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Evaluation of Handmade Extra-Corporeal Loop versus Metallic Clips in Securing the Appendicular Stump in Laparoscopic Appendicectomy  [PDF]
Mohamed Yousef A., Abdallah M. Taha, Asmaa Gaber R., Mahmoud Abdelhameid, Mohammed A. Omar, Mohamed Abdelshafy
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1103117
Abstract:
Introduction: Laparoscopic appendicectomy has gained popularity due to the advantages of minimal-access surgery. Inadequate closure of the appendix stump leads to intra-abdominal surgical site infection or even fecal fistula. The base of the appendix can be secured with endostapler, endoloops, metallic clips or intracorporeal ligature. Aim: To evaluate the handmade extra-corporeal loop versus endoclip in securing the base of the appendix in non-complicated acute appendicitis. Methods: During the period from April 2014 to February 2016, in South Valley University, Aswan University and Sohag University hospitals (these are tertiary hospitals), 400 laparoscopic appendicectomy patients were included in this prospective study. In total, 240 patients were female and the overall average age was 25.6 years old. Patients were divided into two equal groups (group L and group C): in group L, handmade extracorporeal loop was used to secure the base of the appendix, the metallic clip was used in group C. Results: The mean operative time was 49 min in group L and 35.4 min in group C (P < 0.05). The mean hospital stay was 2.07 days in group L and 2 days in group C, and this was not significant (P > 0.05). Complications varied between port- site wound infection and delayed intestinal sounds, fecal fistula and there were no statistically significant differences. Conclusion: Using extracorporeal handmade loop or the metallic clips to secure the appendicular stump is safe, feasible, easy and inexpensive methods. The loop takes a little more time in its preparation. Metallic clips are inappropriate for edematous wide base appendix.
A Modified Limberg Flap versus Z Plasty Flap Technique in Management of Recurrent Pilonidal Disease: A Comparative Prospective Study  [PDF]
Asmaa Gaber R., Mohamed Yousef A., Mohamed Abdel Shafy Mohamed, Abd-El-Aal A. Saleem, Hassan A. Abdallah, Hamdy M. Husein
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1104715
Abstract:
Background: There are controversies about the etiology and management of recurrent pilonidal sinus. The numbers of techniques are testament in treating pilonidal sinus (PNS) and no single procedure is superior in all aspects. Aim of the study: The aim of this study was to compare two operative procedures (modified Limberg flap versus Z plasty flap) in management of recurrent pilonidal sinus, regarding their complications including recurrences of the disease, morbidity, hospital stay, day off work and postoperative complications. Patients and methods: This is comparative prospective study between modified Limberg flap and Z plasty flap in treatment of recurrent pilonidal sinus. 30 patients were divided into 2 groups: Group (1) treated with modified Limberg flap and group (2) treated with Z plasty, and we followed up the patients in both groups for postoperative complications, hospital stay, day off work, recurrences, patients satisfactions. Results: Operative time, hospital stay duration, complete wound healing was longer in group (2) Z plasty group. Mobilization was early in MLF group than Z plasty group (1 day versus 2 days). Time to return to work, it was 14 (12 - 16) days in MLF groups and 18 (15 - 22) in Z plasty group (p < 0.001). Infection occurred only in one in MLF group (1) and 2 patients in Z plasty group (2). The mean time for complete healing of the wound after Modified Limberg flap group (1) was 16 ± 4.2 days while in Z plasty group (2) it was 22 ± 6.8 days. Satisfaction score was better in MLF group (1). Recurrence hadn’t occurred in any of the patients included in this study during the follow-up period. Conclusion: Both of modified Limberg flap and Z-plasty technique are used to cause flattening of the natal cleft, thus reducing local recurrence rates. So, we recommend use of flap technique for recurrent pilonidal sinus patients; modified Limberg transposition flap is better than Z plasty flap, because of the less hospital stay time, early return to work, and cosmetically more accepted as it has less postoperative complications. Also Z plasty flap has a major limitation as it is difficult to apply if there is a wide defect in the horizontal axis.
Boundary Control Problem of Infinite Order Distributed Hyperbolic Systems Involving Time Lags  [PDF]
Bahaa Gaber Mohamed
Intelligent Control and Automation (ICA) , 2012, DOI: 10.4236/ica.2012.33024
Abstract: Various optimal boundary control problems for linear infinite order distributed hyperbolic systems involving constant time lags are considered. Constraints on controls are imposed. Necessary and sufficient optimality conditions for the Neumann problem with the quadratic performance functional are derived.
Effects of the 2003 European heatwave on the Central Mediterranean Sea: surface fluxes and the dynamical response
A. Olita,R. Sorgente,S. Natale,S. Gaber?ek
Ocean Science (OS) & Discussions (OSD) , 2007,
Abstract: The effects of the 2003 European heatwave on the sea surface layer of the Central Mediterranean were studied using a regional 3-D ocean model. The model was used to simulate the period 2000 to 2004 and its performance was validated using remotely-sensed and in situ data. Analysis of the results focused on changes in the Sea Surface Temperature (SST) and on changes to the surface and sub-surface current field. This permitted us to identify and quantify the anomalies of atmospheric and sea surface parameters that accompanied the heatwave. The dominant annual cycle in each variable was first removed and a wavelet analysis then used to locate anomalies in the time-frequency domain. We found that the excess heating affecting the sea surface in the summer of 2003 was related to a significant increase in air temperature, a decrease in wind stress and reduction of all components of the upward heat flux. The monthly averages of the model SST were found to be in good agreement with remotely-sensed data during the period studied, although the ocean model tended to underestimate extreme events. The spatial distribution of SST anomalies as well as their time-frequency location was similar for both the remotely-sensed and model temperatures. We also found, on the basis of the period of the observed anomaly, that the event was not limited to the few summer months of 2003 but was part of a longer phenomenon. Both the model results and experimental data suggest the anomalous heating mainly affected the top 15 m of ocean and was associated with strong surface stratification and low mixing. The skill of the model to reproduce the sub-surface hydrographic features during the heatwave was checked by comparison with temperature and salinity measurements. This showed that the model was generally in good agreement with observations. The model and observations showed that the anomalous warming also modified the currents in the region, most noticeably the Atlantic Ionian Stream (AIS) and the Atlantic Tunisian Current (ATC). The AIS was reduced in intensity and showed less meandering, mainly due to the reduced density gradient and low winds, while the ATC was enhanced in strength, the two currents appearing to modulate each other in order to conserve the total transport of Modified Atlantic Water.
The Sicily Channel Regional Model forecasting system: initial boundary conditions sensitivity and case study evaluation
S. Gaber?ek,R. Sorgente,S. Natale,A. Ribotti
Ocean Science Discussions (OSD) , 2006,
Abstract: The Sicily Channel Regional Model forecasting system was tested using an optimization package for the initial and lateral boundary conditions. Spurious high frequency oscillations during the spin-up time were successfully reduced both in duration and magnitude by optimizing the time tendency of the free surface elevation using the Variational Initialization and Forcing Platform method developed in the framework of the Mediterranean Forecasting System Towards the Environmental Prediction project. The effect of optimization was most profound for the free surface elevation, where all oscillations with periods shorter than 4 h were suppressed. The overall forecast skill was assessed on a 5 day case study starting on 6 April 2005, characterized by a fast passage of a deepening atmospheric low-pressure field with strong winds and marked wind direction change. We compared the predicted variables with in-situ and remotely sensed data. The forecasts of temperature, including the sea surface temperature, and salinity were quite successful, while the forecasted currents, especially within the surface layer, were not in good agreement with the measurements.
The Sicily Channel Regional Model forecasting system: initial boundary conditions sensitivity and case study evaluation
S. Gaber?ek,R. Sorgente,S. Natale,A. Ribotti
Ocean Science (OS) & Discussions (OSD) , 2007,
Abstract: The Sicily Channel Regional Model forecasting system was tested using an optimization package for the initial and lateral boundary conditions. Spurious high frequency oscillations during the spin-up time were successfully reduced both in duration and magnitude by optimizing the time tendency of the free surface elevation using the Variational Initialization and Forcing Platform method developed in the framework of the Mediterranean Forecasting System Towards the Environmental Prediction project. The effect of optimization was most profound for the free surface elevation, where all oscillations with periods shorter than 4 h were suppressed. The overall forecast skill was assessed on a 5 day case study starting on 6 April 2005, characterized by a fast passage of a deepening atmospheric low–pressure field with strong winds and marked wind direction change. We compared the predicted variables with in–situ and remotely sensed data. The forecasts of temperature, including the sea surface temperature, and salinity were quite successful, while the forecasted currents, especially within the surface layer, were not in good agreement with the measurements.
Central Mediterranean Sea forecast: effects of high-resolution atmospheric forcings
S. Natale,R. Sorgente,S. Gaber?ek,A. Ribotti
Ocean Science Discussions (OSD) , 2006,
Abstract: Ocean forecasts over the Central Mediterranean, produced by a near real time regional scale system, have been evaluated in order to assess their predictability. The ocean circulation model has been forced at the surface by a medium, high or very high resolution atmospheric forcing. The simulated ocean parameters have been compared with satellite data and they were found to be generally in good agreement. High and very high resolution atmospheric forcings have been able to form noticeable, although short-lived, surface current structures, due to their ability to detect transient atmospheric disturbances. The existence of the current structures has not been directly assessed due to lack of measurements. The ocean model in the slave mode was not able to develop dynamics different from the driving coarse resolution model which provides the boundary conditions.
Dynamics of semifluxons in Nb long Josephson 0-pi junctions
E. Goldobin,A. Sterck,T. Gaber,D. Koelle,R. Kleiner
Physics , 2003, DOI: 10.1103/PhysRevLett.92.057005
Abstract: We propose, implement and test experimentally long Josephson 0-pi junctions fabricated using conventional Nb-AlOx-Nb technology. We show that using a pair of current injectors, one can create an arbitrary discontinuity of the Josephson phase and in particular a pi-discontinuity, just like in d-wave/s-wave or in d-wave/d-wave junctions, and study fractional Josephson vortices which spontaneously appear. Moreover, using such junctions, we can investigate the \emph{dynamics} of the fractional vortices -- a domain which is not yet available for natural 0-pi-junctions due to their inherently high damping. We observe half-integer zero-field steps which appear on the current-voltage characteristics due to hopping of semifluxons.
Parallel Graph Transformation based on Merged Approach
Asmaa Aouat
IAES International Journal of Robotics and Automation (IJRA) , 2013, DOI: 10.11591/ijra.v2i2.1610
Abstract: Graph transformation is one of the key concepts in graph grammar. In order to accelerate the graph transformation, the concept of parallel graph transformation has been proposed by different tools such as AGG tool. The theory of parallel graph transformation used by AGG just allows clarifying the concepts of conflict and dependency between the transformation rules. This work proposes an approach of parallel graph transformations which enables dependent transformation rules to be executed in parallel.
Fiscal stimulations for improving the business environment in Republic of Macedonia
Stevan Gaber
Perspectives of Innovations, Economics and Business , 2009,
Abstract: In conditions when the national economy is hit hard with catastrophic economic consequences from financial crises, mutual coordinative approach between fiscal authorities and independent monetary institution, entrusted for macroeconomic stability, is particularly essential. This paper focuses on the situation, when there is not, at least temporary, constructive dialog between the two most important institutions in the country, and consequences are paid by enterprises and citizens.
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