Introduction: Frozen shoulder is a common condition that affects the working population. Current management regimes are variable nationwide and the evidence base on which to base these decisions is poor. The longevity...Introduction: Frozen shoulder is a common condition that affects the working population. Current management regimes are variable nationwide and the evidence base on which to base these decisions is poor. The longevity and severity of symptoms often result in great economic burden, both to health services and in terms of absence from work. Early surgical intervention with arthroscopic capsular release may result in improved symptoms and earlier return to both work and leisure activities. Aims: The aim of our prospective cohort study was to investigate whether early intervention with arthroscopic capsular release resulted in improvement of symptoms and whether this would in turn provide overall economic benefit to society. Methods: Patients diagnosed with frozen shoulder at an elective orthopaedic specialist shoulder clinic were recruited prospectively. Data were gathered by way of questionnaire to ascertain the demographic information of the patient as well as their previous treatment in the primary care setting and absence from work. Initial Oxford Shoulder Score (OSS) was also calculated: Arthroscopic capsular release was then performed and further data gathered at four-week post-operative follow-up. Economic impact of delay to treatment and cost of intervention were calculated using government data from the national tariff which cost different forms of treatment. Statistical analysis was then performed on the results. Results: Twenty five patients were recruited. Mean results were: Age of patients: 53.5 years, duration of symptoms prior to intervention: 35.2 weeks, days absent from work: 31.5, number of previous physiotherapy sessions: 7.2, number of steroid injections: 1.3. Mean pre-operative OSS was 37.4 (range 27 - 58, SD 7.4). Mean post-operative OSS was 15.9 (range 12 - 22, SD 2.3), P 0.01. Mean improvement in OSS was 21.5 (range 12 - 38, SD 7.1). The cost of non-operative treatment per patient including absence from work to the point of surgical intervention was ￡3954. The overall cost of arthroscopic capsular release per patient was ￡1861, a difference of ￡2093. There were no surgical complications. Conclusion: Arthroscopic capsular release improved shoulder function on OSS within four weeks. This is significantly shorter than the natural history of frozen shoulder. The overall cost of arthroscopic capsular release is significantly less than the cost of treating the patients non-operatively up to the point of surgical intervention. Early surgical intervention may improve symptoms quickly and reduce economic burden of the disease. A randomised controlled trial comparing early with late intervention would further elucidate potential benefits.展开更多
The urgent need to develop customized functional products only possible by 3D printing had realized when faced with the unavailability of medical devices like surgical instruments during the coronavirus-19 disease and...The urgent need to develop customized functional products only possible by 3D printing had realized when faced with the unavailability of medical devices like surgical instruments during the coronavirus-19 disease and the ondemand necessity to perform surgery during space missions.Biopolymers have recently been the most appropriate option for fabricating surgical instruments via 3D printing in terms of cheaper and faster processing.Among all 3D printing techniques,fused deposition modelling(FDM)is a low-cost and more rapid printing technique.This article proposes the fabrication of surgical instruments,namely,forceps and hemostat using the fused deposition modeling(FDM)process.Excellent mechanical properties are the only indicator to judge the quality of the functional parts.The mechanical properties of FDM-processed parts depend on various process parameters.These parameters are layer height,infill pattern,top/bottom pattern,number of top/bottom layers,infill density,flow,number of shells,printing temperature,build plate temperature,printing speed,and fan speed.Tensile strength and modulus of elasticity are chosen as evaluation indexes to ascertain the mechanical properties of polylactic acid(PLA)parts printed by FDM.The experiments have performed through Taguchi’s L27orthogonal array(OA).Variance analysis(ANOVA)ascertains the significance of the process parameters and their percent contributions to the evaluation indexes.Finally,as a multiobjective optimization technique,grey relational analysis(GRA)obtains an optimal set of FDM process parameters to fabricate the best parts with comprehensive mechanical properties.Scanning electron microscopy(SEM)examines the types of defects and strong bonding between rasters.The proposed research ensures the successful fabrication of functional surgical tools with substantial ultimate tensile strength(42.6 MPa)and modulus of elasticity(3274 MPa).展开更多
Unmanned Aerial Vehicles(UAVs)or drones introduced for military applications are gaining popularity in several other fields as well such as security and surveillance,due to their ability to perform repetitive and tedi...Unmanned Aerial Vehicles(UAVs)or drones introduced for military applications are gaining popularity in several other fields as well such as security and surveillance,due to their ability to perform repetitive and tedious tasks in hazardous environments.Their increased demand created the requirement for enabling the UAVs to traverse independently through the Three Dimensional(3D)flight environment consisting of various obstacles which have been efficiently addressed by metaheuristics in past literature.However,not a single optimization algorithms can solve all kind of optimization problem effectively.Therefore,there is dire need to integrate metaheuristic for general acceptability.To address this issue,in this paper,a novel reinforcement learning controlled Grey Wolf Optimisation-Archimedes Optimisation Algorithm(QGA)has been exhaustively introduced and exhaustively validated firstly on 22 benchmark functions and then,utilized to obtain the optimum flyable path without collision for UAVs in three dimensional environment.The performance of the developed QGA has been compared against the various metaheuristics.The simulation experimental results reveal that the QGA algorithm acquire a feasible and effective flyable path more efficiently in complicated environment.展开更多
文摘Introduction: Frozen shoulder is a common condition that affects the working population. Current management regimes are variable nationwide and the evidence base on which to base these decisions is poor. The longevity and severity of symptoms often result in great economic burden, both to health services and in terms of absence from work. Early surgical intervention with arthroscopic capsular release may result in improved symptoms and earlier return to both work and leisure activities. Aims: The aim of our prospective cohort study was to investigate whether early intervention with arthroscopic capsular release resulted in improvement of symptoms and whether this would in turn provide overall economic benefit to society. Methods: Patients diagnosed with frozen shoulder at an elective orthopaedic specialist shoulder clinic were recruited prospectively. Data were gathered by way of questionnaire to ascertain the demographic information of the patient as well as their previous treatment in the primary care setting and absence from work. Initial Oxford Shoulder Score (OSS) was also calculated: Arthroscopic capsular release was then performed and further data gathered at four-week post-operative follow-up. Economic impact of delay to treatment and cost of intervention were calculated using government data from the national tariff which cost different forms of treatment. Statistical analysis was then performed on the results. Results: Twenty five patients were recruited. Mean results were: Age of patients: 53.5 years, duration of symptoms prior to intervention: 35.2 weeks, days absent from work: 31.5, number of previous physiotherapy sessions: 7.2, number of steroid injections: 1.3. Mean pre-operative OSS was 37.4 (range 27 - 58, SD 7.4). Mean post-operative OSS was 15.9 (range 12 - 22, SD 2.3), P 0.01. Mean improvement in OSS was 21.5 (range 12 - 38, SD 7.1). The cost of non-operative treatment per patient including absence from work to the point of surgical intervention was ￡3954. The overall cost of arthroscopic capsular release per patient was ￡1861, a difference of ￡2093. There were no surgical complications. Conclusion: Arthroscopic capsular release improved shoulder function on OSS within four weeks. This is significantly shorter than the natural history of frozen shoulder. The overall cost of arthroscopic capsular release is significantly less than the cost of treating the patients non-operatively up to the point of surgical intervention. Early surgical intervention may improve symptoms quickly and reduce economic burden of the disease. A randomised controlled trial comparing early with late intervention would further elucidate potential benefits.
文摘The urgent need to develop customized functional products only possible by 3D printing had realized when faced with the unavailability of medical devices like surgical instruments during the coronavirus-19 disease and the ondemand necessity to perform surgery during space missions.Biopolymers have recently been the most appropriate option for fabricating surgical instruments via 3D printing in terms of cheaper and faster processing.Among all 3D printing techniques,fused deposition modelling(FDM)is a low-cost and more rapid printing technique.This article proposes the fabrication of surgical instruments,namely,forceps and hemostat using the fused deposition modeling(FDM)process.Excellent mechanical properties are the only indicator to judge the quality of the functional parts.The mechanical properties of FDM-processed parts depend on various process parameters.These parameters are layer height,infill pattern,top/bottom pattern,number of top/bottom layers,infill density,flow,number of shells,printing temperature,build plate temperature,printing speed,and fan speed.Tensile strength and modulus of elasticity are chosen as evaluation indexes to ascertain the mechanical properties of polylactic acid(PLA)parts printed by FDM.The experiments have performed through Taguchi’s L27orthogonal array(OA).Variance analysis(ANOVA)ascertains the significance of the process parameters and their percent contributions to the evaluation indexes.Finally,as a multiobjective optimization technique,grey relational analysis(GRA)obtains an optimal set of FDM process parameters to fabricate the best parts with comprehensive mechanical properties.Scanning electron microscopy(SEM)examines the types of defects and strong bonding between rasters.The proposed research ensures the successful fabrication of functional surgical tools with substantial ultimate tensile strength(42.6 MPa)and modulus of elasticity(3274 MPa).
基金funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2022R66),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘Unmanned Aerial Vehicles(UAVs)or drones introduced for military applications are gaining popularity in several other fields as well such as security and surveillance,due to their ability to perform repetitive and tedious tasks in hazardous environments.Their increased demand created the requirement for enabling the UAVs to traverse independently through the Three Dimensional(3D)flight environment consisting of various obstacles which have been efficiently addressed by metaheuristics in past literature.However,not a single optimization algorithms can solve all kind of optimization problem effectively.Therefore,there is dire need to integrate metaheuristic for general acceptability.To address this issue,in this paper,a novel reinforcement learning controlled Grey Wolf Optimisation-Archimedes Optimisation Algorithm(QGA)has been exhaustively introduced and exhaustively validated firstly on 22 benchmark functions and then,utilized to obtain the optimum flyable path without collision for UAVs in three dimensional environment.The performance of the developed QGA has been compared against the various metaheuristics.The simulation experimental results reveal that the QGA algorithm acquire a feasible and effective flyable path more efficiently in complicated environment.
