Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aestheti...Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.展开更多
Integrated building design is inherently a multi-objective optimization problem where two or more conflicting objectives must be minimized and/or maximized concurrently.Many multi-objective optimization algorithms hav...Integrated building design is inherently a multi-objective optimization problem where two or more conflicting objectives must be minimized and/or maximized concurrently.Many multi-objective optimization algorithms have been developed;however few of them are tested in solving building design problems.This paper compares performance of seven commonly-used multi-objective evolutionary optimization algorithms in solving the design problem of a nearly zero energy building(n ZEB) where more than 1.610 solutions would be possible.The compared algorithms include a controlled non-dominated sorting genetic algorithm witha passive archive(p NSGA-II),a multi-objective particle swarm optimization(MOPSO),a two-phase optimization using the genetic algorithm(PR_GA),an elitist non-dominated sorting evolution strategy(ENSES),a multi-objective evolutionary algorithm based on the concept of epsilon dominance(ev MOGA),a multi-objective differential evolution algorithm(sp MODE-II),and a multi-objective dragonfly algorithm(MODA).Several criteria was used to compare performance of these algorithms.In most cases,the quality of the obtained solutions was improved when the number of generations was increased.The optimization results of running each algorithm20 times with gradually increasing number of evaluations indicated that the PR_GA algorithm had a high repeatability to explore a large area of the solution-space and achieved close-to-optimal solutions with a good diversity,followed by the p NSGA-II,ev MOGA and sp MODE-II.Uncompetitive results were achieved by the ENSES,MOPSO and MODA in most running cases.The study also found that 1400-1800 were minimum required number of evaluations to stabilize optimization results of the building energy model.展开更多
This study presents the synchronisation between two non-linear Lorenz chaotic systems using an adaptive intuitionistic fuzzy controller(AIFC).This problem is solved in the presence of external disturbances and uncerta...This study presents the synchronisation between two non-linear Lorenz chaotic systems using an adaptive intuitionistic fuzzy controller(AIFC).This problem is solved in the presence of external disturbances and uncertainties.Two classes of Lorenz systems have been formulated one as the master and the other as the slave.The master and slave systems have different initial conditions.Under different initial conditions,both systems diverge.This is called the butterfly effect that rules the behaviour of chaotic systems.AIFC is chosen as a different method that has not been used before to synchronise the chaotic systems.The scaling factors of the inputs and the output of the intuitionistic fuzzy controller(IFC)are tuned using the artificial bee colony(ABC)algorithm depending on a specified objective function.Then IFC stability is studied when it is applied to synchronise the Lorenz system.The simulation results achieved to assess the adequacy of the proposed control and to exhibit its dependability to synchronise the Lorenz system.展开更多
Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center...Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.展开更多
This paper presents a comparative study of different decoupling control schemes for a two-input, two-output(TITO) binary distillation column via proportional-integral(PI)controller. The key idea behind this paper is d...This paper presents a comparative study of different decoupling control schemes for a two-input, two-output(TITO) binary distillation column via proportional-integral(PI)controller. The key idea behind this paper is designing two novel fuzzy decoupling schemes that depend on human knowledge,instead of the system mathematical model used in conventional decoupling schemes. Based on conventional and inverted decoupling schemes, fuzzy and inverted fuzzy decoupling schemes are developed. The control effect is compared using simulation results for the proposed two schemes with conventional decoupling and inverted decoupling. The proposed fuzzy decoupling schemes are easy to realize and simple to design, besides they have a good decoupling capability. Two methods are used to prove asymptotic stability of each loop and the entire closed-loop system by applying the proposed fuzzy decoupling-based PI controller.The Wood and Berry model of a binary distillation column is used to illustrate the applicability of the proposed schemes.展开更多
Tectonic setting of the Neoproterozoic ophiolites is poorly understood.Because of extensive serpentinization/metamorphism in the mantle section,accessory chromian spinel has been used as an important geotectonic indic...Tectonic setting of the Neoproterozoic ophiolites is poorly understood.Because of extensive serpentinization/metamorphism in the mantle section,accessory chromian spinel has been used as an important geotectonic indicator.展开更多
Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxa...Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxanes addition and avoid delay of radiotherapy. Patients and Methods: A total of 63 patients with pT1-2, and pN1-3, M0 breast cancer underwent conservative surgery followed by adjuvant 4 cycles AC followed by 4 cycles Paclitaxel 175 mg/m2 every 3 weeks. Adjuvant radiotherapy started during the first and second cycle of paclitaxel (CCRT). Toxicities evaluated at the base time, weekly during radiation therapy and every 3 months for 24 months for skin, pulmonary, cardiac, lymphedema, subcutaneous fibrosis and cosmoses. Survival reported at 2-year median follow-up. Results: At median follow up time of 24 months (6 - 30), we did not report any toxicity postpone or stop treatment and only two patients had grade III acute dermatitis. Fifty-two patients (82.5%) had satisfactory cosmoses and none of the patients developed local recurrence. Conclusion: Three-weekly paclitaxel during radiotherapy is considered safe without significant complications and acceptable cosmoses with excellent local control and could be considered to avoid radiotherapy delay.展开更多
Background: Antioxidants such as vitamin C can eliminate free radicles responsible for oxidative stress. Objective: To assess the serum level of vitamin C in a sample of multiple sclerosis (MS) patients to investigate...Background: Antioxidants such as vitamin C can eliminate free radicles responsible for oxidative stress. Objective: To assess the serum level of vitamin C in a sample of multiple sclerosis (MS) patients to investigate a possible role of vitamin C in the pathogenesis of MS. Subjects and Methods: Forty patients with MS and twenty healthy controls were included in this study. Vitamin C level was estimated for each participant. Results: Serum vitamin C levels were significantly lower among the patients (ranging from 0.28 mg/dL to 0.75 mg/dL with mean 0.47 ± 0.14 mg/dL and median of 0.46 mg/dL) compared to controls (ranging from 0.60 mg/dL to 2.90 mg/dL with mean 1.87 ± 0.61 mg/dL and median of 1.90 mg/dL) (P Conclusion: Patients with MS tended to have low serum vitamin C levels, and younger patients had lower serum levels.展开更多
Neoproterozoic ophiolitic Serpentinites are common in the Arabian-Nubian Shield （ANS） of the Eastern Desert （ED） of Egypt, which were formed in arc stage in different tectonic setting. Thus they might subject to e...Neoproterozoic ophiolitic Serpentinites are common in the Arabian-Nubian Shield （ANS） of the Eastern Desert （ED） of Egypt, which were formed in arc stage in different tectonic setting. Thus they might subject to exchange with the crustal material derived from recycling subducting oceanic lithosphere. This caused metasomatism enriching the rocks in incompatible elements and forming non- residual minerals. Herein,展开更多
An observer-based adaptive fuzzy control is presented for a class of nonlinear systems with unknown time delays. The state observer is first designed, and then the controller is designed via the adaptive fuzzy control...An observer-based adaptive fuzzy control is presented for a class of nonlinear systems with unknown time delays. The state observer is first designed, and then the controller is designed via the adaptive fuzzy control method based on the observed states. Both the designed observer and controller are independent of time delays. Using an appropriate Lyapunov-Krasovskii functional, the uncertainty of the unknown time delay is compensated, and then the fuzzy logic system in Mamdani type is utilized to approximate the unknown nonlinear functions. Based on the Lyapunov stability theory, the constructed observer-based controller and the closed-loop system are proved to be asymptotically stable. The designed control law is independent of the time delays and has a simple form with only one adaptive parameter vector, which is to be updated on-line. Simulation results are presented to demonstrate the effectiveness of the proposed approach.展开更多
This paper presents an observer based dynamic fuzzy logic system （DFLS） scheme for a class of unknown single-input single-output （SISO） nonlinear dynamic systems with external disturbances. The proposed approach d...This paper presents an observer based dynamic fuzzy logic system （DFLS） scheme for a class of unknown single-input single-output （SISO） nonlinear dynamic systems with external disturbances. The proposed approach does not need the availability of the state variables. Within this scheme, the DFLS is employed to identify the unknown nonlinear dynamic system. The control law and parameter adaptation laws of the DFLS are derived based on Lyapunov synthesis approach. The control law is robustfied in H∞ sense to attenuate external disturbance, model uncertainties, and fuzzy approximation errors. It is shown that under appropriate assumptions, it guarantees the boundedness of all the signals in the closed-loop system and the asymptotic convergence to zero of tracking errors. The proposed method is applied to an inverted pendulum system to verify the effectiveness of the proposed algorithms.展开更多
文摘Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.
文摘Integrated building design is inherently a multi-objective optimization problem where two or more conflicting objectives must be minimized and/or maximized concurrently.Many multi-objective optimization algorithms have been developed;however few of them are tested in solving building design problems.This paper compares performance of seven commonly-used multi-objective evolutionary optimization algorithms in solving the design problem of a nearly zero energy building(n ZEB) where more than 1.610 solutions would be possible.The compared algorithms include a controlled non-dominated sorting genetic algorithm witha passive archive(p NSGA-II),a multi-objective particle swarm optimization(MOPSO),a two-phase optimization using the genetic algorithm(PR_GA),an elitist non-dominated sorting evolution strategy(ENSES),a multi-objective evolutionary algorithm based on the concept of epsilon dominance(ev MOGA),a multi-objective differential evolution algorithm(sp MODE-II),and a multi-objective dragonfly algorithm(MODA).Several criteria was used to compare performance of these algorithms.In most cases,the quality of the obtained solutions was improved when the number of generations was increased.The optimization results of running each algorithm20 times with gradually increasing number of evaluations indicated that the PR_GA algorithm had a high repeatability to explore a large area of the solution-space and achieved close-to-optimal solutions with a good diversity,followed by the p NSGA-II,ev MOGA and sp MODE-II.Uncompetitive results were achieved by the ENSES,MOPSO and MODA in most running cases.The study also found that 1400-1800 were minimum required number of evaluations to stabilize optimization results of the building energy model.
文摘This study presents the synchronisation between two non-linear Lorenz chaotic systems using an adaptive intuitionistic fuzzy controller(AIFC).This problem is solved in the presence of external disturbances and uncertainties.Two classes of Lorenz systems have been formulated one as the master and the other as the slave.The master and slave systems have different initial conditions.Under different initial conditions,both systems diverge.This is called the butterfly effect that rules the behaviour of chaotic systems.AIFC is chosen as a different method that has not been used before to synchronise the chaotic systems.The scaling factors of the inputs and the output of the intuitionistic fuzzy controller(IFC)are tuned using the artificial bee colony(ABC)algorithm depending on a specified objective function.Then IFC stability is studied when it is applied to synchronise the Lorenz system.The simulation results achieved to assess the adequacy of the proposed control and to exhibit its dependability to synchronise the Lorenz system.
文摘Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.
文摘This paper presents a comparative study of different decoupling control schemes for a two-input, two-output(TITO) binary distillation column via proportional-integral(PI)controller. The key idea behind this paper is designing two novel fuzzy decoupling schemes that depend on human knowledge,instead of the system mathematical model used in conventional decoupling schemes. Based on conventional and inverted decoupling schemes, fuzzy and inverted fuzzy decoupling schemes are developed. The control effect is compared using simulation results for the proposed two schemes with conventional decoupling and inverted decoupling. The proposed fuzzy decoupling schemes are easy to realize and simple to design, besides they have a good decoupling capability. Two methods are used to prove asymptotic stability of each loop and the entire closed-loop system by applying the proposed fuzzy decoupling-based PI controller.The Wood and Berry model of a binary distillation column is used to illustrate the applicability of the proposed schemes.
文摘Tectonic setting of the Neoproterozoic ophiolites is poorly understood.Because of extensive serpentinization/metamorphism in the mantle section,accessory chromian spinel has been used as an important geotectonic indicator.
文摘Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxanes addition and avoid delay of radiotherapy. Patients and Methods: A total of 63 patients with pT1-2, and pN1-3, M0 breast cancer underwent conservative surgery followed by adjuvant 4 cycles AC followed by 4 cycles Paclitaxel 175 mg/m2 every 3 weeks. Adjuvant radiotherapy started during the first and second cycle of paclitaxel (CCRT). Toxicities evaluated at the base time, weekly during radiation therapy and every 3 months for 24 months for skin, pulmonary, cardiac, lymphedema, subcutaneous fibrosis and cosmoses. Survival reported at 2-year median follow-up. Results: At median follow up time of 24 months (6 - 30), we did not report any toxicity postpone or stop treatment and only two patients had grade III acute dermatitis. Fifty-two patients (82.5%) had satisfactory cosmoses and none of the patients developed local recurrence. Conclusion: Three-weekly paclitaxel during radiotherapy is considered safe without significant complications and acceptable cosmoses with excellent local control and could be considered to avoid radiotherapy delay.
文摘Background: Antioxidants such as vitamin C can eliminate free radicles responsible for oxidative stress. Objective: To assess the serum level of vitamin C in a sample of multiple sclerosis (MS) patients to investigate a possible role of vitamin C in the pathogenesis of MS. Subjects and Methods: Forty patients with MS and twenty healthy controls were included in this study. Vitamin C level was estimated for each participant. Results: Serum vitamin C levels were significantly lower among the patients (ranging from 0.28 mg/dL to 0.75 mg/dL with mean 0.47 ± 0.14 mg/dL and median of 0.46 mg/dL) compared to controls (ranging from 0.60 mg/dL to 2.90 mg/dL with mean 1.87 ± 0.61 mg/dL and median of 1.90 mg/dL) (P Conclusion: Patients with MS tended to have low serum vitamin C levels, and younger patients had lower serum levels.
文摘Neoproterozoic ophiolitic Serpentinites are common in the Arabian-Nubian Shield （ANS） of the Eastern Desert （ED） of Egypt, which were formed in arc stage in different tectonic setting. Thus they might subject to exchange with the crustal material derived from recycling subducting oceanic lithosphere. This caused metasomatism enriching the rocks in incompatible elements and forming non- residual minerals. Herein,
文摘An observer-based adaptive fuzzy control is presented for a class of nonlinear systems with unknown time delays. The state observer is first designed, and then the controller is designed via the adaptive fuzzy control method based on the observed states. Both the designed observer and controller are independent of time delays. Using an appropriate Lyapunov-Krasovskii functional, the uncertainty of the unknown time delay is compensated, and then the fuzzy logic system in Mamdani type is utilized to approximate the unknown nonlinear functions. Based on the Lyapunov stability theory, the constructed observer-based controller and the closed-loop system are proved to be asymptotically stable. The designed control law is independent of the time delays and has a simple form with only one adaptive parameter vector, which is to be updated on-line. Simulation results are presented to demonstrate the effectiveness of the proposed approach.
文摘This paper presents an observer based dynamic fuzzy logic system （DFLS） scheme for a class of unknown single-input single-output （SISO） nonlinear dynamic systems with external disturbances. The proposed approach does not need the availability of the state variables. Within this scheme, the DFLS is employed to identify the unknown nonlinear dynamic system. The control law and parameter adaptation laws of the DFLS are derived based on Lyapunov synthesis approach. The control law is robustfied in H∞ sense to attenuate external disturbance, model uncertainties, and fuzzy approximation errors. It is shown that under appropriate assumptions, it guarantees the boundedness of all the signals in the closed-loop system and the asymptotic convergence to zero of tracking errors. The proposed method is applied to an inverted pendulum system to verify the effectiveness of the proposed algorithms.
