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- Clough, Rachel E, et al.
(author)
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Endovascular treatment of acute aortic syndrome
- 2011
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In: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 54:6, s. 1580-1587
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Journal article (peer-reviewed)abstract
- BACKGROUND: The term acute aortic syndrome (AAS) encompasses a range of conditions that have a risk of imminent aortic rupture and where delays in treatment result in increased mortality. Endovascular treatment offers an attractive alternative to open surgery but little is known about the durability of the repair and the factors that predict mortality. METHODS: Prospective data were collected for a cohort of 110 consecutive patients with endovascular treatment for AAS. Patient and procedural characteristics were related to short- and midterm outcome using multivariate logistic regression analysis. RESULTS: There were 75 men and 35 women with a median age of 68 (range 57-76) years. The pathologies treated were acute dissection (35), symptomatic aneurysm (32), infected aneurysm (18), transection (12), chronic dissection (9), penetrating ulcer (3), and intramural hematoma (1). Thirty-day mortality was 12.7% and this was associated with hypotension (odds ratio [OR], 5.25), use of general anesthetic (OR, 5.23), long procedure duration (OR, 2.03), and increasing age (OR, 1.07). The causes of death were aortic rupture (4), myocardial infarction (4), stroke (3), and multisystem organ failure (3). The stroke and paraplegia rates were 7.3% and 6.4%, respectively. The 1-year survival was 81% and the 5-year survival 63%. Secondary procedures were required in 13 (11.8%) patients. Factors associated with death at 1 year were presence of an aortic fistula (OR, 9.78), perioperative stroke (OR, 5.87), and use of general anesthetic (OR, 3.76); and at 5 years were aortic fistula (OR, 12.31) and increasing age (OR, 1.06). CONCLUSIONS: Acute aortic syndrome carries significant early and late mortality. Emergency endovascular repair offers a minimally invasive treatment option associated with acceptable short and midterm results. Continued surveillance is important as secondary procedures and aortic-related deaths continue to occur throughout the follow-up period.
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| 2. |
- Muroyama, Alexander, 1990, et al.
(author)
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Simulation and Analysis for Sustainability in Manufacturing
- 2011
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In: ASME 2011 International Design Engineering Technical Conferences & Computers and Information in Engineering Conference.
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Conference paper (peer-reviewed)abstract
- Sustainability has become a ubiquitous term in almost every field, especially in engineering design and manufacturing. Recently, an increased awareness of environmental problems and resource depletion has led to an emphasis on environmentally friendly practices. This is especially true in the manufacturing industry where energy consumption and the amount of waste generated can be high. This requires proactive tools to be developed to carefully analyze the cause-effect of current manufacturing practices and to investigate alternative practices. One such approach to sustainable manufacturing is the combined use of Discrete Event Simulation (DES) and Life Cycle Assessment (LCA) to analyze the utilization and processing of manufacturing resources in a factory setting. On an economic aspect such methods can significantly reduce the financial and environmental costs by evaluating the system performance before its construction or use. In this project, what-if scenarios in a simplified golf ball factory using as close to real-world data as possible demonstrate DES and LCA’s ability to facilitate decision-making and optimize the manufacturing process. Plastic injection molding, an energy-intensive step in the golf ball manufacturing process, is the focus of the DES model. AutoMod, a 3-D modeling software, was used to build the DES model and AutoStat was used to run the trials and analyze the data. By varying the input parameters such as type and number of injection molding machines and material used, the simulation model can output data indicating the most productive and energy efficient methods. On a more detailed level, the simulations can provide valuable information on bottlenecks or imbalances in the system. Correcting these can allow the factory to be both “greener” and more cost-effective.
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