study consisted of 108 plaster models of children aged from 4 to 5.5 years. They were divided into five groups: the cleft lip group, the cleft palate (CP) group, the unilateral cleft lip and palate group, the bilateral cleft lip and palate group, and the NO group. The NO group was used as a control group. All cleft-affected children were treated only with surgery. Dental arch length and widths were measured. The dental arch dimensions of the cleft lip group were nearly similar to those in the controls. Moreover, the mandibular transverse widths of the CP group were close to those in the controls. However, the mandibular arch length and all maxillary dimensions of the CP group were smaller than those in the controls. In the unilateral cleft lip and palate group, the arch lengths in both jaws and the maxillary transverse widths were smaller than those in the controls, whereas the mandibular transverse widths were similar to those in the controls. In the bilateral cleft lip and palate group, the arch lengths in both jaws were close to those in the controls, but both arches were narrower than those in the controls. The various types of CLP were found to be associated with differences in most maxillary and some mandibular arch dimensions. These data can be used for cleft patient counseling and treatment planning.

  1. Cleft palate caused by congenital teratoma.

    Science.gov (United States)

    Veyssière, Alexis; Streit, Libor; Traoré, Hamady; Bénateau, Hervé

    2017-02-01

    A cleft palate results from incomplete fusion of the lateral palatine processes, the median nasal septum and the median palatine process. This case report describes a rare case of congenital teratoma originating from the nasal septum that may have interfered with the fusion of the palatal shelves during embryonic development, resulting in a cleft palate. An infant girl was born at 40 weeks of gestation weighing 3020 g with a complete cleft palate associated with a large central nasopharyngeal tumour. Computed tomography (CT) of the head showed a well defined mass of mixed density. The tumour was attached to the nasal septum in direct contact with the cleft palate. A biopsy confirmed the teratoma. Tumour resection was performed at 5 months, soft palate reconstruction at 7 months and hard palate closure at 14 months. There was no sign of local recurrence 1 year later. Most teratomas are benign and the prognosis is usually good. However, recurrence is not rare if germ cell carcinomatous foci are present within the teratoma. For these reasons, we advocate the use of a two-stage procedure in which closure of the cleft palate is postponed until histological examination confirms complete excision of the teratoma.

  2. On the robustness of two-stage estimators

    KAUST Repository

    Zhelonkin, Mikhail

    2012-04-01

    The aim of this note is to provide a general framework for the analysis of the robustness properties of a broad class of two-stage models. We derive the influence function, the change-of-variance function, and the asymptotic variance of a general two-stage M-estimator, and provide their interpretations. We illustrate our results in the case of the two-stage maximum likelihood estimator and the two-stage least squares estimator. © 2011.

  3. Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate

    OpenAIRE

    Xu, Hao; Mei, Xiao-Peng; Xu, Li-Xian

    2017-01-01

    Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery ...

  4. Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study

    Science.gov (United States)

    Sitzman, Thomas J; Hossain, Monir; Carle, Adam C; Heaton, Pamela C; Britto, Maria T

    2017-01-01

    Objectives To test whether cleft centres vary in their use of secondary cleft palate surgery, also known as revision palate surgery, and if so to identify modifiable hospital factors and surgeon factors that are associated with use of secondary surgery. Design Retrospective cohort study. Setting Forty-three paediatric hospitals across the USA. Patients Children with cleft lip and palate who underwent primary cleft palate repair from 1999 to 2013. Main outcome measures Time from primary cleft palate repair to secondary palate surgery. Results We identified 4939 children who underwent primary cleft palate repair. At 10 years after primary palate repair, 44% of children had undergone secondary palate surgery. Significant variation existed among hospitals (ppalate repair before 9 months of age was associated with an increased hazard of secondary palate surgery (initial HR 6.74, 95% CI 5.30 to 8.73). Postoperative antibiotics, surgeon procedure volume and hospital procedure volume were not associated with time to secondary surgery (p>0.05). Of the outcome variation attributable to hospitals and surgeons, between-hospital differences accounted for 59% (ppalate surgery exists depending on a child’s age at primary palate repair and the hospital and surgeon performing their repair. Performing primary palate repair before 9 months of age substantially increases the hazard of secondary surgery. Further research is needed to identify other factors contributing to variation in palate surgery outcomes among hospitals and surgeons. PMID:29479567

  5. [Suture simulator - Cleft palate surgery].

    Science.gov (United States)

    Devinck, F; Riot, S; Qassemyar, A; Belkhou, A; Wolber, A; Martinot Duquennoy, V; Guerreschi, P

    2017-04-01

    Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix.

    Science.gov (United States)

    Emodi, Omri; Ginini, Jiriys George; van Aalst, John A; Shilo, Dekel; Naddaf, Raja; Aizenbud, Dror; Rachmiel, Adi

    2018-03-01

    Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

  7. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency

    OpenAIRE

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-01-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of...

  8. Two-stage anaerobic digestion of cheese whey

    Energy Technology Data Exchange (ETDEWEB)

    Lo, K V; Liao, P H

    1986-01-01

    A two-stage digestion of cheese whey was studied using two anaerobic rotating biological contact reactors. The second-stage reactor receiving partially treated effluent from the first-stage reactor could be operated at a hydraulic retention time of one day. The results indicated that two-stage digestion is a feasible alternative for treating whey. 6 references.

  9. Influence of Timing of Delayed Hard Palate Closure on Articulation Skills in 3-Year-Old Danish Children with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje; Kisling-Møller, Mia; Nielsen, Joan Bogh; Jørgensen, Line Dahl; Andersen, Mikael; Bolund, Stig; Andersen, Helene Søgaard

    2018-01-01

    Background: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims: To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral…

  10. Incidence of Cleft Lip and Palate in Uganda

    NARCIS (Netherlands)

    Dreise, Marieke; Galiwango, George; Hodges, Andrew

    Objective: The purpose of the study was to estimate the need for resources for cleft repairs in Uganda by determining the overall incidence of oral-facial clefts and the ratio of isolated cleft lip to isolated cleft palate to cleft lip and palate. Design: A 1-year prospective study was implemented

  11. Delayed closure of the palatal defect using buccal inversion and palatal rotation flaps after maxillectomy.

    Science.gov (United States)

    Jung, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Oh, Hee-Kyun

    2013-03-01

    Maxillectomy leaves oronasal and oroantral defects that result in functional impairment of mastication, deglutition, and speech. Many treatment options are suggested and tried including the palatal flap as local flap. Although palatal flaps have been used to repair various oral cavity defects, they have certain limitations due to the dimensions. The amount and location of the palatal tissues available are important for palatal repair. Secondary intentional healing after maxillectomy will allow the epithelialization of the defect margin adjacent to remained palate, and there will be more mucosa that is available for closure of the defect. We delayed the closure of the palatal defect, while the patient underwent prosthetic treatment for functional recovery in 5 maxillectomy patients. Delayed closure of palatal defect with local flap was done at 10.8 ± 7.9 months after the maxillectomy. While delayed closure in hemimaxillectomy patients left postoperative fistula, it provided separation of the oral cavity and nasal/sinus cavity and adequate surface for prosthesis in partial maxillectomy patients.

  12. Aspiration pneumonia in patients with cleft palate

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.

  13. Aspiration pneumonia in patients with cleft palate

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il

    2003-01-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group

  14. Evidence-based medicine: cleft palate.

    Science.gov (United States)

    Chepla, Kyle J; Gosain, Arun K

    2013-12-01

    After reading this article, the participant should be able to: 1. Describe recent changes in treatment of cleft palate. 2. Compare the efficacy of different surgical treatments. 3. Assess their own knowledge of cleft palate repair. 4. Determine where further individual in-depth study and development are warranted. The Maintenance of Certification in Plastic Surgery series is designed to ensure professional development and measure continued competency within a specialty or subspecialty. The present article provides an evaluation of the interval studies regarding the management of cleft palate with a specific focus on craniofacial growth, speech outcomes, and obstructive sleep apnea since the last Maintenance of Certification in Plastic Surgery article on the subject published in 2010. This purpose of this article is to update plastic and craniomaxillofacial surgeons on recent changes in treatment of cleft palate, provide a means for accurate self-assessment, and guide further individual in-depth study and development.

  15. A two-stage method for inverse medium scattering

    KAUST Repository

    Ito, Kazufumi; Jin, Bangti; Zou, Jun

    2013-01-01

    We present a novel numerical method to the time-harmonic inverse medium scattering problem of recovering the refractive index from noisy near-field scattered data. The approach consists of two stages, one pruning step of detecting the scatterer

  16. Evidence of two-stage melting of Wigner solids

    Science.gov (United States)

    Knighton, Talbot; Wu, Zhe; Huang, Jian; Serafin, Alessandro; Xia, J. S.; Pfeiffer, L. N.; West, K. W.

    2018-02-01

    Ultralow carrier concentrations of two-dimensional holes down to p =1 ×109cm-2 are realized. Remarkable insulating states are found below a critical density of pc=4 ×109cm-2 or rs≈40 . Sensitive dc V-I measurement as a function of temperature and electric field reveals a two-stage phase transition supporting the melting of a Wigner solid as a two-stage first-order transition.

  17. Micro-structured Beta-Tricalcium Phosphate for Repair of the Alveolar Cleft in Cleft Lip and Palate Patients : A Pilot Study

    NARCIS (Netherlands)

    de Ruiter, AP; Janssen, Nard; van Es, Robert; Frank, Michael; Meijer, Gert; Koole, Ron; Rosenberg, Toine

    2015-01-01

    OBJECTIVES: Can a synthetic bone substitute be used to repair the alveolar cleft to bypass donor site morbidity as well as to shorten the operating time? In earlier experimental studies, micro-structured beta-tricalcium phosphate (β-TCP) provided similar bone healing when compared with grafting with

  18. A Two-stage Improvement Method for Robot Based 3D Surface Scanning

    Science.gov (United States)

    He, F. B.; Liang, Y. D.; Wang, R. F.; Lin, Y. S.

    2018-03-01

    As known that the surface of unknown object was difficult to measure or recognize precisely, hence the 3D laser scanning technology was introduced and used properly in surface reconstruction. Usually, the surface scanning speed was slower and the scanning quality would be better, while the speed was faster and the quality would be worse. In this case, the paper presented a new two-stage scanning method in order to pursuit the quality of surface scanning in a faster speed. The first stage was rough scanning to get general point cloud data of object’s surface, and then the second stage was specific scanning to repair missing regions which were determined by chord length discrete method. Meanwhile, a system containing a robotic manipulator and a handy scanner was also developed to implement the two-stage scanning method, and relevant paths were planned according to minimum enclosing ball and regional coverage theories.

  19. Prevalence, cause, and location of palatal fistula in operated complete unilateral cleft lip and palate: retrospective study.

    Science.gov (United States)

    de Agostino Biella Passos, Vivian; de Carvalho Carrara, Cleide Felício; da Silva Dalben, Gisele; Costa, Beatriz; Gomide, Marcia Ribeiro

    2014-03-01

    To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. Retrospective analysis of patient records and evaluation of preoperative initial photographs. Tertiary craniofacial center. Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.

  20. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje

    2017-01-01

    Background Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims To assess the influence of different timing of hard palate closure in a two-stage procedure on articu......Background Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. Aims To assess the influence of different timing of hard palate closure in a two-stage procedure...... on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery...

  1. Isolated cleft palate requires different surgical protocols depending on cleft type.

    Science.gov (United States)

    Elander, Anna; Persson, Christina; Lilja, Jan; Mark, Hans

    2017-08-01

    A staged protocol for isolated cleft palate (CPO), comprising the early repair of the soft palate at 6 months and delayed repair of the eventual cleft in the hard palate until 4 years, designed to improve maxillary growth, was introduced. CPO is frequently associated with additional congenital conditions. The study evaluates this surgical protocol for clefts in the soft palate (CPS) and for clefts in the hard and soft palate (CPH), with or without additional malformation, regarding primary and secondary surgical interventions needed for cleft closure and for correction of velopharyngeal insufficiency until 10 years of age. Of 94 consecutive children with CPO, divided into four groups with (+) or without (-) additional malformations (CPS + or CPS - and CPH + or CPH-), hard palate repair was required in 53%, performed with small local flaps in 21% and with bilateral mucoperiosteal flaps in 32%. The total incidence of soft palate re-repair was 2% and the fistula repair of the hard palate was 5%. The total incidence of secondary velopharyngeal surgery was 17% until 10 years, varying from 0% for CPS - and 15% for CPH-, to 28% for CPS + and 30% for CPH+. The described staged protocol for repair of CPO is found to be safe in terms of perioperative surgical results, with comparatively low need for secondary interventions. Furthermore, the study indicates that the presence of a cleft in the hard palate and/or additional conditions have a negative impact on the development of the velopharyngeal function.

  2. Cleft Palate Foundation

    Science.gov (United States)

    ... craniofacial journeys. Read the press release here. American Cleft Palate-Craniofacial Association 1504 East Franklin Street, Suite 102 ... order bottles Order ACPA publications © Copyright 2017 American Cleft Palate-Craniofacial Association. Website by Mixer Creative Follow us ...

  3. Modified Nance palatal button

    Directory of Open Access Journals (Sweden)

    Nitin Arora

    2015-01-01

    Full Text Available This paper describes modified Nance palatal button by which problems encountered in the palatal region around the acrylic button during space closure and molar distalization can be minimized.

  4. Two-stage electrolysis to enrich tritium in environmental water

    International Nuclear Information System (INIS)

    Shima, Nagayoshi; Muranaka, Takeshi

    2007-01-01

    We present a two-stage electrolyzing procedure to enrich tritium in environmental waters. Tritium is first enriched rapidly through a commercially-available electrolyser with a large 50A current, and then through a newly-designed electrolyser that avoids the memory effect, with a 6A current. Tritium recovery factor obtained by such a two-stage electrolysis was greater than that obtained when using the commercially-available device solely. Water samples collected in 2006 in lakes and along the Pacific coast of Aomori prefecture, Japan, were electrolyzed using the two-stage method. Tritium concentrations in these samples ranged from 0.2 to 0.9 Bq/L and were half or less, that in samples collected at the same sites in 1992. (author)

  5. Two-stage thermal/nonthermal waste treatment process

    International Nuclear Information System (INIS)

    Rosocha, L.A.; Anderson, G.K.; Coogan, J.J.; Kang, M.; Tennant, R.A.; Wantuck, P.J.

    1993-01-01

    An innovative waste treatment technology is being developed in Los Alamos to address the destruction of hazardous organic wastes. The technology described in this report uses two stages: a packed bed reactor (PBR) in the first stage to volatilize and/or combust liquid organics and a silent discharge plasma (SDP) reactor to remove entrained hazardous compounds in the off-gas to even lower levels. We have constructed pre-pilot-scale PBR-SDP apparatus and tested the two stages separately and in combined modes. These tests are described in the report

  6. Evaluation of the Transverse Craniofacial Morphology of Adolescents With Repaired Unilateral Cleft Lip and Palate Using Cone-Beam Computed Tomography.

    Science.gov (United States)

    Buyuk, Suleyman Kutalmiş; Celikoglu, Mevlut; Benkli, Yasin Atakan; Sekerci, Ahmet Ercan

    2016-10-01

    The aim of the study was to evaluate the transverse craniofacial morphology of the adolescent patients affected by unilateral cleft lip and palate (UCLP) and to compare the findings with age- and sex-matched control group without any cleft using their cone-beam computed tomography (CBCT) images. The study sample (n = 56 patients; mean age: 14.35 ± 3.06 years) consisted of 26 UCLP (n = 26 patients; 10 women and 16 men; mean age: 13.70 ± 2.94 years) and 30 control (n = 30 patients; 19 women and 11 men; mean age: 14.90 ± 3.10 years) subjects. Twenty-five conventional skeletal and dental tissue landmarks were identified. Twenty widely used frontal cephalometric variables (14 linear distances, 3 angles, and 3 ratios) were measured. The data were analyzed using the independent t-test between the groups. Patients affected by UCLP had statistically significantly smaller interorbital width (89.83 ± 4.16 mm), maxillary width (58.02 ± 5.77 mm), maxillary intermolar width (52.83 ± 4.83 mm), and upper face height (57.64 ± 4.57 mm) (P cleft width had significant effect on Cr-ANS (r = 0.446, P = 0.022) and the ANS-isf (r = 0.459, P = 0.018) measurements. The UCLP group showed statistically significantly smaller values for interorbital width, maxillary width, maxillary intermolar width, and upper face height than the noncleft controls.

  7. Development of Explosive Ripper with Two-Stage Combustion

    Science.gov (United States)

    1974-10-01

    inch pipe duct work, the width of this duct proved to be detrimental in marginally rippable material; the duct, instead of the penetrator tip, was...marginally rippable rock. ID. Operating Requirements 2. Fuel The two-stage combustion device is designed to operate using S A 42. the same diesel

  8. Engineering analysis of the two-stage trifluoride precipitation process

    International Nuclear Information System (INIS)

    Luerkens, D.w.W.

    1984-06-01

    An engineering analysis of two-stage trifluoride precipitation processes is developed. Precipitation kinetics are modeled using consecutive reactions to represent fluoride complexation. Material balances across the precipitators are used to model the time dependent concentration profiles of the main chemical species. The results of the engineering analysis are correlated with previous experimental work on plutonium trifluoride and cerium trifluoride

  9. Composite likelihood and two-stage estimation in family studies

    DEFF Research Database (Denmark)

    Andersen, Elisabeth Anne Wreford

    2004-01-01

    In this paper register based family studies provide the motivation for linking a two-stage estimation procedure in copula models for multivariate failure time data with a composite likelihood approach. The asymptotic properties of the estimators in both parametric and semi-parametric models are d...

  10. On the robustness of two-stage estimators

    KAUST Repository

    Zhelonkin, Mikhail; Genton, Marc G.; Ronchetti, Elvezio

    2012-01-01

    The aim of this note is to provide a general framework for the analysis of the robustness properties of a broad class of two-stage models. We derive the influence function, the change-of-variance function, and the asymptotic variance of a general

  11. Two-Stage Fuzzy Portfolio Selection Problem with Transaction Costs

    Directory of Open Access Journals (Sweden)

    Yanju Chen

    2015-01-01

    Full Text Available This paper studies a two-period portfolio selection problem. The problem is formulated as a two-stage fuzzy portfolio selection model with transaction costs, in which the future returns of risky security are characterized by possibility distributions. The objective of the proposed model is to achieve the maximum utility in terms of the expected value and variance of the final wealth. Given the first-stage decision vector and a realization of fuzzy return, the optimal value expression of the second-stage programming problem is derived. As a result, the proposed two-stage model is equivalent to a single-stage model, and the analytical optimal solution of the two-stage model is obtained, which helps us to discuss the properties of the optimal solution. Finally, some numerical experiments are performed to demonstrate the new modeling idea and the effectiveness. The computational results provided by the proposed model show that the more risk-averse investor will invest more wealth in the risk-free security. They also show that the optimal invested amount in risky security increases as the risk-free return decreases and the optimal utility increases as the risk-free return increases, whereas the optimal utility increases as the transaction costs decrease. In most instances the utilities provided by the proposed two-stage model are larger than those provided by the single-stage model.

  12. We can predict postpalatoplasty velopharyngeal insufficiency in cleft palate patients.

    Science.gov (United States)

    Leclerc, Jacques E; Godbout, Audrey; Arteau-Gauthier, Isabelle; Lacour, Sophie; Abel, Kati; McConnell, Elisa-Maude

    2014-02-01

    To find an anatomical measurement of the cleft palate (or a calculated parameter) that predicts the occurrence of velopharyngeal insufficiency (VPI) after palatal cleft repair. Retrospective cohort study. Charts were reviewed from cleft palate patients who underwent palatoplasty by the Von Langenbeck technique for isolated cleft palate or Bardach two-flap palatoplasty for cleft lip-palate. Seven anatomical cleft parameters were prospectively measured during the palatoplasty procedure. Three blinded speech-language pathologists retrospectively scored the clinically assessed VPI at 4 years of age. The recommendation of pharyngoplasty was also used as an indicator of VPI. From 1993 to 2008, 67 patients were enrolled in the study. The best predicting parameter was the ratio a/(30 - b1), in which a is defined as the posterior gap between the soft palate and the posterior pharyngeal wall and b1 is the width of the cleft at the hard palate level. An a/(30 - b1) ratio >0.7 to 0.8 is associated with a higher risk of developing VPI (relative risk = 2.2-5.1, sensitivity = 72%-81%, P cleft at the hard palate level and the posterior gap between the soft palate and the posterior pharyngeal wall were found to be the most significant parameters in predicting VPI. The best correlation was obtained with the ratio a/(30 - b1). 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Evaluation of 5-year-old children with complete cleft lip and palate: Multicenter study. Part 1: Lip and nose aesthetic results.

    Science.gov (United States)

    Dissaux, Caroline; Bodin, Frédéric; Grollemund, Bruno; Picard, Arnaud; Vazquez, Marie-Paule; Morand, Béatrice; James, Isabelle; Kauffmann, Isabelle; Bruant-Rodier, Catherine

    2015-12-01

    Cleft surgery is marked by all the controversies and the multiplication of protocols, as it has been shown by the Eurocleft study. The objective of this pilot study is to start a comparison and analyzing procedure between primary surgical protocols in French centers. Four French centers with different primary surgical protocols for cleft lip and palate repair, have accepted to be involved in this retrospective study. In each center, 20 consecutive patients with complete cleft lip and palate (10 UCLP and 10 BCLP per center), non syndromic, have been evaluated at a mean age of 5 [4,6]. In this first part, the aesthetic results of nose and lip repair were assessed based on the scale established by Mortier et al. (1997). Considering nose outcome, primary cleft repair surgery including a nasal dissection gives a statistically significant benefit in terms of septum deviation. Considering lip result, muscular dehiscence rate is significantly higher in BCLP patients with a two-stage lip closure. The centers using Millard one-stage lip closure do not have uniform results. For UCLP patients, the quality of scar is not statistically different between Skoog and Millard techniques. Primary results based on a simple, reproducible evaluation protocol. Extension to other centers required. Therapeutic study. Level III/retrospective multicenter comparative study. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Two-Stage Variable Sample-Rate Conversion System

    Science.gov (United States)

    Tkacenko, Andre

    2009-01-01

    A two-stage variable sample-rate conversion (SRC) system has been pro posed as part of a digital signal-processing system in a digital com munication radio receiver that utilizes a variety of data rates. The proposed system would be used as an interface between (1) an analog- todigital converter used in the front end of the receiver to sample an intermediatefrequency signal at a fixed input rate and (2) digita lly implemented tracking loops in subsequent stages that operate at v arious sample rates that are generally lower than the input sample r ate. This Two-Stage System would be capable of converting from an input sample rate to a desired lower output sample rate that could be var iable and not necessarily a rational fraction of the input rate.

  15. Energy demand in Portuguese manufacturing: a two-stage model

    International Nuclear Information System (INIS)

    Borges, A.M.; Pereira, A.M.

    1992-01-01

    We use a two-stage model of factor demand to estimate the parameters determining energy demand in Portuguese manufacturing. In the first stage, a capital-labor-energy-materials framework is used to analyze the substitutability between energy as a whole and other factors of production. In the second stage, total energy demand is decomposed into oil, coal and electricity demands. The two stages are fully integrated since the energy composite used in the first stage and its price are obtained from the second stage energy sub-model. The estimates obtained indicate that energy demand in manufacturing responds significantly to price changes. In addition, estimation results suggest that there are important substitution possibilities among energy forms and between energy and other factors of production. The role of price changes in energy-demand forecasting, as well as in energy policy in general, is clearly established. (author)

  16. Two-step two-stage fission gas release model

    International Nuclear Information System (INIS)

    Kim, Yong-soo; Lee, Chan-bock

    2006-01-01

    Based on the recent theoretical model, two-step two-stage model is developed which incorporates two stage diffusion processes, grain lattice and grain boundary diffusion, coupled with the two step burn-up factor in the low and high burn-up regime. FRAPCON-3 code and its in-pile data sets have been used for the benchmarking and validation of this model. Results reveals that its prediction is in better agreement with the experimental measurements than that by any model contained in the FRAPCON-3 code such as ANS 5.4, modified ANS5.4, and Forsberg-Massih model over whole burn-up range up to 70,000 MWd/MTU. (author)

  17. Fissura palatina reparada: fechamento velofaríngeo antes e durante o som basal Cleft palate repair: velopharyngeal closure before and during the basal tone

    Directory of Open Access Journals (Sweden)

    Giseane Conterno

    2010-04-01

    Full Text Available Portadores de fissura palatina apresentam inadequado fechamento velofaríngeo (FVF, com consequente hipernasalidade vocal que pode ser diminuída com o som basal. OBJETIVO: Comparar o FVF durante a realização do som basal com a emissão em registro modal, em pacientes com fissura palatina pós-forame reparada. MATERIAIS E MÉTODOS: Estudo de Casos com quatro homens adultos, portadores de fissura palatina pós-forame reparada. Imagens do FVF por nasofaringoscopia, durante a emissão da vogal [a] em registro modal e basal. Julgamento das imagens realizado por quatro otorrinolaringologistas. RESULTADOS: Em três sujeitos, não houve mudança no tipo de FVF entre os registros analisados; as modificações que ocorreram na maioria dos sujeitos referem-se apenas ao grau de movimentação das estruturas envolvidas, pois, em registro basal, o movimento das paredes laterais da faringe se manteve, o movimento da parede posterior da faringe estabilizou, o movimento do véu palatino diminuiu discretamente, e a Prega de Passavant se evidenciou. CONCLUSÕES: O tipo de FVF se manteve em três dos quatro sujeitos analisados, quando comparado o registro modal com o basal, havendo modificações no grau da movimentação das estruturas envolvidas, evidenciando a Prega de Passavant.Patients with palatine fissure have inadequate velopharyngeal closure (VPC, with consequent vocal hypernasality which can be reduced by a basal tone. AIM: to compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. MATERIALS AND METHODS: case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. RESULTS: in three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects

  18. Two-Stage Fuzzy Portfolio Selection Problem with Transaction Costs

    OpenAIRE

    Chen, Yanju; Wang, Ye

    2015-01-01

    This paper studies a two-period portfolio selection problem. The problem is formulated as a two-stage fuzzy portfolio selection model with transaction costs, in which the future returns of risky security are characterized by possibility distributions. The objective of the proposed model is to achieve the maximum utility in terms of the expected value and variance of the final wealth. Given the first-stage decision vector and a realization of fuzzy return, the optimal value expression of the s...

  19. Two-stage precipitation of neptunium (IV) oxalate

    International Nuclear Information System (INIS)

    Luerkens, D.W.

    1983-07-01

    Neptunium (IV) oxalate was precipitated using a two-stage precipitation system. A series of precipitation experiments was used to identify the significant process variables affecting precipitate characteristics. Process variables tested were input concentrations, solubility conditions in the first stage precipitator, precipitation temperatures, and residence time in the first stage precipitator. A procedure has been demonstrated that produces neptunium (IV) oxalate particles that filter well and readily calcine to the oxide

  20. Improved Early Cleft Lip and Palate Complications at a Surgery Specialty Center in the Developing World.

    Science.gov (United States)

    Park, Eugene; Deshpande, Gaurav; Schonmeyr, Bjorn; Restrepo, Carolina; Campbell, Alex

    2018-01-01

    To evaluate complication rates following cleft lip and cleft palate repairs during the transition from mission-based care to center-based care in a developing region. We performed a retrospective review of 3419 patients who underwent cleft lip repair and 1728 patients who underwent cleft palate repair in Guwahati, India between December 2010 and February 2014. Of those who underwent cleft lip repair, 654 were treated during a surgical mission and 2765 were treated at a permanent center. Of those who underwent cleft palate repair, 236 were treated during a surgical mission and 1491 were treated at a permanent center. Two large surgical missions to Guwahati, India, and the Guwahati Comprehensive Cleft Care Center (GCCCC) in Assam, India. Overall complication rates following cleft lip and cleft palate repair. Overall complication rates following cleft lip repair were 13.2% for the first mission, 6.7% for the second mission, and 4.0% at GCCCC. Overall complication rates following cleft palate repair were 28.0% for the first mission, 30.0% for the second mission, and 15.8% at GCCCC. Complication rates following cleft palate repair by the subset of surgeons permanently based at GCCCC (7.2%) were lower than visiting surgeons ( P cleft care delivery in the developing world can lead to decreased complication rates.

  1. Palate dimensions in six-year-old children with unilateral cleft lip and palate: a six-center study on dental casts.

    Science.gov (United States)

    Koželj, Vesna; Vegnuti, Miljana; Drevenšek, Martina; Hortis-Dzierzbicka, Maria; Gonzalez-Landa, Gonzalo; Hanstein, Siiri; Klimova, Irena; Kobus, Kazimierz; Kobus-Zaleśna, Katarzyna; Semb, Gunvor; Shaw, Bill

    2012-11-01

    To compare palatal dimensions in 6-year-old children with unilateral cleft lip and palate (UCLP) treated by different protocols with those of noncleft children. Retrospective intercenter outcome study. Patients : Upper dental casts from 129 children with repaired UCLP and 30 controls were analyzed by the trigonometric method. Six European cleft centers. Main outcome measures : Sagittal, transverse, and vertical dimensions of the palate were observed. Palate variables were analyzed with descriptive methods and nonparametric tests. Regarding several various characteristics measured on a relatively small number of subjects, hierarchical, k-means clustering, and principal component analyses were used. Mean values of the observed dimensions for five cleft groups differed significantly from the control (p cleft differed significantly from all other cleft groups in most variables (p palate. A similar number of treated children were classified into each cluster, while all children without clefts were classified in the same cluster. The percentage of treated children from a particular group that fit this cluster ranged from 0% to 70% and increased with age at palatal closure and number of primary surgical procedures. At 6 years of age, children with stepwise repair and hard palate closure after the age of two more frequently result in palatal dimensions of noncleft control than children with earlier palatal closure and one-stage cleft repair.

  2. Use of early hard palate closure using a vomer flap in cleft lip and palate patients.

    Science.gov (United States)

    Smarius, Bram J A; Breugem, Corstiaan C

    2016-08-01

    The aim of the present study was to determine the influence of the vomer flap during cleft palate closure. A retrospective review was performed of all consecutive unilateral/bilateral complete cleft lip and palate (Veau III en IV) children who were treated by a simultaneous lip and hard palate closure using a vomer flap. Data were collected for sex, date of birth, syndrome, adoption, cleft palate type, type of repair, date of cleft repair, cleft width, lateral incisions, fistula and location of fistula. Ninety-one children (M = 62, F 29) were operated. Mean age at time of lip closure and vomer flap was 5.8 months (range 2.9 months to 49.2 months, SD 7.1) and the mean age at palate closure was 13.6 months (range 6.3 months to 79.9 months, SD 10.8). The mean cleft width at first assessment was 13.0 mm (range 7-22 mm) compared to 8.8 mm (range 4-15 mm) at second assessment (mean difference 4.6 mm, 95% CI 3.93-5.35, p cleft width, subsequently leading to a low fistula incidence (1.1%). Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Two stage treatment of dairy effluent using immobilized Chlorella pyrenoidosa

    Science.gov (United States)

    2013-01-01

    Background Dairy effluents contains high organic load and unscrupulous discharge of these effluents into aquatic bodies is a matter of serious concern besides deteriorating their water quality. Whilst physico-chemical treatment is the common mode of treatment, immobilized microalgae can be potentially employed to treat high organic content which offer numerous benefits along with waste water treatment. Methods A novel low cost two stage treatment was employed for the complete treatment of dairy effluent. The first stage consists of treating the diary effluent in a photobioreactor (1 L) using immobilized Chlorella pyrenoidosa while the second stage involves a two column sand bed filtration technique. Results Whilst NH4+-N was completely removed, a 98% removal of PO43--P was achieved within 96 h of two stage purification processes. The filtrate was tested for toxicity and no mortality was observed in the zebra fish which was used as a model at the end of 96 h bioassay. Moreover, a significant decrease in biological oxygen demand and chemical oxygen demand was achieved by this novel method. Also the biomass separated was tested as a biofertilizer to the rice seeds and a 30% increase in terms of length of root and shoot was observed after the addition of biomass to the rice plants. Conclusions We conclude that the two stage treatment of dairy effluent is highly effective in removal of BOD and COD besides nutrients like nitrates and phosphates. The treatment also helps in discharging treated waste water safely into the receiving water bodies since it is non toxic for aquatic life. Further, the algal biomass separated after first stage of treatment was highly capable of increasing the growth of rice plants because of nitrogen fixation ability of the green alga and offers a great potential as a biofertilizer. PMID:24355316

  4. Experimental studies of two-stage centrifugal dust concentrator

    Science.gov (United States)

    Vechkanova, M. V.; Fadin, Yu M.; Ovsyannikov, Yu G.

    2018-03-01

    The article presents data of experimental results of two-stage centrifugal dust concentrator, describes its design, and shows the development of a method of engineering calculation and laboratory investigations. For the experiments, the authors used quartz, ceramic dust and slag. Experimental dispersion analysis of dust particles was obtained by sedimentation method. To build a mathematical model of the process, dust collection was built using central composite rotatable design of the four factorial experiment. A sequence of experiments was conducted in accordance with the table of random numbers. Conclusion were made.

  5. Evaluating damping elements for two-stage suspension vehicles

    Directory of Open Access Journals (Sweden)

    Ronald M. Martinod R.

    2012-01-01

    Full Text Available The technical state of the damping elements for a vehicle having two-stage suspension was evaluated by using numerical models based on the multi-body system theory; a set of virtual tests used the eigenproblem mathematical method. A test was developed based on experimental modal analysis (EMA applied to a physical system as the basis for validating the numerical models. The study focused on evaluating vehicle dynamics to determine the influence of the dampers’ technical state in each suspension state.

  6. Two-Stage Fan I: Aerodynamic and Mechanical Design

    Science.gov (United States)

    Messenger, H. E.; Kennedy, E. E.

    1972-01-01

    A two-stage, highly-loaded fan was designed to deliver an overall pressure ratio of 2.8 with an adiabatic efficiency of 83.9 percent. At the first rotor inlet, design flow per unit annulus area is 42 lbm/sec/sq ft (205 kg/sec/sq m), hub/tip ratio is 0.4 with a tip diameter of 31 inches (0.787 m), and design tip speed is 1450 ft/sec (441.96 m/sec). Other features include use of multiple-circular-arc airfoils, resettable stators, and split casings over the rotor tip sections for casing treatment tests.

  7. Two-stage, high power X-band amplifier experiment

    International Nuclear Information System (INIS)

    Kuang, E.; Davis, T.J.; Ivers, J.D.; Kerslick, G.S.; Nation, J.A.; Schaechter, L.

    1993-01-01

    At output powers in excess of 100 MW the authors have noted the development of sidebands in many TWT structures. To address this problem an experiment using a narrow bandwidth, two-stage TWT is in progress. The TWT amplifier consists of a dielectric (e = 5) slow-wave structure, a 30 dB sever section and a 8.8-9.0 GHz passband periodic, metallic structure. The electron beam used in this experiment is a 950 kV, 1 kA, 50 ns pencil beam propagating along an applied axial field of 9 kG. The dielectric first stage has a maximum gain of 30 dB measured at 8.87 GHz, with output powers of up to 50 MW in the TM 01 mode. In these experiments the dielectric amplifier output power is about 3-5 MW and the output power of the complete two-stage device is ∼160 MW at the input frequency. The sidebands detected in earlier experiments have been eliminated. The authors also report measurements of the energy spread of the electron beam resulting from the amplification process. These experimental results are compared with MAGIC code simulations and analytic work they have carried out on such devices

  8. Two-stage liquefaction of a Spanish subbituminous coal

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, M.T.; Fernandez, I.; Benito, A.M.; Cebolla, V.; Miranda, J.L.; Oelert, H.H. (Instituto de Carboquimica, Zaragoza (Spain))

    1993-05-01

    A Spanish subbituminous coal has been processed in two-stage liquefaction in a non-integrated process. The first-stage coal liquefaction has been carried out in a continuous pilot plant in Germany at Clausthal Technical University at 400[degree]C, 20 MPa hydrogen pressure and anthracene oil as solvent. The second-stage coal liquefaction has been performed in continuous operation in a hydroprocessing unit at the Instituto de Carboquimica at 450[degree]C and 10 MPa hydrogen pressure, with two commercial catalysts: Harshaw HT-400E (Co-Mo/Al[sub 2]O[sub 3]) and HT-500E (Ni-Mo/Al[sub 2]O[sub 3]). The total conversion for the first-stage coal liquefaction was 75.41 wt% (coal d.a.f.), being 3.79 wt% gases, 2.58 wt% primary condensate and 69.04 wt% heavy liquids. The heteroatoms removal for the second-stage liquefaction was 97-99 wt% of S, 85-87 wt% of N and 93-100 wt% of O. The hydroprocessed liquids have about 70% of compounds with boiling point below 350[degree]C, and meet the sulphur and nitrogen specifications for refinery feedstocks. Liquids from two-stage coal liquefaction have been distilled, and the naphtha, kerosene and diesel fractions obtained have been characterized. 39 refs., 3 figs., 8 tabs.

  9. Two-stage perceptual learning to break visual crowding.

    Science.gov (United States)

    Zhu, Ziyun; Fan, Zhenzhi; Fang, Fang

    2016-01-01

    When a target is presented with nearby flankers in the peripheral visual field, it becomes harder to identify, which is referred to as crowding. Crowding sets a fundamental limit of object recognition in peripheral vision, preventing us from fully appreciating cluttered visual scenes. We trained adult human subjects on a crowded orientation discrimination task and investigated whether crowding could be completely eliminated by training. We discovered a two-stage learning process with this training task. In the early stage, when the target and flankers were separated beyond a certain distance, subjects acquired a relatively general ability to break crowding, as evidenced by the fact that the breaking of crowding could transfer to another crowded orientation, even a crowded motion stimulus, although the transfer to the opposite visual hemi-field was weak. In the late stage, like many classical perceptual learning effects, subjects' performance gradually improved and showed specificity to the trained orientation. We also found that, when the target and flankers were spaced too finely, training could only reduce, rather than completely eliminate, the crowding effect. This two-stage learning process illustrates a learning strategy for our brain to deal with the notoriously difficult problem of identifying peripheral objects in clutter. The brain first learned to solve the "easy and general" part of the problem (i.e., improving the processing resolution and segmenting the target and flankers) and then tackle the "difficult and specific" part (i.e., refining the representation of the target).

  10. Runway Operations Planning: A Two-Stage Heuristic Algorithm

    Science.gov (United States)

    Anagnostakis, Ioannis; Clarke, John-Paul

    2003-01-01

    The airport runway is a scarce resource that must be shared by different runway operations (arrivals, departures and runway crossings). Given the possible sequences of runway events, careful Runway Operations Planning (ROP) is required if runway utilization is to be maximized. From the perspective of departures, ROP solutions are aircraft departure schedules developed by optimally allocating runway time for departures given the time required for arrivals and crossings. In addition to the obvious objective of maximizing throughput, other objectives, such as guaranteeing fairness and minimizing environmental impact, can also be incorporated into the ROP solution subject to constraints introduced by Air Traffic Control (ATC) procedures. This paper introduces a two stage heuristic algorithm for solving the Runway Operations Planning (ROP) problem. In the first stage, sequences of departure class slots and runway crossings slots are generated and ranked based on departure runway throughput under stochastic conditions. In the second stage, the departure class slots are populated with specific flights from the pool of available aircraft, by solving an integer program with a Branch & Bound algorithm implementation. Preliminary results from this implementation of the two-stage algorithm on real-world traffic data are presented.

  11. TWO-STAGE HEAT PUMPS FOR ENERGY SAVING TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    A. E. Denysova

    2017-09-01

    Full Text Available The problem of energy saving becomes one of the most important in power engineering. It is caused by exhaustion of world reserves in hydrocarbon fuel, such as gas, oil and coal representing sources of traditional heat supply. Conventional sources have essential shortcomings: low power, ecological and economic efficiencies, that can be eliminated by using alternative methods of power supply, like the considered one: low-temperature natural heat of ground waters of on the basis of heat pump installations application. The heat supply system considered provides an effective use of two stages heat pump installation operating as heat source at ground waters during the lowest ambient temperature period. Proposed is a calculation method of heat pump installations on the basis of groundwater energy. Calculated are the values of electric energy consumption by the compressors’ drive, and the heat supply system transformation coefficient µ for a low-potential source of heat from ground waters allowing to estimate high efficiency of two stages heat pump installations.

  12. Two stage approach to dynamic soil structure interaction

    International Nuclear Information System (INIS)

    Nelson, I.

    1981-01-01

    A two stage approach is used to reduce the effective size of soil island required to solve dynamic soil structure interaction problems. The ficticious boundaries of the conventional soil island are chosen sufficiently far from the structure so that the presence of the structure causes only a slight perturbation on the soil response near the boundaries. While the resulting finite element model of the soil structure system can be solved, it requires a formidable computational effort. Currently, a two stage approach is used to reduce this effort. The combined soil structure system has many frequencies and wavelengths. For a stiff structure, the lowest frequencies are those associated with the motion of the structure as a rigid body. In the soil, these modes have the longest wavelengths and attenuate most slowly. The higher frequency deformational modes of the structure have shorter wavelengths and their effect attenuates more rapidly with distance from the structure. The difference in soil response between a computation with a refined structural model, and one with a crude model, tends towards zero a very short distance from the structure. In the current work, the 'crude model' is a rigid structure with the same geometry and inertial properties as the refined model. Preliminary calculations indicated that a rigid structure would be a good low frequency approximation to the actual structure, provided the structure was much stiffer than the native soil. (orig./RW)

  13. Repetitive, small-bore two-stage light gas gun

    International Nuclear Information System (INIS)

    Combs, S.K.; Foust, C.R.; Fehling, D.T.; Gouge, M.J.; Milora, S.L.

    1991-01-01

    A repetitive two-stage light gas gun for high-speed pellet injection has been developed at Oak Ridge National Laboratory. In general, applications of the two-stage light gas gun have been limited to only single shots, with a finite time (at least minutes) needed for recovery and preparation for the next shot. The new device overcomes problems associated with repetitive operation, including rapidly evacuating the propellant gases, reloading the gun breech with a new projectile, returning the piston to its initial position, and refilling the first- and second-stage gas volumes to the appropriate pressure levels. In addition, some components are subjected to and must survive severe operating conditions, which include rapid cycling to high pressures and temperatures (up to thousands of bars and thousands of kelvins) and significant mechanical shocks. Small plastic projectiles (4-mm nominal size) and helium gas have been used in the prototype device, which was equipped with a 1-m-long pump tube and a 1-m-long gun barrel, to demonstrate repetitive operation (up to 1 Hz) at relatively high pellet velocities (up to 3000 m/s). The equipment is described, and experimental results are presented. 124 refs., 6 figs., 5 tabs

  14. Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix

    Directory of Open Access Journals (Sweden)

    Omri Emodi, DMD

    2018-03-01

    Full Text Available Summary:. Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%. We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.

  15. Assessing Technical Performance and Determining the Learning Curve in Cleft Palate Surgery Using a High-Fidelity Cleft Palate Simulator.

    Science.gov (United States)

    Podolsky, Dale J; Fisher, David M; Wong Riff, Karen W; Szasz, Peter; Looi, Thomas; Drake, James M; Forrest, Christopher R

    2018-06-01

    This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high-fidelity cleft palate simulator through a longitudinal simulation training exercise. Three residents performed five and one resident performed nine consecutive endoscopically recorded cleft palate repairs using a cleft palate simulator. Two fellows in pediatric plastic surgery and two expert cleft surgeons also performed recorded simulated repairs. The Cleft Palate Objective Structured Assessment of Technical Skill (CLOSATS) and end-product scales were developed to assess performance. Two blinded cleft surgeons assessed the recordings and the final repairs using the CLOSATS, end-product scale, and a previously developed global rating scale. The average procedure-specific (CLOSATS), global rating, and end-product scores increased logarithmically after each successive simulation session for the residents. Reliability of the CLOSATS (average item intraclass correlation coefficient (ICC), 0.85 ± 0.093) and global ratings (average item ICC, 0.91 ± 0.02) among the raters was high. Reliability of the end-product assessments was lower (average item ICC, 0.66 ± 0.15). Standard setting linear regression using an overall cutoff score of 7 of 10 corresponded to a pass score for the CLOSATS and the global score of 44 (maximum, 60) and 23 (maximum, 30), respectively. Using logarithmic best-fit curves, 6.3 simulation sessions are required to reach the minimum standard. A high-fidelity cleft palate simulator has been developed that improves technical performance in cleft palate repair. The simulator and technical assessment scores can be used to determine performance before operating on patients.

  16. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency.

    Science.gov (United States)

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-09-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance.

  17. Cleft Lip and Palate

    Science.gov (United States)

    Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly. They happen early during ... A baby can have a cleft lip, a cleft palate, or both. A cleft lip happens if the ...

  18. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje

    2018-01-01

    BACKGROUND: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. AIMS: To assess the influence of different timing of hard palate closure in a two-stage procedure...... on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery...

  19. On the prior probabilities for two-stage Bayesian estimates

    International Nuclear Information System (INIS)

    Kohut, P.

    1992-01-01

    The method of Bayesian inference is reexamined for its applicability and for the required underlying assumptions in obtaining and using prior probability estimates. Two different approaches are suggested to determine the first-stage priors in the two-stage Bayesian analysis which avoid certain assumptions required for other techniques. In the first scheme, the prior is obtained through a true frequency based distribution generated at selected intervals utilizing actual sampling of the failure rate distributions. The population variability distribution is generated as the weighed average of the frequency distributions. The second method is based on a non-parametric Bayesian approach using the Maximum Entropy Principle. Specific features such as integral properties or selected parameters of prior distributions may be obtained with minimal assumptions. It is indicated how various quantiles may also be generated with a least square technique

  20. Two-stage hydroprocessing of synthetic crude gas oil

    Energy Technology Data Exchange (ETDEWEB)

    Mahay, A.; Chmielowiec, J.; Fisher, I.P.; Monnier, J. (Petro-Canada Products, Missisauga, ON (Canada). Research and Development Centre)

    1992-02-01

    The hydrocracking of synthetic crude gas oils (SGO), which are commercially produced from Canadian oil sands, is strongly inhibited by nitrogen-containing species. To alleviate the pronounced effect of these nitrogenous compounds, SGO was hydrotreated at severe conditions prior to hydrocracking to reduce its N content from 1665 to about 390 ppm (by weight). Hydrocracking was then performed using a commercial nickel-tungsten catalyst supported on silica-alumina. Two-stage hydroprocessing of SGO was assessed in terms of product yields and quality. As expected, higher gas oil conversion were achieved mostly from an increase in naphtha yield. The middle distillate product quality was also clearly improved as the diesel fuel cetane number increased by 13%. Diesel engine tests indicated that particulate emissions in exhaust gases were lowered by 20%. Finally, pseudo first-order kinetic equations were derived for the overall conversion of the major gas oil components. 17 refs., 2 figs., 8 tabs.

  1. Quick pace of property acquisitions requires two-stage evaluations

    International Nuclear Information System (INIS)

    Hollo, R.; Lockwood, S.

    1994-01-01

    The traditional method of evaluating oil and gas reserves may be too cumbersome for the quick pace of oil and gas property acquisition. An acquisition evaluator must decide quickly if a property meets basic purchase criteria. The current business climate requires a two-stage approach. First, the evaluator makes a quick assessment of the property and submits a bid. If the bid is accepted then the evaluator goes on with a detailed analysis, which represents the second stage. Acquisition of producing properties has become an important activity for many independent oil and gas producers, who must be able to evaluate reserves quickly enough to make effective business decisions yet accurately enough to avoid costly mistakes. Independent thus must be familiar with how transactions usually progress as well as with the basic methods of property evaluation. The paper discusses acquisition activity, the initial offer, the final offer, property evaluation, and fair market value

  2. Hybrid biogas upgrading in a two-stage thermophilic reactor

    DEFF Research Database (Denmark)

    Corbellini, Viola; Kougias, Panagiotis; Treu, Laura

    2018-01-01

    The aim of this study is to propose a hybrid biogas upgrading configuration composed of two-stage thermophilic reactors. Hydrogen is directly injected in the first stage reactor. The output gas from the first reactor (in-situ biogas upgrade) is subsequently transferred to a second upflow reactor...... (ex-situ upgrade), in which enriched hydrogenotrophic culture is responsible for the hydrogenation of carbon dioxide to methane. The overall objective of the work was to perform an initial methane enrichment in the in-situ reactor, avoiding deterioration of the process due to elevated pH levels......, and subsequently, to complete the biogas upgrading process in the ex-situ chamber. The methane content in the first stage reactor reached on average 87% and the corresponding value in the second stage was 91%, with a maximum of 95%. A remarkable accumulation of volatile fatty acids was observed in the first...

  3. GENERALISED MODEL BASED CONFIDENCE INTERVALS IN TWO STAGE CLUSTER SAMPLING

    Directory of Open Access Journals (Sweden)

    Christopher Ouma Onyango

    2010-09-01

    Full Text Available Chambers and Dorfman (2002 constructed bootstrap confidence intervals in model based estimation for finite population totals assuming that auxiliary values are available throughout a target population and that the auxiliary values are independent. They also assumed that the cluster sizes are known throughout the target population. We now extend to two stage sampling in which the cluster sizes are known only for the sampled clusters, and we therefore predict the unobserved part of the population total. Jan and Elinor (2008 have done similar work, but unlike them, we use a general model, in which the auxiliary values are not necessarily independent. We demonstrate that the asymptotic properties of our proposed estimator and its coverage rates are better than those constructed under the model assisted local polynomial regression model.

  4. Two-Stage Part-Based Pedestrian Detection

    DEFF Research Database (Denmark)

    Møgelmose, Andreas; Prioletti, Antonio; Trivedi, Mohan M.

    2012-01-01

    Detecting pedestrians is still a challenging task for automotive vision system due the extreme variability of targets, lighting conditions, occlusions, and high speed vehicle motion. A lot of research has been focused on this problem in the last 10 years and detectors based on classifiers has...... gained a special place among the different approaches presented. This work presents a state-of-the-art pedestrian detection system based on a two stages classifier. Candidates are extracted with a Haar cascade classifier trained with the DaimlerDB dataset and then validated through part-based HOG...... of several metrics, such as detection rate, false positives per hour, and frame rate. The novelty of this system rely in the combination of HOG part-based approach, tracking based on specific optimized feature and porting on a real prototype....

  5. Device for two-stage cementing of casing

    Energy Technology Data Exchange (ETDEWEB)

    Kudimov, D A; Goncharevskiy, Ye N; Luneva, L G; Shchelochkov, S N; Shil' nikova, L N; Tereshchenko, V G; Vasiliev, V A; Volkova, V V; Zhdokov, K I

    1981-01-01

    A device is claimed for two-stage cementing of casing. It consists of a body with lateral plugging vents, upper and lower movable sleeves, a check valve with axial channels that's situated in the lower sleeve, and a displacement limiting device for the lower sleeve. To improve the cementing process of the casing by preventing overflow of cementing fluids from the annular space into the first stage casing, the limiter is equipped with a spring rod that is capable of covering the axial channels of the check valve while it's in an operating mode. In addition, the rod in the upper part is equipped with a reinforced area under the axial channels of the check valve.

  6. Two-stage decision approach to material accounting

    International Nuclear Information System (INIS)

    Opelka, J.H.; Sutton, W.B.

    1982-01-01

    The validity of the alarm threshold 4sigma has been checked for hypothetical large and small facilities using a two-stage decision model in which the diverter's strategic variable is the quantity diverted, and the defender's strategic variables are the alarm threshold and the effectiveness of the physical security and material control systems in the possible presence of a diverter. For large facilities, the material accounting system inherently appears not to be a particularly useful system for the deterrence of diversions, and essentially no improvement can be made by lowering the alarm threshold below 4sigma. For small facilities, reduction of the threshold to 2sigma or 3sigma is a cost effective change for the accounting system, but is probably less cost effective than making improvements in the material control and physical security systems

  7. The hybrid two stage anticlockwise cycle for ecological energy conversion

    Directory of Open Access Journals (Sweden)

    Cyklis Piotr

    2016-01-01

    Full Text Available The anticlockwise cycle is commonly used for refrigeration, air conditioning and heat pumps applications. The application of refrigerant in the compression cycle is within the temperature limits of the triple point and the critical point. New refrigerants such as 1234yf or 1234ze have many disadvantages, therefore natural refrigerants application is favourable. The carbon dioxide and water can be applied only in the hybrid two stages cycle. The possibilities of this solutions are shown for refrigerating applications, as well some experimental results of the adsorption-compression double stages cycle, powered with solar collectors are shown. As a high temperature cycle the adsorption system is applied. The low temperature cycle is the compression stage with carbon dioxide as a working fluid. This allows to achieve relatively high COP for low temperature cycle and for the whole system.

  8. High Performance Gasification with the Two-Stage Gasifier

    DEFF Research Database (Denmark)

    Gøbel, Benny; Hindsgaul, Claus; Henriksen, Ulrik Birk

    2002-01-01

    , air preheating and pyrolysis, hereby very high energy efficiencies can be achieved. Encouraging results are obtained at a 100 kWth laboratory facility. The tar content in the raw gas is measured to be below 25 mg/Nm3 and around 5 mg/Nm3 after gas cleaning with traditional baghouse filter. Furthermore...... a cold gas efficiency exceeding 90% is obtained. In the original design of the two-stage gasification process, the pyrolysis unit consists of a screw conveyor with external heating, and the char unit is a fixed bed gasifier. This design is well proven during more than 1000 hours of testing with various...... fuels, and is a suitable design for medium size gasifiers....

  9. A two-stage method for inverse medium scattering

    KAUST Repository

    Ito, Kazufumi

    2013-03-01

    We present a novel numerical method to the time-harmonic inverse medium scattering problem of recovering the refractive index from noisy near-field scattered data. The approach consists of two stages, one pruning step of detecting the scatterer support, and one resolution enhancing step with nonsmooth mixed regularization. The first step is strictly direct and of sampling type, and it faithfully detects the scatterer support. The second step is an innovative application of nonsmooth mixed regularization, and it accurately resolves the scatterer size as well as intensities. The nonsmooth model can be efficiently solved by a semi-smooth Newton-type method. Numerical results for two- and three-dimensional examples indicate that the new approach is accurate, computationally efficient, and robust with respect to data noise. © 2012 Elsevier Inc.

  10. Runway Operations Planning: A Two-Stage Solution Methodology

    Science.gov (United States)

    Anagnostakis, Ioannis; Clarke, John-Paul

    2003-01-01

    The airport runway is a scarce resource that must be shared by different runway operations (arrivals, departures and runway crossings). Given the possible sequences of runway events, careful Runway Operations Planning (ROP) is required if runway utilization is to be maximized. Thus, Runway Operations Planning (ROP) is a critical component of airport operations planning in general and surface operations planning in particular. From the perspective of departures, ROP solutions are aircraft departure schedules developed by optimally allocating runway time for departures given the time required for arrivals and crossings. In addition to the obvious objective of maximizing throughput, other objectives, such as guaranteeing fairness and minimizing environmental impact, may be incorporated into the ROP solution subject to constraints introduced by Air Traffic Control (ATC) procedures. Generating optimal runway operations plans was approached in with a 'one-stage' optimization routine that considered all the desired objectives and constraints, and the characteristics of each aircraft (weight class, destination, Air Traffic Control (ATC) constraints) at the same time. Since, however, at any given point in time, there is less uncertainty in the predicted demand for departure resources in terms of weight class than in terms of specific aircraft, the ROP problem can be parsed into two stages. In the context of the Departure Planner (OP) research project, this paper introduces Runway Operations Planning (ROP) as part of the wider Surface Operations Optimization (SOO) and describes a proposed 'two stage' heuristic algorithm for solving the Runway Operations Planning (ROP) problem. Focus is specifically given on including runway crossings in the planning process of runway operations. In the first stage, sequences of departure class slots and runwy crossings slots are generated and ranked based on departure runway throughput under stochastic conditions. In the second stage, the

  11. Two-stage repair of low anorectal malformations in girls: is it truly a ...

    African Journals Online (AJOL)

    continence in these children because of wound dehiscence and infection; thus, protective colostomy may still be ... the protective effect on wound healing after anal reconstruction. The aim of this study was to define ... Pena [3] introduced the PSARP for infants and children with ARM. They advocated performing a colostomy ...

  12. Effect of Silica Fume on two-stage Concrete Strength

    Science.gov (United States)

    Abdelgader, H. S.; El-Baden, A. S.

    2015-11-01

    Two-stage concrete (TSC) is an innovative concrete that does not require vibration for placing and compaction. TSC is a simple concept; it is made using the same basic constituents as traditional concrete: cement, coarse aggregate, sand and water as well as mineral and chemical admixtures. As its name suggests, it is produced through a two-stage process. Firstly washed coarse aggregate is placed into the formwork in-situ. Later a specifically designed self compacting grout is introduced into the form from the lowest point under gravity pressure to fill the voids, cementing the aggregate into a monolith. The hardened concrete is dense, homogeneous and has in general improved engineering properties and durability. This paper presents the results from a research work attempt to study the effect of silica fume (SF) and superplasticizers admixtures (SP) on compressive and tensile strength of TSC using various combinations of water to cement ratio (w/c) and cement to sand ratio (c/s). Thirty six concrete mixes with different grout constituents were tested. From each mix twenty four standard cylinder samples of size (150mm×300mm) of concrete containing crushed aggregate were produced. The tested samples were made from combinations of w/c equal to: 0.45, 0.55 and 0.85, and three c/s of values: 0.5, 1 and 1.5. Silica fume was added at a dosage of 6% of weight of cement, while superplasticizer was added at a dosage of 2% of cement weight. Results indicated that both tensile and compressive strength of TSC can be statistically derived as a function of w/c and c/s with good correlation coefficients. The basic principle of traditional concrete, which says that an increase in water/cement ratio will lead to a reduction in compressive strength, was shown to hold true for TSC specimens tested. Using a combination of both silica fume and superplasticisers caused a significant increase in strength relative to control mixes.

  13. Chemokine Signaling during Midline Epithelial Seam Disintegration Facilitates Palatal Fusion

    Science.gov (United States)

    Suttorp, Christiaan M.; Cremers, Niels A.; van Rheden, René; Regan, Raymond F.; Helmich, Pia; van Kempen, Sven; Kuijpers-Jagtman, Anne M.; Wagener, Frank A.D.T.G.

    2017-01-01

    Disintegration of the midline epithelial seam (MES) is crucial for palatal fusion, and failure results in cleft palate. Palatal fusion and wound repair share many common signaling pathways related to epithelial-mesenchymal cross-talk. We postulate that chemokine CXCL11, its receptor CXCR3, and the cytoprotective enzyme heme oxygenase (HO), which are crucial during wound repair, also play a decisive role in MES disintegration. Fetal growth restriction and craniofacial abnormalities were present in HO-2 knockout (KO) mice without effects on palatal fusion. CXCL11 and CXCR3 were highly expressed in the disintegrating MES in both wild-type and HO-2 KO animals. Multiple apoptotic DNA fragments were present within the disintegrating MES and phagocytized by recruited CXCR3-positive wt and HO-2 KO macrophages. Macrophages located near the MES were HO-1-positive, and more HO-1-positive cells were present in HO-2 KO mice compared to wild-type. This study of embryonic and palatal development provided evidence that supports the hypothesis that the MES itself plays a prominent role in palatal fusion by orchestrating epithelial apoptosis and macrophage recruitment via CXCL11-CXCR3 signaling. PMID:29164113

  14. Teaching Palatoplasty Using a High-Fidelity Cleft Palate Simulator.

    Science.gov (United States)

    Cheng, Homan; Podolsky, Dale J; Fisher, David M; Wong, Karen W; Lorenz, H Peter; Khosla, Rohit K; Drake, James M; Forrest, Christopher R

    2018-01-01

    Cleft palate repair is a challenging procedure for cleft surgeons to teach. A novel high-fidelity cleft palate simulator has been described for surgeon training. This study evaluates the simulator's effect on surgeon procedural confidence and palatoplasty knowledge among learners. Plastic surgery trainees attended a palatoplasty workshop consisting of a didactic session on cleft palate anatomy and repair followed by a simulation session. Participants completed a procedural confidence questionnaire and palatoplasty knowledge test immediately before and after the workshop. All participants reported significantly higher procedural confidence following the workshop (p cleft palate surgery experience had higher procedural confidence before (p cleft palate experience did not have higher mean baseline test scores than those with no experience (30 percent versus 28 percent; p > 0.05), but did have significantly higher scores after the workshop (61 percent versus 35 percent; p cleft palate simulator as a training tool to teach palatoplasty. Improved procedural confidence and knowledge were observed after a single session, with benefits seen among trainees both with and without previous cleft experience.

  15. Chemokine Signaling during Midline Epithelial Seam Disintegration Facilitates Palatal Fusion

    Directory of Open Access Journals (Sweden)

    Christiaan M. Suttorp

    2017-10-01

    Full Text Available Disintegration of the midline epithelial seam (MES is crucial for palatal fusion, and failure results in cleft palate. Palatal fusion and wound repair share many common signaling pathways related to epithelial-mesenchymal cross-talk. We postulate that chemokine CXCL11, its receptor CXCR3, and the cytoprotective enzyme heme oxygenase (HO, which are crucial during wound repair, also play a decisive role in MES disintegration. Fetal growth restriction and craniofacial abnormalities were present in HO-2 knockout (KO mice without effects on palatal fusion. CXCL11 and CXCR3 were highly expressed in the disintegrating MES in both wild-type and HO-2 KO animals. Multiple apoptotic DNA fragments were present within the disintegrating MES and phagocytized by recruited CXCR3-positive wt and HO-2 KO macrophages. Macrophages located near the MES were HO-1-positive, and more HO-1-positive cells were present in HO-2 KO mice compared to wild-type. This study of embryonic and palatal development provided evidence that supports the hypothesis that the MES itself plays a prominent role in palatal fusion by orchestrating epithelial apoptosis and macrophage recruitment via CXCL11-CXCR3 signaling.

  16. Dynamic two-stage mechanism of versatile DNA damage recognition by xeroderma pigmentosum group C protein

    Energy Technology Data Exchange (ETDEWEB)

    Clement, Flurina C.; Camenisch, Ulrike; Fei, Jia; Kaczmarek, Nina; Mathieu, Nadine [Institute of Pharmacology and Toxicology, University of Zuerich-Vetsuisse, Winterthurerstrasse 260, CH-8057 Zuerich (Switzerland); Naegeli, Hanspeter, E-mail: naegelih@vetpharm.uzh.ch [Institute of Pharmacology and Toxicology, University of Zuerich-Vetsuisse, Winterthurerstrasse 260, CH-8057 Zuerich (Switzerland)

    2010-03-01

    The recognition and subsequent repair of DNA damage are essential reactions for the maintenance of genome stability. A key general sensor of DNA lesions is xeroderma pigmentosum group C (XPC) protein, which recognizes a wide variety of helix-distorting DNA adducts arising from ultraviolet (UV) radiation, genotoxic chemicals and reactive metabolic byproducts. By detecting damaged DNA sites, this unique molecular sensor initiates the global genome repair (GGR) pathway, which allows for the removal of all the aforementioned lesions by a limited repertoire of excision factors. A faulty GGR activity causes the accumulation of DNA adducts leading to mutagenesis, carcinogenesis, neurological degeneration and other traits of premature aging. Recent findings indicate that XPC protein achieves its extraordinary substrate versatility by an entirely indirect readout strategy implemented in two clearly discernible stages. First, the XPC subunit uses a dynamic sensor interface to monitor the double helix for the presence of non-hydrogen-bonded bases. This initial screening generates a transient nucleoprotein intermediate that subsequently matures into the ultimate recognition complex by trapping undamaged nucleotides in the abnormally oscillating native strand, in a way that no direct contacts are made between XPC protein and the offending lesion itself. It remains to be elucidated how accessory factors like Rad23B, centrin-2 or the UV-damaged DNA-binding complex contribute to this dynamic two-stage quality control process.

  17. Cleft lip and palate repair - discharge

    Science.gov (United States)

    ... NOT eat include: Seeds, nuts, bits of candy, chocolate chips, or granola (not plain, nor mixed into ... child to a speech therapist. Most times, speech therapy lasts 2 months. You will be told when ...

  18. The Epidemiology of Cleft Lip and Palate in Canada, 1998 to 2007.

    Science.gov (United States)

    Matthews, Jennifer L K; Oddone-Paolucci, Elizabeth; Harrop, Robertston A

    2015-07-01

    To examine the birth prevalence, gender distribution, and pattern of surgical intervention for clefts in Canada (1998 to 2007). Also to highlight the difficulties associated with studying the epidemiology of clefts using the current data collection mechanisms. Epidemiologic data acquired from the Canadian Institute for Health Information. Population-based study in Canada 1998 to 2007. All live births with an International Classification of Diseases (9th or 10th revision) diagnostic code for cleft palate or for cleft lip with or without cleft palate or with a surgical intervention code for repair of cleft lip or cleft palate. Birth prevalence, gender distribution, and pattern of surgical intervention. There were 3,015,325 live births in Canada (1998 to 2007). The mean birth prevalence was 0.82 per 1000 live births for cleft lip with or without cleft palate and 0.58 per 1000 live births for cleft palate. The birth prevalence of cleft lip with or without cleft palate was significantly higher in boys, with a stable boy to girl ratio of 1.75:1. Cleft palate was significantly greater in girls; however, the boy to girl ratio decreased from 0.97:1 in 1998 to 0.59:1 in 2007. The median age of repair in Canada from 1998 to 2007 was 4.7 months for cleft lip and 11.6 months for cleft palate. Thirty percent of patients underwent cleft palate repair after age 1. The birth prevalence of cleft palate and cleft lip with or without cleft palate is stable in Canada. An increasing birth prevalence of cleft palate in girls is suggested. The timing of surgical intervention is consistent with current standards. The challenges associated with collecting these data in Canada are discussed.

  19. Eliminating Survivor Bias in Two-stage Instrumental Variable Estimators.

    Science.gov (United States)

    Vansteelandt, Stijn; Walter, Stefan; Tchetgen Tchetgen, Eric

    2018-07-01

    Mendelian randomization studies commonly focus on elderly populations. This makes the instrumental variables analysis of such studies sensitive to survivor bias, a type of selection bias. A particular concern is that the instrumental variable conditions, even when valid for the source population, may be violated for the selective population of individuals who survive the onset of the study. This is potentially very damaging because Mendelian randomization studies are known to be sensitive to bias due to even minor violations of the instrumental variable conditions. Interestingly, the instrumental variable conditions continue to hold within certain risk sets of individuals who are still alive at a given age when the instrument and unmeasured confounders exert additive effects on the exposure, and moreover, the exposure and unmeasured confounders exert additive effects on the hazard of death. In this article, we will exploit this property to derive a two-stage instrumental variable estimator for the effect of exposure on mortality, which is insulated against the above described selection bias under these additivity assumptions.

  20. Two-stage image denoising considering interscale and intrascale dependencies

    Science.gov (United States)

    Shahdoosti, Hamid Reza

    2017-11-01

    A solution to the problem of reducing the noise of grayscale images is presented. To consider the intrascale and interscale dependencies, this study makes use of a model. It is shown that the dependency between a wavelet coefficient and its predecessors can be modeled by the first-order Markov chain, which means that the parent conveys all of the information necessary for efficient estimation. Using this fact, the proposed method employs the Kalman filter in the wavelet domain for image denoising. The proposed method has two stages. The first stage employs a simple denoising algorithm to provide the noise-free image, by which the parameters of the model such as state transition matrix, variance of the process noise, the observation model, and the covariance of the observation noise are estimated. In the second stage, the Kalman filter is applied to the wavelet coefficients of the noisy image to estimate the noise-free coefficients. In fact, the Kalman filter is used to estimate the coefficients of high-frequency subbands from the coefficients of coarser scales and noisy observations of neighboring coefficients. In this way, both the interscale and intrascale dependencies are taken into account. Results are presented and discussed on a set of standard 8-bit grayscale images. The experimental results demonstrate that the proposed method achieves performances competitive with the state-of-the-art denoising methods in terms of both peak-signal-to-noise ratio and subjective visual quality.

  1. Two-Stage Electricity Demand Modeling Using Machine Learning Algorithms

    Directory of Open Access Journals (Sweden)

    Krzysztof Gajowniczek

    2017-10-01

    Full Text Available Forecasting of electricity demand has become one of the most important areas of research in the electric power industry, as it is a critical component of cost-efficient power system management and planning. In this context, accurate and robust load forecasting is supposed to play a key role in reducing generation costs, and deals with the reliability of the power system. However, due to demand peaks in the power system, forecasts are inaccurate and prone to high numbers of errors. In this paper, our contributions comprise a proposed data-mining scheme for demand modeling through peak detection, as well as the use of this information to feed the forecasting system. For this purpose, we have taken a different approach from that of time series forecasting, representing it as a two-stage pattern recognition problem. We have developed a peak classification model followed by a forecasting model to estimate an aggregated demand volume. We have utilized a set of machine learning algorithms to benefit from both accurate detection of the peaks and precise forecasts, as applied to the Polish power system. The key finding is that the algorithms can detect 96.3% of electricity peaks (load value equal to or above the 99th percentile of the load distribution and deliver accurate forecasts, with mean absolute percentage error (MAPE of 3.10% and resistant mean absolute percentage error (r-MAPE of 2.70% for the 24 h forecasting horizon.

  2. FIRST DIRECT EVIDENCE OF TWO STAGES IN FREE RECALL

    Directory of Open Access Journals (Sweden)

    Eugen Tarnow

    2015-12-01

    Full Text Available I find that exactly two stages can be seen directly in sequential free recall distributions. These distributions show that the first three recalls come from the emptying of working memory, recalls 6 and above come from a second stage and the 4th and 5th recalls are mixtures of the two.A discontinuity, a rounded step function, is shown to exist in the fitted linear slope of the recall distributions as the recall shifts from the emptying of working memory (positive slope to the second stage (negative slope. The discontinuity leads to a first estimate of the capacity of working memory at 4-4.5 items. The total recall is shown to be a linear combination of the content of working memory and items recalled in the second stage with 3.0-3.9 items coming from working memory, a second estimate of the capacity of working memory. A third, separate upper limit on the capacity of working memory is found (3.06 items, corresponding to the requirement that the content of working memory cannot exceed the total recall, item by item. This third limit is presumably the best limit on the average capacity of unchunked working memory.The second stage of recall is shown to be reactivation: The average times to retrieve additional items in free recall obey a linear relationship as a function of the recall probability which mimics recognition and cued recall, both mechanisms using reactivation (Tarnow, 2008.

  3. A two-stage DEA approach for environmental efficiency measurement.

    Science.gov (United States)

    Song, Malin; Wang, Shuhong; Liu, Wei

    2014-05-01

    The slacks-based measure (SBM) model based on the constant returns to scale has achieved some good results in addressing the undesirable outputs, such as waste water and water gas, in measuring environmental efficiency. However, the traditional SBM model cannot deal with the scenario in which desirable outputs are constant. Based on the axiomatic theory of productivity, this paper carries out a systematic research on the SBM model considering undesirable outputs, and further expands the SBM model from the perspective of network analysis. The new model can not only perform efficiency evaluation considering undesirable outputs, but also calculate desirable and undesirable outputs separately. The latter advantage successfully solves the "dependence" problem of outputs, that is, we can not increase the desirable outputs without producing any undesirable outputs. The following illustration shows that the efficiency values obtained by two-stage approach are smaller than those obtained by the traditional SBM model. Our approach provides a more profound analysis on how to improve environmental efficiency of the decision making units.

  4. Two-stage nuclear refrigeration with enhanced nuclear moments

    International Nuclear Information System (INIS)

    Hunik, R.

    1979-01-01

    Experiments are described in which an enhanced nuclear system is used as a precoolant for a nuclear demagnetisation stage. The results show the promising advantages of such a system in those circumstances for which a large cooling power is required at extremely low temperatures. A theoretical review of nuclear enhancement at the microscopic level and its macroscopic thermodynamical consequences is given. The experimental equipment for the implementation of the nuclear enhanced refrigeration method is described and the experiments on two-stage nuclear demagnetisation are discussed. With the nuclear enhanced system PrCu 6 the author could precool a nuclear stage of indium in a magnetic field of 6 T down to temperatures below 10 mK; this resulted in temperature below 1 mK after demagnetisation of the indium. It is demonstrated that the interaction energy between the nuclear moments in an enhanced nuclear system can exceed the nuclear dipolar interaction. Several experiments are described on pulsed nuclear magnetic resonance, as utilised for thermometry purposes. It is shown that platinum NMR-thermometry gives very satisfactory results around 1 mK. The results of experiments on nuclear orientation of radioactive nuclei, e.g. the brute force polarisation of 95 NbPt and 60 CoCu, are presented, some of which are of major importance for the thermometry in the milli-Kelvin region. (Auth.)

  5. Cone-Beam Computed Tomography Analysis of the Nasopharyngeal Airway in Nonsyndromic Cleft Lip and Palate Subjects.

    Science.gov (United States)

    Al-Fahdawi, Mahmood Abd; Farid, Mary Medhat; El-Fotouh, Mona Abou; El-Kassaby, Marwa Abdelwahab

    2017-03-01

      To assess the nasopharyngeal airway volume, cross-sectional area, and depth in previously repaired nonsyndromic unilateral cleft lip and palate versus bilateral cleft lip and palate patients compared with noncleft controls using cone-beam computed tomography with the ultimate goal of finding whether cleft lip and palate patients are more liable to nasopharyngeal airway obstruction.   A retrospective analysis comparing bilateral cleft lip and palate, unilateral cleft lip and palate, and control subjects. Significance at P ≤ .05.   Cleft Care Center and the outpatient clinic that are both affiliated with our faculty.   Cone-beam computed tomography data were selected of 58 individuals aged 9 to 12 years: 14 with bilateral cleft lip and palate and 20 with unilateral cleft lip and palate as well as 24 age- and gender-matched noncleft controls.   Volume, depth, and cross-sectional area of nasopharyngeal airway were measured.   Patients with bilateral cleft lip and palate showed significantly larger nasopharyngeal airway volume than controls and patients with unilateral cleft lip and palate (P cleft lip and palate showed significantly larger cross-sectional area than those with unilateral cleft lip and palate (P .05). Patients with bilateral cleft lip and palate showed significantly larger depth than controls and those with unilateral cleft lip and palate (P cleft lip and palate showed insignificant nasopharyngeal airway volume, cross-sectional area, and depth compared with controls (P > .05).   Unilateral and bilateral cleft lip and palate patients did not show significantly less volume, cross-sectional area, or depth of nasopharyngeal airway than controls. From the results of this study we conclude that unilateral and bilateral cleft lip and palate patients at the studied age and stage of repaired clefts are not more prone to nasopharyngeal airway obstruction than controls.

  6. Two-stage Catalytic Reduction of NOx with Hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Umit S. Ozkan; Erik M. Holmgreen; Matthew M. Yung; Jonathan Halter; Joel Hiltner

    2005-12-21

    A two-stage system for the catalytic reduction of NO from lean-burn natural gas reciprocating engine exhaust is investigated. Each of the two stages uses a distinct catalyst. The first stage is oxidation of NO to NO{sub 2} and the second stage is reduction of NO{sub 2} to N{sub 2} with a hydrocarbon. The central idea is that since NO{sub 2} is a more easily reduced species than NO, it should be better able to compete with oxygen for the combustion reaction of hydrocarbon, which is a challenge in lean conditions. Early work focused on demonstrating that the N{sub 2} yield obtained when NO{sub 2} was reduced was greater than when NO was reduced. NO{sub 2} reduction catalysts were designed and silver supported on alumina (Ag/Al{sub 2}O{sub 3}) was found to be quite active, able to achieve 95% N{sub 2} yield in 10% O{sub 2} using propane as the reducing agent. The design of a catalyst for NO oxidation was also investigated, and a Co/TiO{sub 2} catalyst prepared by sol-gel was shown to have high activity for the reaction, able to reach equilibrium conversion of 80% at 300 C at GHSV of 50,000h{sup -1}. After it was shown that NO{sub 2} could be more easily reduced to N{sub 2} than NO, the focus shifted on developing a catalyst that could use methane as the reducing agent. The Ag/Al{sub 2}O{sub 3} catalyst was tested and found to be inactive for NOx reduction with methane. Through iterative catalyst design, a palladium-based catalyst on a sulfated-zirconia support (Pd/SZ) was synthesized and shown to be able to selectively reduce NO{sub 2} in lean conditions using methane. Development of catalysts for the oxidation reaction also continued and higher activity, as well as stability in 10% water, was observed on a Co/ZrO{sub 2} catalyst, which reached equilibrium conversion of 94% at 250 C at the same GHSV. The Co/ZrO{sub 2} catalyst was also found to be extremely active for oxidation of CO, ethane, and propane, which could potential eliminate the need for any separate

  7. Essential Palatal Myoclonus

    Directory of Open Access Journals (Sweden)

    Bhuwan Raj Pandey

    2017-06-01

    Full Text Available Introduction: Palatal myoclonus is a rare condition presenting with clicking sound in ear or muscle tremor in pharynx. There are two varieties: essential and symptomatic. Various treatment options exists ranging from watchful observation to botulinum toxin injection. We have not found any reported case of palatal myoclonus from our country. Here we present a case of essential palatal myoclonus managed with clonazepam. Case report: A young female presented in Ear Nose and Throat clinic with complain of auditory click and spontaneous rhythmic movement of throat muscles for eight months. On examination, there was involuntary, rhythmic contraction of bilateral soft-palate, uvula, and base of tongue. Neurological, eye, and peripheral examination were normal. A diagnosis of essential palatal myoclonus was made. It was managed successfully with clonazepam; patient was still on low dose clonazepam at the time of making this report. Conclusion: Essential palatal myoclonus can be clinically diagnosed and managed even in settings where MRI is not available or affordable.

  8. Causes for the two stages of the disruption energy quench

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, F.C.; Donne, A.J.H.; Heijnen, S.H.; Rommers, J.R.; Tanzi, C.P. [FOM-Instituut voor Plasmafysica, Rijnhuizen (Netherlands); Vries, P.C. de; Waidmann, G. [Forschungszentrum Juelich GmbH (Germany). Inst. fuer Plasmaphysik

    1994-12-31

    It is a well-established fact that the energy quench of tokamak disruptions takes place in two stages separated by a plateau period. The total quench duration of typically a few hundred {mu}s is thought to be a combination of Alfven and magnetic diffusion times: Phase 1: a large cold m=1 bubble eats out the hot core within the q=1 surface. Since the normal thermal isolation of the outer layers is still intact this phase means an adiabatic flattening of the inner temperature distribution. Phase 2: after a plateau period the second quench occurs when the edge thermal barrier collapses and a major part of the plasma energy is lost in conjunction with a negative surface voltage spike and a positive spike of the plasma current. In the experimental and theoretical literature on this subject not much attention is given to the evolution of the density distribution during these two phases. This may be caused by the great difficulties one has to keep the fringe counters of multichannel interferometers on track during the very fast changing evolution. The interferometer at TEXTOR can follow this evolution. The spatial resolution after inversion is limited because of the modest number of interferometer channels. In RTP an 18-channel fast interferometer is available next to a 4-channel pulse radar reflectometer which makes it possible to investigate the density profile evolution with both good time (2 {mu}s)- and spatial (0.1a)-resolution. A fast 20-channel ECE-heterodyne radiometer and a 5-camera SXR system allows to follow the temperature profile evolution as well. In this paper theoretical models will be revisited and compared to the new experimental evidence. (author) 9 refs., 3 figs.

  9. Causes for the two stages of the disruption energy quench

    International Nuclear Information System (INIS)

    Schueller, F.C.; Donne, A.J.H.; Heijnen, S.H.; Rommers, J.R.; Tanzi, C.P.; Vries, P.C. de; Waidmann, G.

    1994-01-01

    It is a well-established fact that the energy quench of tokamak disruptions takes place in two stages separated by a plateau period. The total quench duration of typically a few hundred μs is thought to be a combination of Alfven and magnetic diffusion times: Phase 1: a large cold m=1 bubble eats out the hot core within the q=1 surface. Since the normal thermal isolation of the outer layers is still intact this phase means an adiabatic flattening of the inner temperature distribution. Phase 2: after a plateau period the second quench occurs when the edge thermal barrier collapses and a major part of the plasma energy is lost in conjunction with a negative surface voltage spike and a positive spike of the plasma current. In the experimental and theoretical literature on this subject not much attention is given to the evolution of the density distribution during these two phases. This may be caused by the great difficulties one has to keep the fringe counters of multichannel interferometers on track during the very fast changing evolution. The interferometer at TEXTOR can follow this evolution. The spatial resolution after inversion is limited because of the modest number of interferometer channels. In RTP an 18-channel fast interferometer is available next to a 4-channel pulse radar reflectometer which makes it possible to investigate the density profile evolution with both good time (2 μs)- and spatial (0.1a)-resolution. A fast 20-channel ECE-heterodyne radiometer and a 5-camera SXR system allows to follow the temperature profile evolution as well. In this paper theoretical models will be revisited and compared to the new experimental evidence. (author) 9 refs., 3 figs

  10. Transport fuels from two-stage coal liquefaction

    Energy Technology Data Exchange (ETDEWEB)

    Benito, A.; Cebolla, V.; Fernandez, I.; Martinez, M.T.; Miranda, J.L.; Oelert, H.; Prado, J.G. (Instituto de Carboquimica CSIC, Zaragoza (Spain))

    1994-03-01

    Four Spanish lignites and their vitrinite concentrates were evaluated for coal liquefaction. Correlationships between the content of vitrinite and conversion in direct liquefaction were observed for the lignites but not for the vitrinite concentrates. The most reactive of the four coals was processed in two-stage liquefaction at a higher scale. First-stage coal liquefaction was carried out in a continuous unit at Clausthal University at a temperature of 400[degree]C at 20 MPa hydrogen pressure and with anthracene oil as a solvent. The coal conversion obtained was 75.41% being 3.79% gases, 2.58% primary condensate and 69.04% heavy liquids. A hydroprocessing unit was built at the Instituto de Carboquimica for the second-stage coal liquefaction. Whole and deasphalted liquids from the first-stage liquefaction were processed at 450[degree]C and 10 MPa hydrogen pressure, with two commercial catalysts: Harshaw HT-400E (Co-Mo/Al[sub 2]O[sub 3]) and HT-500E (Ni-Mo/Al[sub 2]O[sub 3]). The effects of liquid hourly space velocity (LHSV), temperature, gas/liquid ratio and catalyst on the heteroatom liquids, and levels of 5 ppm of nitrogen and 52 ppm of sulphur were reached at 450[degree]C, 10 MPa hydrogen pressure, 0.08 kg H[sub 2]/kg feedstock and with Harshaw HT-500E catalyst. The liquids obtained were hydroprocessed again at 420[degree]C, 10 MPa hydrogen pressure and 0.06 kg H[sub 2]/kg feedstock to hydrogenate the aromatic structures. In these conditions, the aromaticity was reduced considerably, and 39% of naphthas and 35% of kerosene fractions were obtained. 18 refs., 4 figs., 4 tabs.

  11. Two-Stage Performance Engineering of Container-based Virtualization

    Directory of Open Access Journals (Sweden)

    Zheng Li

    2018-02-01

    Full Text Available Cloud computing has become a compelling paradigm built on compute and storage virtualization technologies. The current virtualization solution in the Cloud widely relies on hypervisor-based technologies. Given the recent booming of the container ecosystem, the container-based virtualization starts receiving more attention for being a promising alternative. Although the container technologies are generally considered to be lightweight, no virtualization solution is ideally resource-free, and the corresponding performance overheads will lead to negative impacts on the quality of Cloud services. To facilitate understanding container technologies from the performance engineering’s perspective, we conducted two-stage performance investigations into Docker containers as a concrete example. At the first stage, we used a physical machine with “just-enough” resource as a baseline to investigate the performance overhead of a standalone Docker container against a standalone virtual machine (VM. With findings contrary to the related work, our evaluation results show that the virtualization’s performance overhead could vary not only on a feature-by-feature basis but also on a job-to-job basis. Moreover, the hypervisor-based technology does not come with higher performance overhead in every case. For example, Docker containers particularly exhibit lower QoS in terms of storage transaction speed. At the ongoing second stage, we employed a physical machine with “fair-enough” resource to implement a container-based MapReduce application and try to optimize its performance. In fact, this machine failed in affording VM-based MapReduce clusters in the same scale. The performance tuning results show that the effects of different optimization strategies could largely be related to the data characteristics. For example, LZO compression can bring the most significant performance improvement when dealing with text data in our case.

  12. A novel route for placing free flap pedicle from a palatal defect

    Directory of Open Access Journals (Sweden)

    Rajeev B Ahuja

    2014-01-01

    Full Text Available One of the better options available to repair a large palatal defect is by employing a free flap. Almost all the times such free flaps are plumbed to facial vessels. The greatest challenge in such cases is the placement of the pedicle from palatal shelf to recipient vessels because there is no direct route available. As majority of large palatal fistulae are encountered in operated cleft palates there is a possibility of routing the pedicle through a cleft in the maxillary arch or via pyriform aperture. When such a possibility doesn′t exist the pedicle is routed behind the maxillary arch. We describe a novel technique of pedicle placement through a maxillary antrostomy, in this case report, where a large palatal fistula in a 16 year old boy was repaired employing a free radial artery forearm flap. The direct route provided by maxillary antrostomy is considered the most expeditious of all possibilities mentioned above.

  13. Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients

    Science.gov (United States)

    Chen, Qi; Zheng, Qian; Shi, Bing; Yin, Heng; Meng, Tian; Zheng, Guang-ning

    2011-01-01

    BACKGROUND: This study was carried out to analyze the relationship between clinical factors and velopharyngeal closure (VPC) in cleft palate patients. METHODS: Chi-square test was used to compare the postoperative velopharyngeal closure rate. Logistic regression model was used to analyze independent variables associated with velopharyngeal closure. RESULTS: Difference of postoperative VPC rate in different cleft types, operative ages and surgical techniques was significant (P=0.000). Results of logistic regression analysis suggested that when operative age was beyond deciduous dentition stage, or cleft palate type was complete, or just had undergone a simple palatoplasty without levator veli palatini retropositioning, patients would suffer a higher velopharyngeal insufficiency rate after primary palatal repair. CONCLUSIONS: Cleft type, operative age and surgical technique were the contributing factors influencing VPC rate after primary palatal repair of cleft palate patients. PMID:22279464

  14. Comparison of the effect of the rotation palatoplasty and V-Y pushback palatoplasty techniques on palate elongation with magnetic resonance imaging.

    Science.gov (United States)

    Isik, D; Bora, A; Yuce, S; Davran, R; Kocak, O F; Canbaz, Y; Avcu, S; Atik, B

    2015-06-01

    Most surgical techniques used in cleft palate repair require the extension of the palate to the pharynx. However, no adequate information exists regarding the extent to which this elongation obtained during operation continues in late postoperative period. In this study, we compared and measured palate elongation in patients with a cleft palate who underwent a V-Y pushback or rotation palatoplasty, by means of magnetic resonance images obtained before and 1 year after surgery. The hard palate, soft palate, and total palate lengths were measured for all of the patients, and the velopharyngeal opening area width was calculated. In patients who underwent the V-Y pushback technique (n=13), the total palate and soft palate lengths were shortened by an average of 0.10 and 0.14cm after surgery, respectively. However, the hard palate length was elongated by an average of 0.13cm. In the rotation palatoplasty group (n=13), the total palate, hard palate, and soft palate lengths were elongated by 0.57, 0.10, and 0.49cm, respectively. The velopharyngeal opening was narrowed by 0.06cm(2) using the V-Y pushback technique and by 0.29cm(2) using the rotational palatoplasty. This study demonstrated that the palate does not elongate during the V-Y pushback technique, as expected. However, rotational palatoplasty elongates the soft palate. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Two-Stage Urethroplasty with Buccal Mucosa for Penoscrotal Hypospadias Reconstruction in a Male with a 46,XX Karyotype.

    Science.gov (United States)

    D'hulst, Pieter; Darras, Jochen; Joniau, Steven; Mattelaer, Pieter; Winne, Linsey; Ponette, Diederik

    2017-09-01

    We present a case regarding a 32-year old African male with penoscrotal hypospadias, left cryptorchidism and a left inguinal hernia. There were moderate masculinization characteristics. He underwent a Lichtenstein hernia repair with perioperative biopsies of the left inguinal testis and epididymis. Microscopic examination showed a Sertoli-only left testis with Leydig-cell hyperplasia and the left epididymis consisted of ovarian tissue with corpora albicantia and maturing follicles. Endocrinological evaluation showed a sex-determining region Y (SRY) negative 46,XX karyotype. We successfully performed a two-stage urethroplasty with buccal mucosa graft to reconstruct his penoscrotal hypospadias.

  16. The Two-stage Constrained Equal Awards and Losses Rules for Multi-Issue Allocation Situation

    NARCIS (Netherlands)

    Lorenzo-Freire, S.; Casas-Mendez, B.; Hendrickx, R.L.P.

    2005-01-01

    This paper considers two-stage solutions for multi-issue allocation situations.Characterisations are provided for the two-stage constrained equal awards and constrained equal losses rules, based on the properties of composition and path independence.

  17. Cleft Lip and Palate Surgery

    Science.gov (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  18. Cleft Palate; A Multidiscipline Approach.

    Science.gov (United States)

    Stark, Richard B., Ed.

    Nineteen articles present a multidisciplinary approach to the management of facial clefts. The following subjects are discussed: the history of cleft lip and cleft palate surgery; cogenital defects; classification; the operation of a cleft palate clinic; physical examination of newborns with cleft lip and/or palate; nursing care; anesthesia;…

  19. A two-stage preventive maintenance optimization model incorporating two-dimensional extended warranty

    International Nuclear Information System (INIS)

    Su, Chun; Wang, Xiaolin

    2016-01-01

    In practice, customers can decide whether to buy an extended warranty or not, at the time of item sale or at the end of the basic warranty. In this paper, by taking into account the moments of customers purchasing two-dimensional extended warranty, the optimization of imperfect preventive maintenance for repairable items is investigated from the manufacturer's perspective. A two-dimensional preventive maintenance strategy is proposed, under which the item is preventively maintained according to a specified age interval or usage interval, whichever occurs first. It is highlighted that when the extended warranty is purchased upon the expiration of the basic warranty, the manufacturer faces a two-stage preventive maintenance optimization problem. Moreover, in the second stage, the possibility of reducing the servicing cost over the extended warranty period is explored by classifying customers on the basis of their usage rates and then providing them with customized preventive maintenance programs. Numerical examples show that offering customized preventive maintenance programs can reduce the manufacturer's warranty cost, while a larger saving in warranty cost comes from encouraging customers to buy the extended warranty at the time of item sale. - Highlights: • A two-dimensional PM strategy is investigated. • Imperfect PM strategy is optimized by considering both two-dimensional BW and EW. • Customers are categorized based on their usage rates throughout the BW period. • Servicing cost of the EW is reduced by offering customized PM programs. • Customers buying the EW at the time of sale is preferred for the manufacturer.

  20. A Rat Model for Muscle Regeneration in the Soft Palate

    Science.gov (United States)

    Carvajal Monroy, Paola L.; Grefte, Sander; Kuijpers-Jagtman, Anne M.; Helmich, Maria P. A. C.; Ulrich, Dietmar J. O.; Von den Hoff, Johannes W.; Wagener, Frank A. D. T. G.

    2013-01-01

    Background Children with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. Despite successful surgical repositioning of the muscles, optimal function is often not achieved. Scar formation and defective regeneration may hamper the functional recovery of the muscles after cleft palate repair. Therefore, the aim of this study is to investigate the anatomy and histology of the soft palate in rats, and to establish an in vivo model for muscle regeneration after surgical injury. Methods Fourteen adult male Sprague Dawley rats were divided into four groups. Groups 1 (n = 4) and 2 (n = 2) were used to investigate the anatomy and histology of the soft palate, respectively. Group 3 (n = 6) was used for surgical wounding of the soft palate, and group 4 (n = 2) was used as unwounded control group. The wounds (1 mm) were evaluated by (immuno)histochemistry (AZAN staining, Pax7, MyoD, MyoG, MyHC, and ASMA) after 7 days. Results The present study shows that the anatomy and histology of the soft palate muscles of the rat is largely comparable with that in humans. All wounds showed clinical evidence of healing after 7 days. AZAN staining demonstrated extensive collagen deposition in the wound area, and initial regeneration of muscle fibers and salivary glands. Proliferating and differentiating satellite cells were identified in the wound area by antibody staining. Conclusions This model is the first, suitable for studying muscle regeneration in the rat soft palate, and allows the development of novel adjuvant strategies to promote muscle regeneration after cleft palate surgery. PMID:23554995

  1. Cleft Lip and Palate

    Science.gov (United States)

    ... from surgery, coping with speech problems, or improving self-esteem. Some teens join support groups or online forums where they can talk to other people who were born with cleft lip or palate. Reviewed by: Rupal Christine Gupta, MD Date reviewed: ...

  2. Epileptic palatal myoclonus

    International Nuclear Information System (INIS)

    Tatum, W.O.; Sperling, M.R.; Jacobstein, J.G.

    1991-01-01

    Palatal myoclonus (PM) is usually caused by lesions of the brainstem. The authors report a case of PM of focal cortical origin in a patient with epilepsia partialis continua. The PM sometimes occurred in isolation, and at other times was accompanied by unilateral face, neck, and arm twitching. This was documented by both EEG and SPECT

  3. Accommodating Picky Palates

    Science.gov (United States)

    Lum, Lydia

    2007-01-01

    Healthy gourmet offerings are fast becoming the norm at college dining halls around the country. At a time when the children of Baby Boomers are hitting higher education in record numbers, college officials have scrambled to accommodate their picky palates and their insistence for healthier meals than were served to past generations. At the same…

  4. Epileptic palatal myoclonus

    Energy Technology Data Exchange (ETDEWEB)

    Tatum, W.O.; Sperling, M.R.; Jacobstein, J.G. (Graduate Hospital, Philadelphia, PA (USA))

    1991-08-01

    Palatal myoclonus (PM) is usually caused by lesions of the brainstem. The authors report a case of PM of focal cortical origin in a patient with epilepsia partialis continua. The PM sometimes occurred in isolation, and at other times was accompanied by unilateral face, neck, and arm twitching. This was documented by both EEG and SPECT.

  5. Cleft Lip and Palate

    Science.gov (United States)

    ... Cleft Lip or Cleft Palate Print en español Labio leporino y paladar hendido Tilt your head back a bit and look in the mirror. Do you see the way your nose connects to your upper lip? Now open your mouth. Do you see the ...

  6. Prevalence of Dental Anomalies in Patients With Nonsyndromic Cleft Lip and/or Palate in a Brazilian Population.

    Science.gov (United States)

    Paranaiba, Lívia Máris Ribeiro; Coletta, Ricardo D; Swerts, Mário Sérgio Oliveira; Quintino, Rafaela Pacífico; de Barros, Letízia Monteiro; Martelli-Júnior, Hercílio

    2013-07-01

    Objective : Many studies have demonstrated a high frequency of dental anomalies in patients with cleft lip and/or palate. Because dental anomalies may complicate dental treatment, we investigated the prevalence of dental anomalies in a group of Brazilian patients with nonsyndromic cleft lip and/or palate. Design, Participants, Setting : Retrospective analysis was performed using clinical records of 296 patients aged between 12 and 30 years with repaired nonsyndromic cleft lip and/or palate without history of tooth extraction and orthodontic treatment. Associations between oral clefts and presence of dental anomalies outside the cleft area were investigated. Results : Dental anomalies were identified in 39.9% of the nonsyndromic cleft lip and/or palate patients, and tooth agenesis (47.5%), impacted tooth (13.1%), and microdontia (12.7%) were the most common anomalies. Cleft lip patients were less affected by dental anomalies compared with cleft palate or cleft lip and palate patients (p  =  .057). Specifically, patients with unilateral cleft lip and palate were significantly more affected by dental anomalies than those with bilateral cleft lip and palate (p  =  .00002), and individuals with unilateral complete cleft lip and palate (p  =  .002) and complete cleft palate (p  =  .01) were significantly more affected by tooth agenesis than other cleft types. Agenesis of the premolars (p  =  .043) and maxillary lateral incisors (p  =  .03) were significantly more frequent in patients with unilateral complete cleft lip and palate. Conclusions : The present study revealed a high frequency of dental anomalies in nonsyndromic cleft lip and/or palate patients and further demonstrated that patients with unilateral cleft lip and palate were frequently more affected by dental anomalies than those with bilateral cleft lip and palate. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning for

  7. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Lohmander, Anette; Persson, Christina; Willadsen, Elisabeth

    2017-01-01

    BACKGROUND AND AIM: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP...... cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children......) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. DESIGN: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10...

  8. Optics of two-stage photovoltaic concentrators with dielectric second stages

    Science.gov (United States)

    Ning, Xiaohui; O'Gallagher, Joseph; Winston, Roland

    1987-04-01

    Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

  9. Two-stage model of development of heterogeneous uranium-lead systems in zircon

    International Nuclear Information System (INIS)

    Mel'nikov, N.N.; Zevchenkov, O.A.

    1985-01-01

    Behaviour of isotope systems of multiphase zircons at their two-stage distortion is considered. The results of calculations testify to the fact that linear correlations on the diagram with concordance can be explained including two-stage discovery of U-Pb systems of cogenetic zircons if zircon is considered physically heterogeneous and losing in its different part different ratios of accumulated radiogenic lead. ''Metamorphism ages'' obtained by these two-stage opening zircons are intermediate, and they not have geochronological significance while ''crystallization ages'' remain rather close to real ones. Two-stage opening zircons in some cases can be diagnosed by discordance of their crystal component

  10. Optics of two-stage photovoltaic concentrators with dielectric second stages.

    Science.gov (United States)

    Ning, X; O'Gallagher, J; Winston, R

    1987-04-01

    Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

  11. Otolaryngology Service Usage in Children With Cleft Palate.

    Science.gov (United States)

    Whittemore, Kenneth R; Dargie, Jenna M; Dornan, Briana K; Boudreau, Brian

    2018-05-01

    To determine the usage of otolaryngology services by children with cleft palate at a pediatric tertiary care facility. Retrospective case series. Specialty clinic at a pediatric tertiary care hospital. Children born between January 1, 1999, and December 31, 2002, with the diagnosis of cleft palate or cleft lip and palate. A total of 41 female and 48 male patients were included. Total number of otolaryngology clinic visits and total number of otolaryngologic surgeries (tympanostomy tube placements and other otologic or upper airway procedures). In the first 5 years of life, these children utilized an average of 8.2 otolaryngology clinic visits (SD = 5.0; range: 1-22) and underwent 3.3 tympanostomy tube surgeries (SD = 2.0; range: 0-10). Seventy-three had their first tube placed at the time of palate repair, and 4 at the time of lip repair. Fifty-one (57.3%) required other otologic or upper airway procedures, including tonsillectomy and/or adenoidectomy (27 children), removal of tympanostomy tubes (24 children), tympanomastoidectomy (3 children), and tympanoplasty (14 children). Of the children who underwent other procedures, they underwent a mean of 1.67 (SD = 0.84; range: 1-4) surgeries. Children with cleft palate are at increased risk for eustachian tube dysfunction, frequently utilize otolaryngology care, and typically receive multiple sets of tympanostomy tubes. This study found that children with cleft palate receive on average of approximately 3 sets of tympanostomy tubes, and the majority required another otologic or upper airway surgery.

  12. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate.

    Science.gov (United States)

    Willadsen, Elisabeth; Boers, Maria; Schöps, Antje; Kisling-Møller, Mia; Nielsen, Joan Bogh; Jørgensen, Line Dahl; Andersen, Mikael; Bolund, Stig; Andersen, Helene Søgaard

    2018-01-01

    Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills. Furthermore, burden of treatment was to be estimated in terms of secondary surgery, hearing and speech therapy. A randomized controlled trial (RCT). Early hard palate closure (EHPC) at 12 months versus late hard palate closure (LHPC) at 36 months in a two-stage procedure was tested in a cohort of 126 Danish-speaking children born with non-syndromic UCLP. All participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used for comparison. Children with EHPC produced significantly more target consonants correctly (83%) than children with LHPC (48%; p < .001). In addition, children with LHPC produced significantly more active cleft speech characteristics than children with EHPC (p < .001). Boys achieved significantly lower PCC-A scores than girls (p = .04) and produced significantly more consonant errors than girls (p = .02). No significant differences were found between groups regarding burden of treatment. The control group performed significantly better than the EHPC and LHPC groups on all compared variables. © 2017 Royal College of Speech

  13. Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes.

    Science.gov (United States)

    Justin, Grant A; Brietzke, Scott E

    2017-01-01

      This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes.   The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate.   Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.   A total of 36 cases were identified, with 12 unique cases from 1981 to 2006 meeting the inclusion criteria. Six cases (50%) were decided by a jury and six by settlement. Five cases involved complications related to the specific surgery, and the other seven were associated with any surgery and perioperative care of children and adults. Cleft palate repair (50%) was the most frequently litigated surgery. Postoperative negligent supervision was the most common allegation (42%) and resulted in a payout in each case (mean = $3,126,032). Death (42%) and brain injury (25%) were the most frequent injuries reported. Financial awards were made in nine cases (after adjusting for inflation, mean = $2,470,552, range = $0 to $7,704,585). The awards were significantly larger for brain injury than other outcomes ($4,675,395 versus $1,368,131 after adjusting for inflation, P = .0101).   Malpractice litigation regarding cleft lip and palate surgery is uncommon. However, significant financial awards involving perioperative brain injury have been reported.

  14. Management of cleft lip and palate in adults

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2009-10-01

    Full Text Available Introduction: With advancement of medical services in developed countries and awareness among the patients, it is rare to find an adult with an unoperated cleft lip and palate. However, the scenario is totally different in developing countries. Working as a part of a team in developing country, where co-coordinated team work is primitive, resources to provide treatment are very thin, public awareness of availability of treatment for this anomaly is minimal, the age of patients reaching for primary treatment varies from few days to late forties. Though the aim and aspiration is to provide holistic multidisciplinary care, the priority is getting treatment for all cleft patients. In such situation, the management of cleft lip and palate demands changes of approach, techniques and philosophy. Aims and Objectives: The deformed anatomy especially the facial bones and dentition is described. Due to well established deformities, the approach for management is individualized. The procedures and modification of procedures has been described. Results and Outcome: The outcome of the primary repair is adults certainly have less than satisfactory outcome for obvious reasons. The expected outcome and expectation of patients and families following primary surgeries in cleft lip and palate has been discussed. Though all adult patients got some improvement in speech after palate repair, achieving normal speech was difficult. The naso-labial appearance was not perfect, but well accepted by the patients and families. There are many psychosocial problems in these patients, the objective evaluation could not be done due to too many variables. However, primary repair of cleft lip and palate is justified and beneficial for the patients.

  15. Revis(iting French palatalization

    Directory of Open Access Journals (Sweden)

    Ali Tifrit

    2016-06-01

    Full Text Available This paper explores the diachrony of French and reconsiders the classical analysis of French palatalizations. It is widely admitted that the transition from Latin dorsal stops to French palatal fricatives is triggered by an external palatalizing object which affects the constitution of the targeted consonant. While this analysis can satisfyingly explain the palatalization of dorsals before /i/, it makes the palatalization before /a/, which occurred a few centuries later, completely opaque. Revising the internal structure and the melody used to describe segments (Government Phonology 2.0 – Pöchtrager 2006 allows us to give a unified analysis of both palatalizations: whether /i/ or /a/, the vocalic environment is indeed the trigger, as it interferes with the structure of dorsals and lead to internal changes. However, while /i/ adds palatality to the consonant, /a/, by its lack of melody (Pöchtrager & Živanović 2010, leads to an internal reconfiguration of the dorsal, which already contains . In other words, we face two kinds of palatalization: an external one and an internal one. Furthermore, our analysis takes the intermediate stages from Latin dorsals to French palatals into consideration and attested dialectal variations observed in Northern France.

  16. Social life aspects of young adults with cleft lip and palate: grounded theory approach.

    Science.gov (United States)

    Chetpakdeechit, Woranuch; Hallberg, Ulrika; Hagberg, Catharina; Mohlin, Bengt

    2009-01-01

    The findings of many questionnaire and inventory studies suggest that people with cleft lip and/or palate report a decreased quality of life. Common problems include dissatisfaction with the external appearance of the lips and nose, speech problems, depression, and anxiety. This qualitative study aimed to explore the subjective perceptions and values of young adults with clefts, particularly with regard to their social lives. Twelve persons participated in an in-depth interview. Among those, seven had a repaired isolated cleft palate involving only the hard/soft palate. Five had a repaired bilateral cleft lip and palate that had been a continuous lesion of the lip, the alveolar process, and the palate. A grounded theory approach was used to conduct and analyze the interviews. The study revealed seven important categories--hoping to be like other people, being treated differently from others, experiencing deviation from others, regarding oneself as being different from others, lack of recognition, low self-esteem, and receiving recognition from significant others--with hoping to be like other people as the core category. Young adults with either cleft lip and palate or isolated cleft palate who received recognition from significant others reported increased self-esteem and greater ability to cope with their social lives.

  17. A restricted test of single word intelligibility in 3-year-old children with and without cleft palate

    DEFF Research Database (Denmark)

    Willadsen, Elisabeth; Poulsen, Mads

    2012-01-01

    Abstract Objective: In a previous study, children with cleft palate with hard palate closure at 12 months of age showed more typical phonological development than children with an unrepaired hard palate at 36 months of age. This finding was based on narrow transcription of word initial target...... hard palate closure at either12 months (HPR (hard palate repaired)) or 36 months (HPU (hard palate unrepaired)), were compared to data obtained from 14 age-matched, typically developing, control children. Methods: Video recordings of the children naming target words were shown to 84 naïve listeners...... consonants obtained from a simple naming test. To evaluate the relevance of this finding, we investigated how well the children's target words were understood by 84 naïve listeners. Design: A cross-sectional study. Participants: Data obtained from twenty-eight children with UCLP, 3 years of age, who received...

  18. Correlation of Palatal Rugoscopy with Gender, Palatal Vault Height ...

    African Journals Online (AJOL)

    Background: Palatal rugae (PR) are asymmetrical irregular elevations, recorded during maxillary cast fabrication , that can be used for identification purpose if previous comparative sources are available. Aim: This study investigated uniqueness of PR patterns in relation to gender, palatal vault forms, and ABO blood groups ...

  19. Receptive and expressive language performance in children with and without Cleft Lip and Palate.

    Science.gov (United States)

    Lamônica, Dionísia Aparecida Cusin; Silva-Mori, Mariana Jales Felix da; Ribeiro, Camila da Costa; Maximino, Luciana Paula

    2016-01-01

    To compare the performance in the abilities of receptive and expressive language of children with cleft lip and palate with that of children without cleft lip and palate with typical 12 to 36-month chronological development. The sample consisted of 60 children aged 12 and 36 months: 30 with cleft lip and palate diagnosis and 30 without cleft lip and palate diagnosis with typical development. The groups were paired according to gender, age (in months), and socioeconomic level. The procedures consisted of analysis of medical records, anamnesis with family members, and valuation of the Early Language Milestone Scale (ELMS). The chart analysis showed 63.34% of the children with unilateral cleft lip and palate, 16.66% with bilateral incisive transforamen cleft, and 20% with post-foramen cleft. Children with cleft lip and palate underwent surgeries (lip repair and/or palatoplasty) at the recommended ages and participated in early intervention programs; 40% presented recurrent otitis history, and 50% attended schools. Statistical analysis included the use of the Mann Whitney test with significance level of p cleft lip and palate showed statistically significant low performance in receptive and expressive language compared with children without cleft lip and palate.

  20. Long-Term Incisal Relationships After Palatoplasty in Patients With Isolated Cleft Palate.

    Science.gov (United States)

    Odom, Elizabeth B; Woo, Albert S; Mendonca, Derick A; Huebener, Donald V; Nissen, Richard J; Skolnick, Gary B; Patel, Kamlesh B

    2016-06-01

    Various palatoplasty techniques have limited incisions in the hard palate due to concerns that these incisions may limit maxillary growth. There is little convincing long-term evidence to support this. Our purpose is to determine incisal relationships, an indicator for future orthognathic procedure, in patients after repair of an isolated cleft of the secondary palate. Our craniofacial database was used to identify patients aged 10 years or greater with an isolated cleft of the secondary palate who underwent palatoplasty between 1985 and 2002. Data collected included age at palatoplasty and follow-up, cleft type, associated syndrome, Robin sequence, surgeon, repair technique, number of operations, and occlusion. Incisal relationship was determined through clinical observation by a pediatric dentist and orthodontist. Seventy eligible patients operated on by 9 surgeons were identified. Class III incisal relationship was seen in 5 patients (7.1%). Palatoplasty techniques over the hard palate (63 of 70 patients) included 2-flap palatoplasty, VY-pushback, and Von Langenbeck repair. There was an association between class III incisal relationship and syndromic diagnosis (P <0.001). Other study variables were not associated with class III incisal relationships. In patients with an isolated cleft of the secondary palate, there was no association between class III incisal relationship and surgeon, age at repair, cleft type, palatoplasty technique, or number of operations. Increased likelihood of class III incisal relationship was associated primarily with syndromic diagnosis.

  1. Two-stage exchange knee arthroplasty: does resistance of the infecting organism influence the outcome?

    Science.gov (United States)

    Kurd, Mark F; Ghanem, Elie; Steinbrecher, Jill; Parvizi, Javad

    2010-08-01

    Periprosthetic joint infection after TKA is a challenging complication. Two-stage exchange arthroplasty is the accepted standard of care, but reported failure rates are increasing. It has been suggested this is due to the increased prevalence of methicillin-resistant infections. We asked the following questions: (1) What is the reinfection rate after two-stage exchange arthroplasty? (2) Which risk factors predict failure? (3) Which variables are associated with acquiring a resistant organism periprosthetic joint infection? This was a case-control study of 102 patients with infected TKA who underwent a two-stage exchange arthroplasty. Ninety-six patients were followed for a minimum of 2 years (mean, 34.5 months; range, 24-90.1 months). Cases were defined as failures of two-stage exchange arthroplasty. Two-stage exchange arthroplasty was successful in controlling the infection in 70 patients (73%). Patients who failed two-stage exchange arthroplasty were 3.37 times more likely to have been originally infected with a methicillin-resistant organism. Older age, higher body mass index, and history of thyroid disease were predisposing factors to infection with a methicillin-resistant organism. Innovative interventions are needed to improve the effectiveness of two-stage exchange arthroplasty for TKA infection with a methicillin-resistant organism as current treatment protocols may not be adequate for control of these virulent pathogens. Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

  2. Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts.

    Science.gov (United States)

    Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

    2009-01-27

    The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.

  3. The Effect of Furlow Palatoplasty Timing on Speech Outcomes in Submucous Cleft Palate.

    Science.gov (United States)

    Swanson, Jordan W; Mitchell, Brianne T; Cohen, Marilyn; Solot, Cynthia; Jackson, Oksana; Low, David; Bartlett, Scott P; Taylor, Jesse A

    2017-08-01

    Because some patients with submucous cleft palate (SMCP) are asymptomatic, surgical treatment is conventionally delayed until hypernasal resonance is identified during speech production. We aim to identify whether speech outcomes after repair of a SMCP is influenced by age of repair. We retrospectively studied nonsyndromic children with SMCP. Speech results, before and after any surgical treatment or physical management of the palate were compared using the Pittsburgh Weighted Speech Scoring system. Furlow palatoplasty was performed on 40 nonsyndromic patients with SMCP, and 26 patients were not surgically treated. Total composite speech scores improved significantly among children repaired between 3 and 4 years of age (P = 0.02), but not older than 4 years (P = 0.63). Twelve (86%) of 14 patients repaired who are older than 4 years had borderline or incompetent speech (composite Pittsburgh Weighted Speech Scoring ≥3) compared with 2 (29%) of 7 repaired between 3 and 4 years of age (P = 0.0068), despite worse prerepair scores in the latter group. Resonance improved in children repaired who are older than 4 years, but articulation errors persisted to a greater degree than those treated before 4 years of age (P = 0.01.) CONCLUSIONS: Submucous cleft palate repair before 4 years of age appears associated with lower ultimate rates of borderline or incompetent speech. Speech of patients repaired at or after 4 years of age seems to be characterized by persistent misarticulation. These findings highlight the importance of timely diagnosis and management.

  4. Design considerations for single-stage and two-stage pneumatic pellet injectors

    International Nuclear Information System (INIS)

    Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

    1988-09-01

    Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs

  5. A influência da queiloplastia realizada em tempo único e em dois tempos cirúrgicos no padrão oclusal de crianças com fissura bilateral completa de lábio e palato Influence of lip repair performed in one and two surgical times on the dental pattern of children with bilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Omar Gabriel da Silva Filho

    2007-04-01

    Full Text Available OBJETIVO: analisar a influência da queiloplastia realizada em tempo único e em dois tempos cirúrgicos no padrão oclusal de cirnaças com fissuras bilateral completa de lábio e palato. METODOLOGIA: a relação oclusal, de acordo com o índice Bauru, para a fissura bilateral completa de lábio e palato, foi estudada em uma amostra de 91 crianças nos estágios de dentadura decídua e mista. As crianças apresentavam fissura bilateral completa de lábio e palato e encontravam-se distribuídas na faixa etária compreendida entre 4 anos e 3 meses e 11 anos no momento do exame oclusal. Todas as crianças foram operadas na infância, no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC-USP, obedecendo dois protocolos de queiloplastia primária: 53 crianças foram submetidas à queiloplastia em tempo único (G1 e 38 crianças foram submetidas à queiloplastia em dois tempos cirúrgicos (G2. RESULTADOS E CONCLUSÕES: o padrão oclusal, mensurado com base numa escala de 1 a 5, de acordo com o índice Bauru para fissura bilateral completa de lábio e palato, obteve média de 2,28 e 2,51 para a queiloplastia realizada em tempo único e em dois tempos cirúrgicos, respectivamente. Os resultados permitem concluir que as cirurgias plásticas primárias comprometem a oclusão na dentadura decídua e mista, independentemente do número de etapas para a realização da queiloplastia.AIM: To analyse the influence of lip repair performed in one and two surgical times on the dental pattern of children with bilateral cleft lip and palate. METHODS: The occlusal relationship of 91 children in the primary and mixed dentition with bilateral cleft lip and palate (BCLP and aged 4 years and 4 months to 21 years was assessed according the Bauru yardstick. All children had BCLP and were operated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, on the basis of two surgical protocols. Of the

  6. Changing strategy and implementation of a new treatment protocol for cleft palate surgery in "Maria Sklodowska Curie" (MSC) Children's Hospital, Bucharest, Romania.

    Science.gov (United States)

    Spataru, Radu; Mark, Hans

    2014-12-01

    In "Maria Sklodowska Curie" (MSC) Children's Hospital, Bucharest, Romania, cleft palate repair has been performed according to von Langenbeck since 1984. The speech was good in most patients but wide clefts had a high percentage of fistulas, abnormal speech due to short length and limited mobility of the soft palate. In 2009, the protocol was changed to Gothenburg Delayed Hard Palate Closure, (DHPC) technique. The present evaluation was performed to study the implementation of this technique. One hundred and sixty-eight patients with cleft palate were admitted, 89 isolated cleft palate (ICP), 53 unilateral (UCLP) and 26 bilateral (BCLP). In these, 228 surgical interventions were performed. Soft Palate Repair (SPR) and Hard Palate Repair (HPR) were performed with the DHPC procedure. The transfer to this technique was successfully performed in three steps: one team visit to Gothenburg by a surgeon from MSC and two visits by surgeons from Gothenburg to the MSC. Patients with SPR and HPR were operated on without major complications and there were no differences in results between Gothenburg surgeons and MSC surgeons. The interventions with SPR and HPR technique were proven to be easy to teach and learn and successfully performed without major complications. For cleft patients at MSC hospital it has meant earlier surgery, less re-operations and complications. This report shows a successful change of strategy for palatal repair with improved outcome regarding surgery. In future, speech and growth will be followed on a regular basis and will be compared with results from the Gothenburg Cleft Team.

  7. Hydrogen production from cellulose in a two-stage process combining fermentation and electrohydrogenesis

    KAUST Repository

    Lalaurette, Elodie; Thammannagowda, Shivegowda; Mohagheghi, Ali; Maness, Pin-Ching; Logan, Bruce E.

    2009-01-01

    A two-stage dark-fermentation and electrohydrogenesis process was used to convert the recalcitrant lignocellulosic materials into hydrogen gas at high yields and rates. Fermentation using Clostridium thermocellum produced 1.67 mol H2/mol

  8. Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

    Science.gov (United States)

    Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

    2018-02-01

    Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT. We identified all patients at a single large academic hospital who had undergone creation of either a one-stage or two-stage BVT between January 2007 and January 2015. Data evaluated included patient demographics, comorbidities, medication use, reasons for abandonment, and interventions performed to maintain patency. Costs were derived from the literature, and effectiveness was expressed in quality-adjusted life-years (QALYs). We analyzed primary and secondary functional patency outcomes as well as survival during follow-up between one-stage and two-stage BVT procedures using multivariate Cox proportional hazards models and Kaplan-Meier analysis with log-rank tests. The incremental cost-effectiveness ratio was used to determine cost savings. We identified 131 patients in whom 57 (44%) one-stage BVT and 74 (56%) two-stage BVT fistulas were created among 8 different vascular surgeons during the study period that each performed both procedures. There was no significant difference in the mean age, male gender, white race, diabetes, coronary disease, or medication profile among patients undergoing one- vs two-stage BVT. After fistula transposition, the median follow-up time was 8.3 months (interquartile range, 3-21 months). Primary patency rates of one-stage BVT were 56% at 12-month follow-up, whereas primary patency rates of two-stage BVT were 72% at 12-month follow-up. Patients undergoing two-stage BVT also had significantly higher rates of secondary functional patency at 12 months (57% for one-stage BVT vs 80% for two-stage BVT) and 24 months (44% for one-stage BVT vs 73% for two-stage BVT) of follow-up (P < .001 using log-rank test). However, there was no significant difference

  9. TWO-STAGE CHARACTER CLASSIFICATION : A COMBINED APPROACH OF CLUSTERING AND SUPPORT VECTOR CLASSIFIERS

    NARCIS (Netherlands)

    Vuurpijl, L.; Schomaker, L.

    2000-01-01

    This paper describes a two-stage classification method for (1) classification of isolated characters and (2) verification of the classification result. Character prototypes are generated using hierarchical clustering. For those prototypes known to sometimes produce wrong classification results, a

  10. Cost-effectiveness Analysis of a Two-stage Screening Intervention for Hepatocellular Carcinoma in Taiwan

    Directory of Open Access Journals (Sweden)

    Sophy Ting-Fang Shih

    2010-01-01

    Conclusion: Screening the population of high-risk individuals for HCC with the two-stage screening intervention in Taiwan is considered potentially cost-effective compared with opportunistic screening in the target population of an HCC endemic area.

  11. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mohammed Zuhaib

    2016-01-01

    Full Text Available Context: Presurgical nasoalveolar moulding (PNAM is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1 To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM. (2 To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM. (3 To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle

  12. A Two-Stage Fuzzy Logic Control Method of Traffic Signal Based on Traffic Urgency Degree

    OpenAIRE

    Yan Ge

    2014-01-01

    City intersection traffic signal control is an important method to improve the efficiency of road network and alleviate traffic congestion. This paper researches traffic signal fuzzy control method on a single intersection. A two-stage traffic signal control method based on traffic urgency degree is proposed according to two-stage fuzzy inference on single intersection. At the first stage, calculate traffic urgency degree for all red phases using traffic urgency evaluation module and select t...

  13. Noncausal two-stage image filtration at presence of observations with anomalous errors

    OpenAIRE

    S. V. Vishnevyy; S. Ya. Zhuk; A. N. Pavliuchenkova

    2013-01-01

    Introduction. It is necessary to develop adaptive algorithms, which allow to detect such regions and to apply filter with respective parameters for suppression of anomalous noises for the purposes of image filtration, which consist of regions with anomalous errors. Development of adaptive algorithm for non-causal two-stage images filtration at pres-ence of observations with anomalous errors. The adaptive algorithm for noncausal two-stage filtration is developed. On the first stage the adaptiv...

  14. Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

    Directory of Open Access Journals (Sweden)

    Chia-Chang Chien

    2009-01-01

    Full Text Available Chia-Chang Chien1, Shu-Fen Huang1,2,3,4, For-Wey Lung1,2,3,41Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; 2Graduate Institute of Behavioral Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; 3Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan; 4Calo Psychiatric Center, Pingtung County, TaiwanObjective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts.Methods: We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST and the Wechsler Adult Intelligence Scale-Revised (WAIS-R assessments.Results: Logistic regression analysis showed the conceptual level responses (CLR index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84. We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%.Conclusion: The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.Keywords: intellectual disability, intelligence screening, two-stage positive screening, Wisconsin Card Sorting Test, Wechsler Adult Intelligence Scale-Revised

  15. Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients.

    Science.gov (United States)

    Ylikontiola, Leena P; Sándor, George K; Harila, Virpi

    2015-01-01

    Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies.

  16. Suction Cup Induced Palatal Fistula: Surgical Closure by Palatal ...

    African Journals Online (AJOL)

    1Department of Pediatrics, Pragna Children's Hospital, Hyderabad, ... Eluru, 4Department of Conservative Dentistry and Endodontics, KIMS Dental College and ... The surgical closure of palatal fistula planned under general anesthesia.

  17. The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems.

    Science.gov (United States)

    Heidsieck, David S P; Smarius, Bram J A; Oomen, Karin P Q; Breugem, Corstiaan C

    2016-09-01

    Otitis media with effusion is common in infants with an unrepaired cleft palate. Although its prevalence is reduced after cleft surgery, many children continue to suffer from middle ear problems during childhood. While the tensor veli palatini muscle is thought to be involved in middle ear ventilation, evidence about its exact anatomy, function, and role in cleft palate surgery is limited. This study aimed to perform a thorough review of the literature on (1) the role of the tensor veli palatini muscle in the Eustachian tube opening and middle ear ventilation, (2) anatomical anomalies in cleft palate infants related to middle ear disease, and (3) their implications for surgical techniques used in cleft palate repair. A literature search on the MEDLINE database was performed using a combination of the keywords "tensor veli palatini muscle," "Eustachian tube," "otitis media with effusion," and "cleft palate." Several studies confirm the important role of the tensor veli palatini muscle in the Eustachian tube opening mechanism. Maintaining the integrity of the tensor veli palatini muscle during cleft palate surgery seems to improve long-term otological outcome. However, anatomical variations in cleft palate children may alter the effect of the tensor veli palatini muscle on the Eustachian tube's dilatation mechanism. More research is warranted to clarify the role of the tensor veli palatini muscle in cleft palate-associated Eustachian tube dysfunction and development of middle ear problems. Optimized surgical management of cleft palate could potentially reduce associated middle ear problems.

  18. Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts

    Directory of Open Access Journals (Sweden)

    Bianca Zeponi Fernandes Mello

    2013-09-01

    Full Text Available OBJECTIVE: The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. MATERIAL AND METHODS: The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group; Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05. RESULTS: The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control group and both groups of patients with cleft lip and palate. There was no statistically significant difference between complete unilateral and bilateral cleft lip and palate groups. CONCLUSIONS: Patients with complete cleft lip and palate were born with an increased anterior dimension of the maxillary dental arch compared to non cleft patients.

  19. Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts

    Science.gov (United States)

    MELLO, Bianca Zeponi Fernandes; FERNANDES, Viviane Mendes; CARRARA, Cleide Felício Carvalho; MACHADO, Maria Aparecida Andrade Moreira; GARIB, Daniela Gamba; OLIVEIRA, Thais Marchini

    2013-01-01

    Objective The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. Material and Methods The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05). Results The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control group and both groups of patients with cleft lip and palate. There was no statistically significant difference between complete unilateral and bilateral cleft lip and palate groups. Conclusions Patients with complete cleft lip and palate were born with an increased anterior dimension of the maxillary dental arch compared to non cleft patients. PMID:24212990

  20. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

    Science.gov (United States)

    Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

    2013-10-01

    The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

  1. Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with cleft palate.

    Science.gov (United States)

    Xu, Hao; Mei, Xiao-Peng; Xu, Li-Xian

    2017-03-01

    Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.

  2. Assessment of Speech in Primary Cleft Palate by Two-layer Closure (Conservative Management).

    Science.gov (United States)

    Jain, Harsha; Rao, Dayashankara; Sharma, Shailender; Gupta, Saurabh

    2012-01-01

    Treatment of the cleft palate has evolved over a long period of time. Various techniques of cleft palate repair that are practiced today are the results of principles learned through many years of modifications. The challenge in the art of modern palatoplasty is no longer successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. Throughout these periods of evolution in the treatment of cleft palate, the effectiveness of various treatment protocols has been challenged by controversies concerning speech and maxillofacial growth. In this article we have evaluated the results of Pinto's modification of Wardill-Kilner palatoplasty without radical dissection of the levator veli palitini muscle on speech and post-op fistula in two different age groups in 20 patients. Preoperative and 6-month postoperative speech assessment values indicated that two-layer palatoplasty (modified Wardill-Kilner V-Y pushback technique) without an intravelar veloplasty technique was good for speech.

  3. Cleft deformities (lip and palate)

    African Journals Online (AJOL)

    dell

    hospital between February 2008 and February 2009, seventeen neonates presented with ..... are low necessitating very large sample sizes often limited by resources. ... Bianco-Davila F: Incidence of cleft lip and palate in northeast of Mexico.

  4. [Surgical correction of cleft palate].

    Science.gov (United States)

    Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

    1990-04-01

    This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

  5. Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis.

    Science.gov (United States)

    Jamshidy, Ladan; Mozaffari, Hamid Reza; Faraji, Payam; Sharifi, Roohollah

    2016-01-01

    Introduction . One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods . A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results . The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion . The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

  6. Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Ladan Jamshidy

    2016-01-01

    Full Text Available Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

  7. Anophthalmia, cleft lip/palate, absent vomer bone, nystagmus, and mental-motor retardation: a new syndrome or Fryns "anophthalmia-plus" syndrome?

    Science.gov (United States)

    Ozçelik, Derya; Sağlam, Ibrahim; SIlan, Fatma; Sezen, Gülbin; Unveren, Toygar

    2008-05-01

    We report that a 4-year-old boy presented with right unilateral complete cleft lip and palate, right anophthalmos, left congenital nystagmus, absence of the vomer bone, mental-motor retardation, and normal lymphocyte karyotype (46, XY). For reconstruction of the deformities, we performed cleft lip repair by Millard's rotation-advancement technique and planned cleft palate repair. This combination of cleft lip and palate, anophthalmos, congenital nystagmus, absent vomer bone, and mental-motor retardation has not, to our knowledge, previously been described. We suggest that this represents either another case of the rare Fryns "anophthalmia-plus" syndrome or a new syndrome.

  8. Frequency analysis of a two-stage planetary gearbox using two different methodologies

    Science.gov (United States)

    Feki, Nabih; Karray, Maha; Khabou, Mohamed Tawfik; Chaari, Fakher; Haddar, Mohamed

    2017-12-01

    This paper is focused on the characterization of the frequency content of vibration signals issued from a two-stage planetary gearbox. To achieve this goal, two different methodologies are adopted: the lumped-parameter modeling approach and the phenomenological modeling approach. The two methodologies aim to describe the complex vibrations generated by a two-stage planetary gearbox. The phenomenological model describes directly the vibrations as measured by a sensor fixed outside the fixed ring gear with respect to an inertial reference frame, while results from a lumped-parameter model are referenced with respect to a rotating frame and then transferred into an inertial reference frame. Two different case studies of the two-stage planetary gear are adopted to describe the vibration and the corresponding spectra using both models. Each case presents a specific geometry and a specific spectral structure.

  9. Optimisation of Refrigeration System with Two-Stage and Intercooler Using Fuzzy Logic and Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Bayram Kılıç

    2017-04-01

    Full Text Available Two-stage compression operation prevents excessive compressor outlet pressure and temperature and this operation provides more efficient working condition in low-temperature refrigeration applications. Vapor compression refrigeration system with two-stage and intercooler is very good solution for low-temperature refrigeration applications. In this study, refrigeration system with two-stage and intercooler were optimized using fuzzy logic and genetic algorithm. The necessary thermodynamic characteristics for optimization were estimated with Fuzzy Logic and liquid phase enthalpy, vapour phase enthalpy, liquid phase entropy, vapour phase entropy values were compared with actual values. As a result, optimum working condition of system was estimated by the Genetic Algorithm as -6.0449 oC for evaporator temperature, 25.0115 oC for condenser temperature and 5.9666 for COP. Morever, irreversibility values of the refrigeration system are calculated.

  10. Design and construction of the X-2 two-stage free piston driven expansion tube

    Science.gov (United States)

    Doolan, Con

    1995-01-01

    This report outlines the design and construction of the X-2 two-stage free piston driven expansion tube. The project has completed its construction phase and the facility has been installed in the new impulsive research laboratory where commissioning is about to take place. The X-2 uses a unique, two-stage driver design which allows a more compact and lower overall cost free piston compressor. The new facility has been constructed in order to examine the performance envelope of the two-stage driver and how well it couple to sub-orbital and super-orbital expansion tubes. Data obtained from these experiments will be used for the design of a much larger facility, X-3, utilizing the same free piston driver concept.

  11. Bias due to two-stage residual-outcome regression analysis in genetic association studies.

    Science.gov (United States)

    Demissie, Serkalem; Cupples, L Adrienne

    2011-11-01

    Association studies of risk factors and complex diseases require careful assessment of potential confounding factors. Two-stage regression analysis, sometimes referred to as residual- or adjusted-outcome analysis, has been increasingly used in association studies of single nucleotide polymorphisms (SNPs) and quantitative traits. In this analysis, first, a residual-outcome is calculated from a regression of the outcome variable on covariates and then the relationship between the adjusted-outcome and the SNP is evaluated by a simple linear regression of the adjusted-outcome on the SNP. In this article, we examine the performance of this two-stage analysis as compared with multiple linear regression (MLR) analysis. Our findings show that when a SNP and a covariate are correlated, the two-stage approach results in biased genotypic effect and loss of power. Bias is always toward the null and increases with the squared-correlation between the SNP and the covariate (). For example, for , 0.1, and 0.5, two-stage analysis results in, respectively, 0, 10, and 50% attenuation in the SNP effect. As expected, MLR was always unbiased. Since individual SNPs often show little or no correlation with covariates, a two-stage analysis is expected to perform as well as MLR in many genetic studies; however, it produces considerably different results from MLR and may lead to incorrect conclusions when independent variables are highly correlated. While a useful alternative to MLR under , the two -stage approach has serious limitations. Its use as a simple substitute for MLR should be avoided. © 2011 Wiley Periodicals, Inc.

  12. Long-term results of the island flap palatal pushback.

    Science.gov (United States)

    Luce, E A; McClinton, M; Hoopes, J E

    1976-09-01

    We analyzed all 104 island flap pushback palatal repairs done through our Facial Rehabilitation Clinic in the period from 1965 to 1971. The results were compared to those in a group of 109 standard pushback repairs. The island flap group had a higher incidence of operative complications, of velopharyngeal insufficiency, and of secondary procedures to correct the latter. (The differences between the two groups were not statistically significant, however.) In this group of patients the island flap repair offered no particular advantage over the V-Y or the Dorrance pushback; in fact, it may have been deleterious. A hypothetical explanation for these results is offered, based on possible continuing osteogenesis by the transplanted mucoperiosteum, to produce an inflexible and poorly functioning velum.

  13. Kinetics analysis of two-stage austenitization in supermartensitic stainless steel

    DEFF Research Database (Denmark)

    Nießen, Frank; Villa, Matteo; Hald, John

    2017-01-01

    The martensite-to-austenite transformation in X4CrNiMo16-5-1 supermartensitic stainless steel was followed in-situ during isochronal heating at 2, 6 and 18 K min−1 applying energy-dispersive synchrotron X-ray diffraction at the BESSY II facility. Austenitization occurred in two stages, separated...... that the austenitization kinetics is governed by Ni-diffusion and that slow transformation kinetics separating the two stages is caused by soft impingement in the martensite phase. Increasing the lath width in the kinetics model had a similar effect on the austenitization kinetics as increasing the heating-rate....

  14. One-stage and two-stage penile buccal mucosa urethroplasty

    Directory of Open Access Journals (Sweden)

    G. Barbagli

    2016-03-01

    Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

  15. Bone-borne palatal distraction to correct the constricted cleft maxilla.

    Science.gov (United States)

    Vyas, Raj M; Jarrahy, Reza; Sisodia, Manisha; Jourabchi, Natanel; Wasson, Kristy L; Bradley, James P

    2009-05-01

    Transverse maxillary hypoplasia, with or without cleft deformity, is typically treated with orthodontic expansion. However, the management of those patients who present later in life with severe uncorrected deformities or who have failed prior orthodontic care remains controversial. Tooth-borne palatal expanders have limitations in this subset of patients with scarred, constricted cleft palate. In this study, we assess the efficacy and safety of using a bone-borne palatal distraction device as an alternative treatment for this difficult subset of patients. Older children with a constricted maxilla who previously had unilateral or bilateral cleft lip and palate repairs and failed orthodontic expansion were included in the study (n = 15). Patients underwent Le Fort I corticotomy with placement of the bone-borne distraction device, expansion at a rate of 0.5 mm/d, and subsequent alveolar bone grafting. Preoperative and follow-up maxillary impressions were compared with assessed improvements in intermolar distance, intercanine distance, alveolar cleft width, and total palatal area. In addition, a small group of noncleft patients with constricted maxillas was treated with bone-borne palatal distraction without a corticotomy (n = 4). The mean amount of distraction in all patients was 14.1 mm, with a follow-up period of 19 months (range, 8-30 months). The average increase in intermolar distance was 8.4 mm, intercanine distance increased by an average of 9.5 mm, and palate surface areas were increased by a mean of 28.9 mm2. Relapse was between 4% and 7%, and all patients underwent subsequent alveolar bone grafting. In addition, the noncleft patients successfully underwent bone-borne palatal distraction without a corticotomy, with a 4% to 5% relapse. Rapid palatal expansion using a bone-borne distraction device in cleft patients with transverse maxillary hypoplasia who have failed nonsurgical orthodontic expansion provides adequate expansion necessary for alveolar bone

  16. A two-stage biological gas to liquid transfer process to convert carbon dioxide into bioplastic

    KAUST Repository

    Al Rowaihi, Israa; Kick, Benjamin; Grö tzinger, Stefan W.; Burger, Christian; Karan, Ram; Weuster-Botz, Dirk; Eppinger, Jö rg; Arold, Stefan T.

    2018-01-01

    The fermentation of carbon dioxide (CO2) with hydrogen (H2) uses available low-cost gases to synthesis acetic acid. Here, we present a two-stage biological process that allows the gas to liquid transfer (Bio-GTL) of CO2 into the biopolymer

  17. Treatment of corn ethanol distillery wastewater using two-stage anaerobic digestion.

    Science.gov (United States)

    Ráduly, B; Gyenge, L; Szilveszter, Sz; Kedves, A; Crognale, S

    In this study the mesophilic two-stage anaerobic digestion (AD) of corn bioethanol distillery wastewater is investigated in laboratory-scale reactors. Two-stage AD technology separates the different sub-processes of the AD in two distinct reactors, enabling the use of optimal conditions for the different microbial consortia involved in the different process phases, and thus allowing for higher applicable organic loading rates (OLRs), shorter hydraulic retention times (HRTs) and better conversion rates of the organic matter, as well as higher methane content of the produced biogas. In our experiments the reactors have been operated in semi-continuous phase-separated mode. A specific methane production of 1,092 mL/(L·d) has been reached at an OLR of 6.5 g TCOD/(L·d) (TCOD: total chemical oxygen demand) and a total HRT of 21 days (5.7 days in the first-stage, and 15.3 days in the second-stage reactor). Nonetheless the methane concentration in the second-stage reactor was very high (78.9%); the two-stage AD outperformed the reference single-stage AD (conducted at the same reactor loading rate and retention time) by only a small margin in terms of volumetric methane production rate. This makes questionable whether the higher methane content of the biogas counterbalances the added complexity of the two-stage digestion.

  18. On response time and cycle time distributions in a two-stage cyclic queue

    NARCIS (Netherlands)

    Boxma, O.J.; Donk, P.

    1982-01-01

    We consider a two-stage closed cyclic queueing model. For the case of an exponential server at each queue we derive the joint distribution of the successive response times of a custumer at both queues, using a reversibility argument. This joint distribution turns out to have a product form. The

  19. Simultaneous versus sequential pharmacokinetic-pharmacodynamic population analysis using an iterative two-stage Bayesian technique

    NARCIS (Netherlands)

    Proost, Johannes H.; Schiere, Sjouke; Eleveld, Douglas J.; Wierda, J. Mark K. H.

    A method for simultaneous pharmacokinetic-pharmacodynamic (PK-PD) population analysis using an Iterative Two-Stage Bayesian (ITSB) algorithm was developed. The method was evaluated using clinical data and Monte Carlo simulations. Data from a clinical study with rocuronium in nine anesthetized

  20. Numerical simulation of brain tumor growth model using two-stage ...

    African Journals Online (AJOL)

    In the recent years, the study of glioma growth to be an active field of research Mathematical models that describe the proliferation and diffusion properties of the growth have been developed by many researchers. In this work, the performance analysis of two-stage Gauss-Seidel (TSGS) method to solve the glioma growth ...

  1. An Efficient Robust Solution to the Two-Stage Stochastic Unit Commitment Problem

    DEFF Research Database (Denmark)

    Blanco, Ignacio; Morales González, Juan Miguel

    2017-01-01

    This paper proposes a reformulation of the scenario-based two-stage unitcommitment problem under uncertainty that allows finding unit-commitment plansthat perform reasonably well both in expectation and for the worst caserealization of the uncertainties. The proposed reformulation is based onpart...

  2. Two-stage bargaining with coverage extension in a dual labour market

    DEFF Research Database (Denmark)

    Roberts, Mark A.; Stæhr, Karsten; Tranæs, Torben

    2000-01-01

    This paper studies coverage extension in a simple general equilibrium model with a dual labour market. The union sector is characterized by two-stage bargaining whereas the firms set wages in the non-union sector. In this model firms and unions of the union sector have a commonality of interest...

  3. Design and construction of a two-stage centrifugal pump | Nordiana ...

    African Journals Online (AJOL)

    Centrifugal pumps are widely used in moving liquids from one location to another in homes, offices and industries. Due to the ever increasing demand for centrifugal pumps it became necessary to design and construction of a two-stage centrifugal pump. The pump consisted of an electric motor, a shaft, two rotating impellers ...

  4. Some design aspects of a two-stage rail-to-rail CMOS op amp

    NARCIS (Netherlands)

    Gierkink, Sander L.J.; Holzmann, Peter J.; Wiegerink, Remco J.; Wassenaar, R.F.

    1999-01-01

    A two-stage low-voltage CMOS op amp with rail-to-rail input and output voltage ranges is presented. The circuit uses complementary differential input pairs to achieve the rail-to-rail common-mode input voltage range. The differential pairs operate in strong inversion, and the constant

  5. Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with spacers.

    Science.gov (United States)

    Boelch, Sebastian Philipp; Weissenberger, Manuel; Spohn, Frederik; Rudert, Maximilian; Luedemann, Martin

    2018-01-10

    Evaluation of infection persistence during the two-stage exchange of the hip is challenging. Joint aspiration before reconstruction is supposed to rule out infection persistence. Sensitivity and specificity of synovial fluid culture and synovial leucocyte count for detecting infection persistence during the two-stage exchange of the hip were evaluated. Ninety-two aspirations before planned joint reconstruction during the two-stage exchange with spacers of the hip were retrospectively analyzed. The sensitivity and specificity of synovial fluid culture was 4.6 and 94.3%. The sensitivity and specificity of synovial leucocyte count at a cut-off value of 2000 cells/μl was 25.0 and 96.9%. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values were significantly higher before prosthesis removal and reconstruction or spacer exchange (p = 0.00; p = 0.013 and p = 0.039; p = 0.002) in the infection persistence group. Receiver operating characteristic area under the curve values before prosthesis removal and reconstruction or spacer exchange for ESR were lower (0.516 and 0.635) than for CRP (0.720 and 0.671). Synovial fluid culture and leucocyte count cannot rule out infection persistence during the two-stage exchange of the hip.

  6. Two-Stage Power Factor Corrected Power Supplies: The Low Component-Stress Approach

    DEFF Research Database (Denmark)

    Petersen, Lars; Andersen, Michael Andreas E.

    2002-01-01

    The discussion concerning the use of single-stage contra two-stage PFC solutions has been going on for the last decade and it continues. The purpose of this paper is to direct the focus back on how the power is processed and not so much as to the number of stages or the amount of power processed...

  7. A two-stage stochastic programming approach for operating multi-energy systems

    DEFF Research Database (Denmark)

    Zeng, Qing; Fang, Jiakun; Chen, Zhe

    2017-01-01

    This paper provides a two-stage stochastic programming approach for joint operating multi-energy systems under uncertainty. Simulation is carried out in a test system to demonstrate the feasibility and efficiency of the proposed approach. The test energy system includes a gas subsystem with a gas...

  8. EVALUATION OF A TWO-STAGE PASSIVE TREATMENT APPROACH FOR MINING INFLUENCE WATERS

    Science.gov (United States)

    A two-stage passive treatment approach was assessed at bench-scale using two Colorado Mining Influenced Waters (MIWs). The first-stage was a limestone drain with the purpose of removing iron and aluminum and mitigating the potential effects of mineral acidity. The second stage w...

  9. The RTD measurement of two stage anaerobic digester using radiotracer in WWTP

    International Nuclear Information System (INIS)

    Jin-Seop, Kim; Jong-Bum, Kim; Sung-Hee, Jung

    2006-01-01

    The aims of this study are to assess the existence and location of the stagnant zone by estimating the MRT (mean residence time) on the two stage anaerobic digester, with the results to be used as informative clue for its better operation

  10. A two-stage meta-analysis identifies several new loci for Parkinson's disease.

    NARCIS (Netherlands)

    Plagnol, V.; Nalls, M.A.; Bras, J.M.; Hernandez, D.; Sharma, M.; Sheerin, U.M.; Saad, M.; Simon-Sanchez, J.; Schulte, C.; Lesage, S.; Sveinbjornsdottir, S.; Amouyel, P.; Arepalli, S.; Band, G.; Barker, R.A.; Bellinguez, C.; Ben-Shlomo, Y.; Berendse, H.W.; Berg, D; Bhatia, K.P.; Bie, R.M. de; Biffi, A.; Bloem, B.R.; Bochdanovits, Z.; Bonin, M.; Brockmann, K.; Brooks, J.; Burn, D.J.; Charlesworth, G.; Chen, H.; Chinnery, P.F.; Chong, S.; Clarke, C.E.; Cookson, M.R.; Cooper, J.M.; Corvol, J.C.; Counsell, J.; Damier, P.; Dartigues, J.F.; Deloukas, P.; Deuschl, G.; Dexter, D.T.; Dijk, K.D. van; Dillman, A.; Durif, F.; Durr, A.; Edkins, S.; Evans, J.R.; Foltynie, T.; Freeman, C.; Gao, J.; Gardner, M.; Gibbs, J.R.; Goate, A.; Gray, E.; Guerreiro, R.; Gustafsson, O.; Harris, C.; Hellenthal, G.; Hilten, J.J. van; Hofman, A.; Hollenbeck, A.; Holton, J.L.; Hu, M.; Huang, X.; Huber, H; Hudson, G.; Hunt, S.E.; Huttenlocher, J.; Illig, T.; Jonsson, P.V.; Langford, C.; Lees, A.J.; Lichtner, P.; Limousin, P.; Lopez, G.; McNeill, A.; Moorby, C.; Moore, M.; Morris, H.A.; Morrison, K.E.; Mudanohwo, E.; O'Sullivan, S.S; Pearson, J.; Pearson, R.; Perlmutter, J.; Petursson, H.; Pirinen, M.; Polnak, P.; Post, B.; Potter, S.C.; Ravina, B.; Revesz, T.; Riess, O.; Rivadeneira, F.; Rizzu, P.; Ryten, M.; Sawcer, S.J.; Schapira, A.; Scheffer, H.; Shaw, K.; Shoulson, I.; Sidransky, E.; Silva, R. de; Smith, C.; Spencer, C.C.; Stefansson, H.; Steinberg, S.; Stockton, J.D.; Strange, A.; Su, Z.; Talbot, K.; Tanner, C.M.; Tashakkori-Ghanbaria, A.; Tison, F.; Trabzuni, D.; Traynor, B.J.; Uitterlinden, A.G.; Vandrovcova, J.; Velseboer, D.; Vidailhet, M.; Vukcevic, D.; Walker, R.; Warrenburg, B.P.C. van de; Weale, M.E.; Wickremaratchi, M.; Williams, N.; Williams-Gray, C.H.; Winder-Rhodes, S.; Stefansson, K.; Martinez, M.; Donnelly, P.; Singleton, A.B.; Hardy, J.; Heutink, P.; Brice, A.; Gasser, T.; Wood, N.W.

    2011-01-01

    A previous genome-wide association (GWA) meta-analysis of 12,386 PD cases and 21,026 controls conducted by the International Parkinson's Disease Genomics Consortium (IPDGC) discovered or confirmed 11 Parkinson's disease (PD) loci. This first analysis of the two-stage IPDGC study

  11. Two-Stage MAS Technique for Analysis of DRA Elements and Arrays on Finite Ground Planes

    DEFF Research Database (Denmark)

    Larsen, Niels Vesterdal; Breinbjerg, Olav

    2007-01-01

    A two-stage Method of Auxiliary Sources (MAS) technique is proposed for analysis of dielectric resonator antenna (DRA) elements and arrays on finite ground planes (FGPs). The problem is solved by first analysing the DRA on an infinite ground plane (IGP) and then using this solution to model the FGP...

  12. A Two-Stage Approach to Civil Conflict: Contested Incompatibilities and Armed Violence

    DEFF Research Database (Denmark)

    Bartusevicius, Henrikas; Gleditsch, Kristian Skrede

    2017-01-01

    conflict origination but have no clear effect on militarization, whereas other features emphasized as shaping the risk of civil war, such as refugee flows and soft state power, strongly influence militarization but not incompatibilities. We posit that a two-stage approach to conflict analysis can help...

  13. Wide-bandwidth bilateral control using two-stage actuator system

    International Nuclear Information System (INIS)

    Kokuryu, Saori; Izutsu, Masaki; Kamamichi, Norihiro; Ishikawa, Jun

    2015-01-01

    This paper proposes a two-stage actuator system that consists of a coarse actuator driven by a ball screw with an AC motor (the first stage) and a fine actuator driven by a voice coil motor (the second stage). The proposed two-stage actuator system is applied to make a wide-bandwidth bilateral control system without needing expensive high-performance actuators. In the proposed system, the first stage has a wide moving range with a narrow control bandwidth, and the second stage has a narrow moving range with a wide control bandwidth. By consolidating these two inexpensive actuators with different control bandwidths in a complementary manner, a wide bandwidth bilateral control system can be constructed based on a mechanical impedance control. To show the validity of the proposed method, a prototype of the two-stage actuator system has been developed and basic performance was evaluated by experiment. The experimental results showed that a light mechanical impedance with a mass of 10 g and a damping coefficient of 2.5 N/(m/s) that is an important factor to establish good transparency in bilateral control has been successfully achieved and also showed that a better force and position responses between a master and slave is achieved by using the proposed two-stage actuator system compared with a narrow bandwidth case using a single ball screw system. (author)

  14. Advancing early detection of autism spectrum disorder by applying an integrated two-stage screening approach

    NARCIS (Netherlands)

    Oosterling, Iris J.; Wensing, Michel; Swinkels, Sophie H.; van der Gaag, Rutger Jan; Visser, Janne C.; Woudenberg, Tim; Minderaa, Ruud; Steenhuis, Mark-Peter; Buitelaar, Jan K.

    Background: Few field trials exist on the impact of implementing guidelines for the early detection of autism spectrum disorders (ASD). The aims of the present study were to develop and evaluate a clinically relevant integrated early detection programme based on the two-stage screening approach of

  15. A Two-Stage Meta-Analysis Identifies Several New Loci for Parkinson's Disease

    NARCIS (Netherlands)

    Plagnol, Vincent; Nalls, Michael A.; Bras, Jose M.; Hernandez, Dena G.; Sharma, Manu; Sheerin, Una-Marie; Saad, Mohamad; Simon-Sanchez, Javier; Schulte, Claudia; Lesage, Suzanne; Sveinbjornsdottir, Sigurlaug; Amouyel, Philippe; Arepalli, Sampath; Band, Gavin; Barker, Roger A.; Bellinguez, Celine; Ben-Shlomo, Yoav; Berendse, Henk W.; Berg, Daniela; Bhatia, Kailash; de Bie, Rob M. A.; Biffi, Alessandro; Bloem, Bas; Bochdanovits, Zoltan; Bonin, Michael; Brockmann, Kathrin; Brooks, Janet; Burn, David J.; Charlesworth, Gavin; Chen, Honglei; Chinnery, Patrick F.; Chong, Sean; Clarke, Carl E.; Cookson, Mark R.; Cooper, J. Mark; Corvol, Jean Christophe; Counsell, Carl; Damier, Philippe; Dartigues, Jean-Francois; Deloukas, Panos; Deuschl, Guenther; Dexter, David T.; van Dijk, Karin D.; Dillman, Allissa; Durif, Frank; Duerr, Alexandra; Edkins, Sarah; Evans, Jonathan R.; Foltynie, Thomas; Freeman, Colin; Gao, Jianjun; Gardner, Michelle; Gibbs, J. Raphael; Goate, Alison; Gray, Emma; Guerreiro, Rita; Gustafsson, Omar; Harris, Clare; Hellenthal, Garrett; van Hilten, Jacobus J.; Hofman, Albert; Hollenbeck, Albert; Holton, Janice; Hu, Michele; Huang, Xuemei; Huber, Heiko; Hudson, Gavin; Hunt, Sarah E.; Huttenlocher, Johanna; Illig, Thomas; Jonsson, Palmi V.; Langford, Cordelia; Lees, Andrew; Lichtner, Peter; Limousin, Patricia; Lopez, Grisel; Lorenz, Delia; McNeill, Alisdair; Moorby, Catriona; Moore, Matthew; Morris, Huw; Morrison, Karen E.; Mudanohwo, Ese; O'Sullivan, Sean S.; Pearson, Justin; Pearson, Richard; Perlmutter, Joel S.; Petursson, Hjoervar; Pirinen, Matti; Pollak, Pierre; Post, Bart; Potter, Simon; Ravina, Bernard; Revesz, Tamas; Riess, Olaf; Rivadeneira, Fernando; Rizzu, Patrizia; Ryten, Mina; Sawcer, Stephen; Schapira, Anthony; Scheffer, Hans; Shaw, Karen; Shoulson, Ira; Sidransky, Ellen; de Silva, Rohan; Smith, Colin; Spencer, Chris C. A.; Stefansson, Hreinn; Steinberg, Stacy; Stockton, Joanna D.; Strange, Amy; Su, Zhan; Talbot, Kevin; Tanner, Carlie M.; Tashakkori-Ghanbaria, Avazeh; Tison, Francois; Trabzuni, Daniah; Traynor, Bryan J.; Uitterlinden, Andre G.; Vandrovcova, Jana; Velseboer, Daan; Vidailhet, Marie; Vukcevic, Damjan; Walker, Robert; van de Warrenburg, Bart; Weale, Michael E.; Wickremaratchi, Mirdhu; Williams, Nigel; Williams-Gray, Caroline H.; Winder-Rhodes, Sophie; Stefansson, Kari; Martinez, Maria; Donnelly, Peter; Singleton, Andrew B.; Hardy, John; Heutink, Peter; Brice, Alexis; Gasser, Thomas; Wood, Nicholas W.

    2011-01-01

    A previous genome-wide association (GWA) meta-analysis of 12,386 PD cases and 21,026 controls conducted by the International Parkinson's Disease Genomics Consortium (IPDGC) discovered or confirmed 11 Parkinson's disease (PD) loci. This first analysis of the two-stage IPDGC study focused on the set

  16. On A Two-Stage Supply Chain Model In The Manufacturing Industry ...

    African Journals Online (AJOL)

    We model a two-stage supply chain where the upstream stage (stage 2) always meet demand from the downstream stage (stage 1).Demand is stochastic hence shortages will occasionally occur at stage 2. Stage 2 must fill these shortages by expediting using overtime production and/or backordering. We derive optimal ...

  17. Two-stage gene regulation of the superoxide stress response soxRS system in Escherichia coli.

    Science.gov (United States)

    Nunoshiba, T

    1996-01-01

    All organisms have adapted to environmental changes by acquiring various functions controlled by gene regulation. In bacteria, a number of specific responses have been found to confer cell survival in various nutrient-limited conditions, and under physiological stresses such as high or low temperature, extreme pH, radiation, and oxidation (for review, see Neidhardt et al., 1987). In this article, I introduce an Escherichia coli (E. coli) global response induced by superoxide stress, the soxRS regulon. The functions controlled by this system consist of a wide variety of enzymes such as manganese-containing SOD (Mn-SOD); glucose 6-phosphate dehydrogenase (G6PD), the DNA repair enzyme endonuclease IV, fumarase C, NADPH:ferredoxin oxidoreductase, and aconitase. This response is positively regulated by a two-stage control system in which SoxR iron-sulfur protein senses exposure to superoxide and nitric oxide, and then activates transcription of the soxS gene, whose product stimulates the expression of the regulon genes. Our recent finding indicates that soxS transcription is initiated in a manner dependent on the rpoS gene encoding RNA polymerase sigma factor, theta s, in response to entering the stationary phase of growth. With this information, mechanisms for prokaryotic coordinating gene expression in response to superoxide stress and in stationary phase are discussed.

  18. Occlusal Classification in Relation to Original Cleft Width in Patients With Unilateral Cleft Lip and Palate.

    Science.gov (United States)

    Huang, Andrew H; Patel, Kamlesh B; Maschhoff, Clayton W; Huebener, Donald V; Skolnick, Gary B; Naidoo, Sybill D; Woo, Albert S

    2015-09-01

    To determine a correlation between the width of the cleft palate measured at the time of lip adhesion, definitive lip repair, and palatoplasty and the subsequent occlusal classification of patients born with unilateral cleft lip and palate. Retrospective, observational study. Referral, urban, children's hospital Participants : Dental models and records of 270 patients were analyzed. None. Angle occlusion classification. The mean age at which occlusal classification was determined was 11 ± 0.3 years. Of the children studies, 84 were diagnosed with Class I or II occlusion, 67 were diagnosed with Class III occlusion, and 119 were lost to follow up or transferred care. Mean cleft widths were significantly larger in subjects with Class III occlusion for all measures at time of lip adhesion and definitive lip repair (P cleft widths were significantly greater at the alveolus (P = .025) but not at the midportion of the hard palate (P = .35) or posterior hard palate (P = .10). Cleft widths from the lip through to the posterior hard palate are generally greater in children who are diagnosed with Class III occlusion later in life. Notably, the alveolar cleft width is significantly greater at each time point for patients who went on to develop Class III occlusion. There were no significant differences in cleft widths between patients diagnosed later with Class I and Class II occlusions.

  19. CLEFT PALATE. FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

    Science.gov (United States)

    RUTHERFORD, DAVID; WESTLAKE, HAROLD

    DESIGNED TO PROVIDE AN ESSENTIAL CORE OF INFORMATION, THIS BOOK TREATS NORMAL AND ABNORMAL DEVELOPMENT, STRUCTURE, AND FUNCTION OF THE LIPS AND PALATE AND THEIR RELATIONSHIPS TO CLEFT LIP AND CLEFT PALATE SPEECH. PROBLEMS OF PERSONAL AND SOCIAL ADJUSTMENT, HEARING, AND SPEECH IN CLEFT LIP OR CLEFT PALATE INDIVIDUALS ARE DISCUSSED. NASAL RESONANCE…

  20. Facts about Cleft Lip and Cleft Palate

    Science.gov (United States)

    ... Information For… Media Policy Makers Facts about Cleft Lip and Cleft Palate Language: English (US) Español (Spanish) Recommend on Facebook ... can make referrals to cleft/craniofacial treatment teams. Cleft Lip & Palate Foundation of Smiles Cleft Lip & Palate Foundation of ...

  1. CFD simulations of compressed air two stage rotary Wankel expander – Parametric analysis

    International Nuclear Information System (INIS)

    Sadiq, Ghada A.; Tozer, Gavin; Al-Dadah, Raya; Mahmoud, Saad

    2017-01-01

    Highlights: • CFD ANSYS-Fluent 3D simulation of Wankel expander is developed. • Single and two-stage expander’s performance is compared. • Inlet and outlet ports shape and configurations are investigated. • Isentropic efficiency of two stage Wankel expander of 91% is achieved. - Abstract: A small scale volumetric Wankel expander is a powerful device for small-scale power generation in compressed air energy storage (CAES) systems and Organic Rankine cycles powered by different heat sources such as, biomass, low temperature geothermal, solar and waste heat leading to significant reduction in CO_2 emissions. Wankel expanders outperform other types of expander due to their ability to produce two power pulses per revolution per chamber additional to higher compactness, lower noise and vibration and lower cost. In this paper, a computational fluid dynamics (CFD) model was developed using ANSYS 16.2 to simulate the flow dynamics for a single and two stage Wankel expanders and to investigate the effect of port configurations, including size and spacing, on the expander’s power output and isentropic efficiency. Also, single-stage and two-stage expanders were analysed with different operating conditions. Single-stage 3D CFD results were compared to published work showing close agreement. The CFD modelling was used to investigate the performance of the rotary device using air as an ideal gas with various port diameters ranging from 15 mm to 50 mm; port spacing varying from 28 mm to 66 mm; different Wankel expander sizes (r = 48, e = 6.6, b = 32) mm and (r = 58, e = 8, b = 40) mm both as single-stage and as two-stage expanders with different configurations and various operating conditions. Results showed that the best Wankel expander design for a single-stage was (r = 48, e = 6.6, b = 32) mm, with the port diameters 20 mm and port spacing equal to 50 mm. Moreover, combining two Wankel expanders horizontally, with a larger one at front, produced 8.52 kW compared

  2. Six years analysis of cleft palate in a university hospital center

    Directory of Open Access Journals (Sweden)

    Farahvash M

    1999-08-01

    Full Text Available Cleft palate is a congenital condition that occurs with the incidence rate of one out of 2000 births. This anomaly produces intraoral pressure changes (increase or decrease, can cause speech, sucking and feeding problems of involved patient. On the other hand, if cleft palate is associated with cleft of the lip or alveolar area, growth and alignment of teeth may change the appearance of the patient and affect the psychologic and occupational future of the patient. Eustatian tube malfunction in involved neonates increase. Many procedures are used to repair the cleft palate and correction of palatal muscles which are: 1 Von Langenbeck (18.5%. 2 Veau-Wardil-Kilner (72.5%. 3 Double opposing Z-Plasty (9%. In this research the demographic criteria of patients including age of the patient at operation rime (mean age 30.14 months, city of residence, family history of cleft palate (12.4%, familial relation of parents (15.2%, associated anomalies, complete or incomplete lesion, weight of patients at the time of surgery (mean 11.28 Kg, hemoglobin (11.3 mg/dl, complications, otitis media and the side of cleft palate are studied in 178 admitted patients to Imam General Hospital between 1989 and 1995.

  3. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors.

    Science.gov (United States)

    Arshad, Anas Imran; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2017-09-01

    Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome. It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology. A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome. Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

    Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

  5. Correlation of Palatal Rugoscopy with Gender, Palatal Vault Height ...

    African Journals Online (AJOL)

    Allen in 1889[3] discussed their role as an identification method. ... a typical orientation pattern, once formed; only changed in its length due to ... along with palatal vault forms as well as ABO blood groups for racial and individualistic soft.

  6. An adaptive two-stage dose-response design method for establishing proof of concept.

    Science.gov (United States)

    Franchetti, Yoko; Anderson, Stewart J; Sampson, Allan R

    2013-01-01

    We propose an adaptive two-stage dose-response design where a prespecified adaptation rule is used to add and/or drop treatment arms between the stages. We extend the multiple comparison procedures-modeling (MCP-Mod) approach into a two-stage design. In each stage, we use the same set of candidate dose-response models and test for a dose-response relationship or proof of concept (PoC) via model-associated statistics. The stage-wise test results are then combined to establish "global" PoC using a conditional error function. Our simulation studies showed good and more robust power in our design method compared to conventional and fixed designs.

  7. Sample size reassessment for a two-stage design controlling the false discovery rate.

    Science.gov (United States)

    Zehetmayer, Sonja; Graf, Alexandra C; Posch, Martin

    2015-11-01

    Sample size calculations for gene expression microarray and NGS-RNA-Seq experiments are challenging because the overall power depends on unknown quantities as the proportion of true null hypotheses and the distribution of the effect sizes under the alternative. We propose a two-stage design with an adaptive interim analysis where these quantities are estimated from the interim data. The second stage sample size is chosen based on these estimates to achieve a specific overall power. The proposed procedure controls the power in all considered scenarios except for very low first stage sample sizes. The false discovery rate (FDR) is controlled despite of the data dependent choice of sample size. The two-stage design can be a useful tool to determine the sample size of high-dimensional studies if in the planning phase there is high uncertainty regarding the expected effect sizes and variability.

  8. Target tracking system based on preliminary and precise two-stage compound cameras

    Science.gov (United States)

    Shen, Yiyan; Hu, Ruolan; She, Jun; Luo, Yiming; Zhou, Jie

    2018-02-01

    Early detection of goals and high-precision of target tracking is two important performance indicators which need to be balanced in actual target search tracking system. This paper proposed a target tracking system with preliminary and precise two - stage compound. This system using a large field of view to achieve the target search. After the target was searched and confirmed, switch into a small field of view for two field of view target tracking. In this system, an appropriate filed switching strategy is the key to achieve tracking. At the same time, two groups PID parameters are add into the system to reduce tracking error. This combination way with preliminary and precise two-stage compound can extend the scope of the target and improve the target tracking accuracy and this method has practical value.

  9. A Two Stage Solution Procedure for Production Planning System with Advance Demand Information

    Science.gov (United States)

    Ueno, Nobuyuki; Kadomoto, Kiyotaka; Hasuike, Takashi; Okuhara, Koji

    We model for ‘Naiji System’ which is a unique corporation technique between a manufacturer and suppliers in Japan. We propose a two stage solution procedure for a production planning problem with advance demand information, which is called ‘Naiji’. Under demand uncertainty, this model is formulated as a nonlinear stochastic programming problem which minimizes the sum of production cost and inventory holding cost subject to a probabilistic constraint and some linear production constraints. By the convexity and the special structure of correlation matrix in the problem where inventory for different periods is not independent, we propose a solution procedure with two stages which are named Mass Customization Production Planning & Management System (MCPS) and Variable Mesh Neighborhood Search (VMNS) based on meta-heuristics. It is shown that the proposed solution procedure is available to get a near optimal solution efficiently and practical for making a good master production schedule in the suppliers.

  10. Gas pollutants removal in a single- and two-stage ejector-venturi scrubber.

    Science.gov (United States)

    Gamisans, Xavier; Sarrà, Montserrrat; Lafuente, F Javier

    2002-03-29

    The absorption of SO(2) and NH(3) from the flue gas into NaOH and H(2)SO(4) solutions, respectively has been studied using an industrial scale ejector-venturi scrubber. A statistical methodology is presented to characterise the performance of the scrubber by varying several factors such as gas pollutant concentration, air flowrate and absorbing solution flowrate. Some types of venturi tube constructions were assessed, including the use of a two-stage venturi tube. The results showed a strong influence of the liquid scrubbing flowrate on pollutant removal efficiency. The initial pollutant concentration and the gas flowrate had a slight influence. The use of a two-stage venturi tube considerably improved the absorption efficiency, although it increased energy consumption. The results of this study will be applicable to the optimal design of venturi-based absorbers for gaseous pollution control or chemical reactors.

  11. Influence of capacity- and time-constrained intermediate storage in two-stage food production systems

    DEFF Research Database (Denmark)

    Akkerman, Renzo; van Donk, Dirk Pieter; Gaalman, Gerard

    2007-01-01

    In food processing, two-stage production systems with a batch processor in the first stage and packaging lines in the second stage are common and mostly separated by capacity- and time-constrained intermediate storage. This combination of constraints is common in practice, but the literature hardly...... of systems like this. Contrary to the common sense in operations management, the LPT rule is able to maximize the total production volume per day. Furthermore, we show that adding one tank has considerable effects. Finally, we conclude that the optimal setup frequency for batches in the first stage...... pays any attention to this. In this paper, we show how various capacity and time constraints influence the performance of a specific two-stage system. We study the effects of several basic scheduling and sequencing rules in the presence of these constraints in order to learn the characteristics...

  12. A simple two stage optimization algorithm for constrained power economic dispatch

    International Nuclear Information System (INIS)

    Huang, G.; Song, K.

    1994-01-01

    A simple two stage optimization algorithm is proposed and investigated for fast computation of constrained power economic dispatch control problems. The method is a simple demonstration of the hierarchical aggregation-disaggregation (HAD) concept. The algorithm first solves an aggregated problem to obtain an initial solution. This aggregated problem turns out to be classical economic dispatch formulation, and it can be solved in 1% of overall computation time. In the second stage, linear programming method finds optimal solution which satisfies power balance constraints, generation and transmission inequality constraints and security constraints. Implementation of the algorithm for IEEE systems and EPRI Scenario systems shows that the two stage method obtains average speedup ratio 10.64 as compared to classical LP-based method

  13. Two-stage combustion for reducing pollutant emissions from gas turbine combustors

    Science.gov (United States)

    Clayton, R. M.; Lewis, D. H.

    1981-01-01

    Combustion and emission results are presented for a premix combustor fueled with admixtures of JP5 with neat H2 and of JP5 with simulated partial-oxidation product gas. The combustor was operated with inlet-air state conditions typical of cruise power for high performance aviation engines. Ultralow NOx, CO and HC emissions and extended lean burning limits were achieved simultaneously. Laboratory scale studies of the non-catalyzed rich-burning characteristics of several paraffin-series hydrocarbon fuels and of JP5 showed sooting limits at equivalence ratios of about 2.0 and that in order to achieve very rich sootless burning it is necessary to premix the reactants thoroughly and to use high levels of air preheat. The application of two-stage combustion for the reduction of fuel NOx was reviewed. An experimental combustor designed and constructed for two-stage combustion experiments is described.

  14. A Sensorless Power Reserve Control Strategy for Two-Stage Grid-Connected PV Systems

    DEFF Research Database (Denmark)

    Sangwongwanich, Ariya; Yang, Yongheng; Blaabjerg, Frede

    2017-01-01

    Due to the still increasing penetration of grid-connected Photovoltaic (PV) systems, advanced active power control functionalities have been introduced in grid regulations. A power reserve control, where namely the active power from the PV panels is reserved during operation, is required for grid...... support. In this paper, a cost-effective solution to realize the power reserve for two-stage grid-connected PV systems is proposed. The proposed solution routinely employs a Maximum Power Point Tracking (MPPT) control to estimate the available PV power and a Constant Power Generation (CPG) control...... performed on a 3-kW two-stage single-phase grid-connected PV system, where the power reserve control is achieved upon demands....

  15. A two staged condensation of vapors of an isobutane tower in installations for sulfuric acid alkylation

    Energy Technology Data Exchange (ETDEWEB)

    Smirnov, N.P.; Feyzkhanov, R.I.; Idrisov, A.D.; Navalikhin, P.G.; Sakharov, V.D.

    1983-01-01

    In order to increase the concentration of isobutane to greater than 72 to 76 percent in an installation for sulfuric acid alkylation, a system of two staged condensation of vapors from an isobutane tower is placed into operation. The first stage condenses the heavier part of the upper distillate of the tower, which is achieved through somewhat of an increase in the condensate temperature. The product which is condensed in the first stage is completely returned to the tower as a live irrigation. The vapors of the isobutane fraction which did not condense in the first stage are sent to two newly installed condensers, from which the product after condensation passes through intermediate tanks to further depropanization. The two staged condensation of vapors of the isobutane tower reduces the content of the inert diluents, the propane and n-butane in the upper distillate of the isobutane tower and creates more favorable conditions for the operation of the isobutane and propane tower.

  16. Optimising the refrigeration cycle with a two-stage centrifugal compressor and a flash intercooler

    Energy Technology Data Exchange (ETDEWEB)

    Roeyttae, Pekka; Turunen-Saaresti, Teemu; Honkatukia, Juha [Lappeenranta University of Technology, Laboratory of Energy and Environmental Technology, PO Box 20, 53851 Lappeenranta (Finland)

    2009-09-15

    The optimisation of a refrigeration process with a two-stage centrifugal compressor and flash intercooler is presented in this paper. The two-stage centrifugal compressor stages are on the same shaft and the electric motor is cooled with the refrigerant. The performance of the centrifugal compressor is evaluated based on semi-empirical specific-speed curves and the effect of the Reynolds number, surface roughness and tip clearance have also been taken into account. The thermodynamic and transport properties of the working fluids are modelled with a real-gas model. The condensing and evaporation temperatures, the temperature after the flash intercooler, and cooling power have been chosen as fixed values in the process. The aim is to gain a maximum coefficient of performance (COP). The method of optimisation, the operation of the compressor and flash intercooler, and the method for estimating the electric motor cooling are also discussed in the article. (author)

  17. A Two-Stage Queue Model to Optimize Layout of Urban Drainage System considering Extreme Rainstorms

    OpenAIRE

    He, Xinhua; Hu, Wenfa

    2017-01-01

    Extreme rainstorm is a main factor to cause urban floods when urban drainage system cannot discharge stormwater successfully. This paper investigates distribution feature of rainstorms and draining process of urban drainage systems and uses a two-stage single-counter queue method M/M/1→M/D/1 to model urban drainage system. The model emphasizes randomness of extreme rainstorms, fuzziness of draining process, and construction and operation cost of drainage system. Its two objectives are total c...

  18. Generation of dense, pulsed beams of refractory metal atoms using two-stage laser ablation

    International Nuclear Information System (INIS)

    Kadar-Kallen, M.A.; Bonin, K.D.

    1994-01-01

    We report a technique for generating a dense, pulsed beam of refractory metal atoms using two-stage laser ablation. An atomic beam of uranium was produced with a peak, ground-state number density of 1x10 12 cm -3 at a distance of z=27 cm from the source. This density can be scaled as 1/z 3 to estimate the density at other distances which are also far from the source

  19. Two-stage hepatectomy: who will not jump over the second hurdle?

    Science.gov (United States)

    Turrini, O; Ewald, J; Viret, F; Sarran, A; Goncalves, A; Delpero, J-R

    2012-03-01

    Two-stage hepatectomy uses compensatory liver regeneration after a first noncurative hepatectomy to enable a second curative resection in patients with bilobar colorectal liver metastasis (CLM). To determine the predictive factors of failure of two-stage hepatectomy. Between 2000 and 2010, 48 patients with irresectable CLM were eligible for two-stage hepatectomy. The planned strategy was a) cleaning of the left hepatic lobe (first hepatectomy), b) right portal vein embolisation and c) right hepatectomy (second hepatectomy). Six patients had occult CLM (n = 5) or extra-hepatic disease (n = 1), which was discovered during the first hepatectomy. Thus, 42 patients completed the first hepatectomy and underwent portal vein embolisation in order to receive the second hepatectomy. Eight patients did not undergo a second hepatectomy due to disease progression. Upon univariate analysis, two factors were identified that precluded patients from having the second hepatectomy: the combined resection of a primary tumour during the first hepatectomy (p = 0.01) and administration of chemotherapy between the two hepatectomies (p = 0.03). An independent association with impairment to perform the two-stage strategy was demonstrated by multivariate analysis for only the combined resection of the primary colorectal cancer during the first hepatectomy (p = 0.04). Due to the small number of patients and the absence of equivalent conclusions in other studies, we cannot recommend performance of an isolated colorectal resection prior to chemotherapy. However, resection of an asymptomatic primary tumour before chemotherapy should not be considered as an outdated procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Single-stage-to-orbit versus two-stage-two-orbit: A cost perspective

    Science.gov (United States)

    Hamaker, Joseph W.

    1996-03-01

    This paper considers the possible life-cycle costs of single-stage-to-orbit (SSTO) and two-stage-to-orbit (TSTO) reusable launch vehicles (RLV's). The analysis parametrically addresses the issue such that the preferred economic choice comes down to the relative complexity of the TSTO compared to the SSTO. The analysis defines the boundary complexity conditions at which the two configurations have equal life-cycle costs, and finally, makes a case for the economic preference of SSTO over TSTO.

  1. Exergy analysis of vapor compression refrigeration cycle with two-stage and intercooler

    Energy Technology Data Exchange (ETDEWEB)

    Kilic, Bayram [Mehmet Akif Ersoy University, Bucak Emin Guelmez Vocational School, Bucak, Burdur (Turkey)

    2012-07-15

    In this study, exergy analyses of vapor compression refrigeration cycle with two-stage and intercooler using refrigerants R507, R407c, R404a were carried out. The necessary thermodynamic values for analyses were calculated by Solkane program. The coefficient of performance, exergetic efficiency and total irreversibility rate of the system in the different operating conditions for these refrigerants were investigated. The coefficient of performance, exergetic efficiency and total irreversibility rate for alternative refrigerants were compared. (orig.)

  2. Control strategy research of two stage topology for pulsed power supply

    International Nuclear Information System (INIS)

    Shi Chunfeng; Wang Rongkun; Huang Yuzhen; Chen Youxin; Yan Hongbin; Gao Daqing

    2013-01-01

    A kind of pulsed power supply of HIRFL-CSR was introduced, the ripple and the current error of the topological structure of the power in the operation process were analyzed, and two stage topology of pulsed power supply was given. The control strategy was simulated and the experiment was done in digital power platform. The results show that the main circuit structure and control method are feasible. (authors)

  3. A novel flow sensor based on resonant sensing with two-stage microleverage mechanism

    Science.gov (United States)

    Yang, B.; Guo, X.; Wang, Q. H.; Lu, C. F.; Hu, D.

    2018-04-01

    The design, simulation, fabrication, and experiments of a novel flow sensor based on resonant sensing with a two-stage microleverage mechanism are presented in this paper. Different from the conventional detection methods for flow sensors, two differential resonators are adopted to implement air flow rate transformation through two-stage leverage magnification. The proposed flow sensor has a high sensitivity since the adopted two-stage microleverage mechanism possesses a higher amplification factor than a single-stage microleverage mechanism. The modal distribution and geometric dimension of the two-stage leverage mechanism and hair are analyzed and optimized by Ansys simulation. A digital closed-loop driving technique with a phase frequency detector-based coordinate rotation digital computer algorithm is implemented for the detection and locking of resonance frequency. The sensor fabricated by the standard deep dry silicon on a glass process has a device dimension of 5100 μm (length) × 5100 μm (width) × 100 μm (height) with a hair diameter of 1000 μm. The preliminary experimental results demonstrate that the maximal mechanical sensitivity of the flow sensor is approximately 7.41 Hz/(m/s)2 at a resonant frequency of 22 kHz for the hair height of 9 mm and increases by 2.42 times as hair height extends from 3 mm to 9 mm. Simultaneously, a detection-limit of 3.23 mm/s air flow amplitude at 60 Hz is confirmed. The proposed flow sensor has great application prospects in the micro-autonomous system and technology, self-stabilizing micro-air vehicles, and environmental monitoring.

  4. Two Stage Fuzzy Methodology to Evaluate the Credit Risks of Investment Projects

    OpenAIRE

    O. Badagadze; G. Sirbiladze; I. Khutsishvili

    2014-01-01

    The work proposes a decision support methodology for the credit risk minimization in selection of investment projects. The methodology provides two stages of projects’ evaluation. Preliminary selection of projects with minor credit risks is made using the Expertons Method. The second stage makes ranking of chosen projects using the Possibilistic Discrimination Analysis Method. The latter is a new modification of a well-known Method of Fuzzy Discrimination Analysis.

  5. A Two-Stage Rural Household Demand Analysis: Microdata Evidence from Jiangsu Province, China

    OpenAIRE

    X.M. Gao; Eric J. Wailes; Gail L. Cramer

    1996-01-01

    In this paper we evaluate economic and demographic effects on China's rural household demand for nine food commodities: vegetables, pork, beef and lamb, poultry, eggs, fish, sugar, fruit, and grain; and five nonfood commodity groups: clothing, fuel, stimulants, housing, and durables. A two-stage budgeting allocation procedure is used to obtain an empirically tractable amalgamative demand system for food commodities which combine an upper-level AIDS model and a lower-level GLES as a modeling f...

  6. Latent Inhibition as a Function of US Intensity in a Two-Stage CER Procedure

    Science.gov (United States)

    Rodriguez, Gabriel; Alonso, Gumersinda

    2004-01-01

    An experiment is reported in which the effect of unconditioned stimulus (US) intensity on latent inhibition (LI) was examined, using a two-stage conditioned emotional response (CER) procedure in rats. A tone was used as the pre-exposed and conditioned stimulus (CS), and a foot-shock of either a low (0.3 mA) or high (0.7 mA) intensity was used as…

  7. Two-stage meta-analysis of survival data from individual participants using percentile ratios

    Science.gov (United States)

    Barrett, Jessica K; Farewell, Vern T; Siannis, Fotios; Tierney, Jayne; Higgins, Julian P T

    2012-01-01

    Methods for individual participant data meta-analysis of survival outcomes commonly focus on the hazard ratio as a measure of treatment effect. Recently, Siannis et al. (2010, Statistics in Medicine 29:3030–3045) proposed the use of percentile ratios as an alternative to hazard ratios. We describe a novel two-stage method for the meta-analysis of percentile ratios that avoids distributional assumptions at the study level. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22825835

  8. Two-staged management for all types of congenital pouch colon

    Directory of Open Access Journals (Sweden)

    Rajendra K Ghritlaharey

    2013-01-01

    Full Text Available Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC. Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 December 2011. Results: CPC comprised of 13.71% (97 of 707 of all anorectal malformations (ARM and 28.19% (97 of 344 of high ARM. Eleven CPC cases (all males were managed with two-staged procedures. Distribution of cases (Narsimha Rao et al.′s classification into types I, II, III, and IV were 1, 2, 6, and 2, respectively. Initial operative procedures performed were window colostomy (n = 6, colostomy proximal to pouch (n = 4, and ligation of colovesical fistula and end colostomy (n = 1. As definitive procedures, pouch excision with abdomino-perineal pull through (APPT of colon in eight, and pouch excision with APPT of ileum in three were performed. The mean age at the time of definitive procedures was 15.6 months (ranges from 3 to 53 months and the mean weight was 7.5 kg (ranges from 4 to 11 kg. Good fecal continence was observed in six and fair in two cases in follow-up periods, while three of our cases lost to follow up. There was no mortality following definitive procedures amongst above 11 cases. Conclusions: Two-staged procedures for all types of CPC can also be performed safely with good results. The most important fact that the definitive procedure is being done without protective stoma and therefore, it avoids stoma closure, stoma-related complications, related cost of stoma closure and hospital stay.

  9. Modelling of an air-cooled two-stage Rankine cycle for electricity production

    International Nuclear Information System (INIS)

    Liu, Bo

    2014-01-01

    This work considers a two stage Rankine cycle architecture slightly different from a standard Rankine cycle for electricity generation. Instead of expanding the steam to extremely low pressure, the vapor leaves the turbine at a higher pressure then having a much smaller specific volume. It is thus possible to greatly reduce the size of the steam turbine. The remaining energy is recovered by a bottoming cycle using a working fluid which has a much higher density than the water steam. Thus, the turbines and heat exchangers are more compact; the turbine exhaust velocity loss is lower. This configuration enables to largely reduce the global size of the steam water turbine and facilitate the use of a dry cooling system. The main advantage of such an air cooled two stage Rankine cycle is the possibility to choose the installation site of a large or medium power plant without the need of a large and constantly available water source; in addition, as compared to water cooled cycles, the risk regarding future operations is reduced (climate conditions may affect water availability or temperature, and imply changes in the water supply regulatory rules). The concept has been investigated by EDF R and D. A 22 MW prototype was developed in the 1970's using ammonia as the working fluid of the bottoming cycle for its high density and high latent heat. However, this fluid is toxic. In order to search more suitable working fluids for the two stage Rankine cycle application and to identify the optimal cycle configuration, we have established a working fluid selection methodology. Some potential candidates have been identified. We have evaluated the performances of the two stage Rankine cycles operating with different working fluids in both design and off design conditions. For the most acceptable working fluids, components of the cycle have been sized. The power plant concept can then be evaluated on a life cycle cost basis. (author)

  10. A Sensorless Power Reserve Control Strategy for Two-Stage Grid-Connected PV Systems

    OpenAIRE

    Sangwongwanich, Ariya; Yang, Yongheng; Blaabjerg, Frede

    2017-01-01

    Due to the still increasing penetration of grid-connected Photovoltaic (PV) systems, advanced active power control functionalities have been introduced in grid regulations. A power reserve control, where namely the active power from the PV panels is reserved during operation, is required for grid support. In this paper, a cost-effective solution to realize the power reserve for two-stage grid-connected PV systems is proposed. The proposed solution routinely employs a Maximum Power Point Track...

  11. Actuator Fault Diagnosis in a Boeing 747 Model via Adaptive Modified Two-Stage Kalman Filter

    Directory of Open Access Journals (Sweden)

    Fikret Caliskan

    2014-01-01

    Full Text Available An adaptive modified two-stage linear Kalman filtering algorithm is utilized to identify the loss of control effectiveness and the magnitude of low degree of stuck faults in a closed-loop nonlinear B747 aircraft. Control effectiveness factors and stuck magnitudes are used to quantify faults entering control systems through actuators. Pseudorandom excitation inputs are used to help distinguish partial loss and stuck faults. The partial loss and stuck faults in the stabilizer are isolated and identified successfully.

  12. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

    DEFF Research Database (Denmark)

    Heliövaara, Arja; Küseler, Annelise; Skaare, Pål

    2017-01-01

    BACKGROUND AND AIM: Good dentofacial growth is a major goal in the treatment of unilateral cleft lip and palate (UCLP). The aim was to evaluate dental arch relationships at age 5 years after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised clinical trials were...... undertaken as an international multi-centre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, D) were tested against a common procedure (Arm A) in the total cohort of 448 children born...

  13. Pre: Surgical orthopedic pre-maxillary alignment in bilateral cleft lip and palate patient

    Directory of Open Access Journals (Sweden)

    Vijaya Prasad Kamavaram Ellore

    2012-01-01

    Full Text Available Pre-surgical orthopedic appliances are mainly used to retract and align the protruded and deviated pre-maxilla and to facilitate initial lip repair. This article presents a case report of a five year old male child patient with bilateral cleft lip and palate in whom a special custom made pre-surgical orthopedic appliance was delivered. Use of a special custom made presurgical orthopedic appliance for repositioning pre-maxilla in bilateral cleft lip and palate patient is discussed in this article.

  14. Two-stage energy storage equalization system for lithium-ion battery pack

    Science.gov (United States)

    Chen, W.; Yang, Z. X.; Dong, G. Q.; Li, Y. B.; He, Q. Y.

    2017-11-01

    How to raise the efficiency of energy storage and maximize storage capacity is a core problem in current energy storage management. For that, two-stage energy storage equalization system which contains two-stage equalization topology and control strategy based on a symmetric multi-winding transformer and DC-DC (direct current-direct current) converter is proposed with bidirectional active equalization theory, in order to realize the objectives of consistent lithium-ion battery packs voltages and cells voltages inside packs by using a method of the Range. Modeling analysis demonstrates that the voltage dispersion of lithium-ion battery packs and cells inside packs can be kept within 2 percent during charging and discharging. Equalization time was 0.5 ms, which shortened equalization time of 33.3 percent compared with DC-DC converter. Therefore, the proposed two-stage lithium-ion battery equalization system can achieve maximum storage capacity between lithium-ion battery packs and cells inside packs, meanwhile efficiency of energy storage is significantly improved.

  15. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling.

    Science.gov (United States)

    Terza, Joseph V; Basu, Anirban; Rathouz, Paul J

    2008-05-01

    The paper focuses on two estimation methods that have been widely used to address endogeneity in empirical research in health economics and health services research-two-stage predictor substitution (2SPS) and two-stage residual inclusion (2SRI). 2SPS is the rote extension (to nonlinear models) of the popular linear two-stage least squares estimator. The 2SRI estimator is similar except that in the second-stage regression, the endogenous variables are not replaced by first-stage predictors. Instead, first-stage residuals are included as additional regressors. In a generic parametric framework, we show that 2SRI is consistent and 2SPS is not. Results from a simulation study and an illustrative example also recommend against 2SPS and favor 2SRI. Our findings are important given that there are many prominent examples of the application of inconsistent 2SPS in the recent literature. This study can be used as a guide by future researchers in health economics who are confronted with endogeneity in their empirical work.

  16. Production of endo-pectate lyase by two stage cultivation of Erwinia carotovora

    Energy Technology Data Exchange (ETDEWEB)

    Fukuoka, Satoshi; Kobayashi, Yoshiaki

    1987-02-26

    The productivity of endo-pectate lyase from Erwinia carotovora GIR 1044 was found to be greatly improved by two stage cultivation: in the first stage the bacterium was grown with an inducing carbon source, e.g., pectin, and in the second stage it was cultivated with glycerol, xylose, or fructose with the addition of monosodium L-glutamate as nitrogen source. In the two stage cultivation using pectin or glycerol as the carbon source the enzyme activity reached 400 units/ml, almost 3 times as much as that of one stage cultivation in a 10 liter fermentor. Using two stage cultivation in the 200 liter fermentor improved enzyme productivity over that in the 10 liter fermentor, with 500 units/ml of activity. Compared with the cultivation in Erlenmeyer flasks, fermentor cultivation improved enzyme productivity. The optimum cultivating conditions were agitation of 480 rpm with aeration of 0.5 vvm at 28 /sup 0/C. (4 figs, 4 tabs, 14 refs)

  17. Assessing efficiency and effectiveness of Malaysian Islamic banks: A two stage DEA analysis

    Science.gov (United States)

    Kamarudin, Norbaizura; Ismail, Wan Rosmanira; Mohd, Muhammad Azri

    2014-06-01

    Islamic banks in Malaysia are indispensable players in the financial industry with the growing needs for syariah compliance system. In the banking industry, most recent studies concerned only on operational efficiency. However rarely on the operational effectiveness. Since the production process of banking industry can be described as a two-stage process, two-stage Data Envelopment Analysis (DEA) can be applied to measure the bank performance. This study was designed to measure the overall performance in terms of efficiency and effectiveness of Islamic banks in Malaysia using Two-Stage DEA approach. This paper presents analysis of a DEA model which split the efficiency and effectiveness in order to evaluate the performance of ten selected Islamic Banks in Malaysia for the financial year period ended 2011. The analysis shows average efficient score is more than average effectiveness score thus we can say that Malaysian Islamic banks were more efficient rather than effective. Furthermore, none of the bank exhibit best practice in both stages as we can say that a bank with better efficiency does not always mean having better effectiveness at the same time.

  18. A two-stage extraction procedure for insensitive munition (IM) explosive compounds in soils.

    Science.gov (United States)

    Felt, Deborah; Gurtowski, Luke; Nestler, Catherine C; Johnson, Jared; Larson, Steven

    2016-12-01

    The Department of Defense (DoD) is developing a new category of insensitive munitions (IMs) that are more resistant to detonation or promulgation from external stimuli than traditional munition formulations. The new explosive constituent compounds are 2,4-dinitroanisole (DNAN), nitroguanidine (NQ), and nitrotriazolone (NTO). The production and use of IM formulations may result in interaction of IM component compounds with soil. The chemical properties of these IM compounds present unique challenges for extraction from environmental matrices such as soil. A two-stage extraction procedure was developed and tested using several soil types amended with known concentrations of IM compounds. This procedure incorporates both an acidified phase and an organic phase to account for the chemical properties of the IM compounds. The method detection limits (MDLs) for all IM compounds in all soil types were regulatory risk-based Regional Screening Level (RSL) criteria for soil proposed by the U.S. Army Public Health Center. At defined environmentally relevant concentrations, the average recovery of each IM compound in each soil type was consistent and greater than 85%. The two-stage extraction method decreased the influence of soil composition on IM compound recovery. UV analysis of NTO established an isosbestic point based on varied pH at a detection wavelength of 341 nm. The two-stage soil extraction method is equally effective for traditional munition compounds, a potentially important point when examining soils exposed to both traditional and insensitive munitions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Two-stage solar concentrators based on parabolic troughs: asymmetric versus symmetric designs.

    Science.gov (United States)

    Schmitz, Max; Cooper, Thomas; Ambrosetti, Gianluca; Steinfeld, Aldo

    2015-11-20

    While nonimaging concentrators can approach the thermodynamic limit of concentration, they generally suffer from poor compactness when designed for small acceptance angles, e.g., to capture direct solar irradiation. Symmetric two-stage systems utilizing an image-forming primary parabolic concentrator in tandem with a nonimaging secondary concentrator partially overcome this compactness problem, but their achievable concentration ratio is ultimately limited by the central obstruction caused by the secondary. Significant improvements can be realized by two-stage systems having asymmetric cross-sections, particularly for 2D line-focus trough designs. We therefore present a detailed analysis of two-stage line-focus asymmetric concentrators for flat receiver geometries and compare them to their symmetric counterparts. Exemplary designs are examined in terms of the key optical performance metrics, namely, geometric concentration ratio, acceptance angle, concentration-acceptance product, aspect ratio, active area fraction, and average number of reflections. Notably, we show that asymmetric designs can achieve significantly higher overall concentrations and are always more compact than symmetric systems designed for the same concentration ratio. Using this analysis as a basis, we develop novel asymmetric designs, including two-wing and nested configurations, which surpass the optical performance of two-mirror aplanats and are comparable with the best reported 2D simultaneous multiple surface designs for both hollow and dielectric-filled secondaries.

  20. Final Report on Two-Stage Fast Spectrum Fuel Cycle Options

    International Nuclear Information System (INIS)

    Yang, Won Sik; Lin, C. S.; Hader, J. S.; Park, T. K.; Deng, P.; Yang, G.; Jung, Y. S.; Kim, T. K.; Stauff, N. E.

    2016-01-01

    This report presents the performance characteristics of two ''two-stage'' fast spectrum fuel cycle options proposed to enhance uranium resource utilization and to reduce nuclear waste generation. One is a two-stage fast spectrum fuel cycle option of continuous recycle of plutonium (Pu) in a fast reactor (FR) and subsequent burning of minor actinides (MAs) in an accelerator-driven system (ADS). The first stage is a sodium-cooled FR fuel cycle starting with low-enriched uranium (LEU) fuel; at the equilibrium cycle, the FR is operated using the recovered Pu and natural uranium without supporting LEU. Pu and uranium (U) are co-extracted from the discharged fuel and recycled in the first stage, and the recovered MAs are sent to the second stage. The second stage is a sodium-cooled ADS in which MAs are burned in an inert matrix fuel form. The discharged fuel of ADS is reprocessed, and all the recovered heavy metals (HMs) are recycled into the ADS. The other is a two-stage FR/ADS fuel cycle option with MA targets loaded in the FR. The recovered MAs are not directly sent to ADS, but partially incinerated in the FR in order to reduce the amount of MAs to be sent to the ADS. This is a heterogeneous recycling option of transuranic (TRU) elements

  1. Application of two-stage biofilter system for the removal of odorous compounds.

    Science.gov (United States)

    Jeong, Gwi-Taek; Park, Don-Hee; Lee, Gwang-Yeon; Cha, Jin-Myeong

    2006-01-01

    Biofiltration is a biological process which is considered to be one of the more successful examples of biotechnological applications to environmental engineering, and is most commonly used in the removal of odoriferous compounds. In this study, we have attempted to assess the efficiency with which both single and complex odoriferous compounds could be removed, using one- or two-stage biofiltration systems. The tested single odor gases, limonene, alpha-pinene, and iso-butyl alcohol, were separately evaluated in the biofilters. Both limonene and alpha-pinene were removed by 90% or more EC (elimination capacity), 364 g/m3/h and 321 g/m3/h, respectively, at an input concentration of 50 ppm and a retention time of 30 s. The iso-butyl alcohol was maintained with an effective removal yield of more than 90% (EC 375 g/m3/h) at an input concentration of 100 ppm. The complex gas removal scheme was applied with a 200 ppm inlet concentration of ethanol, 70 ppm of acetaldehyde, and 70 ppm of toluene with residence time of 45 s in a one- or two-stage biofiltration system. The removal yield of toluene was determined to be lower than that of the other gases in the one-stage biofilter. Otherwise, the complex gases were sufficiently eliminated by the two-stage biofiltration system.

  2. Effects of earthworm casts and zeolite on the two-stage composting of green waste

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Lu, E-mail: zhanglu1211@gmail.com; Sun, Xiangyang, E-mail: xysunbjfu@gmail.com

    2015-05-15

    Highlights: • Earthworm casts (EWCs) and clinoptilolite (CL) were used in green waste composting. • Addition of EWCs + CL improved physico-chemical and microbiological properties. • Addition of EWCs + CL extended the duration of thermophilic periods during composting. • Addition of EWCs + CL enhanced humification, cellulose degradation, and nutrients. • Combined addition of 0.30% EWCs + 25% CL reduced composting time to 21 days. - Abstract: Because it helps protect the environment and encourages economic development, composting has become a viable method for organic waste disposal. The objective of this study was to investigate the effects of earthworm casts (EWCs) (at 0.0%, 0.30%, and 0.60%) and zeolite (clinoptilolite, CL) (at 0%, 15%, and 25%) on the two-stage composting of green waste. The combination of EWCs and CL improved the conditions of the composting process and the quality of the compost products in terms of the thermophilic phase, humification, nitrification, microbial numbers and enzyme activities, the degradation of cellulose and hemicellulose, and physico-chemical characteristics and nutrient contents of final composts. The compost matured in only 21 days with the optimized two-stage composting method rather than in the 90–270 days required for traditional composting. The optimal two-stage composting and the best quality compost were obtained with 0.30% EWCs and 25% CL.

  3. Effects of earthworm casts and zeolite on the two-stage composting of green waste

    International Nuclear Information System (INIS)

    Zhang, Lu; Sun, Xiangyang

    2015-01-01

    Highlights: • Earthworm casts (EWCs) and clinoptilolite (CL) were used in green waste composting. • Addition of EWCs + CL improved physico-chemical and microbiological properties. • Addition of EWCs + CL extended the duration of thermophilic periods during composting. • Addition of EWCs + CL enhanced humification, cellulose degradation, and nutrients. • Combined addition of 0.30% EWCs + 25% CL reduced composting time to 21 days. - Abstract: Because it helps protect the environment and encourages economic development, composting has become a viable method for organic waste disposal. The objective of this study was to investigate the effects of earthworm casts (EWCs) (at 0.0%, 0.30%, and 0.60%) and zeolite (clinoptilolite, CL) (at 0%, 15%, and 25%) on the two-stage composting of green waste. The combination of EWCs and CL improved the conditions of the composting process and the quality of the compost products in terms of the thermophilic phase, humification, nitrification, microbial numbers and enzyme activities, the degradation of cellulose and hemicellulose, and physico-chemical characteristics and nutrient contents of final composts. The compost matured in only 21 days with the optimized two-stage composting method rather than in the 90–270 days required for traditional composting. The optimal two-stage composting and the best quality compost were obtained with 0.30% EWCs and 25% CL

  4. Is the continuous two-stage anaerobic digestion process well suited for all substrates?

    Science.gov (United States)

    Lindner, Jonas; Zielonka, Simon; Oechsner, Hans; Lemmer, Andreas

    2016-01-01

    Two-stage anaerobic digestion systems are often considered to be advantageous compared to one-stage processes. Although process conditions and fermenter setups are well examined, overall substrate degradation in these systems is controversially discussed. Therefore, the aim of this study was to investigate how substrates with different fibre and sugar contents (hay/straw, maize silage, sugar beet) influence the degradation rate and methane production. Intermediates and gas compositions, as well as methane yields and VS-degradation degrees were recorded. The sugar beet substrate lead to a higher pH-value drop 5.67 in the acidification reactor, which resulted in a six time higher hydrogen production in comparison to the hay/straw substrate (pH-value drop 5.34). As the achieved yields in the two-stage system showed a difference of 70.6% for the hay/straw substrate, and only 7.8% for the sugar beet substrate. Therefore two-stage systems seem to be only recommendable for digesting sugar rich substrates. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Study on the Control Algorithm of Two-Stage DC-DC Converter for Electric Vehicles

    Directory of Open Access Journals (Sweden)

    Changhao Piao

    2014-01-01

    Full Text Available The fast response, high efficiency, and good reliability are very important characteristics to electric vehicles (EVs dc/dc converters. Two-stage dc-dc converter is a kind of dc-dc topologies that can offer those characteristics to EVs. Presently, nonlinear control is an active area of research in the field of the control algorithm of dc-dc converters. However, very few papers research on two-stage converter for EVs. In this paper, a fixed switching frequency sliding mode (FSFSM controller and double-integral sliding mode (DISM controller for two-stage dc-dc converter are proposed. And a conventional linear control (lag is chosen as the comparison. The performances of the proposed FSFSM controller are compared with those obtained by the lag controller. In consequence, the satisfactory simulation and experiment results show that the FSFSM controller is capable of offering good large-signal operations with fast dynamical responses to the converter. At last, some other simulation results are presented to prove that the DISM controller is a promising method for the converter to eliminate the steady-state error.

  6. Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

    Science.gov (United States)

    Bril, Aleksander; Kalinina, Olga; Levina, Anastasia

    2018-03-01

    The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

  7. Two-stage commercial evaluation of engineering systems production projects for high-rise buildings

    Directory of Open Access Journals (Sweden)

    Bril Aleksander

    2018-01-01

    Full Text Available The paper is devoted to the current and debatable problem of methodology of choosing the effective innovative enterprises for venture financing. A two-stage system of commercial innovation evaluation based on the UNIDO methodology is proposed. Engineering systems account for 25 to 40% of the cost of high-rise residential buildings. This proportion increases with the use of new construction technologies. Analysis of the construction market in Russia showed that the production of internal engineering systems elements based on innovative technologies has a growth trend. The production of simple elements is organized in small enterprises on the basis of new technologies. The most attractive for development is the use of venture financing of small innovative business. To improve the efficiency of these operations, the paper proposes a methodology for a two-stage evaluation of small business development projects. A two-stage system of commercial evaluation of innovative projects allows creating an information base for informed and coordinated decision-making on venture financing of enterprises that produce engineering systems elements for the construction business.

  8. Two-Stage Liver Transplantation with Temporary Porto-Middle Hepatic Vein Shunt

    Directory of Open Access Journals (Sweden)

    Giovanni Varotti

    2010-01-01

    Full Text Available Two-stage liver transplantation (LT has been reported for cases of fulminant liver failure that can lead to toxic hepatic syndrome, or massive hemorrhages resulting in uncontrollable bleeding. Technically, the first stage of the procedure consists of a total hepatectomy with preservation of the recipient's inferior vena cava (IVC, followed by the creation of a temporary end-to-side porto-caval shunt (TPCS. The second stage consists of removing the TPCS and implanting a liver graft when one becomes available. We report a case of a two-stage total hepatectomy and LT in which a temporary end-to-end anastomosis between the portal vein and the middle hepatic vein (TPMHV was performed as an alternative to the classic end-to-end TPCS. The creation of a TPMHV proved technically feasible and showed some advantages compared to the standard TPCS. In cases in which a two-stage LT with side-to-side caval reconstruction is utilized, TPMHV can be considered as a safe and effective alternative to standard TPCS.

  9. The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study.

    Science.gov (United States)

    Smarius, B J A; Guillaume, C H A L; Jonker, G; van der Molen, A B Mink; Breugem, C C

    2018-02-22

    Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children. A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children's Hospital. This study compared the period January 2010 through December 2012 when pharyngeal packing was applied according to local protocol (group A) with the period January 2013 till December 2015 when pharyngeal packing was no longer applied after removal from the protocol (group B). Data were collected for sex, age at operation, cleft lip/palate type, type of repair, lateral incisions, length of hospital stay, and complications in the first 6 weeks after surgery. Early complications included wound dehiscence, postoperative bleeding, infection, fever, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI). This study included 489 cleft lip/palate operations (group A n = 246, group B n = 243). A total of 39 (15.9%) early complications were recorded in group A and a total of 40 (16.5%) in group B. There were no significant differences (P = 0.902) in complications between the two groups; however, there was a significant difference (P cleft lip/palate surgery was not associated with an increased early postoperative complication rate. Therefore, the traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned. The traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned.

  10. Empirical study of classification process for two-stage turbo air classifier in series

    Science.gov (United States)

    Yu, Yuan; Liu, Jiaxiang; Li, Gang

    2013-05-01

    The suitable process parameters for a two-stage turbo air classifier are important for obtaining the ultrafine powder that has a narrow particle-size distribution, however little has been published internationally on the classification process for the two-stage turbo air classifier in series. The influence of the process parameters of a two-stage turbo air classifier in series on classification performance is empirically studied by using aluminum oxide powders as the experimental material. The experimental results show the following: 1) When the rotor cage rotary speed of the first-stage classifier is increased from 2 300 r/min to 2 500 r/min with a constant rotor cage rotary speed of the second-stage classifier, classification precision is increased from 0.64 to 0.67. However, in this case, the final ultrafine powder yield is decreased from 79% to 74%, which means the classification precision and the final ultrafine powder yield can be regulated through adjusting the rotor cage rotary speed of the first-stage classifier. 2) When the rotor cage rotary speed of the second-stage classifier is increased from 2 500 r/min to 3 100 r/min with a constant rotor cage rotary speed of the first-stage classifier, the cut size is decreased from 13.16 μm to 8.76 μm, which means the cut size of the ultrafine powder can be regulated through adjusting the rotor cage rotary speed of the second-stage classifier. 3) When the feeding speed is increased from 35 kg/h to 50 kg/h, the "fish-hook" effect is strengthened, which makes the ultrafine powder yield decrease. 4) To weaken the "fish-hook" effect, the equalization of the two-stage wind speeds or the combination of a high first-stage wind speed with a low second-stage wind speed should be selected. This empirical study provides a criterion of process parameter configurations for a two-stage or multi-stage classifier in series, which offers a theoretical basis for practical production.

  11. Development and testing of a two stage granular filter to improve collection efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Rangan, R.S.; Prakash, S.G.; Chakravarti, S.; Rao, S.R.

    1999-07-01

    A circulating bed granular filter (CBGF) with a single filtration stage was tested with a PFB combustor in the Coal Research Facility of BHEL R and D in Hyderabad during the years 1993--95. Filter outlet dust loading varied between 20--50 mg/Nm{sup 3} for an inlet dust loading of 5--8 gms/Nm{sup 3}. The results were reported in Fluidized Bed Combustion-Volume 2, ASME 1995. Though the outlet consists of predominantly fine particulates below 2 microns, it is still beyond present day gas turbine specifications for particulate concentration. In order to enhance the collection efficiency, a two-stage granular filtration concept was evolved, wherein the filter depth is divided between two stages, accommodated in two separate vertically mounted units. The design also incorporates BHEL's scale-up concept of multiple parallel stages. The two-stage concept minimizes reentrainment of captured dust by providing clean granules in the upper stage, from where gases finally exit the filter. The design ensures that dusty gases come in contact with granules having a higher dust concentration at the bottom of the two-stage unit, where most of the cleaning is completed. A second filtration stage of cleaned granules is provided in the top unit (where the granules are returned to the system after dedusting) minimizing reentrainment. Tests were conducted to determine the optimum granule to dust ratio (G/D ratio) which decides the granule circulation rate required for the desired collection efficiency. The data brings out the importance of pre-separation and the limitation on inlet dust loading for any continuous system of granular filtration. Collection efficiencies obtained were much higher (outlet dust being 3--9 mg/Nm{sub 3}) than in the single stage filter tested earlier for similar dust loading at the inlet. The results indicate that two-stage granular filtration has a high potential for HTHT application with fewer risks as compared to other systems under development.

  12. Factors contributing to hearing impairment in patients with cleft lip/palate in Malaysia: A prospective study of 346 ears.

    Science.gov (United States)

    Cheong, Jack Pein; Soo, Siew Shuin; Manuel, Anura Michelle

    2016-09-01

    To determine the factors contributing towards hearing impairment in patients with cleft lip/palate. A prospective analysis was conducted on 173 patients (346 ears) with cleft lip and palate (CL/P) who presented to the combined cleft clinic at University Malaya Medical Centre (UMMC) over 12 months. The patients' hearing status was determined using otoacoustic emission (OAE), pure tone audiometry (PTA) and auditory brainstem response (ABR). These results were analysed against several parameters, which included age, gender, race, types of cleft pathology, impact and timing of repair surgery. The patients' age ranged from 1-26 years old. They comprised 30% with unilateral cleft lip and palate (UCLP), 28% with bilateral cleft lip and palate (BCLP), 28% with isolated cleft palate (ICP) and 14% with isolated cleft lip (ICL). Majority of the patients (68.2%) had normal otoscopic findings. Out of the 346 ears, 241 ears (70%) ears had passed the hearing tests. There was no significant relationship between patients' gender and ethnicity with their hearing status. The types of cleft pathology significantly influenced the outcome of PTA and ABR screening results (p cleft groups and the outcome of hearing tests. However, hearing improvement occurred when palatal repair was performed at the age of cleft patients had normal hearing (70%). Hearing threshold varied significantly between the different types of cleft pathology. Surgery conferred no significant impact on the hearing outcome unless surgery was performed at the age of <1 year old. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Maximum likelihood estimation of signal detection model parameters for the assessment of two-stage diagnostic strategies.

    Science.gov (United States)

    Lirio, R B; Dondériz, I C; Pérez Abalo, M C

    1992-08-01

    The methodology of Receiver Operating Characteristic curves based on the signal detection model is extended to evaluate the accuracy of two-stage diagnostic strategies. A computer program is developed for the maximum likelihood estimation of parameters that characterize the sensitivity and specificity of two-stage classifiers according to this extended methodology. Its use is briefly illustrated with data collected in a two-stage screening for auditory defects.

  14. The experimental study of a two-stage photovoltaic thermal system based on solar trough concentration

    International Nuclear Information System (INIS)

    Tan, Lijun; Ji, Xu; Li, Ming; Leng, Congbin; Luo, Xi; Li, Haili

    2014-01-01

    Highlights: • A two-stage photovoltaic thermal system based on solar trough concentration. • Maximum cell efficiency of 5.21% with the mirror opening width of 57 cm. • With single cycle, maximum temperatures rise in the heating stage is 12.06 °C. • With 30 min multiple cycles, working medium temperature 62.8 °C, increased 28.7 °C. - Abstract: A two-stage photovoltaic thermal system based on solar trough concentration is proposed, in which the metal cavity heating stage is added on the basis of the PV/T stage, and thermal energy with higher temperature is output while electric energy is output. With the 1.8 m 2 mirror PV/T system, the characteristic parameters of the space solar cell under non-concentrating solar radiation and concentrating solar radiation are respectively tested experimentally, and the solar cell output characteristics at different opening widths of concentrating mirror of the PV/T stage under condensation are also tested experimentally. When the mirror opening width was 57 cm, the solar cell efficiency reached maximum value of 5.21%. The experimental platform of the two-stage photovoltaic thermal system was established, with a 1.8 m 2 mirror PV/T stage and a 15 m 2 mirror heating stage, or a 1.8 m 2 mirror PV/T stage and a 30 m 2 mirror heating stage. The results showed that with single cycle, the long metal cavity heating stage would bring lower thermal efficiency, but temperature rise of the working medium is higher, up to 12.06 °C with only single cycle. With 30 min closed multiple cycles, the temperature of the working medium in the water tank was 62.8 °C, with an increase of 28.7 °C, and thermal energy with higher temperature could be output

  15. Comparisons of single-stage and two-stage approaches to genomic selection.

    Science.gov (United States)

    Schulz-Streeck, Torben; Ogutu, Joseph O; Piepho, Hans-Peter

    2013-01-01

    Genomic selection (GS) is a method for predicting breeding values of plants or animals using many molecular markers that is commonly implemented in two stages. In plant breeding the first stage usually involves computation of adjusted means for genotypes which are then used to predict genomic breeding values in the second stage. We compared two classical stage-wise approaches, which either ignore or approximate correlations among the means by a diagonal matrix, and a new method, to a single-stage analysis for GS using ridge regression best linear unbiased prediction (RR-BLUP). The new stage-wise method rotates (orthogonalizes) the adjusted means from the first stage before submitting them to the second stage. This makes the errors approximately independently and identically normally distributed, which is a prerequisite for many procedures that are potentially useful for GS such as machine learning methods (e.g. boosting) and regularized regression methods (e.g. lasso). This is illustrated in this paper using componentwise boosting. The componentwise boosting method minimizes squared error loss using least squares and iteratively and automatically selects markers that are most predictive of genomic breeding values. Results are compared with those of RR-BLUP using fivefold cross-validation. The new stage-wise approach with rotated means was slightly more similar to the single-stage analysis than the classical two-stage approaches based on non-rotated means for two unbalanced datasets. This suggests that rotation is a worthwhile pre-processing step in GS for the two-stage approaches for unbalanced datasets. Moreover, the predictive accuracy of stage-wise RR-BLUP was higher (5.0-6.1%) than that of componentwise boosting.

  16. Clinical evaluation of two-stage mandibular wisdom tooth extraction method to avoid mental nerve paresthesia

    International Nuclear Information System (INIS)

    Nozoe, Etsuro; Nakamura, Yasunori; Okawachi, Takako; Ishihata, Kiyohide; Shinnakasu, Mana; Nakamura, Norifumi

    2011-01-01

    Clinical courses following two-stage mandibular wisdom tooth extraction (TMWTE) carried out for preventing postoperative mental nerve paresthesia (MNP) were analyzed. When panoramic X-ray showed overlapping of wisdom tooth root on the superior 1/2 or more of the mandibular canal, interruption of the white line of the superior wall of the canal, or diversion of the canal, CT examination was facilitated. In cases where contact between the tooth root and canal was demonstrated in CT examination, TMWTE was then selected after gaining the patient's consent. TMWTE consisted of removing more than a half of the tooth crown and tooth root extraction at the second step after 2-3 months. The clinical features of wisdom teeth extracted and postoperative courses including tooth movement and occurrence of MNP during two-stage MWTE were evaluated. TMWTE was carried out for 40 teeth among 811 wisdom teeth (4.9%) that were extracted from 2007 to 2009. Among them, complete procedures were accomplished in 39 teeth, and crown removal was performed insufficiently at the first-stage operation in one tooth. Tooth movement was detected in 37 of 40 cases (92.5%). No postoperative MNP was observed in cases in which complete two-stage MWTE was carried out, but one case with insufficient crown removal was complicated by postoperative MNP. Seven mild complications (dehiscence, cold sensitivity, etc.) were noted after the first-stage operation. Therefore, we conclude that TMWTE for high-risk cases assessed by X-ray findings is useful to avoid MNP after MWTE. (author)

  17. PALATAL ROTATONIAL FLAP: AN ALTERNATIVE FOR PALATAL PRIMARY INTENTION NEALING

    OpenAIRE

    García Linares, Sixto A.

    2014-01-01

    Objectives- The present clinical study tries to show an alternative for closing of superior bicuspids alveolus to maintain alveolar ridge and to avoid alveolitis because of first intention wound healing. Results. It was observed after 15 days; 12 patients had a complete wound healing of the alveolus and the palate showed a mattress of consistent granulation. A patient discontinued the treatment. Two patients had a wound healing lip to 75%. They didn't register adverse effects: hemorrhage, int...

  18. Recent developments of a two-stage light gas gun for pellet injection

    International Nuclear Information System (INIS)

    Reggiori, A.

    1984-01-01

    A report is given on a two-stage pneumatic gun operated with ambient air as first stage driver which has been built and tested. Cylindrical polyethylene pellets of 1 mm diameter and 1 mm length have been launched at velocities up to 1800 m/s, with divergence angles of the pellet trajectory less than 1 0 . It is possible to optimize the pressure pulse for pellets of different masses, simply changing the mass of the piston and/or the initial pressures in the second stage. (author)

  19. Grids heat loading of an ion source in two-stage acceleration system

    International Nuclear Information System (INIS)

    Okumura, Yoshikazu; Ohara, Yoshihiro; Ohga, Tokumichi

    1978-05-01

    Heat loading of the extraction grids, which is one of the critical problems limiting the beam pulse duration at high power level, has been investigated experimentally, with an ion source in a two-stage acceleration system of four multi-aperture grids. The loading of each grid depends largely on extraction current and grid gap pressures; it decreases with improvement of the beam optics and with decrease of the pressures. In optimum operating modes, its level is typically less than -- 2% of the total beam power or -- 200 W/cm 2 at beam energies of 50 - 70 kV. (auth.)

  20. Two-Stage Maximum Likelihood Estimation (TSMLE for MT-CDMA Signals in the Indoor Environment

    Directory of Open Access Journals (Sweden)

    Sesay Abu B

    2004-01-01

    Full Text Available This paper proposes a two-stage maximum likelihood estimation (TSMLE technique suited for multitone code division multiple access (MT-CDMA system. Here, an analytical framework is presented in the indoor environment for determining the average bit error rate (BER of the system, over Rayleigh and Ricean fading channels. The analytical model is derived for quadrature phase shift keying (QPSK modulation technique by taking into account the number of tones, signal bandwidth (BW, bit rate, and transmission power. Numerical results are presented to validate the analysis, and to justify the approximations made therein. Moreover, these results are shown to agree completely with those obtained by simulation.

  1. The global stability of a delayed predator-prey system with two stage-structure

    International Nuclear Information System (INIS)

    Wang Fengyan; Pang Guoping

    2009-01-01

    Based on the classical delayed stage-structured model and Lotka-Volterra predator-prey model, we introduce and study a delayed predator-prey system, where prey and predator have two stages, an immature stage and a mature stage. The time delays are the time lengths between the immature's birth and maturity of prey and predator species. Results on global asymptotic stability of nonnegative equilibria of the delay system are given, which generalize and suggest that good continuity exists between the predator-prey system and its corresponding stage-structured system.

  2. Forecasting long memory series subject to structural change: A two-stage approach

    DEFF Research Database (Denmark)

    Papailias, Fotis; Dias, Gustavo Fruet

    2015-01-01

    A two-stage forecasting approach for long memory time series is introduced. In the first step, we estimate the fractional exponent and, by applying the fractional differencing operator, obtain the underlying weakly dependent series. In the second step, we produce multi-step-ahead forecasts...... for the weakly dependent series and obtain their long memory counterparts by applying the fractional cumulation operator. The methodology applies to both stationary and nonstationary cases. Simulations and an application to seven time series provide evidence that the new methodology is more robust to structural...

  3. Two-Stage Load Shedding for Secondary Control in Hierarchical Operation of Islanded Microgrids

    DEFF Research Database (Denmark)

    Zhou, Quan; Li, Zhiyi; Wu, Qiuwei

    2018-01-01

    A two-stage load shedding scheme is presented to cope with the severe power deficit caused by microgrid islanding. Coordinated with the fast response of inverter-based distributed energy resources (DERs), load shedding at each stage and the resulting power flow redistribution are estimated....... The first stage of load shedding will cease rapid frequency decline in which the measured frequency deviation is employed to guide the load shedding level and process. Once a new steady-state is reached, the second stage is activated, which performs load shedding according to the priorities of loads...

  4. The rearrangement process in a two-stage broadcast switching network

    DEFF Research Database (Denmark)

    Jacobsen, Søren B.

    1988-01-01

    The rearrangement process in the two-stage broadcast switching network presented by F.K. Hwang and G.W. Richards (ibid., vol.COM-33, no.10, p.1025-1035, Oct. 1985) is considered. By defining a certain function it is possible to calculate an upper bound on the number of connections to be moved...... during a rearrangement. When each inlet channel appears twice, the maximum number of connections to be moved is found. For a special class of inlet assignment patterns in the case of which each inlet channel appears three times, the maximum number of connections to be moved is also found. In the general...

  5. Risk-Averse Suppliers’ Optimal Pricing Strategies in a Two-Stage Supply Chain

    Directory of Open Access Journals (Sweden)

    Rui Shen

    2013-01-01

    Full Text Available Risk-averse suppliers’ optimal pricing strategies in two-stage supply chains under competitive environment are discussed. The suppliers in this paper focus more on losses as compared to profits, and they care their long-term relationship with their customers. We introduce for the suppliers a loss function, which covers both current loss and future loss. The optimal wholesale price is solved under situations of risk neutral, risk averse, and a combination of minimizing loss and controlling risk, respectively. Besides, some properties of and relations among these optimal wholesale prices are given as well. A numerical example is given to illustrate the performance of the proposed method.

  6. Modelling of Two-Stage Methane Digestion With Pretreatment of Biomass

    Science.gov (United States)

    Dychko, A.; Remez, N.; Opolinskyi, I.; Kraychuk, S.; Ostapchuk, N.; Yevtieieva, L.

    2018-04-01

    Systems of anaerobic digestion should be used for processing of organic waste. Managing the process of anaerobic recycling of organic waste requires reliable predicting of biogas production. Development of mathematical model of process of organic waste digestion allows determining the rate of biogas output at the two-stage process of anaerobic digestion considering the first stage. Verification of Konto's model, based on the studied anaerobic processing of organic waste, is implemented. The dependencies of biogas output and its rate from time are set and may be used to predict the process of anaerobic processing of organic waste.

  7. Simple Digital Control of a Two-Stage PFC Converter Using DSPIC30F Microprocessor

    DEFF Research Database (Denmark)

    Török, Lajos; Munk-Nielsen, Stig

    2010-01-01

    The use of dsPIC digital signal controllers (DSC) in Switch Mode Power Supply (SMPS) applications opens new perspectives for cheap and flexible digital control solutions. This paper presents the digital control of a two stage power factor corrector (PFC) converter. The PFC circuit is designed...... and built for 70W rated output power. Average current mode control for boost converter and current programmed control for forward converter are implemented on a dsPIC30F1010. Pulse Width Modulation (PWM) technique is used to drive the switching MOSFETs. Results show that digital solutions with ds...

  8. A comprehensive review on two-stage integrative schemes for the valorization of dark fermentative effluents.

    Science.gov (United States)

    Sivagurunathan, Periyasamy; Kuppam, Chandrasekhar; Mudhoo, Ackmez; Saratale, Ganesh D; Kadier, Abudukeremu; Zhen, Guangyin; Chatellard, Lucile; Trably, Eric; Kumar, Gopalakrishnan

    2017-12-21

    This review provides the alternative routes towards the valorization of dark H 2 fermentation effluents that are mainly rich in volatile fatty acids such as acetate and butyrate. Various enhancement and alternative routes such as photo fermentation, anaerobic digestion, utilization of microbial electrochemical systems, and algal system towards the generation of bioenergy and electricity and also for efficient organic matter utilization are highlighted. What is more, various integration schemes and two-stage fermentation for the possible scale up are reviewed. Moreover, recent progress for enhanced performance towards waste stabilization and overall utilization of useful and higher COD present in the organic source into value-added products are extensively discussed.

  9. An Investigation on the Formation of Carbon Nanotubes by Two-Stage Chemical Vapor Deposition

    Directory of Open Access Journals (Sweden)

    M. S. Shamsudin

    2012-01-01

    Full Text Available High density of carbon nanotubes (CNTs has been synthesized from agricultural hydrocarbon: camphor oil using a one-hour synthesis time and a titanium dioxide sol gel catalyst. The pyrolysis temperature is studied in the range of 700–900°C at increments of 50°C. The synthesis process is done using a custom-made two-stage catalytic chemical vapor deposition apparatus. The CNT characteristics are investigated by field emission scanning electron microscopy and micro-Raman spectroscopy. The experimental results showed that structural properties of CNT are highly dependent on pyrolysis temperature changes.

  10. A Novel Two-Stage Dynamic Spectrum Sharing Scheme in Cognitive Radio Networks

    Institute of Scientific and Technical Information of China (English)

    Guodong Zhang; Wei Heng; Tian Liang; Chao Meng; Jinming Hu

    2016-01-01

    In order to enhance the efficiency of spectrum utilization and reduce communication overhead in spectrum sharing process,we propose a two-stage dynamic spectrum sharing scheme in which cooperative and noncooperative modes are analyzed in both stages.In particular,the existence and the uniqueness of Nash Equilibrium (NE) strategies for noncooperative mode are proved.In addition,a distributed iterative algorithm is proposed to obtain the optimal solutions of the scheme.Simulation studies are carried out to show the performance comparison between two modes as well as the system revenue improvement of the proposed scheme compared with a conventional scheme without a virtual price control factor.

  11. The Design, Construction and Operation of a 75 kW Two-Stage Gasifier

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Birk; Ahrenfeldt, Jesper; Jensen, Torben Kvist

    2003-01-01

    The Two-Stage Gasifier was operated for several weeks (465 hours) and of these 190 hours continuously. The gasifier is operated automatically unattended day and night, and only small adjustments of the feeding rate were necessary once or twice a day. The operation was successful, and the output...... as expected. The engine operated well on the produced gas, and no deposits were observed in the engine afterwards. The bag house filter was an excellent and well operating gas cleaning system. Small amounts of deposits consisting of salts and carbonates were observed in the hot gas heat exchangers. The top...

  12. Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

    OpenAIRE

    Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

    2009-01-01

    Chia-Chang Chien1, Shu-Fen Huang1,2,3,4, For-Wey Lung1,2,3,41Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; 2Graduate Institute of Behavioral Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; 3Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan; 4Calo Psychiatric Center, Pingtung County, TaiwanObjective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of militar...

  13. High-speed pellet injection with a two-stage pneumatic gun

    International Nuclear Information System (INIS)

    Reggiori, A.; Carlevaro, R.; Riva, G.; Daminelli, G.B.; Scaramuzzi, F.; Frattolillo, A.; Martinis, L.; Cardoni, P.; Mori, L.

    1988-01-01

    The injection of pellets of frozen hydrogen isotopes into fusion plasmas is envisioned as a fueling technique for future fusion reactors. Research is underway to obtain high injection speeds for solid H 2 and D 2 pellets. The optimization of a two-stage light gas gun is being pursued by the Milano group; the search for a convenient method of creating pellets with good mechanical properties and a secure attachment to the cold surface on which they are formed is carried out in Frascati. Velocities >2000 m/s have been obtained, but reproducibility is not yet satisfactory

  14. Artificial immune system and sheep flock algorithms for two-stage fixed-charge transportation problem

    DEFF Research Database (Denmark)

    Kannan, Devika; Govindan, Kannan; Soleimani, Hamed

    2014-01-01

    In this paper, we cope with a two-stage distribution planning problem of supply chain regarding fixed charges. The focus of the paper is on developing efficient solution methodologies of the selected NP-hard problem. Based on computational limitations, common exact and approximation solution...... approaches are unable to solve real-world instances of such NP-hard problems in a reasonable time. These approaches involve cumbersome computational steps in real-size cases. In order to solve the mixed integer linear programming model, we develop an artificial immune system and a sheep flock algorithm...

  15. Development of an innovative two-stage process, a combination of acidogenic hydrogenesis and methanogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Han, S.K.; Shin, H.S. [Korea Advanced Inst. of Science and Technology, Daejeon (Korea, Republic of). Dept. of Civil and Enviromental Engineering

    2004-07-01

    Hydrogen produced from waste by means of fermentative bacteria is an attractive way to produce this fuel as an alternative to fossil fuels. It also helps treat the associated waste. The authors have undertaken to optimize acidogenic hydrogenesis and methanogenesis. Building on this, they then developed a two-stage process that produces both hydrogen and methane. Acidogenic hydrogenesis of food waste was investigated using a leaching bed reactor. The dilution rate was varied in order to maximize efficiency which was as high as 70.8 per cent. Further to this, an upflow anaerobic sludge blanket reactor converted the wastewater from acidogenic hydrogenesis into methane. Chemical oxygen demand (COD) removal rates exceeded 96 per cent up to a COD loading of 12.9 COD/l/d. After this, the authors devised a new two-stage process based on a combination of acidogenic hydrogenesis and methanogenesis. The authors report on results for this process using food waste as feedstock. 5 refs., 5 figs.

  16. Fueling of magnetically confined plasmas by single- and two-stage repeating pneumatic pellet injectors

    International Nuclear Information System (INIS)

    Gouge, M.J.; Combs, S.K.; Foust, C.R.; Milora, S.L.

    1990-01-01

    Advanced plasma fueling systems for magnetic fusion confinement experiments are under development at Oak Ridge National Laboratory (ORNL). The general approach is that of producing and accelerating frozen hydrogenic pellets to speeds in the kilometer-per-second range using single shot and repetitive pneumatic (light-gas gun) pellet injectors. The millimeter-to-centimeter size pellets enter the plasma and continuously ablate because of the plasma electron heat flux, depositing fuel atoms along the pellet trajectory. This fueling method allows direct fueling in the interior of the hot plasma and is more efficient than the alternative method of injecting room temperature fuel gas at the wall of the plasma vacuum chamber. Single-stage pneumatic injectors based on the light-gas gun concept have provided hydrogenic fuel pellets in the speed range of 1--2 km/s in single-shot injector designs. Repetition rates up to 5 Hz have been demonstrated in repetitive injector designs. Future fusion reactor-scale devices may need higher pellet velocities because of the larger plasma size and higher plasma temperatures. Repetitive two-stage pneumatic injectors are under development at ORNL to provide long-pulse plasma fueling in the 3--5 km/s speed range. Recently, a repeating, two-stage light-gas gun achieved repetitive operation at 1 Hz with speeds in the range of 2--3 km/s

  17. Plant specification of a generic human-error data through a two-stage Bayesian approach

    International Nuclear Information System (INIS)

    Heising, C.D.; Patterson, E.I.

    1984-01-01

    Expert judgement concerning human performance in nuclear power plants is quantitatively coupled with actuarial data on such performance in order to derive plant-specific human-error rate probability distributions. The coupling procedure consists of a two-stage application of Bayes' theorem to information which is grouped by type. The first information type contains expert judgement concerning human performance at nuclear power plants in general. Data collected on human performance at a group of similar plants forms the second information type. The third information type consists of data on human performance in a specific plant which has the same characteristics as the group members. The first and second information types are coupled in the first application of Bayes' theorem to derive a probability distribution for population performance. This distribution is then combined with the third information type in a second application of Bayes' theorem to determine a plant-specific human-error rate probability distribution. The two stage Bayesian procedure thus provides a means to quantitatively couple sparse data with expert judgement in order to obtain a human performance probability distribution based upon available information. Example calculations for a group of like reactors are also given. (author)

  18. A two-stage stochastic programming model for the optimal design of distributed energy systems

    International Nuclear Information System (INIS)

    Zhou, Zhe; Zhang, Jianyun; Liu, Pei; Li, Zheng; Georgiadis, Michael C.; Pistikopoulos, Efstratios N.

    2013-01-01

    Highlights: ► The optimal design of distributed energy systems under uncertainty is studied. ► A stochastic model is developed using genetic algorithm and Monte Carlo method. ► The proposed system possesses inherent robustness under uncertainty. ► The inherent robustness is due to energy storage facilities and grid connection. -- Abstract: A distributed energy system is a multi-input and multi-output energy system with substantial energy, economic and environmental benefits. The optimal design of such a complex system under energy demand and supply uncertainty poses significant challenges in terms of both modelling and corresponding solution strategies. This paper proposes a two-stage stochastic programming model for the optimal design of distributed energy systems. A two-stage decomposition based solution strategy is used to solve the optimization problem with genetic algorithm performing the search on the first stage variables and a Monte Carlo method dealing with uncertainty in the second stage. The model is applied to the planning of a distributed energy system in a hotel. Detailed computational results are presented and compared with those generated by a deterministic model. The impacts of demand and supply uncertainty on the optimal design of distributed energy systems are systematically investigated using proposed modelling framework and solution approach.

  19. A Two-Stage Method to Determine Optimal Product Sampling considering Dynamic Potential Market

    Science.gov (United States)

    Hu, Zhineng; Lu, Wei; Han, Bing

    2015-01-01

    This paper develops an optimization model for the diffusion effects of free samples under dynamic changes in potential market based on the characteristics of independent product and presents a two-stage method to figure out the sampling level. The impact analysis of the key factors on the sampling level shows that the increase of the external coefficient or internal coefficient has a negative influence on the sampling level. And the changing rate of the potential market has no significant influence on the sampling level whereas the repeat purchase has a positive one. Using logistic analysis and regression analysis, the global sensitivity analysis gives a whole analysis of the interaction of all parameters, which provides a two-stage method to estimate the impact of the relevant parameters in the case of inaccuracy of the parameters and to be able to construct a 95% confidence interval for the predicted sampling level. Finally, the paper provides the operational steps to improve the accuracy of the parameter estimation and an innovational way to estimate the sampling level. PMID:25821847

  20. Multiobjective Two-Stage Stochastic Programming Problems with Interval Discrete Random Variables

    Directory of Open Access Journals (Sweden)

    S. K. Barik

    2012-01-01

    Full Text Available Most of the real-life decision-making problems have more than one conflicting and incommensurable objective functions. In this paper, we present a multiobjective two-stage stochastic linear programming problem considering some parameters of the linear constraints as interval type discrete random variables with known probability distribution. Randomness of the discrete intervals are considered for the model parameters. Further, the concepts of best optimum and worst optimum solution are analyzed in two-stage stochastic programming. To solve the stated problem, first we remove the randomness of the problem and formulate an equivalent deterministic linear programming model with multiobjective interval coefficients. Then the deterministic multiobjective model is solved using weighting method, where we apply the solution procedure of interval linear programming technique. We obtain the upper and lower bound of the objective function as the best and the worst value, respectively. It highlights the possible risk involved in the decision-making tool. A numerical example is presented to demonstrate the proposed solution procedure.

  1. Two stage bioethanol refining with multi litre stacked microbial fuel cell and microbial electrolysis cell.

    Science.gov (United States)

    Sugnaux, Marc; Happe, Manuel; Cachelin, Christian Pierre; Gloriod, Olivier; Huguenin, Gérald; Blatter, Maxime; Fischer, Fabian

    2016-12-01

    Ethanol, electricity, hydrogen and methane were produced in a two stage bioethanol refinery setup based on a 10L microbial fuel cell (MFC) and a 33L microbial electrolysis cell (MEC). The MFC was a triple stack for ethanol and electricity co-generation. The stack configuration produced more ethanol with faster glucose consumption the higher the stack potential. Under electrolytic conditions ethanol productivity outperformed standard conditions and reached 96.3% of the theoretically best case. At lower external loads currents and working potentials oscillated in a self-synchronized manner over all three MFC units in the stack. In the second refining stage, fermentation waste was converted into methane, using the scale up MEC stack. The bioelectric methanisation reached 91% efficiency at room temperature with an applied voltage of 1.5V using nickel cathodes. The two stage bioethanol refining process employing bioelectrochemical reactors produces more energy vectors than is possible with today's ethanol distilleries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Two staged incentive contract focused on efficiency and innovation matching in critical chain project management

    Directory of Open Access Journals (Sweden)

    Min Zhang

    2014-09-01

    Full Text Available Purpose: The purpose of this paper is to define the relative optimal incentive contract to effectively encourage employees to improve work efficiency while actively implementing innovative behavior. Design/methodology/approach: This paper analyzes a two staged incentive contract coordinated with efficiency and innovation in Critical Chain Project Management using learning real options, based on principle-agent theory. The situational experiment is used to analyze the validity of the basic model. Finding: The two staged incentive scheme is more suitable for employees to create and implement learning real options, which will throw themselves into innovation process efficiently in Critical Chain Project Management. We prove that the combination of tolerance for early failure and reward for long-term success is effective in motivating innovation. Research limitations/implications: We do not include the individual characteristics of uncertain perception, which might affect the consistency of external validity. The basic model and the experiment design need to improve. Practical Implications: The project managers should pay closer attention to early innovation behavior and monitoring feedback of competition time in the implementation of Critical Chain Project Management. Originality/value: The central contribution of this paper is the theoretical and experimental analysis of incentive schemes for innovation in Critical Chain Project Management using the principal-agent theory, to encourage the completion of CCPM methods as well as imitative free-riding on the creative ideas of other members in the team.

  3. Two-stage acid saccharification of fractionated Gelidium amansii minimizing the sugar decomposition.

    Science.gov (United States)

    Jeong, Tae Su; Kim, Young Soo; Oh, Kyeong Keun

    2011-11-01

    Two-stage acid hydrolysis was conducted on easy reacting cellulose and resistant reacting cellulose of fractionated Gelidium amansii (f-GA). Acid hydrolysis of f-GA was performed at between 170 and 200 °C for a period of 0-5 min, and an acid concentration of 2-5% (w/v, H2SO4) to determine the optimal conditions for acid hydrolysis. In the first stage of the acid hydrolysis, an optimum glucose yield of 33.7% was obtained at a reaction temperature of 190 °C, an acid concentration of 3.0%, and a reaction time of 3 min. In the second stage, a glucose yield of 34.2%, on the basis the amount of residual cellulose from the f-GA, was obtained at a temperature of 190 °C, a sulfuric acid concentration of 4.0%, and a reaction time 3.7 min. Finally, 68.58% of the cellulose derived from f-GA was converted into glucose through two-stage acid saccharification under aforementioned conditions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Use of a two-stage light-gas gun as an injector for electromagnetic railguns

    International Nuclear Information System (INIS)

    Shahinpoor, M.

    1989-01-01

    Ablation of wall materials is known to be a major factor limiting the performance of railguns. To minimize this effect, it is desirable too inject projectiles into railgun at velocities greater than the ablation threshold velocity (6-8 km/s for copper rails). Because two-stage light-gas guns are capable of achieving such velocities, a program was initiated to design, build and evaluate the performance of a two-stage light gas gun, utilizing hydrogen gas, for use as an injector to an electromagnetic railgun. This effort is part of a project to develop a hypervelocity electromagnetic launcher (HELEOS) for use in equation-of-state studies. In this paper, the specific design features that enhance compatibility of the injector with the railgun, including a slip-joint between the injector launch tube and the coupling section to the railgun are described. The operational capabilities for using all major projectile velocity measuring techniques, such as in-bore pressure gauges, laser and CW x-ray interrupt techniques, flash x-ray and continuous in-bore velocity measurements using VISAR interferometry are also discussed. Finally an internal ballistics code for optimizing gun performance has been utilized to interpret performance data of the gun

  5. Statistical inference for extended or shortened phase II studies based on Simon's two-stage designs.

    Science.gov (United States)

    Zhao, Junjun; Yu, Menggang; Feng, Xi-Ping

    2015-06-07

    Simon's two-stage designs are popular choices for conducting phase II clinical trials, especially in the oncology trials to reduce the number of patients placed on ineffective experimental therapies. Recently Koyama and Chen (2008) discussed how to conduct proper inference for such studies because they found that inference procedures used with Simon's designs almost always ignore the actual sampling plan used. In particular, they proposed an inference method for studies when the actual second stage sample sizes differ from planned ones. We consider an alternative inference method based on likelihood ratio. In particular, we order permissible sample paths under Simon's two-stage designs using their corresponding conditional likelihood. In this way, we can calculate p-values using the common definition: the probability of obtaining a test statistic value at least as extreme as that observed under the null hypothesis. In addition to providing inference for a couple of scenarios where Koyama and Chen's method can be difficult to apply, the resulting estimate based on our method appears to have certain advantage in terms of inference properties in many numerical simulations. It generally led to smaller biases and narrower confidence intervals while maintaining similar coverages. We also illustrated the two methods in a real data setting. Inference procedures used with Simon's designs almost always ignore the actual sampling plan. Reported P-values, point estimates and confidence intervals for the response rate are not usually adjusted for the design's adaptiveness. Proper statistical inference procedures should be used.

  6. Study on a high capacity two-stage free piston Stirling cryocooler working around 30 K

    Science.gov (United States)

    Wang, Xiaotao; Zhu, Jian; Chen, Shuai; Dai, Wei; Li, Ke; Pang, Xiaomin; Yu, Guoyao; Luo, Ercang

    2016-12-01

    This paper presents a two-stage high-capacity free-piston Stirling cryocooler driven by a linear compressor to meet the requirement of the high temperature superconductor (HTS) motor applications. The cryocooler system comprises a single piston linear compressor, a two-stage free piston Stirling cryocooler and a passive oscillator. A single stepped displacer configuration was adopted. A numerical model based on the thermoacoustic theory was used to optimize the system operating and structure parameters. Distributions of pressure wave, phase differences between the pressure wave and the volume flow rate and different energy flows are presented for a better understanding of the system. Some characterizing experimental results are presented. Thus far, the cryocooler has reached a lowest cold-head temperature of 27.6 K and achieved a cooling power of 78 W at 40 K with an input electric power of 3.2 kW, which indicates a relative Carnot efficiency of 14.8%. When the cold-head temperature increased to 77 K, the cooling power reached 284 W with a relative Carnot efficiency of 25.9%. The influences of different parameters such as mean pressure, input electric power and cold-head temperature are also investigated.

  7. Two-stage heterotrophic and phototrophic culture strategy for algal biomass and lipid production.

    Science.gov (United States)

    Zheng, Yubin; Chi, Zhanyou; Lucker, Ben; Chen, Shulin

    2012-01-01

    A two-stage heterotrophic and phototrophic culture strategy for algal biomass and lipid production was studied, wherein high density heterotrophic cultures of Chlorellasorokiniana serve as seed for subsequent phototrophic growth. The data showed growth rate, cell density and productivity of heterotrophic C.sorokiniana were 3.0, 3.3 and 7.4 times higher than phototrophic counterpart, respectively. Hetero- and phototrophic algal seeds had similar biomass/lipid production and fatty acid profile when inoculated into phototrophic culture system. To expand the application, food waste and wastewater were tested as feedstock for heterotrophic growth, and supported cell growth successfully. These results demonstrated the advantages of using heterotrophic algae cells as seeds for open algae culture system. Additionally, high inoculation rate of heterotrophic algal seed can be utilized as an effective method for contamination control. This two-stage heterotrophic phototrophic process is promising to provide a more efficient way for large scale production of algal biomass and biofuels. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Two-stage single-volume exchange transfusion in severe hemolytic disease of the newborn.

    Science.gov (United States)

    Abbas, Wael; Attia, Nayera I; Hassanein, Sahar M A

    2012-07-01

    Evaluation of two-stage single-volume exchange transfusion (TSSV-ET) in decreasing the post-exchange rebound increase in serum bilirubin level, with subsequent reduction of the need for repeated exchange transfusions. The study included 104 neonates with hyperbilirubinemia needing exchange transfusion. They were randomly enrolled into two equal groups, each group comprised 52 neonates. TSSV-ET was performed for the 52 neonates and the traditional single-stage double-volume exchange transfusion (SSDV-ET) was performed to 52 neonates. TSSV-ET significantly lowered rebound serum bilirubin level (12.7 ± 1.1 mg/dL), compared to SSDV-ET (17.3 ± 1.7 mg/dL), p < 0.001. Need for repeated exchange transfusions was significantly lower in TSSV-ET group (13.5%), compared to 32.7% in SSDV-ET group, p < 0.05. No significant difference was found between the two groups as regards the morbidity (11.5% and 9.6%, respectively) and the mortality (1.9% for both groups). Two-stage single-volume exchange transfusion proved to be more effective in reducing rebound serum bilirubin level post-exchange and in decreasing the need for repeated exchange transfusions.

  9. QUICKGUN: An algorithm for estimating the performance of two-stage light gas guns

    International Nuclear Information System (INIS)

    Milora, S.L.; Combs, S.K.; Gouge, M.J.; Kincaid, R.W.

    1990-09-01

    An approximate method is described for solving the equation of motion of a projectile accelerated by a two-stage light gas gun that uses high-pressure (<100-bar) gas from a storage reservoir to drive a piston to moderate speed (<400 m/s) for the purpose of compressing the low molecular weight propellant gas (hydrogen or helium) to high pressure (1000 to 10,000 bar) and temperature (1000 to 10,000 K). Zero-dimensional, adiabatic (isentropic) processes are used to describe the time dependence of the ideal gas thermodynamic properties of the storage reservoir and the first and second stages of the system. A one-dimensional model based on an approximate method of characteristics, or wave diagram analysis, for flow with friction (nonisentropic) is used to describe the nonsteady compressible flow processes in the launch tube. Linear approximations are used for the characteristic and fluid particle trajectories by averaging the values of the flow parameters at the breech and at the base of the projectile. An assumed functional form for the Mach number at the breech provides the necessary boundary condition. Results of the calculation are compared with data obtained from two-stage light gas gun experiments at Oak Ridge National Laboratory for solid deuterium and nylon projectiles with masses ranging from 10 to 35 mg and for projectile speeds between 1.6 and 4.5 km/s. The predicted and measured velocities generally agree to within 15%. 19 refs., 3 figs., 2 tabs

  10. Fate of dissolved organic nitrogen in two stage trickling filter process.

    Science.gov (United States)

    Simsek, Halis; Kasi, Murthy; Wadhawan, Tanush; Bye, Christopher; Blonigen, Mark; Khan, Eakalak

    2012-10-15

    Dissolved organic nitrogen (DON) represents a significant portion of nitrogen in the final effluent of wastewater treatment plants (WWTPs). Biodegradable portion of DON (BDON) can support algal growth and/or consume dissolved oxygen in the receiving waters. The fate of DON and BDON has not been studied for trickling filter WWTPs. DON and BDON data were collected along the treatment train of a WWTP with a two-stage trickling filter process. DON concentrations in the influent and effluent were 27% and 14% of total dissolved nitrogen (TDN). The plant removed about 62% and 72% of the influent DON and BDON mainly by the trickling filters. The final effluent BDON values averaged 1.8 mg/L. BDON was found to be between 51% and 69% of the DON in raw wastewater and after various treatment units. The fate of DON and BDON through the two-stage trickling filter treatment plant was modeled. The BioWin v3.1 model was successfully applied to simulate ammonia, nitrite, nitrate, TDN, DON and BDON concentrations along the treatment train. The maximum growth rates for ammonia oxidizing bacteria (AOB) and nitrite oxidizing bacteria, and AOB half saturation constant influenced ammonia and nitrate output results. Hydrolysis and ammonification rates influenced all of the nitrogen species in the model output, including BDON. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Two stage heterotrophy/photoinduction culture of Scenedesmus incrassatulus: potential for lutein production.

    Science.gov (United States)

    Flórez-Miranda, Liliana; Cañizares-Villanueva, Rosa Olivia; Melchy-Antonio, Orlando; Martínez-Jerónimo, Fernando; Flores-Ortíz, Cesar Mateo

    2017-11-20

    A biomass production process including two stages, heterotrophy/photoinduction (TSHP), was developed to improve biomass and lutein production by the green microalgae Scenedesmus incrassatulus. To determine the effects of different nitrogen sources (yeast extract and urea) and temperature in the heterotrophic stage, experiments using shake flask cultures with glucose as the carbon source were carried out. The highest biomass productivity and specific pigment concentrations were reached using urea+vitamins (U+V) at 30°C. The first stage of the TSHP process was done in a 6L bioreactor, and the inductions in a 3L airlift photobioreactor. At the end of the heterotrophic stage, S. incrassatulus achieved the maximal biomass concentration, increasing from 7.22gL -1 to 17.98gL -1 with an increase in initial glucose concentration from 10.6gL -1 to 30.3gL -1 . However, the higher initial glucose concentration resulted in a lower specific growth rate (μ) and lower cell yield (Y x/s ), possibly due to substrate inhibition. After 24h of photoinduction, lutein content in S. incrassatulus biomass was 7 times higher than that obtained at the end of heterotrophic cultivation, and the lutein productivity was 1.6 times higher compared with autotrophic culture of this microalga. Hence, the two-stage heterotrophy/photoinduction culture is an effective strategy for high cell density and lutein production in S. incrassatulus. Copyright © 2017. Published by Elsevier B.V.

  12. Optimization of Two-Stage Peltier Modules: Structure and Exergetic Efficiency

    Directory of Open Access Journals (Sweden)

    Cesar Ramirez-Lopez

    2012-08-01

    Full Text Available In this paper we undertake the theoretical analysis of a two-stage semiconductor thermoelectric module (TEM which contains an arbitrary and different number of thermocouples, n1 and n2, in each stage (pyramid-styled TEM. The analysis is based on a dimensionless entropy balance set of equations. We study the effects of n1 and n2, the flowing electric currents through each stage, the applied temperatures and the thermoelectric properties of the semiconductor materials on the exergetic efficiency. Our main result implies that the electric currents flowing in each stage must necessarily be different with a ratio about 4.3 if the best thermal performance and the highest temperature difference possible between the cold and hot side of the device are pursued. This fact had not been pointed out before for pyramid-styled two stage TEM. The ratio n1/n2 should be about 8.

  13. Hydrodeoxygenation of oils from cellulose in single and two-stage hydropyrolysis

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, J.D.; Snape, C.E. [Strathclyde Univ., Glasgow (United Kingdom); Luengo, C.A. [Universidade Estadual de Campinas, SP (Brazil). Dept. de Fisica Aplicada

    1996-09-01

    To investigate the removal of oxygen (hydrodeoxygenation) during the hydropyrolysis of cellulose, single and two-stage experiments on pure cellulose have been carried out using hydrogen pressures up to 10 MPa and temperatures over the range 300-520{sup o}C. Carbon, oxygen and aromaticity balances have been determined from the product yields and compositions. For the two-stage tests, the primary oils were passed through a bed of commercial Ni/Mo {gamma}-alumina-supported catalyst (Criterion 424, presulphided) at 400{sup o}C. Raising the hydrogen pressure from atmospheric to 10 MPa increased the carbon conversion by 10 mole % which was roughly equally divided between the oil and hydrocarbon gases. The oxygen content of the primary oil was reduced by over 10% to below 20% w/w. The addition of a dispersed iron sulphide catalyst further increased the oil yield at 10 MPa and reduces the oxygen content of the oil by a further 10%. The effect of hydrogen pressure on oil yields was most pronounced at low flow rates where it is beneficial in helping to overcome diffusional resistances. Unlike the dispersed iron sulphide in the first stage, the use of the Ni-Mo catalyst in the second stage reduced both the oxygen content and aromaticity of the oils. (Author)

  14. Two-stage stochastic programming model for the regional-scale electricity planning under demand uncertainty

    International Nuclear Information System (INIS)

    Huang, Yun-Hsun; Wu, Jung-Hua; Hsu, Yu-Ju

    2016-01-01

    Traditional electricity supply planning models regard the electricity demand as a deterministic parameter and require the total power output to satisfy the aggregate electricity demand. But in today's world, the electric system planners are facing tremendously complex environments full of uncertainties, where electricity demand is a key source of uncertainty. In addition, electricity demand patterns are considerably different for different regions. This paper developed a multi-region optimization model based on two-stage stochastic programming framework to incorporate the demand uncertainty. Furthermore, the decision tree method and Monte Carlo simulation approach are integrated into the model to simplify electricity demands in the form of nodes and determine the values and probabilities. The proposed model was successfully applied to a real case study (i.e. Taiwan's electricity sector) to show its applicability. Detail simulation results were presented and compared with those generated by a deterministic model. Finally, the long-term electricity development roadmap at a regional level could be provided on the basis of our simulation results. - Highlights: • A multi-region, two-stage stochastic programming model has been developed. • The decision tree and Monte Carlo simulation are integrated into the framework. • Taiwan's electricity sector is used to illustrate the applicability of the model. • The results under deterministic and stochastic cases are shown for comparison. • Optimal portfolios of regional generation technologies can be identified.

  15. Final Report on Two-Stage Fast Spectrum Fuel Cycle Options

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Won Sik [Purdue Univ., West Lafayette, IN (United States); Lin, C. S. [Purdue Univ., West Lafayette, IN (United States); Hader, J. S. [Purdue Univ., West Lafayette, IN (United States); Park, T. K. [Purdue Univ., West Lafayette, IN (United States); Deng, P. [Purdue Univ., West Lafayette, IN (United States); Yang, G. [Purdue Univ., West Lafayette, IN (United States); Jung, Y. S. [Purdue Univ., West Lafayette, IN (United States); Kim, T. K. [Argonne National Lab. (ANL), Argonne, IL (United States); Stauff, N. E. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-01-30

    This report presents the performance characteristics of two “two-stage” fast spectrum fuel cycle options proposed to enhance uranium resource utilization and to reduce nuclear waste generation. One is a two-stage fast spectrum fuel cycle option of continuous recycle of plutonium (Pu) in a fast reactor (FR) and subsequent burning of minor actinides (MAs) in an accelerator-driven system (ADS). The first stage is a sodium-cooled FR fuel cycle starting with low-enriched uranium (LEU) fuel; at the equilibrium cycle, the FR is operated using the recovered Pu and natural uranium without supporting LEU. Pu and uranium (U) are co-extracted from the discharged fuel and recycled in the first stage, and the recovered MAs are sent to the second stage. The second stage is a sodium-cooled ADS in which MAs are burned in an inert matrix fuel form. The discharged fuel of ADS is reprocessed, and all the recovered heavy metals (HMs) are recycled into the ADS. The other is a two-stage FR/ADS fuel cycle option with MA targets loaded in the FR. The recovered MAs are not directly sent to ADS, but partially incinerated in the FR in order to reduce the amount of MAs to be sent to the ADS. This is a heterogeneous recycling option of transuranic (TRU) elements

  16. A two-stage inexact joint-probabilistic programming method for air quality management under uncertainty.

    Science.gov (United States)

    Lv, Y; Huang, G H; Li, Y P; Yang, Z F; Sun, W

    2011-03-01

    A two-stage inexact joint-probabilistic programming (TIJP) method is developed for planning a regional air quality management system with multiple pollutants and multiple sources. The TIJP method incorporates the techniques of two-stage stochastic programming, joint-probabilistic constraint programming and interval mathematical programming, where uncertainties expressed as probability distributions and interval values can be addressed. Moreover, it can not only examine the risk of violating joint-probability constraints, but also account for economic penalties as corrective measures against any infeasibility. The developed TIJP method is applied to a case study of a regional air pollution control problem, where the air quality index (AQI) is introduced for evaluation of the integrated air quality management system associated with multiple pollutants. The joint-probability exists in the environmental constraints for AQI, such that individual probabilistic constraints for each pollutant can be efficiently incorporated within the TIJP model. The results indicate that useful solutions for air quality management practices have been generated; they can help decision makers to identify desired pollution abatement strategies with minimized system cost and maximized environmental efficiency. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Many-Objective Particle Swarm Optimization Using Two-Stage Strategy and Parallel Cell Coordinate System.

    Science.gov (United States)

    Hu, Wang; Yen, Gary G; Luo, Guangchun

    2017-06-01

    It is a daunting challenge to balance the convergence and diversity of an approximate Pareto front in a many-objective optimization evolutionary algorithm. A novel algorithm, named many-objective particle swarm optimization with the two-stage strategy and parallel cell coordinate system (PCCS), is proposed in this paper to improve the comprehensive performance in terms of the convergence and diversity. In the proposed two-stage strategy, the convergence and diversity are separately emphasized at different stages by a single-objective optimizer and a many-objective optimizer, respectively. A PCCS is exploited to manage the diversity, such as maintaining a diverse archive, identifying the dominance resistant solutions, and selecting the diversified solutions. In addition, a leader group is used for selecting the global best solutions to balance the exploitation and exploration of a population. The experimental results illustrate that the proposed algorithm outperforms six chosen state-of-the-art designs in terms of the inverted generational distance and hypervolume over the DTLZ test suite.

  18. Two stage, low temperature, catalyzed fluidized bed incineration with in situ neutralization for radioactive mixed wastes

    International Nuclear Information System (INIS)

    Wade, J.F.; Williams, P.M.

    1995-01-01

    A two stage, low temperature, catalyzed fluidized bed incineration process is proving successful at incinerating hazardous wastes containing nuclear material. The process operates at 550 degrees C and 650 degrees C in its two stages. Acid gas neutralization takes place in situ using sodium carbonate as a sorbent in the first stage bed. The feed material to the incinerator is hazardous waste-as defined by the Resource Conservation and Recovery Act-mixed with radioactive materials. The radioactive materials are plutonium, uranium, and americium that are byproducts of nuclear weapons production. Despite its low temperature operation, this system successfully destroyed poly-chlorinated biphenyls at a 99.99992% destruction and removal efficiency. Radionuclides and volatile heavy metals leave the fluidized beds and enter the air pollution control system in minimal amounts. Recently collected modeling and experimental data show the process minimizes dioxin and furan production. The report also discusses air pollution, ash solidification, and other data collected from pilot- and demonstration-scale testing. The testing took place at Rocky Flats Environmental Technology Site, a US Department of Energy facility, in the 1970s, 1980s, and 1990s

  19. On bi-criteria two-stage transportation problem: a case study

    Directory of Open Access Journals (Sweden)

    Ahmad MURAD

    2010-01-01

    Full Text Available The study of the optimum distribution of goods between sources and destinations is one of the important topics in projects economics. This importance comes as a result of minimizing the transportation cost, deterioration, time, etc. The classical transportation problem constitutes one of the major areas of application for linear programming. The aim of this problem is to obtain the optimum distribution of goods from different sources to different destinations which minimizes the total transportation cost. From the practical point of view, the transportation problems may differ from the classical form. It may contain one or more objective function, one or more stage to transport, one or more type of commodity with one or more means of transport. The aim of this paper is to construct an optimization model for transportation problem for one of mill-stones companies. The model is formulated as a bi-criteria two-stage transportation problem with a special structure depending on the capacities of suppliers, warehouses and requirements of the destinations. A solution algorithm is introduced to solve this class of bi-criteria two-stage transportation problem to obtain the set of non-dominated extreme points and the efficient solutions accompanied with each one that enables the decision maker to choose the best one. The solution algorithm mainly based on the fruitful application of the methods for treating transportation problems, theory of duality of linear programming and the methods of solving bi-criteria linear programming problems.

  20. Two-stage effects of awareness cascade on epidemic spreading in multiplex networks

    Science.gov (United States)

    Guo, Quantong; Jiang, Xin; Lei, Yanjun; Li, Meng; Ma, Yifang; Zheng, Zhiming

    2015-01-01

    Human awareness plays an important role in the spread of infectious diseases and the control of propagation patterns. The dynamic process with human awareness is called awareness cascade, during which individuals exhibit herd-like behavior because they are making decisions based on the actions of other individuals [Borge-Holthoefer et al., J. Complex Networks 1, 3 (2013), 10.1093/comnet/cnt006]. In this paper, to investigate the epidemic spreading with awareness cascade, we propose a local awareness controlled contagion spreading model on multiplex networks. By theoretical analysis using a microscopic Markov chain approach and numerical simulations, we find the emergence of an abrupt transition of epidemic threshold βc with the local awareness ratio α approximating 0.5 , which induces two-stage effects on epidemic threshold and the final epidemic size. These findings indicate that the increase of α can accelerate the outbreak of epidemics. Furthermore, a simple 1D lattice model is investigated to illustrate the two-stage-like sharp transition at αc≈0.5 . The results can give us a better understanding of why some epidemics cannot break out in reality and also provide a potential access to suppressing and controlling the awareness cascading systems.

  1. Risk averse optimal operation of a virtual power plant using two stage stochastic programming

    International Nuclear Information System (INIS)

    Tajeddini, Mohammad Amin; Rahimi-Kian, Ashkan; Soroudi, Alireza

    2014-01-01

    VPP (Virtual Power Plant) is defined as a cluster of energy conversion/storage units which are centrally operated in order to improve the technical and economic performance. This paper addresses the optimal operation of a VPP considering the risk factors affecting its daily operation profits. The optimal operation is modelled in both day ahead and balancing markets as a two-stage stochastic mixed integer linear programming in order to maximize a GenCo (generation companies) expected profit. Furthermore, the CVaR (Conditional Value at Risk) is used as a risk measure technique in order to control the risk of low profit scenarios. The uncertain parameters, including the PV power output, wind power output and day-ahead market prices are modelled through scenarios. The proposed model is successfully applied to a real case study to show its applicability and the results are presented and thoroughly discussed. - Highlights: • Virtual power plant modelling considering a set of energy generating and conversion units. • Uncertainty modelling using two stage stochastic programming technique. • Risk modelling using conditional value at risk. • Flexible operation of renewable energy resources. • Electricity price uncertainty in day ahead energy markets

  2. A preventive maintenance policy based on dependent two-stage deterioration and external shocks

    International Nuclear Information System (INIS)

    Yang, Li; Ma, Xiaobing; Peng, Rui; Zhai, Qingqing; Zhao, Yu

    2017-01-01

    This paper proposes a preventive maintenance policy for a single-unit system whose failure has two competing and dependent causes, i.e., internal deterioration and sudden shocks. The internal failure process is divided into two stages, i.e. normal and defective. Shocks arrive according to a non-homogeneous Poisson process (NHPP), leading to the failure of the system immediately. The occurrence rate of a shock is affected by the state of the system. Both an age-based replacement and finite number of periodic inspections are schemed simultaneously to deal with the competing failures. The objective of this study is to determine the optimal preventive replacement interval, inspection interval and number of inspections such that the expected cost per unit time is minimized. A case study on oil pipeline maintenance is presented to illustrate the maintenance policy. - Highlights: • A maintenance model based on two-stage deterioration and sudden shocks is developed. • The impact of internal system state on external shock process is studied. • A new preventive maintenance strategy combining age-based replacements and periodic inspections is proposed. • Postponed replacement of a defective system is provided by restricting the number of inspections.

  3. Two-stage supercharging of a passenger car diesel engine; Zweistufige Aufladung eines Pkw-Dieselmotors

    Energy Technology Data Exchange (ETDEWEB)

    Wittmer, A.; Albrecht, P.; Becker, B.; Vogt, G.; Fischer, R. [Erphi Elektronik GmbH, Holzkirchen (Germany)

    2004-07-01

    Two-stage supercharging of internal combustion engines with specific capacities beyond 70 kW/l opens up new options for smaller charge volumes. A low-pressure and a high-pressure supercharger are connected in series, with by-passes. The control strategy is described in this contribution using a model of exhaust counterpressure. The potential of a two-stage supercharged diesel engine with CR injection was proved in two engines and in dynamic driving tests. The new concept offers optimum chances for downsizing provided that the driving performance is not affected. (orig.) [German] Die zweistufige Aufladung von Verbrennungsmotoren eroeffnet mit spezifischen Leistungen jenseits von 70 kW/l weitere Moeglichkeiten der Hubraumverkleinerung. Dabei werden ein Niederdruck- und ein Hochdrucklader mit Umgehungsleitungen in Reihe geschaltet. Die erforderliche Regelungsstrategie zum kontrollierten Uebergang von einer Stufe auf die naechste erfolgt in dem hier vorliegenden Beitrag anhand eines Modells fuer den Abgasgegendruck. Hierbei wird das Regelorgan so angesteuert, dass sich der gewuenschte Druck vor den Turbinen einstellt. An zwei Motoren konnten stationaere Ergebnisse das Leistungspotential eines zweistufig aufgeladenen Dieselmotors mit 'Common Rail' Einspritzung nachgewiesen werden. Die dynamischen Fahrversuche belegen eindrucksvoll den schnellen Ladedruckaufbau auch aus tiefen Drehzahlbereichen bei gleichzeitig gutem Uebergangsverhalten von der Hochdruck- auf die Niederdruckstufe. Damit bietet der zweistufig aufgeladene Dieselmotor mit dem hier dargestellten Regelungsverfahren optimale Voraussetzungen fuer 'Downsizing' unter der Randbedingung, dass moeglichst keine Einbussen bei den Fahrleistungen hinzunehmen sind. (orig.)

  4. A low-voltage sense amplifier with two-stage operational amplifier clamping for flash memory

    Science.gov (United States)

    Guo, Jiarong

    2017-04-01

    A low-voltage sense amplifier with reference current generator utilizing two-stage operational amplifier clamp structure for flash memory is presented in this paper, capable of operating with minimum supply voltage at 1 V. A new reference current generation circuit composed of a reference cell and a two-stage operational amplifier clamping the drain pole of the reference cell is used to generate the reference current, which avoids the threshold limitation caused by current mirror transistor in the traditional sense amplifier. A novel reference voltage generation circuit using dummy bit-line structure without pull-down current is also adopted, which not only improves the sense window enhancing read precision but also saves power consumption. The sense amplifier was implemented in a flash realized in 90 nm flash technology. Experimental results show the access time is 14.7 ns with power supply of 1.2 V and slow corner at 125 °C. Project supported by the National Natural Science Fundation of China (No. 61376028).

  5. Robust Frequency-Domain Constrained Feedback Design via a Two-Stage Heuristic Approach.

    Science.gov (United States)

    Li, Xianwei; Gao, Huijun

    2015-10-01

    Based on a two-stage heuristic method, this paper is concerned with the design of robust feedback controllers with restricted frequency-domain specifications (RFDSs) for uncertain linear discrete-time systems. Polytopic uncertainties are assumed to enter all the system matrices, while RFDSs are motivated by the fact that practical design specifications are often described in restricted finite frequency ranges. Dilated multipliers are first introduced to relax the generalized Kalman-Yakubovich-Popov lemma for output feedback controller synthesis and robust performance analysis. Then a two-stage approach to output feedback controller synthesis is proposed: at the first stage, a robust full-information (FI) controller is designed, which is used to construct a required output feedback controller at the second stage. To improve the solvability of the synthesis method, heuristic iterative algorithms are further formulated for exploring the feedback gain and optimizing the initial FI controller at the individual stage. The effectiveness of the proposed design method is finally demonstrated by the application to active control of suspension systems.

  6. Two-stage agglomeration of fine-grained herbal nettle waste

    Science.gov (United States)

    Obidziński, Sławomir; Joka, Magdalena; Fijoł, Olga

    2017-10-01

    This paper compares the densification work necessary for the pressure agglomeration of fine-grained dusty nettle waste, with the densification work involved in two-stage agglomeration of the same material. In the first stage, the material was pre-densified through coating with a binder material in the form of a 5% potato starch solution, and then subjected to pressure agglomeration. A number of tests were conducted to determine the effect of the moisture content in the nettle waste (15, 18 and 21%), as well as the process temperature (50, 70, 90°C) on the values of densification work and the density of the obtained pellets. For pre-densified pellets from a mixture of nettle waste and a starch solution, the conducted tests determined the effect of pellet particle size (1, 2, and 3 mm) and the process temperature (50, 70, 90°C) on the same values. On the basis of the tests, we concluded that the introduction of a binder material and the use of two-stage agglomeration in nettle waste densification resulted in increased densification work (as compared to the densification of nettle waste alone) and increased pellet density.

  7. Two-Stage Classification Approach for Human Detection in Camera Video in Bulk Ports

    Directory of Open Access Journals (Sweden)

    Mi Chao

    2015-09-01

    Full Text Available With the development of automation in ports, the video surveillance systems with automated human detection begun to be applied in open-air handling operation areas for safety and security. The accuracy of traditional human detection based on the video camera is not high enough to meet the requirements of operation surveillance. One of the key reasons is that Histograms of Oriented Gradients (HOG features of the human body will show great different between front & back standing (F&B and side standing (Side human body. Therefore, the final training for classifier will only gain a few useful specific features which have contribution to classification and are insufficient to support effective classification, while using the HOG features directly extracted by the samples from different human postures. This paper proposes a two-stage classification method to improve the accuracy of human detection. In the first stage, during preprocessing classification, images is mainly divided into possible F&B human body and not F&B human body, and then they were put into the second-stage classification among side human and non-human recognition. The experimental results in Tianjin port show that the two-stage classifier can improve the classification accuracy of human detection obviously.

  8. A two-stage heating scheme for heat assisted magnetic recording

    Science.gov (United States)

    Xiong, Shaomin; Kim, Jeongmin; Wang, Yuan; Zhang, Xiang; Bogy, David

    2014-05-01

    Heat Assisted Magnetic Recording (HAMR) has been proposed to extend the storage areal density beyond 1 Tb/in.2 for the next generation magnetic storage. A near field transducer (NFT) is widely used in HAMR systems to locally heat the magnetic disk during the writing process. However, much of the laser power is absorbed around the NFT, which causes overheating of the NFT and reduces its reliability. In this work, a two-stage heating scheme is proposed to reduce the thermal load by separating the NFT heating process into two individual heating stages from an optical waveguide and a NFT, respectively. As the first stage, the optical waveguide is placed in front of the NFT and delivers part of laser energy directly onto the disk surface to heat it up to a peak temperature somewhat lower than the Curie temperature of the magnetic material. Then, the NFT works as the second heating stage to heat a smaller area inside the waveguide heated area further to reach the Curie point. The energy applied to the NFT in the second heating stage is reduced compared with a typical single stage NFT heating system. With this reduced thermal load to the NFT by the two-stage heating scheme, the lifetime of the NFT can be extended orders longer under the cyclic load condition.

  9. Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics

    Science.gov (United States)

    2012-01-01

    Background In 1998, a process of centralisation was initiated for services for children born with a cleft lip or palate in the UK. We studied the timing of this process in England according to its impact on the number of hospitals and surgeons involved in primary surgical repairs. Methods All live born patients with a cleft lip and/or palate born between April 1997 and December 2008 were identified in Hospital Episode Statistics, the database of admissions to English National Health Service hospitals. Children were included if they had diagnostic codes for a cleft as well as procedure codes for a primary surgical cleft repair. Children with codes indicating additional congenital anomalies or syndromes were excluded as their additional problems could have determined when and where they were treated. Results We identified 10,892 children with a cleft. 21.0% were excluded because of additional anomalies or syndromes. Of the remaining 8,606 patients, 30.4% had a surgical lip repair only, 41.7% a palate repair only, and 28.0% both a lip and palate repair. The number of hospitals that carried out these primary repairs reduced from 49 in 1997 to 13, with 11 of these performing repairs on at least 40 children born in 2008. The number of surgeons responsible for repairs reduced from 98 to 26, with 22 performing repairs on at least 20 children born in 2008. In the same period, average length of hospital stay reduced from 3.8 to 3.0 days for primary lip repairs, from 3.8 to 3.3 days for primary palate repairs, and from 4.6 to 2.6 days for combined repairs with no evidence for a change in emergency readmission rates. The speed of centralisation varied with the earliest of the nine regions completing it in 2001 and the last in 2007. Conclusions Between 1998 and 2007, cleft services in England were centralised. According to a survey among patients’ parents, the quality of cleft care improved in the same period. Surgical care became more consistent with current

  10. Prevalence of cleft lip and cleft palate in rural north-central guatemala.

    Science.gov (United States)

    Matute, Jorge; Lydick, Elaine A; Torres, Olga R; Owen, Karen K; Jacobsen, Kathryn H

    2015-05-01

    To estimate the number of new cases of cleft lip and cleft palate in the department (state) of Alta Verapaz, Guatemala, in 2012. Cross-sectional survey of midwives from communities identified through a two-stage cluster-sampling process. Midwives were asked how many babies they had delivered in the past year and how many of those newborns had various types of birth defects, as illustrated in pictures. Indigenous Mayan communities in rural north-central Guatemala. Midwives (n = 129) who had delivered babies in the previous year. Reports of babies born with cleft lip and cleft palate. A 1-year prevalence rate of 18.9 per 10,000 for cleft lip and 4.7 per 10,000 for cleft palate was estimated for Alta Verapaz. None of the cases of cleft lip also had cleft palate. The indigenous communities in north-central Guatemala might have a relatively high cleft lip prevalence rate compared with the global average.

  11. DNA repair

    International Nuclear Information System (INIS)

    Setlow, R.

    1978-01-01

    Some topics discussed are as follows: difficulty in extrapolating data from E. coli to mammalian systems; mutations caused by UV-induced changes in DNA; mutants deficient in excision repair; other postreplication mechanisms; kinds of excision repair systems; detection of repair by biochemical or biophysical means; human mutants deficient in repair; mutagenic effects of UV on XP cells; and detection of UV-repair defects among XP individuals

  12. Distribution of extracellular potassium and electrophysiologic changes during two-stage coronary ligation in the isolated, perfused canine heart

    NARCIS (Netherlands)

    Coronel, R.; Fiolet, J. W.; Wilms-Schopman, J. G.; Opthof, T.; Schaapherder, A. F.; Janse, M. J.

    1989-01-01

    We studied the relation between [K+]o and the electrophysiologic changes during a "Harris two-stage ligation," which is an occlusion of a coronary artery, preceded by a 30-minute period of 50% reduction of flow through the artery. This two-stage ligation has been reported to be antiarrhythmic. Local

  13. Performance of an iterative two-stage bayesian technique for population pharmacokinetic analysis of rich data sets

    NARCIS (Netherlands)

    Proost, Johannes H.; Eleveld, Douglas J.

    2006-01-01

    Purpose. To test the suitability of an Iterative Two-Stage Bayesian (ITSB) technique for population pharmacokinetic analysis of rich data sets, and to compare ITSB with Standard Two-Stage (STS) analysis and nonlinear Mixed Effect Modeling (MEM). Materials and Methods. Data from a clinical study with

  14. Esthetic Composition of Smile in Individuals with Cleft Lip, Alveolus, and Palate: Visibility of the Periodontium and the Esthetics of Smile

    OpenAIRE

    Esper, Luis Augusto; Sbrana, Michyele Cristhiane; Cunha, Mércia Jussara da Silva; Moreira, Guilherme Santos; de Almeida, Ana Lúcia Pompéia Fraga

    2012-01-01

    Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15–30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Ma...

  15. Spectral Analysis of Word-Initial Alveolar and Velar Plosives Produced by Iranian Children with Cleft Lip and Palate

    Science.gov (United States)

    Eshghi, Marziye; Zajac, David J.; Bijankhan, Mahmood; Shirazi, Mohsen

    2013-01-01

    Spectral moment analysis (SMA) was used to describe voiceless alveolar and velar stop-plosive production in Persian-speaking children with repaired cleft lip and palate (CLP). Participants included 11 children with bilateral CLP who were undergoing maxillary expansion and 20 children without any type of orofacial clefts. Four of the children with…

  16. A randomized controlled trial comparing two techniques for unilateral cleft lip and palate: Growth and speech outcomes during mixed dentition.

    Science.gov (United States)

    Ganesh, Praveen; Murthy, Jyotsna; Ulaghanathan, Navitha; Savitha, V H

    2015-07-01

    To study the growth and speech outcomes in children who were operated on for unilateral cleft lip and palate (UCLP) by a single surgeon using two different treatment protocols. A total of 200 consecutive patients with nonsyndromic UCLP were randomly allocated to two different treatment protocols. Of the 200 patients, 179 completed the protocol. However, only 85 patients presented for follow-up during the mixed dentition period (7-10 years of age). The following treatment protocol was followed. Protocol 1 consisted of the vomer flap (VF), whereby patients underwent primary lip nose repair and vomer flap for hard palate single-layer closure, followed by soft palate repair 6 months later; Protocol 2 consisted of the two-flap technique (TF), whereby the cleft palate (CP) was repaired by two-flap technique after primary lip and nose repair. GOSLON Yardstick scores for dental arch relation, and speech outcomes based on universal reporting parameters, were noted. A total of 40 patients in the VF group and 45 in the TF group completed the treatment protocols. The GOSLON scores showed marginally better outcomes in the VF group compared to the TF group. Statistically significant differences were found only in two speech parameters, with better outcomes in the TF group. Our results showed marginally better growth outcome in the VF group compared to the TF group. However, the speech outcomes were better in the TF group. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Australian children with cleft palate achieve age-appropriate speech by 5 years of age.

    Science.gov (United States)

    Chacon, Antonia; Parkin, Melissa; Broome, Kate; Purcell, Alison

    2017-12-01

    Children with cleft palate demonstrate atypical speech sound development, which can influence their intelligibility, literacy and learning. There is limited documentation regarding how speech sound errors change over time in cleft palate speech and the effect that these errors have upon mono-versus polysyllabic word production. The objective of this study was to examine the phonetic and phonological speech skills of children with cleft palate at ages 3 and 5. A cross-sectional observational design was used. Eligible participants were aged 3 or 5 years with a repaired cleft palate. The Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest and a non-standardised list of mono- and polysyllabic words were administered once for each child. The Profile of Phonology (PROPH) was used to analyse each child's speech. N = 51 children with cleft palate participated in the study. Three-year-old children with cleft palate produced significantly more speech errors than their typically-developing peers, but no difference was apparent at 5 years. The 5-year-olds demonstrated greater phonetic and phonological accuracy than the 3-year-old children. Polysyllabic words were more affected by errors than monosyllables in the 3-year-old group only. Children with cleft palate are prone to phonetic and phonological speech errors in their preschool years. Most of these speech errors approximate typically-developing children by 5 years. At 3 years, word shape has an influence upon phonological speech accuracy. Speech pathology intervention is indicated to support the intelligibility of these children from their earliest stages of development. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Myofibroblasts in palatal wound healing: prospects for the reduction of wound contraction after cleft palate repair.

    NARCIS (Netherlands)

    Beurden, H.E. van; Hoff, J.W. Von den; Torensma, R.; Maltha, J.C.; Kuijpers-Jagtman, A.M.

    2005-01-01

    The surgical closure of orofacial clefts is considered to impair maxillary growth and dento-alveolar development. Wound contraction and subsequent scar tissue formation, during healing of these surgical wounds, contribute largely to these growth disturbances. The potential to minimize wound

  19. 3-D shape analysis of palatal surface in patients with unilateral complete cleft lip and palate.

    Science.gov (United States)

    Rusková, Hana; Bejdová, Sárka; Peterka, Miroslav; Krajíček, Václav; Velemínská, Jana

    2014-07-01

    Facial development of patients with unilateral complete cleft lip and palate (UCLP) is associated with many problems including deformity of the palate. The aim of this study was to evaluate palatal morphology and variability in patients with UCLP compared with Czech norms using methods of geometric morphometrics. The study was based on virtual dental cast analysis of 29 UCLP patients and 29 control individuals at the age of 15 years. The variability of palatal shape in UCLP patients was greater than that in nonclefted palates. Only 24% of clefted palates fell within the variability of controls. The palatal form of UCLP patients (range from 11.8 to 17.2 years) was not correlated with age. Compared with control palates, palates of UCLP patients were narrower, more anteriorly than posteriorly. Apart from the praemaxilla region, they were also shallower, and the difference increased posteriorly. The UCLP palate was characterised by the asymmetry of its vault. The maximum height of the palatal vault was anterior on the clefted side, whereas it was posterior on the nonclefted side. The slope of the UCLP palate was more inclined compared with the control group. The praemaxilla was therefore situated more inferiorly. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of fecal microorganisms of children with cleft palate before and after palatoplasty

    Directory of Open Access Journals (Sweden)

    Narciso Almeida Vieira

    2013-09-01

    Full Text Available This study isolated and quantified intestinal bacteria of children with cleft palate before and after palatoplasty. A prospective study was conducted from May 2007 to September 2008 on 18 children with cleft palate, aged one to four years, of both genders, attending a tertiary cleft center in Brazil for palatoplasty, to analyze the effect of surgical palate repair on the concentration of anaerobes Bacteroides sp, Bifidobacterium sp and microaerophiles Lactobacillus sp in feces of infants with cleft palate before and 24 hours after treatment with cefazolin for palatoplasty. There was significant reduction of Lactobacillus sp (p < 0.002, Bacteroides sp (p < 0.001 and Bifidobacterium sp (p = 0.021 after palatoplasty, revealing that surgery and utilization of cefazolin significantly influenced the fecal microbiota comparing collections before and after surgery. However, due to study limitations, it was not possible to conclude that other isolated factors, such as surgical stress, anesthetics and other medications used in palatoplasty might have a significant influence on the microbiota. Considering the important participation of the intestinal microbiota on both local and systemic metabolic and immunological activities of the host, professionals should be attentive to the possible influence of these changes in patients submitted to cleft repair.

  1. Palatoplasty: suturing the mucoperiosteal flaps to the hard palate through hole.

    Science.gov (United States)

    Hwang, Kun; Lee, Ji Hun; Kim, Yu Jin; Le, Se Il

    2009-05-01

    We satisfactorily repaired a wide cleft palate using a method of V-Y pushback and anchoring the oral mucoperiosteal flap onto the bony ridge of the cleft. An 8-year-old Vietnamese girl had a wide incomplete bilateral posterior cleft palate associated with congenital cardiac malformations. The gap of the posterior cleft was 2.5 cm, which exceeded the total widths of the palatal shelves. We applied V-Y pushback and used a vomer flap to close the wide cleft palate. The posterior two thirds of the nasal mucosae from the cleft margins were sutured to the vomer flap. The nasal side of the anterior one third of the bony cleft was uncovered. The elevated bilateral mucoperiosteal flaps were brought together to the midline and sutured to the anterior triangular flap in a V-Y pushback fashion. Four holes were drilled 5 mm lateral to each bony cleft margin. The lateral sides of the mucoperiosteal flaps were fixed to the palate bone with 3-0 Vicryl through the hole. This method reduces the tension of the flap which might frequently cause oronasal fistula and also improve viability.

  2. Dentoalveolar growth inhibition induced by bone denudation on palates: a study of two isolated cleft palates with asymmetric scar tissue distribution.

    Science.gov (United States)

    Ishikawa, H; Iwasaki, H; Tsukada, H; Chu, S; Nakamura, S; Yamamoto, K

    1999-09-01

    This report presents two cases of isolated cleft palate with asymmetric distribution of postsurgical scar tissue determined by laser Doppler flowmetry. To determine the effect of mucoperiosteal denudation of the bone on maxillary alveolar growth, the analysis of dentoalveolar structures compared the affected side to the unaffected side of each case. Two Japanese girls with isolated cleft palates were examined. Both subjects had undergone pushback operations (a modified version of the procedure of Wardill) for palatal repair at 18 months of age. Palatal blood flow was examined by laser Doppler flowmetry when the girls were 12 years old to determine the extent of postsurgical scar tissue over the denuded bone. To analyze the maxillary dentoalveolar structures three dimensionally, the whole surface of the upper dental cast was measured and recorded by an optical measuring device when the girls were 7 years old. Analysis via flowmetry showed that the palatal scar tissue area was limited to the anterior tooth region on the right (unaffected) side but extended posteriorly to the premolar region on the left (affected) side in both subjects. The two girls had similar dentoalveolar structures, with the dental and alveolar arches deflected lingually at the deciduous molar area on the affected side. There were no differences in the buccolingual inclination of deciduous molars or in the vertical growth of the alveolar processes between the affected and unaffected sides. In both girls, bone denudation in the premolar region appeared to result in less than 3 mm of displacement of the teeth palatally, with no change in lingual inclination. Any effects of scar tissue on the vertical development of the alveolus were not substantiated.

  3. Two-stage atlas subset selection in multi-atlas based image segmentation.

    Science.gov (United States)

    Zhao, Tingting; Ruan, Dan

    2015-06-01

    Fast growing access to large databases and cloud stored data presents a unique opportunity for multi-atlas based image segmentation and also presents challenges in heterogeneous atlas quality and computation burden. This work aims to develop a novel two-stage method tailored to the special needs in the face of large atlas collection with varied quality, so that high-accuracy segmentation can be achieved with low computational cost. An atlas subset selection scheme is proposed to substitute a significant portion of the computationally expensive full-fledged registration in the conventional scheme with a low-cost alternative. More specifically, the authors introduce a two-stage atlas subset selection method. In the first stage, an augmented subset is obtained based on a low-cost registration configuration and a preliminary relevance metric; in the second stage, the subset is further narrowed down to a fusion set of desired size, based on full-fledged registration and a refined relevance metric. An inference model is developed to characterize the relationship between the preliminary and refined relevance metrics, and a proper augmented subset size is derived to ensure that the desired atlases survive the preliminary selection with high probability. The performance of the proposed scheme has been assessed with cross validation based on two clinical datasets consisting of manually segmented prostate and brain magnetic resonance images, respectively. The proposed scheme demonstrates comparable end-to-end segmentation performance as the conventional single-stage selection method, but with significant computation reduction. Compared with the alternative computation reduction method, their scheme improves the mean and medium Dice similarity coefficient value from (0.74, 0.78) to (0.83, 0.85) and from (0.82, 0.84) to (0.95, 0.95) for prostate and corpus callosum segmentation, respectively, with statistical significance. The authors have developed a novel two-stage atlas

  4. Two-stage atlas subset selection in multi-atlas based image segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Tingting, E-mail: tingtingzhao@mednet.ucla.edu; Ruan, Dan, E-mail: druan@mednet.ucla.edu [The Department of Radiation Oncology, University of California, Los Angeles, California 90095 (United States)

    2015-06-15

    Purpose: Fast growing access to large databases and cloud stored data presents a unique opportunity for multi-atlas based image segmentation and also presents challenges in heterogeneous atlas quality and computation burden. This work aims to develop a novel two-stage method tailored to the special needs in the face of large atlas collection with varied quality, so that high-accuracy segmentation can be achieved with low computational cost. Methods: An atlas subset selection scheme is proposed to substitute a significant portion of the computationally expensive full-fledged registration in the conventional scheme with a low-cost alternative. More specifically, the authors introduce a two-stage atlas subset selection method. In the first stage, an augmented subset is obtained based on a low-cost registration configuration and a preliminary relevance metric; in the second stage, the subset is further narrowed down to a fusion set of desired size, based on full-fledged registration and a refined relevance metric. An inference model is developed to characterize the relationship between the preliminary and refined relevance metrics, and a proper augmented subset size is derived to ensure that the desired atlases survive the preliminary selection with high probability. Results: The performance of the proposed scheme has been assessed with cross validation based on two clinical datasets consisting of manually segmented prostate and brain magnetic resonance images, respectively. The proposed scheme demonstrates comparable end-to-end segmentation performance as the conventional single-stage selection method, but with significant computation reduction. Compared with the alternative computation reduction method, their scheme improves the mean and medium Dice similarity coefficient value from (0.74, 0.78) to (0.83, 0.85) and from (0.82, 0.84) to (0.95, 0.95) for prostate and corpus callosum segmentation, respectively, with statistical significance. Conclusions: The authors

  5. Two-stage atlas subset selection in multi-atlas based image segmentation

    International Nuclear Information System (INIS)

    Zhao, Tingting; Ruan, Dan

    2015-01-01

    Purpose: Fast growing access to large databases and cloud stored data presents a unique opportunity for multi-atlas based image segmentation and also presents challenges in heterogeneous atlas quality and computation burden. This work aims to develop a novel two-stage method tailored to the special needs in the face of large atlas collection with varied quality, so that high-accuracy segmentation can be achieved with low computational cost. Methods: An atlas subset selection scheme is proposed to substitute a significant portion of the computationally expensive full-fledged registration in the conventional scheme with a low-cost alternative. More specifically, the authors introduce a two-stage atlas subset selection method. In the first stage, an augmented subset is obtained based on a low-cost registration configuration and a preliminary relevance metric; in the second stage, the subset is further narrowed down to a fusion set of desired size, based on full-fledged registration and a refined relevance metric. An inference model is developed to characterize the relationship between the preliminary and refined relevance metrics, and a proper augmented subset size is derived to ensure that the desired atlases survive the preliminary selection with high probability. Results: The performance of the proposed scheme has been assessed with cross validation based on two clinical datasets consisting of manually segmented prostate and brain magnetic resonance images, respectively. The proposed scheme demonstrates comparable end-to-end segmentation performance as the conventional single-stage selection method, but with significant computation reduction. Compared with the alternative computation reduction method, their scheme improves the mean and medium Dice similarity coefficient value from (0.74, 0.78) to (0.83, 0.85) and from (0.82, 0.84) to (0.95, 0.95) for prostate and corpus callosum segmentation, respectively, with statistical significance. Conclusions: The authors

  6. Two stages and three components of the postural preparation to action.

    Science.gov (United States)

    Krishnan, Vennila; Aruin, Alexander S; Latash, Mark L

    2011-07-01

    Previous studies of postural preparation to action/perturbation have primarily focused on anticipatory postural adjustments (APAs), the changes in muscle activation levels resulting in the production of net forces and moments of force. We hypothesized that postural preparation to action consists of two stages: (1) Early postural adjustments (EPAs), seen a few hundred ms prior to an expected external perturbation and (2) APAs seen about 100 ms prior to the perturbation. We also hypothesized that each stage consists of three components, anticipatory synergy adjustments seen as changes in covariation of the magnitudes of commands to muscle groups (M-modes), changes in averaged across trials levels of muscle activation, and mechanical effects such as shifts of the center of pressure. Nine healthy participants were subjected to external perturbations created by a swinging pendulum while standing in a semi-squatting posture. Electrical activity of twelve trunk and leg muscles and displacements of the center of pressure were recorded and analyzed. Principal component analysis was used to identify four M-modes within the space of muscle activations using indices of integrated muscle activation. This analysis was performed twice, over two phases, 400-700 ms prior to the perturbation and over 200 ms just prior to the perturbation. Similar robust results were obtained using the data from both phases. An index of a multi-M-mode synergy stabilizing the center of pressure displacement was computed using the framework of the uncontrolled manifold hypothesis. The results showed high synergy indices during quiet stance. Each of the two stages started with a drop in the synergy index followed by a change in the averaged across trials activation levels in postural muscles. There was a very long electromechanical delay during the early postural adjustments and a much shorter delay during the APAs. Overall, the results support our main hypothesis on the two stages and three components

  7. Evaluation of a modified two-stage inferior alveolar nerve block technique: A preliminary investigation

    Directory of Open Access Journals (Sweden)

    Ashwin Rao

    2017-01-01

    Full Text Available Introduction: The two-stage technique of inferior alveolar nerve block (IANB administration does not address the pain associated with “needle insertion” and “local anesthetic solution deposition” in the “first stage” of the injection. This study evaluated a “modified two stage technique” to the reaction of children during “needle insertion” and “local anesthetic solution deposition” during the “first stage” and compared it to the “first phase” of the IANB administered with the standard one-stage technique. Materials and Methods: This was a parallel, single-blinded comparative study. A total of 34 children (between 6 and 10 years of age were randomly divided into two groups to receive an IANB either through the modified two-stage technique (MTST (Group A; 15 children or the standard one-stage technique (SOST (Group B; 19 children. The evaluation was done using the Face Legs Activity Cry Consolability (FLACC; which is an objective scale based on the expressions of the child scale. The obtained data was analyzed using Fishers Exact test with the P value set at <0.05 as level of significance. Results: 73.7% of children in Group B indicated moderate pain during the “first phase” of SOST and no children indicated such in the “first stage” of group A. Group A had 33.3% children who scored “0” indicating relaxed/comfortable children compared to 0% in Group B. In Group A, 66.7% of children scored between 1–3 indicating mild discomfort compared to 26.3% in group B. The difference in the scores between the two groups in each category (relaxed/comfortable, mild discomfort, moderate pain was highly significant (P < 0.001. Conclusion: Reaction of children in Group A during “needle insertion” and “local anesthetic solution deposition” in the “first stage” of MTST was significantly lower than that of Group B during the “first phase” of the SOST.

  8. CIRPLAST: Cleft Lip and Palate Missions in Peru.

    Science.gov (United States)

    Navarro, Carlos E

    2015-06-01

    The author presents a 20-year experience leading cleft lip and palate surgical volunteer missions in Peru for CIRPLAST, a nonprofit volunteer plastic surgery goodwill program that has provided free surgery for patients with cleft lip and palate deformities in remote areas of Peru. Surgical procedures were performed by the author, together with a group of experienced plastic surgeons, under the auspices of the Peruvian Plastic Surgery Society, and local health authorities. CIRPLAST missions are scheduled annually in different locations around Peru. Selected patients for surgery after adequate screening are photographed, and their cleft deformity is recorded. Scheduled patients or their parents, when they are minors, sign an informed consent form. Patients operated on in any given day are examined and photographed 1 day after surgery, before discharge. Between 30 and 35 patients are operated on at each mission site. About 2 weeks after the mission, patients are checked and photographed, and the outcome of surgery is recorded. Complications that may occur are recorded and treated by the CIRPLAST team as soon as possible. Almost all operations are performed under general endotracheal anesthesia coupled by local anesthesia containing a vasoconstrictor, to reduce bleeding and facilitate tissue dissection. All wounds of the lip and palate are closed with absorbable sutures, to avoid the need for suture removal. After cleft lip surgery, patients go to the recovery room for monitoring by nurses until they recover completely. A total of 6108 cleft lip and palate repairs, primary and secondary, were performed by CIRPLAST in 141 missions, between May 12, 1994, and October 15, 2014. The medical records of the 5162 patients (84.5%) who returned for follow-up (ranging from 12 days to 9 years) were reviewed retrospectively. Between 45% and 70% of the patients operated on a mission have returned for early follow-up and some the following year. There were 3176 males (51.9%) and 2932

  9. Product prioritization in a two-stage food production system with intermediate storage

    DEFF Research Database (Denmark)

    Akkerman, Renzo; van Donk, Dirk Pieter

    2007-01-01

    In the food-processing industry, usually a limited number of storage tanks for intermediate storage is available, which are used for different products. The market sometimes requires extremely short lead times for some products, leading to prioritization of these products, partly through...... the performance improvements for the prioritized product, as well as the negative effects for the other products. We also show how the effect decreases with more storage tanks, and increases with more products....... the dedication of a storage tank. This type of situation has hardly been investigated, although planners struggle with it in practice. This paper aims at investigating the fundamental effect of prioritization and dedicated storage in a two-stage production system, for various product mixes. We show...

  10. Hugoniot measurements in vanadium using the LNL two-stage light-gas gun

    International Nuclear Information System (INIS)

    Gathers, G.R.; Mitchell, A.C.; Holmes, N.C.

    1983-01-01

    Hugoniot measurements on vanadium have been made using the LLNL two-stage light-gas gun. The direct collision method with electrical pins and a tantalum flyer accelerated to 6.28 km/s was used. Alt'shuler, et. al., have reported Hugoniot measurements in vanadium using explosives and the impedance match method. They reported a kink in the U/sub s/ - U/sub p/ relationship at 183 GPa, and attribute it to electronic transitions. The upper portion of their curve is based on a single point at 339 GPa. The present work was performed to further investigate the equation-of-state in the high-pressure range

  11. Two-stage multilevel en bloc spondylectomy with resection and replacement of the aorta.

    Science.gov (United States)

    Gösling, Thomas; Pichlmaier, Maximilian A; Länger, Florian; Krettek, Christian; Hüfner, Tobias

    2013-05-01

    We report a case of multilevel spondylectomy in which resection and replacement of the adjacent aorta were done. Although spondylectomy is nowadays an established technique, no report on a combined aortic resection and replacement has been reported so far. The case of a 43-year-old man with a primary chondrosarcoma of the thoracic spine is presented. The local pathology necessitated resection of the aorta. We did a two-stage procedure with resection and replacement of the aorta using a heart-lung machine followed by secondary tumor resection and spinal reconstruction. The procedure was successful. A tumor-free margin was achieved. The patient is free of disease 48 months after surgery. En bloc spondylectomy in combination with aortic resection is feasible and might expand the possibility of producing tumor-free margins in special situations.

  12. Integrated Circuit Design of 3 Electrode Sensing System Using Two-Stage Operational Amplifier

    Science.gov (United States)

    Rani, S.; Abdullah, W. F. H.; Zain, Z. M.; N, Aqmar N. Z.

    2018-03-01

    This paper presents the design of a two-stage operational amplifier(op amp) for 3-electrode sensing system readout circuits. The designs have been simulated using 0.13μm CMOS technology from Silterra (Malaysia) with Mentor graphics tools. The purpose of this projects is mainly to design a miniature interfacing circuit to detect the redox reaction in the form of current using standard analog modules. The potentiostat consists of several op amps combined together in order to analyse the signal coming from the 3-electrode sensing system. This op amp design will be used in potentiostat circuit device and to analyse the functionality for each module of the system.

  13. Design of a Two-stage High-capacity Stirling Cryocooler Operating below 30K

    Science.gov (United States)

    Wang, Xiaotao; Dai, Wei; Zhu, Jian; Chen, Shuai; Li, Haibing; Luo, Ercang

    The high capacity cryocooler working below 30K can find many applications such as superconducting motors, superconducting cables and cryopump. Compared to the GM cryocooler, the Stirling cryocooler can achieve higher efficiency and more compact structure. Because of these obvious advantages, we have designed a two stage free piston Stirling cryocooler system, which is driven by a moving magnet linear compressor with an operating frequency of 40 Hz and a maximum 5 kW input electric power. The first stage of the cryocooler is designed to operate in the liquid nitrogen temperature and output a cooling power of 100 W. And the second stage is expected to simultaneously provide a cooling power of 50 W below the temperature of 30 K. In order to achieve the best system efficiency, a numerical model based on the thermoacoustic model was developed to optimize the system operating and structure parameters.

  14. Two-stage autotransplantation of human submandibular gland: a novel approach to treat postradiogenic xerostomia.

    Science.gov (United States)

    Hagen, Rudolf; Scheich, Matthias; Kleinsasser, Norbert; Burghartz, Marc

    2016-08-01

    Xerostomia is a persistent side effect of radiotherapy (RT), which severely reduces the quality of life of the patients affected. Besides drug treatment and new irradiation strategies, surgical procedures aim for tissue protection of the submandibular gland. Using a new surgical approach, the submandibular gland was autotransplanted in 6 patients to the patient's forearm for the period of RT and reimplanted into the floor of the mouth 2-3 months after completion of RT. Saxon's test was performed during different time points to evaluate patient's saliva production. Furthermore patients had to answer EORTC QLQ-HN35 questionnaire and visual analog scale. Following this two-stage autotransplantation, xerostomia in the patients was markedly reduced due to improved saliva production of the reimplanted gland. Whether this promising novel approach is a reliable treatment option for RT patients in general should be evaluated in further studies.

  15. Compact high-flux two-stage solar collectors based on tailored edge-ray concentrators

    Science.gov (United States)

    Friedman, Robert P.; Gordon, Jeffrey M.; Ries, Harald

    1995-08-01

    Using the recently-invented tailored edge-ray concentrator (TERC) approach for the design of compact two-stage high-flux solar collectors--a focusing primary reflector and a nonimaging TERC secondary reflector--we present: 1) a new primary reflector shape based on the TERC approach and a secondary TERC tailored to its particular flux map, such that more compact concentrators emerge at flux concentration levels in excess of 90% of the thermodynamic limit; and 2) calculations and raytrace simulations result which demonstrate the V-cone approximations to a wide variety of TERCs attain the concentration of the TERC to within a few percent, and hence represent practical secondary concentrators that may be superior to corresponding compound parabolic concentrator or trumpet secondaries.

  16. On the optimal use of a slow server in two-stage queueing systems

    Science.gov (United States)

    Papachristos, Ioannis; Pandelis, Dimitrios G.

    2017-07-01

    We consider two-stage tandem queueing systems with a dedicated server in each queue and a slower flexible server that can attend both queues. We assume Poisson arrivals and exponential service times, and linear holding costs for jobs present in the system. We study the optimal dynamic assignment of servers to jobs assuming that two servers cannot collaborate to work on the same job and preemptions are not allowed. We formulate the problem as a Markov decision process and derive properties of the optimal allocation for the dedicated (fast) servers. Specifically, we show that the one downstream should not idle, and the same is true for the one upstream when holding costs are larger there. The optimal allocation of the slow server is investigated through extensive numerical experiments that lead to conjectures on the structure of the optimal policy.

  17. Sensorless Reserved Power Control Strategy for Two-Stage Grid-Connected Photovoltaic Systems

    DEFF Research Database (Denmark)

    Sangwongwanich, Ariya; Yang, Yongheng; Blaabjerg, Frede

    2016-01-01

    Due to still increasing penetration level of grid-connected Photovoltaic (PV) systems, advanced active power control functionalities have been introduced in grid regulations. A reserved power control, where the active power from the PV panels is reserved during operation, is required for grid...... support. In this paper, a cost-effective solution to realize the reserved power control for grid-connected PV systems is proposed. The proposed solution routinely employs a Maximum Power Point Tracking (MPPT) control to estimate the available PV power and a Constant Power Generation (CPG) control...... to achieve the power reserve. In this method, the irradiance measurements that have been used in conventional control schemes to estimate the available PV power are not required, and thereby being a sensorless solution. Simulations and experimental tests have been performed on a 3-kW two-stage single...

  18. Two-Stage Optimal Scheduling of Electric Vehicle Charging based on Transactive Control

    DEFF Research Database (Denmark)

    Liu, Zhaoxi; Wu, Qiuwei; Ma, Kang

    2018-01-01

    In this paper, a two-stage optimal charging scheme based on transactive control is proposed for the aggregator to manage day-ahead electricity procurement and real-time EV charging management in order to minimize its total operating cost. The day-ahead electricity procurement considers both the day......-ahead energy cost and expected real-time operation cost. In the real-time charging management, the cost of employing the charging flexibility from the EV owners is explicitly modelled. The aggregator uses a transactive market to manage the real-time charging demand to provide the regulating power. A model...... predictive control (MPC) based method is proposed for the aggregator to clear the transactive market. The realtime charging decisions of the EVs are determined by the clearing of the proposed transactive market according to the realtime requests and preferences of the EV owners. As such, the aggregators...

  19. Determination Bounds for Intermediate Products in a Two-Stage Network DEA

    Directory of Open Access Journals (Sweden)

    Hadi Bagherzadeh Valami

    2016-03-01

    Full Text Available The internal structure of decision making unit (DMU is the key element at extension of network DEA. In general considering internal performance evaluation of system is a better criterion than the conventional DEA-models, essentially based on the initial inputs and final outputs of the system. The internal performance of a system is dependent on the relation between sub-DMUs and intermediate products. Since the intermediate measures are consumed by some sub-DMUs produced by the others, it is possible to produce systems; the role of intermediate production is twice output and input. That's why they can be analyzed based on conventional mathematical modeling. In this paper we introduce a new method for determining bounds for intermediate product in a two stage network DEA structure.

  20. Two-Stage Electric Vehicle Charging Coordination in Low Voltage Distribution Grids

    DEFF Research Database (Denmark)

    Bhattarai, Bishnu Prasad; Bak-Jensen, Birgitte; Pillai, Jayakrishnan Radhakrishna

    2014-01-01

    ). Being a sizable rated element, electric vehicles (EVs) can offer a great deal of demand flexibility in future intelligent grids. This paper first investigates and analyzes driving pattern and charging requirements of EVs. Secondly, a two-stage charging algorithm, namely local adaptive control...... encompassed by a central coordinative control, is proposed to realize the flexibility offered by EV. The local control enables adaptive charging; whereas the central coordinative control prepares optimized charging schedules. Results from various scenarios show that the proposed algorithm enables significant......Increased environmental awareness in the recent years has encouraged rapid growth of renewable energy sources (RESs); especially solar PV and wind. One of the effective solutions to compensate intermittencies in generation from the RESs is to enable consumer participation in demand response (DR...

  1. An X-ray Experiment with Two-Stage Korean Sounding Rocket

    Directory of Open Access Journals (Sweden)

    Uk-Won Nam

    1998-12-01

    Full Text Available The test result of the X-ray observation system is presented which have been developed at Korea Astronomy Observatory for 3 years (1995-1997. The instrument, which is composed of detector and signal processing parts, is designed for the future observations of compact X-ray sources. The performance of the instrument was tested by mounting on the two-stage Korean Sounding Rocket, which was launched from Taean rocket flight center on June 11 at 10:00 KST 1998. Telemetry data were received from individual parts of the instrument for 32 and 55.7 sec, respectively, since the launch of the rocket. In this paper, the result of the data analysis based on the telemetry data and discussion about the performance of the instrument is reported.

  2. Mediastinal Bronchogenic Cyst With Acute Cardiac Dysfunction: Two-Stage Surgical Approach.

    Science.gov (United States)

    Smail, Hassiba; Baste, Jean Marc; Melki, Jean; Peillon, Christophe

    2015-10-01

    We describe a two-stage surgical approach in a patient with cardiac dysfunction and hemodynamic compromise resulting from a massive and compressive mediastinal bronchogenic cyst. To drain this cyst, video-assisted mediastinoscopy was performed as an emergency procedure, which immediately improved the patient's cardiac function. Five days later and under video thoracoscopy, resection of the cyst margins was impossible because the cyst was tightly adherent to the left atrium. We performed deroofing of this cyst through a right thoracotomy. The patient had an uncomplicated postoperative recovery, and no recurrence was observed at the long-term follow-up visit. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Two-stage triolein breath test differentiates pancreatic insufficiency from other causes of malabsorption

    International Nuclear Information System (INIS)

    Goff, J.S.

    1982-01-01

    In 24 patients with malabsorption, [ 14 C]triolein breath tests were conducted before and together with the administration of pancreatic enzymes (Pancrease, Johnson and Johnson, Skillman, N.J.). Eleven patients with pancreatic insufficiency had a significant rise in peak percent dose per hour 14 CO 2 excretion after Pancrease, whereas 13 patients with other causes of malabsorption had no increase in 14 CO 2 excretion (2.61 +/- 0.96 vs. 0.15 +/- 0.45, p less than 0.001). The two-stage [ 14 C]triolein breath test appears to be an accurate and simple noninvasive test of fat malabsorption that differentiates steatorrhea secondary to pancreatic insufficiency from other causes of steatorrhea

  4. Two-Stage Surgery for a Large Cervical Dumbbell Tumour in Neurofibromatosis 1: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohd Ariff S

    2011-11-01

    Full Text Available Spinal neurofibromas occur sporadically and typically occur in association with neurofibromatosis 1. Patients afflicted with neurofibromatosis 1 usually present with involvement of several nerve roots. This report describes the case of a 14- year-old child with a large intraspinal, but extradural tumour with paraspinal extension, dumbbell neurofibroma of the cervical region extending from the C2 to C4 vertebrae. The lesions were readily detected by MR imaging and were successfully resected in a two-stage surgery. The time interval between the first and second surgery was one month. We provide a brief review of the literature regarding various surgical approaches, emphasising the utility of anterior and posterior approaches.

  5. Effekt of a two-stage nursing assesment and intervention - a randomized intervention study

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Poulsen, Ingrid; Hendriksen, Carsten

    % of geriatric patients have complex and often unresolved caring needs. The objective was to examine the effect of a two-stage nursing assessment and intervention to address the patients uncompensated problems given just after discharge from ED and one and six months after. Method: We conducted a prospective...... nursing assessment comprising a checklist of 10 physical, mental, medical and social items. The focus was on unresolved problems which require medical intervention, new or different home care services, or comprehensive geriatric assessment. Following this the nurses made relevant referrals...... to the geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: Primary endpoints will be presented as unplanned readmission to ED; admission to nursing home; and death. Secondary endpoints will be presented as physical function; depressive symptoms...

  6. Two-stage SQUID systems and transducers development for MiniGRAIL

    International Nuclear Information System (INIS)

    Gottardi, L; Podt, M; Bassan, M; Flokstra, J; Karbalai-Sadegh, A; Minenkov, Y; Reinke, W; Shumack, A; Srinivas, S; Waard, A de; Frossati, G

    2004-01-01

    We present measurements on a two-stage SQUID system based on a dc-SQUID as a sensor and a DROS as an amplifier. We measured the intrinsic noise of the dc-SQUID at 4.2 K. A new dc-SQUID has been fabricated. It was specially designed to be used with MiniGRAIL transducers. Cooling fins have been added in order to improve the cooling of the SQUID and the design is optimized to achieve the quantum limit of the sensor SQUID at temperatures above 100 mK. In this paper we also report the effect of the deposition of a Nb film on the quality factor of a small mass Al5056 resonator. Finally, the results of Q-factor measurements on a capacitive transducer for the current MiniGRAIL run are presented

  7. A Two-Stage Diagnosis Framework for Wind Turbine Gearbox Condition Monitoring

    Directory of Open Access Journals (Sweden)

    Janet M. Twomey

    2013-01-01

    Full Text Available Advances in high performance sensing technologies enable the development of wind turbine condition monitoring system to diagnose and predict the system-wide effects of failure events. This paper presents a vibration-based two stage fault detection framework for failure diagnosis of rotating components in wind turbines. The proposed framework integrates an analytical defect detection method and a graphical verification method together to ensure the diagnosis efficiency and accuracy. The efficacy of the proposed methodology is demonstrated with a case study with the gearbox condition monitoring Round Robin study dataset provided by the National Renewable Energy Laboratory (NREL. The developed methodology successfully picked five faults out of seven in total with accurate severity levels without producing any false alarm in the blind analysis. The case study results indicated that the developed fault detection framework is effective for analyzing gear and bearing faults in wind turbine drive train system based upon system vibration characteristics.

  8. Development of advanced air-blown entrained-flow two-stage bituminous coal IGCC gasifier

    Directory of Open Access Journals (Sweden)

    Abaimov Nikolay A.

    2017-01-01

    Full Text Available Integrated gasification combined cycle (IGCC technology has two main advantages: high efficiency, and low levels of harmful emissions. Key element of IGCC is gasifier, which converts solid fuel into a combustible synthesis gas. One of the most promising gasifiers is air-blown entrained-flow two-stage bituminous coal gasifier developed by Mitsubishi Heavy Industries (MHI. The most obvious way to develop advanced gasifier is improvement of commercial-scale 1700 t/d MHI gasifier using the computational fluid dynamics (CFD method. Modernization of commercial-scale 1700 t/d MHI gasifier is made by changing the regime parameters in order to improve its cold gas efficiency (CGE and environmental performance, namely H2/CO ratio. The first change is supply of high temperature (900°C steam in gasifier second stage. And the second change is additional heating of blast air to 900°C.

  9. The Sources of Efficiency of the Nigerian Banking Industry: A Two- Stage Approach

    Directory of Open Access Journals (Sweden)

    Frances Obafemi

    2013-11-01

    Full Text Available The paper employed a two-stage Data Envelopment Analysis (DEA approach to examine the sources oftechnical efficiency in the Nigerian banking sub-sector. Using a cross sectionof commercial and merchant banks, the study showed that the Nigerian bankingindustry was not efficient both in the pre-and-post-liberalization era. Thestudy further revealed that market share was the strongest determinant oftechnical efficiency in the Nigerian banking Industry. Thus, appropriatemacroeconomic policy, institutional development and structural reforms mustaccompany financial liberalization to create the stable environment requiredfor it to succeed. Hence, the present bank consolidation and reforms by theCentral Bank of Nigeria, which started with Soludo and continued with Sanusi,are considered necessary, especially in the areas of e banking and reorganizingthe management of banks.

  10. A Two-stage DC-DC Converter for the Fuel Cell-Supercapacitor Hybrid System

    DEFF Research Database (Denmark)

    Zhang, Zhe; Thomsen, Ole Cornelius; Andersen, Michael A. E.

    2009-01-01

    A wide input range multi-stage converter is proposed with the fuel cells and supercapacitors as a hybrid system. The front-end two-phase boost converter is used to optimize the output power and to reduce the current ripple of fuel cells. The supercapacitor power module is connected by push...... and designed. A 1kW prototype controlled by TMS320F2808 DSP is built in the lab. Simulation and experimental results confirm the feasibility of the proposed two stage dc-dc converter system.......-pull-forward half bridge (PPFHB) converter with coupled inductors in the second stage to handle the slow transient response of the fuel cells and realize the bidirectional power flow control. Moreover, this cascaded structure simplifies the power management. The control strategy for the whole system is analyzed...

  11. Improvement of two-stage GM refrigerator performance using a hybrid regenerator

    International Nuclear Information System (INIS)

    Ke, G.; Makuuchi, H.; Hashimoto, T.; Onishi, A.; Li, R.; Satoh, T.; Kanazawa, Y.

    1994-01-01

    To improve the performance of two-stage GM refrigerators, a hybrid regenerator with magnetic materials of Er 3 Ni and ErNi 0.9 Co 0.1 was used in the 2nd stage regenerator because of its large heat exchange capacity. The largest refrigeration capacity achieved with the hybrid regenerator was 0.95W at helium liquefied temperature of 4.2K. This capacity is 15.9% greater than the 0.82W refrigerator with only Er 3 Ni as the 2nd regenerator material. Use of the hybrid regenerator not only increases the refrigeration capacity at 4.2K, but also allows the 4K GM refrigerator to be used with large 1st stage refrigeration capacity, thus making it more practical

  12. Hydrogen and methane production from household solid waste in the two-stage fermentation process

    DEFF Research Database (Denmark)

    Lui, D.; Liu, D.; Zeng, Raymond Jianxiong

    2006-01-01

    A two-stage process combined hydrogen and methane production from household solid waste was demonstrated working successfully. The yield of 43 mL H-2/g volatile solid (VS) added was generated in the first hydrogen production stage and the methane production in the second stage was 500 mL CH4/g VS...... added. This figure was 21% higher than the methane yield from the one-stage process, which was run as control. Sparging of the hydrogen reactor with methane gas resulted in doubling of the hydrogen production. PH was observed as a key factor affecting fermentation pathway in hydrogen production stage....... Furthermore, this study also provided direct evidence in the dynamic fermentation process that, hydrogen production increase was reflected by acetate to butyrate ratio increase in liquid phase. (c) 2006 Elsevier Ltd. All rights reserved....

  13. Discrete time population dynamics of a two-stage species with recruitment and capture

    International Nuclear Information System (INIS)

    Ladino, Lilia M.; Mammana, Cristiana; Michetti, Elisabetta; Valverde, Jose C.

    2016-01-01

    This work models and analyzes the dynamics of a two-stage species with recruitment and capture factors. It arises from the discretization of a previous model developed by Ladino and Valverde (2013), which represents a progress in the knowledge of the dynamics of exploited populations. Although the methods used here are related to the study of discrete-time systems and are different from those related to continuous version, the results are similar in both the discrete and the continuous case what confirm the skill in the selection of the factors to design the model. Unlike for the continuous-time case, for the discrete-time one some (non-negative) parametric constraints are derived from the biological significance of the model and become fundamental for the proofs of such results. Finally, numerical simulations show different scenarios of dynamics related to the analytical results which confirm the validity of the model.

  14. Validation of Continuous CHP Operation of a Two-Stage Biomass Gasifier

    DEFF Research Database (Denmark)

    Ahrenfeldt, Jesper; Henriksen, Ulrik Birk; Jensen, Torben Kvist

    2006-01-01

    The Viking gasification plant at the Technical University of Denmark was built to demonstrate a continuous combined heat and power operation of a two-stage gasifier fueled with wood chips. The nominal input of the gasifier is 75 kW thermal. To validate the continuous operation of the plant, a 9-day...... measurement campaign was performed. The campaign verified a stable operation of the plant, and the energy balance resulted in an overall fuel to gas efficiency of 93% and a wood to electricity efficiency of 25%. Very low tar content in the producer gas was observed: only 0.1 mg/Nm3 naphthalene could...... be measured in raw gas. A stable engine operation on the producer gas was observed, and very low emissions of aldehydes, N2O, and polycyclic aromatic hydrocarbons were measured....

  15. Evaluation of biological hydrogen sulfide oxidation coupled with two-stage upflow filtration for groundwater treatment.

    Science.gov (United States)

    Levine, Audrey D; Raymer, Blake J; Jahn, Johna

    2004-01-01

    Hydrogen sulfide in groundwater can be oxidized by aerobic bacteria to form elemental sulfur and biomass. While this treatment approach is effective for conversion of hydrogen sulfide, it is important to have adequate control of the biomass exiting the biological treatment system to prevent release of elemental sulfur into the distribution system. Pilot scale tests were conducted on a Florida groundwater to evaluate the use of two-stage upflow filtration downstream of biological sulfur oxidation. The combined biological and filtration process was capable of excellent removal of hydrogen sulfide and associated turbidity. Additional benefits of this treatment approach include elimination of odor generation, reduction of chlorine demand, and improved stability of the finished water.

  16. Shaft Position Influence on Technical Characteristics of Universal Two-Stages Helical Speed Reducers

    Directory of Open Access Journals (Sweden)

    Мilan Rackov

    2005-10-01

    Full Text Available Purchasers of speed reducers decide on buying those reducers, that can the most approximately satisfy their demands with much smaller costs. Amount of used material, ie. mass and dimensions of gear unit influences on gear units price. Mass and dimensions of gear unit, besides output torque, gear unit ratio and efficiency, are the most important parameters of technical characteristics of gear units and their quality. Centre distance and position of shafts have significant influence on output torque, gear unit ratio and mass of gear unit through overall dimension of gear unit housing. Thus these characteristics are dependent on each other. This paper deals with analyzing of centre distance and shaft position influence on output torque and ratio of universal two stages gear units.

  17. Stepwise encapsulation and controlled two-stage release system for cis-Diamminediiodoplatinum.

    Science.gov (United States)

    Chen, Yun; Li, Qian; Wu, Qingsheng

    2014-01-01

    cis-Diamminediiodoplatinum (cis-DIDP) is a cisplatin-like anticancer drug with higher anticancer activity, but lower stability and price than cisplatin. In this study, a cis-DIDP carrier system based on micro-sized stearic acid was prepared by an emulsion solvent evaporation method. The maximum drug loading capacity of cis-DIDP-loaded solid lipid nanoparticles was 22.03%, and their encapsulation efficiency was 97.24%. In vitro drug release in phosphate-buffered saline (pH =7.4) at 37.5°C exhibited a unique two-stage process, which could prove beneficial for patients with tumors and malignancies. MTT (3-[4,5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay results showed that cis-DIDP released from cis-DIDP-loaded solid lipid nanoparticles had better inhibition activity than cis-DIDP that had not been loaded.

  18. A Two-stage Kalman Filter for Sensorless Direct Torque Controlled PM Synchronous Motor Drive

    Directory of Open Access Journals (Sweden)

    Boyu Yi

    2013-01-01

    Full Text Available This paper presents an optimal two-stage extended Kalman filter (OTSEKF for closed-loop flux, torque, and speed estimation of a permanent magnet synchronous motor (PMSM to achieve sensorless DTC-SVPWM operation of drive system. The novel observer is obtained by using the same transformation as in a linear Kalman observer, which is proposed by C.-S. Hsieh and F.-C. Chen in 1999. The OTSEKF is an effective implementation of the extended Kalman filter (EKF and provides a recursive optimum state estimation for PMSMs using terminal signals that may be polluted by noise. Compared to a conventional EKF, the OTSEKF reduces the number of arithmetic operations. Simulation and experimental results verify the effectiveness of the proposed OTSEKF observer for DTC of PMSMs.

  19. Economic Design of Acceptance Sampling Plans in a Two-Stage Supply Chain

    Directory of Open Access Journals (Sweden)

    Lie-Fern Hsu

    2012-01-01

    Full Text Available Supply Chain Management, which is concerned with material and information flows between facilities and the final customers, has been considered the most popular operations strategy for improving organizational competitiveness nowadays. With the advanced development of computer technology, it is getting easier to derive an acceptance sampling plan satisfying both the producer's and consumer's quality and risk requirements. However, all the available QC tables and computer software determine the sampling plan on a noneconomic basis. In this paper, we design an economic model to determine the optimal sampling plan in a two-stage supply chain that minimizes the producer's and the consumer's total quality cost while satisfying both the producer's and consumer's quality and risk requirements. Numerical examples show that the optimal sampling plan is quite sensitive to the producer's product quality. The product's inspection, internal failure, and postsale failure costs also have an effect on the optimal sampling plan.

  20. A two-stage metal valorisation process from electric arc furnace dust (EAFD

    Directory of Open Access Journals (Sweden)

    H. Issa

    2016-04-01

    Full Text Available This paper demonstrates possibility of separate zinc and lead recovery from coal composite pellets, composed of EAFD with other synergetic iron-bearing wastes and by-products (mill scale, pyrite-cinder, magnetite concentrate, through a two-stage process. The results show that in the first, low temp erature stage performed in electro-resistant furnace, removal of lead is enabled due to presence of chlorides in the system. In the second stage, performed at higher temperatures in Direct Current (DC plasma furnace, valorisation of zinc is conducted. Using this process, several final products were obtained, including a higher purity zinc oxide, which, by its properties, corresponds washed Waelz oxide.

  1. Optimal design of distributed energy resource systems based on two-stage stochastic programming

    International Nuclear Information System (INIS)

    Yang, Yun; Zhang, Shijie; Xiao, Yunhan

    2017-01-01

    Highlights: • A two-stage stochastic programming model is built to design DER systems under uncertainties. • Uncertain energy demands have a significant effect on the optimal design. • Uncertain energy prices and renewable energy intensity have little effect on the optimal design. • The economy is overestimated if the system is designed without considering the uncertainties. • The uncertainty in energy prices has the significant and greatest effect on the economy. - Abstract: Multiple uncertainties exist in the optimal design of distributed energy resource (DER) systems. The expected energy, economic, and environmental benefits may not be achieved and a deficit in energy supply may occur if the uncertainties are not handled properly. This study focuses on the optimal design of DER systems with consideration of the uncertainties. A two-stage stochastic programming model is built in consideration of the discreteness of equipment capacities, equipment partial load operation and output bounds as well as of the influence of ambient temperature on gas turbine performance. The stochastic model is then transformed into its deterministic equivalent and solved. For an illustrative example, the model is applied to a hospital in Lianyungang, China. Comparative studies are performed to evaluate the effect of the uncertainties in load demands, energy prices, and renewable energy intensity separately and simultaneously on the system’s economy and optimal design. Results show that the uncertainties in load demands have a significant effect on the optimal system design, whereas the uncertainties in energy prices and renewable energy intensity have almost no effect. Results regarding economy show that it is obviously overestimated if the system is designed without considering the uncertainties.

  2. Kinetics of two-stage fermentation process for the production of hydrogen

    Energy Technology Data Exchange (ETDEWEB)

    Nath, Kaushik [Department of Chemical Engineering, G.H. Patel College of Engineering and Technology, Vallabh Vidyanagar 388 120, Gujarat (India); Muthukumar, Manoj; Kumar, Anish; Das, Debabrata [Fermentation Technology Laboratory, Department of Biotechnology, Indian Institute of Technology, Kharagpur 721302 (India)

    2008-02-15

    Two-stage process described in the present work is a combination of dark and photofermentation in a sequential batch mode. In the first stage glucose is fermented to acetate, CO{sub 2} and H{sub 2} in an anaerobic dark fermentation by Enterobacter cloacae DM11. This is followed by a successive second stage where acetate is converted to H{sub 2} and CO{sub 2} in a photobioreactor by photosynthetic bacteria, Rhodobacter sphaeroides O.U. 001. The yield of hydrogen in the first stage was about 3.31molH{sub 2}(molglucose){sup -1} (approximately 82% of theoretical) and that in the second stage was about 1.5-1.72molH{sub 2}(molaceticacid){sup -1} (approximately 37-43% of theoretical). The overall yield of hydrogen in two-stage process considering glucose as preliminary substrate was found to be higher compared to a single stage process. Monod model, with incorporation of substrate inhibition term, has been used to determine the growth kinetic parameters for the first stage. The values of maximum specific growth rate ({mu} {sub max}) and K{sub s} (saturation constant) were 0.398h{sup -1} and 5.509gl{sup -1}, respectively, using glucose as substrate. The experimental substrate and biomass concentration profiles have good resemblance with those obtained by kinetic model predictions. A model based on logistic equation has been developed to describe the growth of R. sphaeroides O.U 001 in the second stage. Modified Gompertz equation was applied to estimate the hydrogen production potential, rate and lag phase time in a batch process for various initial concentration of glucose, based on the cumulative hydrogen production curves. Both the curve fitting and statistical analysis showed that the equation was suitable to describe the progress of cumulative hydrogen production. (author)

  3. Removal of trichloroethylene (TCE) contaminated soil using a two-stage anaerobic-aerobic composting technique.

    Science.gov (United States)

    Ponza, Supat; Parkpian, Preeda; Polprasert, Chongrak; Shrestha, Rajendra P; Jugsujinda, Aroon

    2010-01-01

    The effect of organic carbon addition on remediation of trichloroethylene (TCE) contaminated clay soil was investigated using a two stage anaerobic-aerobic composting system. TCE removal rate and processes involved were determined. Uncontaminated clay soil was treated with composting materials (dried cow manure, rice husk and cane molasses) to represent carbon based treatments (5%, 10% and 20% OC). All treatments were spiked with TCE at 1,000 mg TCE/kg DW and incubated under anaerobic and mesophillic condition (35 degrees C) for 8 weeks followed by continuous aerobic condition for another 6 weeks. TCE dissipation, its metabolites and biogas composition were measured throughout the experimental period. Results show that TCE degradation depended upon the amount of organic carbon (OC) contained within the composting treatments/matrices. The highest TCE removal percentage (97%) and rate (75.06 micro Mole/kg DW/day) were obtained from a treatment of 10% OC composting matrices as compared to 87% and 27.75 micro Mole/kg DW/day for 20% OC, and 83% and 38.08 micro Mole/kg DW/day for soil control treatment. TCE removal rate was first order reaction kinetics. Highest degradation rate constant (k(1) = 0.035 day(- 1)) was also obtained from the 10% OC treatment, followed by 20% OC (k(1) = 0.026 day(- 1)) and 5% OC or soil control treatment (k(1) = 0.023 day(- 1)). The half-life was 20, 27 and 30 days, respectively. The overall results suggest that sequential two stages anaerobic-aerobic composting technique has potential for remediation of TCE in heavy texture soil, providing that easily biodegradable source of organic carbon is present.

  4. Design of a Two-Stage Light Gas Gun for Muzzle Velocities of 10 - 11 kms

    Science.gov (United States)

    Bogdanoff, David W.

    2016-01-01

    Space debris poses a major risk to spacecraft. In low earth orbit, impact velocities can be 10 11 kms and as high as 15 kms. For debris shield design, it would be desirable to be able to launch controlled shape projectiles to these velocities. The design of the proposed 10 11 kmsec gun uses, as a starting point, the Ames 1.280.22 two stage gun, which has achieved muzzle velocities of 10 11.3 kmsec. That gun is scaled up to a 0.3125 launch tube diameter. The gun is then optimized with respect to maximum pressures by varying the pump tube length to diameter ratio (LD), the piston mass and the hydrogen pressure. A pump tube LD of 36.4 is selected giving the best overall performance. Piezometric ratios for the optimized guns are found to be 2.3, much more favorable than for more traditional two stage light gas guns, which range from 4 to 6. The maximum powder chamber pressures are 20 to 30 ksi. To reduce maximum pressures, the desirable range of the included angle of the cone of the high pressure coupling is found to be 7.3 to 14.6 degrees. Lowering the break valve rupture pressure is found to lower the maximum projectile base pressure, but to raise the maximum gun pressure. For the optimized gun with a pump tube LD of 36.4, increasing the muzzle velocity by decreasing the projectile mass and increasing the powder loads is studied. It appears that saboted spheres could be launched to 10.25 and possibly as high as 10.7 10.8 kmsec, and that disc-like plastic models could be launched to 11.05 kms. The use of a tantalum liner to greatly reduce bore erosion and increase muzzle velocity is discussed. With a tantalum liner, CFD code calculations predict muzzle velocities as high as 12 to 13 kms.

  5. Study of two-stage turbine characteristic and its influence on turbo-compound engine performance

    International Nuclear Information System (INIS)

    Zhao, Rongchao; Zhuge, Weilin; Zhang, Yangjun; Yang, Mingyang; Martinez-Botas, Ricardo; Yin, Yong

    2015-01-01

    Highlights: • An analytical model was built to study the interactions between two turbines in series. • The impacts of HP VGT and LP VGT on turbo-compound engine performance were investigated. • The fuel reductions obtained by HP VGT at 1900 rpm and 1000 rpm are 3.08% and 7.83% respectively. • The optimum value of AR ranged from 2.0 to 2.5 as the turbo-compound engine speed decreases. - Abstract: Turbo-compounding is an effective way to recover waste heat from engine exhaust and reduce fuel consumption for internal combustion engine (ICE). The characteristics of two-stage turbine, including turbocharger turbine and power turbine, have significant effects on the overall performance of turbo-compound engine. This paper investigates the interaction between two turbines in a turbo-compound engine and its impact on the engine performance. Firstly an analytical model is built to investigate the effects of turbine equivalent flow area on the two-stage turbine characteristics, including swallowing capacity and load split. Next both simulation and experimental method are carried out to study the effects of high pressure variable geometry turbine (HP VGT), low pressure variable geometry turbine (LP VGT) and combined VGT on the engine overall performance. The results show that the engine performance is more sensitive to HP VGT compared with LP VGT at all the operation conditions, which is caused by the larger influences of HP VGT on the total expansion ratio and engine air–fuel ratio. Using the HP VGT method, the fuel reductions of the turbo-compound engine at 1900 rpm and 1000 rpm are 3.08% and 7.83% respectively, in comparison with the baseline engine. The corresponding optimum values of AR are 2.0 and 2.5

  6. Anti-kindling induced by two-stage coordinated reset stimulation with weak onset intensity

    Directory of Open Access Journals (Sweden)

    Magteld eZeitler

    2016-05-01

    Full Text Available Abnormal neuronal synchrony plays an important role in a number of brain diseases. To specifically counteract abnormal neuronal synchrony by desynchronization, Coordinated Reset (CR stimulation, a spatiotemporally patterned stimulation technique, was designed with computational means. In neuronal networks with spike timing–dependent plasticity CR stimulation causes a decrease of synaptic weights and finally anti-kindling, i.e. unlearning of abnormally strong synaptic connectivity and abnormal neuronal synchrony. Long-lasting desynchronizing aftereffects of CR stimulation have been verified in pre-clinical and clinical proof of concept studies. In general, for different neuromodulation approaches, both invasive and non-invasive, it is desirable to enable effective stimulation at reduced stimulation intensities, thereby avoiding side effects. For the first time, we here present a two-stage CR stimulation protocol, where two qualitatively different types of CR stimulation are delivered one after another, and the first stage comes at a particularly weak stimulation intensity. Numerical simulations show that a two-stage CR stimulation can induce the same degree of anti-kindling as a single-stage CR stimulation with intermediate stimulation intensity. This stimulation approach might be clinically beneficial in patients suffering from brain diseases characterized by abnormal neuronal synchrony where a first treatment stage should be performed at particularly weak stimulation intensities in order to avoid side effects. This might, e.g., be relevant in the context of acoustic CR stimulation in tinnitus patients with hyperacusis or in the case of electrical deep brain CR stimulation with sub-optimally positioned leads or side effects caused by stimulation of the target itself. We discuss how to apply our method in first in man and proof of concept studies.

  7. Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

    Directory of Open Access Journals (Sweden)

    Jiajun Feng

    2016-03-01

    Full Text Available BackgroundThe aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant.MethodsWe analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant.ResultsThe average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry.ConclusionsThis approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

  8. Two-stage double-effect ammonia/lithium nitrate absorption cycle

    International Nuclear Information System (INIS)

    Ventas, R.; Lecuona, A.; Vereda, C.; Legrand, M.

    2016-01-01

    Highlights: • A two stage double effect cycle with NH3-LiNO3 is proposed. • The cycle operates at lower pressures than conventional. • Adiabatic absorber offers better performance than the diabatic version. • Evaporator external inlet temperatures higher than −10 °C avoids crystallization. • Maximum COP is 1.25 for driving water inlet temperature of 100 C. - Abstract: The two-stage configuration of a double-effect absorption cycle using ammonia/lithium nitrate as working fluid is studied by means of a thermodynamic model. The maximum pressure of this cycle configuration is the same as the single-effect cycle, up to 15.8 bars, being an advantage over the double-effect conventional configuration with three pressure levels that exhibits much higher maximum pressure. The performance of the cycle and the limitation imposed by crystallization of the working fluid is determined for both adiabatic and diabatic absorber cycles. Both cycles offer similar COP; however the adiabatic variant shows a larger margin against crystallization. This cycle can produce cold for external inlet evaporator temperatures down to −10 °C, but for this limit the crystallization could happen at high inlet generator temperatures. The maximum COP can be 1.25 for an external inlet generator temperature of 100 °C. This cycle shows a better COP than a typical double effect cycle with in-parallel configuration for the range of the moderate temperatures under study and using the same working fluid. Comparisons with double effect cycles using H_2O/LiBr and NH_3/H_2O as working fluids are also offered, highlighting the present configurations advantages regarding COP, evaporation and condensation temperatures as well as crystallization.

  9. Two-stage high frequency pulse tube refrigerator with base temperature below 10 K

    Science.gov (United States)

    Chen, Liubiao; Wu, Xianlin; Liu, Sixue; Zhu, Xiaoshuang; Pan, Changzhao; Guo, Jia; Zhou, Yuan; Wang, Junjie

    2017-12-01

    This paper introduces our recent experimental results of pulse tube refrigerator driven by linear compressor. The working frequency is 23-30 Hz, which is much higher than the G-M type cooler (the developed cryocooler will be called high frequency pulse tube refrigerator in this paper). To achieve a temperature below 10 K, two types of two-stage configuration, gas coupled and thermal coupled, have been designed, built and tested. At present, both types can achieve a no-load temperature below 10 K by using only one compressor. As to gas-coupled HPTR, the second stage can achieve a cooling power of 16 mW/10K when the first stage applied a 400 mW heat load at 60 K with a total input power of 400 W. As to thermal-coupled HPTR, the designed cooling power of the first stage is 10W/80K, and then the temperature of the second stage can get a temperature below 10 K with a total input power of 300 W. In the current preliminary experiment, liquid nitrogen is used to replace the first coaxial configuration as the precooling stage, and a no-load temperature 9.6 K can be achieved with a stainless steel mesh regenerator. Using Er3Ni sphere with a diameter about 50-60 micron, the simulation results show it is possible to achieve a temperature below 8 K. The configuration, the phase shifters and the regenerative materials of the developed two types of two-stage high frequency pulse tube refrigerator will be discussed, and some typical experimental results and considerations for achieving a better performance will also be presented in this paper.

  10. A Two-Stage Composition Method for Danger-Aware Services Based on Context Similarity

    Science.gov (United States)

    Wang, Junbo; Cheng, Zixue; Jing, Lei; Ota, Kaoru; Kansen, Mizuo

    Context-aware systems detect user's physical and social contexts based on sensor networks, and provide services that adapt to the user accordingly. Representing, detecting, and managing the contexts are important issues in context-aware systems. Composition of contexts is a useful method for these works, since it can detect a context by automatically composing small pieces of information to discover service. Danger-aware services are a kind of context-aware services which need description of relations between a user and his/her surrounding objects and between users. However when applying the existing composition methods to danger-aware services, they show the following shortcomings that (1) they have not provided an explicit method for representing composition of multi-user' contexts, (2) there is no flexible reasoning mechanism based on similarity of contexts, so that they can just provide services exactly following the predefined context reasoning rules. Therefore, in this paper, we propose a two-stage composition method based on context similarity to solve the above problems. The first stage is composition of the useful information to represent the context for a single user. The second stage is composition of multi-users' contexts to provide services by considering the relation of users. Finally the danger degree of the detected context is computed by using context similarity between the detected context and the predefined context. Context is dynamically represented based on two-stage composition rules and a Situation theory based Ontology, which combines the advantages of Ontology and Situation theory. We implement the system in an indoor ubiquitous environment, and evaluate the system through two experiments with the support of subjects. The experiment results show the method is effective, and the accuracy of danger detection is acceptable to a danger-aware system.

  11. Incidence of Speech-Correcting Surgery in Children With Isolated Cleft Palate.

    Science.gov (United States)

    Gustafsson, Charlotta; Heliövaara, Arja; Leikola, Junnu; Rautio, Jorma

    2018-01-01

    Speech-correcting surgeries (pharyngoplasty) are performed to correct velopharyngeal insufficiency (VPI). This study aimed to analyze the need for speech-correcting surgery in children with isolated cleft palate (ICP) and to determine differences among cleft extent, gender, and primary technique used. In addition, we assessed the timing and number of secondary procedures performed and the incidence of operated fistulas. Retrospective medical chart review study from hospital archives and electronic records. These comprised the 423 consecutive nonsyndromic children (157 males and 266 females) with ICP treated at the Cleft Palate and Craniofacial Center of Helsinki University Hospital during 1990 to 2016. The total incidence of VPI surgery was 33.3% and the fistula repair rate, 7.8%. Children with cleft of both the hard and soft palate (n = 300) had a VPI secondary surgery rate of 37.3% (fistula repair rate 10.7%), whereas children with only cleft of the soft palate (n = 123) had a corresponding rate of 23.6% (fistula repair rate 0.8%). Gender and primary palatoplasty technique were not considered significant factors in need for VPI surgery. The majority of VPI surgeries were performed before school age. One fifth of patients receiving speech-correcting surgery had more than one subsequent procedure. The need for speech-correcting surgery and fistula repair was related to the severity of the cleft. Although the majority of the corrective surgeries were done before the age of 7 years, a considerable number were performed at a later stage, necessitating long-term observation.

  12. Large Sphenoethmoidal Encephalocele Associated with Agenesis of Corpus Callosum and Cleft Palate

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-06-01

    Full Text Available AbstractBasal encephalocele is a rare craniofacial anomaly. In the presentpaper we report a 10-year-old boy presented with cleftpalate, congenital nystagmus, and hypertelorism. During preoperativeevaluation for cleft palate repair, a pulsatile masswas detected in the pharynx. Magnetic resonance imagingshowed sphenoethmoidal type of basal encephalocele andagenesis of corpus callosum. Neurosurgical consultation wasperformed for further evaluation and management.Iran J Med Sci 2010; 35(2: 154-156.

  13. Comparison of single-stage and temperature-phased two-stage anaerobic digestion of oily food waste

    International Nuclear Information System (INIS)

    Wu, Li-Jie; Kobayashi, Takuro; Li, Yu-You; Xu, Kai-Qin

    2015-01-01

    Highlights: • A single-stage and two two-stage anaerobic systems were synchronously operated. • Similar methane production 0.44 L/g VS_a_d_d_e_d from oily food waste was achieved. • The first stage of the two-stage process became inefficient due to serious pH drop. • Recycle favored the hythan production in the two-stage digestion. • The conversion of unsaturated fatty acids was enhanced by recycle introduction. - Abstract: Anaerobic digestion is an effective technology to recover energy from oily food waste. A single-stage system and temperature-phased two-stage systems with and without recycle for anaerobic digestion of oily food waste were constructed to compare the operation performances. The synchronous operation indicated the similar ability to produce methane in the three systems, with a methane yield of 0.44 L/g VS_a_d_d_e_d. The pH drop to less than 4.0 in the first stage of two-stage system without recycle resulted in poor hydrolysis, and methane or hydrogen was not produced in this stage. Alkalinity supplement from the second stage of two-stage system with recycle improved pH in the first stage to 5.4. Consequently, 35.3% of the particulate COD in the influent was reduced in the first stage of two-stage system with recycle according to a COD mass balance, and hydrogen was produced with a percentage of 31.7%, accordingly. Similar solids and organic matter were removed in the single-stage system and two-stage system without recycle. More lipid degradation and the conversion of long-chain fatty acids were achieved in the single-stage system. Recycling was proved to be effective in promoting the conversion of unsaturated long-chain fatty acids into saturated fatty acids in the two-stage system.

  14. Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age.

    Science.gov (United States)

    Yamanishi, Tadashi; Nishio, Juntaro; Sako, Michiyo; Kohara, Hiroshi; Hirano, Yoshiko; Yamanishi, Yukiko; Adachi, Tadafumi; Miya, Shigenori; Mukai, Takao

    2011-02-01

    Determining the optimal timing and procedure of palatal surgery for children with cleft lip and palate has long raised a major controversy. An early two-stage palatoplasty protocol has been a recent trend in an attempt to obtain preferable maxillary growth without compromising adequate speech development. In this study, we aim to address whether the resulting maxillofacial growth and speech development obtained by an early 2-stage palatoplasty protocol are better than those obtained by conventional 1-stage push-back palatoplasty. Seventy-two nonsyndromic children with complete unilateral cleft lip and palate were enrolled in this study. They were divided into 2 groups: 30 children, who were treated with early 2-stage palatoplasty, in which soft palate closure was performed using a modified Furlow's procedure at 12 months of age and hard palate closure was performed at 18 months of age (Early Tow Stage [ETS] group: 22 boys, 8 girls), and 42 children, who underwent 1-stage Wardill-Kilner push-back palatoplasty at 12 months of age (Push Back [PB] group: 31 boys, 11 girls). Cephalometric analysis for maxillofacial growth and assessments of speech development were performed for each child at 4 years of age. The ETS group showed a lager maxillary length than the PB group [anterior nasal spine (ANS)-ptm': ETS, 46.7 ± 2.0 mm; PB, 43.6 ± 2.3 mm]. The ANS in the ETS group was positioned more anteriorly than that in the PB group (N'-ANS: ETS, 2.5 ± 1.8 mm; PB, 0.26 ± 2.5 mm), whereas the posterior edge of the maxilla positioned anteroposteiorly was comparable between the 2 groups. The anterior facial height was significantly greater in the ETS group than in the PB group (N-N': ETS, 43.3 ± 2.9 mm; PB, 40.1 ± 2.3 mm, S-S': ETS, 29.7 ± 3.2 mm; PB, 31.0 ± 3.2 mm). No statistically significant differences were observed in the incidence of either velopharyngeal incompetence or articulation errors between the 2 groups at 4 years of age. Our results show that the early 2

  15. Experimental and numerical studies on two-stage combustion of biomass

    Energy Technology Data Exchange (ETDEWEB)

    Houshfar, Eshan

    2012-07-01

    In this thesis, two-stage combustion of biomass was experimentally/numerically investigated in a multifuel reactor. The following emissions issues have been the main focus of the work: 1- NOx and N2O 2- Unburnt species (CO and CxHy) 3- Corrosion related emissions.The study had a focus on two-stage combustion in order to reduce pollutant emissions (primarily NOx emissions). It is well known that pollutant emissions are very dependent on the process conditions such as temperature, reactant concentrations and residence times. On the other hand, emissions are also dependent on the fuel properties (moisture content, volatiles, alkali content, etc.). A detailed study of the important parameters with suitable biomass fuels in order to optimize the various process conditions was performed. Different experimental studies were carried out on biomass fuels in order to study the effect of fuel properties and combustion parameters on pollutant emissions. Process conditions typical for biomass combustion processes were studied. Advanced experimental equipment was used in these studies. The experiments showed the effects of staged air combustion, compared to non-staged combustion, on the emission levels clearly. A NOx reduction of up to 85% was reached with staged air combustion using demolition wood as fuel. An optimum primary excess air ratio of 0.8-0.95 was found as a minimizing parameter for the NOx emissions for staged air combustion. Air staging had, however, a negative effect on N2O emissions. Even though the trends showed a very small reduction in the NOx level as temperature increased for non-staged combustion, the effect of temperature was not significant for NOx and CxHy, neither in staged air combustion or non-staged combustion, while it had a great influence on the N2O and CO emissions, with decreasing levels with increasing temperature. Furthermore, flue gas recirculation (FGR) was used in combination with staged combustion to obtain an enhanced NOx reduction. The

  16. Hydrogen and methane production from condensed molasses fermentation soluble by a two-stage anaerobic process

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Chiu-Yue; Liang, You-Chyuan; Lay, Chyi-How [Feng Chia Univ., Taichung, Taiwan (China). Dept. of Environmental Engineering and Science; Chen, Chin-Chao [Chungchou Institute of Technology, Taiwan (China). Environmental Resources Lab.; Chang, Feng-Yuan [Feng Chia Univ., Taichung, Taiwan (China). Research Center for Energy and Resources

    2010-07-01

    The treatment of condensed molasses fermentation soluble (CMS) is a troublesome problem for glutamate manufacturing factory. However, CMS contains high carbohydrate and nutrient contents and is an attractive and commercially potential feedstock for bioenergy production. The aim of this paper is to produce hydrogen and methane by two-stage anaerobic fermentation process. The fermentative hydrogen production from CMS was conducted in a continuously-stirred tank bioreactor (working volume 4 L) which was operated at a hydraulic retention time (HRT) of 8 h, organic loading rate (OLR) of 120 kg COD/m{sup 3}-d, temperature of 35 C, pH 5.5 and sewage sludge as seed. The anaerobic methane production was conducted in an up-flow bioreactor (working volume 11 L) which was operated at a HRT of 24 -60 hrs, OLR of 4.0-10 kg COD/m{sup 3}-d, temperature of 35 C, pH 7.0 with using anaerobic granule sludge from fructose manufacturing factory as the seed and the effluent from hydrogen production process as the substrate. These two reactors have been operated successfully for more than 400 days. The steady-state hydrogen content, hydrogen production rate and hydrogen production yield in the hydrogen fermentation system were 37%, 169 mmol-H{sub 2}/L-d and 93 mmol-H{sub 2}/g carbohydrate{sub removed}, respectively. In the methane fermentation system, the peak methane content and methane production rate were 66.5 and 86.8 mmol-CH{sub 4}/L-d with methane production yield of 189.3 mmol-CH{sub 4}/g COD{sub removed} at an OLR 10 kg/m{sup 3}-d. The energy production rate was used to elucidate the energy efficiency for this two-stage process. The total energy production rate of 133.3 kJ/L/d was obtained with 5.5 kJ/L/d from hydrogen fermentation and 127.8 kJ/L/d from methane fermentation. (orig.)

  17. Adaptive Urban Stormwater Management Using a Two-stage Stochastic Optimization Model

    Science.gov (United States)

    Hung, F.; Hobbs, B. F.; McGarity, A. E.

    2014-12-01

    In many older cities, stormwater results in combined sewer overflows (CSOs) and consequent water quality impairments. Because of the expense of traditional approaches for controlling CSOs, cities are considering the use of green infrastructure (GI) to reduce runoff and pollutants. Examples of GI include tree trenches, rain gardens, green roofs, and rain barrels. However, the cost and effectiveness of GI are uncertain, especially at the watershed scale. We present a two-stage stochastic extension of the Stormwater Investment Strategy Evaluation (StormWISE) model (A. McGarity, JWRPM, 2012, 111-24) to explicitly model and optimize these uncertainties in an adaptive management framework. A two-stage model represents the immediate commitment of resources ("here & now") followed by later investment and adaptation decisions ("wait & see"). A case study is presented for Philadelphia, which intends to extensively deploy GI over the next two decades (PWD, "Green City, Clean Water - Implementation and Adaptive Management Plan," 2011). After first-stage decisions are made, the model updates the stochastic objective and constraints (learning). We model two types of "learning" about GI cost and performance. One assumes that learning occurs over time, is automatic, and does not depend on what has been done in stage one (basic model). The other considers learning resulting from active experimentation and learning-by-doing (advanced model). Both require expert probability elicitations, and learning from research and monitoring is modelled by Bayesian updating (as in S. Jacobi et al., JWRPM, 2013, 534-43). The model allocates limited financial resources to GI investments over time to achieve multiple objectives with a given reliability. Objectives include minimizing construction and O&M costs; achieving nutrient, sediment, and runoff volume targets; and community concerns, such as aesthetics, CO2 emissions, heat islands, and recreational values. CVaR (Conditional Value at Risk) and

  18. Combined two-stage xanthate processes for the treatment of copper-containing wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Y.K. [Department of Safety Health and Environmental Engineering, Central Taiwan University of Sciences and Technology, Taichung (Taiwan); Leu, M.H. [Department of Environmental Engineering, Kun Shan University of Technology, Yung-Kang City (Taiwan); Chang, J.E.; Lin, T.F.; Chen, T.C. [Department of Environmental Engineering, National Cheng Kung University, Tainan City (Taiwan); Chiang, L.C.; Shih, P.H. [Department of Environmental Engineering and Science, Fooyin University, Kaohsiung County (Taiwan)

    2007-02-15

    Heavy metal removal is mainly conducted by adjusting the wastewater pH to form metal hydroxide precipitates. However, in recent years, the xanthate process with a high metal removal efficiency, attracted attention due to its use of sorption/desorption of heavy metals from aqueous solutions. In this study, two kinds of agricultural xanthates, insoluble peanut-shell xanthate (IPX) and insoluble starch xanthate (ISX), were used as sorbents to treat the copper-containing wastewater (Cu concentration from 50 to 1,000 mg/L). The experimental results showed that the maximum Cu removal efficiency by IPX was 93.5 % in the case of high Cu concentrations, whereby 81.1 % of copper could rapidly be removed within one minute. Moreover, copper-containing wastewater could also be treated by ISX over a wide range (50 to 1,000 mg/L) to a level that meets the Taiwan EPA's effluent regulations (3 mg/L) within 20 minutes. Whereas IPX had a maximum binding capacity for copper of 185 mg/g IPX, the capacity for ISX was 120 mg/g ISX. IPX is cheaper than ISX, and has the benefits of a rapid reaction and a high copper binding capacity, however, it exhibits a lower copper removal efficiency. A sequential IPX and ISX treatment (i.e., two-stage xanthate processes) could therefore be an excellent alternative. The results obtained using the two-stage xanthate process revealed an effective copper treatment. The effluent (C{sub e}) was below 0.6 mg/L, compared to the influent (C{sub 0}) of 1,001 mg/L at pH = 4 and a dilution rate of 0.6 h{sup -1}. Furthermore, the Cu-ISX complex formed could meet the Taiwan TCLP regulations, and be classified as non-hazardous waste. The xanthatilization of agricultural wastes offers a comprehensive strategy for solving both agricultural waste disposal and metal-containing wastewater treatment problems. (Abstract Copyright [2007], Wiley Periodicals, Inc.)

  19. Hydrogen production from cellulose in a two-stage process combining fermentation and electrohydrogenesis

    KAUST Repository

    Lalaurette, Elodie

    2009-08-01

    A two-stage dark-fermentation and electrohydrogenesis process was used to convert the recalcitrant lignocellulosic materials into hydrogen gas at high yields and rates. Fermentation using Clostridium thermocellum produced 1.67 mol H2/mol-glucose at a rate of 0.25 L H2/L-d with a corn stover lignocellulose feed, and 1.64 mol H2/mol-glucose and 1.65 L H2/L-d with a cellobiose feed. The lignocelluose and cellobiose fermentation effluent consisted primarily of: acetic, lactic, succinic, and formic acids and ethanol. An additional 800 ± 290 mL H2/g-COD was produced from a synthetic effluent with a wastewater inoculum (fermentation effluent inoculum; FEI) by electrohydrogensis using microbial electrolysis cells (MECs). Hydrogen yields were increased to 980 ± 110 mL H2/g-COD with the synthetic effluent by combining in the inoculum samples from multiple microbial fuel cells (MFCs) each pre-acclimated to a single substrate (single substrate inocula; SSI). Hydrogen yields and production rates with SSI and the actual fermentation effluents were 980 ± 110 mL/g-COD and 1.11 ± 0.13 L/L-d (synthetic); 900 ± 140 mL/g-COD and 0.96 ± 0.16 L/L-d (cellobiose); and 750 ± 180 mL/g-COD and 1.00 ± 0.19 L/L-d (lignocellulose). A maximum hydrogen production rate of 1.11 ± 0.13 L H2/L reactor/d was produced with synthetic effluent. Energy efficiencies based on electricity needed for the MEC using SSI were 270 ± 20% for the synthetic effluent, 230 ± 50% for lignocellulose effluent and 220 ± 30% for the cellobiose effluent. COD removals were ∼90% for the synthetic effluents, and 70-85% based on VFA removal (65% COD removal) with the cellobiose and lignocellulose effluent. The overall hydrogen yield was 9.95 mol-H2/mol-glucose for the cellobiose. These results show that pre-acclimation of MFCs to single substrates improves performance with a complex mixture of substrates, and that high hydrogen yields and gas production rates can be achieved using a two-stage fermentation and MEC

  20. Studies on quantitative physiology of Trichoderma reesei with two-stage continuous culture for cellulase production

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, D; Andreotti, R; Mandels, M; Gallo, B; Reese, E T

    1979-11-01

    By employing a two-stage continuous-culture system, some of the more important physiological parameters involved in cellulase biosynthesis have been evaluated with an ultimate objective of designing an optimally controlled cellulase process. The two-stage continuous-culture system was run for a period of 1350 hr with Trichoderma reesei strain MCG-77. The temperature and pH were controlled at 32/sup 0/C and pH 4.5 for the first stage (growth) and 28/sup 0/C and pH 3.5 for the second stage (enzyme production). Lactose was the only carbon source for both stages. The ratio of specific uptake rate of carbon to that of nitrogen, Q(C)/Q(N), that supported good cell growth ranged from 11 to 15, and the ratio for maximum specific enzyme productivity ranged from 5 to 13. The maintenance coefficients determined for oxygen, M/sub 0/, and for carbon source, M/sub c/, are 0.85 mmol O/sub 2//g biomass/hr and 0.14 mmol hexose/g biomass/hr, respectively. The yield constants determined are: Y/sub X/O/ = 32.3 g biomass/mol O/sub 2/, Y/sub X/C/ = 1.1 g biomass/g C or Y/sub X/C/ = 0.44 g biomass/g hexose, Y/sub X/N/ = 12.5 g biomass/g nitrogen for the cell growth stage, and Y/sub X/N/ = 16.6 g biomass/g nitrogen for the enzyme production stage. Enzyme was produced only in the second stage. Volumetric and specific enzyme productivities obtained were 90 IU/liter/hrand 8 IU/g biomass/hr, respectively. The maximum specific enzyme productivity observed was 14.8 IU/g biomass/hr. The optimal dilution rate in the second stage that corresponded to the maximum enzyme productivity was 0.026 approx. 0.028 hr/sup -1/, and the specific growth rate in the second stage that supported maximum specific enzyme productivity was equal to or slightly less than zero.

  1. Removal of cesium from simulated liquid waste with countercurrent two-stage adsorption followed by microfiltration

    Energy Technology Data Exchange (ETDEWEB)

    Han, Fei; Zhang, Guang-Hui [School of Environmental Science and Engineering, Tianjin University, Tianjin, 300072 (China); Gu, Ping, E-mail: guping@tju.edu.cn [School of Environmental Science and Engineering, Tianjin University, Tianjin, 300072 (China)

    2012-07-30

    Highlights: Black-Right-Pointing-Pointer The adsorption isotherm of cesium by copper ferrocyanide followed a Freundlich model. Black-Right-Pointing-Pointer Decontamination factor of cesium was higher in lab-scale test than that in jar test. Black-Right-Pointing-Pointer A countercurrent two-stage adsorption-microfiltration process was achieved. Black-Right-Pointing-Pointer Cesium concentration in the effluent could be calculated. Black-Right-Pointing-Pointer It is a new cesium removal process with a higher decontamination factor. - Abstract: Copper ferrocyanide (CuFC) was used as an adsorbent to remove cesium. Jar test results showed that the adsorption capacity of CuFC was better than that of potassium zinc hexacyanoferrate. Lab-scale tests were performed by an adsorption-microfiltration process, and the mean decontamination factor (DF) was 463 when the initial cesium concentration was 101.3 {mu}g/L, the dosage of CuFC was 40 mg/L and the adsorption time was 20 min. The cesium concentration in the effluent continuously decreased with the operation time, which indicated that the used adsorbent retained its adsorption capacity. To use this capacity, experiments on a countercurrent two-stage adsorption (CTA)-microfiltration (MF) process were carried out with CuFC adsorption combined with membrane separation. A calculation method for determining the cesium concentration in the effluent was given, and batch tests in a pressure cup were performed to verify the calculated method. The results showed that the experimental values fitted well with the calculated values in the CTA-MF process. The mean DF was 1123 when the dilution factor was 0.4, the initial cesium concentration was 98.75 {mu}g/L and the dosage of CuFC and adsorption time were the same as those used in the lab-scale test. The DF obtained by CTA-MF process was more than three times higher than the single-stage adsorption in the jar test.

  2. A farm-scale pilot plant for biohydrogen and biomethane production by two-stage fermentation

    Directory of Open Access Journals (Sweden)

    R. Oberti

    2013-09-01

    Full Text Available Hydrogen is considered one of the possible main energy carriers for the future, thanks to its unique environmental properties. Indeed, its energy content (120 MJ/kg can be exploited virtually without emitting any exhaust in the atmosphere except for water. Renewable production of hydrogen can be obtained through common biological processes on which relies anaerobic digestion, a well-established technology in use at farm-scale for treating different biomass and residues. Despite two-stage hydrogen and methane producing fermentation is a simple variant of the traditional anaerobic digestion, it is a relatively new approach mainly studied at laboratory scale. It is based on biomass fermentation in two separate, seuqential stages, each maintaining conditions optimized to promote specific bacterial consortia: in the first acidophilic reactorhydrogen is produced production, while volatile fatty acids-rich effluent is sent to the second reactor where traditional methane rich biogas production is accomplished. A two-stage pilot-scale plant was designed, manufactured and installed at the experimental farm of the University of Milano and operated using a biomass mixture of livestock effluents mixed with sugar/starch-rich residues (rotten fruits and potatoes and expired fruit juices, afeedstock mixture based on waste biomasses directly available in the rural area where plant is installed. The hydrogenic and the methanogenic reactors, both CSTR type, had a total volume of 0.7m3 and 3.8 m3 respectively, and were operated in thermophilic conditions (55 2 °C without any external pH control, and were fully automated. After a brief description of the requirements of the system, this contribution gives a detailed description of its components and of engineering solutions to the problems encountered during the plant realization and start-up. The paper also discusses the results obtained in a first experimental run which lead to production in the range of previous

  3. Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision

    Science.gov (United States)

    Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen

    2017-01-01

    Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p cost drivers were the cost of the implant and

  4. Two-stage laparoscopic approaches for high anorectal malformation: transumbilical colostomy and anorectoplasty.

    Science.gov (United States)

    Yang, Li; Tang, Shao-Tao; Li, Shuai; Aubdoollah, T H; Cao, Guo-Qing; Lei, Hai-Yan; Wang, Xin-Xing

    2014-11-01

    Trans-umbilical colostomy (TUC) has been previously created in patients with Hirschsprung's disease and intermediate anorectal malformation (ARM), but not in patients with high-ARM. The purposes of this study were to assess the feasibility, safety, complications and cosmetic results of TUC in a divided fashion, and subsequently stoma closure and laparoscopic assisted anorectoplasty (LAARP) were simultaneously completed by using the colostomy site for a laparoscopic port in high-ARM patients. Twenty male patients with high-ARMs were chosen for this two-stage procedure. The first-stage consisted of creating the TUC in double-barreled fashion colostomy with a high chimney at the umbilicus, and the loop was divided at the same time, in such a way that the two diverting ends were located at the umbilical incision with the distal end half closed and slightly higher than proximal end. In the second-stage, 3 to 7 months later, the stoma was closed through a peristomal skin incision followed by end-to-end anastomosis and simultaneously LAARP was performed by placing a laparoscopic port at the umbilicus, which was previously the colonostomy site. Umbilical wound closure was performed in a semi-opened fashion to create a deep umbilicus. TUC and LAARP were successfully performed in 20 patients. Four cases with bladder neck fistulas and 16 cases with prostatic urethra fistulas were found. Postoperative complications were rectal mucosal prolapsed in three cases, anal stricture in two cases and wound dehiscence in one case. Neither umbilical ring narrowing, parastomal hernia nor obstructive symptoms was observed. Neither umbilical nor perineal wound infection was observed. Stoma care was easily carried-out by attaching stoma bag. Healing of umbilical wounds after the second-stage was excellent. Early functional stooling outcome were satisfactory. The umbilicus may be an alternative stoma site for double-barreled colostomy in high-ARM patients. The two-stage laparoscopic

  5. Numerical Investigation and Experimental Demonstration of Chaos from Two-Stage Colpitts Oscillator in the Ultrahigh Frequency Range

    DEFF Research Database (Denmark)

    Bumeliene, S.; Tamasevicius, A.; Mykolaitis, G.

    2006-01-01

    A hardware prototype of the two-stage Colpitts oscillator employing the microwave BFG520 type transistors with the threshold frequency of 9 GHz and designed to operate in the ultrahigh frequency range (300–1000 MHz) is described. The practical circuit in addition to the intrinsic two-stage oscill......A hardware prototype of the two-stage Colpitts oscillator employing the microwave BFG520 type transistors with the threshold frequency of 9 GHz and designed to operate in the ultrahigh frequency range (300–1000 MHz) is described. The practical circuit in addition to the intrinsic two......-stage oscillator contains an emitter follower acting as a buffer and minimizing the influence of the load. The circuit is investigated both numerically and experimentally. Typical phase portraits, Lyapunov exponents, Lyapunov dimension and broadband continuous power spectra are presented. The main advantage...

  6. A New Cost-Effective Multi-Drive Solution based on a Two-Stage Direct Power Electronic Conversion Topology

    DEFF Research Database (Denmark)

    Klumpner, Christian; Blaabjerg, Frede

    2002-01-01

    of a protection circuit involving twelve diodes with full voltage/current ratings used only during faulty situations, makes this topology not so attractive. Lately, two stage Direct Power Electronic Conversion (DPEC) topologies have been proposed, providing similar functionality as a matrix converter but allowing...... shared by many loads, making this topology more cost effective. The functionality of the proposed two-stage multi-drive direct power electronic conversion topology is validated by experiments on a realistic laboratory prototype....

  7. Normal Theory Two-Stage ML Estimator When Data Are Missing at the Item Level.

    Science.gov (United States)

    Savalei, Victoria; Rhemtulla, Mijke

    2017-08-01

    In many modeling contexts, the variables in the model are linear composites of the raw items measured for each participant; for instance, regression and path analysis models rely on scale scores, and structural equation models often use parcels as indicators of latent constructs. Currently, no analytic estimation method exists to appropriately handle missing data at the item level. Item-level multiple imputation (MI), however, can handle such missing data straightforwardly. In this article, we develop an analytic approach for dealing with item-level missing data-that is, one that obtains a unique set of parameter estimates directly from the incomplete data set and does not require imputations. The proposed approach is a variant of the two-stage maximum likelihood (TSML) methodology, and it is the analytic equivalent of item-level MI. We compare the new TSML approach to three existing alternatives for handling item-level missing data: scale-level full information maximum likelihood, available-case maximum likelihood, and item-level MI. We find that the TSML approach is the best analytic approach, and its performance is similar to item-level MI. We recommend its implementation in popular software and its further study.

  8. Biogas production of Chicken Manure by Two-stage fermentation process

    Science.gov (United States)

    Liu, Xin Yuan; Wang, Jing Jing; Nie, Jia Min; Wu, Nan; Yang, Fang; Yang, Ren Jie

    2018-06-01

    This paper performs a batch experiment for pre-acidification treatment and methane production from chicken manure by the two-stage anaerobic fermentation process. Results shows that the acetate was the main component in volatile fatty acids produced at the end of pre-acidification stage, accounting for 68% of the total amount. The daily biogas production experienced three peak period in methane production stage, and the methane content reached 60% in the second period and then slowly reduced to 44.5% in the third period. The cumulative methane production was fitted by modified Gompertz equation, and the kinetic parameters of the methane production potential, the maximum methane production rate and lag phase time were 345.2 ml, 0.948 ml/h and 343.5 h, respectively. The methane yield of 183 ml-CH4/g-VSremoved during the methane production stage and VS removal efficiency of 52.7% for the whole fermentation process were achieved.

  9. Study on the effect of mutated bacillus megaterium in two-stage fermentation of vitamin C

    International Nuclear Information System (INIS)

    Lv Shujuan; Wang Jun; Yao Jianming; Yu Zengliang

    2003-01-01

    Bacillus megaterium as a companion strain in two-stage fermentation of vitamin C could secrete some active substances to spur growth of Gluconobacter oxydans to produce 2-KLG. In the fermenting system where Gluconobacter oxydans was combined with GB82-a mutated strain of B. megaterium by ion implantation, the amount of 2-KLG harvested was larger than that produced by the original B. megaterium BP52 being substituted for GB82. In this paper, authors studied the effect of the active substances secreted by GB82 to enhance the capability of Gluconobacter oxydans to produce 2-KLG. The supernate of GB82 sampled at different cultivation times all had much more activity to spur Gluconobacter oxydans to yield 2-KLG than that of the original B. megaterium, which might be due to the genetic changes in the active components caused by ion implantation. Furthermore, the active substances of GB82's supernate would lose a part of its activity in extreme environments, which is typical of some proteins

  10. A Two-Stage Queue Model to Optimize Layout of Urban Drainage System considering Extreme Rainstorms

    Directory of Open Access Journals (Sweden)

    Xinhua He

    2017-01-01

    Full Text Available Extreme rainstorm is a main factor to cause urban floods when urban drainage system cannot discharge stormwater successfully. This paper investigates distribution feature of rainstorms and draining process of urban drainage systems and uses a two-stage single-counter queue method M/M/1→M/D/1 to model urban drainage system. The model emphasizes randomness of extreme rainstorms, fuzziness of draining process, and construction and operation cost of drainage system. Its two objectives are total cost of construction and operation and overall sojourn time of stormwater. An improved genetic algorithm is redesigned to solve this complex nondeterministic problem, which incorporates with stochastic and fuzzy characteristics in whole drainage process. A numerical example in Shanghai illustrates how to implement the model, and comparisons with alternative algorithms show its performance in computational flexibility and efficiency. Discussions on sensitivity of four main parameters, that is, quantity of pump stations, drainage pipe diameter, rainstorm precipitation intensity, and confidence levels, are also presented to provide guidance for designing urban drainage system.

  11. A Risk-Based Interval Two-Stage Programming Model for Agricultural System Management under Uncertainty

    Directory of Open Access Journals (Sweden)

    Ye Xu

    2016-01-01

    Full Text Available Nonpoint source (NPS pollution caused by agricultural activities is main reason that water quality in watershed becomes worse, even leading to deterioration. Moreover, pollution control is accompanied with revenue’s fall for agricultural system. How to design and generate a cost-effective and environmentally friendly agricultural production pattern is a critical issue for local managers. In this study, a risk-based interval two-stage programming model (RBITSP was developed. Compared to general ITSP model, significant contribution made by RBITSP model was that it emphasized importance of financial risk under various probabilistic levels, rather than only being concentrated on expected economic benefit, where risk is expressed as the probability of not meeting target profit under each individual scenario realization. This way effectively avoided solutions’ inaccuracy caused by traditional expected objective function and generated a variety of solutions through adjusting weight coefficients, which reflected trade-off between system economy and reliability. A case study of agricultural production management with the Tai Lake watershed was used to demonstrate superiority of proposed model. Obtained results could be a base for designing land-structure adjustment patterns and farmland retirement schemes and realizing balance of system benefit, system-failure risk, and water-body protection.

  12. A two-stage flow-based intrusion detection model for next-generation networks.

    Science.gov (United States)

    Umer, Muhammad Fahad; Sher, Muhammad; Bi, Yaxin

    2018-01-01

    The next-generation network provides state-of-the-art access-independent services over converged mobile and fixed networks. Security in the converged network environment is a major challenge. Traditional packet and protocol-based intrusion detection techniques cannot be used in next-generation networks due to slow throughput, low accuracy and their inability to inspect encrypted payload. An alternative solution for protection of next-generation networks is to use network flow records for detection of malicious activity in the network traffic. The network flow records are independent of access networks and user applications. In this paper, we propose a two-stage flow-based intrusion detection system for next-generation networks. The first stage uses an enhanced unsupervised one-class support vector machine which separates malicious flows from normal network traffic. The second stage uses a self-organizing map which automatically groups malicious flows into different alert clusters. We validated the proposed approach on two flow-based datasets and obtained promising results.

  13. A two-stage bioprocess for hydrogen and methane production from rice straw bioethanol residues.

    Science.gov (United States)

    Cheng, Hai-Hsuan; Whang, Liang-Ming; Wu, Chao-Wei; Chung, Man-Chien

    2012-06-01

    This study evaluates a two-stage bioprocess for recovering hydrogen and methane while treating organic residues of fermentative bioethanol from rice straw. The obtained results indicate that controlling a proper volumetric loading rate, substrate-to-biomass ratio, or F/M ratio is important to maximizing biohydrogen production from rice straw bioethanol residues. Clostridium tyrobutyricum, the identified major hydrogen-producing bacteria enriched in the hydrogen bioreactor, is likely utilizing lactate and acetate for biohydrogen production. The occurrence of acetogenesis during biohydrogen fermentation may reduce the B/A ratio and lead to a lower hydrogen production. Organic residues remained in the effluent of hydrogen bioreactor can be effectively converted to methane with a rate of 2.8 mmol CH(4)/gVSS/h at VLR of 4.6 kg COD/m(3)/d. Finally, approximately 75% of COD in rice straw bioethanol residues can be removed and among that 1.3% and 66.1% of COD can be recovered in the forms of hydrogen and methane, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Antioxidant activity and total phenolic content of Moringa oleifera leaves in two stages of maturity.

    Science.gov (United States)

    Sreelatha, S; Padma, P R

    2009-12-01

    Antioxidants play an important role in inhibiting and scavenging free radicals, thus providing protection to human against infections and degenerative diseases. Current research is now directed towards natural antioxidants originated from plants due to safe therapeutics. Moringa oleifera is used in Indian traditional medicine for a wide range of various ailments. To understand the mechanism of pharmacological actions, antioxidant properties of the Moringa oleifera leaf extracts were tested in two stages of maturity using standard in vitro models. The successive aqueous extract of Moringa oleifera exhibited strong scavenging effect on 2, 2-diphenyl-2-picryl hydrazyl (DPPH) free radical, superoxide, nitric oxide radical and inhibition of lipid per oxidation. The free radical scavenging effect of Moringa oleifera leaf extract was comparable with that of the reference antioxidants. The data obtained in the present study suggests that the extracts of Moringa oleifera both mature and tender leaves have potent antioxidant activity against free radicals, prevent oxidative damage to major biomolecules and afford significant protection against oxidative damage.

  15. Spectral Characteristic Based on Fabry—Pérot Laser Diode with Two-Stage Optical Feedback

    International Nuclear Information System (INIS)

    Wu Jian-Wei; Nakarmi Bikash

    2013-01-01

    An optical device, consisting of a multi-mode Fabry—Pérot laser diode (MMFP-LD) with two-stage optical feedback, is proposed and experimentally demonstrated. The results show that the single-mode output with side-mode suppression ratio (SMSR) of ∼21.7 dB is attained by using the first-stage feedback. By using the second-stage feedback, the SMSR of single-mode operation could be increased to ∼28.5 dB while injection feedback power of −29 dBm is introduced into the laser diode. In the case of up to −29 dBm feedback power, the outcome SMSR is rapidly decayed to a very low level so that an obvious multi-mode operation in the output spectrum could be achieved at the feedback power level of −15.5 dBm. Thus, a transition between single- and multi-mode operations could be flexibly controlled by adjusting the injected power in the second-stage feedback system. Additionally, in the case of injection locking, the outcome SMSR and output power at the locked wavelength are as high as ∼50 dB and ∼5.8 dBm, respectively

  16. Two-stage light-gas magnetoplasma accelerator for hypervelocity impact simulation

    International Nuclear Information System (INIS)

    Khramtsov, P P; Vasetskij, V A; Makhnach, A I; Grishenko, V M; Chernik, M Yu; Shikh, I A; Doroshko, M V

    2016-01-01

    The development of macroparticles acceleration methods for high-speed impact simulation in a laboratory is an actual problem due to increasing of space flights duration and necessity of providing adequate spacecraft protection against micrometeoroid and space debris impacts. This paper presents results of experimental study of a two-stage light- gas magnetoplasma launcher for acceleration of a macroparticle, in which a coaxial plasma accelerator creates a shock wave in a high-pressure channel filled with light gas. Graphite and steel spheres with diameter of 2.5-4 mm were used as a projectile and were accelerated to the speed of 0.8-4.8 km/s. A launching of particle occurred in vacuum. For projectile velocity control the speed measuring method was developed. The error of this metod does not exceed 5%. The process of projectile flight from the barrel and the process of a particle collision with a target were registered by use of high-speed camera. The results of projectile collision with elements of meteoroid shielding are presented. In order to increase the projectile velocity, the high-pressure channel should be filled with hydrogen. However, we used helium in our experiments for safety reasons. Therefore, we can expect that the range of mass and velocity of the accelerated particles can be extended by use of hydrogen as an accelerating gas. (paper)

  17. Two-stage light-gas magnetoplasma accelerator for hypervelocity impact simulation

    Science.gov (United States)

    Khramtsov, P. P.; Vasetskij, V. A.; Makhnach, A. I.; Grishenko, V. M.; Chernik, M. Yu; Shikh, I. A.; Doroshko, M. V.

    2016-11-01

    The development of macroparticles acceleration methods for high-speed impact simulation in a laboratory is an actual problem due to increasing of space flights duration and necessity of providing adequate spacecraft protection against micrometeoroid and space debris impacts. This paper presents results of experimental study of a two-stage light- gas magnetoplasma launcher for acceleration of a macroparticle, in which a coaxial plasma accelerator creates a shock wave in a high-pressure channel filled with light gas. Graphite and steel spheres with diameter of 2.5-4 mm were used as a projectile and were accelerated to the speed of 0.8-4.8 km/s. A launching of particle occurred in vacuum. For projectile velocity control the speed measuring method was developed. The error of this metod does not exceed 5%. The process of projectile flight from the barrel and the process of a particle collision with a target were registered by use of high-speed camera. The results of projectile collision with elements of meteoroid shielding are presented. In order to increase the projectile velocity, the high-pressure channel should be filled with hydrogen. However, we used helium in our experiments for safety reasons. Therefore, we can expect that the range of mass and velocity of the accelerated particles can be extended by use of hydrogen as an accelerating gas.

  18. Two stage S-N curve in corrosion fatigue of extruded magnesium alloy AZ31

    Directory of Open Access Journals (Sweden)

    Yoshiharu Mutoh

    2009-11-01

    Full Text Available Tension-compression fatigue tests of extruded AZ31 magnesium alloys were carried out under corrosive environments:(a high humidity environment (80 %RH and (b 5 wt. %NaCl environment. It was found that the reduction rate of fatiguestrength due to corrosive environment was 0.12 under a high humidity and 0.53 under a NaCl environment. It was alsoobserved that under corrosive environments, the S-N curve was not a single curve but a two-stage curve. Above the fatiguelimit under low humidity, the crack nucleation mechanism was due to a localized slip band formation mechanism. Below thefatigue limit under low humidity, the reduction in fatigue strength was attributed to the corrosion pit formation and growth to the critical size for fatigue crack nucleation under the combined effect of cyclic load and the corrosive environment. The critical size was attained when the stress intensity factor range reached the threshold value for crack growth.

  19. Two-Stage Regularized Linear Discriminant Analysis for 2-D Data.

    Science.gov (United States)

    Zhao, Jianhua; Shi, Lei; Zhu, Ji

    2015-08-01

    Fisher linear discriminant analysis (LDA) involves within-class and between-class covariance matrices. For 2-D data such as images, regularized LDA (RLDA) can improve LDA due to the regularized eigenvalues of the estimated within-class matrix. However, it fails to consider the eigenvectors and the estimated between-class matrix. To improve these two matrices simultaneously, we propose in this paper a new two-stage method for 2-D data, namely a bidirectional LDA (BLDA) in the first stage and the RLDA in the second stage, where both BLDA and RLDA are based on the Fisher criterion that tackles correlation. BLDA performs the LDA under special separable covariance constraints that incorporate the row and column correlations inherent in 2-D data. The main novelty is that we propose a simple but effective statistical test to determine the subspace dimensionality in the first stage. As a result, the first stage reduces the dimensionality substantially while keeping the significant discriminant information in the data. This enables the second stage to perform RLDA in a much lower dimensional subspace, and thus improves the two estimated matrices simultaneously. Experiments on a number of 2-D synthetic and real-world data sets show that BLDA+RLDA outperforms several closely related competitors.

  20. Design of Korean nuclear reliability data-base network using a two-stage Bayesian concept

    International Nuclear Information System (INIS)

    Kim, T.W.; Jeong, K.S.; Chae, S.K.

    1987-01-01

    In an analysis of probabilistic risk, safety, and reliability of a nuclear power plant, the reliability data base (DB) must be established first. As the importance of the reliability data base increases, event reporting systems such as the US Nuclear Regulatory Commission's Licensee Event Report and the International Atomic Energy Agency's Incident Reporting System have been developed. In Korea, however, the systematic reliability data base is not yet available. Therefore, foreign data bases have been directly quoted in reliability analyses of Korean plants. In order to develop a reliability data base for Korean plants, the problem is which methodology is to be used, and the application limits of the selected method must be solved and clarified. After starting the commercial operation of Korea Nuclear Unit-1 (KNU-1) in 1978, six nuclear power plants have begun operation. Of these, only KNU-3 is a Canada Deuterium Uranium pressurized heavy-water reactor, and the others are all pressurized water reactors. This paper describes the proposed reliability data-base network (KNRDS) for Korean nuclear power plants in the context of two-stage Bayesian (TSB) procedure of Kaplan. It describes the concept of TSB to obtain the Korean-specific plant reliability data base, which is updated with the incorporation of both the reported generic reliability data and the operation experiences of similar plants