Fifty Years of Innovation in Plastic Surgery

Richard M Kwasnicki,Archie Hughes-Hallett,Hani J Marcus,Guang-Zhong Yang,Ara Darzi,Shehan Hettiaratchy 대한성형외과학회 2016 Archives of Plastic Surgery Vol.43 No.2

Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

Fifty Years of Innovation in Plastic Surgery

Kwasnicki, Richard M,Hughes-Hallett, Archie,Marcus, Hani J,Yang, Guang-Zhong,Darzi, Ara,Hettiaratchy, Shehan Korean Society of Plastic and Reconstructive Surge 2016 Archives of Plastic Surgery Vol.43 No.2

Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

Buddhist Economic Philosophy

S. B. Hettiaratchi 동국대학교 불교사회문화연구원 2005 불교문화연구 Vol.6 No.-

Ancestry of Sakyamuni Buddha and its Expansion to Sri Lanka a Socio-political Problem

S.B. Hettiaratchi 동국대학교 불교사회문화연구원 2009 불교문화연구 Vol.10 No.1

열대 매립지에서 메탄발생을 평가하기 위한 탄소 수지

( J. P. A. Hettiaratchi ),( J. Sanderson ),( V. B. Stein ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.2

지구상의 위생 매립지로부터의 배출은, 대기 중으로 인위적인 CH₄ 배출의 약 10-15%를 차지하는 것으로 평가된다. 매립지 CH₄배출조사의 대부분은 북미와 유럽의 매립지에서 실행되었다. 비록 세계 인구의 2/3이상이 열대 개발도상국에서 살지라도, 이러한 국가에 자리잡은 매립지로부터 배출되는 CH₄는 거의 알려져 있지 않다. 본 논문은 대략 1백만톤의 도시고형 폐기물을 배출하는 Chile의 진행 중인 매립지에서 조사되어진, 일반적인 배출특성에 관해 서술한다. 매립지는 매립가스 수집시스템과 침출수를 갖추고 있다. 수집된 침출수는 생물학적 반응으로 매립지의 진행을 위해 재순환된다. 조사하는 동안, 가스 배출원의 종류를 가스 소각시설, 20개의 끓어진 gas well, 표면배출과 침출수의 수집부과 관련된 “hot spots”으로부터 배출을 명확히 하였다. 총 232 flux chamber의 측정은 매립지의 23hectare 지역에서 실행하였다. 측정된 메탄과 이산화탄소의 평균 배출비율은 각각 172g/m²·day와 389g/m²·day이다. 이러한 평균 배줄비율은 평균 배출 비율이 CH₄ 13,230g/m²·day, CO² 23,290g/m²·day인 4개의 “hot spots”은 포함되어 있지 않다. 비록 침출수 수집부 “hot spots”이 매립지의 표면적에 적은 비율을 차지하고 있더라도, 총 매립지 가스 배출량의 대략 절반을 차지한다. 모든 요인을 포함하면, 이 매립지의 배출은 CH₄ 32,800ton/y와 CO₂ 65,000ton/y으로 측정된다. 조사된 데이터는 매립지의 탄소 물질수지를 세우기 위해서 분석되었다. 북미와 유럽의 매립지를 비교하면, Chile 매립지는 단기간에 많은 량의 가스를 배출하였다. 이러한 조사는 많은 강우와 같은 기후적인 요소, 폐기물내 높은 유기물의 함량과 같은 폐기물의 구성인자로 인한 것이다. Emissions from sanitary landfills around the world are estimated to account for about 10-15% of the worldwide anthropogenic CH4 emissions into the atmosphere. To date, most of the research on landfill CH₄ emissions has been directed at landfills in North America and Europe. Although more than two- thirds of the world population lives in tropical developing countries, very little is known of CH₄ emissions from landfills located in those countries. This paper presents results from a comprehensive emission characterization survey conducted at an operating landfill in Chile that receives approximately one million tonnes of municipal solid waste annually. The landfill is equipped with state-of-the-art leachate and landfill gas collection systems. The collected leachate is re-circulated to enable operation of the landfill as a bioreactor. During the survey, several categories of gas emission sources were identified: a gas incinerator connected to a network of wells, 20 disconnected gas wells, surface emissions and emissions from “hot spots” associated with leachate pools. A total of 232 flux chamber measurements were made over the 23-hectare surface area of the landfill. The average flux rates of methane and carbon dioxide measured were 172 g*m^-2*day^-1 and 389 g*m^-2day^-1, respectively. These average flux-rates do not include the contribution made by the four hot spots which had average emission rates of 13,230 g*m^-2day^-1 CH₄ and 23,290 g*m^-2*day^-1 CO₂. Although the leachate pool “hot spots” accounted for a small portion of the landfill’s surface area, they accounted for approximately half of the total landfill gas emissions. Including all sources, the emissions for this landfill were estimated to be 32,800 tonnes/year CH₄ and 65,000 tonnes/year CO₂. The collected data was analysed to develop a carbon balance model for the landfill. Results show that in comparison to landfills in North America and Europe, the Chilean landfill produces higher gas quantities over shorter time periods. This observation is to the climatic factors, such as high rainfall, and waste composition factors such as high organic content of the waste.

열대지방의 침출수 재순환 매립지: 잠재적인 응용성과 고려 사항

( J. P. A. Hettiaratchi ),( V. B. Stein ),( C. Viswanathan ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.2

생물반응기 또는 바이오셀 매립지로 알려진, 침출수 재순환형 매립지는 높은 수준의 지하수 오염 방지, 매립지 침출수 처리의 경제적인 효율, 높은 에너지 잠재력이 있는 바이오가스의 증가, 매립지 지역의 보존, 매립된 폐기물에서 자원회수 등의 잠재력으로, 각 계절에 따른 일반적인 매립지의 대안으로 알려져 있다. 이러한 매립지는 최적조건에서 메탄생성을 위해 혐기성으로 조절하거나, 매립지의 혼합에 의한 배양토를 생성하기 위한 호기성 형식이나, 자원회수를 위해 잇따른 혼합으로 따른 호기성 형식으로 조절한다. 일반적인 매립지와 침출수 재순환 매립지에는 설계와 운영면에서 비슷한 점이 있더라도 많은 다른 점이 있다. 게다가, 침출수 재순환형 매립지는 각각 새로운 개념, 설계, 운영특징을 여전히 발전시키고 있다. 본 논문에서는 열대 개발도상국에서 적용하는 운영방식과 설계에 정밀한 재감토를 기본적으로 하여 두 가지 개념의 매립방식의 형태를 비교한다. 침출수 재순환형 매립지의 개념은 비교적 수분함량이 낮고 도시고형 폐기물이 음식 폐기물보다 적은 비율을 차지하고 있는 북미가 기원이다. 한편, 열대 개발도상국의 도시고형 폐기불은 음식폐기물과 같은 생분해가 가능한 유기물질의 비율이 높다. 게다가, 열대 도시고형 폐기물의 수분함량은 다른 기후의 개발도상국의 폐기물에 비해 높다. 그러므로, 만약 이러한 자체로 열대 개발도상국에 적용한다면, 설계와 운영에 심각한 변화가 주어져야 할 것이다. The leachate re-circulation landfill, also known as landfill bioreactor or landfill biocell, is being touted as an alternative to the conventional landfill for several reasons, including: the potential to achieve a high level of groundwater contamination control, cost-efficient management of landfill leachate, increased production of biogas with high energy potential, the possibility of conserving landfill space and recovering resources from the landfilled waste. These landfills can be operated anaerobically for optimum methane production and/or aerobically to produce compost to be recovered by landfill mining, or sequentially under anaerobic mode followed by aerobic operation with subsequent mining for resource recovery. Although there are a number of design and operational similarities between conventional landfills and leachate re-circulation landfills, a large number of differences also exist. Furthermore, leachate re-circulation landfill being a relatively new concept, design, and operational features are still evolving. This paper contrasts the features of the two concepts of landfilling based on a critical review of the design and operation practices as applied in tropical developing countries. The leachate re-circulation landfill concept has its origins in North America, where municipal solid waste has a smaller percentage of food waste and relatively low initial moisture content. On the other hand, solid waste generated in municipalities of tropical developing countries contains a large percentage of biodegradable organic material such as food wastes. Furthermore, the initial moisture content of tropical solid waste is much higher than that of waste produced in temperate or cold climates of the developed world. Therefore, if this concept is to be adopted in tropical developing countries, with its accrued benefits noted above, serious considerations should be given to design and operational changes that need to be made.

LEACHATE RE-CIRCULATION LANDFILLS IN TROPICAL CLIMATES: POTENTIAL APPLICATIONS AND SPECIAL CONSIDERATIONS

( J. P. A. Hettiaratchi ),( V. B. Stein ),( C. Viswanathan ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.1

The leachate re-circulation landfill, also known as landfill bioreactor or landfill biocell, is being touted as an alternative to the conventional landfill for several reasons, including: the potential to achieve a high level of groundwater contamination control, cost-efficient management of landfill leachate, increased production of biogas with high energy potential, the possibility of conserving landfill space and recovering resources from the landfilled waste. These landfills can be operated anaerobically for optimum methane production and/or aerobically to produce compost to be recovered by landfill mining, or sequentially under anaerobic mode followed by aerobic operation with subsequent mining for resource recovery. Although there are a number of design and operational similarities between conventional landfills and leachate re-circulation landfills, a large number of differences also exist. Furthermore, leachate recirculation landfill being a relatively new concept, design, and operational features are still evolving. This paper contrasts the features of the two concepts of landfilling based on a critical review of the design and operation practices as applied in tropical developing countries. The leachate re-circulation landfill concept has its origins in North America, where municipal solid waste has a smaller percentage of food waste and relatively low initial moisture content. On the other hand, solid waste generated in municipalities of tropical developing countries contains a large percentage of biodegradable organic material such as food wastes. Furthermore, the initial moisture content of tropical solid waste is much higher than that of waste produced in temperate or cold climates of the developed world. Therefore, if this concept is to be adopted in tropical developing countries, with its accrued benefits noted above, serious considerations should be given to design and operational changes that need to be made.

A CARBON BALANCE APPROACH TO ESTIMATE METHANE EMISSIONS FROM TROPICAL LANDFILLS

( J. P. A. Hettiaratchi ),( J. Sanderson ),( V. B. Stein ) 한국폐기물자원순환학회 2002 APLAS Vol.2002 No.1

Emissions from sanitary landfills around the world are estimated to account for about 10-15% of the worldwide anthropogenic CH₄ emissions into the atmosphere. To date, most of the research on landfill CH₄ emissions has been directed at landfills in North America and Europe. Although more than two-thirds of the world population lives in tropical developing countries, very little is known of CH₄ emissions from landfills located in those countries. This paper presents results from a comprehensive emission characterization survey conducted at an operating landfill in Chile that receives approximately one million tonnes of municipal solid waste annually. The landfill is equipped with state-of- the-art leachate and landfill gas collection systems. The collected leachate is re-circulated to enable operation of the landfill as a bioreactor. During the survey, several categories of gas emission sources were identified: a gas incinerator connected to a network of wells, 20 disconnected gas wells, surface emissions and emissions from “hot spots” associated with leachate pools. A total of 232 flux chamber measurements were made over the 23-hectare surface area of the landfill. The average flux rates of methane and carbon dioxide measured were 172 g*m^-2*day^-1 and 389 g*m^-2*day^-1, respectively. These average flux-rates do not include the contribution made by the four hot spots which had average emission rates of 13,230 g*m^-2*day^-1 CH₄ and 23,290 g*m^-2*day^-1 CO₂. Although the leachate pool “hot spots” accounted for a small portion of the landfill's surface area, they accounted for approximately half of the total landfill gas emissions. Including all sources, the emissions for this landfill were estimated to be 32,800 tonnes/year CH₄ and 65,000 tonnes/year CO₂. The collected data was analysed to develop a carbon balance model for the landfill. Results show that in comparison to landfills in North America and Europe, the Chilean landfill produces higher gas quantities over shorter time periods. This observation is to the climatic factors, such as high rainfall, and waste composition factors such as high organic content of the waste.