Pre-operative embolization of hypervascular spinal metastasis using percutaneous direct intra-tumoural injection with Onyx under local anesthesia.

PubMed

Lim, Kai-Zheong; Goldschlager, Tony; Chandra, Ronil V

2017-10-01

Intra-operative blood loss remains a major cause of perioperative morbidity for patients with hypervascular spinal metastasis undergoing surgery. Pre-operative embolization is used to reduce intraoperative blood loss and operative time. This is commonly performed under general anesthesia via a trans-arterial approach, which carries a risk of spinal stroke. We propose an alternative technique for embolization of hypervascular metastases using the Onyx embolic agent via a percutaneous direct intra-tumoural injection under local anesthesia and sedation to reduce embolization risks and procedure time, as well as operative blood loss and operative time. A 74-year-old man presented with thoracic myelopathy with back and radicular pain on background of metastatic renal cell carcinoma. Magnetic resonance imaging (MRI) revealed a 3cm mass centered on the right lamina of T10 with extension into the spinal canal. The patient underwent a percutaneous imaging-guided direct intra-tumoural contrast parenchymogram, and Onyx embolization via a single needle. Initial needle placement and tumour assessment was completed in 30min; embolization time was 15min. Complete devascularization was achieved with no complications. Surgical resection was performed with lower than expected operative blood loss (150ml) and operative time (90min). His pre-operative symptoms improved, and he was discharged home the following day. At 6-month follow-up there was no recurrence of his symptoms. Further evaluation of direct percutaneous intra-tumoural Onyx embolization for hypervascular spinal tumours is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcome of renal transplantation with and without intra-operative diuretics.

PubMed

Hanif, F; Macrae, A N; Littlejohn, M G; Clancy, M J; Murio, E

2011-01-01

This paper presents an e-survey of current clinical practice of use of intra-operative diuretics during renal transplantation in the United Kingdom and a study to compare outcome of renal transplants carried out with or without intra-operative diuretics in our centre. An e-mail questionnaire to renal transplant surgeons exploring their practice of renal transplantation with or without intra-operative diuretics, the type of a diuretic/s if used and the relevant doses. An observational study comparing the outcome of renal transplant recipients, group no-diuretics (GND, n = 80) carried out from 2004 to 2008 versus group diuretics (GD n = 69) renal transplant recipients who received intra-operative diuretics over a one year period is presented. Outcome measures were incidence of delayed graft function and a comparison of graft survival in both groups. Forty surgeons answered from 18 transplant centres with a response rate of 67%. 13 surgeons do not use diuretics. Mannitol is used by 10/40, Furosemide 6/40 and 11 surgeons use a combination of both. In comparative study there was no significant overall difference in one year graft survival of GD versus GND (N = 65/69, 94% and 75/80, 94% respectively, p = 0.08) and the incidence of delayed graft function was also comparable (16/69, 23% and 21/80, 26% respectively, p = 0.07). The donor characteristics in both groups were comparable. The study showed variation in clinical practice on the use of intra-operative diuretics in renal transplantation and it did not demonstrate that the use of diuretics can improve renal graft survival. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Intra-operative measurement of applied forces during anterior scoliosis correction.

PubMed

Fairhurst, H; Little, J P; Adam, C J

2016-12-01

Spinal instrumentation and fusion for the treatment of scoliosis is primarily a mechanical intervention to correct the deformity and halt further progression. While implant-related complications remain a concern, little is known about the magnitudes of the forces applied to the spine during surgery, which may affect post-surgical outcomes. In this study, the compressive forces applied to each spinal segment during anterior instrumentation were measured in a series of patients with Adolescent Idiopathic Scoliosis. A force transducer was designed and retrofit to a routinely used surgical tool, and compressive forces applied to each segment during surgery were measured for 15 scoliosis patients. Cobb angle correction achieved by each force was measured on intra-operative fluoroscope images. Relative changes in orientation of the screw within the vertebra were also measured to detect intra-operative screw plough. Intra-operative forces were measured for a total of 95 spinal segments. The mean applied compressive force was 540N (SD 230N, range 88N-1019N). There was a clear trend for higher forces to be applied at segments toward the apex of the scoliosis. Fluoroscopic evidence of screw plough was detected at 10 segments (10.5%). The magnitude of forces applied during anterior scoliosis correction vary over a broad range. These forces do reach magnitudes capable of causing intra-operative vertebral body screw plough. Surgeons should be aware there is a risk for tissue overload during correction, however the clinical implications of intra-operative screw plough remain unclear. The dataset presented here is valuable for providing realistic input parameters for in silico surgical simulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pediatric awake craniotomy and intra-operative stimulation mapping.

PubMed

Balogun, James A; Khan, Osaama H; Taylor, Michael; Dirks, Peter; Der, Tara; Carter Snead Iii, O; Weiss, Shelly; Ochi, Ayako; Drake, James; Rutka, James T

2014-11-01

The indications for operating on lesions in or near areas of cortical eloquence balance the benefit of resection with the risk of permanent neurological deficit. In adults, awake craniotomy has become a versatile tool in tumor, epilepsy and functional neurosurgery, permitting intra-operative stimulation mapping particularly for language, sensory and motor cortical pathways. This allows for maximal tumor resection with considerable reduction in the risk of post-operative speech and motor deficits. We report our experience of awake craniotomy and cortical stimulation for epilepsy and supratentorial tumors located in and around eloquent areas in a pediatric population (n=10, five females). The presenting symptom was mainly seizures and all children had normal neurological examinations. Neuroimaging showed lesions in the left opercular (n=4) and precentral or peri-sylvian regions (n=6). Three right-sided and seven left-sided awake craniotomies were performed. Two patients had a history of prior craniotomy. All patients had intra-operative mapping for either speech or motor or both using cortical stimulation. The surgical goal for tumor patients was gross total resection, while for all epilepsy procedures, focal cortical resections were completed without any difficulty. None of the patients had permanent post-operative neurologic deficits. The patient with an epileptic focus over the speech area in the left frontal lobe had a mild word finding difficulty post-operatively but this improved progressively. Follow-up ranged from 6 to 27 months. Pediatric awake craniotomy with intra-operative mapping is a precise, safe and reliable method allowing for resection of lesions in eloquent areas. Further validations on larger number of patients will be needed to verify the utility of this technique in the pediatric population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Intra-Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience

PubMed Central

Arshad, Nur Zaiti Md; Ng, Beng Kwang; Paiman, Noor Asmaliza Md; Mahdy, Zaleha Abdullah; Noor, Rushdan Mohd

2018-01-01

Background: Accuracy of diagnosis with intra-operative frozen sections is extremely important in the evaluation of ovarian tumors so that appropriate surgical procedures can be selected. Study design: All patients who with intra-operative frozen sections for ovarian masses in a tertiary center over nine years from June 2008 until April 2017 were reviewed. Frozen section diagnosis and final histopathological reports were compared. Main outcome measures: Sensitivity, specificity, positive and negative predictive values of intra-operative frozen section as compared to final histopathological results for ovarian tumors. Results: A total of 92 cases were recruited for final evaluation. The frozen section diagnoses were comparable with the final histopathological reports in 83.7% of cases. The sensitivity, specificity, positive predictive value and negative predictive value for benign and malignant ovarian tumors were 95.6%, 85.1%, 86.0% and 95.2% and 69.2%, 100%, 100% and 89.2% respectively. For borderline ovarian tumors, the sensitivity and specificity were 76.2% and 88.7%, respectively; the positive predictive value was 66.7% and the negative predictive value was 92.7%. Conclusion: The accuracy of intra-operative frozen section diagnoses for ovarian tumors is high and this approach remains a reliable option in assessing ovarian masses intra-operatively. PMID:29373916

Effects of intra-operative fluoroscopic 3D-imaging on peri-operative imaging strategy in calcaneal fracture surgery.

PubMed

Beerekamp, M S H; Backes, M; Schep, N W L; Ubbink, D T; Luitse, J S; Schepers, T; Goslings, J C

2017-12-01

Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging (2D-imaging). The aim of this study was to assess the effects of additional 3D-imaging on intra-operative corrections, peri-operative imaging used, and patient-relevant outcomes compared to 2D-imaging alone. In this before-after study, data of adult patients who underwent open reduction and internal fixation (ORIF) of a calcaneal fracture between 2000 and 2014 in our level-I Trauma center were collected. 3D-imaging (BV Pulsera with 3D-RX, Philips Healthcare, Best, The Netherlands) was available as of 2007 at the surgeons' discretion. Patient and fracture characteristics, peri-operative imaging, intra-operative corrections and patient-relevant outcomes were collected from the hospital databases. Patients in whom additional 3D-imaging was applied were compared to those undergoing 2D-imaging alone. A total of 231 patients were included of whom 107 (46%) were operated with the use of 3D-imaging. No significant differences were found in baseline characteristics. The median duration of surgery was significantly longer when using 3D-imaging (2:08 vs. 1:54 h; p = 0.002). Corrections after additional 3D-imaging were performed in 53% of the patients. However, significantly fewer corrections were made after 2D-imaging when 3D-imaging was available (Risk difference (RD) -15%; 95% Confidence interval (CI) -29 to -2). Peri-operative imaging, besides intra-operative 3D-imaging, and patient-relevant outcomes were similar between groups. Intra-operative 3D-imaging provides additional information resulting in additional corrections. Moreover, 3D-imaging probably changed the surgeons' attitude to rely more on 3D-imaging, hence a 15%-decrease of

Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases.

PubMed Central

Wadley, J.; Dorward, N.; Kitchen, N.; Thomas, D.

1999-01-01

Operative neurosurgery has recently entered an exciting era of image guided surgery or neuronavigation and application of this novel technology is beginning to have a significant impact in many ways in a variety of intracranial procedures. In order to fully assess the advantages of image guided techniques over conventional planning and surgery in selected cases, detailed prospective evaluation has been carried out during the advanced development of an optically tracked neuronavigation system. Over a 2-year period, 300 operative neurosurgical procedures have been performed with the assistance of interactive image guidance, as well as the development of new software applications and hardware tools. A broad range of intracranial neurosurgical procedures were seen to benefit from image guidance, including 163 craniotomies, 53 interactive stereotactic biopsies, 7 tracked neuroendoscopies and 37 complex skull base procedures. The most common pathological diagnoses were cerebral glioma in 98 cases, meningioma in 64 and metastasis in 23. Detailed analysis of a battery of postoperative questions revealed benefits in operative planning, appreciation of anatomy, lesion location, safety of surgery and greatly enhanced surgical confidence. The authors believe that image guided surgical technology, with new developments such as those described, has a significant role to play in contemporary neurosurgery and its widespread adoption in practice will be realised in the near future. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:10615186

Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

PubMed

Siu, Joey; Maran, Nikki; Paterson-Brown, Simon

2016-06-01

The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Intra-operative visualization of brain tumors with 5-aminolevulinic acid-induced fluorescence.

PubMed

Widhalm, Georg

2014-01-01

Precise histopathological diagnosis of brain tumors is essential for the correct patient management. Furthermore, complete resection of brain tumors is associated with an improved patient prognosis. However, histopathological undergrading and incomplete tumor removal are not uncommon, especially due to insufficient intra-operative visualization of brain tumor tissue. The fluorescent dye 5-aminolevulinic acid (5-ALA) is currently applied for fluorescence-guided resections of high-grade gliomas. The value of 5-ALA-induced protoporphyrin (PpIX) fluorescence for intra-operative visualization of other tumors than high-grade gliomas remains unclear. Within the frame of this thesis, we found a significantly higher rate of complete resections of our high-grade gliomas as compared to control cases by using the newly established 5-ALA fluorescence technology at our department. Additionally, we showed that MRI spectroscopy-based chemical shift imaging (CSI) is capable to identify intratumoral high-grade glioma areas (= anaplastic foci) during navigation guided resections to avoid histopathological undergrading. However, the accuracy of navigation systems with integrated pre-operative imaging data such as CSI declines during resections due to intra-operative brainshift. In two further studies, we found that 5-ALA induced PpIX fluorescence is capable as a novel intra-operative marker to detect anaplastic foci within initially suspected low-grade gliomas independent of brainshift. Finally, we showed that the application of 5-ALA is also of relevance in needle biopsies for intra-operative identification of representative brain tumor tissue. These data indicate that 5-ALA is not only of major importance for resection of high-grade gliomas, but also for intra-operative visualization of anaplastic foci as well as representative brain tumor tissue in needle biopsies unaffected by brainshift. Consequently, this new technique might become a novel standard in brain tumor surgery that

Intra-operative characterisation of subthalamic oscillations in Parkinson’s disease

PubMed Central

Geng, Xinyi; Xu, Xin; Horn, Andreas; Li, Ningfei; Ling, Zhipei; Brown, Peter; Wang, Shouyan

2018-01-01

Objective This study aims to use the activities recorded directly from the deep brain stimulation (DBS) electrode to address the focality and distinct nature of the local field potential (LFP) activities of different frequency. Methods Pre-operative and intra-operative magnetic resonance imaging (MRI) were acquired from patients with Parkinson’s disease (PD) who underwent DBS in the subthalamic nucleus and intra-operative LFP recording at rest and during cued movements. Images were reconstructed and 3-D visualized using Lead-DBS® toolbox to determine the coordinates of contact. The resting spectral power and movement-related power modulation of LFP oscillations were estimated. Results Both subthalamic LFP activity recorded at rest and its modulation by movement had focal maxima in the alpha, beta and gamma bands. The spatial distribution of alpha band activity and its modulation was significantly different to that in the beta band. Moreover, there were significant differences in the scale and timing of movement related modulation across the frequency bands. Conclusion Subthalamic LFP activities within specific frequency bands can be distinguished by spatial topography and pattern of movement related modulation. Significance Assessment of the frequency, focality and pattern of movement related modulation of subthalamic LFPs reveals a heterogeneity of neural population activity in this region. This could potentially be leveraged to finesse intra-operative targeting and post-operative contact selection. PMID:29567582

Outcome Determining Factors for displaced Intra-articular Calcaneal Fractures treated operatively

PubMed Central

Chan, KL; Idham, HM; Izani, IM; Nahulan, T

2015-01-01

Introduction: Calcaneal fractures are caused by high energy trauma and mostly are intra-articular fractures. Nondisplaced intra-articular calcaneal fracture (IACF) can be treated non-operatively. However, displaced intra-articular need to be reduced and fixed anatomically to facilitate early ankle rehabilitation and minimize functional impairment. This study was done to find out the outcome of the IACF patients who underwent operative treatment. Methods: 62 patients with IACF were selected in this study and had been followed up from June 2009 to May 2013. They were placed into two groups; the operative treated and non-operative treated groups. Bilateral ankle lateral view plain radiographs were taken for comparison of the Bohler and Gissane angles. Both groups of patients were assessed by the Maryland Foot Score (MFS) and the SF-36v2 general health survey questionnaire. The ability of the patients to perform activity of daily living (ADL) and /or return to work (RTW) was assessed as well. Results: The operative treatment group of displaced IACF patients achieved no significant better scores in the mean MFS and SF-36v2 mean scores as compared to non operated cases. There was no difference in RTW between the 2 groups, but earlier ADL was recorded in the operated group. However, this study had found 5 associated factors which causes major effect to the patients’ outcome to treatment. Conclusions: The patient’s compliance with post-operative rehabilitation regimen were found to be significantly related with the outcomes. PMID:28611903

7 CFR 272.2 - Plan of operation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 60 days prior to implementation. Minor changes to approved sampling plans shall be submitted at least... Plan of Operation. The State and FNS (USDA) further agree to fully comply with any changes in Federal... effect that, no person in the United States shall, on the grounds of sex, race, color, age, political...

7 CFR 272.2 - Plan of operation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 60 days prior to implementation. Minor changes to approved sampling plans shall be submitted at least... Plan of Operation. The State and FNS (USDA) further agree to fully comply with any changes in Federal... effect that, no person in the United States shall, on the grounds of sex, race, color, age, political...

7 CFR 272.2 - Plan of operation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 60 days prior to implementation. Minor changes to approved sampling plans shall be submitted at least... Plan of Operation. The State and FNS (USDA) further agree to fully comply with any changes in Federal... effect that, no person in the United States shall, on the grounds of sex, race, color, age, political...

[Identification and management of intra-operative suspicious tissues in 20 transsphenoidal surgery cases].

PubMed

Liu, Jun-Feng; Ke, Chang-Shu; Chen, Xi; Xu, Yu; Zhang, Hua-Qiu; Chen, Juan; Gan, Chao; Li, Chao-Xi; Lei, Ting

2013-05-01

To determine appropriate protocols for the identification and management of intra operative suspicious tissues during transsphenoidal surgery. Clinical data and pathological reports of 20 patients with intra-operative suspicious tissues during transsphenoidal surgeries were analyzed retrospectively. The methods for discriminating between adenoma and normal pituitary tissues were reviewed. The postoperative pathological reports revealed that adenoma and normal pituitary tissues coexisted in 9 samples, while 5 samples were identified as normal pituitary tissues, 2 as adenoma tissues, and 4 as other tissues. Adenomas were distinguished from normal pituitary tissues on the basis of intra-operative appearance, texture, blood supply and possible existence of boundary. If decisions are difficult to made during surgeries from the appearance of the suspicious tissues, pathological examinations are advised as a guidance for the next steps.

Benefits to blood banks of a sales and operations planning process.

PubMed

Keal, Donald A; Hebert, Phil

2010-12-01

A formal sales and operations planning (S&OP) process is a decision making and communication process that balances supply and demand while integrating all business operational components with customer-focused business plans that links high level strategic plans to day-to-day operations. Furthermore, S&OP can assist in managing change across the organization as it provides the opportunity to be proactive in the face of problems and opportunities while establishing a plan for everyone to follow. Some of the key outcomes from a robust S&OP process in blood banking would include: higher customer satisfaction (donors and health care providers), balanced inventory across product lines and customers, more stable production rates and higher productivity, more cooperation across the entire operation, and timely updates to the business plan resulting in better forecasting and fewer surprises that negatively impact the bottom line. © 2010 American Association of Blood Banks.

Rotational X-ray angiography: a method for intra-operative volume imaging of the left-atrium and pulmonary veins for atrial fibrillation ablation guidance

NASA Astrophysics Data System (ADS)

Manzke, R.; Zagorchev, L.; d'Avila, A.; Thiagalingam, A.; Reddy, V. Y.; Chan, R. C.

2007-03-01

Catheter-based ablation in the left atrium and pulmonary veins (LAPV) for treatment of atrial fibrillation in cardiac electrophysiology (EP) are complex and require knowledge of heart chamber anatomy. Electroanatomical mapping (EAM) is typically used to define cardiac structures by combining electromagnetic spatial catheter localization with surface models which interpolate the anatomy between EAM point locations in 3D. Recently, the incorporation of pre-operative volumetric CT or MR data sets has allowed for more detailed maps of LAPV anatomy to be used intra-operatively. Preoperative data sets are however a rough guide since they can be acquired several days to weeks prior to EP intervention. Due to positional and physiological changes, the intra-operative cardiac anatomy can be different from that depicted in the pre-operative data. We present an application of contrast-enhanced rotational X-ray imaging for CT-like reconstruction of 3D LAPV anatomy during the intervention itself. Depending on the heart size a single or two selective contrastenhanced rotational acquisitions are performed and CT-like volumes are reconstructed with 3D filtered back projection. In case of dual injection, the two volumes depicting the left and right portions of the LAPV are registered and fused. The data sets are visualized and segmented intra-procedurally to provide anatomical data and surface models for intervention guidance. Our results from animal and human experiments indicate that the anatomical information from intra-operative CT-like reconstructions compares favorably with preacquired imaging data and can be of sufficient quality for intra-operative guidance.

[Operative treatment of displaced intra-articular calcaneal fractures].

PubMed

Zwipp, H; Rammelt, S; Amlang, M; Pompach, M; Dürr, C

2013-12-01

Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was

Value of intra-operative neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy for benign goitre.

PubMed

Page, C; Cuvelier, P; Biet, A; Strunski, V

2015-06-01

This study aimed to evaluate the impact of intra-operative neuromonitoring of the recurrent laryngeal nerve during total thyroidectomy for benign goitre. A single-centre retrospective study using historical controls was conducted for a 10-year period, comprising a series of 767 patients treated by total thyroidectomy for benign goitre. Of these, 306 had intra-operative neuromonitoring of the recurrent laryngeal nerve and 461 did not. Post-operative laryngeal mobility was assessed in all patients by direct laryngoscopy before hospital discharge and at post-operative follow-up visits. In all, 6 out of 461 patients (1.30 per cent) in the control group and 6 out of 306 patients (1.96 per cent) in the intra-operative neuromonitoring group developed permanent recurrent laryngeal nerve palsy. No statistically significant difference was observed between the two patient groups. Intra-operative neuromonitoring does not appear to affect the post-operative recurrent laryngeal nerve palsy rate or to reliably predict post-operative recurrent laryngeal nerve palsy. However, it can accurately predict good nerve function after thyroidectomy.

Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.

PubMed

Hambright, D; Hellman, M; Barrack, R

2018-01-01

The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% versus 52%, p = 0.001) and femoral offset inequality (18% versus 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% versus 7%, p = 0.023) and version (0% versus 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: Bone Joint J 2018;100B(1 Supple A):36-43. ©2018 The British Editorial Society of Bone & Joint Surgery.

Patient-specific instrumentation for total knee arthroplasty does not match the pre-operative plan as assessed by intra-operative computer-assisted navigation.

PubMed

Scholes, Corey; Sahni, Varun; Lustig, Sebastien; Parker, David A; Coolican, Myles R J

2014-03-01

The introduction of patient-specific instruments (PSI) for guiding bone cuts could increase the incidence of malalignment in primary total knee arthroplasty. The purpose of this study was to assess the agreement between one type of patient-specific instrumentation (Zimmer PSI) and the pre-operative plan with respect to bone cuts and component alignment during TKR using imageless computer navigation. A consecutive series of 30 femoral and tibial guides were assessed in-theatre by the same surgeon using computer navigation. Following surgical exposure, the PSI cutting guides were placed on the joint surface and alignment assessed using the navigation tracker. The difference between in-theatre data and the pre-operative plan was recorded and analysed. The error between in-theatre measurements and pre-operative plan for the femoral and tibial components exceeded 3° for 3 and 17% of the sample, respectively, while the error for total coronal alignment exceeded 3° for 27% of the sample. The present results indicate that alignment with Zimmer PSI cutting blocks, assessed by imageless navigation, does not match the pre-operative plan in a proportion of cases. To prevent unnecessary increases in the incidence of malalignment in primary TKR, it is recommended that these devices should not be used without objective verification of alignment, either in real-time or with post-operative imaging. Further work is required to identify the source of discrepancies and validate these devices prior to routine use. II.

77 FR 24979 - Plan of Operations, Environmental Assessment, Big Thicket National Preserve, Texas

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... DEPARTMENT OF THE INTERIOR National Park Service [7148-NZY] Plan of Operations, Environmental.... ACTION: Notice of Availability of a Plan of Operations and Environmental Assessment for a 30-day public... Energy Company (Cimarex), a Plan of Operations to conduct the Rivers Edge 3-D Seismic Survey within the...

Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial.

PubMed

Griffin, Damian; Parsons, Nick; Shaw, Ewart; Kulikov, Yuri; Hutchinson, Charles; Thorogood, Margaret; Lamb, Sarah E

2014-07-24

To investigate whether surgery by open reduction and internal fixation provides benefit compared with non-operative treatment for displaced, intra-articular calcaneal fractures. Pragmatic, multicentre, two arm, parallel group, assessor blinded randomised controlled trial (UK Heel Fracture Trial). 22 tertiary referral hospitals, United Kingdom. 151 patients with acute displaced intra-articular calcaneal fractures randomly allocated to operative (n=73) or non-operative (n=78) treatment. The primary outcome measure was patient reported Kerr-Atkins score for pain and function (scale 0-100, 100 being the best possible score) at two years after injury. Secondary outcomes were complications; hindfoot pain and function (American Orthopaedic Foot and Ankle Society score); general health (SF-36); quality of life (EQ-5D); clinical examination; walking speed; and gait symmetry. Analysis was by intention to treat. 95% follow-up was achieved for the primary outcome (69 in operative group and 74 in non-operative group), and a complete set of secondary outcomes were available for 75% of participants. There was no significant difference in the primary outcome (mean Kerr-Atkins score 69.8 in operative group v 65.7 in non-operative group; adjusted 95% confidence interval of difference -7.1 to 7.0) or in any of the secondary outcomes between treatment groups. Complications and reoperations were more common in those who received operative care (estimated odds ratio 7.5, 95% confidence interval 2.0 to 41.8). Operative treatment compared with non-operative care showed no symptomatic or functional advantage after two years in patients with typical displaced intra-articular fractures of the calcaneus, and the risk of complications was higher after surgery. Based on these findings, operative treatment by open reduction and internal fixation is not recommended for these fractures.Trial registration Current Controlled Trials ISRCTN37188541. © Griffin et al 2014.

Role of imprint cytology in intra operative diagnosis of thyroid lesions.

PubMed

Anila, K R; Krishna, G

2014-07-01

Intra-operative imprint cytology is an important diagnostic modality in the diagnosis of thyroid lesions. A correct intra-operative diagnosis helps eliminate the need for second surgery. To study diagnostic accuracy of imprint cytology and to compare the imprint cytology results with that of the corresponding paraffin section diagnosis in thyroidectomy cases. This is a prospective study of 84 patients who have undergone thyroidectomies over a period of one year at the Department of Surgery, Thiruvananthapuram, Kerala, India. The intraoperative imprint cytology smears were stained by Papanicolaou method. The imprint cytology interpretation was later compared with the paraffin section diagnosis. Of the 84 patients using haematoxylin and eosin stained histopathology sections as the gold standard, the diagnostic sensitivity of imprint cytology was 75% and specificity was 100%. Positive predictive value was 100%. Negative predictive value was 98.74%. Imprint cytology has high sensitivity and specificity in diagnosing lesions of the thyroid. The problems faced were in diagnosing follicular carcinomas and differentiating low grade lymphoma from lymphocytic thyroiditis. Imprint cytology is a simple, reliable diagnostic technique. It has high sensitivity and specificity in intra-operative diagnosis of lesions of thyroid. In spite of the advent of newer diagnostic modalities like frozen sections, imprint cytology still holds its unique position in the current perspective.

Radiation protection for an intra-operative X-ray device

PubMed Central

Eaton, D J; Gonzalez, R; Duck, S; Keshtgar, M

2011-01-01

Objectives Therapeutic partial breast irradiation can be delivered intra-operatively using the Intrabeam 50 kVp compact X-ray device. Spherical applicators are added to the source to give an isotropic radiation dose. The low energy of this unit leads to rapid attenuation with distance, but dose rates are much greater than for diagnostic procedures. Methods To investigate the shielding requirements for this unit, attenuation measurements were carried out with manufacturer-provided tungsten–rubber sheets, lead, plasterboard and bricks. A prospective environmental dose rate survey was also conducted in the designated theatre. Results As a result of isotropic geometry, the scattered dose around shielding can be 1% of primary and thus often dominates measured dose rates compared with transmission. The absorbed dose rate of the unshielded source at 1 m was 11.6 mGy h−1 but this was reduced by 95% with the shielding sheets. Measured values for the common shielding materials were similar to reference data for the attenuation of a 50 kVp diagnostic X-ray beam. Two lead screens were constructed to shield operators remaining in the theatre and an air vent into a service corridor. A lead apron would also provide suitable attenuation, although a screen allows greater flexibility for treatment operators. With these measures, staff doses were reduced to negligible quantities. Survey measurements taken during patient treatments confirmed no additional measures were required, but the theatre should be a controlled area and access restricted. Conclusion Results from this study and reference data can be used for planning other facilities. PMID:21304003

LANL continuity of operations plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Senutovitch, Diane M

2010-12-22

The Los Alamos National Laboratory (LANL) is a premier national security research institution, delivering scientific and engineering solutions for the nation's most crucial and complex problems. Our primary responsibility is to ensure the safety, security, and reliability of the nation's nuclear stockpile. LANL emphasizes worker safety, effective operational safeguards and security, and environmental stewardship, outstanding science remains the foundation of work at the Laboratory. In addition to supporting the Laboratory's core national security mission, our work advances bioscience, chemistry, computer science, earth and environmental sciences, materials science, and physics disciplines. To accomplish LANL's mission, we must ensure that the Laboratorymore » EFs continue to be performed during a continuity event, including localized acts of nature, accidents, technological or attack-related emergencies, and pandemic or epidemic events. The LANL Continuity of Operations (COOP) Plan documents the overall LANL COOP Program and provides the operational framework to implement continuity policies, requirements, and responsibilities at LANL, as required by DOE 0 150.1, Continuity Programs, May 2008. LANL must maintain its ability to perform the nation's PMEFs, which are: (1) maintain the safety and security of nuclear materials in the DOE Complex at fixed sites and in transit; (2) respond to a nuclear incident, both domestically and internationally, caused by terrorist activity, natural disaster, or accident, including mobilizing the resources to support these efforts; and (3) support the nation's energy infrastructure. This plan supports Continuity of Operations for Los Alamos National Laboratory (LANL). This plan issues LANL policy as directed by the DOE 0 150.1, Continuity Programs, and provides direction for the orderly continuation of LANL EFs for 30 days of closure or 60 days for a pandemic/epidemic event. Initiation of COOP operations may be required to support

Implementation of molecular intra-operative assessment of sentinel lymph node in breast cancer.

PubMed

Khaddage, Abir; Berremila, Sid-Ali; Forest, Fabien; Clemenson, Alix; Bouteille, Catherine; Seffert, Pierre; Peoc'h, Michel

2011-02-01

Sentinel lymph node (SLN) biopsy is used as a staging procedure in early breast cancer, however, histology based intra-operative assessment of the SLN status has a low sensitivity. The one-step nucleic acid amplification (OSNA) method was developed to detect metastases by amplification of cytokeratin (CK) 19 mRNA. Experience with OSNA during a French multi-centric prospective study, as well as intra-operative clinical routine use, is reported. For the clinical study 80 SLNs from 46 patients were assessed. During routine use, the central slice of the SLN from 197 patients was investigated by permanent histology and the remainder was assessed by OSNA. During the clinical study, OSNA detected 15/17 metastases, including all the macrometastases, reaching a 96.3% concordance rate, 88.2% sensitivity and 98.4% specificity. During routine use, both OSNA and histology detected 25 patients with metastasis. OSNA is an accurate tool for intra-operative assessment of SLN status and could reduce the need for second surgery.

Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment.

PubMed

Spencer, Brian A; Mont, Michael A; McGrath, Mike S; Boyd, Bradley; Mitrick, Michael F

2009-12-01

New technology using magnetic resonance imaging (MRI) allows the surgeon to place total knee replacement components into each patient's pre-arthritic natural alignment. This study evaluated the initial intra-operative experience using this technique. Twenty-one patients had a sagittal MRI of their arthritic knee to determine component placement for a total knee replacement. Cutting guides were machined to control all intra-operative cuts. Intra-operative events were recorded and these knees were compared to a matching cohort of the senior surgeon's previous 30 conventional total knee replacements. Post-operative scanograms were obtained from each patient and coronal alignment was compared to previous studies using conventional and computer-assisted techniques. There were no intra-operative or acute post-operative complications. There were no differences in blood loss and there was a mean decrease in operative time of 14% compared to a cohort of patients with conventional knee replacements. The average deviation from the mechanical axis was 1.2 degrees of varus, which was comparable to previously reported conventional and computer-assisted techniques. Custom-fit total knee replacement appeared to be a safe procedure for uncomplicated cases of osteoarthritis.

Twisted intra-abdominal cyst in a neonate: a surprise revelation.

PubMed

Mohamed, Ferzine; Telugu, Ramesh Babu; Karl, Immanuel Sampath

2017-08-08

We, herein, present a male neonate with an antenatally detected intra-abdominal cyst who presented at 18 days of life at which time, the ultrasound revealed a 5×4 cm cyst. Since he was asymptomatic, we planned to repeat the ultrasound a month later and operate if the cyst showed no regression. However, a week later, he presented with an acute abdomen, irritable cry and a repeat ultrasound showing a larger (8×6 cm) cystic mass with debris within. He was taken up for an emergency laparotomy. Intraoperatively, the cyst was found arising from the left lateral abdominal wall free from all structures with a twisted pedicle. Histopathology surprisingly revealed seminiferous tubules within the cyst wall with the vas deferens, thus confirming the diagnosis of a torsion of intra-abdominal testis. Hence, we emphasise the importance of examining for an undescended testis when dealing with a male neonate presenting with a cystic intra-abdominal mass. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hinode/EIS science planning and operations tools

NASA Astrophysics Data System (ADS)

Rainnie, Jonn A.

2016-07-01

We present the design, implementation and maintenance of the suite of software enabling scientists to design and schedule Hinode/EIS1 operations. The total of this software is the EIS Science Planning Tools (EISPT), and is predominately written in IDL (Interactive Data Language), coupled with SolarSoft (SSW), an IDL library developed for solar missions. Hinode is a multi-instrument and wavelength mission designed to observe the Sun. It is a joint Japan/UK/US consortium (with ESA and Norwegian involvement). Launched in September 2006, its principal scientific goals are to study the Sun's variability and the causes of solar activity. Hinode operations are coordinated at ISAS (Tokyo, Japan). A daily Science Operations meeting is attended by the instrument teams and the spacecraft team. Nominally, science plan uploads cover periods of two or three days. When the forthcoming operations have been agreed, the necessary spacecraft operations parameters are created. These include scheduling for spacecraft pointing and ground stations. The Extreme UV Imaging Spectrometer (EIS) instrument, led by the UK (the PI institute is MSSL), is designed to observe the emission spectral lines of the solar atmosphere. Observations are composed of reusable, hierarchical components, including lines lists (wavelengths of spectral lines), rasters (exposure times, line list, etc.) and studies (defines one or more rasters). Studies are the basic unit of "timeline" scheduling. They are a useful construct for generating more complex sequences of observations, reducing the planning burden. Instrument observations must first be validated. An initial requirement was that operations be shared equally by the 3 main EIS teams (Japan, UK and US). Hence, a major design focus of the software was "Remote Operations", whereby any scientist in any location can run the software, schedule a science plan and send it to the spacecraft commanding team. It would then be validated and combined with the science

Intra-operative disruptions, surgeon's mental workload, and technical performance in a full-scale simulated procedure.

PubMed

Weigl, Matthias; Stefan, Philipp; Abhari, Kamyar; Wucherer, Patrick; Fallavollita, Pascal; Lazarovici, Marc; Weidert, Simon; Euler, Ekkehard; Catchpole, Ken

2016-02-01

Surgical flow disruptions occur frequently and jeopardize perioperative care and surgical performance. So far, insights into subjective and cognitive implications of intra-operative disruptions for surgeons and inherent consequences for performance are inconsistent. This study aimed to investigate the effect of surgical flow disruption on surgeon's intra-operative workload and technical performance. In a full-scale OR simulation, 19 surgeons were randomly allocated to either of the two disruption scenarios (telephone call vs. patient discomfort). Using a mixed virtual reality simulator with a computerized, high-fidelity mannequin, all surgeons were trained in performing a vertebroplasty procedure and subsequently performed such a procedure under experimental conditions. Standardized measures on subjective workload and technical performance (trocar positioning deviation from expert-defined standard, number, and duration of X-ray acquisitions) were collected. Intra-operative workload during simulated disruption scenarios was significantly higher compared to training sessions (p < .01). Surgeons in the telephone call scenario experienced significantly more distraction compared to their colleagues in the patient discomfort scenario (p < .05). However, workload tended to be increased in surgeons who coped with distractions due to patient discomfort. Technical performance was not significantly different between both disruption scenarios. We found a significant association between surgeons' intra-operative workload and technical performance such that surgeons with increased mental workload tended to perform worse (β = .55, p = .04). Surgical flow disruptions affect surgeons' intra-operative workload. Increased mental workload was associated with inferior technical performance. Our simulation-based findings emphasize the need to establish smooth surgical flow which is characterized by a low level of process deviations and disruptions.

The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.

PubMed

Weigl, Matthias; Antoniadis, Sophia; Chiapponi, Costanza; Bruns, Christiane; Sevdalis, Nick

2015-01-01

Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery). Intra-operative interruptions were assessed via expert observation using a well-validated observation tool. Surgeons, nurses, and anesthesiologists assessed their intra-operative workload directly after case completion based on three items of the validated Surgery Task Load Index (mental demand, situational stress, distraction). A total of 56 elective cases (35 open, 21 laparoscopic) with 94 workload ratings were included. Mean intra-operative duration was 1 h 37 min. Intra-operative interruptions were on average observed 9.78 times per hour. People who entered/exited the OR (30.6 %) as well as telephone-/beeper-related disruptions (23.6 %) occurred most often. Equipment and OR environment-related interruptions were associated with highest interference with team functioning particularly in laparoscopic procedures. After identifying task and procedural influences, partial correlational analyses revealed that case-irrelevant communications were negatively associated with surgeons' mental fatigue and situational stress, whereas surgeons' reported distraction was increased by case-irrelevant communication and procedural disruptions. OR nurses' and anesthesiologists' perceived workload was also related to intra-operative interruption events. Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine

Inter-observer and intra-observer agreement between embryologists during selection of a single Day 5 embryo for transfer: a multicenter study.

PubMed

Storr, Ashleigh; Venetis, Christos A; Cooke, Simon; Kilani, Suha; Ledger, William

2017-02-01

What is the inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer? The inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer was generally good, although not optimal, even among experienced embryologists. Previous research on the morphological assessment of early stage (two pronuclei to Day 3) embryos has shown varying levels of inter-observer and intra-observer agreement. However, single blastocyst transfer is now becoming increasingly popular and there are no published data that assess inter-observer and intra-observer agreement when selecting a single embryo for Day 5 transfer. This was a prospective study involving 10 embryologists working at five different IVF clinics within a single organization between July 2013 and November 2015. The top 10 embryologists were selected based on their yearly Quality Assurance Program scores for blastocyst grading and were asked to morphologically grade all Day 5 embryos and choose a single embryo for transfer in a survey of 100 cases using 2D images. A total of 1000 decisions were therefore assessed. For each case, Day 5 images were shown, followed by a Day 3 and Day 5 image of the same embryo. Subgroup analyses were also performed based on the following characteristics of embryologists: the level of clinical embryology experience in the laboratory; amount of research experience; number of days per week spent grading embryos. The agreement between these embryologists and the one that scored the embryos on the actual day of transfer was also evaluated. Inter-observer and intra-observer variability was assessed using the kappa coefficient to evaluate the extent of agreement. This study showed that all 10 embryologists agreed on the embryo chosen for transfer in 50 out of 100 cases. In 93 out of 100 cases, at least 6 out of the 10 embryologists agreed. The inter-observer and intra-observer agreement among

30 CFR 780.14 - Operation plan: Maps and plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Operation plan: Maps and plans. 780.14 Section... PLAN § 780.14 Operation plan: Maps and plans. Each application shall contain maps and plans as follows: (a) The maps and plans shall show the lands proposed to be affected throughout the operation and any...

30 CFR 784.23 - Operation plan: Maps and plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Operation plan: Maps and plans. 784.23 Section... PLAN § 784.23 Operation plan: Maps and plans. Each application shall contain maps and plans as follows... INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER...

Automatische Kamerapositionierung für intra-operative Visualisierungen in der onkologischen Leberchirurgie

NASA Astrophysics Data System (ADS)

Mühler, Konrad; Hansen, Christian; Neugebauer, Mathias; Preim, Bernhard

In diesem Beitrag wird ein Verfahren vorgestellt, mit dessen Hilfe automatisch gute Blickpunkte auf dreidimensionale Planungsmodelle für die Leberchirurgie berechnet werden können. Das Verfahren passt die Position der virtuellen Kamera während einer Operation dynamisch an, insbesondere im Falle einer Aktualisierung von onkologischen Planungsdaten durch neue intra-operative Befunde.

Use of virtual slide system for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan.

PubMed

Tsuchihashi, Yasunari; Takamatsu, Terumasa; Hashimoto, Yukimasa; Takashima, Tooru; Nakano, Kooji; Fujita, Setsuya

2008-07-15

We started to use virtual slide (VS) and virtual microscopy (VM) systems for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan. In the system we used a digital slide scanner, VASSALO by CLARO Inc., and a broadband optic fibre provided by NTT West Japan Inc. with the best effort capacity of 100 Mbps. The client is the pathology laboratory of Yamashiro Public Hospital, one of the local centre hospitals located in the south of Kyoto Prefecture, where a full-time pathologist is not present. The client is connected by VPN to the telepathology centre of our institute located in central Kyoto. As a result of the recent 15 test cases of VS telepathology diagnosis, including cases judging negative or positive surgical margins, we could estimate the usefulness of VS in intra-operative remote diagnosis. The time required for the frozen section VS file making was found to be around 10 min when we use x10 objective and if the maximal dimension of the frozen sample is less than 20 mm. Good correct focus of VS images was attained in all cases and all the fields of each tissue specimen. Up to now the capacity of best effort B-band appears to be sufficient to attain diagnosis on time in intra-operation. Telepathology diagnosis was achieved within 5 minutes in most cases using VS viewer provided by CLARO Inc. The VS telepathology system was found to be superior to the conventional still image telepathology system using a robotic microscope since in the former we can observe much greater image information than in the latter in a certain limited time of intra-operation and in the much more efficient ways. In the near future VS telepathology will replace conventional still image telepathology with a robotic microscope even in quick frozen intra-operative diagnosis.

Use of virtual slide system for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan

PubMed Central

Tsuchihashi, Yasunari; Takamatsu, Terumasa; Hashimoto, Yukimasa; Takashima, Tooru; Nakano, Kooji; Fujita, Setsuya

2008-01-01

We started to use virtual slide (VS) and virtual microscopy (VM) systems for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan. In the system we used a digital slide scanner, VASSALO by CLARO Inc., and a broadband optic fibre provided by NTT West Japan Inc. with the best effort capacity of 100 Mbps. The client is the pathology laboratory of Yamashiro Public hospital, one of the local centre hospitals located in the south of Kyoto Prefecture, where a fulltime pathologist is not present. The client is connected by VPN to the telepathology centre of our institute located in central Kyoto. As a result of the recent 15 test cases of VS telepathology diagnosis, including cases judging negative or positive surgical margins, we could estimate the usefulness of VS in intra-operative remote diagnosis. The time required for the frozen section VS file making was found to be around 10 min when we use ×10 objective and if the maximal dimension of the frozen sample is less than 20 mm. Good correct focus of VS images was attained in all cases and all the fields of each tissue specimen. Up to now the capacity of best effort B-band appears to be sufficient to attain diagnosis on time in intra-operation. Telepathology diagnosis was achieved within 5 minutes in most cases using VS viewer provided by CLARO Inc. The VS telepathology system was found to be superior to the conventional still image telepathology system using a robotic microscope since in the former we can observe much greater image information than in the latter in a certain limited time of intra-operation and in the much more efficient ways. In the near future VS telepathology will replace conventional still image telepathology with a robotic microscope even in quick frozen intra-operative diagnosis. PMID:18673520

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes.

PubMed

Sayyah-Melli, Manizheh; Tehrani-Gadim, Sepideh; Dastranj-Tabrizi, Ali; Gatrehsamani, Fatemeh; Morteza, Ghojazadeh; Ouladesahebmadarek, Elaheh; Farzadi, Laya; Kazemi-Shishvan, Maryamalsadat

2009-08-01

To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receive Diphereline 3.75 mg, 4 times every 28 days (group I), and Cabergoline 0.5 mg, once a week for 6 weeks (group II), were included in this study. Clinical symptoms, feasibility of intra-operative dissection, intraoperative complications, sonographic, and pathologic characteristics of the tumor were evaluated. Thirteen patients from group I, and 10 patients from group II underwent surgery. There was a significant difference between the groups in the rate of lymphocyte infiltration (p=0.003), but not in other pathologic features. In both groups, the mitotic index was between 0-10. While there was no significant difference between the groups in the number (p=0.30), and volume of leiomyomas (p=0.65), however, changes in the uterine artery circulation was significant (p=0.001 [group I], p=0.026 [group II]). In addition, there was a significant difference between the groups for intra-operative hemorrhage and adhesion of leiomyomas to the uterine wall. This study found that Cabergoline is as effective as Diphereline in the shrinkage of myomas, accompanied by improvement in the sonographic, clinical, and intra-operative outcomes without any adverse pathological changes, and could be a good medical regimen as an adjunct to surgical management.

Intra-operatively customized implant coating strategies for local and controlled drug delivery to bone.

PubMed

Trajkovski, Branko; Petersen, Ansgar; Strube, Patrick; Mehta, Manav; Duda, Georg N

2012-09-01

Bone is one of the few tissues in the human body with high endogenous healing capacity. However, failure of the healing process presents a significant clinical challenge; it is a tremendous burden for the individual and has related health and economic consequences. To overcome such healing deficits, various concepts for a local drug delivery to bone have been developed during the last decades. However, in many cases these concepts do not meet the specific requirements of either surgeons who must use these strategies or individual patients who might benefit from them. We describe currently available methods for local drug delivery and their limitations in therapy. Various solutions for drug delivery to bone focusing on clinical applications and intra-operative constraints are discussed and drug delivery by implant coating is highlighted. Finally, a new set of design and performance requirements for intra-operatively customized implant coatings for controlled drug delivery is proposed. In the future, these requirements may improve approaches for local and intra-operative treatment of patients. Copyright © 2012 Elsevier B.V. All rights reserved.

Minimally invasive fixation in tibial plateau fractures using an pre-operative and intra-operative real size 3D printing.

PubMed

Giannetti, Silvio; Bizzotto, Nicola; Stancati, Andrea; Santucci, Attilio

2017-03-01

The purpose of our study was to compare the outcome after minimally invasive reconstruction and internal fixation with and without the use of pre- and intra-operative real size 3D printing for patients with displaced tibial plateau fractures (TPFs). We prospectively followed up 40 consecutive adult patients with closed TPF who underwent surgical treatment of reconstruction of the tibial plateau with the use of minimally invasive fixation. Sixteen patients (group 1) were operated using a pre-operative and intra-operative real size 3D-model, while 24 patients (group 2) were operated without 3D-model printing, but using only pre-operative and intra-operative 3D Tc-scan images. The mean operating time was 148.2±15.9min for group 1 and 174.5±22.2min for group 2 (p=0.041). In addition, the mean intraoperative blood loss was less in group 1 (520mL) than in group 2 (546mL) (p=0.534). After discharge, all patients were followed up at 6 weeks, 12 weeks, 6 months, 1year and then every year post surgically and radiographic evaluation was carried out each time using clinical and radiological Rasmussen's score, with no significant differences between the two groups. Two patients (group 2) developed infection which resolved within 3 weeks after usage of antibiotics. Neither superficial nor deep infections were present in group 1. In all patients, no non-union occurred. No intraoperative, perioperative, or postoperative complications, such as loss of valgus correction, bone fractures, or metallic plate failures were detected at follow-up. In patients operated with the use of 3D-model printing, we found a significant reduction in surgical time. Moreover, the technique without a 3D-model increased the patient's and the surgeon's exposure to radiation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Individual differences and day-to-day fluctuations in goal planning and type 1 diabetes management.

PubMed

Wiebe, Deborah J; Baker, Ashley C; Suchy, Yana; Stump, Tammy K; Berg, Cynthia A

2018-04-26

To examine whether individual differences and day-to-day fluctuations in diabetes goal planning are associated with Type 1 diabetes (T1D) management during late adolescence, and whether lapses in daily diabetes goal planning are more disruptive to diabetes management among those with poorer executive functioning (EF). Late adolescents with T1D (N = 236, Mage = 17.77 years) completed survey measures assessing individual differences in levels of diabetes goal planning and adherence, as well as survey and performance-based measures of EF; glycemic control was assessed through glycated hemoglobin (HbA1c) assays. Participants then completed a 2-week daily diary, rating items measuring daily diabetes goal planning, goal effort, and adherence, and recording blood-glucose tests from their glucometer at the end of each day. Analyses of survey measures indicated that higher individual differences in diabetes goal planning were associated with better adherence and glycemic control. Analyses of daily data using hierarchical linear modeling indicated that adolescents displayed higher daily adherence and lower blood-glucose levels on days when they had higher-than-their-average levels of daily goal planning and daily goal effort. EF moderated the association between daily goal planning and daily adherence, indicating that lapses in daily goal planning were more disruptive for adolescents with poorer EF. Both individual differences and day-to-day fluctuations in diabetes goal planning are associated with diabetes management, highlighting the challenges of managing T1D in daily life. Youth in late adolescence with poorer EF may especially benefit from planning to attain diabetes goals on a daily basis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Intra-Operative Predictors of difficult cholecystectomy and Conversion to Open Cholecystectomy - A New Scoring System.

PubMed

Ahmed, Nauman; Hassan, Maaz Ul; Tahira, Maham; Samad, Abdul; Rana, Hamad Naeem

2018-01-01

To evaluate the intra-operative scoring system to predict difficult cholecystectomy and conversion to open surgery. This descriptive study was conducted from March 2016 to August, 2016 in the Department of Surgery, Shalimar Hospital. The study recruited 120 patients of either gender, age greater than 18 years and indicated for laparoscopic cholecystectomy (LC). Intra-operatively all patients were evaluated using the new scoring system. The scoring system included five aspects; appearance and adhesion of Gall Bladder (GB), distension or contracture degree of GB, ease in access, local or septic complications, and time required for cystic artery and duct identification. The scoring system ranges from 0 to 10, classified as score of <2 being considered easy, 2 to 4 moderate, 5-7 very difficult, and 8 to 10, extreme. Patient demographic data (i.e. age, gender), co-morbidities, intra-operative scores using the scoring system and conversion to open were recorded. The data was analysed using statistical analysis software SPSS (IBM). Among one hundred and twenty participants, sixty seven percent were females and the mean age (years) was 43.05 ± 14.16. Co-morbidities were present in twenty percent patients with eleven diagnosed with diabetes, six with hypertension and five with both hypertension and diabetes. The conversion rate to open surgery was 6.7%. The overall mean intra-operative scores were 3.52 ± 2.23; however significant difference was seen in mean operative score of converted to open and those not converted to open (8.00 ± 0.92 Vs. 3.20 V 1.92; p-value = 0.001). Among eight cases converted to open, three (37.5%) were in very difficult category while five (62.5%) were in extreme category. Moreover, age greater than 40 years and being diabetic were also the risk factors for conversion to open surgery. The new intra-operative scoring system is a valuable assessment tool to predict difficult laparoscopic cholecystectomy and conversion parameters to open surgery and

Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract.

PubMed

Hubalewska-Dydejczyk, A; Kulig, J; Szybinski, P; Mikolajczak, R; Pach, D; Sowa-Staszczak, A; Fröss-Baron, K; Huszno, B

2007-10-01

Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue "marked" by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [(99m)Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [(99m)Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [(99m)Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [(99m)Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology.

Bimanual, intra-operative, fluoroscopy-guided removal of nasopharyngeal migratory fish bone from carotid space.

PubMed

Al-Abduwani, J A; Bhargava, D; Sawhney, S; Al-Abri, R

2010-07-01

We report a rare and unusual case of a patient with an ingested fishbone which migrated from the oropharynx to the anterior compartment of the retropharyngeal space and then to the deep neck space in the nasopharynx (i.e. the carotid space). This report aims to describe a successful, minimally invasive method of foreign body removal which avoided both major skull base surgery and any potential life-threatening complications. A secondary aim is to highlight the role of intra-operative fluoroscopy, an under-used tool. We present a 67-year-old man with a history of fish bone impaction but no fish bone visible on plain X-ray or flexible endoscopy. The diagnosis of fish bone lodged in the retropharyngeal space was confirmed by computed tomography. Surgical exploration of the anterior retropharyngeal space failed to locate the fish bone, as it had migrated to a new, unknown location. Intra-operative fluoroscopy was vital for the removal of the fish bone, as it was impossible to see with the naked eye and had migrated from its previously imaged position. The fish bone was finally retrieved bimanually using external pressure on the submandibular region, which displaced the fish bone, and fluoroscopic guidance, which assisted its removal from the nasopharyngeal lumen. To the best of our knowledge, this is the first reported case of bimanual, intra-operative, fluoroscopy-guided, intra-luminal removal of a migratory fish bone from the deep neck space in this region of the nasopharynx.

Operational Plan for Underground Storage Tank 322 R2U2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Griffin, D.

2017-06-07

This Operational Plan provides the operator of the tank system with guidelines relating to the safe and compliant operation and maintenance of the tank system. The tank system schematic and list of emergency contacts shall be posted near the tank so they are visible to tank personnel. This Operational Plan shall be kept on file by the Facility Supervisor. It should be understood when managing this tank system that it is used to store hazardous waste temporarily for 90 calendar days or less. The rinsewater handled in the tank system is considered hazardous and may exhibit the characteristic of toxicity.

Prospective evaluation of intra-operative quick parathyroid hormone assay as an early predictor of post thyroidectomy hypocalcaemia.

PubMed

Reddy, Ashwini C; Chand, Gyan; Sabaretnam, M; Mishra, Anjali; Agarwal, Gaurav; Agarwal, Amit; Verma, A K; Mishra, S K

2016-10-01

Hypocalcaemia following total thyroidectomy is a major contributing factor in delayed hospital discharge and dissuading surgeons from day care thyroidectomy. We prospectively evaluated the utility of Intra-operative serum quick parathyroid hormone level measurement twenty minutes after total thyroidectomy in predicting post-operative hypocalcemia. Prospective longitudinal study which included patients undergoing total thyroidectomy for benign or malignant thyroid disorders at SGPGIMS, Lucknow, India from November 2013 to February 2015. Patients who received calcium prophylaxis were excluded from the study. Intraoperative serum quick PTH level measurements were done twenty minutes after resection of thyroid. Serum calcium levels were estimated preoperatively and on three consecutive post operative days. Calcium supplementation was started in patients with symptomatic hypocalcemia. The study included 100 patients with a mean age of 41 years, range 17-72 years. 48 patients had Euthyroid multinodular goitre, 10 patients grave's disease and 42 patients had differentiated thyroid cancer. Total thyroidectomy was performed in 88 patients, total thyroidectomy with lymph node dissection in 12 patients. Post-operatively 23% patients experienced symptomatic hypocalcemia. The IOPTH level of 9 pmol/L, twenty minutes after total thyroidectomy, had the highest sensitivity and specificity of 92% and 83% respectively in predicting post-operative hypocalcemia. Parathyroid hormone assay twenty minutes after thyroidectomy is an accurate and reliable means of predicting clinically relevant hypocalcemia. Patients with PTH values greater than 9 pmol/L twenty minutes after thyroidectomy, can be safely discharged on the same postoperative day as the probability of life threatening hypocalcemia is unlikely. Copyright © 2016. Published by Elsevier Ltd.

Safety and feasibility of intra-operative device closure of atrial septal defect with transthoracic minimal invasion.

PubMed

Chen, Qiang; Cao, Hua; Zhang, Gui-Can; Chen, Liang-Wan; Chen, Dao-Zhong

2012-01-01

The study aims to evaluate the safety and feasibility of intra-operative device closure of atrial septal defect with transthoracic minimal invasion. From May 2006 to June 2009, 252 patients with secundum-type atrial septal defect closure were enrolled in our institution. The patients were divided into two groups, with 182 patients in group I with intra-operative device closure and 72 in group II with surgical closure. In group I, the patients' age ranged from 3 months to 62 years (mean±standard deviation, 19.0±16.7 years). This approach involved a transthoracic minimal invasion that was performed after full evaluation of the atrial septal defect by transthoracic echocardiography, deploying the device through the delivery sheath to occlude the atrial septal defect. In group I, 180 patients were occluded successfully under this approach. The size of the occluder device implanted ranged from 6 to 48 mm. Minor complications occurred, which included transient arrhythmias (n=23) and pleural effusion (n=15). Two patients with postoperative cardiac arrest were successfully cardiopulmonary resuscitated. Another two patients with occluder dislodged back into the right atrium were turned to surgical repair with cardiopulmonary bypass on the postoperative day. In group II, all patients were occluded successfully, and almost all patients needed blood transfusion and suffered from various minor complications. All discharged patients were followed up for 1-5 years. During this period, we found no recurrence, no thrombosis, even no device failure. In our comparative studies, group II had significantly longer intensive care unit (ICU) stay and hospital stay than group I (p<0.05). The cost for group I was less than group II (p<0.05). Intra-operative device closure of atrial septal defect with transthoracic minimal invasion is a safe and feasible technique. It had the advantages of cost savings, yielding better cosmetic results, and leaving less trauma than surgical closure.

Spitzer Mission Operation System Planning for IRAC Warm-Instrument Characterization

NASA Technical Reports Server (NTRS)

Hunt, Joseph C., Jr.; Sarrel, Marc A.; Mahoney, William A.

2010-01-01

This paper will describe how the Spitzer Mission Operations System planned and executed the characterization phase between Spitzer's cryogenic mission and its warm mission. To the largest extend possible, the execution of this phase was done with existing processing and procedures. The modifications that were made were in response to the differences of the characterization phase compared to normal phases before and after. The primary two categories of difference are: unknown date of execution due to uncertainty of knowledge of the date of helium depletion, and the short cycle time for data analysis and re-planning during execution. In addition, all of the planning and design had to be done in parallel with normal operations, and we had to transition smoothly back to normal operations following the transition. This paper will also describe the re-planning we had to do following an anomaly discovered in the first days after helium depletion.

Orbital Express Mission Operations Planning and Resource Management using ASPEN

NASA Technical Reports Server (NTRS)

Chouinard, Caroline; Knight, Russell; Jones, Grailing; Tran, Danny

2008-01-01

The Orbital Express satellite servicing demonstrator program is a DARPA program aimed at developing "a safe and cost-effective approach to autonomously service satellites in orbit". The system consists of: a) the Autonomous Space Transport Robotic Operations (ASTRO) vehicle, under development by Boeing Integrated Defense Systems, and b) a prototype modular next-generation serviceable satellite, NEXTSat, being developed by Ball Aerospace. Flexibility of ASPEN: a) Accommodate changes to procedures; b) Accommodate changes to daily losses and gains; c) Responsive re-planning; and d) Critical to success of mission planning Auto-Generation of activity models: a) Created plans quickly; b) Repetition/Re-use of models each day; and c) Guarantees the AML syntax. One SRP per day vs. Tactical team

Intra-operative periarticular multimodal injection in total knee arthroplasty: a local hospital experience in Hong Kong.

PubMed

Fan, J Ch

2018-04-01

Data from a local report revealed the superior outcome of regional anaesthesia and analgesia compared with general anaesthesia and intravenous patient-controlled analgesia in total knee arthroplasty. This retrospective study aimed to assess the efficacy of intra-operative periarticular multimodal injection in improving postoperative pain and reducing morphine consumption with patient-controlled analgesia after total knee arthroplasty in patients with knee osteoarthritis. From July 2005 to May 2009, 213 total knee arthroplasties without intra-operative periarticular multimodal injection (control group) were performed at a local hospital. From June 2009 to December 2012, 185 total knee arthroplasties were performed with intra-operative periarticular multimodal injection (cocktail group). The inclusion criteria were osteoarthritis of the knee, single method of anaesthesia (general or neuraxial), simple total knee arthroplasty without any metal augmentation or constraint, and postoperative patient-controlled analgesia. Postoperative patient-controlled morphine doses were compared. A total of 152 total knee arthroplasties were recruited to the cocktail group, and 89 to the control group. Duration of tourniquet application and preoperative knee score did not significantly correlate with morphine consumption by patient-controlled analgesia. Multimodal injection significantly decreased such consumption for 36 h. When injection was separately analysed for general and neuraxial anaesthesia, the effect lasted for 42 h and 24 h, respectively. Intra-operative periarticular multimodal injection decreased morphine consumption for up to 42 h postoperatively.

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation.

PubMed

Jaberi, Ramin; Siavashpour, Zahra; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-12-01

Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in 'organs-applicators', while maintaining target dose at the original level. There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients' plans to be able to serve as a clinical tool.

Artificial neural network based gynaecological image-guided adaptive brachytherapy treatment planning correction of intra-fractional organs at risk dose variation

PubMed Central

Jaberi, Ramin; Aghamiri, Mahmoud Reza; Kirisits, Christian; Ghaderi, Reza

2017-01-01

Purpose Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study. Second computed tomography scan was done for each patient after finishing brachytherapy treatment with applicators in situ. Artificial neural networks (ANNs) based models were used to predict intra-fractional OARs dose-volume histogram parameters variations and propose a new final plan. Results A model was developed to estimate the intra-fractional organs dose variations during gynaecological intracavitary brachytherapy. Also, ANNs were used to modify the final brachytherapy treatment plan to compensate dosimetrically for changes in ‘organs-applicators’, while maintaining target dose at the original level. Conclusions There are semi-automatic and fast responding models that can be used in the routine clinical workflow to reduce individually IGABT uncertainties. These models can be more validated by more patients’ plans to be able to serve as a clinical tool. PMID:29441094

Program operational summary: Operational 90 day manned test of a regenerative life support system

NASA Technical Reports Server (NTRS)

Jackson, J. K.; Wamsley, J. R.; Bonura, M. S.; Seeman, J. S.

1972-01-01

An operational 90-day manned test of a regenerative life support system was successfully completed. This test was performed with a crew of four carefully selected and trained men in a space station simulator (SSS) which had a two gas atmosphere maintained at a total pressure of 68.9, 10 psia, and composed of oxygen at a partial pressure of 3.05 psia with nitrogen as the diluent. The test was planned to provide data on regenerative life support subsystems and on integrated system operations in a closed ecology, similar to that of a space station. All crew equipment and expendables were stored onboard at the start of the mission to eliminate the need for pass-in operations. The significant accomplishments of the test, some of the pertinent test results, some of the problem areas, and conclusions are presented.

Comparison of linac-based fractionated stereotactic radiotherapy and tomotherapy treatment plans for intra-cranial tumors

NASA Astrophysics Data System (ADS)

Jang, Bo Shim; Suk, Lee; Sam, Ju Cho; Sang, Hoon Lee; Juree, Kim; Kwang, Hwan Cho; Chul, Kee Min; Hyun Do, Huh; Rena, Lee; Dae, Sik Yang; Young, Je Park; Won, Seob Yoon; Chul, Yong Kim; Soo, Il Kwon

2010-11-01

This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors, according to some cases. In this study, linac-based fractionated stereotactic radiotherapy and tomotherapy treatment were administered to five patients diagnosed with intra-cranial cancer in which the dose of 18-20 Gy was applied on 3-5 separate occasions. The tumor dosing was decided by evaluating the inhomogeneous index (II) and conformity index (CI). Also, the radiation-sensitive tissue was evaluated using low dose factors V1, V2, V3, V4, V5, and V10, as well as the non-irradiation ratio volume (NIV). The values of the II for each prescription dose in the linac-based non-coplanar radiotherapy plan and tomotherapy treatment plan were (0.125±0.113) and (0.090±0.180), respectively, and the values of the CI were (0.899±0.149) and (0.917±0.114), respectively. The low dose areas, V1, V2, V3, V4, V5, and V10, in radiation-sensitive tissues in the linac-based non-coplanar radiotherapy plan fell into the ranges 0.3%-95.6%, 0.1%-87.6%, 0.1%-78.8%, 38.8%-69.9%, 26.6%-65.2%, and 4.2%-39.7%, respectively, and the tomotherapy treatment plan had ranges of 13.6%-100%, 3.5%-100%, 0.4%-94.9%, 0.2%-82.2%, 0.1%-78.5%, and 0.3%-46.3%, respectively. Regarding the NIV for each organ, it is possible to obtain similar values except for the irradiation area of the brain stem. The percentages of NIV 10%, NIV20%, and NIV30%for the brain stem in each patient were 15%-99.8%, 33.4%-100%, and 39.8%-100%, respectively, in the fractionated stereotactic treatment plan and 44.2%-96.5%, 77.7%-99.8%, and 87.8%-100%, respectively, in the tomotherapy treatment plan. In order to achieve higher-quality treatment of intra-cranial tumors, treatment plans should be tailored according to the isodose target volume, inhomogeneous index, conformity index, position of the tumor upon fractionated stereotactic radiosurgery, and radiation

Intra-operative fiducial-based CT/fluoroscope image registration framework for image-guided robot-assisted joint fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Morad, Samir; Gibbons, Peter; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

2017-08-01

Joint fractures must be accurately reduced minimising soft tissue damages to avoid negative surgical outcomes. To this regard, we have developed the RAFS surgical system, which allows the percutaneous reduction of intra-articular fractures and provides intra-operative real-time 3D image guidance to the surgeon. Earlier experiments showed the effectiveness of the RAFS system on phantoms, but also key issues which precluded its use in a clinical application. This work proposes a redesign of the RAFS's navigation system overcoming the earlier version's issues, aiming to move the RAFS system into a surgical environment. The navigation system is improved through an image registration framework allowing the intra-operative registration between pre-operative CT images and intra-operative fluoroscopic images of a fractured bone using a custom-made fiducial marker. The objective of the registration is to estimate the relative pose between a bone fragment and an orthopaedic manipulation pin inserted into it intra-operatively. The actual pose of the bone fragment can be updated in real time using an optical tracker, enabling the image guidance. Experiments on phantom and cadavers demonstrated the accuracy and reliability of the registration framework, showing a reduction accuracy (sTRE) of about [Formula: see text] (phantom) and [Formula: see text] (cadavers). Four distal femur fractures were successfully reduced in cadaveric specimens using the improved navigation system and the RAFS system following the new clinical workflow (reduction error [Formula: see text], [Formula: see text]. Experiments showed the feasibility of the image registration framework. It was successfully integrated into the navigation system, allowing the use of the RAFS system in a realistic surgical application.

Intra-operative 3D guidance in prostate brachytherapy using a non-isocentric C-arm.

PubMed

Jain, A; Deguet, A; Iordachita, I; Chintalapani, G; Blevins, J; Le, Y; Armour, E; Burdette, C; Song, D; Fichtinger, G

2007-01-01

Intra-operative guidance in Transrectal Ultrasound (TRUS) guided prostate brachytherapy requires localization of inserted radioactive seeds relative to the prostate. Seeds were reconstructed using a typical C-arm, and exported to a commercial brachytherapy system for dosimetry analysis. Technical obstacles for 3D reconstruction on a non-isocentric C-arm included pose-dependent C-arm calibration; distortion correction; pose estimation of C-arm images; seed reconstruction; and C-arm to TRUS registration. In precision-machined hard phantoms with 40-100 seeds, we correctly reconstructed 99.8% seeds with a mean 3D accuracy of 0.68 mm. In soft tissue phantoms with 45-87 seeds and clinically realistic 15 degrees C-arm motion, we correctly reconstructed 100% seeds with an accuracy of 1.3 mm. The reconstructed 3D seed positions were then registered to the prostate segmented from TRUS. In a Phase-1 clinical trial, so far on 4 patients with 66-84 seeds, we achieved intra-operative monitoring of seed distribution and dosimetry. We optimized the 100% prescribed iso-dose contour by inserting an average of 3.75 additional seeds, making intra-operative dosimetry possible on a typical C-arm, at negligible additional cost to the existing clinical installation.

Galileo mission planning for Low Gain Antenna based operations

NASA Technical Reports Server (NTRS)

Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

1994-01-01

The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include

Galileo mission planning for Low Gain Antenna based operations

NASA Astrophysics Data System (ADS)

Gershman, R.; Buxbaum, K. L.; Ludwinski, J. M.; Paczkowski, B. G.

1994-11-01

The Galileo mission operations concept is undergoing substantial redesign, necessitated by the deployment failure of the High Gain Antenna, while the spacecraft is on its way to Jupiter. The new design applies state-of-the-art technology and processes to increase the telemetry rate available through the Low Gain Antenna and to increase the information density of the telemetry. This paper describes the mission planning process being developed as part of this redesign. Principal topics include a brief description of the new mission concept and anticipated science return (these have been covered more extensively in earlier papers), identification of key drivers on the mission planning process, a description of the process and its implementation schedule, a discussion of the application of automated mission planning tool to the process, and a status report on mission planning work to date. Galileo enhancements include extensive reprogramming of on-board computers and substantial hard ware and software upgrades for the Deep Space Network (DSN). The principal mode of operation will be onboard recording of science data followed by extended playback periods. A variety of techniques will be used to compress and edit the data both before recording and during playback. A highly-compressed real-time science data stream will also be important. The telemetry rate will be increased using advanced coding techniques and advanced receivers. Galileo mission planning for orbital operations now involves partitioning of several scarce resources. Particularly difficult are division of the telemetry among the many users (eleven instruments, radio science, engineering monitoring, and navigation) and allocation of space on the tape recorder at each of the ten satellite encounters. The planning process is complicated by uncertainty in forecast performance of the DSN modifications and the non-deterministic nature of the new data compression schemes. Key mission planning steps include

Occurrence, elimination, enantiomeric distribution and intra-day variations of chiral pharmaceuticals in major wastewater treatment plants in Beijing, China.

PubMed

Duan, Lei; Zhang, Yizhe; Wang, Bin; Deng, Shubo; Huang, Jun; Wang, Yujue; Yu, Gang

2018-04-18

The occurrence, eliminations, enantiomeric distribution and intra-day variations of five chiral pharmaceuticals (three beta-blockers and two antidepressants) were investigated in eight major WWTPs in Beijing, China. The results revealed that metoprolol (MTP) and venlafaxine (VFX) were of the highest concentrations among the five determined pharmaceuticals with mean concentrations of 803 ng L -1 and 408 ng L -1 , respectively in influents, and 354 ng L -1 and 165 ng L -1 in effluents, respectively. Their removal efficiencies, intra-day concentration changes and enantiomeric profiles during wastewater treatment were further analyzed. Loads of these two chiral pharmaceuticals were also studied to reveal drug use pattern. A/A/O+MBR (anaerobic/anoxic/oxic + membrane bio-reactor) followed by joint disinfection treatment process exhibited the high removal efficiencies. No or weak enantioselectivity was observed in most WWTPs. However, obvious enantiomeric fraction (EF) changing of MTP was observed in WWTP3 employing A/A/O+MBR. Intra-day concentration fluctuations of MTP were smaller than VFX. A quick response to sudden rise influent concentration of MTP was observed in WWTP1 effluent but EF response lagged behind. Similar bihourly EF variations in influents and effluents were also observed in most WWTPs for MTP and VFX in consideration of hydraulic residence time (HRT). Copyright © 2018 Elsevier Ltd. All rights reserved.

[Pre-operation evaluation and intra-operation management of cochlear implantation].

PubMed

Zhang, Dao-xing; Hu, Bao-hua; Xiao, Yu-li; Shi, Bo-ning

2004-10-01

To summarize pre-operation evaluation experiences in cochlear implantation. Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Among the total 158 cases, 116 cases with normal structure, 42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37.6 dB SPL. Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.

Experimental evaluation of possible side effects of intra-operative photodynamic therapy on rabbit blood vessels and nerves.

PubMed

Kübler, Alexander C; Stenzel, W; Rühling, M; Meul, B; Fischer, J-H

2003-01-01

Tumours of the head and neck show a high local tumour recurrence rate ranging between 7 and 30% despite combined treatment modalities. To improve these data, photodynamic therapy (PDT) might be used as an additional treatment besides surgery and radio-chemotherapy. Intra-operative PDT has been proposed to "sterilise" the tumour bed after surgical tumour resection in order to kill any remaining tumour cells which are responsible for local tumour recurrences. Often, during head and neck surgery, large blood vessels and important nerve structures are exposed and could potentially be harmed by intra-operative PDT. Despite the fact that mTHPC is the most commonly used photosensitiser for head and neck tumours, there are no data on potential detrimental side effects of intra-operative PDT onto these vital structures. The purpose of this study was to use a maximal treatment protocol in rabbit observing possible damage to the blood vessels and nerve structures and thus judge the most severe event that could happen in patients. In rabbits the large blood vessels and nerve structures at the neck and at the groin area were surgically exposed and treated by mTHPC-mediated intra-operative PDT. Various treatment parameters (drug-light interval, light dosage, follow up interval) were modified in order to find the critical treatment parameters which might cause maximum tissue effects. The intention was to define the most severe clinical complications which could be expected from mTHPC mediated intra-operative PDT. The most severe tissue reactions were found at a drug dosage of 0.3 mg/kg, a drug-light interval of 24 hours and a light dosage of 20 J/cm(2). Complete necrosis was found for the muscles, fat and connective tissue within the entire treatment field. Blood vessels demonstrated severe oedema, media-hyperplasia or loosening of the endothelial layer leading to various degrees of local thrombosis but no break down of the vessel wall or any rupture was noted. Most nerves were

Can the rapid identification of mature spermatozoa during microdissection testicular sperm extraction guide operative planning?

PubMed

Alrabeeah, K; Doucet, R; Boulet, E; Phillips, S; Al-Hathal, N; Bissonnette, F; Kadoch, I J; Zini, A

2015-05-01

The minimum sperm count and quality that must be identified during microdissection testicular sperm extraction (micro-TESE) to deem the procedure successful remains to be established. We conducted a retrospective study of 81 consecutive men with non-obstructive azoospermia who underwent a primary (first) micro-TESE between March 2007 and October 2013. Final assessment of sperm recovery [reported on the day of (intracytoplasmic sperm injection) ICSI] was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a unilateral (with limited or complete microdissection) or bilateral micro-TESE was guided by the intra-operative identification of sperm recovery (≥5 motile or non-motile sperm) from the first testicle. Overall, sperm recovery was successful in 56% (45/81) of the men. A unilateral micro-TESE was performed in 47% (38/81) of the men (based on intra-operative identification of sperm) and in 100% (38/38) of these men, spermatozoa was found on final assessment. In 42% (16/38) of the unilateral cases, a limited microdissection was performed (owing to the rapid intra-operative identification of sperm). The remaining 43 men underwent a bilateral micro-TESE and 16% (7/43) of these men had sperm identified on final assessment. The cumulative ICSI pregnancy rates (per cycle started and per embryo transfer) were 47% (21/45) and 60% (21/35), respectively, with a mean (±SD) of 1.9 ± 1.0 embryos transferred. The data demonstrate that intra-operative assessment of sperm recovery can correctly identify those men that require a unilateral micro-TESE. Moreover, the rapid identification of sperm recovery can allow some men to undergo a limited unilateral micro-TESE and avoid the need for complete testicular microdissection. © 2015 American Society of Andrology and European Academy of Andrology.

Estimation of intra-operator variability in perfusion parameter measurements using DCE-US.

PubMed

Gauthier, Marianne; Leguerney, Ingrid; Thalmensi, Jessie; Chebil, Mohamed; Parisot, Sarah; Peronneau, Pierre; Roche, Alain; Lassau, Nathalie

2011-03-28

To investigate intra-operator variability of semi-quantitative perfusion parameters using dynamic contrast-enhanced ultrasonography (DCE-US), following bolus injections of SonoVue(®). The in vitro experiments were conducted using three in-house sets up based on pumping a fluid through a phantom placed in a water tank. In the in vivo experiments, B16F10 melanoma cells were xenografted to five nude mice. Both in vitro and in vivo, images were acquired following bolus injections of the ultrasound contrast agent SonoVue(®) (Bracco, Milan, Italy) and using a Toshiba Aplio(®) ultrasound scanner connected to a 2.9-5.8 MHz linear transducer (PZT, PLT 604AT probe) (Toshiba, Japan) allowing harmonic imaging ("Vascular Recognition Imaging") involving linear raw data. A mathematical model based on the dye-dilution theory was developed by the Gustave Roussy Institute, Villejuif, France and used to evaluate seven perfusion parameters from time-intensity curves. Intra-operator variability analyses were based on determining perfusion parameter coefficients of variation (CV). In vitro, different volumes of SonoVue(®) were tested with the three phantoms: intra-operator variability was found to range from 2.33% to 23.72%. In vivo, experiments were performed on tumor tissues and perfusion parameters exhibited values ranging from 1.48% to 29.97%. In addition, the area under the curve (AUC) and the area under the wash-out (AUWO) were two of the parameters of great interest since throughout in vitro and in vivo experiments their variability was lower than 15.79%. AUC and AUWO appear to be the most reliable parameters for assessing tumor perfusion using DCE-US as they exhibited the lowest CV values.

Intra-operative mapping of the atria: the first step towards individualization of atrial fibrillation therapy?

PubMed

Kik, Charles; Mouws, Elisabeth M J P; Bogers, Ad J J C; de Groot, Natasja M S

2017-07-01

Atrial fibrillation (AF), an age-related progressive disease, is becoming a worldwide epidemic with a prevalence rate of 33 million. Areas covered: In this expert review, an overview of important results obtained from previous intra-operative mapping studies is provided. In addition, our novel intra-operative high resolution mapping studies, its surgical considerations and data analyses are discussed. Furthermore, the importance of high resolution mapping studies of both sinus rhythm and AF for the development of future AF therapy is underlined by our most recent results. Expert commentary: Progression of AF is determined by the extensiveness of electropathology which is defined as conduction disorders caused by structural damage of atrial tissue. The severity of electropathology is a major determinant of therapy failure. At present, we do not have any diagnostic tool to determine the degree of electropathology in the individual patient and we can thus not select the most optimal treatment modality for the individual patient. An intra-operative, high resolution scale, epicardial mapping approach combined with quantification of electrical parameters may serve as a diagnostic tool to stage AF in the individual patient and to provide patient tailored therapy.

Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

NASA Astrophysics Data System (ADS)

Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

2017-12-01

3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

Space shuttle operations integration plan

NASA Technical Reports Server (NTRS)

1975-01-01

The Operations Integration Plan is presented, which is to provide functional definition of the activities necessary to develop and integrate shuttle operating plans and facilities to support flight, flight control, and operations. It identifies the major tasks, the organizations responsible, their interrelationships, the sequence of activities and interfaces, and the resultant products related to operations integration.

Inter- and intra-individual variation in urinary biomarker concentrations over a 6-day sampling period. Part 1: metals.

PubMed

Smolders, Roel; Koch, Holger M; Moos, Rebecca K; Cocker, John; Jones, Kate; Warren, Nick; Levy, Len; Bevan, Ruth; Hays, Sean M; Aylward, Lesa L

2014-12-01

The aim of the current HBM-study is to further the understanding of the impact of inter- and intra-individual variability in HBM surveys as it may have implications for the design and interpretation of the study outcomes. As spot samples only provide a snapshot in time of the concentrations of chemicals in an individual, it remains unclear to what extent intra-individual variability plays a role in the overall variability of population-wide HBM surveys. The current paper describes the results of an intensive biomonitoring study, in which all individual urine samples of 8 individuals were collected over a 6-day sampling period (a total of 352 unique samples). By analyzing different metals (As, Cd, Mn, Ni) in each individual sample, inter- and intra-individual variability for these four metals could be determined, and the relationships between exposure, internal dose, and sampling protocol assessed. Although the range of biomarker values for different metals was well within the normal range reported in large-scale population surveys, large intra-individual differences over a 6-day period could also be observed. Typically, measured biomarker values span at least an order of magnitude within an individual, and more if specific exposure episodes could be identified. Fish consumption for example caused a twenty- to thirty-fold increase in urinary As-levels over a period of 2-6h. Intra-class correlation coefficients (ICC) were typically low for uncorrected biomarker values (between 0.104 and 0.460 for the 4 metals), but improved when corrected for creatinine or specific gravity (SG). The results show that even though urine is a preferred matrix for HBM studies, there are certain methodological issues that need to be taken into account in the interpretation of urinary biomarker data, related to the intrinsic variability of the urination process itself, the relationship between exposure events and biomarker quantification, and the timing of sampling. When setting up HBM

Estimation of intra-operator variability in perfusion parameter measurements using DCE-US

PubMed Central

Gauthier, Marianne; Leguerney, Ingrid; Thalmensi, Jessie; Chebil, Mohamed; Parisot, Sarah; Peronneau, Pierre; Roche, Alain; Lassau, Nathalie

2011-01-01

AIM: To investigate intra-operator variability of semi-quantitative perfusion parameters using dynamic contrast-enhanced ultrasonography (DCE-US), following bolus injections of SonoVue®. METHODS: The in vitro experiments were conducted using three in-house sets up based on pumping a fluid through a phantom placed in a water tank. In the in vivo experiments, B16F10 melanoma cells were xenografted to five nude mice. Both in vitro and in vivo, images were acquired following bolus injections of the ultrasound contrast agent SonoVue® (Bracco, Milan, Italy) and using a Toshiba Aplio® ultrasound scanner connected to a 2.9-5.8 MHz linear transducer (PZT, PLT 604AT probe) (Toshiba, Japan) allowing harmonic imaging (“Vascular Recognition Imaging”) involving linear raw data. A mathematical model based on the dye-dilution theory was developed by the Gustave Roussy Institute, Villejuif, France and used to evaluate seven perfusion parameters from time-intensity curves. Intra-operator variability analyses were based on determining perfusion parameter coefficients of variation (CV). RESULTS: In vitro, different volumes of SonoVue® were tested with the three phantoms: intra-operator variability was found to range from 2.33% to 23.72%. In vivo, experiments were performed on tumor tissues and perfusion parameters exhibited values ranging from 1.48% to 29.97%. In addition, the area under the curve (AUC) and the area under the wash-out (AUWO) were two of the parameters of great interest since throughout in vitro and in vivo experiments their variability was lower than 15.79%. CONCLUSION: AUC and AUWO appear to be the most reliable parameters for assessing tumor perfusion using DCE-US as they exhibited the lowest CV values. PMID:21512654

Intra-Hour Dispatch and Automatic Generator Control Demonstration with Solar Forecasting - Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coimbra, Carlos F. M.

2016-02-25

In this project we address multiple resource integration challenges associated with increasing levels of solar penetration that arise from the variability and uncertainty in solar irradiance. We will model the SMUD service region as its own balancing region, and develop an integrated, real-time operational tool that takes solar-load forecast uncertainties into consideration and commits optimal energy resources and reserves for intra-hour and intra-day decisions. The primary objectives of this effort are to reduce power system operation cost by committing appropriate amount of energy resources and reserves, as well as to provide operators a prediction of the generation fleet’s behavior inmore » real time for realistic PV penetration scenarios. The proposed methodology includes the following steps: clustering analysis on the expected solar variability per region for the SMUD system, Day-ahead (DA) and real-time (RT) load forecasts for the entire service areas, 1-year of intra-hour CPR forecasts for cluster centers, 1-year of smart re-forecasting CPR forecasts in real-time for determination of irreducible errors, and uncertainty quantification for integrated solar-load for both distributed and central stations (selected locations within service region) PV generation.« less

Ambulatory measurement of the scapulohumeral rhythm: intra- and inter-operator agreement of a protocol based on inertial and magnetic sensors.

PubMed

Parel, I; Cutti, A G; Fiumana, G; Porcellini, G; Verni, G; Accardo, A P

2012-04-01

To measure the scapulohumeral rhythm (SHR) in outpatient settings, the motion analysis protocol named ISEO (INAIL Shoulder and Elbow Outpatient protocol) was developed, based on inertial and magnetic sensors. To complete the sensor-to-segment calibration, ISEO requires the involvement of an operator for sensor placement and for positioning the patient's arm in a predefined posture. Since this can affect the measure, this study aimed at quantifying ISEO intra- and inter-operator agreement. Forty subjects were considered, together with two operators, A and B. Three measurement sessions were completed for each subject: two by A and one by B. In each session, the humerus and scapula rotations were measured during sagittal and scapular plane elevation movements. ISEO intra- and inter-operator agreement were assessed by computing, between sessions, the: (1) similarity of the scapulohumeral patterns through the Coefficient of Multiple Correlation (CMC(2)), both considering and excluding the difference of the initial value of the scapula rotations between two sessions (inter-session offset); (2) 95% Smallest Detectable Difference (SDD(95)) in scapula range of motion. Results for CMC(2) showed that the intra- and inter-operator agreement is acceptable (median≥0.85, lower-whisker ≥ 0.75) for most of the scapula rotations, independently from the movement and the inter-session offset. The only exception is the agreement for scapula protraction-retraction and for scapula medio-lateral rotation during abduction (inter-operator), which is acceptable only if the inter-session offset is removed. SDD(95) values ranged from 4.4° to 8.6° for the inter-operator and between 4.9° and 8.5° for the intra-operator agreement. In conclusion, ISEO presents a high intra- and inter-operator agreement, particularly with the scapula inter-session offset removed. Copyright © 2011 Elsevier B.V. All rights reserved.

Inside the beating heart: an in vivo feasibility study on fusing pre- and intra-operative imaging for minimally invasive therapy.

PubMed

Linte, Cristian A; Moore, John; Wedlake, Chris; Bainbridge, Daniel; Guiraudon, Gérard M; Jones, Douglas L; Peters, Terry M

2009-03-01

An interventional system for minimally invasive cardiac surgery was developed for therapy delivery inside the beating heart, in absence of direct vision. A system was developed to provide a virtual reality (VR) environment that integrates pre-operative imaging, real-time intra-operative guidance using 2D trans-esophageal ultrasound, and models of the surgical tools tracked using a magnetic tracking system. Detailed 3D dynamic cardiac models were synthesized from high-resolution pre-operative MR data and registered within the intra-operative imaging environment. The feature-based registration technique was employed to fuse pre- and intra-operative data during in vivo intracardiac procedures on porcine subjects. This method was found to be suitable for in vivo applications as it relies on easily identifiable landmarks, and hence, it ensures satisfactory alignment of pre- and intra-operative anatomy in the region of interest (4.8 mm RMS alignment accuracy) within the VR environment. Our initial experience in translating this work to guide intracardiac interventions, such as mitral valve implantation and atrial septal defect repair demonstrated feasibility of the methods. Surgical guidance in the absence of direct vision and with no exposure to ionizing radiation was achieved, so our virtual environment constitutes a feasible candidate for performing various off-pump intracardiac interventions.

Unidentified retained inferior vena cava myxoma detected by intra-operative trans-oesophageal echocardiography.

PubMed

Vohra, H A; Phillips, N J; Nel, L; Diprose, P; Ohri, S K

2010-06-01

We report a unilateral right atrial familial myxoma with a multicentric nature discovered during cardiac surgery. After the patient was weaned off cardiopulmonary bypass, an inferior vena cava myxoma was discovered with intra-operative trans-oesophageal echocardiogram (TOE) which had been missed preoperatively and during surgery.

30 CFR 780.13 - Operation plan: Blasting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Operation plan: Blasting. 780.13 Section 780.13... SURFACE MINING PERMIT APPLICATIONS-MINIMUM REQUIREMENTS FOR RECLAMATION AND OPERATION PLAN § 780.13 Operation plan: Blasting. (a) Blasting plan. Each application shall contain a blasting plan for the proposed...

Biomedical programs operations plans

NASA Technical Reports Server (NTRS)

Walbrecher, H. F.

1974-01-01

Operational guidelines for the space shuttle life sciences payloads are presented. An operational assessment of the medical experimental altitude test for Skylab, and Skylab life sciences documentation are discussed along with the operations posture and collection of space shuttle operational planning data.

The Mission Operations Planning Assistant

NASA Technical Reports Server (NTRS)

Schuetzle, James G.

1987-01-01

The Mission Operations Planning Assistant (MOPA) is a knowledge-based system developed to support the planning and scheduling of instrument activities on the Upper Atmospheric Research Satellite (UARS). The MOPA system represents and maintains instrument plans at two levels of abstraction in order to keep plans comprehensible to both UARS Principal Investigators and Command Management personnel. The hierarchical representation of plans also allows MOPA to automatically create detailed instrument activity plans from which spacecraft command loads may be generated. The MOPA system was developed on a Symbolics 3640 computer using the ZetaLisp and ART languages. MOPA's features include a textual and graphical interface for plan inspection and modification, recognition of instrument operational constraint violations during the planning process, and consistency maintenance between the different planning levels. This paper describes the current MOPA system.

The mission operations planning assistant

NASA Technical Reports Server (NTRS)

Schuetzle, James G.

1987-01-01

The Mission Operations Planning Assistant (MOPA) is a knowledge-based system developed to support the planning and scheduling of instrument activities on the Upper Atmospheric Research Satellite (UARS). The MOPA system represents and maintains instrument plans at two levels of abstraction in order to keep plans comprehensible to both UARS Prinicpal Investigators and Command Management personnel. The hierarchical representation of plans also allows MOPA to automatically create detailed instrument activity plans from which spacecraft command loads may be generated. The MOPA system was developed on a Symbolics 3640 computer using the ZETALISP and ART languages. MOPA's features include a textual and graphical interface for plan inspection and modification, recognition of instrument operational constraint violations during the planning process, and consistency maintenance between the different planning levels. This paper describes the current MOPA system.

Postoperative Adhesion Development Following Cesarean and Open Intra-Abdominal Gynecological Operations

PubMed Central

Awonuga, Awoniyi O.; Fletcher, Nicole M.; Saed, Ghassan M.; Diamond, Michael P.

2011-01-01

In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions. PMID:21775773

Architecture for spacecraft operations planning

NASA Technical Reports Server (NTRS)

Davis, William S.

1991-01-01

A system which generates plans for the dynamic environment of space operations is discussed. This system synthesizes plans by combining known operations under a set of physical, functional, and temperal constraints from various plan entities, which are modeled independently but combine in a flexible manner to suit dynamic planning needs. This independence allows the generation of a single plan source which can be compiled and applied to a variety of agents. The architecture blends elements of temperal logic, nonlinear planning, and object oriented constraint modeling to achieve its flexibility. This system was applied to the domain of the Intravehicular Activity (IVA) maintenance and repair aboard Space Station Freedom testbed.

Operator-assisted planning and execution of proximity operations subject to operational constraints

NASA Technical Reports Server (NTRS)

Grunwald, Arthur J.; Ellis, Stephen R.

1991-01-01

Future multi-vehicle operations will involve multiple scenarios that will require a planning tool for the rapid, interactive creation of fuel-efficient trajectories. The planning process must deal with higher-order, non-linear processes involving dynamics that are often counter-intuitive. The optimization of resulting trajectories can be difficult to envision. An interaction proximity operations planning system is being developed to provide the operator with easily interpreted visual feedback of trajectories and constraints. This system is hosted on an IRIS 4D graphics platform and utilizes the Clohessy-Wiltshire equations. An inverse dynamics algorithm is used to remove non-linearities while the trajectory maneuvers are decoupled and separated in a geometric spreadsheet. The operator has direct control of the position and time of trajectory waypoints to achieve the desired end conditions. Graphics provide the operator with visualization of satisfying operational constraints such as structural clearance, plume impingement, approach velocity limits, and arrival or departure corridors. Primer vector theory is combined with graphical presentation to improve operator understanding of suggested automated system solutions and to allow the operator to review, edit, or provide corrective action to the trajectory plan.

Space Station Freedom operations planning

NASA Technical Reports Server (NTRS)

Accola, Anne L.; Keith, Bryant

1989-01-01

The Space Station Freedom program is developing an operations planning structure which assigns responsibility for planning activities to three tiers of management. The strategic level develops the policy, goals and requirements for the program over a five-year horizon. Planning at the tactical level emphasizes program integration and planning for a two-year horizon. The tactical planning process, architecture, and products have been documented and discussed with the international partners. Tactical planning includes the assignment of user and system hardware as well as significant operational events to a time increment (the period of time from the arrival of one Shuttle to the manned base to the arrival of the next). Execution-level planning emphasizes implementation, and each organization produces detailed plans, by increment, that are specific to its function.

Earth Resources Technology Satellite Operations Control Center (OCC). ERTS-B flight activation plan

NASA Technical Reports Server (NTRS)

1974-01-01

Included in this plan are general objectives through Day 7, operational guidelines and restraints. Following the activation of all subsystems (through Day 3), special series of payload operations were performed to obtain data samples for the different combinations of exposure/gain settings. This took place from Day 4 through Day 7. The Orbit Adjust was employed to perform vernier corrections after the orbit had been defined. The orbit data was collected through Day 3, with the corrections being made from Day 4 through Day 7. ERTS command auxiliary memory (ECAM) was turned on in Day 3 and the memory dumped to a narrow band tape recorder. A verification of memory was done in the off line mode. ECAM was not used in a payload support mode until Day 7.

[Low field intra-operative magnetic resonance imaging for brain tumour surgery: preliminary experience].

PubMed

Roldán, Pedro; García, Sergio; González, Josep; Reyes, Luis Alberto; Torales, Jorge; Valero, Ricard; Oleaga, Laura; Enseñat, Joaquim

Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital. A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015. A record was made of the data as regards surgical times, resection rates, histological diagnosis, hospital stay, and survival rates during follow-up. The study included 50 patients, with a mean age of 55 years (±13.7), a preoperative mean Karnofsky of 92 (being 81 post-operatively), and a mean follow-up of 10.5 months (±6.5). There were 26% re-operations due to recurrence. High-grade gliomas were reported in 56%, low-grade gliomas in 24%, and 20% "Other" tumours. Overall hospital stay was 10 days (±4.5). Depending on the histologiacl diagnosis, the "Others" group had a longer hospital stay. Overall, there were 52% complete removal, 18% of maximum removals, and 30% of partial removals. The overall survival rates during follow-up was 84%. iMRI is a safe and effective tool for brain tumour surgery. Its use allows an increase in resection rates, and minimises post-operative complications. Its implementation involves an increase in surgical time, which improves with the characteristic learning curve. More studies are needed to establish its role in the long-term survival of patients. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Automating Space Station operations planning

NASA Technical Reports Server (NTRS)

Ziemer, Kathleen A.

1989-01-01

The development and implementation of the operations planning processes for the Space Station are discussed. A three level planning process, consisting of strategic, tactical, and execution level planning, is being developed. The integration of the planning procedures into a tactical planning system is examined and the planning phases are illustrated.

A computational method for estimating the dosimetric effect of intra-fraction motion on step-and-shoot IMRT and compensator plans

NASA Astrophysics Data System (ADS)

Waghorn, Ben J.; Shah, Amish P.; Ngwa, Wilfred; Meeks, Sanford L.; Moore, Joseph A.; Siebers, Jeffrey V.; Langen, Katja M.

2010-07-01

Intra-fraction organ motion during intensity-modulated radiation therapy (IMRT) treatment can cause differences between the planned and the delivered dose distribution. To investigate the extent of these dosimetric changes, a computational model was developed and validated. The computational method allows for calculation of the rigid motion perturbed three-dimensional dose distribution in the CT volume and therefore a dose volume histogram-based assessment of the dosimetric impact of intra-fraction motion on a rigidly moving body. The method was developed and validated for both step-and-shoot IMRT and solid compensator IMRT treatment plans. For each segment (or beam), fluence maps were exported from the treatment planning system. Fluence maps were shifted according to the target position deduced from a motion track. These shifted, motion-encoded fluence maps were then re-imported into the treatment planning system and were used to calculate the motion-encoded dose distribution. To validate the accuracy of the motion-encoded dose distribution the treatment plan was delivered to a moving cylindrical phantom using a programmed four-dimensional motion phantom. Extended dose response (EDR-2) film was used to measure a planar dose distribution for comparison with the calculated motion-encoded distribution using a gamma index analysis (3% dose difference, 3 mm distance-to-agreement). A series of motion tracks incorporating both inter-beam step-function shifts and continuous sinusoidal motion were tested. The method was shown to accurately predict the film's dose distribution for all of the tested motion tracks, both for the step-and-shoot IMRT and compensator plans. The average gamma analysis pass rate for the measured dose distribution with respect to the calculated motion-encoded distribution was 98.3 ± 0.7%. For static delivery the average film-to-calculation pass rate was 98.7 ± 0.2%. In summary, a computational technique has been developed to calculate the

13. Operational planning for a specific intervention.

PubMed

2014-05-01

Every intervention must follow an operational plan. Operational plans delineate actions required to meet an objective that is part of the strategic plan (overarching goal). Operational plans dictate the critical pathways for the interventions that will be followed during and following the implementation of the intervention. Operational plans include: (1) an introduction and brief situation report; (2) an overview of the task(s), objectives, and the overarching goal to be addressed; (3) the methods that will be employed; (4) planning factors; (5) the resources that will be required including personnel, equipment, and supplies; (6) timelines, benchmarks, and milestones including their respective indicators, startup time, end point, and estimates of the time required for completion; (7) the administrative structure to be employed; (8) an operating budget; (9) the strategy for acquiring the funding required; (10) roles and responsibilities of the personnel including position descriptions and the competencies required of the personnel (skill sets); (11) mechanisms for monitoring the progress including the indicators that will be employed, (12) safety, including health of the personnel, required immunisations, accommodations, and reporting structure; (13) self-sufficiency; and (14) reporting and accounting. There are many generic items in an operational plan that can be used in successive plans. Without a detailed operational plan, interventions are doomed to probable failure and can profoundly negatively impact other projects operational in the area.

Colombo Plan Intra-Regional Technician Training Colloquium (6th, Kuala Lumpur, Malaysia, April 21-25, 1975).

ERIC Educational Resources Information Center

Colombo Plan Bureau (Sri Lanka).

Proceedings of the Sixth Colloquium on Intra-Regional Technical Training sponsored jointly by the Colombo Plan and the Government of Malaysia are presented in this report. Four working papers are presented centered around three main areas of concern: influence of technical education on economic development; how the status of technicians could be…

Parkland College 2001-2003 Operational Plan.

ERIC Educational Resources Information Center

Parkland Coll., Champaign, IL.

This Parkland College (Illinois) Operational Plan supports the document titled Parkland College 1999-2004: A Strategic Plan for Excellence. Strategic goals and strategies are followed by specific operational action plans that support the completion of the given corresponding strategy. The four goals include: (1) to develop the highest educational…

78 FR 21245 - Continuity of Operations Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

...; Order No. 778] Continuity of Operations Plan AGENCY: Federal Energy Regulatory Commission, DOE. ACTION: Final rule. SUMMARY: In this Final Rule the Commission revises its Continuity of Operations Plan... Commission's Continuity of Operations Plan (COOP) regulations to incorporate its regional offices into the...

Displaced intra-articular calcaneal fractures.

PubMed

Bajammal, Sohail; Tornetta, Paul; Sanders, David; Bhandari, Mohit

2005-01-01

Calcaneal fractures comprise 1 to 2 percent of all fractures. Approximately 75% of calcaneal fractures are intra-articular. The management of intra-articular calcaneal fractures remains controversial. Nonoperative treatment options include elevation, ice, early mobilization, and cyclic compression of the plantar arch. Operative treatment options include closed reduction and percutaneous pin fixation, open reduction and internal fixation, and arthrodesis. The effect of operative versus nonoperative treatment has been the focus of several comparative studies. This study was designed to determine the effect of operative treatment compared with nonoperative treatment on the rate of union, complications, and functional outcome after intra-articular calcaneal fracture in adults.

Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

PubMed

Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

2016-07-01

Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

Feasibility study of low-dose intra-operative cone-beam CT for image-guided surgery

NASA Astrophysics Data System (ADS)

Han, Xiao; Shi, Shuanghe; Bian, Junguo; Helm, Patrick; Sidky, Emil Y.; Pan, Xiaochuan

2011-03-01

Cone-beam computed tomography (CBCT) has been increasingly used during surgical procedures for providing accurate three-dimensional anatomical information for intra-operative navigation and verification. High-quality CBCT images are in general obtained through reconstruction from projection data acquired at hundreds of view angles, which is associated with a non-negligible amount of radiation exposure to the patient. In this work, we have applied a novel image-reconstruction algorithm, the adaptive-steepest-descent-POCS (ASD-POCS) algorithm, to reconstruct CBCT images from projection data at a significantly reduced number of view angles. Preliminary results from experimental studies involving both simulated data and real data show that images of comparable quality to those presently available in clinical image-guidance systems can be obtained by use of the ASD-POCS algorithm from a fraction of the projection data that are currently used. The result implies potential value of the proposed reconstruction technique for low-dose intra-operative CBCT imaging applications.

Planning Systems for Distributed Operations

NASA Technical Reports Server (NTRS)

Maxwell, Theresa G.

2002-01-01

This viewgraph representation presents an overview of the mission planning process involving distributed operations (such as the International Space Station (ISS)) and the computer hardware and software systems needed to support such an effort. Topics considered include: evolution of distributed planning systems, ISS distributed planning, the Payload Planning System (PPS), future developments in distributed planning systems, Request Oriented Scheduling Engine (ROSE) and Next Generation distributed planning systems.

An approach to evaluate the intra-urban thermal variability in summer using an urban indicator.

PubMed

Massetti, Luciano; Petralli, Martina; Brandani, Giada; Orlandini, Simone

2014-09-01

Urban planners and managers need tools to evaluate the performance of the present state and future development of cities in terms of comfort and quality of life. In this paper, an approach to analyse the intra-urban summer thermal variability, using an urban planning indicator, is presented. The proportion of buildings and concrete surfaces in a specific buffer area are calculated. Besides, the relationship between urban and temperature indicators is investigated and used to produce thermal maps of the city. This approach is applied to the analysis of intra-urban variability in Florence (Italy), of two thermal indices (heat index and cooling degree days) used to evaluate impacts on thermal comfort and energy consumption for indoor cooling. Our results suggest that urban planning indicators can describe intra-urban thermal variability in a way that can easily be used by urban planners for evaluating the effects of future urbanization scenarios on human health. Copyright © 2014 Elsevier Ltd. All rights reserved.

We the People: Law Day USA 1987. 1987 Planning Guide.

ERIC Educational Resources Information Center

American Bar Association, Chicago, IL.

"We the People" is the theme for the 1987 American Bar Association's 30th annual Law Day USA, observed May 1. This guide brings together information to help plan and execute programs which call attention to the principles and practices of United States law and justice. The guide contains facts about Law Day; tips for planning a Law Day…

Operation Plan 14-44 ICEBERG

DTIC Science & Technology

1944-12-31

report of de struction is required. C. H. McMOHKCS Chief of Staff 258 DISTRIBUTION : Same as Op- Plan 14-44 1. E. KEETOW Asst. Flag Secretary...w by author*/ oficLIss OPERATION PLAN 14—44 ICEBERG \\. CiNcPOA BRIG GEN W.A.DUMAS FORC6S UNCLAES1FO Report Documentation Page Form ApprovedOMB No...4. TITLE AND SUBTITLE Operation Plan 14-44 Iceberg 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT

Intra-Operative Surgical Irrigation of the Surgical Incision: What Does the Future Hold-Saline, Antibiotic Agents, or Antiseptic Agents?

PubMed

Edmiston, Charles E; Leaper, David J

2016-12-01

Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure. Review of PubMed and OVID for pertinent, scientific, and clinical publications in the English language was performed. Incision irrigation was found to afford a three-fold benefit: First, to hydrate the bed; second, to assist in allowing better examination of the area immediately before closure; and finally, by removing superficial and deep incisional contamination and lowering the bioburden, expedite the healing process. The clinical practice of intra-operative peritoneal lavage is highly variable and is dependent solely on surgeon preference. By contrast, intra-operative irrigation after device-related procedures has become a standard of care for the prophylaxis of acute peri-prosthetic infection. The clinical evidence that supports the use of antibiotic irrigation is limited and based on retrospective analysis and few acceptable randomized controlled trials. The results of laboratory and animal studies using aqueous 0.05% chlorhexidine gluconate are favorable, suggesting that further studies are justified to determine its clinical efficacy. The adoption of appropriate and standardized intra-operative irrigation practices into peri-operative care bundles, which include other evidence-based strategies (weight-based antimicrobial prophylaxis, antimicrobial sutures, maintenance of normothermia, and glycemic control), offers

43 CFR 3592.1 - Operating plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OPERATIONS Plans and Maps § 3592.1 Operating plans. (a) Before conducting any operations under any lease(s... description of geologic conditions and mineral resources, with appropriate maps, within the area where mining is to be conducted; (3) A copy of a suitable map or aerial photograph showing the topography, the...

43 CFR 3592.1 - Operating plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OPERATIONS Plans and Maps § 3592.1 Operating plans. (a) Before conducting any operations under any lease(s... description of geologic conditions and mineral resources, with appropriate maps, within the area where mining is to be conducted; (3) A copy of a suitable map or aerial photograph showing the topography, the...

43 CFR 3592.1 - Operating plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OPERATIONS Plans and Maps § 3592.1 Operating plans. (a) Before conducting any operations under any lease(s... description of geologic conditions and mineral resources, with appropriate maps, within the area where mining is to be conducted; (3) A copy of a suitable map or aerial photograph showing the topography, the...

Intra-operative cardiac monitoring by trans-oesophageal Doppler is not risk free in surgical patients.

PubMed

Siddiqui, Muhammad Rafay Sameen; Sajid, Muhammad Shafiq; Baig, Mirza Khurram

2009-04-01

The advancement of medical technology and future improvements in public health will lead to surgeons operating on high risk patients. One of these advances is to use intra-operative trans-oesophageal Doppler (TOD) to optimise fluid management. TOD is known to be the most effective technique for intraoperative cardiac monitoring. We report a case of a potentially life threatening complication from intraoperative TOD monitoring.

Uncertainty and operational considerations in mass prophylaxis workforce planning.

PubMed

Hupert, Nathaniel; Xiong, Wei; King, Kathleen; Castorena, Michelle; Hawkins, Caitlin; Wu, Cindie; Muckstadt, John A

2009-12-01

The public health response to an influenza pandemic or other large-scale health emergency may include mass prophylaxis using multiple points of dispensing (PODs) to deliver countermeasures rapidly to affected populations. Computer models created to date to determine "optimal" staffing levels at PODs typically assume stable patient demand for service. The authors investigated POD function under dynamic and uncertain operational environments. The authors constructed a Monte Carlo simulation model of mass prophylaxis (the Dynamic POD Simulator, or D-PODS) to assess the consequences of nonstationary patient arrival patterns on POD function under a variety of POD layouts and staffing plans. Compared are the performance of a standard POD layout under steady-state and variable patient arrival rates that may mimic real-life variation in patient demand. To achieve similar performance, PODs functioning under nonstationary patient arrival rates require higher staffing levels than would be predicted using the assumption of stationary arrival rates. Furthermore, PODs may develop severe bottlenecks unless staffing levels vary over time to meet changing patient arrival patterns. Efficient POD networks therefore require command and control systems capable of dynamically adjusting intra- and inter-POD staff levels to meet demand. In addition, under real-world operating conditions of heightened uncertainty, fewer large PODs will require a smaller total staff than many small PODs to achieve comparable performance. Modeling environments that capture the effects of fundamental uncertainties in public health disasters are essential for the realistic evaluation of response mechanisms and policies. D-PODS quantifies POD operational efficiency under more realistic conditions than have been modeled previously. The authors' experiments demonstrate that effective POD staffing plans must be responsive to variation and uncertainty in POD arrival patterns. These experiments highlight the need

Operational Plan Ontology Model for Interconnection and Interoperability

NASA Astrophysics Data System (ADS)

Long, F.; Sun, Y. K.; Shi, H. Q.

2017-03-01

Aiming at the assistant decision-making system’s bottleneck of processing the operational plan data and information, this paper starts from the analysis of the problem of traditional expression and the technical advantage of ontology, and then it defines the elements of the operational plan ontology model and determines the basis of construction. Later, it builds up a semi-knowledge-level operational plan ontology model. Finally, it probes into the operational plan expression based on the operational plan ontology model and the usage of the application software. Thus, this paper has the theoretical significance and application value in the improvement of interconnection and interoperability of the operational plan among assistant decision-making systems.

Shuttle operations era planning for flight operations

NASA Technical Reports Server (NTRS)

Holt, J. D.; Beckman, D. A.

1984-01-01

The Space Transportation System (STS) provides routine access to space for a wide range of customers in which cargos vary from single payloads on dedicated flights to multiple payloads that share Shuttle resources. This paper describes the flight operations planning process from payload introduction through flight assignment to execution of the payload objectives and the changes that have been introduced to improve that process. Particular attention is given to the factors that influence the amount of preflight preparation necessary to satisfy customer requirements. The partnership between the STS operations team and the customer is described in terms of their functions and responsibilities in the development of a flight plan. A description of the Mission Control Center (MCC) and payload support capabilities completes the overview of Shuttle flight operations.

Intra-operative 3D imaging system for robot-assisted fracture manipulation.

PubMed

Dagnino, G; Georgilas, I; Tarassoli, P; Atkins, R; Dogramadzi, S

2015-01-01

Reduction is a crucial step in the treatment of broken bones. Achieving precise anatomical alignment of bone fragments is essential for a good fast healing process. Percutaneous techniques are associated with faster recovery time and lower infection risk. However, deducing intra-operatively the desired reduction position is quite challenging due to the currently available technology. The 2D nature of this technology (i.e. the image intensifier) doesn't provide enough information to the surgeon regarding the fracture alignment and rotation, which is actually a three-dimensional problem. This paper describes the design and development of a 3D imaging system for the intra-operative virtual reduction of joint fractures. The proposed imaging system is able to receive and segment CT scan data of the fracture, to generate the 3D models of the bone fragments, and display them on a GUI. A commercial optical tracker was included into the system to track the actual pose of the bone fragments in the physical space, and generate the corresponding pose relations in the virtual environment of the imaging system. The surgeon virtually reduces the fracture in the 3D virtual environment, and a robotic manipulator connected to the fracture through an orthopedic pin executes the physical reductions accordingly. The system is here evaluated through fracture reduction experiments, demonstrating a reduction accuracy of 1.04 ± 0.69 mm (translational RMSE) and 0.89 ± 0.71 ° (rotational RMSE).

Pressure-relieving properties of a intra-operative warming device.

PubMed

Baker, E A; Leaper, D J

2003-04-01

The primary objective of this study was to determine differences in interface pressure between four mattress combinations: a standard operating table mattress, a pressure-relieving gel pad and an under-patient warming device set at 38 degrees C (Pegasus Inditherm System) and at ambient temperature. The secondary objective was to determine whether the warming device remains stable in extreme surgical positions. Interface pressures obtained with all four combinations were measured in 10 healthy volunteers using force sensing array technology. The warming device demonstrated better or equivalent pressure relief when compared with the standard gel pad. There was no significant difference in subject position 'shift' between the mattress, the gel pad and the warming device for either the Trendelenberg or reverse Trendelenberg positions. Both pressure-relieving mattresses and warming reduce intra-operative pressure damage. A mattress with both properties may further reduce pressure damage postoperatively. The warming device used in this study appears stable--subject 'slippage' was minimal in extreme positions. Research needs to be conducted among real anaesthetised patients to support these conclusions.

Intra-operative monitoring of the common peroneal nerve during total knee replacement.

PubMed Central

Unwin, A J; Thomas, M

1994-01-01

We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work. Images Figure 6. PMID:7837197

Gallic Acid Attenuates Postoperative Intra-Abdominal Adhesion by Inhibiting Inflammatory Reaction in a Rat Model

PubMed Central

Wei, Guangbing; Wu, Yunhua; Gao, Qi; Shen, Cong; Chen, Zilu; Wang, Kang; Yu, Junhui

2018-01-01

Background Intra-abdominal adhesion is one of the most common complications after abdominal surgery. The efficacy of current treatments for intra-abdominal adhesion is unsatisfactory. In this study, we investigated the effect of gallic acid on the prevention and treatment of intra-abdominal adhesions after abdominal surgery using an intra-abdominal adhesion rat model. Material/Methods The experimental rats were randomly divided into the sham operation group, the control group, the chitosan group, and 3 gallic acid groups of different concentrations. All rats except those in the sham operation group received cecal abrasion to induce adhesion. From the first postoperative day, the rats in the gallic acid groups were administered different concentrations of gallic acid in a 2-ml gavage daily. All rats were sacrificed on postoperative day 7, and the degree of intra-abdominal adhesion was evaluated by the naked eye. The amount of collagen deposited between the injured peritoneal tissues was assessed by Sirius red staining. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor-β (TGF-β) were measured by ELISA. Western blot was used to detect the level of NF-κB phosphorylation in the injured peritoneal or adhesion tissues of the rats. Results Compared with the control group, the scores of intra-abdominal adhesions in the rats treated with larger doses of gallic acid were significantly decreased, and the degree of inflammation and fibrosis was also significantly decreased. Gallic acid significantly reduced IL-6, TNF-α, and TGF-β1 serum levels. NF-κB phosphorylation in the higher gallic acid groups was significantly reduced. Conclusions Gallic acid inhibits the formation of postoperative intra-abdominal adhesions in rats by inhibiting the inflammatory reaction and fibrogenesis. Gallic acid is a promising drug for preventing intra-abdominal adhesions. PMID:29429982

Decreasing cartilage damage in a rat model of osteoarthritis by intra-articular injection of deoxycholic acid

PubMed Central

Yan, Zhaowei; Xiong, Jianbin; Zhao, Chunyang; Qin, Chenhao; He, Chunyan

2015-01-01

Background: The aim of this experimental study was to evaluate the effect of intra-articular injection of Deoxycholic acid (DCA) on articular cartilage and subchondral bone following induction of knee Osteoarthritis (OA) in a rat model. Methods: Twenty-four Sprague Dawley rats were randomized divided into 4 groups (n = 6). Eighteen of the 24 rats underwent surgical destabilization of the medial meniscus on the right knee joints to induce OA, were divided into 3 groups: DCA 30 mg/kg group, DCA 120 mg/kg group and OA group. The rats in DCA-treated groups were given intra-articular injections of DCA (30 mg/kg or 120 mg/kg) in the operated knees once per 3 days for 42 days. The rats in OA group given intra-articular injections of vehicle alone in the operated knees under the same conditions. The remaining 6 rats (sham-operation group) received sham operations on the right knee joints. 45 days postoperatively, all of the animals were euthanized for macroscopic, histological and radiographic analysis to evaluate the effect of DCA on OA and to determine its potential mechanisms. Results: The results showed that DCA attenuated the severity of OA by reducing macroscopic observation sores for femoral condyles and histological sores for articular cartilage. DCA also significantly decreased bone destruction and erosion of joint evaluated by radiographic examination. Furthermore, DCA could markedly reduce the release of MMP-1, MMP-3 and IL-1β in serum. Conclusions: Intra-articular injection of DCA is beneficial for knee OA. It might repair and protect OA cartilage by delaying cartilage degeneration and impairing the function of inflammatory mediators. These findings highlight DCA might be a useful therapeutic agent for OA. PMID:26309557

On intra-supply chain system with an improved distribution plan, multiple sales locations and quality assurance.

PubMed

Chiu, Singa Wang; Huang, Chao-Chih; Chiang, Kuo-Wei; Wu, Mei-Fang

2015-01-01

Transnational companies, operating in extremely competitive global markets, always seek to lower different operating costs, such as inventory holding costs in their intra- supply chain system. This paper incorporates a cost reducing product distribution policy into an intra-supply chain system with multiple sales locations and quality assurance studied by [Chiu et al., Expert Syst Appl, 40:2669-2676, (2013)]. Under the proposed cost reducing distribution policy, an added initial delivery of end items is distributed to multiple sales locations to meet their demand during the production unit's uptime and rework time. After rework when the remaining production lot goes through quality assurance, n fixed quantity installments of finished items are then transported to sales locations at a fixed time interval. Mathematical modeling and optimization techniques are used to derive closed-form optimal operating policies for the proposed system. Furthermore, the study demonstrates significant savings in stock holding costs for both the production unit and sales locations. Alternative of outsourcing product delivery task to an external distributor is analyzed to assist managerial decision making in potential outsourcing issues in order to facilitate further reduction in operating costs.

Search for Intra-day Optical Variability in Mrk 501

NASA Astrophysics Data System (ADS)

Feng, Hai-Cheng; Liu, H. T.; Fan, X. L.; Zhao, Yinghe; Bai, J. M.; Wang, Fang; Xiong, D. R.; Li, S. K.

2017-11-01

We present our observations of the optical intra-day variability (IDV) in γ-ray BL Lac object Mrk 501. The observations were run with the 1.02 m and 2.4 m optical telescopes at Yunnan Observatories from 2005 April to 2012 May. The light curve at the R band on 2010 May 15 passes both variability tests (the F-test and the ANOVA test). A flare within the light curve on 2010 May 15 has a magnitude change of {{Δ }}m=0.03+/- {0.005}{stat}+/- {0.007}{sys} mag, a darkening timescale of {τ }{{d}}=26.7 minutes, and an amplitude of IDV {Amp}=2.9 % +/- 0.7 % . A decline described by 11 consecutive flux measurements within the flare can be fitted linearly with a Pearson’s correlation coefficient r = 0.945 at the confidence level of > 99.99 % . Under the assumptions that the IDV is tightly connected to the mass of the black hole, and that the flare duration, being two times {τ }{{d}}, is representative of the minimum characteristic timescale, we can derive upper bounds to the mass of the black hole. In the case of the Kerr black hole, the timescale of {{Δ }}{t}\\min {ob}=0.89 hr gives {M}\\bullet ≲ {10}9.20{M}⊙ , which is consistent with measurements reported in the literature. This agreement indicates that the hypothesis about {M}\\bullet and {{Δ }}{t}\\min {ob} is consistent with the measurements/data.

Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

PubMed

Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

2017-01-01

Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.

Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions

PubMed Central

Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

2017-01-01

Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping. PMID:28700619

How to Plan a Theme Based Field Day

ERIC Educational Resources Information Center

Shea, Scott A.; Fagala, Lisa M.

2006-01-01

Having a theme-based field day is a great way to get away from doing the traditional track-and-field type events, such as the softball throw, 50 yard dash, and sack race, year after year. In a theme-based field day format all stations or events are planned around a particular theme. This allows the teacher to be creative while also adding…

Use of auditory evoked potentials for intra-operative awareness in anesthesia: a consciousness-based conceptual model.

PubMed

Dong, Xuebao; Suo, Puxia; Yuan, Xin; Yao, Xuefeng

2015-01-01

Auditory evoked potentials (AEPs) have been used as a measure of the depth of anesthesia during the intra-operative process. AEPs are classically divided, on the basis of their latency, into first, fast, middle, slow, and late components. The use of auditory evoked potential has been advocated for the assessment of Intra-operative awareness (IOA), but has not been considered seriously enough to universalize it. It is because we have not explored enough the impact of auditory perception and auditory processing on the IOA phenomena as well as on the subsequent psychological impact of IOA on the patient. More importantly, we have seldom tried to look at the phenomena of IOP from the perspective of consciousness itself. This perspective is especially important because many of IOA phenomena exist in the subconscious domain than they do in the conscious domain of explicit recall. Two important forms of these subconscious manifestations of IOA are the implicit recall phenomena and post-operative dreams related to the operation. Here, we present an integrated auditory consciousness-based model of IOA. We start with a brief description of auditory awareness and the factors affecting it. Further, we proceed to the evaluation of conscious and subconscious information processing by auditory modality and how they interact during and after intra-operative period. Further, we show that both conscious and subconscious auditory processing affect the IOA experience and both have serious psychological implications on the patient subsequently. These effects could be prevented by using auditory evoked potential during monitoring of anesthesia, especially the mid-latency auditory evoked potentials (MLAERs). To conclude our model with present hypothesis, we propose that the use of auditory evoked potential should be universal with general anesthesia use in order to prevent the occurrences of distressing outcomes resulting from both conscious and subconscious auditory processing during

NIF Operations Management Plan, August 2011

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Wonterghem, Bruno M.

Lawrence Livermore National Laboratory’s (LLNL) National Ignition Facility (NIF) is a key component of the National Nuclear Security Administration’s (NNSA) Stockpile Stewardship Program, whose purpose is to maintain the safety, reliability, and effectiveness of our nation’s nuclear stockpile without underground nuclear testing. The NIF is crucial to the Stockpile Stewardship Program because it is the only facility that can create the conditions of extreme temperature and pressure—conditions that exist only in stars or in exploding nuclear weapons—that are relevant to understanding how our modern nuclear weapons operate. As such, the NIF’s primary mission is to attain fusion ignition in themore » laboratory. Fusion ignition not only supports Stockpile Stewardship needs, but also provides the basis for future decisions about fusion’s potential as a long-term energy source. Additionally, NIF provides scientists with access to high-energy-density regimes that can yield new insight and understanding in the areas of astrophysics, hydrodynamics, material properties, plasma physics, and radiative properties. The use of the NIF to support the Stockpile Stewardship Program and the advancement of basic high-energy-density science understanding is planned and managed through program-level execution plans and NIF directorate-level management teams. An example of a plan is the National Ignition Campaign Execution Plan. The NIF Operations Management Plan provides an overview of the NIF Operations organization and describes how the NIF is supported by the LLNL infrastructure and how it is safely and responsibly managed and operated. Detailed information on NIF management of the organization is found in a series of supporting plans, policies, and procedures. A list of related acronyms can be found in Appendix A of this document. The purpose of this document is to provide a roadmap of how the NIF Operations organization functions. It provides a guide to

76 FR 77431 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... (DG) DG-4014, ``Decommissioning Planning During Operations.'' This guide describes a method that the.... The draft regulatory guide entitled, ``Decommissioning Planning During Operations,'' is temporarily..., 40, 50, 70, and 72 RIN 3150-AI55 [NRC-2011-0286; NRC-2008-0030] Decommissioning Planning During...

78 FR 663 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...] Decommissioning Planning During Operations AGENCY: Nuclear Regulatory Commission. ACTION: Regulatory guide..., ``Decommissioning Planning During Operations.'' The guide describes a method that the NRC staff considers acceptable for use by holders of licenses in complying with the NRC's Decommissioning Planning Rule (DPR) (76 FR...

77 FR 41107 - Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

..., 40, 50, 70, and 72 [NRC-2011-0162] Decommissioning Planning During Operations AGENCY: Nuclear... (DG) 4014, ``Decommissioning Planning During Operations.'' This guide describes a method that the NRC staff considers acceptable for use in complying with the NRC's Decommissioning Planning Rule. The NRC...

40 CFR 265.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: (i) Changes in operating plans or facility design affect the post-closure plan, or (ii) Events which... operation, or no later than 60 days after an unexpected event has occurred which has affected the post... operation, or no more than 60 days after an unexpected event has occurred which has affected the post...

40 CFR 265.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: (i) Changes in operating plans or facility design affect the post-closure plan, or (ii) Events which... operation, or no later than 60 days after an unexpected event has occurred which has affected the post... operation, or no more than 60 days after an unexpected event has occurred which has affected the post...

New problem with sales, inventories, and operations planning in a supply chain environment

NASA Astrophysics Data System (ADS)

Thomas, Andre; Lamouri, Samir

2000-10-01

The highest level of planning and control system is necessary, because production and logistics systems are not so flexible to follow, from day to day, sales evolutions. The companies are therefore held to standardize the good practices concerning the elaboration of their Sales, Inventories and Operations Planning (SIOP). The SIOP makes it possible to implement the strategic objectives defined by Top Management at the time of the Business Plan. It is the link between sales and manufacturing planning. The objectives of each of those depend on the specificity of their trade: the Sales Department will go for a maximum sales whereas Production will endeavor to keep industrial cost prices as low as possible while the Finance Department will try to optimize the use of available funds. There are several tools for this optimization: Graphical method and linear programming. Today, the economic context requires robust optimization.

Cloud and Sun-glint statistics derived from GOES and MODIS observations over the Intra-Americas Sea for GEO-CAPE mission planning

NASA Astrophysics Data System (ADS)

Feng, Lian; Hu, Chuanmin; Barnes, Brian B.; Mannino, Antonio; Heidinger, Andrew K.; Strabala, Kathleen; Iraci, Laura T.

2017-02-01

Knowledge of cloud cover, frequency, and duration is not only important to study cloud dynamics, but also critical in determining when and where to take ocean measurements from geostationary orbits such as the Geostationary Coastal and Air Pollution Events (GEO-CAPE) mission due to the challenges in achieving complete hemispheric coverage of coastal oceans, estuaries, and inland waters at hourly frequency. Using GOES hourly measurements at 4 km nadir resolution between 2006 and 2011, the number of cloud-free hourly observations per day (Ncf) for solar zenith angle θo < 80° was estimated for each 0.1° location of the Intra-Americas Sea. The number of Sun-glint-affected hourly observations per day (Nsg) was also calculated based on the planned GEO-CAPE observation geometry and realistic wind speed. High-latitude and equatorial oceans showed the lowest Ncf (<2.4) in all climatological months, and highest Ncf was observed in the Gulf of Mexico (GoM) and Caribbean (>4.5). Different regions showed differences in seasonality of cloud-free conditions and also showed differences in the hour of a day at which the satellite observations would have the maximal cloud-free and glint-free probability (Tmax). Cloud cover from Moderate Resolution Imaging Spectroradiometer (MODIS) 1 km measurements are >10% higher than those from the MODIS 250 m measurements, supporting ocean color missions at subkilometer resolutions to enhance both spatial coverage and temporal frequency. These findings provide valuable information for GEO-CAPE mission planning to maximize its science value through minimizing the impacts of clouds and Sun glint.

How To Plan a Curriculum Demonstration Day.

ERIC Educational Resources Information Center

Mahan, James M.

This report provides some guidance and materials that could be useful to those considering planning and conducting a curriculum demonstration day in a local school. These materials were used successfully in ERIE's pilot school, and they demonstrate a fully implemented elementary school science curriculum. Included in the document are a checklist…

T.E.A. Study: three-day ertapenem versus three-day Ampicillin-Sulbactam.

PubMed

Catena, Fausto; Vallicelli, Carlo; Ansaloni, Luca; Sartelli, Massimo; Di Saverio, Salomone; Schiavina, Riccardo; Pasqualini, Eddi; Amaduzzi, Annalisa; Coccolini, Federico; Cucchi, Michele; Lazzareschi, Daniel; Baiocchi, Gian Luca; Pinna, Antonio D

2013-04-30

Intra-abdominal infections are one of the most common infections encountered by a general surgeon. However, despite this prevalence, standardized guidelines outlining the proper use of antibiotic therapy are poorly defined due to a lack of clinical trials investigating the ideal duration of antibiotic treatment. The aim of this study is to compare the efficacy and safety of a three-day treatment regimen of Ampicillin-Sulbactam to that of a three-day regimen of Ertapenem in patients with localized peritonitis ranging from mild to moderate severity. This study is a prospective, multi-center, randomized investigation performed in the Department of General, Emergency, and Transplant Surgery of St. Orsola-Malpighi University Hospital in Bologna, Italy. Discrete data were analyzed using the Chi-squared and Fisher exact tests. Differences between the two study groups were considered statistically significant for p-values less than 0.05. 71 patients were treated with Ertapenem and 71 patients were treated with Ampicillin-Sulbactam. The two groups were comparable in terms of age and gender as well as the site of abdominal infection. Post-operative infection was identified in 12 patients: 10 with wound infections and 2 with intra-abdominal infections. In the Ertapenem group, 69 of the 71 patients (97%) were treated successfully, while the therapy failed in 2 cases (3%). Therapy failures were more frequent in the Unasyn group, amounting to 10 of 71 cases (p = 0.03). According to these preliminary findings, the authors conclude that a three-day Ertapenem treatment regimen is the most effective antibiotic therapy for patients with localized intra-abdominal infections ranging from mild to moderate severity. Trial registration: ClinicalTrials.gov: NCT00630513.

30 CFR 780.11 - Operation plan: General requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Operation plan: General requirements. 780.11... PLAN § 780.11 Operation plan: General requirements. Each application shall contain a description of the... INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER...

30 CFR 784.11 - Operation plan: General requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Operation plan: General requirements. 784.11... PLAN § 784.11 Operation plan: General requirements. Each application shall contain a description of the... INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER...

A distributed planning concept for Space Station payload operations

NASA Technical Reports Server (NTRS)

Hagopian, Jeff; Maxwell, Theresa; Reed, Tracey

1994-01-01

The complex and diverse nature of the payload operations to be performed on the Space Station requires a robust and flexible planning approach. The planning approach for Space Station payload operations must support the phased development of the Space Station, as well as the geographically distributed users of the Space Station. To date, the planning approach for manned operations in space has been one of centralized planning to the n-th degree of detail. This approach, while valid for short duration flights, incurs high operations costs and is not conducive to long duration Space Station operations. The Space Station payload operations planning concept must reduce operations costs, accommodate phased station development, support distributed users, and provide flexibility. One way to meet these objectives is to distribute the planning functions across a hierarchy of payload planning organizations based on their particular needs and expertise. This paper presents a planning concept which satisfies all phases of the development of the Space Station (manned Shuttle flights, unmanned Station operations, and permanent manned operations), and the migration from centralized to distributed planning functions. Identified in this paper are the payload planning functions which can be distributed and the process by which these functions are performed.

[Interventional Radiology for Intra-Abdominal Abscess after Gastrectomy].

PubMed

Matsuura, Norihiro; Fujitani, Kazumasa; Kawada, Junji; Nishikawa, Kazuhiro; Nakatsuka, Rie; Miyazaki, Susumu; Danno, Katsuki; Motoori, Masaaki; Kubota, Masaru; Matsuda, Chu; Yoshida, Hiroshi; Iwase, Kazuhiro; Tanaka, Yasuhiro

2015-11-01

Approximately 20% of patients develop some complications after gastrectomy. These complications should be treated appropriately to achieve a positive outcome. The records of 6 patients with postoperative intra-abdominal abscesses treated with interventional radiology (IVR) were analyzed. The cause of abscess was anastomotic leakage in 4 patients and contaminated surgery after gastric perforation in 2 patients. Intra-abdominal abscesses were detected on postoperative day 12 (median), and an IVR-guided drainage tube was inserted with a median interval of 1 day. The drainage tube was kept in place for 26 days (median), and patients were discharged 6.5 days (median) after drainage tube removal. No patients were converted to open surgery. Early IVR-guided drainage was essential and effective for intra-abdominal abscess treatment after gastrectomy.

NASA deep space network operations planning and preparation

NASA Technical Reports Server (NTRS)

Jensen, W. N.

1982-01-01

The responsibilities and structural organization of the Operations Planning Group of NASA Deep Space Network (DSN) Operations are outlined. The Operations Planning group establishes an early interface with a user's planning organization to educate the user on DSN capabilities and limitations for deep space tracking support. A team of one or two individuals works through all phases of the spacecraft launch and also provides planning and preparation for specific events such as planetary encounters. Coordinating interface is also provided for nonflight projects such as radio astronomy and VLBI experiments. The group is divided into a Long Range Support Planning element and a Near Term Operations Coordination element.

Interactive orbital proximity operations planning system

NASA Technical Reports Server (NTRS)

Grunwald, Arthur J.; Ellis, Stephen R.

1990-01-01

An interactive graphical planning system for on-site planning of proximity operations in the congested multispacecraft environment about the space station is presented. The system shows the astronaut a bird's eye perspective of the space station, the orbital plane, and the co-orbiting spacecraft. The system operates in two operational modes: (1) a viewpoint mode, in which the astronaut is able to move the viewpoint around in the orbital plane to range in on areas of interest; and (2) a trajectory design mode, in which the trajectory is planned. Trajectory design involves the composition of a set of waypoints which result in a fuel-optimal trajectory which satisfies all operational constraints, such as departure and arrival constraints, plume impingement constraints, and structural constraints. The main purpose of the system is to present the trajectory and the constraints in an easily interpretable graphical format. Through a graphical interactive process, the trajectory waypoints are edited until all operational constraints are satisfied. A series of experiments was conducted to evaluate the system. Eight airline pilots with no prior background in orbital mechanics participated in the experiments. Subject training included a stand-alone training session of about 6 hours duration, in which the subjects became familiar with orbital mechanics concepts and performed a series of exercises to familiarize themselves with the control and display features of the system. They then carried out a series of production runs in which 90 different trajectory design situations were randomly addressed. The purpose of these experiments was to investigate how the planning time, planning efforts, and fuel expenditures were affected by the planning difficulty. Some results of these experiments are presented.

36 CFR 9.9 - Plan of operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Plan of operations. 9.9 Section 9.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.9 Plan of operations. (a) No operations shall be conducted within any...

36 CFR 9.9 - Plan of operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Plan of operations. 9.9 Section 9.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.9 Plan of operations. (a) No operations shall be conducted within any...

36 CFR 9.9 - Plan of operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Plan of operations. 9.9 Section 9.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.9 Plan of operations. (a) No operations shall be conducted within any...

36 CFR 9.9 - Plan of operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Plan of operations. 9.9 Section 9.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT Mining and Mining Claims § 9.9 Plan of operations. (a) No operations shall be conducted within any...

Astrophysics science operations - Near-term plans and vision

NASA Technical Reports Server (NTRS)

Riegler, Guenter R.

1991-01-01

Astrophysics science operations planned by the Science Operations branch of NASA Astrophysics Division for the 1990s for the purpose of gathering spaceborne astronomical data are described. The paper describes the near-future plans of the Science Operations in the areas of the preparation of the proposal; the planning and execution of spaceborne observations; the collection, processing, and analysis data; and the dissemination of results. Also presented are concepts planned for introduction at the beginning of the 20th century, including the concepts of open communications, transparent instrument and observatory operations, a spiral requirements development method, and an automated research assistant.

Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats.

PubMed

Silveira, Francisco; Quinn, Robert J; Adrian, Anna M; Owen, Martin R; Bush, Mark A

2017-01-16

To assess the effect of intra-operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats. In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radiographs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR). A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different. The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.

ASB Clinical Biomechanics Award Paper 2010: Virtual Pre-Operative Reconstruction Planning for Comminuted Articular Fractures

PubMed Central

Thomas, Thaddeus P.; Anderson, Donald D.; Willis, Andrew R.; Liu, Pengcheng; Marsh, J. Lawrence; Brown, Thomas D.

2010-01-01

Background Highly comminuted intra-articular fractures are complex and difficult injuries to treat. Once emergent care is rendered, the definitive treatment objective is to restore the original anatomy while minimizing surgically induced trauma. Operations that use limited or percutaneous approaches help preserve tissue vitality, but reduced visibility makes reconstruction more difficult. A pre-operative plan of how comminuted fragments would best be re-positioned to restore anatomy helps in executing a successful reduction. Methods In this study, methods for virtually reconstructing a tibial plafond fracture were developed and applied to clinical cases. Building upon previous benchtop work, novel image analysis techniques and puzzle solving algorithms were developed for clinical application. Specialty image analysis tools were used to segment the fracture fragment geometries from CT data. The original anatomy was then restored by matching fragment native (periosteal and subchondral) bone surfaces to an intact template, generated from the uninjured contralateral limb. Findings Virtual reconstructions obtained for ten tibial plafond fracture cases had average alignment errors of 0.39 (0.5 standard deviation) mm. In addition to precise reduction planning, 3D puzzle solutions can help identify articular deformities and bone loss. Interpretation The results from this study indicate that 3D puzzle solving provides a powerful new tool for planning the surgical reconstruction of comminuted articular fractures. PMID:21215501

Interactive orbital proximity operations planning system

NASA Technical Reports Server (NTRS)

Grunwald, Arthur J.; Ellis, Stephen R.

1988-01-01

An interactive graphical proximity operations planning system was developed, which allows on-site design of efficient, complex, multiburn maneuvers in a dynamic multispacecraft environment. Maneuvering takes place in and out of the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of orbital dynamics and complex time-varying operational constraints. This difficulty is greatly overcome by visualizing the relative trajectories and the relevant constraints in an easily interpretable graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of a Space Station and co-orbiting spacecraft on the background of the Station's orbital plane. The operator has control over the two modes of operation: a viewing system mode, which enables the exporation of the spatial situation about the Space Station and thus the ability to choose and zoom in on areas of interest; and a trajectory design mode, which allows the interactive editing of a series of way points and maneuvering burns to obtain a trajectory that complies with all operational constraints. A first version of this display was completed. An experimental program is planned in which operators will carry out a series of design missions which vary in complexity and constraints.

TU-AB-303-12: Towards Inter and Intra Fraction Plan Adaptation for the MR-Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kontaxis, C; Bol, G; Lagendijk, J

Purpose: To develop a new sequencer for IMRT that during treatment can account for anatomy changes provided by online and real-time MRI. This sequencer employs a novel inter and intra fraction scheme that converges to the prescribed dose without a final segment weight optimization (SWO) and enables immediate optimization and delivery of radiation adapted to the deformed anatomy. Methods: The sequencer is initially supplied with a voxel-based dose prescription and during the optimization iteratively generates segments that provide this prescribed dose. Every iteration selects the best segment for the current anatomy state, calculates the dose it will deliver, warps itmore » back to the reference prescription grid and subtracts it from the remaining prescribed dose. This process continues until a certain percentage of dose or a number of segments has been delivered. The anatomy changes that occur during treatment require that convergence is achieved without a final SWO. This is resolved by adding the difference between the prescribed and delivered dose up to this fraction to the prescription of the subsequent fraction. This process is repeated for all fractions of the treatment. Results: Two breast cases were selected to stress test the pipeline by producing artificial inter and intra fraction anatomy deformations using a combination of incrementally applied rigid transformations. The dose convergence of the adaptive scheme over the entire treatment, relative to the prescribed dose, was on average 8.6% higher than the static plans delivered to the respective deformed anatomies and only 1.6% less than the static segment weighted plans on the static anatomy. Conclusion: This new adaptive sequencing strategy enables dose convergence without the need of SWO while adapting the plan to intermediate anatomies, which is a prerequisite for online plan adaptation. We are now testing our pipeline on prostate cases using clinical anatomy deformation data from our department

Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications

PubMed Central

Rak, Vaclav; Ira, Daniel; Masek, Michal

2009-01-01

Background: In a retrospective study we analysed intra-articular calcaneal fracture treatment by comparing results and complications related to fracture stabilization with nonlocking calcaneal plates and locking compression plates. Materials and Methods: We performed 76 osteosynthesis (67 patients) of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Forty-two operations using nonlocking calcaneal plates (group A) were performed during the first three years, and 34 calcaneal fractures were stabilized using locking compression plates (group B) in 2007. In the Sanders type IV fractures, reconstruction of the calcaneal shape was attempted. Depending on the type of late complication, we performed subtalar arthroscopy in six cases, arthroscopically assisted subtalar distraction bone block arthrodesis in six cases, and plate removal with lateral-wall decompression in five cases. The patients were evaluated by the AOFAS Ankle-Hindfoot Scale. Results: Wound healing complications were 7/42 (17%) in group A and 1/34 (3%) in group B. No patient had deep osseous infection or foot rebound compartment syndrome. Preoperative size of Böhler's angle correlated with postoperative clinical results in both groups. There were no late complications necessitating corrective procedure or arthroscopy until December 2008 in Group B. All late complications ccurred in Group A. The overall results according to the AOFAS Ankle Hindfoot Scale were good or excellent in 23/42 (55%) in group A and in 30/34 (85%) in group B. Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical method. Fewer complications and better results related to treatment with locking compression plates confirmed in comparison to nonlocking ones were noted for all Sanders types of intra-articular calcaneal fractures. Age and Sanders type IV fractures are not considered to be the contraindications

Cloud and Sun-Glint Statistics Derived from GOES and MODIS Observations Over the Intra-Americas Sea for GEO-CAPE Mission Planning

NASA Technical Reports Server (NTRS)

Feng, Lian; Hu, Chuanmin; Barnes, Brian B.; Mannino, Antonio; Heidinger, Andrew K.; Strabala, Kathleen; Iraci, Laura T.

2017-01-01

Knowledge of cloud cover, frequency, and duration is not only important to study cloud dynamics, but also critical in determining when and where to take ocean measurements from geostationary orbits such as the Geostationary Coastal and Air Pollution Events (GEO-CAPE) mission due to the challenges in achieving complete hemispheric coverage of coastal oceans, estuaries, and inland waters at hourly frequency. Using GOES hourly measurements at 4 km nadir resolution between 2006 and 2011, the number of cloud-free hourly observations per day (N(sub cf)) for solar zenith angle Theta(sub 0) less than 80 degrees was estimated for each 0.1 degree location of the Intra-Americas Sea. The number of Sun-glint-affected hourly observations per day [Ns(sub sg)] was also calculated based on the planned GEO-CAPE observation geometry and realistic wind speed. High-latitude and equatorial oceans showed the lowest N(sub cf) (less than 2.4) in all climatological months, and highest N(sub cf) was observed in the Gulf of Mexico (GoM) and Caribbean (greater than 4.5). Different regions showed differences in seasonality of cloud-free conditions and also showed differences in the hour of a day at which the satellite observations would have the maximal cloud-free and glint-free probability (Temperature maximum). Cloud cover from Moderate Resolution Imaging Spectroradiometer (MODIS) 1 km measurements are greater than 10 degrees higher than those from the MODIS 250 m measurements, supporting ocean color missions at subkilometer resolutions to enhance both spatial coverage and temporal frequency. These findings provide valuable information for GEO-CAPE mission planning to maximize its science value through minimizing the impacts of clouds and Sun glint.

Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation

PubMed Central

Bohne, Felix; Martínez-Llordella, Marc; Lozano, Juan-José; Miquel, Rosa; Benítez, Carlos; Londoño, María-Carlota; Manzia, Tommaso-María; Angelico, Roberta; Swinkels, Dorine W.; Tjalsma, Harold; López, Marta; Abraldes, Juan G.; Bonaccorsi-Riani, Eliano; Jaeckel, Elmar; Taubert, Richard; Pirenne, Jacques; Rimola, Antoni; Tisone, Giuseppe; Sánchez-Fueyo, Alberto

2011-01-01

Following organ transplantation, lifelong immunosuppressive therapy is required to prevent the host immune system from destroying the allograft. This can cause severe side effects and increased recipient morbidity and mortality. Complete cessation of immunosuppressive drugs has been successfully accomplished in selected transplant recipients, providing proof of principle that operational allograft tolerance is attainable in clinical transplantation. The intra-graft molecular pathways associated with successful drug withdrawal, however, are not well defined. In this study, we analyzed sequential blood and liver tissue samples collected from liver transplant recipients enrolled in a prospective multicenter immunosuppressive drug withdrawal clinical trial. Before initiation of drug withdrawal, operationally tolerant and non-tolerant recipients differed in the intra-graft expression of genes involved in the regulation of iron homeostasis. Furthermore, as compared with non-tolerant recipients, operationally tolerant patients exhibited higher serum levels of hepcidin and ferritin and increased hepatocyte iron deposition. Finally, liver tissue gene expression measurements accurately predicted the outcome of immunosuppressive withdrawal in an independent set of patients. These results point to a critical role for iron metabolism in the regulation of intra-graft alloimmune responses in humans and provide a set of biomarkers to conduct drug-weaning trials in liver transplantation. PMID:22156196

14 CFR 136.13 - Helicopter performance plan and operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Helicopter performance plan and operations... Helicopter performance plan and operations. (a) Each operator must complete a performance plan before each helicopter commercial air tour, or flight operated under 14 CFR 91.146 or 91.147. The pilot in command must...

14 CFR 136.13 - Helicopter performance plan and operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Helicopter performance plan and operations... Helicopter performance plan and operations. (a) Each operator must complete a performance plan before each helicopter commercial air tour, or flight operated under 14 CFR 91.146 or 91.147. The pilot in command must...

14 CFR 136.13 - Helicopter performance plan and operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Helicopter performance plan and operations... Helicopter performance plan and operations. (a) Each operator must complete a performance plan before each helicopter commercial air tour, or flight operated under 14 CFR 91.146 or 91.147. The pilot in command must...

Fundamentals of Day Camping. An Ideal Reference for Administrators of Day Camps and School-Age Day Care Programs. Revised.

ERIC Educational Resources Information Center

Mitchell, Grace; And Others

This revised edition of a 1961 publication outlines the steps involved in establishing a new day camp, and presents guidelines for day camp operation. Four chapters cover: (1) preliminary decisions and planning for a new camp; (2) site selection, legal and regulatory considerations, and property management; (3) deciding on buildings and equipment…

Optimization and planning of operating theatre activities: an original definition of pathways and process modeling.

PubMed

Barbagallo, Simone; Corradi, Luca; de Ville de Goyet, Jean; Iannucci, Marina; Porro, Ivan; Rosso, Nicola; Tanfani, Elena; Testi, Angela

2015-05-17

The Operating Room (OR) is a key resource of all major hospitals, but it also accounts for up 40% of resource costs. Improving cost effectiveness, while maintaining a quality of care, is a universal objective. These goals imply an optimization of planning and a scheduling of the activities involved. This is highly challenging due to the inherent variable and unpredictable nature of surgery. A Business Process Modeling Notation (BPMN 2.0) was used for the representation of the "OR Process" (being defined as the sequence of all of the elementary steps between "patient ready for surgery" to "patient operated upon") as a general pathway ("path"). The path was then both further standardized as much as possible and, at the same time, keeping all of the key-elements that would allow one to address or define the other steps of planning, and the inherent and wide variability in terms of patient specificity. The path was used to schedule OR activity, room-by-room, and day-by-day, feeding the process from a "waiting list database" and using a mathematical optimization model with the objective of ending up in an optimized planning. The OR process was defined with special attention paid to flows, timing and resource involvement. Standardization involved a dynamics operation and defined an expected operating time for each operation. The optimization model has been implemented and tested on real clinical data. The comparison of the results reported with the real data, shows that by using the optimization model, allows for the scheduling of about 30% more patients than in actual practice, as well as to better exploit the OR efficiency, increasing the average operating room utilization rate up to 20%. The optimization of OR activity planning is essential in order to manage the hospital's waiting list. Optimal planning is facilitated by defining the operation as a standard pathway where all variables are taken into account. By allowing a precise scheduling, it feeds the process of

Surgical and functional outcomes after operative management of complex and displaced intra-articular glenoid fractures.

PubMed

Anavian, Jack; Gauger, Erich M; Schroder, Lisa K; Wijdicks, Coen A; Cole, Peter A

2012-04-04

Operative treatment is indicated for displaced fractures of the glenoid fossa. However, little is known regarding functional outcomes in these patients. This study assesses surgical and functional results after treatment of displaced, high-energy, complex, intra-articular glenoid fractures. Thirty-three patients with displaced intra-articular fractures of the glenoid were treated surgically between 2002 and 2009. The indications for operative treatment included articular fracture gap or step-off of ≥ 4 mm. Twenty-five patients also had extra-articular scapular involvement. A posterior approach was utilized in twenty-one patients, an anterior approach in seven, and a combined approach in five. Functional outcomes, including Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-36 (SF-36) scores, shoulder motion and strength, and return to work and/or activities, were obtained for thirty patients (91%). At a mean follow-up of twenty-seven months (range, twelve to seventy-three months), all patients had radiographic union of the fracture. The mean DASH score was 10.8 (range, 0 to 42). All mean SF-36 subscores were comparable with those of the normal population. Twenty-six patients (87%) were pain-free at the time of follow-up, and four had mild pain with prolonged activity. Twenty-seven (90%) of thirty patients returned to their preinjury level of work and/or activities. Our data suggest that surgical treatment for complex, displaced intra-articular glenoid fractures with or without involvement of the scapular neck and body can be associated with good functional outcomes and a low complication rate.

Mission Operations Planning and Scheduling System (MOPSS)

NASA Technical Reports Server (NTRS)

Wood, Terri; Hempel, Paul

2011-01-01

MOPSS is a generic framework that can be configured on the fly to support a wide range of planning and scheduling applications. It is currently used to support seven missions at Goddard Space Flight Center (GSFC) in roles that include science planning, mission planning, and real-time control. Prior to MOPSS, each spacecraft project built its own planning and scheduling capability to plan satellite activities and communications and to create the commands to be uplinked to the spacecraft. This approach required creating a data repository for storing planning and scheduling information, building user interfaces to display data, generating needed scheduling algorithms, and implementing customized external interfaces. Complex scheduling problems that involved reacting to multiple variable situations were analyzed manually. Operators then used the results to add commands to the schedule. Each architecture was unique to specific satellite requirements. MOPSS is an expert system that automates mission operations and frees the flight operations team to concentrate on critical activities. It is easily reconfigured by the flight operations team as the mission evolves. The heart of the system is a custom object-oriented data layer mapped onto an Oracle relational database. The combination of these two technologies allows a user or system engineer to capture any type of scheduling or planning data in the system's generic data storage via a GUI.

7 CFR 1466.9 - EQIP plan of operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... General Provisions § 1466.9 EQIP plan of operations. (a) All conservation practices in the EQIP plan of... EQIP plan of operations must include: (1) A description of the participant's specific conservation and... for achieving the participant's conservation, natural resource, and environmental objectives; (3) A...

7 CFR 1466.9 - EQIP plan of operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... General Provisions § 1466.9 EQIP plan of operations. (a) All conservation practices in the EQIP plan of... EQIP plan of operations must include: (1) A description of the participant's specific conservation and... for achieving the participant's conservation, natural resource, and environmental objectives; (3) A...

7 CFR 1466.9 - EQIP plan of operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... General Provisions § 1466.9 EQIP plan of operations. (a) All conservation practices in the EQIP plan of... EQIP plan of operations must include: (1) A description of the participant's specific conservation and... for achieving the participant's conservation, natural resource, and environmental objectives; (3) A...

7 CFR 1466.9 - EQIP plan of operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... General Provisions § 1466.9 EQIP plan of operations. (a) All conservation practices in the EQIP plan of... EQIP plan of operations must include: (1) A description of the participant's specific conservation and... for achieving the participant's conservation, natural resource, and environmental objectives; (3) A...

7 CFR 1466.9 - EQIP plan of operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... General Provisions § 1466.9 EQIP plan of operations. (a) All conservation practices in the EQIP plan of... EQIP plan of operations must include: (1) A description of the participant's specific conservation and... for achieving the participant's conservation, natural resource, and environmental objectives; (3) A...

Test, Control and Monitor System (TCMS) operations plan

NASA Technical Reports Server (NTRS)

Macfarlane, C. K.; Conroy, M. P.

1993-01-01

The purpose is to provide a clear understanding of the Test, Control and Monitor System (TCMS) operating environment and to describe the method of operations for TCMS. TCMS is a complex and sophisticated checkout system focused on support of the Space Station Freedom Program (SSFP) and related activities. An understanding of the TCMS operating environment is provided and operational responsibilities are defined. NASA and the Payload Ground Operations Contractor (PGOC) will use it as a guide to manage the operation of the TCMS computer systems and associated networks and workstations. All TCMS operational functions are examined. Other plans and detailed operating procedures relating to an individual operational function are referenced within this plan. This plan augments existing Technical Support Management Directives (TSMD's), Standard Practices, and other management documentation which will be followed where applicable.

Runway Operations Planning: A Two-Stage Solution Methodology

NASA Technical Reports Server (NTRS)

Anagnostakis, Ioannis; Clarke, John-Paul

2003-01-01

The airport runway is a scarce resource that must be shared by different runway operations (arrivals, departures and runway crossings). Given the possible sequences of runway events, careful Runway Operations Planning (ROP) is required if runway utilization is to be maximized. Thus, Runway Operations Planning (ROP) is a critical component of airport operations planning in general and surface operations planning in particular. From the perspective of departures, ROP solutions are aircraft departure schedules developed by optimally allocating runway time for departures given the time required for arrivals and crossings. In addition to the obvious objective of maximizing throughput, other objectives, such as guaranteeing fairness and minimizing environmental impact, may be incorporated into the ROP solution subject to constraints introduced by Air Traffic Control (ATC) procedures. Generating optimal runway operations plans was approached in with a 'one-stage' optimization routine that considered all the desired objectives and constraints, and the characteristics of each aircraft (weight class, destination, Air Traffic Control (ATC) constraints) at the same time. Since, however, at any given point in time, there is less uncertainty in the predicted demand for departure resources in terms of weight class than in terms of specific aircraft, the ROP problem can be parsed into two stages. In the context of the Departure Planner (OP) research project, this paper introduces Runway Operations Planning (ROP) as part of the wider Surface Operations Optimization (SOO) and describes a proposed 'two stage' heuristic algorithm for solving the Runway Operations Planning (ROP) problem. Focus is specifically given on including runway crossings in the planning process of runway operations. In the first stage, sequences of departure class slots and runwy crossings slots are generated and ranked based on departure runway throughput under stochastic conditions. In the second stage, the

36 CFR 9.37 - Plan of operations approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regional Director shall not approve a plan of operations: (1) Until the operator shows that the operations... Regional Director shall make an environmental analysis of such plan, and: (1) Notify the operator that the... specified by the Regional Director, he shall comply with § 9.37(b) (1) through (5). (c) The Regional...

36 CFR 9.37 - Plan of operations approval.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Regional Director shall not approve a plan of operations: (1) Until the operator shows that the operations... Regional Director shall make an environmental analysis of such plan, and: (1) Notify the operator that the... specified by the Regional Director, he shall comply with § 9.37(b) (1) through (5). (c) The Regional...

36 CFR 9.37 - Plan of operations approval.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Regional Director shall not approve a plan of operations: (1) Until the operator shows that the operations... Regional Director shall make an environmental analysis of such plan, and: (1) Notify the operator that the... specified by the Regional Director, he shall comply with § 9.37(b) (1) through (5). (c) The Regional...

36 CFR 9.37 - Plan of operations approval.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regional Director shall not approve a plan of operations: (1) Until the operator shows that the operations... Regional Director shall make an environmental analysis of such plan, and: (1) Notify the operator that the... specified by the Regional Director, he shall comply with § 9.37(b) (1) through (5). (c) The Regional...

Kennedy Space Center Orion Processing Team Planning for Ground Operations

NASA Technical Reports Server (NTRS)

Letchworth, Gary; Schlierf, Roland

2011-01-01

Topics in this presentation are: Constellation Ares I/Orion/Ground Ops Elements Orion Ground Operations Flow Orion Operations Planning Process and Toolset Overview, including: 1 Orion Concept of Operations by Phase 2 Ops Analysis Capabilities Overview 3 Operations Planning Evolution 4 Functional Flow Block Diagrams 5 Operations Timeline Development 6 Discrete Event Simulation (DES) Modeling 7 Ground Operations Planning Document Database (GOPDb) Using Operations Planning Tools for Operability Improvements includes: 1 Kaizen/Lean Events 2 Mockups 3 Human Factors Analysis

77 FR 8751 - Guidance for Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

..., 40, 50, 70, and 72 [NRC-2011-0286] Guidance for Decommissioning Planning During Operations AGENCY... Guide, DG-4014, ``Decommissioning Planning During Operations'' in the Federal Register with a public... Guide DG-4014, ``Decommissioning Planning During Operations.'' This DG refers to NUREG-1757 Volume 3...

10 CFR 436.102 - General operations plan format and content.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false General operations plan format and content. 436.102... PROGRAMS Guidelines for General Operations Plans § 436.102 General operations plan format and content. (a... effective date of these guidelines, a general operations 10-year plan which shall consist of two parts, an...

Intra-dialytic exercise training: a pragmatic approach.

PubMed

Greenwood, Sharlene A; Naish, Patrick; Clark, Rachel; O'Connor, Ellen; Pursey, Victoria A; Macdougall, Iain C; Mercer, Thomas H; Koufaki, Pelagia

2014-09-01

This continuing education paper outlines the skills and knowledge required to plan, implement and evaluate a pragmatic approach to intra-dialytic exercise training. The aim of this continuing education article is to enable the nephrology multi-disciplinary team (MDT) to plan, implement and evaluate the provision of intra-dialytic exercise training for patients receiving haemodialysis therapy. After reading this article the reader should be able to: Appreciate the level of evidence base for the clinical effectiveness of renal exercise rehabilitation and locate credible sources of research and educational information Understand and consider the need for appropriate evaluation and assessment outcomes as part of a renal rehabilitation plan Understand the components of exercise programming and prescription as part of an integrated renal rehabilitation plan Develop a sustainable longer term exercise and physical activity plan. © 2014 The Authors Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.

The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

PubMed

Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

2015-04-01

Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

7 CFR 1465.6 - AMA plan of operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false AMA plan of operations. 1465.6 Section 1465.6... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS AGRICULTURAL MANAGEMENT ASSISTANCE General Provisions § 1465.6 AMA plan of operations. (a) All conservation practices in the APO must be approved by...

Operations planning for Space Station Freedom - And beyond

NASA Technical Reports Server (NTRS)

Gibson, Stephen S.; Martin, Thomas E.; Durham, H. J.

1992-01-01

The potential of automated planning and electronic execution systems for enhancing operations on board Space Station Freedom (SSF) are discussed. To exploit this potential the Operations Planning and Scheduling Subsystem is being developed at the NASA Johnson Space Center. Such systems may also make valuable contributions to the operation of resource-constrained, long-duration space habitats of the future. Points that should be considered during the design of future long-duration manned space missions are discussed. Early development of a detailed operations concept as an end-to-end mission description offers a basis for iterative design evaluation, refinement, and option comparison, particularly when used with an advanced operations planning system capable of modeling the operations and resource constraints of the proposed designs.

SDDOT transportation systems management & operations program plan.

DOT National Transportation Integrated Search

2016-06-01

The objective of this project is the development of a comprehensive Transportation Systems Management and : Operations (TSM&O) Program Plan for the South Dakota Department of Transportation. This plan guides : business planning and strategic decision...

Automated Planning and Scheduling for Planetary Rover Distributed Operations

NASA Technical Reports Server (NTRS)

Backes, Paul G.; Rabideau, Gregg; Tso, Kam S.; Chien, Steve

1999-01-01

Automated planning and Scheduling, including automated path planning, has been integrated with an Internet-based distributed operations system for planetary rover operations. The resulting prototype system enables faster generation of valid rover command sequences by a distributed planetary rover operations team. The Web Interface for Telescience (WITS) provides Internet-based distributed collaboration, the Automated Scheduling and Planning Environment (ASPEN) provides automated planning and scheduling, and an automated path planner provided path planning. The system was demonstrated on the Rocky 7 research rover at JPL.

Comparative analysis of operational forecasts versus actual weather conditions in airline flight planning: Summary report

NASA Technical Reports Server (NTRS)

Keitz, J. F.

1982-01-01

The impact of more timely and accurate weather data on airline flight planning with the emphasis on fuel savings is studied. This summary report discusses the results of each of the four major tasks of the study. Task 1 compared airline flight plans based on operational forecasts to plans based on the verifying analyses and found that average fuel savings of 1.2 to 2.5 percent are possible with improved forecasts. Task 2 consisted of similar comparisons but used a model developed for the FAA by SRI International that simulated the impact of ATc diversions on the flight plans. While parts of Task 2 confirm the Task I findings, inconsistency with other data and the known impact of ATC suggests that other Task 2 findings are the result of errors in the model. Task 3 compares segment weather data from operational flight plans with the weather actually observed by the aircraft and finds the average error could result in fuel burn penalties (or savings) of up to 3.6 percent for the average 8747 flight. In Task 4 an in-depth analysis of the weather forecast for the 33 days included in the study finds that significant errors exist on 15 days. Wind speeds in the area of maximum winds are underestimated by 20 to 50 kts., a finding confirmed in the other three tasks.

Planning in the Continuous Operations Environment of the International Space Station

NASA Technical Reports Server (NTRS)

Maxwell, Theresa; Hagopian, Jeff

1996-01-01

The continuous operation planning approach developed for the operations planning of the International Space Station (ISS) is reported on. The approach was designed to be a robust and cost-effective method. It separates ISS planning into two planning functions: long-range planning for a fixed length planning horizon which continually moves forward as ISS operations progress, and short-range planning which takes a small segment of the long-range plan and develops a detailed operations schedule. The continuous approach is compared with the incremental approach, the short and long-range planning functions are described, and the benefits and challenges of implementing a continuous operations planning approach for the ISS are summarized.

Evaluation of the rate of decompression in anterior cervical corpectomy using an intra-operative computerized tomography scan (O-Arm system).

PubMed

Costa, Francesco; Tomei, Massimo; Sassi, Marco; Cardia, Andrea; Ortolina, Alessandro; Servello, Domenico; Fornari, Maurizio

2012-02-01

The purpose of this study was to evaluate the efficacy of intra-operative computerized tomography (CT) scanning in the analysis of bone removal accuracy during anterior cervical corpectomy, in order to allow any necessary immediate correction in the event of inadequate bone removal. From September 2009 to December 2010 we performed an intra-operative (CT) scan using the O-Arm(™) Image system to assess the rate of central and lateral decompression in all patients treated for cervical spondylotic myelopathy by anterior cervical corpectomy and fusion. Out of a population of 187 patients admitted to our department, with a diagnosis of myelopathy due to spondylotic degenerative cervical stenosis, 15 patients underwent a surgical treatment with anterior cervical corpectomy and fusion. There were nine males (60%) and six females (40%); the mean age was 52.4 years, ranging from 41 to 57 years. The pre-operative radiologic investigations (MRI and CT scans) revealed in the nine patients (60%) the extent of the compression to one vertebral body (C4 one case, C5 four cases, C6 four cases), while in the six cases (40%) the compression regarded two vertebral body (C3 and C4 one case, C4 and C5 two cases, C5 and C6 three cases). During surgery, when the decompression was judged completely, a CT scan was performed: in 11 cases (73.3%) the decompression was considered adequate, while in four cases (26.7%) it was deemed insufficient and the surgical strategy was changed in order to optimize the bone removal. In these cases an additional scan was taken to prove the efficacy of decompression, achieved in all patients. Intra-operative CT scan performed during cervical corpectomy is a really useful tool in helping to ensure complete bone removal and the adequacy of surgery. The O-arm(™) Image system grants optimal image quality, allowing correctly assessing the rate of decompression and, in any case of doubt, allows an intra-operative evaluation of the final correct positioning of

Intra and post-operative complications of esophageal achalasia.

PubMed

Pugliese, Luigi; Peri, Andrea; Tinozzi, Francesco Paolo; Zonta, Sandro; di Stefano, Michele; Meloni, Federica; Pietrabissa, Andrea

2013-01-01

To evaluate and discuss all the potential complications affecting morbidity of patients treated with surgery for primary achalasia. A review of the available English literature published to date has been conducted. All articles reporting surgical experience in achalasia were examined and then were selected only those specifically inherent to the topic at issue. Mucosal perforation is the main intra-operative complication while persistence or recurrence of the disease and gastro-esophageal reflux are those mostly affecting patients afterwards, even at long-term follow-up. A few other less common morbidities, as well as the technical considerations useful to minimize and manage each complication mentioned, are reported. Minimally invasive surgery for achalasia consent to treat patients with a low rate of perioperative complications that can be managed with conservative approach in the majority of cases. Risk of esophageal cancer exists in these patients and remains although surgical therapy. Laparoscopic Heller myotomy along with partial fundoplication is a safe and effective procedure that should be considered as the treatment of choice at first evaluation of achalasic patients rather than endoscopic techniques. Robotic technology may add further contribution in diminishing perioperative complications.

Intra-operative probe for brain cancer: feasibility study

NASA Astrophysics Data System (ADS)

Vu Thi, M. H.; Charon, Y.; Duval, M. A.; Lefebvre, F.; Menard, L.; Pitre, S.; Pinot, L.; Siebert, R.

2007-07-01

The present work aims a new medical probe for surgeons devoted to brain cancers, in particular glioblastoma multiforme. Within the last years, our group has started the development of a new intra-operative beta imaging probe. More recently, we took an alternative approach for the same application: a fluorescence probe. In both cases the purpose is to differentiate normal from tumor brain tissue. In a first step, we developed set-ups capable to measure autofluorescence. They are based on a dedicated epi-fluorescence design and on specific fiber optic probes. Relative signal amplitude, spectral shape and fluorescence lifetime measurements are foreseen to distinguish normal and cancer tissue by analyzing fluorophores like NADH, lipopigments and porphyrines. The autofluorescence spectra are recorded in the 460-640 nm range with a low resolution spectrometer. For lifetime measurements a fast detector (APD) is used together with a TCSPC-carte. Intrinsic wavelength- and time-resolutions are a few nm and 200 ps, respectively. Different samples have been analyzed to validate our new detection system and to allow a first configuration of our medical fluorescence probe. First results from the tissue measurements are shown.

Improved long-term survival after intra-operative single high-dose ATG-Fresenius induction in renal transplantation: a single centre experience.

PubMed

Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

2009-01-01

In organ grafts donor-specific sensitization is initiated immediately after revascularization. Therefore, in 1990 we introduced the intra-operative single high-dose ATG-Fresenius (ATG-F) induction in addition to standard triple drug therapy (TDT) consisting of steroids, azathioprine and cyclosporin. A total of 778 first renal transplantations from deceased donors, performed between 1987 and 1998, were included in this evaluation. This retrospective analysis of clinic records and electronic databases presents data of all recipients of first kidney grafts who received two different ATG-F inductions (1(st) group: 9 mg/kg body weight as single high-dose intra-operatively, n=484; 2(nd) group: 3 mg/kg body weight on 7 or 8 consecutive days as multiple-dose starting also intra-operatively, n=78) and standard TDT alone (3(rd) group: TDT alone, n=216). The 10-year patient survival rates were 72.6+/-2.6% (TDT + ATG-F single high-dose), 79.5+/-5.1% (TDT + ATG-F multiple-dose) and 67.2+/-3.7%% (TDT alone; Kaplan-Meier estimates with standard errors; ATG-F vs TDT alone, p=0.001). The 10-year graft survival rates with censoring of patients that died with a functioning graft were 73.8+/-2.4%, 57.7+/-5.8% and 58.4+/-3.6% (Kaplan-Meier estimates with standard errors; 1(st) vs 2(nd )and 3(rd) group, respectively, p<0.001) and the 10-year graft survival rates with patient death counted as graft failure were 58.3+/-2.7%, 55.7+/-5.8% and 48.2+/-3.5% (Kaplan-Meier estimates with standard errors; ATG-F single high-dose vs TDT, p=0.023). In pre-sensitized recipients there were also significant differences in favour of ATG-F, more notably in the single high-dose ATG-F induction. A total of 69% of the patients in the two cohorts receiving ATG-F did not experience any transplant rejections compared to 56% in patients undergoing TDT alone (p=0.018). The incidence of infectious complications was comparable across all groups. According to evidence obtained from the routine documentation of 778

Using conditional probability to identify trends in intra-day high-frequency equity pricing

NASA Astrophysics Data System (ADS)

Rechenthin, Michael; Street, W. Nick

2013-12-01

By examining the conditional probabilities of price movements in a popular US stock over different high-frequency intra-day timespans, varying levels of trend predictability are identified. This study demonstrates the existence of predictable short-term trends in the market; understanding the probability of price movement can be useful to high-frequency traders. Price movement was examined in trade-by-trade (tick) data along with temporal timespans between 1 s to 30 min for 52 one-week periods for one highly-traded stock. We hypothesize that much of the initial predictability of trade-by-trade (tick) data is due to traditional market dynamics, or the bouncing of the price between the stock’s bid and ask. Only after timespans of between 5 to 10 s does this cease to explain the predictability; after this timespan, two consecutive movements in the same direction occur with higher probability than that of movements in the opposite direction. This pattern holds up to a one-minute interval, after which the strength of the pattern weakens.

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

PubMed

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

Conservative management of post-appendicectomy intra-abdominal abscesses.

PubMed

Ben Dhaou, Mahdi; Ghorbel, Sofiene; Chouikh, Taieb; Charieg, Awatef; Nouira, Faouzi; Ben Khalifa, Sonia; Khemakhem, Rachid; Jlidi, Said; Chaouachi, Béji

2010-10-14

Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85%) with clinical, biological and radiological recovery of the abscess. There was one failure (14%). The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days). In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20). Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.

Conservative management of post-appendicectomy intra-abdominal abscesses

PubMed Central

2010-01-01

Purpose Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Methods Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. Results This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85%) with clinical, biological and radiological recovery of the abscess. There was one failure (14%). The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days). In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20). Conclusion Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization. PMID:20946659

Planning actions in robot automated operations

NASA Technical Reports Server (NTRS)

Das, A.

1988-01-01

Action planning in robot automated operations requires intelligent task level programming. Invoking intelligence necessiates a typical blackboard based architecture, where, a plan is a vector between the start frame and the goal frame. This vector is composed of partially ordered bases. A partial ordering of bases presents good and bad sides in action planning. Partial ordering demands the use of a temporal data base management system.

Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

2016-10-01

In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

49 CFR 386.83 - Sanction for failure to pay civil penalties or abide by payment plan; operation in interstate...

Code of Federal Regulations, 2014 CFR

2014-10-01

... abide by payment plan; operation in interstate commerce prohibited. 386.83 Section 386.83 Transportation... commerce prohibited. (a)(1) General rule. (i) A CMV owner or operator that fails to pay a civil penalty in... from operating in interstate commerce starting on the next (i.e., the 91st) day. The prohibition...

Comparative analysis of operational forecasts versus actual weather conditions in airline flight planning, volume 4

NASA Technical Reports Server (NTRS)

Keitz, J. F.

1982-01-01

The impact of more timely and accurate weather data on airline flight planning with the emphasis on fuel savings is studied. This volume of the report discusses the results of Task 4 of the four major tasks included in the study. Task 4 uses flight plan segment wind and temperature differences as indicators of dates and geographic areas for which significant forecast errors may have occurred. An in-depth analysis is then conducted for the days identified. The analysis show that significant errors occur in the operational forecast on 15 of the 33 arbitrarily selected days included in the study. Wind speeds in an area of maximum winds are underestimated by at least 20 to 25 kts. on 14 of these days. The analysis also show that there is a tendency to repeat the same forecast errors from prog to prog. Also, some perceived forecast errors from the flight plan comparisons could not be verified by visual inspection of the corresponding National Meteorological Center forecast and analyses charts, and it is likely that they are the result of weather data interpolation techniques or some other data processing procedure in the airlines' flight planning systems.

Intra-individual variation in urinary iodine concentration: effect of statistical correction on population distribution using seasonal three-consecutive-day spot urine in children

PubMed Central

Ji, Xiaohong; Liu, Peng; Sun, Zhenqi; Su, Xiaohui; Wang, Wei; Gao, Yanhui; Sun, Dianjun

2016-01-01

Objective To determine the effect of statistical correction for intra-individual variation on estimated urinary iodine concentration (UIC) by sampling on 3 consecutive days in four seasons in children. Setting School-aged children from urban and rural primary schools in Harbin, Heilongjiang, China. Participants 748 and 640 children aged 8–11 years were recruited from urban and rural schools, respectively, in Harbin. Primary and secondary outcome measures The spot urine samples were collected once a day for 3 consecutive days in each season over 1 year. The UIC of the first day was corrected by two statistical correction methods: the average correction method (average of days 1, 2; average of days 1, 2 and 3) and the variance correction method (UIC of day 1 corrected by two replicates and by three replicates). The variance correction method determined the SD between subjects (Sb) and within subjects (Sw), and calculated the correction coefficient (Fi), Fi=Sb/(Sb+Sw/di), where di was the number of observations. The UIC of day 1 was then corrected using the following equation: Results The variance correction methods showed the overall Fi was 0.742 for 2 days’ correction and 0.829 for 3 days’ correction; the values for the seasons spring, summer, autumn and winter were 0.730, 0.684, 0.706 and 0.703 for 2 days’ correction and 0.809, 0.742, 0.796 and 0.804 for 3 days’ correction, respectively. After removal of the individual effect, the correlation coefficient between consecutive days was 0.224, and between non-consecutive days 0.050. Conclusions The variance correction method is effective for correcting intra-individual variation in estimated UIC following sampling on 3 consecutive days in four seasons in children. The method varies little between ages, sexes and urban or rural setting, but does vary between seasons. PMID:26920442

Advancing metropolitan planning for operations : the building blocks of a model transportation plan incorporating operations : a desk reference

DOT National Transportation Integrated Search

2010-04-01

This publication is a resource designed to enable transportation planners and their planning partners to build a transportation plan that includes operations objectives, performance measures, and strategies that are relevant to their region, that ref...

Technical aspects of virtual liver resection planning.

PubMed

Glombitza, G; Lamadé, W; Demiris, A M; Göpfert, M R; Mayer, A; Bahner, M L; Meinzer, H P; Richter, G; Lehnert, T; Herfarth, C

1998-01-01

Operability of a liver tumor is depending on its three dimensional relation to the intrahepatic vascular trees which define autonomously functioning liver (sub-)segments. Precise operation planning is complicated by anatomic variability, distortion of the vascular trees by the tumor or preceding liver resections. Because of the missing possibility to track the deformation of the liver during the operation an integration of the resection planning system into an intra-operative navigation system is not feasible. So the main task of an operation planning system in this domain is a quantifiable patient selection by exact prediction of post-operative liver function and a quantifiable resection proposal. The system quantifies the organ structures and resection volumes by means of absolute and relative values. It defines resection planes depending on security margins and the vascular trees and presents the data in visualized form as a 3D movie. The new 3D operation planning system offers quantifiable liver resection proposals based on individualized liver anatomy. The results are visualized in digital movies as well as in quantitative reports.

Apollo Soyuz mission planning and operations

NASA Technical Reports Server (NTRS)

Frank, M. P., III

1976-01-01

The paper describes the Apollo Soyuz project from the points of view of working group organization, mission plan definition, joint operations concept, and mission preparation. The concept for joint operations considered contingency situations as well as nominal operations. Preparations for the joint flight included cooperative tracking tests and combined training of the flight crews and mission control personnel.

Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

PubMed

Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

2017-10-01

In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

Intra-operative post-induction hyperthermia, possibly malignant hyperthermia: Anesthetic implications, challenges and management

PubMed Central

Gulabani, Michell; Gurha, Pavan; Ahmad, Sabih; Dass, Prashant

2014-01-01

Malignant Hyperthermia is a pharmacogenetic disorder. Classical manifestations comprise of tachycardia, increase in expired carbon dioxide levels, muscle rigidity, hyperthermia (>38.8°C) and unexpected acidosis. Here we report a case of 16-year-old female patient, ASA-I with chronic rhino-sinusitis and slight strabismus of the left eye posted for functional endoscopic sinus surgery, developing a rise in ETCO2 and temperature immediately following anesthesia induction. She was aggressively managed to an uneventful recovery. We present a case of intra-operative post-induction hyperthermia possibly MH, its anesthetic implications, challenges encountered and its management. PMID:25425784

Health sector operational planning and budgeting processes in Kenya—“never the twain shall meet”

PubMed Central

Molyneux, Sassy; Goodman, Catherine

2015-01-01

Summary Operational planning is considered an important tool for translating government policies and strategic objectives into day‐to‐day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top‐down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local‐level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. PMID:25783862

ISS Payload Operations: The Need for and Benefit of Responsive Planning

NASA Technical Reports Server (NTRS)

Nahay, Ed; Boster, Mandee

2000-01-01

International Space Station (ISS) payload operations are controlled through implementation of a payload operations plan. This plan, which represents the defined approach to payload operations in general, can vary in terms of level of definition. The detailed plan provides the specific sequence and timing of each component of a payload's operations. Such an approach to planning was implemented in the Spacelab program. The responsive plan provides a flexible approach to payload operations through generalization. A responsive approach to planning was implemented in the NASA/Mir Phase 1 program, and was identified as a need during the Skylab program. The current approach to ISS payload operations planning and control tends toward detailed planning, rather than responsive planning. The use of detailed plans provides for the efficient use of limited resources onboard the ISS. It restricts flexibility in payload operations, which is inconsistent with the dynamic nature of the ISS science program, and it restricts crew desires for flexibility and autonomy. Also, detailed planning is manpower intensive. The development and implementation of a responsive plan provides for a more dynamic, more accommodating, and less manpower intensive approach to planning. The science program becomes more dynamic and responsive as the plan provides flexibility to accommodate real-time science accomplishments. Communications limitations and the crew desire for flexibility and autonomy in plan implementation are readily accommodated with responsive planning. Manpower efficiencies are accomplished through a reduction in requirements collection and coordination, plan development, and maintenance. Through examples and assessments, this paper identifies the need to transition from detailed to responsive plans for ISS payload operations. Examples depict specific characteristics of the plans. Assessments identify the following: the means by which responsive plans accommodate the dynamic nature of

Role of intraoperative ultrasound in achieving complete resection of intra-axial solid brain tumours.

PubMed

Mari, Abdul Razaque; Shah, Irfanullah; Imran, Muhammed; Ashraf, Junaid

2014-12-01

To determine the frequency of completeness of resection for intra-axial solid brain tumours with the help of intra-operative ultrasound to detect residual brain tumour. The cross-sectional study was conducted at the Department of Neurosurgery, Dow University of Health Sciences and Civil Hospital Karachi, from September 2009 to June 2010 and comprised patients with intra-axial solid brain lesion. During operation following standard craniotomy, multi-plane sonographic examination was performed using intra-operative ultrasound for tumour localisation and calculation of dimension, followed by tumour resection in the standard fashion. At the end of tumour resection ultrasound was again used for the detection of any residual tumour. Results of intra-operative ultrasound were compared with post-operative contrast magnetic resonance imaging. Of the 39 cases in which intra-operative ultrasound was performed, 32(82.1%) were males and 7(17.9%) were females, with an overall mean age of 42.6±19.7 years. Intra-operative ultrasonography was able to localise and delineate the tumour in all 39 (100%) cases. It showed no residual tumour in 36 (92.3%) cases, but in 3(7.7%) cases residual tumour was detected. Post-operative contrast enhancing magnetic resonance imaging showed no residual tumour in 35(89.7%) cases and in 4(10.3%) cases residual tumour was detected. The frequency of completely resected intra-axial solid brain tumour was 35(89.7%), while in 4(10.3%) cases incomplete resection was observed. The study concluded that intra-operative ultrasonography has an important role in achieving increased frequency of completely resected intra-axial solid brain tumours.

Operational plans for life science payloads - From experiment selection through postflight reporting

NASA Technical Reports Server (NTRS)

Mccollum, G. W.; Nelson, W. G.; Wells, G. W.

1976-01-01

Key features of operational plans developed in a study of the Space Shuttle era life science payloads program are presented. The data describes the overall acquisition, staging, and integration of payload elements, as well as program implementation methods and mission support requirements. Five configurations were selected as representative payloads: (a) carry-on laboratories - medical emphasis experiments, (b) mini-laboratories - medical/biology experiments, (c) seven-day dedicated laboratories - medical/biology experiments, (d) 30-day dedicated laboratories - Regenerative Life Support Evaluation (RLSE) with selected life science experiments, and (e) Biomedical Experiments Scientific Satellite (BESS) - extended duration primate (Type I) and small vertebrate (Type II) missions. The recommended operational methods described in the paper are compared to the fundamental data which has been developed in the life science Spacelab Mission Simulation (SMS) test series. Areas assessed include crew training, experiment development and integration, testing, data-dissemination, organization interfaces, and principal investigator working relationships.

Plant operation planning and scheduling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jammar, R.J.

When properly designed, planning and scheduling can actually add millions of dollars per year to the bottom line. Planning and scheduling is a continuum of decisions starting with crude selection and ending with establishing short-term targets for crude processing and blending. It also includes maintaining optimization and operation simulation models. It is thought that conservatively, a refinery may save from $5 million to $10 million a year if it pays more attention to the processes behind proper planning and scheduling. Of course, the amount of savings can reach staggering proportions for companies now at the bottom of the Solomon Associatesmore » Inc. refinery performance ranking.« less

The effect of post-traumatic-stress-disorder on intra-operative analgesia in a veteran population during cataract procedures carried out using retrobulbar or topical anesthesia: a retrospective study.

PubMed

Rapoport, Yuna; Wayman, Laura L; Chomsky, Amy S

2017-06-07

A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality. A retrospective study of 330 cataract surgeries performed by resident physicians between January and September 2012 at the Veterans Affairs Medical Center Tennessee Valley Healthcare System, Nashville and Murfreesboro Campuses was completed. Three hundred and thirty veteran patients were selected if their cataract surgery was performed between January and September 2012. Combined cases were excluded. The primary outcome evaluated was intra-operative analgesia. Secondary outcomes included history of post-traumatic-stress-disorder, anesthesia type, first or second eye, pain control, intra-operative heart rate and blood pressure, age, and case complexity. Data was analyzed using an unpaired two-sample Welch's t-test assuming unequal variance and Z test of comparison of proportions. Patients with post-traumatic-stress-disorder reported higher pain scores, had longer operative times, and were more likely to have received a retrobulbar block. Operative time was not associated with an increased pain score, irrespective of anesthesia type, when controlled for PTSD. Complex cases had longer operative times, more sedation, and higher pain scores. P < 0.05 was used consistently. Post-traumatic stress disorder and anxiety are more prevalent in the veteran population. Our data suggests that a history of post-traumatic-stress-disorder was correlated with higher pain scores, longer operative times

The HAL 9000 Space Operating System Real-Time Planning Engine Design and Operations Requirements

NASA Technical Reports Server (NTRS)

Stetson, Howard; Watson, Michael D.; Shaughnessy, Ray

2012-01-01

In support of future deep space manned missions, an autonomous/automated vehicle, providing crew autonomy and an autonomous response planning system, will be required due to the light time delays in communication. Vehicle capabilities as a whole must provide for tactical response to vehicle system failures and space environmental effects induced failures, for risk mitigation of permanent loss of communication with Earth, and for assured crew return capabilities. The complexity of human rated space systems and the limited crew sizes and crew skills mix drive the need for a robust autonomous capability on-board the vehicle. The HAL 9000 Space Operating System[2] designed for such missions and space craft includes the first distributed real-time planning / re-planning system. This paper will detail the software architecture of the multiple planning engine system, and the interface design for plan changes, approval and implementation that is performed autonomously. Operations scenarios will be defined for analysis of the planning engines operations and its requirements for nominal / off nominal activities. An assessment of the distributed realtime re-planning system, in the defined operations environment, will be provided as well as findings as it pertains to the vehicle, crew, and mission control requirements needed for implementation.

Development of a novel handheld intra-operative laparoscopic Compton camera for 18F-Fluoro-2-deoxy-2-D-glucose-guided surgery

NASA Astrophysics Data System (ADS)

Nakamura, Y.; Shimazoe, K.; Takahashi, H.; Yoshimura, S.; Seto, Y.; Kato, S.; Takahashi, M.; Momose, T.

2016-08-01

As well as pre-operative roadmapping by 18F-Fluoro-2-deoxy-2-D-glucose (FDG) positron emission tomography, intra-operative localization of the tracer is important to identify local margins for less-invasive surgery, especially FDG-guided surgery. The objective of this paper is to develop a laparoscopic Compton camera and system aimed at use for intra-operative FDG imaging for accurate and less-invasive dissections. The laparoscopic Compton camera consists of four layers of a 12-pixel cross-shaped array of GFAG crystals (2× 2× 3 mm3) and through silicon via multi-pixel photon counters and dedicated individual readout electronics based on a dynamic time-over-threshold method. Experimental results yielded a spatial resolution of 4 mm (FWHM) for a 10 mm working distance and an absolute detection efficiency of 0.11 cps kBq-1, corresponding to an intrinsic detection efficiency of  ˜0.18%. In an experiment using a NEMA-like well-shaped FDG phantom, a φ 5× 10 mm cylindrical hot spot was clearly obtained even in the presence of a background distribution surrounding the Compton camera and the hot spot. We successfully obtained reconstructed images of a resected lymph node and primary tumor ex vivo after FDG administration to a patient having esophageal cancer. These performance characteristics indicate a new possibility of FDG-directed surgery by using a Compton camera intra-operatively.

Comparison of intra-articular methotrexate with intra-articular triamcinolone hexacetonide by thermography.

PubMed

Bird, H A; Ring, E F; Daniel, R; Bacon, P A

1977-01-01

A comparison of intra-articular methotrexate and intra-articular triamcinolone hexacetonide was made in 42 arthritic patients with persistent bilateral knee effusions. One knee was injected with either 5 mg methotrexate (two injections of 2.5 mg a week apart) or a single injection of 20 mg triamcinolone. An objective assessment of both knees was made by quantitative thermography at 0,3,7,14 and 21 days. Joints injected with triamcinolone showed a greater fall in thermographic index (T.I) than the joints injected with methotrexate, which showed similar change to the non-injected knee joints in both groups. Four patients received larger doses of methotrexate, up to 20 mg, though the fall in T.I. was still less than the mean fall for triamcinolone injected joints. Peak venous blood levels of methotrexate were reached 1 hour after intra-articular injection, and a sphygmomanometer cuff inflated around the leg above the injected knee for periods of up to 1 hour did not appreciably delay this. Methotrexate had no immediate anti-inflammatory effect, even in psoriatic arthropathy, and did not give the relief of intra-articular steroid.

36 CFR 223.32 - Timber sale operating plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Timber sale operating plan... SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Timber Sale Contracts Contract Conditions and Provisions § 223.32 Timber sale operating plan. Sale contracts with a term of 2 years or more shall provide...

26 CFR 11.412(c)-7 - Election to treat certain retroactive plan amendments as made on the first day of the plan year.

Code of Federal Regulations, 2012 CFR

2012-04-01

... amendments as made on the first day of the plan year. 11.412(c)-7 Section 11.412(c)-7 Internal Revenue... treat certain retroactive plan amendments as made on the first day of the plan year. (a) General rule... the date of the close of the first plan year to which the amendment applies and the date on which the...

26 CFR 11.412(c)-7 - Election to treat certain retroactive plan amendments as made on the first day of the plan year.

Code of Federal Regulations, 2010 CFR

2010-04-01

... amendments as made on the first day of the plan year. 11.412(c)-7 Section 11.412(c)-7 Internal Revenue... treat certain retroactive plan amendments as made on the first day of the plan year. (a) General rule... the date of the close of the first plan year to which the amendment applies and the date on which the...

26 CFR 11.412(c)-7 - Election to treat certain retroactive plan amendments as made on the first day of the plan year.

Code of Federal Regulations, 2014 CFR

2014-04-01

... amendments as made on the first day of the plan year. 11.412(c)-7 Section 11.412(c)-7 Internal Revenue... treat certain retroactive plan amendments as made on the first day of the plan year. (a) General rule... the date of the close of the first plan year to which the amendment applies and the date on which the...

26 CFR 11.412(c)-7 - Election to treat certain retroactive plan amendments as made on the first day of the plan year.

Code of Federal Regulations, 2013 CFR

2013-04-01

... amendments as made on the first day of the plan year. 11.412(c)-7 Section 11.412(c)-7 Internal Revenue... treat certain retroactive plan amendments as made on the first day of the plan year. (a) General rule... the date of the close of the first plan year to which the amendment applies and the date on which the...

26 CFR 11.412(c)-7 - Election to treat certain retroactive plan amendments as made on the first day of the plan year.

Code of Federal Regulations, 2011 CFR

2011-04-01

... amendments as made on the first day of the plan year. 11.412(c)-7 Section 11.412(c)-7 Internal Revenue... treat certain retroactive plan amendments as made on the first day of the plan year. (a) General rule... the date of the close of the first plan year to which the amendment applies and the date on which the...

Operation CASTLE. Operation Plan Number 3-53. March - May 1954,

DTIC Science & Technology

Nuclear radiation, *Nuclear explosions, *Radiation dosage, *Test methods, *Military operations, *Military planning, Radiobiology, Missions, Marshall Islands , Eniwetok Atoll, Bikini Atoll, Atmospheric physics, Low level, Radiation

77 FR 14047 - Guidance for Decommissioning Planning During Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

...)-4014, ``Decommissioning Planning During Operations.'' This action is necessary to correct the NRC's... NUCLEAR REGULATORY COMMISSION [NRC-2011-0286] Guidance for Decommissioning Planning During Operations AGENCY: Nuclear Regulatory Commission. ACTION: Draft regulatory guide; correction. SUMMARY: The U...

Science operations planning and implementation for Rosetta

NASA Astrophysics Data System (ADS)

Koschny, Detlef; Sweeney, Mark; Montagon, Elsa; Hoofs, Raymond; van der Plas, Peter

2002-07-01

The Rosetta mission is a cornerstone mission of the Horizon 2000 programme of the European Space Agency. It will be launched to comet 46P/Wirtanen in January 2003. This mission is the first of a series of planetary missions, including Mars Express, Smart-I (to the Moon), and BepiColombo (to Mercury). All these missions have similar requirements for their scientific operations. The Experiments H/W and S/W are developed by Principal Investigators, working at scientific institutes. They are also responsible for the operation of their experiments and for the generation of related operational documentation. The Science Operations Centre (SOC) has the task to consolidate the inputs of the different experimenters and the Lander and ensure that the resulting science operations timeline is free of conflicts. It forwards this timeline to the Mission Operations Centre (MOC) which combines the science operations with the operations of the other spacecraft subsystems and the orbit and attitude of the spacecraft. The MOC is also responsible for uplinking the operational command sequences to the spacecraft and for returning the received telemetry to the user. In a collaboration between the team of the Rosetta Project Scientist at the Research and Science Support Department of ESA/ESTEC and the European Space Operations Centre (ESA/ESOC), a concept for the SOC/MOC and their interfaces was developed for the Rosetta mission. This concept is generic enough to allow its implementation also for the other planetary missions. The design phase is now complete, and implementation is on-going. This paper briefly presents the architecture of the complex ground segment, concentrating on the elements required for planning of scientific operations, and then details the software tools EPS (Experiment Planning System) and PTB (Project Test Bed) which are used in the planning process.

Applying analysis tools in planning for operations

DOT National Transportation Integrated Search

2009-09-01

More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

Intra-operative cone beam computed tomography can help avoid reinterventions and reduce CT follow up after infrarenal EVAR.

PubMed

Törnqvist, P; Dias, N; Sonesson, B; Kristmundsson, T; Resch, T

2015-04-01

Re-interventions after endovascular abdominal aortic aneurysm repair (EVAR) are common and therefore a strict imaging follow up protocol is required. The purpose of this study was to evaluate whether cone beam computed tomography (CBCT) can detect intra-operative complications and to compare this with angiography and the 1 month CT follow up (computed tomography angiography [CTA]). Fifty-one patients (44 men) were enrolled in a prospective trial. Patients underwent completion angiography and CBCT during infrarenal EVAR. Contrast was used except when pre-operative renal insufficiency was present or if the maximum contrast dose threshold was reached. CBCT reconstruction included the top of the stent graft to the iliac bifurcation. Endoleaks, kinks, or compressions were recorded. CBCT was technically successful in all patients. Twelve endoleaks were detected on completion digital subtraction angiography (CA). CBCT detected 4/5 type 1 endoleaks, but only one type 2 endoleak. CTA identified eight type 2 endoleaks and one residual type I endoleak. Two cases of stent compression were seen on CA. CBCT revealed five stent compressions and one kink, which resulted in four intra-operative adjunctive manoeuvres. CTA identified all cases of kinks or compressions that were left untreated. Two of them were corrected later. No additional kinks/compressions were found on CTA. Groin closure consisted of 78 fascia sutures, nine cut downs, and 11 percutaneous sutures. Seven femoral artery pseudoaneurysms (<1 cm) were detected on CTA, but no intervention was needed. CA is better than CBCT in detecting and categorizing endoleaks but CBCT (with or without contrast) is better than CA for detection of kinks or stentgraft compression. CTA plus CBCT identified all significant complications noted on the 1 month follow up CTA. The use of intra-operative CA and CBCT could replace early CTA after standard EVAR thus reducing overall radiation and contrast use. Technical development might further

Family Day Care: Suggestions, Ideas, Guides.

ERIC Educational Resources Information Center

Saunders, Minta M., Ed.; Sherrod, Betty C., Ed.

This manual was developed by the United Day Care Services, Inc. and is intended to serve as a guide for others who are planning to work in the area of family day care. The history of the development of the United Day Care Services' family day care unit is summarized and a brief resume of how the unit operates is presented. The areas covered in the…

Spacelab operations planning. [ground handling, launch, flight and experiments

NASA Technical Reports Server (NTRS)

Lee, T. J.

1976-01-01

The paper reviews NASA planning in the fields of ground, launch and flight operations and experiment integration to effectively operate Spacelab. Payload mission planning is discussed taking consideration of orbital analysis and the mission of a multiuser payload which may be either single or multidiscipline. Payload analytical integration - as active process of analyses to ensure that the experiment payload is compatible to the mission objectives and profile ground and flight operations and that the resource demands upon Spacelab can be satisfied - is considered. Software integration is touched upon and the major integration levels in ground operational processing of Spacelab and its experimental payloads are examined. Flight operations, encompassing the operation of the Space Transportation System and the payload, are discussed as are the initial Spacelab missions. Charts and diagrams are presented illustrating the various planning areas.

Space Shuttle operational logistics plan

NASA Technical Reports Server (NTRS)

Botts, J. W.

1983-01-01

The Kennedy Space Center plan for logistics to support Space Shuttle Operations and to establish the related policies, requirements, and responsibilities are described. The Directorate of Shuttle Management and Operations logistics responsibilities required by the Kennedy Organizational Manual, and the self-sufficiency contracting concept are implemented. The Space Shuttle Program Level 1 and Level 2 logistics policies and requirements applicable to KSC that are presented in HQ NASA and Johnson Space Center directives are also implemented.

Potential predictors for the amount of intra-operative brain shift during deep brain stimulation surgery

NASA Astrophysics Data System (ADS)

Datteri, Ryan; Pallavaram, Srivatsan; Konrad, Peter E.; Neimat, Joseph S.; D'Haese, Pierre-François; Dawant, Benoit M.

2011-03-01

A number of groups have reported on the occurrence of intra-operative brain shift during deep brain stimulation (DBS) surgery. This has a number of implications for the procedure including an increased chance of intra-cranial bleeding and complications due to the need for more exploratory electrodes to account for the brain shift. It has been reported that the amount of pneumocephalus or air invasion into the cranial cavity due to the opening of the dura correlates with intraoperative brain shift. Therefore, pre-operatively predicting the amount of pneumocephalus expected during surgery is of interest toward accounting for brain shift. In this study, we used 64 DBS patients who received bilateral electrode implantations and had a post-operative CT scan acquired immediately after surgery (CT-PI). For each patient, the volumes of the pneumocephalus, left ventricle, right ventricle, third ventricle, white matter, grey matter, and cerebral spinal fluid were calculated. The pneumocephalus was calculated from the CT-PI utilizing a region growing technique that was initialized with an atlas-based image registration method. A multi-atlas-based image segmentation method was used to segment out the ventricles of each patient. The Statistical Parametric Mapping (SPM) software package was utilized to calculate the volumes of the cerebral spinal fluid (CSF), white matter and grey matter. The volume of individual structures had a moderate correlation with pneumocephalus. Utilizing a multi-linear regression between the volume of the pneumocephalus and the statistically relevant individual structures a Pearson's coefficient of r = 0.4123 (p = 0.0103) was found. This study shows preliminary results that could be used to develop a method to predict the amount of pneumocephalus ahead of the surgery.

Applying analysis tools in planning for operations : case study #3 -- using archived data as a tool for operations planning

DOT National Transportation Integrated Search

2009-09-01

More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

Interactive orbital proximity operations planning system

NASA Technical Reports Server (NTRS)

Grunwald, Arthur J.; Ellis, Stephen R.

1989-01-01

An interactive, graphical proximity operations planning system was developed which allows on-site design of efficient, complex, multiburn maneuvers in the dynamic multispacecraft environment about the space station. Maneuvering takes place in, as well as out of, the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of relative orbital motion trajectories and complex operational constraints, which are both time varying and highly dependent on the mission scenario. This difficulty is greatly overcome by visualizing the relative trajectories and the relative constraints in an easily interpretable, graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of the space station and co-orbiting spacecraft on the background of the station's orbital plane. The operator has control over two modes of operation: (1) a viewing system mode, which enables him or her to explore the spatial situation about the space station and thus choose and frame in on areas of interest; and (2) a trajectory design mode, which allows the interactive editing of a series of way-points and maneuvering burns to obtain a trajectory which complies with all operational constraints. Through a graphical interactive process, the operator will continue to modify the trajectory design until all operational constraints are met. The effectiveness of this display format in complex trajectory design is presently being evaluated in an ongoing experimental program.

ICD Complex Operations and Maintenance Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gibson, P. L.

2007-06-25

This Operations and Maintenance (O&M) Plan describes how the Idaho National Laboratory (INL) conducts operations, winterization, and startup of the Idaho CERCLA Disposal Facility (ICDF) Complex. The ICDF Complex is the centralized INL facility responsible for the receipt, storage, treatment (as necessary), and disposal of INL Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation waste.

Mechanisms of microregulation of private hospitals by health plan operators.

PubMed

Ugá, Maria Alicia Domínguez; Vasconcellos, Miguel Murat; Lima, Sheyla Maria Lemos; Portela, Margareth Crisóstomo; Gerschman, Silvia

2009-10-01

To analyze the mechanisms employed by health plan operators for microregulation of clinical management and health care qualification within care-providing hospitals. A nation-wide cross-sectional study was carried out. The universe consisted of hospitals which provided care to health plan operators in 2006. A sample of 83 units was selected, stratified by Brazilian macroregion and type of hospital. Data were obtained by means of a questionnaire administered to hospital managers. Microregulation of hospitals by health plan operators was minimal or almost absent in terms of health care qualification. Operator activity focused predominantly on intense control of the amount of services used by patients. Hospitals providing services to health plan operators did not constitute health micro-systems parallel or supplementary to the Sistema Unico de Saúde (SUS - Brazilian National Health System). The private care-providing hospitals were predominantly associated with SUS. However, these did not belong to a private care-provider network, even though their service usage was subject to strong regulation by health plan operators. Operator intervention in the form of system management was incipient or virtually absent. Roughly one-half of investigated hospitals reported adopting clinical directives, whereas only 25.4% reported managing pathology and 30.5% reported managing cases. Contractual relationships between hospitals and health plan operators are merely commercial contracts with little if any incorporation of aspects related to the quality of care, being generally limited to aspects such as establishment of prices, timeframes, and payment procedures.

Variation in day-case nasal surgery - why cannot we improve our day-case rates?

PubMed

Hopkins, C; Browne, J; Slack, R; Brown, P

2007-02-01

The NHS plan states that 75% of all elective operations should be performed as day-cases. We set out to evaluate day surgery rates in sinonasal surgery and to identify factors limiting current practice. Prospective multicentre cohort study. 3128 patients undergoing sinonasal surgery during 2000 and 2001. Same day discharge, complication and readmission rates. There is potential selection bias due to the non-random selection of NHS Trusts and patients in this study. However, as results are similar to Hospital Episode Statistics data such bias is probably small. Only 15.5% of all procedures are performed as day surgery. We are achieving day-case rates of 18, 20 and 6% for nasal polypectomy, intranasal antrostomy and extensive FESS respectively, compared with recently published targets of 90%, 80% and 50%. Factors significantly associated with overnight admission were use of packs, extensive surgery, excess post-operative bleeding and high ASA grade. There was considerable unexplained variation in day-case rates and the use of packs between different surgeons. A third of consultants pack all patients post-operatively. More than 51% of consultants admit all patients, while 5% discharge all patients on the day of surgery. There were no excess adverse events or readmissions amongst the day surgery patients. However, only 17% of in-patients would have liked to be discharged on the day of surgery. Both patient and surgeon must overcome resistance to day case surgery before targets can be reached. Strategies for improving day-case rates in sinonasal surgery. All ASA grade 1 and 2 patients could be considered for day-case surgery, but particularly those with less extensive disease on radiography, and those planned to undergo less extensive procedures. Excess peri-operative bleeding was reported in 6% of patients. There must therefore be provision for overnight admission if required. Greater utilisation of day-case units, selective use of packs, and earlier removal may

Clinical, biochemical and genetic risk factors for 30-day and 5-year mortality in 518 adult patients subjected to cardiopulmonary bypass during cardiac surgery - the INFLACOR study.

PubMed

Kowalik, Maciej Michał; Lango, Romuald; Siondalski, Piotr; Chmara, Magdalena; Brzeziński, Maciej; Lewandowski, Krzysztof; Jagielak, Dariusz; Klapkowski, Andrzej; Rogowski, Jan

2018-04-25

There is increasing evidence that genetic variability influences patients' early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFLAmmation in Cardiac OpeRations) cohort. In a prospectively recruited cohort of 518 adult Polish Caucasians, who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFα, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their association with 30-day and 5-year mortality. The 30-day mortality was associated with: pre-operative prothrombin international normalized ratio, intra-operative blood lactate, postoperative serum creatine phosphokinase, and acute kidney injury requiring renal replacement therapy (AKI-RRT) in logistic regression. Factors that determined the 5-year survival included: pre-operative NYHA class, history of peripheral artery disease and severe chronic obstructive pulmonary disease, intra-operative blood transfusion; and postoperative peripheral hypothermia, myocardial infarction, infection, and AKI-RRT in Cox regression. Serum levels of IL-6 and ICAM-1 measured three hours after the operation were associated with 30-day and 5-year mortality, respectively. The ICAM1 rs5498 was associated with 30-day and 5-year survival with borderline significance. Different risk factors determined the early (30-day) and late (5-year) survival after adult cardiac surgery in which cardiopulmonary bypass was used. Future genetic association studies in cardiac surgical patients should account for the identified chronic and perioperative risk factors.

Pre-clinical validation of a new intra-operative "dual beam Doppler" blood flowmeter in an artificial circuit.

PubMed

Cikirikcioglu, Mustafa; Cikirikcioglu, Y Banu; Khabiri, Ebrahim; Djebaili, M Karim; Kalangos, Afksendiyos; Walpoth, Beat H

2006-01-01

Intra-operative flow measurement during coronary or peripheral bypass operations is helpful for ruling out technical failures and for prediction of complication and patency rates. Preclinical validation of the flowmeters is required in order to rely on the intra-operatively measured results. The aim of this study is to evaluate a new "dual beam Doppler" blood flowmeter before clinical application and to compare it with the established "transit time flow measure-ment" technique in an artificial circuit. Measurements were performed in an experimental flow model using pig blood and pig arteries. Three different flowmeters were used: Quantix OR (dual beam doppler flowmeter), CardioMed (transit time flowmeter), and Transonic (transit time flowmeter). Three validation tests were performed to assess correlation, precision, and repeatability of devices. (1) Correlation and agreement analysis was performed with various flow amounts (10-350 mL/min) (n = 160). (2) Device reproducibility and measurement stability were tested with a constant flow (flow amount = 300 mL/min) (n = 30). (3) A user accuracy test (intra- and inter-observer variability) was performed by 5 different observers with a constant flow (flow amount = 205 mL/min) (n = 75). Time collected true flow was used as a reference method in all steps and all tests were performed in a blind manner. Results are shown as mean values +/- standard deviations. Pear-son's correlation and Bland-Altman plot analyses were used to compare measurements. The mean flow was 167 +/- 98 mL/min for true flow and 162 +/- 94 mL/min, 165 +/- 94 mL/min, and 166 +/- 100 mL/min for Quantix OR, CardioMed, and Transonic, respectively. Correlation coefficients between Quantix OR, Medi-Stim, Transonic, and time collected true flow were over 0.98 (P = .01). Most of the measured results ( > 90%) were between +/- 1.96 SD agreement limits in Bland and Altman plot analysis. All devices showed good results in the reproducibility test. During the user

Treatment of Displaced Intra-articular Calcaneal Fractures by Intramedullary Nail. Preliminary Report.

PubMed

Falis, Mirosław; Pyszel, Krystian

2016-03-23

Open reduction and plate stabilisation is a recognised method of treatment of intra-articular calcaneal fractures. The surgical approach to the calcaneal bone used in these procedures is associated with a high risk of complications. The aim of this paper is to present the author's experience with a new surgical method and analyse early outcomes of the treatment of calcaneal fractures by Calcanail intramedullary nailing. The study encompassed 17 patients (5 women and 12 men) with 18 calcaneal fractures (5 in the right foot and 13 in the left foot). The mean age of the patients was 47 years (range: 22-68 years). The mean time between the injury and surgery was 6 days (range: 3-14 days). The mean duration of follow-up was 12 months (range: 6-18 months). The fractures were classified according to the system presented by Guy Utheza. Bone union was achieved in all patients within 12 weeks of surgery. No infectious complications were observed. The mean AOFAS score was 82/100. Mean Bohler's angle was -3 degrees pre-operatively and +29 degrees post-operatively. 1. The use of Calcanail intramedullary nailing in the treatment of displaced intra-articular fractures is a minimally invasive procedure associated with a low risk of complications. 2. The innovative posterior approach allows for the intrafocal reduction of an articular surface fracture through the prepared intramedullary canal.

Chance-Constrained Day-Ahead Hourly Scheduling in Distribution System Operation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, Huaiguang; Zhang, Yingchen; Muljadi, Eduard

This paper aims to propose a two-step approach for day-ahead hourly scheduling in a distribution system operation, which contains two operation costs, the operation cost at substation level and feeder level. In the first step, the objective is to minimize the electric power purchase from the day-ahead market with the stochastic optimization. The historical data of day-ahead hourly electric power consumption is used to provide the forecast results with the forecasting error, which is presented by a chance constraint and formulated into a deterministic form by Gaussian mixture model (GMM). In the second step, the objective is to minimize themore » system loss. Considering the nonconvexity of the three-phase balanced AC optimal power flow problem in distribution systems, the second-order cone program (SOCP) is used to relax the problem. Then, a distributed optimization approach is built based on the alternating direction method of multiplier (ADMM). The results shows that the validity and effectiveness method.« less

An innovative approach to capability-based emergency operations planning

PubMed Central

Keim, Mark E

2013-01-01

This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology. PMID:28228987

An innovative approach to capability-based emergency operations planning.

PubMed

Keim, Mark E

2013-01-01

This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology.

The first clinical application of planning software for laparoscopic microwave thermosphere ablation of malignant liver tumours.

PubMed

Berber, Eren

2015-07-01

Liver tumour ablation is an operator-dependent procedure. The determination of the optimum needle trajectory and correct ablation parameters could be challenging. The aim of this study was to report the utility of a new, procedure planning software for microwave ablation (MWA) of liver tumours. This was a feasibility study in a pilot group of five patients with nine metastatic liver tumours who underwent laparoscopic MWA. Pre-operatively, parameters predicting the desired ablation zones were calculated for each tumour. Intra-operatively, this planning strategy was followed for both antenna placement and energy application. Post-operative 2-week computed tomography (CT) scans were performed to evaluate complete tumour destruction. The patients had an average of two tumours (range 1-4), measuring 1.9 ± 0.4 cm (range 0.9-4.4 cm). The ablation time was 7.1 ± 1.3 min (range 2.5-10 min) at 100W. There were no complications or mortality. The patients were discharged home on post-operative day (POD) 1. At 2-week CT scans, there were no residual tumours, with a complete ablation demonstrated in all lesions. This study describes and validates pre-treatment planning software for MWA of liver tumours. This software was found useful to determine precisely the ablation parameters and needle placement to create a predicted zone of ablation. © 2015 International Hepato-Pancreato-Biliary Association.

Multi Sector Planning Tools for Trajectory-Based Operations

NASA Technical Reports Server (NTRS)

Prevot, Thomas; Mainini, Matthew; Brasil, Connie

2010-01-01

This paper discusses a suite of multi sector planning tools for trajectory-based operations that were developed and evaluated in the Airspace Operations Laboratory (AOL) at the NASA Ames Research Center. The toolset included tools for traffic load and complexity assessment as well as trajectory planning and coordination. The situation assessment tools included an integrated suite of interactive traffic displays, load tables, load graphs, and dynamic aircraft filters. The planning toolset allowed for single and multi aircraft trajectory planning and data communication-based coordination of trajectories between operators. Also newly introduced was a real-time computation of sector complexity into the toolset that operators could use in lieu of aircraft count to better estimate and manage sector workload, especially in situations with convective weather. The tools were used during a joint NASA/FAA multi sector planner simulation in the AOL in 2009 that had multiple objectives with the assessment of the effectiveness of the tools being one of them. Current air traffic control operators who were experienced as area supervisors and traffic management coordinators used the tools throughout the simulation and provided their usefulness and usability ratings in post simulation questionnaires. This paper presents these subjective assessments as well as the actual usage data that was collected during the simulation. The toolset was rated very useful and usable overall. Many elements received high scores by the operators and were used frequently and successfully. Other functions were not used at all, but various requests for new functions and capabilities were received that could be added to the toolset.

30 CFR 285.620 - What is a Construction and Operations Plan (COP)?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What is a Construction and Operations Plan (COP... Information Requirements Construction and Operations Plan for Commercial Leases § 285.620 What is a Construction and Operations Plan (COP)? The COP describes your construction, operations, and conceptual...

MO-B-BRC-00: Prostate HDR Treatment Planning - Considering Different Imaging Modalities

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

43 CFR 3931.10 - Exploration plans and plans of development for mining and in situ operations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... for mining and in situ operations. 3931.10 Section 3931.10 Public Lands: Interior Regulations Relating....10 Exploration plans and plans of development for mining and in situ operations. (a) The POD must... development of the oil shale resources in the lease. (b) The operator must submit to the proper BLM office an...

43 CFR 3931.10 - Exploration plans and plans of development for mining and in situ operations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... for mining and in situ operations. 3931.10 Section 3931.10 Public Lands: Interior Regulations Relating....10 Exploration plans and plans of development for mining and in situ operations. (a) The POD must... development of the oil shale resources in the lease. (b) The operator must submit to the proper BLM office an...

43 CFR 3931.10 - Exploration plans and plans of development for mining and in situ operations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for mining and in situ operations. 3931.10 Section 3931.10 Public Lands: Interior Regulations Relating....10 Exploration plans and plans of development for mining and in situ operations. (a) The POD must... development of the oil shale resources in the lease. (b) The operator must submit to the proper BLM office an...

43 CFR 3931.10 - Exploration plans and plans of development for mining and in situ operations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... for mining and in situ operations. 3931.10 Section 3931.10 Public Lands: Interior Regulations Relating....10 Exploration plans and plans of development for mining and in situ operations. (a) The POD must... development of the oil shale resources in the lease. (b) The operator must submit to the proper BLM office an...

Ulysses operations at Jupiter - Planning for the unknown

NASA Technical Reports Server (NTRS)

Angold, N.; Beech, P.; Garcia-Perez, R.; Mcgarry, A.; Standley, S.

1992-01-01

The operational preparations for the Ulysses encounter with Jupiter are described with particular attention given to requirements for survival in the Jovian environment, ground-segment planning, a deep-space network, and encounter activities. It is concluded that the successful operation of the Ulysses spacecraft at Jupiter was the culmination of many years of activity, from spacecraft design and mission planning to the coordination of the encounter activities and production of the detailed timeline.

30 CFR 250.290 - What operations require approval of the Conceptual Plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Plans and Information Deepwater Operations Plans (dwop) § 250.290 What operations require approval of the Conceptual Plan? You may... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What operations require approval of the...

Management of interstitial ectopic pregnancies with a combined intra-amniotic and systemic approach.

PubMed

Swank, Morgan L; Harken, Tabetha R; Porto, Manuel

2013-08-01

Approximately 2% of all pregnancies are ectopic; of these, 4% are interstitial or cervical. There exists no clear consensus as to whether surgical or medical management is superior. We present three cases of advanced nonfallopian tube ectopic pregnancies from 6 to 8 weeks of gestation. Our first two cases were managed with a combined intrafetal, intra-amniotic and systemic approach using methotrexate and potassium chloride, whereas our third case was managed with an intra-amniotic approach alone. Our combined approach cases were successful, with resolution of human chorionic gonadotropin in 50 and 34 days, whereas our single approach case re-presented with bleeding requiring uterine artery embolization and operative removal of products of conception. Patients presenting with advanced interstitial or cervical pregnancies who are clinically stable can be offered medical management with a combined approach.

Petroleum refinery operational planning using robust optimization

NASA Astrophysics Data System (ADS)

Leiras, A.; Hamacher, S.; Elkamel, A.

2010-12-01

In this article, the robust optimization methodology is applied to deal with uncertainties in the prices of saleable products, operating costs, product demand, and product yield in the context of refinery operational planning. A numerical study demonstrates the effectiveness of the proposed robust approach. The benefits of incorporating uncertainty in the different model parameters were evaluated in terms of the cost of ignoring uncertainty in the problem. The calculations suggest that this benefit is equivalent to 7.47% of the deterministic solution value, which indicates that the robust model may offer advantages to those involved with refinery operational planning. In addition, the probability bounds of constraint violation are calculated to help the decision-maker adopt a more appropriate parameter to control robustness and judge the tradeoff between conservatism and total profit.

Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

PubMed

Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

2017-07-25

Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity

Treatment Planning and Image Guidance for Radiofrequency Ablations of Large Tumors

PubMed Central

Ren, Hongliang; Campos-Nanez, Enrique; Yaniv, Ziv; Banovac, Filip; Abeledo, Hernan; Hata, Nobuhiko; Cleary, Kevin

2014-01-01

This article addresses the two key challenges in computer-assisted percutaneous tumor ablation: planning multiple overlapping ablations for large tumors while avoiding critical structures, and executing the prescribed plan. Towards semi-automatic treatment planning for image-guided surgical interventions, we develop a systematic approach to the needle-based ablation placement task, ranging from pre-operative planning algorithms to an intra-operative execution platform. The planning system incorporates clinical constraints on ablations and trajectories using a multiple objective optimization formulation, which consists of optimal path selection and ablation coverage optimization based on integer programming. The system implementation is presented and validated in phantom studies and on an animal model. The presented system can potentially be further extended for other ablation techniques such as cryotherapy. PMID:24235279

The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm.

PubMed

Abdulrasak, M; Resch, T; Sonesson, B; Holst, J; Kristmundsson, T; Dias, N V

2017-01-01

The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months' follow-up. In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15-72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to

Operations and maintenance plan : Dallas Integrated Corridor Management (ICM) demonstration project.

DOT National Transportation Integrated Search

2014-01-01

This Operations and Maintenance (O&M) Plan describes how the Integrated Corridor Management System (ICMS) will be used in daily transportation operations and maintenance activities. The Plan addresses the activities needed to effectively operate the ...

Pre-operative intra-articular deep tissue sampling with novel retrograde forceps improves the diagnostics in periprosthetic joint infection.

PubMed

Wimmer, Matthias D; Ploeger, Milena M; Friedrich, Max J; Hügle, Thomas; Gravius, Sascha; Randau, Thomas M

2017-07-01

Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes. Thirty patients (male n = 15, 50%; female n = 15, 50%) with 30 suspected PJIs in painful total hip arthroplasties (THAs) were included in this prospective, controlled, non-blinded trial. The results were compared with intra-operatively obtained representative deep tissue samples. In summary, 27 out of 30 patients were diagnosed correctly as infected (17/17) or non-infected (10/13). The sensitivity to predict a PJI using the Retroforce® sampling forceps in addition to standard diagnostics was 85%, the specificity 100%. Retrograde synovial biopsy is a new and rapid diagnostic procedure under local anaesthesia in patients with painful THAs with similar histological results compared to deep tissue sampling.

GTC Science Operations and Instrumentation Plan

NASA Astrophysics Data System (ADS)

Cabrera-Lavers, A.

2017-03-01

The 10.4 m Gran Telescopio CANARIAS came into operation in 2009, and now we can clearly state without any doubt that we have in our hands an extraordinary tool to produce science with all its capabilities and functionalities operating under specs. This contribution summarizes the current status of the night operation of the telescope and describe GTC short- and medium- term instrumentation plan, that will make possible to provide access up to five different instruments to the users community from middle 2017, largely enhancing the scientific return from the telescope.

Forecasting Wind and Solar Generation: Improving System Operations, Greening the Grid (Spanish Version)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tian, Tian; Chernyakhovskiy, Ilya; Brancucci Martinez-Anido, Carlo

This document is the Spanish version of 'Greening the Grid- Forecasting Wind and Solar Generation Improving System Operations'. It discusses improving system operations with forecasting with and solar generation. By integrating variable renewable energy (VRE) forecasts into system operations, power system operators can anticipate up- and down-ramps in VRE generation in order to cost-effectively balance load and generation in intra-day and day-ahead scheduling. This leads to reduced fuel costs, improved system reliability, and maximum use of renewable resources.

Use of Intra-Arterial Chemotherapy and Embolization Before Limb Salvage Surgery for Osteosarcoma of the Lower Extremity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang Huojun, E-mail: chyyzhj@hotmail.com; Yang Jijin, E-mail: yangjijin@live.com; Lu Jianping

We report our experience with the use of intra-arterial chemotherapy and embolization before limb salvage surgery in patients with osteosarcoma of the lower extremity. We evaluated the effect of this procedure on the degree of tumor necrosis and on the amount of blood loss during surgery. We reviewed the medical records of all patients who received intra-arterial chemotherapy and embolization before undergoing limb salvage surgery for osteosarcoma of the lower extremity at our institution between January 2003 and April 2008. Patient demographic, tumor characteristics, treatment details, postembolization complications, and surgical and pathological findings were recorded for each patient. We evaluatedmore » the operative time, estimated blood loss (EBL), and volume of blood transfusion during surgery and in the postoperative period in all patients in the study group. The same parameters were recorded for 65 other patients with lower extremity osteosarcoma who underwent limb salvage operation at our institution without undergoing preoperative intervention. The study included 47 patients (25 males and 22 females). Angiography showed that the tumors were hypervascular. Intra-arterial chemotherapy and embolization were performed successfully, resulting in a substantial reduction or complete disappearance of tumor stain in all patients. No major complications were encountered. At the time of surgery, performed 3-7 days after embolization, a fibrous edematous band around the tumor was observed in 43 of the 47 patients, facilitating surgery. The goal of limb salvage was achieved successfully in all cases. Percentage tumor necrosis induced by treatment ranged from 70.2% to 94.2% (average, 82.9%). EBL during surgery, EBL from drains in the postoperative period, total EBL, and transfusion volumes were significantly lower in the 47 study patients compared to the 65 patients who underwent surgery without preoperative treatment with intra-arterial chemotherapy and embolization

Pulmonary and systemic inflammatory responses to intra-amniotic IL-1α in fetal sheep

PubMed Central

Kramer, Boris W.; Nitsos, Ilias; Pillow, J. Jane; Collins, Jennifer J. P.; Polglase, Graeme R.; Newnham, John P.; Jobe, Alan H.

2011-01-01

Clinical and epidemiological studies implicate IL-1 as an important mediator of perinatal inflammation. We tested the hypothesis that intra-amniotic IL-1α would induce pulmonary and systemic fetal inflammatory responses. Sheep with singleton fetuses were given an intra-amniotic injection of recombinant sheep IL-1α (100 μg) and were delivered 1, 3, or 7 days later, at 124 ± 1 days gestation (n=5–8/group). A separate group of sheep were given two intra-amniotic IL-1α injections (100 μg dose each): 7 days and again 1 day prior to delivery. IL-1α induced a robust increase in monocytes, neutrophils, lymphocytes, and IL-8 protein in bronchoalveolar lavage fluid. H2O2 secretion was increased in inflammatory cells isolated from lungs of IL-1α-exposed lambs upon LPS challenge in vitro compared with control monocytes. T lymphocytes were recruited to the lung. IL-1β, cyclooxygenase-1, and cyclooxygenase-2 mRNA expression increased in the lung 1 day after intra-amniotic IL-1α exposure. Lung volumes increased 7 days after intra-amniotic IL-1α exposure, with minimal anatomic changes in air space morphology. The weight of the posterior mediastinal lymph node draining the lung and the gastrointestinal tract doubled, inducible nitric oxide synthase (NOSII)-positive cells increased, and Foxp3-positive T-regulatory lymphocytes decreased in the lymph node after IL-1α exposure. In the blood, neutrophil counts and plasma haptoglobin increased after IL-1α exposure. Compared with a single exposure, exposure to intra-amniotic IL-1α 7 days and again 1 day before delivery had a variable effect (increases in some inflammatory markers, but not pulmonary cytokines). IL-1α is a potent mediator of the fetal inflammatory response syndrome. PMID:21665964

Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

PubMed

Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

2011-01-01

A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

NAS operational evolution plan : a foundation for capacity enhancement 2001-2010

DOT National Transportation Integrated Search

2001-06-01

This series of World Wide Web slides focuses on the Operational Evolution Plan, which is a 10-year plan for aviation operational improvements to increase capacity and safety in the United States. This plan is unique in that it integrates all actions:...

How can we maximize the use of our operating lists? An analysis of factors influencing theatre efficiency in oculoplastic day surgery.

PubMed

Nagendran, Sonali T; Siah, We Fong; Litwin, Andre; Barbosa, Christine; Jayatilake, Jan; Malhotra, Raman

2016-12-01

Operating theatre utilization has become the principal measure of NHS operating theatre service performance. We analysed data from oculoplastic theatres in a tertiary centre to identify factors influencing theatre efficiency. We conducted three audits on operating theatre utilization in 2011, 2014 and 2015. Data was collected from real time information entered into the hospital database, including time of arrival, induction, first cut and close of operation. The primary outcome measure was the operating list utilization rate, a combined value of anaesthetic and surgical time as a proportion of the total planned session time. The initial 2011 audit recorded an operating list utilization rate of 81.2%. However, this dropped to 64.5% in 2014 following new management and a move to a new theatre suite. Analysis of the factors contributing to poor theatre efficiency led to changes that streamlined the patient pathway, including standardized case scheduling and reducing staggered patient arrival. A 2015 reaudit analyzing the effects of these changes demonstrated an increase in the operating list utilization rate to 78%. It was significantly higher (p < 0.01) for whole-day lists (85%) compared to half-day lists (75%), suggesting that whole-day lists were more efficient. Operating theatres are a valuable resource and the factors affecting theatre efficiency within our unit are common and will be relevant to units elsewhere. Correcting them can lead to significant improvements in patient care. Data from this study may provide a benchmark for other units in the United Kingdom.

Graduate Student Project: Operations Management Product Plan

ERIC Educational Resources Information Center

Fish, Lynn

2007-01-01

An operations management product project is an effective instructional technique that fills a void in current operations management literature in product planning. More than 94.1% of 286 graduates favored the project as a learning tool, and results demonstrate the significant impact the project had in predicting student performance. The author…

Effelsberg Monitoring of a Sample of RadioAstron Blazars: Analysis of Intra-Day Variability

NASA Astrophysics Data System (ADS)

Liu, Jun; Bignall, Hayley; Krichbaum, Thomas; Liu, Xiang; Kraus, Alex; Kovalev, Yuri; Sokolovsky, Kirill; Angelakis, Emmanouil; Zensus, J.

2018-04-01

We present the first results of an ongoing intra-day variability (IDV) flux density monitoring program of 107 blazars, which were selected from a sample of RadioAstron space very long baseline interferometry (VLBI) targets. The~IDV observations were performed with the Effelsberg 100-m radio telescope at 4.8\\,GHz, focusing on the statistical properties of IDV in a relatively large sample of compact active galactic nuclei (AGN). We investigated the dependence of rapid ($<$3 day) variability on various source properties through a likelihood approach. We found that the IDV amplitude depends on flux density and that fainter sources vary by about a factor of 3 more than their brighter counterparts. We also found a significant difference in the variability amplitude between inverted- and flat-spectrum radio sources, with the former exhibiting stronger variations. $\\gamma$-ray loud sources were found to vary by up to a factor 4 more than $\\gamma$-ray quiet ones, with 4$\\sigma$ significance. However a galactic latitude dependence was barely observed, which suggests that it is predominantly the intrinsic properties (e.g., angular size, core-dominance) of the blazars that determine how they scintillate, rather than the directional dependence in the interstellar medium (ISM). We showed that the uncertainty in the VLBI brightness temperatures obtained from the space VLBI data of the RadioAstron satellite can be as high as $\\sim$70\\% due to the presence of the rapid flux density variations. Our statistical results support the view that IDV at centimeter wavelengths is predominantly caused by interstellar scintillation (ISS) of the emission from the most compact, core-dominant region in an AGN.

Integrating operation design into infrastructure planning to foster robustness of planned water systems

NASA Astrophysics Data System (ADS)

Bertoni, Federica; Giuliani, Matteo; Castelletti, Andrea

2017-04-01

Over the past years, many studies have looked at the planning and management of water infrastructure systems as two separate problems, where the dynamic component (i.e., operations) is considered only after the static problem (i.e., planning) has been resolved. Most recent works have started to investigate planning and management as two strictly interconnected faces of the same problem, where the former is solved jointly with the latter in an integrated framework. This brings advantages to multi-purpose water reservoir systems, where several optimal operating strategies exist and similar system designs might perform differently on the long term depending on the considered short-term operating tradeoff. An operationally robust design will be therefore one performing well across multiple feasible tradeoff operating policies. This work aims at studying the interaction between short-term operating strategies and their impacts on long-term structural decisions, when long-lived infrastructures with complex ecological impacts and multi-sectoral demands to satisfy (i.e., reservoirs) are considered. A parametric reinforcement learning approach is adopted for nesting optimization and control yielding to both optimal reservoir design and optimal operational policies for water reservoir systems. The method is demonstrated on a synthetic reservoir that must be designed and operated for ensuring reliable water supply to downstream users. At first, the optimal design capacity derived is compared with the 'no-fail storage' computed through Rippl, a capacity design function that returns the minimum storage needed to satisfy specified water demands without allowing supply shortfall. Then, the optimal reservoir volume is used to simulate the simplified case study under other operating objectives than water supply, in order to assess whether and how the system performance changes. The more robust the infrastructural design, the smaller the difference between the performances of

Planning of vessel grafts for reconstructive surgery in congenital heart diseases

NASA Astrophysics Data System (ADS)

Rietdorf, U.; Riesenkampff, E.; Schwarz, T.; Kuehne, T.; Meinzer, H.-P.; Wolf, I.

2010-02-01

The Fontan operation is a surgical treatment for patients with severe congenital heart diseases, where a biventricular correction of the heart can't be achieved. In these cases, a uni-ventricular system is established. During the last step of surgery a tunnel segment is placed to connect the inferior caval vein directly with the pulmonary artery, bypassing the right atrium and ventricle. Thus, the existing ventricle works for the body circulation, while the venous blood is passively directed to the pulmonary arteries. Fontan tunnels can be placed intra- and extracardially. The location, length and shape of the tunnel must be planned accurately. Furthermore, if the tunnel is placed extracardially, it must be positioned between other anatomical structures without constraining them. We developed a software system to support planning of the tunnel location, shape, and size, making pre-operative preparation of the tunnel material possible. The system allows for interactive placement and adjustment of the tunnel, affords a three-dimensional visualization of the virtual Fontan tunnel inside the thorax, and provides a quantification of the length, circumferences and diameters of the tunnel segments. The visualization and quantification can be used to plan and prepare the tunnel material for surgery in order to reduce the intra-operative time and to improve the fit of the tunnel patch.

The intra-umbilical approach in umbilical hernia.

PubMed

Arslan, Sukru; Korkut, Ercan

2014-02-01

To investigate the "intra-umbilical incision", a smaller incision compared to classic incisions, in cases of umbilical hernia, and which we believe will contribute to patient satisfaction in aesthetic terms, and also the practicability of such operations. The umbilical margins of eight patients with an umbilical hernia were marked between the levels of 6 and 12 o'clock, and a median intra-umbilical skin incision was performed between these two points. In some cases, where exploration could not be performed sufficiently, the incision was extended horizontally from 6 or 12 o'clock. Hernia repair and mesh placement was then performed using an intra-umbilical approach. Patients were investigated according to the defect size and requirement for intra-umbilical incision extension. No requirement for intra-umbilical incision was encountered in six patients with a facial defect diameter smaller than 4 cm, while the incision had to be extended in two patients with defects greater than 4 cm. The intra-umbilical approach in umbilical hernia surgery is aesthetically superior to classical approaches and is a practicable technique.

Real-time planning/replanning of ongoing operations in a crisis situation

NASA Astrophysics Data System (ADS)

Griffith, David A.; Smith, Gregory M.

1997-02-01

The ability to examine the planned position and movement of police vehicles, personnel, weapons, and status of police assets is an implied requirement in the conduct of police activities. Displays showing the time police vehicles leave on assignment, stops along their route, time of return to station, quantity of vehicles, types of weapons, radio frequencies, and other pertinent information could help in crisis situations. It would be especially helpful if it were easily accessible and simple to understand. Rome Laboratory developed a system for monitoring interrelated planned events and for changing these events to correct for deviations in the plan. The system is called force level execution (FLEX), and it displays information on timing charts, tables, and a geographic map background. The FLEX graphics enhance the military commander's ability to grasp the tactical situation which typically includes 2000 to 3000 air sorties per day. A sortie is a single flight of a single aircraft. Because the 'fog of war' causes unexpected events, status reports are needed, replanning options are generated, and new plans are issued to correct for these unexpected events. The authors believe there are law enforcement and other crisis situations that are analogous to some military scenarios. These may include state police operating over large geographical areas, coordination with county police operating over somewhat smaller areas, coordination with the county sheriff's office and city police, not only for criminal apprehension, but for disaster relief. Other participants in a crisis situation may include fire departments, ambulances, emergency medical vehicles, hospitals, rescue operations, etc. The position of police vehicles, foot patrolman, helicopters and emergency vehicles can all be superimposed upon a map background, with appropriate cultural features such as roads, rivers, bridges, state and country boundaries, etc. When police vehicles incorporate the global positioning

Application of genetic algorithm in integrated setup planning and operation sequencing

NASA Astrophysics Data System (ADS)

Kafashi, Sajad; Shakeri, Mohsen

2011-01-01

Process planning is an essential component for linking design and manufacturing process. Setup planning and operation sequencing is two main tasks in process planning. Many researches solved these two problems separately. Considering the fact that the two functions are complementary, it is necessary to integrate them more tightly so that performance of a manufacturing system can be improved economically and competitively. This paper present a generative system and genetic algorithm (GA) approach to process plan the given part. The proposed approach and optimization methodology analyses the TAD (tool approach direction), tolerance relation between features and feature precedence relations to generate all possible setups and operations using workshop resource database. Based on these technological constraints the GA algorithm approach, which adopts the feature-based representation, optimizes the setup plan and sequence of operations using cost indices. Case study show that the developed system can generate satisfactory results in optimizing the setup planning and operation sequencing simultaneously in feasible condition.

Systematic analysis of the scatter environment in clinical intra-operative high dose rate (IOHDR) brachytherapy

NASA Astrophysics Data System (ADS)

Oh, Moonseong

Most brachytherapy planning systems are based on a dose calculation algorithm that assumes an infinite scatter environment surrounding the target volume and applicator. In intra-operative high dose rate brachytherapy (IOHDR) where treatment catheters are typically laid either directly on a tumor bed or within applicators that may have little or no scatter material above them, the lack of scatter from one side of the applicator can result in serious underdosage during treatment. Therefore, full analyses of the physical processes such as the photoelectric effect, Rayleigh, and Compton scattering that contribute to dosimetric errors have to be investigated and documented to result in more accurate treatment delivery to patients undergoing IOHDR procedures. Monte Carlo simulation results showed the Compton scattering effect is about 40 times more probable than photoelectric effect for the treated areas of single source, 4 x 4, and 2 x 4 cm2. Also, the dose variations with and without photoelectric effect were 0.3 ˜ 0.7%, which are within the uncertainty in Monte Carlo simulations. Also, Monte Carlo simulation studies were done to verify the following experimental results for quantification of dosimetric errors in clinical IOHDR brachytherapy. The first experimental study was performed to quantify the inaccuracy in clinical dose delivery due to the incomplete scatter conditions inherent in IOHDR brachytherapy. Treatment plans were developed for 3 different treatment surface areas (4 x 4, 7 x 7, 12 x 12 cm2), each with prescription points located at 3 distances (0.5 cm, 1.0 cm, and 1.5 cm) from the source dwell positions. Measurements showed that the magnitude of the underdosage varies from about 8% to 13% of the prescription dose as the prescription depth is increased from 0.5 cm to 1.5 cm. This treatment error was found to be independent of the irradiated area and strongly dependent on the prescription distance. The study was extended to confirm the underdosage for

Web Application Software for Ground Operations Planning Database (GOPDb) Management

NASA Technical Reports Server (NTRS)

Lanham, Clifton; Kallner, Shawn; Gernand, Jeffrey

2013-01-01

A Web application facilitates collaborative development of the ground operations planning document. This will reduce costs and development time for new programs by incorporating the data governance, access control, and revision tracking of the ground operations planning data. Ground Operations Planning requires the creation and maintenance of detailed timelines and documentation. The GOPDb Web application was created using state-of-the-art Web 2.0 technologies, and was deployed as SaaS (Software as a Service), with an emphasis on data governance and security needs. Application access is managed using two-factor authentication, with data write permissions tied to user roles and responsibilities. Multiple instances of the application can be deployed on a Web server to meet the robust needs for multiple, future programs with minimal additional cost. This innovation features high availability and scalability, with no additional software that needs to be bought or installed. For data governance and security (data quality, management, business process management, and risk management for data handling), the software uses NAMS. No local copy/cloning of data is permitted. Data change log/tracking is addressed, as well as collaboration, work flow, and process standardization. The software provides on-line documentation and detailed Web-based help. There are multiple ways that this software can be deployed on a Web server to meet ground operations planning needs for future programs. The software could be used to support commercial crew ground operations planning, as well as commercial payload/satellite ground operations planning. The application source code and database schema are owned by NASA.

Discrepancies Between Planned and Actual Operating Room Turnaround Times at a Large Rural Hospital in Germany

PubMed Central

Morgenegg, Regula; Heinze, Franziska; Wieferich, Katharina; Schiffer, Ralf; Stueber, Frank; Luedi, Markus M.; Doll, Dietrich

2017-01-01

Objectives While several factors have been shown to influence operating room (OR) turnaround times, few comparisons of planned and actual OR turnaround times have been performed. This study aimed to compare planned and actual OR turnaround times at a large rural hospital in Northern Germany. Methods This retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014. The frequency distributions of planned and actual OR turnaround times were compared and correlations between turnaround times and various factors were established, including the time of day of the procedure, patient age and the planned duration of the surgery. Results There was a significant difference between mean planned and actual OR turnaround times (0.32 versus 0.64 hours; P <0.001). In addition, significant correlations were noted between actual OR turnaround times and the time of day of the surgery, patient age, actual duration of the procedure and staffing changes affecting the surgeon or the medical specialty of the surgery (P <0.001 each). The quotient of actual/planned OR turnaround times ranged from 1.733–3.000. Conclusion Significant discrepancies between planned and actual OR turnaround times were noted during the study period. Such findings may be potentially used in future studies to establish a tool to improve OR planning, measure OR management performance and enable benchmarking. PMID:29372083

Activity Planning for the Mars Exploration Rovers

NASA Technical Reports Server (NTRS)

Bresina, John L.; Jonsson, Ari K.; Morris, Paul H.; Rajan, Kanna

2004-01-01

Operating the Mars Exploration Rovers is a challenging, time-pressured task. Each day, the operations team must generate a new plan describing the rover activities for the next day. These plans must abide by resource limitations, safety rules, and temporal constraints. The objective is to achieve as much science as possible, choosing from a set of observation requests that oversubscribe rover resources. In order to accomplish this objective, given the short amount of planning time available, the MAPGEN (Mixed-initiative Activity Plan GENerator) system was made a mission-critical part of the ground operations system. MAPGEN is a mixed-initiative system that employs automated constraint-based planning, scheduling, and temporal reasoning to assist operations staff in generating the daily activity plans. This paper describes the adaptation of constraint-based planning and temporal reasoning to a mixed-initiative setting and the key technical solutions developed for the mission deployment of MAPGEN.

Distributed Operations Planning

NASA Technical Reports Server (NTRS)

Fox, Jason; Norris, Jeffrey; Powell, Mark; Rabe, Kenneth; Shams, Khawaja

2007-01-01

Maestro software provides a secure and distributed mission planning system for long-term missions in general, and the Mars Exploration Rover Mission (MER) specifically. Maestro, the successor to the Science Activity Planner, has a heavy emphasis on portability and distributed operations, and requires no data replication or expensive hardware, instead relying on a set of services functioning on JPL institutional servers. Maestro works on most current computers with network connections, including laptops. When browsing down-link data from a spacecraft, Maestro functions similarly to being on a Web browser. After authenticating the user, it connects to a database server to query an index of data products. It then contacts a Web server to download and display the actual data products. The software also includes collaboration support based upon a highly reliable messaging system. Modifications made to targets in one instance are quickly and securely transmitted to other instances of Maestro. The back end that has been developed for Maestro could benefit many future missions by reducing the cost of centralized operations system architecture.

36 CFR 292.67 - Operating plan approval-outstanding mineral rights.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-outstanding mineral rights. 292.67 Section 292.67 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Outstanding Mineral Rights § 292.67 Operating plan approval—outstanding mineral rights. (a) Upon receipt of an operating plan...

36 CFR 292.67 - Operating plan approval-outstanding mineral rights.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-outstanding mineral rights. 292.67 Section 292.67 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Outstanding Mineral Rights § 292.67 Operating plan approval—outstanding mineral rights. (a) Upon receipt of an operating plan...

36 CFR 292.67 - Operating plan approval-outstanding mineral rights.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-outstanding mineral rights. 292.67 Section 292.67 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Outstanding Mineral Rights § 292.67 Operating plan approval—outstanding mineral rights. (a) Upon receipt of an operating plan...

36 CFR 292.67 - Operating plan approval-outstanding mineral rights.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-outstanding mineral rights. 292.67 Section 292.67 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Outstanding Mineral Rights § 292.67 Operating plan approval—outstanding mineral rights. (a) Upon receipt of an operating plan...

Guidance system operations plan for manned CM earth orbital missions using program SKYLARK 1. Section 4: Operational modes

NASA Technical Reports Server (NTRS)

Dunbar, J. C.

1972-01-01

The operational modes for the guidance system operations plan for Program SKYLARK 1 are presented. The procedures control the guidance and navigation system interfaces with the flight crew and the mission control center. The guidance operational concept is designed to comprise a set of manually initiated programs and functions which may be arranged by the flight crew to implement a large class of flight plans. This concept will permit both a late flight plan definition and a capability for real time flight plan changes.

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision.

PubMed

Biggs, M Antonia; Harper, Cynthia C; Brindis, Claire D

2015-08-01

To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required. In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants. Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols. Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision. III.

30 CFR 250.111 - Who oversees operations under my welding plan?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false Who oversees operations under my welding plan... SHELF General Performance Standards § 250.111 Who oversees operations under my welding plan? A welding supervisor or a designated person in charge must be thoroughly familiar with your welding plan. This person...

Mandible reconstruction with free fibula flaps: Outcome of a cost-effective individual planning concept compared with virtual surgical planning.

PubMed

Rommel, Niklas; Kesting, Marco Rainer; Rohleder, Nils Hagen; Bauer, Florian Martin Josef; Wolff, Klaus-Dietrich; Weitz, Jochen

2017-08-01

The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome. 31 patients undergoing mandibular reconstruction with a microvascular free fibular flap were divided into two groups and retrospectively reviewed. For the first group A (18 of 31 patients), an individual method with stererolithographic (STL) models, silicon templates and hand-made cutting guides was used (about 250 € planning costs/patient). For the second group B (13 of 31 patients), VSP including pre-fabricated cutting guides was used (about 2500 € planning costs/patient). We found no statistically significant differences with respect to intra-operative time of mandibular reconstruction, duration of hospitalisation or post-operative complications between the two groups (p ≥ 0.05). The surgical outcomes and operative efficiency of this individual and cost-effective planning concept are comparable with the much more expensive complete VSP concept. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Surgical treatment of intra-articular calcaneal fractures.

PubMed

Stapleton, John J; Zgonis, Thomas

2014-10-01

Most intra-articular calcaneal fractures are a result of high-energy trauma. The operative management of calcaneal fractures has been based on achieving anatomic reduction and minimizing complications of the compromised soft tissue envelope. The traditional extensile lateral approach offers advantages of achieving adequate fracture reduction with the risk of wound-healing complications and infection. Limited open reduction and internal fixation techniques with or without using external fixation focuses on achieving fracture reduction with less risk of wound complications but higher risk of malunion. This article discusses key points of operative management for various intra-articular calcaneal fracture patterns and clinical presentations. Copyright © 2014 Elsevier Inc. All rights reserved.

AIS ASM Operational Integration Plan

DTIC Science & Technology

2013-08-01

al. | Public August 2013 This page intentionally left blank. AIS ASM Operational Integration Plan v ...that supply AIS Routers as part of their AIS shoreside network software : Kongsberg C-Scope, Gatehouse AIS, Transas AIS Network, and CNS DataSwitch...commercial systems would be suitable for the current USCG traffic conditions. The ASM Manager is software that adds the required queuing and

Electric Vehicle Sharing Planning and Operations

DOT National Transportation Integrated Search

2018-02-01

Dongfang Zhao (ORCID ID 0000-0002-5424-9915); Xiaopeng (Shaw) Li (ORCID ID 0000-0002-5264-3775); Yu Zhang (ORCID ID 0000-0003-1202-626X) This project includes literature review and proposing a model for EV planning and operations. We first conducted ...

The unsuspected prosthetic joint infection : incidence and consequences of positive intra-operative cultures in presumed aseptic knee and hip revisions.

PubMed

Jacobs, A M E; Bénard, M; Meis, J F; van Hellemondt, G; Goosen, J H M

2017-11-01

Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes. For all patients three or more separate intra-operative cultures were obtained. Patients were diagnosed with a previously unsuspected prosthetic joint infection (PJI) if two or more cultures were positive with the same organism. Records were reviewed for demographic details, pre-operative laboratory results and culture results. The primary outcome measure was infection-free implant survival at two years. The incidence of unsuspected PJI was 27 out of 340 (7.9%) in TKA and 41 out of 339 (12.1%) in THA. Following revision TKA, the rate of infection-free implant survival in patients with an unsuspected PJI was 88% (95% confidence intervals (CI) 60 to 97) at two years compared with 98% (95% CI 94 to 99) in patients without PJI (p = 0.001). After THA, the rate of survival was similar in those with unsuspected PJI (92% (95% CI 73 to 98) at two years) and those without (94% (95% CI 89 to 97), p = 0.31). Following revision of TKA and THA for aseptic diagnoses, around 10% of cases were found to have positive cultures. In the knee, such cases had inferior infection-free survival at two years compared with those with negative cultures; there was no difference between the groups following THA. Cite this article: Bone Joint J 2017;99-B:1482-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

Day-night variation in operationally retrieved TOVS temperature biases

NASA Technical Reports Server (NTRS)

Kidder, Stanley Q.; Achtemeier, Gary L.

1986-01-01

Several authors have reported that operationally retrieved TOVS (TIROS Operational Vertical Sounder) temperatures are biased with respect to rawinsonde temperatures or temperature analyses. This note reports a case study from which it is concluded that, at least for the time period Mar. 26 through Apr. 8, 1979, there was a significant day-night variation in TOVS mean layer virtual temperature biases with respect to objective analyses of rawinsonde data over the U.S.

30 CFR 250.111 - Who oversees operations under my welding plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Who oversees operations under my welding plan... § 250.111 Who oversees operations under my welding plan? A welding supervisor or a designated person in charge must be thoroughly familiar with your welding plan. This person must ensure that each welder is...

30 CFR 250.111 - Who oversees operations under my welding plan?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false Who oversees operations under my welding plan... Performance Standards § 250.111 Who oversees operations under my welding plan? A welding supervisor or a designated person in charge must be thoroughly familiar with your welding plan. This person must ensure that...

30 CFR 250.111 - Who oversees operations under my welding plan?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false Who oversees operations under my welding plan... Performance Standards § 250.111 Who oversees operations under my welding plan? A welding supervisor or a designated person in charge must be thoroughly familiar with your welding plan. This person must ensure that...

30 CFR 250.111 - Who oversees operations under my welding plan?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false Who oversees operations under my welding plan... Performance Standards § 250.111 Who oversees operations under my welding plan? A welding supervisor or a designated person in charge must be thoroughly familiar with your welding plan. This person must ensure that...

7 CFR 636.8 - WHIP plan of operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.8 WHIP plan of... plan of operations encompasses the parcel of land where habitat will be established, improved... one of the following as determined by NRCS: (1) Fish and wildlife habitat conditions that are of...

7 CFR 636.8 - WHIP plan of operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.8 WHIP plan of... plan of operations encompasses the parcel of land where habitat will be established, improved... one of the following as determined by NRCS: (1) Fish and wildlife habitat conditions that are of...

7 CFR 636.8 - WHIP plan of operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.8 WHIP plan of... plan of operations encompasses the parcel of land where habitat will be established, improved... one of the following as determined by NRCS: (1) Fish and wildlife habitat conditions that are of...

7 CFR 636.8 - WHIP plan of operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.8 WHIP plan of... plan of operations encompasses the parcel of land where habitat will be established, improved... one of the following as determined by NRCS: (1) Fish and wildlife habitat conditions that are of...

42 CFR 37.100 - Coal mine operator plan for medical examinations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Coal mine operator plan for medical examinations... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF COAL MINERS General Requirements § 37.100 Coal mine operator plan for medical examinations. (a) Each coal mine operator must submit and...

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

NASA Technical Reports Server (NTRS)

Hall, Timothy A.

2011-01-01

In 2008 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organization to find ways to reduce the costs of International Space station (ISS) console operations in the Mission Control Center (MCC). Each MOD organization was asked to identify projects that would help them attain a goal of a 30% reduction in operating costs by 2012. The MOD Operations and Planning organization responded to this challenge by launching several software automation projects that would allow them to greatly improve ISS console operations and reduce staffing and operating costs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the plan of eliminating two full time ISS console support positions by 2012. This will account for an overall 10 EP reduction in staffing for the Operations and Planning organization. These automation projects focused on utilizing software to automate many administrative and often repetitive tasks involved with processing ISS planning and daily operations information. This information was exchanged between the ground flight control teams in Houston and around the globe, as well as with the ISS astronaut crew. These tasks ranged from managing mission plan changes from around the globe, to uploading and downloading information to and from the ISS crew, to even more complex tasks that required multiple decision points to process the data, track approvals and deliver it to the correct recipient across network and security boundaries. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture between several planning tools; as well as a engaging a previously research level technology (TRL 2-3) developed by Ames Research Center (ARC) that utilized an intelligent agent based system to manage and automate file traffic flow

Comparative analysis of operational forecasts versus actual weather conditions in airline flight planning, volume 1

NASA Technical Reports Server (NTRS)

Keitz, J. F.

1982-01-01

The impact of more timely and accurate weather data on airline flight planning with the emphasis on fuel savings is studied. This volume of the report discusses the results of Task 1 of the four major tasks included in the study. Task 1 compares flight plans based on forecasts with plans based on the verifying analysis from 33 days during the summer and fall of 1979. The comparisons show that: (1) potential fuel savings conservatively estimated to be between 1.2 and 2.5 percent could result from using more timely and accurate weather data in flight planning and route selection; (2) the Suitland forecast generally underestimates wind speeds; and (3) the track selection methodology of many airlines operating on the North Atlantic may not be optimum resulting in their selecting other than the optimum North Atlantic Organized Track about 50 percent of the time.

The first clinical application of planning software for laparoscopic microwave thermosphere ablation of malignant liver tumours

PubMed Central

Berber, Eren

2015-01-01

Background Liver tumour ablation is an operator-dependent procedure. The determination of the optimum needle trajectory and correct ablation parameters could be challenging. The aim of this study was to report the utility of a new, procedure planning software for microwave ablation (MWA) of liver tumours. Methods This was a feasibility study in a pilot group of five patients with nine metastatic liver tumours who underwent laparoscopic MWA. Pre-operatively, parameters predicting the desired ablation zones were calculated for each tumour. Intra-operatively, this planning strategy was followed for both antenna placement and energy application. Post-operative 2-week computed tomography (CT) scans were performed to evaluate complete tumour destruction. Results The patients had an average of two tumours (range 1–4), measuring 1.9 ± 0.4 cm (range 0.9–4.4 cm). The ablation time was 7.1 ± 1.3 min (range 2.5–10 min) at 100W. There were no complications or mortality. The patients were discharged home on post-operative day (POD) 1. At 2-week CT scans, there were no residual tumours, with a complete ablation demonstrated in all lesions. Conclusions This study describes and validates pre-treatment planning software for MWA of liver tumours. This software was found useful to determine precisely the ablation parameters and needle placement to create a predicted zone of ablation. PMID:25980481

Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty compared with bilateral staged tympanoplasty.

PubMed

Olusesi, A D; Oyeniran, O

2017-05-01

Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials. A prospective randomised observational study was performed of 38 chronic suppurative otitis media patients (76 ears) who were assigned to undergo bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential tympanoplasty performed 3 months apart (20 patients, 40 ears). Disease duration, intra-operative findings, combined duration of surgery, post-operative graft appearance at 6 weeks, post-operative complications, re-do rate and relative cost of surgery were recorded. Tympanic membrane perforations were predominantly subtotal (p = 0.36, odds ratio = 0.75). Most grafts were harvested from the conchal cartilage and fewer from the tragus (p = 0.59, odds ratio = 1.016). Types of complication, post-operative hearing gain and revision rates were similar in both patient groups. Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.

36 CFR 228.56 - Operating plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Operating plans. 228.56 Section 228.56 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE MINERALS... the environment and improvements, including timely reclamation of disturbed lands. Significant changes...

36 CFR 228.56 - Operating plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Operating plans. 228.56 Section 228.56 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE MINERALS... the environment and improvements, including timely reclamation of disturbed lands. Significant changes...

36 CFR 292.64 - Plan of operations-approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Plan of operations-approval. 292.64 Section 292.64 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Locatable Minerals § 292.64 Plan of...

36 CFR 292.64 - Plan of operations-approval.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Plan of operations-approval. 292.64 Section 292.64 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Locatable Minerals § 292.64 Plan of...

36 CFR 292.64 - Plan of operations-approval.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Plan of operations-approval. 292.64 Section 292.64 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Locatable Minerals § 292.64 Plan of...

36 CFR 292.64 - Plan of operations-approval.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Plan of operations-approval. 292.64 Section 292.64 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Locatable Minerals § 292.64 Plan of...

36 CFR 292.64 - Plan of operations-approval.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Plan of operations-approval. 292.64 Section 292.64 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Locatable Minerals § 292.64 Plan of...

36 CFR 228.5 - Plan of operations-approval.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Plan of operations-approval. 228.5 Section 228.5 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... plans, the Forest Service will arrange for consultation with appropriate agencies of the Department of...

A novel approach emphasising intra-operative superficial margin enhancement of head-neck tumours with narrow-band imaging in transoral robotic surgery.

PubMed

Vicini, C; Montevecchi, F; D'Agostino, G; DE Vito, A; Meccariello, G

2015-06-01

The primary goal of surgical oncology is to obtain a tumour resection with disease-free margins. Transoral robotic surgery (TORS) for surgical treatment of head-neck cancer is commensurate with standard treatments. However, the likelihood of positive margins after TORS is up to 20.2% in a recent US survey. The aim of this study is to evaluate the efficacy and the feasibility of narrow-band imaging (NBI) during TORS in order to improve the ability to achieve disease-free margins during tumour excision. The present study was conducted at the ENT, Head- Neck Surgery and Oral Surgery Unit, Department of Special Surgery, Morgagni Pierantoni Hospital, Azienda USL Romagna. From March 2008 to January 2015, 333 TORS were carried out for malignant and benign diseases. For the present study, we retrospectively evaluated 58 biopsy-proven squamous cell carcinoma patients who underwent TORS procedures. Patients were divided into 2 groups: (1) 32 who underwent TORS and intra-operative NBI evaluation (NBI-TORS); (2) 21 who underwent TORS with standard intra-operative white-light imaging (WLITORS). Frozen section analysis of margins on surgical specimens showed a higher rate of negative superficial lateral margins in the NBI-TORS group compared with the WLI-TORS group (87.9% vs. 57.9%, respectively, p = 0.02). The sensitivity and specificity of intra-operative use of NBI, respectively, were 72.5% and 66.7% with a negative predictive value of 87.9%. Tumour margin enhancement provided by NBI associated with magnification and 3-dimensional view of the surgical field might increase the capability to achieve an oncologically-safe resection in challenging anatomical areas where minimal curative resection is strongly recommended for function preservation.

Day to Day Operations of Home School Families: Selecting from a Menu of Educational Choices to Meet Students' Individual Instructional Needs

ERIC Educational Resources Information Center

Anthony, Kenneth V.; Burroughs, Susie

2012-01-01

This study examined the day to day operations of home schools. The case study method was used with four families from a larger pool of families that held membership in a home school organization. Data was gathered using interviews, observations, and artifacts. Findings suggest that these families operated their home schools using traditional…

[Philanthropic hospitals and the operation of provider-owned health plans in Brazil].

PubMed

Lima, Sheyla Maria Lemos; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Barbosa, Pedro Ribeiro; Gerschman, Silvia; Vasconcellos, Miguel Murat

2007-02-01

To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.

The Intra-Umbilical Approach in Umbilical Hernia

PubMed Central

Arslan, Sukru; Korkut, Ercan

2014-01-01

Objective: To investigate the “intra-umbilical incision”, a smaller incision compared to classic incisions, in cases of umbilical hernia, and which we believe will contribute to patient satisfaction in aesthetic terms, and also the practicability of such operations. Materials and Methods: The umbilical margins of eight patients with an umbilical hernia were marked between the levels of 6 and 12 o’clock, and a median intra-umbilical skin incision was performed between these two points. In some cases, where exploration could not be performed sufficiently, the incision was extended horizontally from 6 or 12 o’clock. Hernia repair and mesh placement was then performed using an intra-umbilical approach. Results: Patients were investigated according to the defect size and requirement for intra-umbilical incision extension. No requirement for intra-umbilical incision was encountered in six patients with a facial defect diameter smaller than 4 cm, while the incision had to be extended in two patients with defects greater than 4 cm. Conclusion: The intra-umbilical approach in umbilical hernia surgery is aesthetically superior to classical approaches and is a practicable technique. PMID:25610291

Using predicted 30 day mortality to plan postoperative colorectal surgery care: a cohort study.

PubMed

Swart, M; Carlisle, J B; Goddard, J

2017-01-01

Preoperative identification of high-risk surgical patients might help to reduce postoperative morbidity and mortality. Using a patient's predicted 30 day mortality to plan postoperative high-dependency unit (HDU) care after elective colorectal surgery might be associated with reduced postoperative morbidity. The 30 day postoperative mortality was predicted for 504 elective colorectal surgical patients in a preoperative clinic. The prediction was used to determine postoperative surgical ward or HDU care. Those with a predicted 30 day mortality of 1-3% mortality, and thus deemed at intermediate risk, had either planned HDU care (n=68) or planned ward care (n=139). The main outcome measures were emergency laparotomy and unplanned critical care admission. There were more emergency laparotomies and unplanned critical care admissions in patients with a predicted 30 day mortality of 1-3% who went to an HDU after surgery compared with patients who went to a ward: 0 vs 14 (10%), P=0.0056 and 0 vs 22 (16%), P=0.0002, respectively. Planned postoperative critical care was associated with a lower rate of complications after elective colorectal surgery. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Interactive orbital proximity operations planning system instruction and training guide

NASA Technical Reports Server (NTRS)

Grunwald, Arthur J.; Ellis, Stephen R.

1994-01-01

This guide instructs users in the operation of a Proximity Operations Planning System. This system uses an interactive graphical method for planning fuel-efficient rendezvous trajectories in the multi-spacecraft environment of the space station and allows the operator to compose a multi-burn transfer trajectory between orbit initial chaser and target trajectories. The available task time (window) of the mission is predetermined and the maneuver is subject to various operational constraints, such as departure, arrival, spatial, plume impingement, and en route passage constraints. The maneuvers are described in terms of the relative motion experienced in a space station centered coordinate system. Both in-orbital plane as well as out-of-orbital plane maneuvering is considered. A number of visual optimization aids are used for assisting the operator in reaching fuel-efficient solutions. These optimization aids are based on the Primer Vector theory. The visual feedback of trajectory shapes, operational constraints, and optimization functions, provided by user-transparent and continuously active background computations, allows the operator to make fast, iterative design changes that rapidly converge to fuel-efficient solutions. The planning tool is an example of operator-assisted optimization of nonlinear cost functions.

GIS Methodology for Planning Planetary-Rover Operations

NASA Technical Reports Server (NTRS)

Powell, Mark; Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang

2007-01-01

A document describes a methodology for utilizing image data downlinked from cameras aboard a robotic ground vehicle (rover) on a remote planet for analyzing and planning operations of the vehicle and of any associated spacecraft. Traditionally, the cataloging and presentation of large numbers of downlinked planetary-exploration images have been done by use of two organizational methods: temporal organization and correlation between activity plans and images. In contrast, the present methodology involves spatial indexing of image data by use of the computational discipline of geographic information systems (GIS), which has been maturing in terrestrial applications for decades, but, until now, has not been widely used in support of exploration of remote planets. The use of GIS to catalog data products for analysis is intended to increase efficiency and effectiveness in planning rover operations, just as GIS has proven to be a source of powerful computational tools in such terrestrial endeavors as law enforcement, military strategic planning, surveying, political science, and epidemiology. The use of GIS also satisfies the need for a map-based user interface that is intuitive to rover-activity planners, many of whom are deeply familiar with maps and know how to use them effectively in field geology.

Orbital Express Mission Operations Planning and Resource Management using ASPEN

NASA Technical Reports Server (NTRS)

Chouinard, Caroline; Knight, Russell; Jones, Grailing; Tran, Daniel

2008-01-01

As satellite equipment and mission operations become more costly, the drive to keep working equipment running with less man-power rises.Demonstrating the feasibility of autonomous satellite servicing was the main goal behind the Orbital Express (OE) mission. Planning the satellite mission operations for OE required the ability to create a plan which could be executed autonomously over variable conditions. The Automated-Scheduling and Planning Environment (ASPEN)tool, developed at the Jet Propulsion Laboratory, was used to create the schedule of events in each daily plan for the two satellites of the OE mission. This paper presents an introduction to the ASPEN tool, the constraints of the OE domain, the variable conditions that were presented within the mission, and the solution to operations that ASPEN provided. ASPEN has been used in several other domains, including research rovers, Deep Space Network scheduling research, and in flight operations for the ASE project's EO1 satellite. Related work is discussed, as are the future of ASPEN and the future of autonomous satellite servicing.

A Revenue Planning Tool for Charter School Operators

ERIC Educational Resources Information Center

Keller, Eric; Hayes, Cheryl D.

2009-01-01

This revenue planning tool aims to help charter school operators develop a sound revenue base that can meet their school's current and future funding needs. It helps identify and assess potential public (federal, state, and local) and private funding sources. The tool incorporates a four-step revenue planning process which includes: (1)…

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis.

PubMed

Utiyama, Edivaldo Massazo; Pflug, Adriano Ribeiro Meyer; Damous, Sérgio Henrique Bastos; Rodrigues, Adilson Costa; Montero, Edna Frasson de Souza; Birolini, Claudio Augusto Vianna

2015-01-01

to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years); 11 patients were male, and four were female. forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

STS-79 Flight Day 5

NASA Technical Reports Server (NTRS)

1996-01-01

On this fifth day of the STS-79 mission, the flight crew, Cmdr. William F. Readdy, Pilot Terrence W. Wilcutt, Mission Specialists, Thomas D. Akers, Shannon Lucid, Jay Apt, and Carl E. Walz, in the first full day of joint Shuttle/Mir operations begin in with the transfer of a biotechnology investigation and logistical supplies from Atlantis to Mir. The Biotechnology System, an investigation that will study the long-term development of cartilage cells in microgravity, was transported to Mir early this morning. During his planned four-month stay on Mir, John Blaha will take weekly samples of the culture which may provide researchers with information on engineering cartilage cells for possible use in transplantation. They also took time out of their schedules to talk with Good Morning America's Elizabeth Vargas in a brief interview. Prior to beginning the day's transfer activities, all nine astronauts and cosmonauts participated in a joint planning session to outline the day's schedule.

Towards intra-operative diagnosis of tumours during breast conserving surgery by selective-sampling Raman micro-spectroscopy

NASA Astrophysics Data System (ADS)

Kong, Kenny; Zaabar, Fazliyana; Rakha, Emad; Ellis, Ian; Koloydenko, Alexey; Notingher, Ioan

2014-10-01

Breast-conserving surgery (BCS) is increasingly employed for the treatment of early stage breast cancer. One of the key challenges in BCS is to ensure complete removal of the tumour while conserving as much healthy tissue as possible. In this study we have investigated the potential of Raman micro-spectroscopy (RMS) for automated intra-operative evaluation of tumour excision. First, a multivariate classification model based on Raman spectra of normal and malignant breast tissue samples was built and achieved diagnosis of mammary ductal carcinoma (DC) with 95.6% sensitivity and 96.2% specificity (5-fold cross-validation). The tumour regions were discriminated from the healthy tissue structures based on increased concentration of nucleic acids and reduced concentration of collagen and fat. The multivariate classification model was then applied to sections from fresh tissue of new patients to produce diagnosis images for DC. The diagnosis images obtained by raster scanning RMS were in agreement with the conventional histopathology diagnosis but were limited to long data acquisition times (typically 10 000 spectra mm-2, which is equivalent to ~5 h mm-2). Selective-sampling based on integrated auto-fluorescence imaging and Raman spectroscopy was used to reduce the number of Raman spectra to ~20 spectra mm-2, which is equivalent to an acquisition time of ~15 min for 5 × 5 mm2 tissue samples. This study suggests that selective-sampling Raman microscopy has the potential to provide a rapid and objective intra-operative method to detect mammary carcinoma in tissue and assess resection margins.

Rationale and operational plan for a U.S. high-altitude magnetic survey

USGS Publications Warehouse

Hildenbrand, Thomas G.; Acuna, Mario; Bracken, Robert E.; Hardwick, Doug; Hinze, William J.; Keller, Gordon R.; Phillips, Jeff; Roest, Walter

2002-01-01

On August 8, 2002, twenty-one scientists from the federal, private and academic sectors met at a workshop in Denver, Co., to discuss the feasibility of collecting magnetic anomaly data on a Canberra aircraft (Figure 1). The need for this 1-day workshop arose because of an exciting and cost-effective opportunity to collect invaluable magnetic anomaly data during a Canberra mission over the U.S. in 2003 and 2004. High Altitude Mapping Missions (HAMM) is currently planning a mission to collect Interferometric Synthetic Aperture Radar (IFSAR) imagery at an altitude of about 15 km and with a flight-line spacing of about 18 km over the conterminous U.S. and Alaska. The additional collection of total and vector magnetic field data would represent a secondary mission objective (i.e., a "piggy-back" magnetometer system). Because HAMM would fund the main flight costs of the mission, the geomagnetic community would obtain invaluable magnetic data at a nominal cost. These unique data would provide new insights on fundamental tectonic and thermal processes and give a new view of the structural and lithologic framework of the crust and possibly the upper mantle. This document highlights: (1) the reasons to conduct this national survey and (2) a preliminary operational plan to collect high-altitude magnetic data of a desired quality and for the expected resources. Although some operational plan issues remain to be resolved, the important conclusions of the workshop are that the Canberra is a very suitable platform to measure the magnetic field and that the planned mission will result in quality high-altitude magnetic data to greatly expand the utility of our national magnetic database.

An Analysis of Current Operational Contract Support Planning Doctrine

DTIC Science & Technology

2015-09-01

P). This project argues for the balanced development of OCS planning acquisition and non-acquisition focused resources to effectively integrate this...planning guidance developed is appropriate for initial entry operations applicable to various levels of theater maturity. 14. SUBJECT TERMS...balanced development of OCS planning acquisition and non- acquisition focused resources to effectively integrate this function across disciplines. The

Tricuspid valve excision using off-pump inflow occlusion technique: role of intra-operative trans-esophageal echocardiography.

PubMed

Gadhinglajkar, Shrinivas; Sreedhar, Rupa; Karunakaran, Jayakumar; Misra, Manoranjan; Somasundaram, Ganesh; Mathew, Thomas

2010-01-01

A pacing system infection may lead to infective endocarditis and systemic sepsis. Tricuspid valve surgery may be required if the valve is severely damaged in the process of endocarditis. Although, cardiopulmonary bypass is the safe choice for performing right-heart procedures, it may carry risk of inducing systemic inflammatory response and multi-organ dysfunction. Some studies have advocated TV surgery without institution of CPB. We report tricuspid valve excision using the off-pump inflow occlusion technique in a 68-year-old man. We also describe role of intra-operative TEE as a monitoring tool at different stages of the surgical procedure.

Airborne Data Link Operational Evaluation Test Plan

DOT National Transportation Integrated Search

1993-08-01

This plan describes an end-to-end study of operational concepts and procedures associated with the introduction of electronic data communications between flight crews and air traffic controllers. Full performance controllers from : terminal facilitie...

7 CFR 272.2 - Plan of operation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 60 days prior to implementation. Minor changes to approved sampling plans shall be submitted at least...) further agree to fully comply with any changes in Federal law and regulations. This agreement may be... the United States shall, on the grounds of sex, race, color, age, political belief, religion, handicap...

Evaluation of Crew-Centric Onboard Mission Operations Planning and Execution Tool: Year 2

NASA Technical Reports Server (NTRS)

Hillenius, S.; Marquez, J.; Korth, D.; Rosenbaum, M.; Deliz, Ivy; Kanefsky, Bob; Zheng, Jimin

2018-01-01

Currently, mission planning for the International Space Station (ISS) is largely affected by ground operators in mission control. The task of creating a week-long mission plan for ISS crew takes dozens of people multiple days to complete, and is often created far in advance of its execution. As such, re-planning or adapting to changing real-time constraints or emergent issues is similarly taxing. As we design for future mission operations concepts to other planets or areas with limited connectivity to Earth, more of these ground-based tasks will need to be handled autonomously by the crew onboard.There is a need for a highly usable (including low training time) tool that enables efficient self-scheduling and execution within a single package. The ISS Program has identified Playbook as a potential option. It already has high crew acceptance as a plan viewer from previous analogs and can now support a crew self-scheduling assessment on ISS or on another mission. The goals of this work, a collaboration between the Human Research Program and the ISS Program, are to inform the design of systems for more autonomous crew operations and provide a platform for research on crew autonomy for future deep space missions. Our second year of the research effort have included new insights on the crew self-scheduling sessions performed by the crew through use on the HERA (Human Exploration Research Analog) and NEEMO (NASA Extreme Environment Mission Operations) analogs. Use on the NEEMO analog involved two self-scheduling strategies where the crew planned and executed two days of EVAs (Extra-Vehicular Activities). On HERA year two represented the first HERA campaign where we were able to perform research tasks. This involved selected flexible activities that the crew could schedule, mock timelines where the crew completed more complex planning exercises, usability evaluation of the crew self-scheduling features, and more insights into the limit of plan complexity that the crew

Intra-arterial catheter system to repeatedly deliver mesenchymal stem cells in a rat renal failure model.

PubMed

Katsuoka, Yuichi; Ohta, Hiroki; Fujimoto, Eisuke; Izuhara, Luna; Yokote, Shinya; Kurihara, Sho; Yamanaka, Shuichiro; Tajiri, Susumu; Chikaraish, Tatsuya; Okano, Hirotaka J; Yokoo, Takashi

2016-04-01

Mesenchymal stem cell therapy in renal failure is rarely used because of low rates of cell engraftment after systemic delivery. Repeated intra-arterial cell administration may improve results; however, no current delivery method permits repeated intra-arterial infusions in a rat model. In this study, we developed an intra-arterial delivery system for repeated stem cell infusion via the aorta, catheterizing the left femoral artery to the suprarenal aorta under fluoroscopic guidance in rats with adenosine-induced renal failure. First, we compared our intra-arterial catheter system (C group, n = 3) with tail vein injection (V group, n = 3) for engraftment efficacy, using mesenchymal stem cells from luciferase transgenic rats. Rats were infused with the cells and euthanized the following day; we performed cell-tracking experiments using a bioluminescence imaging system to assess the distribution of the infused cells. Second, we assessed the safety of the system over a 30-day period in a second group of six rats receiving infusions every 7 days. Cells infused through our delivery system efficiently engrafted into the kidney, compared with peripheral venous infusion. In five of the six rats in the safety study, the delivery system remained patent for at least 9 days (range, 9-24 days). Complications became evident only after 10 days. Our intra-arterial catheter system was effective in delivering cells to the kidney and permitted repeated injection of cells.

IBM PC/IX operating system evaluation plan

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Granier, Martin; Hall, Philip P.; Triantafyllopoulos, Spiros

1984-01-01

An evaluation plan for the IBM PC/IX Operating System designed for IBM PC/XT computers is discussed. The evaluation plan covers the areas of performance measurement and evaluation, software facilities available, man-machine interface considerations, networking, and the suitability of PC/IX as a development environment within the University of Southwestern Louisiana NASA PC Research and Development project. In order to compare and evaluate the PC/IX system, comparisons with other available UNIX-based systems are also included.

Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation.

PubMed

Boonen, Bert; Schotanus, Martijn G M; Kerens, Bart; Hulsmans, Frans-Jan; Tuinebreijer, Wim E; Kort, Nanne P

2017-09-01

To assess whether there is a significant difference between the alignment of the individual femoral and tibial components (in the frontal, sagittal and horizontal planes) as calculated pre-operatively (digital plan) and the actually achieved alignment in vivo obtained with the use of patient-specific positioning guides (PSPGs) for TKA. It was hypothesised that there would be no difference between post-op implant position and pre-op digital plan. Twenty-six patients were included in this non-inferiority trial. Software permitted matching of the pre-operative MRI scan (and therefore calculated prosthesis position) to a pre-operative CT scan and then to a post-operative full-leg CT scan to determine deviations from pre-op planning in all three anatomical planes. For the femoral component, mean absolute deviations from planning were 1.8° (SD 1.3), 2.5° (SD 1.6) and 1.6° (SD 1.4) in the frontal, sagittal and transverse planes, respectively. For the tibial component, mean absolute deviations from planning were 1.7° (SD 1.2), 1.7° (SD 1.5) and 3.2° (SD 3.6) in the frontal, sagittal and transverse planes, respectively. Absolute mean deviation from planned mechanical axis was 1.9°. The a priori specified null hypothesis for equivalence testing: the difference from planning is >3 or <-3 was rejected for all comparisons except for the tibial transverse plane. PSPG was able to adequately reproduce the pre-op plan in all planes, except for the tibial rotation in the transverse plane. Possible explanations for outliers are discussed and highlight the importance for adequate training surgeons before they start using PSPG in their day-by-day practise. Prospective cohort study, Level II.

Missouri commercial vehicle operations : state business plan

DOT National Transportation Integrated Search

1998-05-15

This business plan is intended to assist this state in improving its commercial vehicle operation regulation, guide the deployment and installation of intelligent transportation systems and to implement these systems in an efficient and cost effectiv...

Celebrate Your Freedom--Assuring Equal Justice for All. Law Day 2002 Planning Guide.

ERIC Educational Resources Information Center

White, Charles, Ed.

The theme for Law Day 2002 was set long before the tragic events of September 11, 2001, and its aftermath. The vision of Law Day planners was to plan programs on how the courts and legal system seek to assure equal access to justice for all people. This guide gives planners the tools for programs and discussions on legal aid, the "pro bono…

Coupling News Sentiment with Web Browsing Data Improves Prediction of Intra-Day Price Dynamics

PubMed Central

Ranco, Gabriele; Bordino, Ilaria; Bormetti, Giacomo; Caldarelli, Guido; Lillo, Fabrizio; Treccani, Michele

2016-01-01

The new digital revolution of big data is deeply changing our capability of understanding society and forecasting the outcome of many social and economic systems. Unfortunately, information can be very heterogeneous in the importance, relevance, and surprise it conveys, affecting severely the predictive power of semantic and statistical methods. Here we show that the aggregation of web users’ behavior can be elicited to overcome this problem in a hard to predict complex system, namely the financial market. Specifically, our in-sample analysis shows that the combined use of sentiment analysis of news and browsing activity of users of Yahoo! Finance greatly helps forecasting intra-day and daily price changes of a set of 100 highly capitalized US stocks traded in the period 2012–2013. Sentiment analysis or browsing activity when taken alone have very small or no predictive power. Conversely, when considering a news signal where in a given time interval we compute the average sentiment of the clicked news, weighted by the number of clicks, we show that for nearly 50% of the companies such signal Granger-causes hourly price returns. Our result indicates a “wisdom-of-the-crowd” effect that allows to exploit users’ activity to identify and weigh properly the relevant and surprising news, enhancing considerably the forecasting power of the news sentiment. PMID:26808833

Coupling News Sentiment with Web Browsing Data Improves Prediction of Intra-Day Price Dynamics.

PubMed

Ranco, Gabriele; Bordino, Ilaria; Bormetti, Giacomo; Caldarelli, Guido; Lillo, Fabrizio; Treccani, Michele

2016-01-01

The new digital revolution of big data is deeply changing our capability of understanding society and forecasting the outcome of many social and economic systems. Unfortunately, information can be very heterogeneous in the importance, relevance, and surprise it conveys, affecting severely the predictive power of semantic and statistical methods. Here we show that the aggregation of web users' behavior can be elicited to overcome this problem in a hard to predict complex system, namely the financial market. Specifically, our in-sample analysis shows that the combined use of sentiment analysis of news and browsing activity of users of Yahoo! Finance greatly helps forecasting intra-day and daily price changes of a set of 100 highly capitalized US stocks traded in the period 2012-2013. Sentiment analysis or browsing activity when taken alone have very small or no predictive power. Conversely, when considering a news signal where in a given time interval we compute the average sentiment of the clicked news, weighted by the number of clicks, we show that for nearly 50% of the companies such signal Granger-causes hourly price returns. Our result indicates a "wisdom-of-the-crowd" effect that allows to exploit users' activity to identify and weigh properly the relevant and surprising news, enhancing considerably the forecasting power of the news sentiment.

Intra-operative electron beam radiotherapy and abdomino-pelvic surgery for cancer: influence on immunological parameters.

PubMed

Bussières, E; Richaud, P; Gualde, N

1992-10-01

Evolution of some immunological parameters was observed during the first month in 20 patients with different abdomino-pelvic cancers who underwent surgery with intra-operative radiation therapy (IORT) (mean dose of 19.44 Gy, range 15, 25). Observed parameters before (DO-) and after procedure (DO+), on seventh (D7) and fourteenth (D14) days and fifth week (D30) were: lymphocyte count, lymphocyte subsets (CD19, CD3, CD4, CD8, CD56), natural killer (NK) activity, immunoglobulins, C3 and C4b fractions of complement, soluble receptor for interleukin 2 (sIL2-R). Results showed a decrease of circulating lymphocytes (DO-: 1189 +/- 168 cells/mm3; D7: 889 +/- 91; P = 0.011), of absolute number of CD3 lymphocytes (DO-: 785 +/- 114 cells/mm3; D7: 563 +/- 86; P = 0.025), of CD4 lymphocytes (DO-: 441 +/- 70 cells/mm3; DO+: 299 +/- 43; P = 0.013) and of CD8 lymphocytes (DO-:361 +/- 50 cells/mm3, D7:250 +/- 44; P = 0.006). All values returned towards preoperative levels by D30. Absolute number of NK cells was unchanged but NK activity was significantly diminished (effector target ratio 5:1 DO-:33 +/- 5%; DO+:44 +/- 7%; D7:18 +/- 3%; D14:21 +/- 4%; D30:25 +/- 4%). sIL2-R was significantly enhanced from D7 to D30. All these impairments are moderate and these observations provide some evidence of satisfactory tolerance to IORT for abdomino-pelvic cancers during the immediate postoperative period.

Nuclear Powerplant Safety: Operations.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Nuclear Energy Office.

Powerplant systems and procedures that ensure the day-to-day health and safety of people in and around the plant is referred to as operational safety. This safety is the result of careful planning, good engineering and design, strict licensing and regulation, and environmental monitoring. Procedures that assure operational safety at nuclear…

Joint operations planning for space surveillance missions on the MSX satellite

NASA Technical Reports Server (NTRS)

Stokes, Grant; Good, Andrew

1994-01-01

The Midcourse Space Experiment (MSX) satellite, sponsored by BMDO, is intended to gather broad-band phenomenology data on missiles, plumes, naturally occurring earthlimb backgrounds and deep space backgrounds. In addition the MSX will be used to conduct functional demonstrations of space-based space surveillance. The JHU/Applied Physics Laboratory (APL), located in Laurel, MD, is the integrator and operator of the MSX satellite. APL will conduct all operations related to the MSX and is charged with the detailed operations planning required to implement all of the experiments run on the MSX except the space surveillance experiments. The non-surveillance operations are generally amenable to being defined months ahead of time and being scheduled on a monthly basis. Lincoln Laboratory, Massachusetts Institute of Technology (LL), located in Lexington, MA, is the provider of one of the principle MSX instruments, the Space-Based Visible (SBV) sensor, and the agency charged with implementing the space surveillance demonstrations on the MSX. The planning timelines for the space surveillance demonstrations are fundamentally different from those for the other experiments. They are generally amenable to being scheduled on a monthly basis, but the specific experiment sequence and pointing must be refined shortly before execution. This allocation of responsibilities to different organizations implies the need for a joint mission planning system for conducting space surveillance demonstrations. This paper details the iterative, joint planning system, based on passing responsibility for generating MSX commands for surveillance operations from APL to LL for specific scheduled operations. The joint planning system, including the generation of a budget for spacecraft resources to be used for surveillance events, has been successfully demonstrated during ground testing of the MSX and is being validated for MSX launch within the year. The planning system developed for the MSX forms a

The United States national volcanic ash operations plan for aviation

USGS Publications Warehouse

Albersheim, Steven; Guffanti, Marianne

2009-01-01

Volcanic-ash clouds are a known hazard to aviation, requiring that aircraft be warned away from ash-contaminated airspace. The exposure of aviation to potential hazards from volcanoes in the United States is significant. In support of existing interagency operations to detect and track volcanic-ash clouds, the United States has prepared a National Volcanic Ash Operations Plan for Aviation to strengthen the warning process in its airspace. The US National Plan documents the responsibilities, communication protocols, and prescribed hazard messages of the Federal Aviation Administration, National Oceanic and Atmospheric Administration, US Geological Survey, and Air Force Weather Agency. The plan introduces a new message format, a Volcano Observatory Notice for Aviation, to provide clear, concise information about volcanic activity, including precursory unrest, to air-traffic controllers (for use in Notices to Airmen) and other aviation users. The plan is online at http://www.ofcm.gov/p35-nvaopa/pdf/FCM-P35-2007-NVAOPA.pdf. While the plan provides general operational practices, it remains the responsibility of the federal agencies involved to implement the described procedures through orders, directives, etc. Since the plan mirrors global guidelines of the International Civil Aviation Organization, it also provides an example that could be adapted by other countries.

Investigations of Moon Polar Regions from Luna-Resource and Luna-Glob Landers - Science Instruments and Operational Plan on Surface

NASA Astrophysics Data System (ADS)

Tretyakov, V.; Mitrofanov, I.; Litvak, M.; Malakhov, A.; Mokrousov, M.

2012-04-01

Scientific goals for Landers of Luna-Resource and Luna-Glob missions will be presented. Both project aimed on search for volatiles and water ice in upper layer of regolith, study structure and content of regolith and investigate of moon's surface exosphere in lunar polar regions. Science devices for payload, which were selected in accordance to the main goals of these missions, will be described. Criteria for potential landing sites selection will be considered: from engineering suitability (flatness and roughness of surface, radio visibility, solar irradiation and so on) and from scientific applicability for these missions. The detailed plan of surface operations during fist moon day will be presented and preliminary plans for sunset and for second and others days will be discussed.

Orbital Express mission operations planning and resource management using ASPEN

NASA Astrophysics Data System (ADS)

Chouinard, Caroline; Knight, Russell; Jones, Grailing; Tran, Daniel

2008-04-01

As satellite equipment and mission operations become more costly, the drive to keep working equipment running with less labor-power rises. Demonstrating the feasibility of autonomous satellite servicing was the main goal behind the Orbital Express (OE) mission. Like a tow-truck delivering gas to a car on the road, the "servicing" satellite of OE had to find the "client" from several kilometers away, connect directly to the client, and transfer fluid (or a battery) autonomously, while on earth-orbit. The mission met 100% of its success criteria, and proved that autonomous satellite servicing is now a reality for space operations. Planning the satellite mission operations for OE required the ability to create a plan which could be executed autonomously over variable conditions. As the constraints for execution could change weekly, daily, and even hourly, the tools used create the mission execution plans needed to be flexible and adaptable to many different kinds of changes. At the same time, the hard constraints of the plans needed to be maintained and satisfied. The Automated Scheduling and Planning Environment (ASPEN) tool, developed at the Jet Propulsion Laboratory, was used to create the schedule of events in each daily plan for the two satellites of the OE mission. This paper presents an introduction to the ASPEN tool, an overview of the constraints of the OE domain, the variable conditions that were presented within the mission, and the solution to operations that ASPEN provided. ASPEN has been used in several other domains, including research rovers, Deep Space Network scheduling research, and in flight operations for the NASA's Earth Observing One mission's EO1 satellite. Related work is discussed, as are the future of ASPEN and the future of autonomous satellite servicing.

The role of intra-NAPL diffusion on mass transfer from MGP residuals

NASA Astrophysics Data System (ADS)

Shafieiyoun, Saeid; Thomson, Neil R.

2018-06-01

An experimental and computational study was performed to investigate the role of multi-component intra-NAPL diffusion on NAPL-water mass transfer. Molecular weight and the NAPL component concentrations were determined to be the most important parameters affecting intra-NAPL diffusion coefficients. Four NAPLs with different viscosities but the same quantified mass were simulated. For a spherical NAPL body, a combination of NAPL properties and interphase mass transfer rate can result in internal diffusion limitations. When the main intra-NAPL diffusion coefficients are in the range of self-diffusion coefficients (10-5 to 10-6 cm2/s), dissolution is not limited by internal diffusion except for high mass transfer rate coefficients (>180 cm/day). For a complex and relatively high viscous NAPL (>50 g/(cm s)), smaller intra-NAPL diffusion coefficients (<10-8) are expected and even low mass transfer rate coefficients ( 6 cm/day) can result in diffusion-limited dissolution.

Short-term complications in intra- and extra-articular anterior cruciate ligament reconstruction. Comparison with the literature on isolated intra-articular reconstruction. A multicenter study by the French Arthroscopy Society.

PubMed

Panisset, J C; Pailhé, R; Schlatterer, B; Sigwalt, L; Sonnery-Cottet, B; Lutz, C; Lustig, S; Batailler, C; Bertiaux, S; Ehkirch, F P; Colombet, P; Steltzlen, C; Louis, M L; D'ingrado, P; Dalmay, F; Imbert, P; Saragaglia, D

2017-12-01

Lateral tenodesis (LT) is performed to limit the risk of iterative tear following anterior cruciate ligament (ACL) reconstruction in at-risk patients. By adding an extra procedure to isolated ACL graft, LT reconstruction increases operating time and may complicate postoperative course. The objective of the present study was to evaluate the rate of early complications. The study hypothesis was that associating ALL reconstruction to ACL reconstruction does not increase the complications rate found with isolated ACL reconstruction. A prospective multicenter study included 392 patients: 70% male; mean age, 29.9 years; treated by associated ACL and LT reconstruction. All adverse events were inventoried. Mean hospital stay was 2 days, with 46% day-surgery. Walking was resumed at a mean 27 days, with an advantage for patients treated by the hamstring technique. The early postoperative complications rate was 12%, with 1.7% specifically implicating LT reconstruction: pain, hematoma, stiffness in flexion and extension, and infection. There was a 5% rate of surgical revision during the first year, predominantly comprising arthrolysis for extension deficit. The 1-year recurrence rate was 2.8%. The complications rate for combined intra- and extra-articular reconstruction was no higher than for isolated intra-articular ACL reconstruction, with no increase in infection or stiffness rates. The rate of complications specific to ALL reconstruction was low, at 1.7%, and mainly involved fixation error causing lateral soft-tissue impingement. IV, prospective multicenter study. Copyright © 2017. Published by Elsevier Masson SAS.

Impact of Accurate 30-Day Status on Operative Mortality: Wanted Dead or Alive, Not Unknown.

PubMed

Ring, W Steves; Edgerton, James R; Herbert, Morley; Prince, Syma; Knoff, Cathy; Jenkins, Kristin M; Jessen, Michael E; Hamman, Baron L

2017-12-01

Risk-adjusted operative mortality is the most important quality metric in cardiac surgery for determining The Society of Thoracic Surgeons (STS) Composite Score for star ratings. Accurate 30-day status is required to determine STS operative mortality. The goal of this study was to determine the effect of unknown or missing 30-day status on risk-adjusted operative mortality in a regional STS Adult Cardiac Surgery Database cooperative and demonstrate the ability to correct these deficiencies by matching with an administrative database. STS Adult Cardiac Surgery Database data were submitted by 27 hospitals from five hospital systems to the Texas Quality Initiative (TQI), a regional quality collaborative. TQI data were matched with a regional hospital claims database to resolve unknown 30-day status. The risk-adjusted operative mortality observed-to-expected (O/E) ratio was determined before and after matching to determine the effect of unknown status on the operative mortality O/E. TQI found an excessive (22%) unknown 30-day status for STS isolated coronary artery bypass grafting cases. Matching the TQI data to the administrative claims database reduced the unknowns to 7%. The STS process of imputing unknown 30-day status as alive underestimates the true operative mortality O/E (1.27 before vs 1.30 after match), while excluding unknowns overestimates the operative mortality O/E (1.57 before vs 1.37 after match) for isolated coronary artery bypass grafting. The current STS algorithm of imputing unknown 30-day status as alive and a strategy of excluding cases with unknown 30-day status both result in erroneous calculation of operative mortality and operative mortality O/E. However, external validation by matching with an administrative database can improve the accuracy of clinical databases such as the STS Adult Cardiac Surgery Database. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Spacelab shaping space operations planning

NASA Technical Reports Server (NTRS)

Steven, F. R.; Reinhold, C.

1976-01-01

An up-to-date picture is presented of the organizational structure, the key management personnel, and management relationships of the Spacelab program. Attention is also given to Spacelab's development status and plans for its operations. A number of charts are provided to illustrate the organizational relations. It is pointed out that the parties involved in Spacelab activities must yet resolve questions about ownership of transportation-system elements, payloads, ground support facilities, and data obtained from space missions.

Applying an AI Planner to Military Operations Planning

DTIC Science & Technology

1993-01-12

This paper describes a prototype system for quickly developing joint military courses of action. The system, SOCAP (System for Operations Crisis...display and applies this technology to military operations planning. This paper describes the Socap problem domain, how SIPE-2 was used to address this problem, and the strengths and weaknesses of our approach.

3D Boolean operations in virtual surgical planning.

PubMed

Charton, Jerome; Laurentjoye, Mathieu; Kim, Youngjun

2017-10-01

Boolean operations in computer-aided design or computer graphics are a set of operations (e.g. intersection, union, subtraction) between two objects (e.g. a patient model and an implant model) that are important in performing accurate and reproducible virtual surgical planning. This requires accurate and robust techniques that can handle various types of data, such as a surface extracted from volumetric data, synthetic models, and 3D scan data. This article compares the performance of the proposed method (Boolean operations by a robust, exact, and simple method between two colliding shells (BORES)) and an existing method based on the Visualization Toolkit (VTK). In all tests presented in this article, BORES could handle complex configurations as well as report impossible configurations of the input. In contrast, the VTK implementations were unstable, do not deal with singular edges and coplanar collisions, and have created several defects. The proposed method of Boolean operations, BORES, is efficient and appropriate for virtual surgical planning. Moreover, it is simple and easy to implement. In future work, we will extend the proposed method to handle non-colliding components.

Electric Motors Maintenance Planning From Its Operating Variables

NASA Astrophysics Data System (ADS)

Rodrigues, Francisco; Fonseca, Inácio; Farinha, José Torres; Ferreira, Luís; Galar, Diego

2017-09-01

The maintenance planning corresponds to an approach that seeks to maximize the availability of equipment and, consequently, increase the levels of competitiveness of companies by increasing production times. This paper presents a maintenance planning based on operating variables (number of hours worked, duty cycles, number of revolutions) to maximizing the availability of operation of electrical motors. The reading of the operating variables and its sampling is done based on predetermined sampling cycles and subsequently is made the data analysis through time series algorithms aiming to launch work orders before reaching the variables limit values. This approach is supported by tools and technologies such as logical applications that enable a graphical user interface for access to relevant information about their Physical Asset HMI (Human Machine Interface), including the control and supervision by acquisition through SCADA (Supervisory Control And data acquisition) data, also including the communication protocols among different logical applications.

Organizing for low cost space operations - Status and plans

NASA Technical Reports Server (NTRS)

Lee, C.

1976-01-01

Design features of the Space Transportation System (vehicle reuse, low cost expendable components, simple payload interfaces, standard support systems) must be matched by economical operational methods to achieve low operating and payload costs. Users will be responsible for their own payloads and will be charged according to the services they require. Efficient use of manpower, simple documentation, simplified test, checkout, and flight planning are firm goals, together with flexibility for quick response to varying user needs. Status of the Shuttle hardware, plans for establishing low cost procedures, and the policy for user charges are discussed.

Randomized trial for superiority of high field strength intra-operative magnetic resonance imaging guided resection in pituitary surgery.

PubMed

Tandon, Vivek; Raheja, Amol; Suri, Ashish; Chandra, P Sarat; Kale, Shashank S; Kumar, Rajinder; Garg, Ajay; Kalaivani, Mani; Pandey, Ravindra M; Sharma, Bhawani S

2017-03-01

Till date there are no randomized trials to suggest the superiority of intra-operative magnetic resonance imaging (IOMRI) guided trans-sphenoidal pituitary resection over two dimensional fluoroscopic (2D-F) guided resections. We conducted this trial to establish the superiority of IOMRI in pituitary surgery. Primary objective was to compare extent of tumor resection between the two study arms. It was a prospective, randomized, outcome assessor and statistician blinded, two arm (A: IOMRI, n=25 and B: 2D-F, n=25), parallel group clinical trial. 4 patients from IOMRI group cross-over to 2D-F group and were consequently analyzed in latter group, based on modified intent to treat method. A total of 50 patients were enrolled till completion of trial (n=25 in each study arm). Demographic profile and baseline parameters were comparable among the two arms (p>0.05) except for higher number of endoscopic procedures and experienced neurosurgeons (>10years) in arm B (p=0.02, 0.002 respectively). Extent of resection was similar in both study arms (A, 94.9% vs B, 93.6%; p=0.78), despite adjusting for experience of operating surgeon and use of microscope/endoscope for surgical resection. We observed that use of IOMRI helped optimize the extent of resection in 5/20 patients (25%) for pituitary tumor resection in-group A. Present study failed to observe superiorty of IOMRI over conventional 2D-F guided resection in pituitary macroadenoma surgery. By use of this technology, younger surgeons could validate their results intra-operatively and hence could increase EOR without causing any increase in complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modular space station, phase B extension. Program operations plan

NASA Technical Reports Server (NTRS)

1971-01-01

An organized approach is defined for establishing the most significant requirements pertaining to mission operations, information management, and computer program design and development for the modular space station program. The operations plan pertains to the space station and experiment module program elements and to the ground elements required for mission management and mission support operations.

40 CFR 63.1347 - Operation and maintenance plan requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants From the Portland Cement Manufacturing Industry Emission Standards and Operating Limits § 63.1347 Operation and maintenance plan requirements. (a...

40 CFR 63.1347 - Operation and maintenance plan requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants From the Portland Cement Manufacturing Industry Emission Standards and Operating Limits § 63.1347 Operation and maintenance plan requirements. (a) You must...

40 CFR 63.1347 - Operation and maintenance plan requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES National Emission Standards for Hazardous Air Pollutants From the Portland Cement Manufacturing Industry Emission Standards and Operating Limits § 63.1347 Operation and maintenance plan requirements. (a) You must...

40 CFR 63.1347 - Operation and maintenance plan requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants From the Portland Cement Manufacturing Industry Emission Standards and Operating Limits § 63.1347 Operation and maintenance plan requirements. (a...

Validation of Fully Automated VMAT Plan Generation for Library-Based Plan-of-the-Day Cervical Cancer Radiotherapy

PubMed Central

Breedveld, Sebastiaan; Voet, Peter W. J.; Heijkoop, Sabrina T.; Mens, Jan-Willem M.; Hoogeman, Mischa S.; Heijmen, Ben J. M.

2016-01-01

Purpose To develop and validate fully automated generation of VMAT plan-libraries for plan-of-the-day adaptive radiotherapy in locally-advanced cervical cancer. Material and Methods Our framework for fully automated treatment plan generation (Erasmus-iCycle) was adapted to create dual-arc VMAT treatment plan libraries for cervical cancer patients. For each of 34 patients, automatically generated VMAT plans (autoVMAT) were compared to manually generated, clinically delivered 9-beam IMRT plans (CLINICAL), and to dual-arc VMAT plans generated manually by an expert planner (manVMAT). Furthermore, all plans were benchmarked against 20-beam equi-angular IMRT plans (autoIMRT). For all plans, a PTV coverage of 99.5% by at least 95% of the prescribed dose (46 Gy) had the highest planning priority, followed by minimization of V45Gy for small bowel (SB). Other OARs considered were bladder, rectum, and sigmoid. Results All plans had a highly similar PTV coverage, within the clinical constraints (above). After plan normalizations for exactly equal median PTV doses in corresponding plans, all evaluated OAR parameters in autoVMAT plans were on average lower than in the CLINICAL plans with an average reduction in SB V45Gy of 34.6% (p<0.001). For 41/44 autoVMAT plans, SB V45Gy was lower than for manVMAT (p<0.001, average reduction 30.3%), while SB V15Gy increased by 2.3% (p = 0.011). AutoIMRT reduced SB V45Gy by another 2.7% compared to autoVMAT, while also resulting in a 9.0% reduction in SB V15Gy (p<0.001), but with a prolonged delivery time. Differences between manVMAT and autoVMAT in bladder, rectal and sigmoid doses were ≤ 1%. Improvements in SB dose delivery with autoVMAT instead of manVMAT were higher for empty bladder PTVs compared to full bladder PTVs, due to differences in concavity of the PTVs. Conclusions Quality of automatically generated VMAT plans was superior to manually generated plans. Automatic VMAT plan generation for cervical cancer has been implemented in

Validation of Fully Automated VMAT Plan Generation for Library-Based Plan-of-the-Day Cervical Cancer Radiotherapy.

PubMed

Sharfo, Abdul Wahab M; Breedveld, Sebastiaan; Voet, Peter W J; Heijkoop, Sabrina T; Mens, Jan-Willem M; Hoogeman, Mischa S; Heijmen, Ben J M

2016-01-01

To develop and validate fully automated generation of VMAT plan-libraries for plan-of-the-day adaptive radiotherapy in locally-advanced cervical cancer. Our framework for fully automated treatment plan generation (Erasmus-iCycle) was adapted to create dual-arc VMAT treatment plan libraries for cervical cancer patients. For each of 34 patients, automatically generated VMAT plans (autoVMAT) were compared to manually generated, clinically delivered 9-beam IMRT plans (CLINICAL), and to dual-arc VMAT plans generated manually by an expert planner (manVMAT). Furthermore, all plans were benchmarked against 20-beam equi-angular IMRT plans (autoIMRT). For all plans, a PTV coverage of 99.5% by at least 95% of the prescribed dose (46 Gy) had the highest planning priority, followed by minimization of V45Gy for small bowel (SB). Other OARs considered were bladder, rectum, and sigmoid. All plans had a highly similar PTV coverage, within the clinical constraints (above). After plan normalizations for exactly equal median PTV doses in corresponding plans, all evaluated OAR parameters in autoVMAT plans were on average lower than in the CLINICAL plans with an average reduction in SB V45Gy of 34.6% (p<0.001). For 41/44 autoVMAT plans, SB V45Gy was lower than for manVMAT (p<0.001, average reduction 30.3%), while SB V15Gy increased by 2.3% (p = 0.011). AutoIMRT reduced SB V45Gy by another 2.7% compared to autoVMAT, while also resulting in a 9.0% reduction in SB V15Gy (p<0.001), but with a prolonged delivery time. Differences between manVMAT and autoVMAT in bladder, rectal and sigmoid doses were ≤ 1%. Improvements in SB dose delivery with autoVMAT instead of manVMAT were higher for empty bladder PTVs compared to full bladder PTVs, due to differences in concavity of the PTVs. Quality of automatically generated VMAT plans was superior to manually generated plans. Automatic VMAT plan generation for cervical cancer has been implemented in our clinical routine. Due to the achieved workload

A Guide to Food Service Operation Planning with Information on Preparing and Submitting Plans and Specifications.

ERIC Educational Resources Information Center

Ohio State Dept. of Health, Columbus.

Guidelines are presented for planning a food service operation which is defined as any place kept or maintained for the purpose of preparing or serving meals or lunches for a consideration. Brief discussions are presented pertaining to the value of planning and the preparation and use of plans and specifications. Recommendations and specifications…

Intra-operative Localization of Brachytherapy Implants Using Intensity-based Registration

PubMed Central

KarimAghaloo, Z.; Abolmaesumi, P.; Ahmidi, N.; Chen, T.K.; Gobbi, D. G.; Fichtinger, G.

2010-01-01

In prostate brachytherapy, a transrectal ultrasound (TRUS) will show the prostate boundary but not all the implanted seeds, while fluoroscopy will show all the seeds clearly but not the boundary. We propose an intensity-based registration between TRUS images and the implant reconstructed from uoroscopy as a means of achieving accurate intra-operative dosimetry. The TRUS images are first filtered and compounded, and then registered to the uoroscopy model via mutual information. A training phantom was implanted with 48 seeds and imaged. Various ultrasound filtering techniques were analyzed, and the best results were achieved with the Bayesian combination of adaptive thresholding, phase congruency, and compensation for the non-uniform ultrasound beam profile in the elevation and lateral directions. The average registration error between corresponding seeds relative to the ground truth was 0.78 mm. The effect of false positives and false negatives in ultrasound were investigated by masking true seeds in the uoroscopy volume or adding false seeds. The registration error remained below 1.01 mm when the false positive rate was 31%, and 0.96 mm when the false negative rate was 31%. This fully automated method delivers excellent registration accuracy and robustness in phantom studies, and promises to demonstrate clinically adequate performance on human data as well. Keywords: Prostate brachytherapy, Ultrasound, Fluoroscopy, Registration. PMID:21152376

l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy.

PubMed

Szabo, P; Lantos, J; Nagy, L; Keki, S; Volgyi, E; Menyhei, G; Illes, Z; Molnar, T

2016-12-01

Asymmetric dimethylarginine (ADMA) inhibits nitric oxide (NO) synthesis and is a marker of atherosclerosis. This study examined the correlation between pre-operative l-arginine and ADMA concentration during carotid endarterectomy (CEA), and jugular lactate indicating anaerobic cerebral metabolism, jugular S100B reflecting blood-brain barrier integrity, and with factors of surgical intervention. The concentration of l-arginine, ADMA, and symmetric dimethylarginine was measured in blood taken under regional anaesthesia from the radial artery of 55 patients prior to CEA. Blood gas parameters, concentration of lactate, and S100B were also serially measured in blood taken from both the radial artery and the jugular bulb before and after carotid clamping, and after release of the clamp. To estimate anaerobic metabolism, the jugulo-arterial ratio of CO 2 gap/oxygen extraction was calculated. Positive correlation was found between pre-operative ADMA levels and the ratio of jugulo-arterial CO 2 gap/oxygen extraction during clamp and reperfusion (p = .005 and p = .01, respectively). An inverse correlation was found between the pre-operative l-arginine concentration and jugular lactate at each time point (both p = .002). The critical pre-operative level of l-arginine was determined by receiver operator curve analysis. If l-arginine was below the cutoff value of 35 μmol/L, jugular S100B concentration was higher 24 h post-operatively (p = .03), and jugular lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range 42.3-74.5 μmol/L]; p = .002). High pre-operative ADMA concentration predicts poor cerebral perfusion indicated by elevated jugulo-arterial CO 2 gap/oxygen extraction. Low pre-operative l

Planning, Management, and Economics of Airport Operation

NASA Technical Reports Server (NTRS)

Wiley, J.

1972-01-01

An overview of the role of the airport in the transportation complex and in the community is presented. The establishment of the airport including its requirements in regional planning and the operation of the airport as a social and economic force are discussed.

The human intra-S checkpoint response to UVC-induced DNA damage.

PubMed

Kaufmann, William K

2010-05-01

The intra-S checkpoint response to 254 nm light (UVC)-induced DNA damage appears to have dual functions to slow the rate of DNA synthesis and stabilize replication forks that become stalled at sites of UVC-induced photoproducts in DNA. These functions should provide more time for repair of damaged DNA before its replication and thereby reduce the frequencies of mutations and chromosomal aberrations in surviving cells. This review tries to summarize the history of discovery of the checkpoint, the current state of understanding of the biological features of intra-S checkpoint signaling and its mechanisms of action with a focus primarily on intra-S checkpoint responses in human cells. The differences in the intra-S checkpoint responses to UVC and ionizing radiation-induced DNA damage are emphasized. Evidence that [6-4]pyrimidine-pyrimidone photoproducts in DNA trigger the response is discussed and the relationships between cellular responses to UVC and the molecular dose of UVC-induced DNA damage are briefly summarized. The role of the intra-S checkpoint response in protecting against solar radiation carcinogenesis remains to be determined.

Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

PubMed Central

Owojuyigbe, Afolabi Muyiwa; Komolafe, Edward O.; Adenekan, Anthony T.; Dada, Muyiwa A.; Onyia, Chiazor U.; Ogunbameru, Ibironke O.; Owagbemi, Oluwafemi F.; Talabi, Ademola O.; Faponle, Fola A.

2016-01-01

Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved. PMID:27251657

Metering Plan: Intelligent Operational Strategies Through Enhanced Metering Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pope, Jason E.

The Sustainability Program at Pacific Northwest National Laboratory (PNNL) has adopted a “triple-bottom-line” approach of environmental stewardship, social responsibility, and economic prosperity to its operations. Metering at PNNL works in support of all three, specifically to measure and inform building energy use and greenhouse gas emissions and minimize water use. The foundation for metering at PNNL is a core goal set, which consists of four objectives: providing accurate data without interruption, analyzing data while it is still new, providing actionable recommendations to operations management, and ensuring PNNL’s compliance with contract metering requirements. These core objectives guide the decisions that wemore » make during annual planning and as we operate throughout the year. This 2016 edition of the Metering Plan conveys the metering practices for and vision of the Sustainability Program. Changes in this plan from the 2015 edition include updated tables and an enhanced discussion on energy tracking systems used at PNNL. This plan also discusses updated benchmarking strategies using PNNL’s graphics and analytics tool, BuildingOS by Lucid Design Group. This plan presents our progress toward the metering goals shared by all federal agencies and highlights our successful completion of metering requirements. Currently, PNNL is fully compliant with the applicable legislative and Executive Order metering requirements. PNNL’s approach to the installation of new meters will be discussed. Perhaps most importantly, this plan details the analysis techniques utilized at PNNL that rely on the endless streams of data newly available as a result of increased meter deployment over the last several years. Previous Metering Plans have documented specific meter connection schemes as PNNL focused on deploying meters in a first step toward managing energy and water use. This plan serves not only to highlight PNNL’s successful completion of agency metering

40 CFR 63.1187 - What do I need to know about operations, maintenance, and monitoring plans?

Code of Federal Regulations, 2010 CFR

2010-07-01

... operations, maintenance, and monitoring plans? 63.1187 Section 63.1187 Protection of Environment... about operations, maintenance, and monitoring plans? (a) An operations, maintenance, and monitoring plan... title V permit. (b) The operations, maintenance, and monitoring plan must include the following: (1...

Operative planning of functional sessions for multisatellite observation and communication systems

NASA Astrophysics Data System (ADS)

Darnopykh, Valeriy V.; Malyshev, Veniamin V.

2012-04-01

An important control aspect of modern satellite observation and communication systems is the control of the functional processes. Functional sessions proceed under conditions of restricted technical ability, large amounts or information to be processed by the on-board equipment, practice inequality of the received information, intentions of system management and operators, interests of customers and other factors. A large number of spacecrafts (SC) in orbital constellation is one of the most important factors affecting the functional process also. Besides that some modern projects of satellite systems are multifunctional that is mixed operations of observation and communication. Therefore the functioning of SC on-board equipment must be accurately co-ordinate. That is why the problem of operative planning the functioning of these systems, while directly affecting the efficiency of the system, is very complex and actual at present. A methodical approach and software package for operative planning of functional processes for satellite observation and communication systems, including multifunctional projects, are considered in the paper. The base scheme of this approach consists of four main stages: stage 1—modeling of SC orbital kinematics and dynamics; stage 2—modeling of system functional processes with all kind of restrictions and criterion function values; stage 3—solving an optimization tasks by numerical applicable algorithms and constructing the optimal (or accuracy) plans; stage 4—repeated plan optimization (different variants) and analyzing. Such scheme is the result of authors practical research which have been realized during last 15 years by the operative planning as for any kinds of single SC as for satellite systems with different structure of orbital constellation. The research helps to unify the procedure of operative planning, to formulate basic principles and approaches for its solving, to develop special software package. The main aspects

Effect of Emodin on Preventing Postoperative Intra-Abdominal Adhesion Formation.

PubMed

Wei, Guangbing; Wu, Yunhua; Gao, Qi; Zhou, Cancan; Wang, Kai; Shen, Cong; Wang, Guanghui; Wang, Kang; Sun, Xuejun; Li, Xuqi

2017-01-01

Postoperative intra-abdominal adhesions are a major complication after abdominal surgery. Although various methods have been used to prevent and treat adhesions, the effects have not been satisfactory. Emodin, a naturally occurring anthraquinone derivative and an active ingredient in traditional Chinese herbs, exhibits a variety of pharmacological effects. In our study, we demonstrated the effect of emodin treatment on preventing postoperative adhesion formation. A total of 48 rats were divided into six groups. Abdominal adhesions were created by abrasion of the cecum and its opposite abdominal wall. In the experimental groups, the rats were administered daily oral doses of emodin. On the seventh day after operation, the rats were euthanized, and blood and pathological specimens were collected. Abdominal adhesion formation was evaluated by necropsy, pathology, immunohistochemistry, Western blot, and enzyme-linked immunosorbent assay analyses. Abdominal adhesions were markedly reduced by emodin treatment. Compared with the control group, collagen deposition was reduced and the peritoneal mesothelial completeness rate was higher in the emodin-treated groups. Emodin had anti-inflammatory effects, reduced oxidative stress, and promoted the movement of the intestinal tract ( P < 0.05). Emodin significantly reduced intra-abdominal adhesion formation in a rat model.

Market day midwives.

PubMed

1994-06-01

In August 1994 in Uganda, the Social Marketing for Change (SOMARC) project invited midwives to counsel clients and sell low-dose oral contraceptives (OCs), condoms, and the progestin-only OCs in local markets. They now sell these contraceptives from vendor stalls in busy markets, which allows clients to speak privately with the midwives. The midwives refer clients to their maternity clinics or to hospitals for other contraceptive methods and reproductive/maternal and child health (MCH) services. All Market Day Midwives have taken a 1-month family planning course and a course in quality of customer service. By the end of March 1994, 17 midwives served 22 marketplaces ranging from rural village markets operating once every 2 weeks to very busy, daily city markets. Some markets have 15 permanent stalls, while other midwives move within markets. Market Day Midwives have been able to add more than 1900 women to the list of women using the OC Pilplan. 65% of the new acceptors had not used any OC before Pilplan. 46% of them would be women considered to be high risk if they were to become pregnant (teenagers, women over 35, and women with many children). These midwives have been successful because they operate where the people are and they provide anonymity. Market Day Midwives have also brought in men who seek them out for family planning/sexually transmitted disease prevention services. They have sold more than 1000 Protector condoms. Another benefit of the market day approach is professional growth of the midwives. They often invest their earnings into new equipment and their private maternity clinics. They have learned the significance of advertising and the value of high-quality customer service. They look to expand into other markets and to integrate MCH products (e.g., oral rehydration) into their contraceptive business.

Centralized operations and maintenance planning at the Atacama Large Millimeter/submillimeter Array (ALMA)

NASA Astrophysics Data System (ADS)

Lopez, Bernhard; Whyborn, Nicholas D.; Guniat, Serge; Hernandez, Octavio; Gairing, Stefan

2016-07-01

The Atacama Large Millimeter/submillimeter Array (ALMA) is a joint project between astronomical organizations in Europe, North America, and East Asia, in collaboration with the Republic of Chile. ALMA consists of 54 twelve-meter antennas and 12 seven-meter antennas operating as an aperture synthesis array in the (sub)millimeter wavelength range. Since the inauguration of the observatory back in March 2013 there has been a continuous effort to establish solid operations processes for effective and efficient management of technical and administrative tasks on site. Here a key aspect had been the centralized maintenance and operations planning: input is collected from science stakeholders, the computerized maintenance management system (CMMS) and from the technical teams spread around the world, then this information is analyzed and consolidated based on the established maintenance strategy, the observatory long-term plan and the short-term priorities definitions. This paper presents the high-level process that has been developed for the planning and scheduling of planned- and unplanned maintenance tasks, and for site operations like the telescope array reconfiguration campaigns. We focus on the centralized planning approach by presenting its genesis, its current implementation for the observatory operations including related planning products, and we explore the necessary next steps in order to fully achieve a comprehensive centralized planning approach for ALMA in steady-state operations.

Mission Operations Planning with Preferences: An Empirical Study

NASA Technical Reports Server (NTRS)

Bresina, John L.; Khatib, Lina; McGann, Conor

2006-01-01

This paper presents an empirical study of some nonexhaustive approaches to optimizing preferences within the context of constraint-based, mixed-initiative planning for mission operations. This work is motivated by the experience of deploying and operating the MAPGEN (Mixed-initiative Activity Plan GENerator) system for the Mars Exploration Rover Mission. Responsiveness to the user is one of the important requirements for MAPGEN, hence, the additional computation time needed to optimize preferences must be kept within reasonabble bounds. This was the primary motivation for studying non-exhaustive optimization approaches. The specific goals of rhe empirical study are to assess the impact on solution quality of two greedy heuristics used in MAPGEN and to assess the improvement gained by applying a linear programming optimization technique to the final solution.

Pharmacology of intra-articular triamcinolone.

PubMed

Scherer, Justin; Rainsford, K D; Kean, Colin A; Kean, Walter F

2014-08-01

The inflammatory joint diseases of juvenile inflammatory arthritis (JIA), rheumatoid arthritis (RA) and osteoarthritis (OA): and also mild to moderate joint injury, all require a multidisciplinary approach to management. Intra-articular injections of corticosteroids have been shown to be a very beneficial adjunctive treatment in the management of the above disorders. It is, therefore, important that clinicians have a good understanding of the clinical actions of intra-articular injections. This article explores the pharmacokinetics, pharmacodynamics, and clinical pharmacology of triamcinolone acetonide (TA) and triamcinolone hexacetonide (TH) in JIA, RA, and OA. Literature search of TA and TH articles was conducted using key word searches in the PubMed and Google Scholar databases and through references within found articles. TA and TH intra-articular injections have been shown to provide good clinical benefit for up to 6 months and even longer. TH has been shown to decrease in the expression of citrullinated proteins, the monoclonal antibody F95, and peptidylarginine deiminase 4 in RA synovium. TA and TH intra-articular injections have a low side effect profile which is similar to other corticosteroid. They have minimal to no mineralocorticoid adverse effects and facial flushing 2-3 days post injections is the most common side effect recorded, and in almost all cases is no worse than nuisance. TA and TH are useful adjunct therapies in the management of JIA, RA, OA, and mild to moderate joint injury.

Innovations for ISS Plug-In Plan (IPiP) Operations

NASA Technical Reports Server (NTRS)

Moore, Kevin D.

2013-01-01

Limited resources and increasing requirements will continue to influence decisions on ISS. The ISS Plug-In Plan (IPiP) supports power and data for utilization, systems, and daily operations through the Electrical Power System (EPS) Secondary Power/Data Subsystem. Given the fluid launch schedule, the focus of the Plug-In Plan has evolved to anticipate future requirements by judicious development and delivery of power supplies, power strips, Alternating Current (AC) power inverters, along with innovative deployment strategies. A partnership of ISS Program Office, Engineering Directorate, Mission Operations, and International Partners poses unique solutions with existing on-board equipment and resources.

Comparison of intra-articular bupivacaine-morphine with bupivacaine-tenoxicam combinations on post-operative analgesia in patients with arthroscopic meniscectomy: a prospective, randomised study.

PubMed

Sanel, Selim; Arpaz, Osman; Unay, Koray; Turkmen, Ismail; Simsek, Selcuk; Ugutmen, Ender

2016-03-01

There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5% bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5% bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. level 1, therapeutic, randomised, multicentric study.

Timing of intra-aortic balloon pump support and 1-year survival.

PubMed

Ramnarine, Ian R; Grayson, Antony D; Dihmis, Walid C; Mediratta, Neeraj K; Fabri, Brian M; Chalmers, John A C

2005-05-01

The relationship between the timing of intra-aortic balloon pump (IABP) support and surgical outcome remains a subject of debate. Peri-operative mechanical circulatory support is commenced either prophylactically or after increasing inotropic support has proved inadequate. This study evaluates the effect timing of IABP support on the 1-year survival of patients undergoing cardiac surgery. From April 1997 to September 2002, 7698 consecutive cardiac surgical procedures were performed. This included 5678 isolated coronary artery bypasses (CABGs), 1245 isolated valve procedures and 775 simultaneous CABG and valve procedures. IABP support was required in 237 patients (3.1%). Twenty-seven patients (0.35%) were classed as high-risk and received preoperative IABP support, 25 patients (0.32%) were haemodynamically compromised and required preoperative IABP support, 120 patients (1.56%) required intra-operative IABP support, and 65 patients (0.84%) required post-operative IABP support. Multiple variables were offered to a Cox proportional hazards model and significant predictors of 1-year survival were identified. These were used to risk adjust Kaplan-Meier survival curves. 1-year follow-up was complete and 450 deaths (5.8%) were recorded. The significant independent predictors of increased mortality at 1-year (P<0.05, HR=hazard ratio) were post-operative renal failure (HR=3.5), increasing EuroSCORE (HR=1.2), post-operative myocardial infarction (HR=3.7), post-operative IABP (HR=4.1) intra-operative IABP (HR=2.8), post-operative stroke (HR=2.5), increasing number of valves (HR=1.6), ejection fraction <30% (HR=1.3) and triple-vessel disease (HR=1.3). After risk-adjustment, 1-year survival for patients who required intra-operative IABP support was significantly greater than for those patients who required IABP support in the post-operative period. Patients who warrant IABP support in the post-operative setting have a significantly increased mortality at 1-year when compared to

Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology.

PubMed

Ng, Ivan; Hwang, Peter Y K; Kumar, Dinesh; Lee, Cheng Kiang; Kockro, Ralf A; Sitoh, Y Y

2009-05-01

To evaluate the feasibility of surgical planning using a virtual reality platform workstation in the treatment of cerebral arterio-venous malformations (AVMs) Patient-specific data of multiple imaging modalities were co-registered, fused and displayed as a 3D stereoscopic object on the Dextroscope, a virtual reality surgical planning platform. This system allows for manipulation of 3D data and for the user to evaluate and appreciate the angio-architecture of the nidus with regards to position and spatial relationships of critical feeders and draining veins. We evaluated the ability of the Dextroscope to influence surgical planning by providing a better understanding of the angio-architecture as well as its impact on the surgeon's pre- and intra-operative confidence and ability to tackle these lesions. Twenty four patients were studied. The mean age was 29.65 years. Following pre-surgical planning on the Dextroscope, 23 patients underwent microsurgical resection after pre-surgical virtual reality planning, during which all had documented complete resection of the AVM. Planning on the virtual reality platform allowed for identification of critical feeders and draining vessels in all patients. The appreciation of the complex patient specific angio-architecture to establish a surgical plan was found to be invaluable in the conduct of the procedure and was found to enhance the surgeon's confidence significantly. Surgical planning of resection of an AVM with a virtual reality system allowed detailed and comprehensive analysis of 3D multi-modality imaging data and, in our experience, proved very helpful in establishing a good surgical strategy, enhancing intra-operative spatial orientation and increasing surgeon's confidence.

Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

NASA Technical Reports Server (NTRS)

Leveton, L. B.; VanderArk, S. T.

2014-01-01

The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day-to-day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

Systemic Operational Design: An Alternative to Estimate Planning

DTIC Science & Technology

2009-05-04

relationships found in the COE. Framing and campaign design, with emphasis on systems theory , have therefore made their way to the forefront of doctrinal...short explanation of the systems theory behind SOD, examines how the SOD process happens, and compares SOD with the time proven “Commander’s Estimate... Theory , Campaign planning, Contemporary Operating Environment, Commander’s Estimate Process, Operational design 16. SECURITY CLASSIFICATION OF

77 FR 37283 - General Provisions; Operating and Strategic Business Planning; Effective Date

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

... directors of each Farm Credit System institution to adopt an operational and strategic business plan to... FARM CREDIT ADMINISTRATION 12 CFR Part 618 RIN 3052-AC66 General Provisions; Operating and Strategic Business Planning; Effective Date AGENCY: Farm Credit Administration. ACTION: Notice of effective...

50 CFR 37.24 - Plan of operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Plan of operation. 37.24 Section 37.24 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM GEOLOGICAL AND GEOPHYSICAL EXPLORATION OF THE COASTAL PLAIN, ARCTIC...

50 CFR 37.24 - Plan of operation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Plan of operation. 37.24 Section 37.24 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM GEOLOGICAL AND GEOPHYSICAL EXPLORATION OF THE COASTAL PLAIN, ARCTIC...

A Hand-Held, Intra-Operative Positron Imaging Probe for Surgical Applications

NASA Astrophysics Data System (ADS)

Sabet, Hamid; Stack, Brendan C.; Nagarkar, Vivek V.

2015-10-01

We have developed a prototype intra-operative β+ imaging probe to help tumor removal and malignant tissue resection. The probe can be used during surgery to provide clear delineation of malignant tissues. Our probe consists of a hybrid scintillator coupled to a silicon photomultiplier (SiPM) array with associated front-end electronics encapsulated in an ergonomic aluminum housing. Pulse shape discrimination electronics has been implemented and integrated into the downstream data acquisition system. The field of view of the probe is 10 ×10 mm2 realized by a 0.4 mm thick CsI:Tl scintillator coupled to a 1 mm thick LYSO. While CsI:Tl layer acts as β+ sensitive detector, LYSO detects gamma radiation where the gamma response can be subtracted from the total signal to improve SNR and contrast. The thickness of the LYSO scintillator is optimized such that it acts as light diffuser to spread the scintillation light generated in CsI:Tl over multiple SiPM pixels for accurate estimation of the β+ interaction location. The probe shows FWHM spatial resolution in the presence of large background radiation. The probe was used to study rabbits with tongue tumors. The experimental results show that the probe can successfully locate the tongue tumors in its active imaging area.

Improving the Operations of the Earth Observing One Mission via Automated Mission Planning

NASA Technical Reports Server (NTRS)

Chien, Steve A.; Tran, Daniel; Rabideau, Gregg; Schaffer, Steve; Mandl, Daniel; Frye, Stuart

2010-01-01

We describe the modeling and reasoning about operations constraints in an automated mission planning system for an earth observing satellite - EO-1. We first discuss the large number of elements that can be naturally represented in an expressive planning and scheduling framework. We then describe a number of constraints that challenge the current state of the art in automated planning systems and discuss how we modeled these constraints as well as discuss tradeoffs in representation versus efficiency. Finally we describe the challenges in efficiently generating operations plans for this mission. These discussions involve lessons learned from an operations model that has been in use since Fall 2004 (called R4) as well as a newer more accurate operations model operational since June 2009 (called R5). We present analysis of the R5 software documenting a significant (greater than 50%) increase in the number of weekly observations scheduled by the EO-1 mission. We also show that the R5 mission planning system produces schedules within 15% of an upper bound on optimal schedules. This operational enhancement has created value of millions of dollars US over the projected remaining lifetime of the EO-1 mission.

Oceanic gamefish/Skylab project field operating plan for operations 4, 5 August. [in Gulf of Mexico

NASA Technical Reports Server (NTRS)

1973-01-01

The operation plans are presented for the oceanic Gamefish/Skylab Experiment 240, which was conducted to obtain fish catch data for the northeast area of the Gulf of Mexico. The plans for surface measurements, aerial observations, and communications are included.

Stereoelectroencephalography based on the Leksell stereotactic frame and Neurotech operation planning software.

PubMed

Zhang, Guangming; Chen, Guoqiang; Meng, Dawei; Liu, Yanwu; Chen, Jianwei; Shu, Lanmei; Liu, Wenbo

2017-06-01

This study aimed to introduce a new stereoelectroencephalography (SEEG) system based on Leksell stereotactic frame (L-SEEG) as well as Neurotech operation planning software, and to investigate its safety, applicability, and reliability.L-SEEG, without the help of navigation, includes SEEG operation planning software (Neurotech), Leksell stereotactic frame, and corresponding surgical instruments. Neurotech operation planning software can be used to display three-dimensional images of the cortex and cortical vessels and to plan the intracranial electrode implantation. In 44 refractory epilepsy patients, 364 intracranial electrodes were implanted through the L-SEEG system, and the postoperative complications such as bleeding, cerebral spinal fluid (CSF) leakage, infection, and electrode-related problems were also investigated.All electrodes were implanted accurately as preoperatively planned shown by postoperative lamina computed tomography and preoperative lamina magnetic resonance imaging. There was no severe complication after intracranial electrode implantation through the L-SEEG system. There were no electrode-related problems, no CSF leakage and no infection after surgery. All the patients recovered favorably after SEEG electrode implantation, and only 1 patient had asymptomatic frontal lateral ventricle hematoma (3 mL).The L-SEEG system with Neurotech operation planning software can be used for safe, accurate, and reliable intracranial electrode implantation for SEEG.

Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

PubMed

Kirkpatrick, A W; Nickerson, D; Roberts, D J; Rosen, M J; McBeth, P B; Petro, C C; Berrevoet, Frederik; Sugrue, M; Xiao, Jimmy; Ball, C G

2017-06-01

Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Bibliographic databases (1950-2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of

Advances in Distributed Operations and Mission Activity Planning for Mars Surface Exploration

NASA Technical Reports Server (NTRS)

Fox, Jason M.; Norris, Jeffrey S.; Powell, Mark W.; Rabe, Kenneth J.; Shams, Khawaja

2006-01-01

A centralized mission activity planning system for any long-term mission, such as the Mars Exploration Rover Mission (MER), is completely infeasible due to budget and geographic constraints. A distributed operations system is key to addressing these constraints; therefore, future system and software engineers must focus on the problem of how to provide a secure, reliable, and distributed mission activity planning system. We will explain how Maestro, the next generation mission activity planning system, with its heavy emphasis on portability and distributed operations has been able to meet these design challenges. MER has been an excellent proving ground for Maestro's new approach to distributed operations. The backend that has been developed for Maestro could benefit many future missions by reducing the cost of centralized operations system architecture.

Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults.

PubMed

Pedersen, E S L; Danquah, I H; Petersen, C B; Tolstrup, J S

2016-12-03

Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling. Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity. Clinical trials NCT01996176 .

National Transonic Facility: A review of the operational plan

NASA Technical Reports Server (NTRS)

Liepmann, H. W.; Black, R. E.; Dietz, R. O.; Kirchner, M. E.; Sears, W. R.

1980-01-01

The proposed National Transonic Facility (NTF) operational plan is reviewed. The NTF will provide an aerodynamic test capability significantly exceeding that of other transonic regime wind tunnels now available. A limited number of academic research program that might use the NTF are suggested. It is concluded that the NTF operational plan is useful for management, technical, instrumentation, and model building techniques available in the specialized field of aerodynamic analysis and simulation. It is also suggested that NASA hold an annual conference to discuss wind tunnel research results and to report on developments that will further improve the utilization and cost effectiveness of the NTF and other wind tunnels.

Iterative Repair Planning for Spacecraft Operations Using the Aspen System

NASA Technical Reports Server (NTRS)

Rabideau, G.; Knight, R.; Chien, S.; Fukunaga, A.; Govindjee, A.

2000-01-01

This paper describes the Automated Scheduling and Planning Environment (ASPEN). ASPEN encodes complex spacecraft knowledge of operability constraints, flight rules, spacecraft hardware, science experiments and operations procedures to allow for automated generation of low level spacecraft sequences. Using a technique called iterative repair, ASPEN classifies constraint violations (i.e., conflicts) and attempts to repair each by performing a planning or scheduling operation. It must reason about which conflict to resolve first and what repair method to try for the given conflict. ASPEN is currently being utilized in the development of automated planner/scheduler systems for several spacecraft, including the UFO-1 naval communications satellite and the Citizen Explorer (CX1) satellite, as well as for planetary rover operations and antenna ground systems automation. This paper focuses on the algorithm and search strategies employed by ASPEN to resolve spacecraft operations constraints, as well as the data structures for representing these constraints.

REM sleep deprivation produces a motivational deficit for food reward that is reversed by intra-accumbens amphetamine in rats

PubMed Central

Hanlon, Erin C.; Benca, Ruth M.; Baldo, Brian A.; Kelley, Ann E.

2010-01-01

Prolonged sleep deprivation in rats produces a characteristic syndrome of increase in food intake accompanied by, paradoxically, decrease in weight, suggesting a potential alteration in motivation for food reward. Using the multiple platform method to produce REM sleep deprivation (REMSD), we investigated the effect of REMSD on motivation for food reinforcement with a progressive ratio operant task, which yields a measure of the motor effort that a hungry animal is willing to expend to obtain food (the point at which the animal quits responding is termed the “break-point”). We found that REMSD rats decreased the break-point for sucrose pellet reinforcement in comparison to controls, as revealed by a within-session decline in responding. This behavioral deficit is similar to that observed in rats with diminished dopamine transmission within the nucleus accumbens (Acb), and, considering that stimulants are frequently used in the clinical setting to reverse the effects of sleepiness, we examined the effect of systemic or intra-Acb amphetamine on break-point in REMSD rats. Animals were given either systemic or intra-Acb amphetamine injections on days 3 and 5 of REMSD. Systemic amphetamine (0.1, 0.5, or 2.5 mg/kg) did not increase break point in REMSD rats. In contrast, intra-Acb infusions of amphetamine (1, 10, or 30 µg/ 0.5 µl bilaterally) reversed the REMSD-induced suppression of progressive ratio responding. Specifically, the two higher doses of intra-Acb amphetamine were able to prolong responding within the session (resulting in an increased break-point) on day 3 of REMSD while only the highest dose was sufficient following 5 days of REMSD. These data suggest that decreased motivation for food reward caused by REMSD may result from a suppression of dopamine function in the Acb. PMID:20619322

REM sleep deprivation produces a motivational deficit for food reward that is reversed by intra-accumbens amphetamine in rats.

PubMed

Hanlon, Erin C; Benca, Ruth M; Baldo, Brian A; Kelley, Ann E

2010-10-30

Prolonged sleep deprivation in rats produces a characteristic syndrome of increase in food intake accompanied by, paradoxically, decrease in weight, suggesting a potential alteration in motivation for food reward. Using the multiple platform method to produce REM sleep deprivation (REMSD), we investigated the effect of REMSD on motivation for food reinforcement with a progressive ratio operant task, which yields a measure of the motor effort that a hungry animal is willing to expend to obtain food (the point at which the animal quits responding is termed the "break-point"). We found that REMSD rats decreased the break point for sucrose pellet reinforcement in comparison to controls, as revealed by a within-session decline in responding. This behavioral deficit is similar to that observed in rats with diminished dopamine transmission within the nucleus accumbens (Acb), and, considering that stimulants are frequently used in the clinical setting to reverse the effects of sleepiness, we examined the effect of systemic or intra-Acb amphetamine on break point in REMSD rats. Animals were given either systemic or intra-Acb amphetamine injections on days 3 and 5 of REMSD. Systemic amphetamine (0.1, 0.5, or 2.5mg/kg) did not increase break point in REMSD rats. In contrast, intra-Acb infusions of amphetamine (1, 10, or 30μg/0.5μl bilaterally) reversed the REMSD-induced suppression of progressive ratio responding. Specifically, the two higher doses of intra-Acb amphetamine were able to prolong responding within the session (resulting in an increased break point) on day 3 of REMSD while only the highest dose was sufficient following 5 days of REMSD. These data suggest that decreased motivation for food reward caused by REMSD may result from a suppression of dopamine function in the Acb. Copyright © 2010 Elsevier Inc. All rights reserved.

Space Shuttle Day-of-Launch Trajectory Design Operations

NASA Technical Reports Server (NTRS)

Harrington, Brian E.

2011-01-01

not meet all constraint criteria, Shuttle would be No-Go for launch. This Shuttle methodology is very similar to other unmanned launch vehicles. By extension, this method would likely be employed for any future NASA launch vehicle. This paper will review the Shuttle s day-of-launch trajectory optimization and verification operations as an example of a more generic application of day-of-launch design and validation. With Shuttle s retirement, it is fitting to document the current state of this critical process and capture lessons learned to benefit current and future launch vehicle endeavors.

The Accommodation Operation. Accommodation Management Module. Operational Management Programme.

ERIC Educational Resources Information Center

Chapman, Janet

This module on accommodation operation is intended to help supervisors or managers achieve a balance in the day-to-day running of the premises and plan for a smooth and successful future. Much of the material is concerned with the housekeeping aspects of accommodation management. The material is presented in a self-instructional format in seven…

Intra-articular decorin influences the fibrosis genetic expression profile in a rabbit model of joint contracture.

PubMed

Abdel, M P; Morrey, M E; Barlow, J D; Grill, D E; Kolbert, C P; An, K N; Steinmann, S P; Morrey, B F; Sanchez-Sotelo, J

2014-01-01

The goal of this study was to determine whether intra-articular administration of the potentially anti-fibrotic agent decorin influences the expression of genes involved in the fibrotic cascade, and ultimately leads to less contracture, in an animal model. A total of 18 rabbits underwent an operation on their right knees to form contractures. Six limbs in group 1 received four intra-articular injections of decorin; six limbs in group 2 received four intra-articular injections of bovine serum albumin (BSA) over eight days; six limbs in group 3 received no injections. The contracted limbs of rabbits in group 1 were biomechanically and genetically compared with the contracted limbs of rabbits in groups 2 and 3, with the use of a calibrated joint measuring device and custom microarray, respectively. There was no statistical difference in the flexion contracture angles between those limbs that received intra-articular decorin versus those that received intra-articular BSA (66° vs 69°; p = 0.41). Likewise, there was no statistical difference between those limbs that received intra-articular decorin versus those who had no injection (66° vs 72°; p = 0.27). When compared with BSA, decorin led to a statistically significant increase in the mRNA expression of 12 genes (p < 0.01). In addition, there was a statistical change in the mRNA expression of three genes, when compared with those without injection. In this model, when administered intra-articularly at eight weeks, 2 mg of decorin had no significant effect on joint contractures. However, our genetic analysis revealed a significant alteration in several fibrotic genes. Cite this article: Bone Joint Res 2014;3:82-8.

Computer-aided position planning of miniplates to treat facial bone defects.

PubMed

Egger, Jan; Wallner, Jürgen; Gall, Markus; Chen, Xiaojun; Schwenzer-Zimmerer, Katja; Reinbacher, Knut; Schmalstieg, Dieter

2017-01-01

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.

Association of operative time of day with outcomes after thoracic organ transplant.

PubMed

George, Timothy J; Arnaoutakis, George J; Merlo, Christian A; Kemp, Clinton D; Baumgartner, William A; Conte, John V; Shah, Ashish S

2011-06-01

Recent emphasis on systems-based approaches to patient safety has led to several studies demonstrating worse outcomes associated with surgery at night. To evaluate whether operative time of day was associated with thoracic organ transplant outcomes, hypothesizing that it would not be associated with increased morbidity or mortality. We conducted a retrospective cohort study of adult heart and lung transplant recipients in the United Network for Organ Sharing database from January 2000 through June 2010. Primary stratification was by operative time of day (night, 7 PM-7 AM; day, 7 AM-7 PM). Primary end points were short-term survival, assessed by the Kaplan-Meier method at 30, 90, and 365 days. Secondary end points encompassed common postoperative complications. Risk-adjusted multivariable Cox proportional hazards regression examined mortality. A total of 27,118 patients were included in the study population. Of the 16,573 who underwent a heart transplant, 8346 (50.36%) did so during the day and 8227 (49.64%) during the night. Of the 10,545 who underwent a lung transplant, 5179 (49.11%) did so during the day and 5366 (50.89%) during the night. During a median follow-up of 32.2 months (interquartile range, 11.2-61.1 months), 8061 patients (28.99%) died. Survival was similar for organ transplants performed during the day and night. Survival rates at 30 days for heart transplants during the day were 95.0% vs 95.2% during the night (hazard ratio [HR], 1.05; 95% confidence interval, 0.83-1.32; P = .67) and for lung transplants during the day were 96.0% vs 95.5% during the night (HR, 1.22; 95% CI, 0.97-1.55; P = .09). At 90 days, survival rates for heart transplants were 92.6% during the day vs 92.7% during the night (HR, 1.05; 95% CI, 0.88-1.26; P = .59) and for lung transplants during the day were 92.7% vs 91.7% during the night (HR, 1.23; 95% CI, 1.04-1.47; P = .02). At 1 year, survival rates for heart transplants during the day were 88.0% vs 87.7% during the night (HR

Remotely Operated Aircraft (ROA) Impact on the National Airspace System (NAS) Work Package, 2005: Composite Report on FAA Flight Plan and Operational Evaluation Plan. Version 7.0

NASA Technical Reports Server (NTRS)

2005-01-01

The purpose of this document is to present the findings that resulted from a high-level analysis and evaluation of the following documents: (1) The OEP (Operational Evolution Plan) Version 7 -- a 10-year plan for operational improvements to increase capacity and efficiency in U.S. air travel and transport and other use of domestic airspace. The OEP is the FAA commitment to operational improvements. It is outcome driven, with clear lines of accountability within FAA organizations. The OEP concentrates on operational solutions and integrates safety, certification, procedures, staffing, equipment, avionics and research; (2) The Draft Flight Plan 2006 through 2010 -- a multi-year strategic effort, setting a course for the FAA through 2001, to provide the safest and most efficient air transportation system in the world; (3) The NAS System Architecture Version 5 -- a blueprint for modernizing the NAS and improving NAS services and capabilities through the year 2015; and (4) The NAS-SR-1000 System Requirements Specification (NASSRS) -- a compilation of requirements which describe the operational capabilities for the NAS. The analysis is particularly focused on examining the documents for relevance to existing and/or planned future UAV operations. The evaluation specifically focuses on potential factors that could materially affect the development of a commercial ROA industry, such as: (1) Design limitations of the CNS/ATM system, (2) Human limitations, The information presented was taken from program specifications or program office lead personnel.

30 CFR 947.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 947.784 Section 947.784 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. (a) Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 922.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 922.784 Section 922.784 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes application...

30 CFR 933.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 933.784 Section 933.784 Mineral Resources OFFICE OF SURFACE... requirements for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 939.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 939.784 Section 939.784 Mineral Resources OFFICE OF SURFACE... requirements for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 941.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 941.784 Section 941.784 Mineral Resources OFFICE OF SURFACE... requirements for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 942.784 - Underground mining permit applications-Minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 942.784 Section 942.784 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes application...

30 CFR 921.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 921.784 Section 921.784 Mineral Resources OFFICE OF SURFACE... requirements for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 905.784 - Underground mining permit applications-Minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 905.784 Section 905.784 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes application...

30 CFR 910.784 - Underground mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 910.784 Section 910.784 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. (a) Part 784 of this chapter, Underground Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes...

30 CFR 933.780 - Surface mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 933.780 Section 933.780 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. Part 780 of this chapter, Surface Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes application...

30 CFR 921.780 - Surface mining permit applications-minimum requirements for reclamation and operation plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements for reclamation and operation plan. 921.780 Section 921.780 Mineral Resources OFFICE OF SURFACE... for reclamation and operation plan. Part 780 of this chapter, Surface Mining Permit Applications—Minimum Requirements for Reclamation and Operation Plan, shall apply to any person who makes application...

30 CFR 903.784 - Underground mining permit applications-Minimum requirements for reclamation and operation plan.