A negentropy minimization approach to adaptive equalization for digital communication systems.

PubMed

Choi, Sooyong; Lee, Te-Won

2004-07-01

In this paper, we introduce and investigate a new adaptive equalization method based on minimizing approximate negentropy of the estimation error for a finite-length equalizer. We consider an approximate negentropy using nonpolynomial expansions of the estimation error as a new performance criterion to improve performance of a linear equalizer based on minimizing minimum mean squared error (MMSE). Negentropy includes higher order statistical information and its minimization provides improved converge, performance and accuracy compared to traditional methods such as MMSE in terms of bit error rate (BER). The proposed negentropy minimization (NEGMIN) equalizer has two kinds of solutions, the MMSE solution and the other one, depending on the ratio of the normalization parameters. The NEGMIN equalizer has best BER performance when the ratio of the normalization parameters is properly adjusted to maximize the output power(variance) of the NEGMIN equalizer. Simulation experiments show that BER performance of the NEGMIN equalizer with the other solution than the MMSE one has similar characteristics to the adaptive minimum bit error rate (AMBER) equalizer. The main advantage of the proposed equalizer is that it needs significantly fewer training symbols than the AMBER equalizer. Furthermore, the proposed equalizer is more robust to nonlinear distortions than the MMSE equalizer.

Minimally inconsistent reasoning in Semantic Web

PubMed Central

Zhang, Xiaowang

2017-01-01

Reasoning with inconsistencies is an important issue for Semantic Web as imperfect information is unavoidable in real applications. For this, different paraconsistent approaches, due to their capacity to draw as nontrivial conclusions by tolerating inconsistencies, have been proposed to reason with inconsistent description logic knowledge bases. However, existing paraconsistent approaches are often criticized for being too skeptical. To this end, this paper presents a non-monotonic paraconsistent version of description logic reasoning, called minimally inconsistent reasoning, where inconsistencies tolerated in the reasoning are minimized so that more reasonable conclusions can be inferred. Some desirable properties are studied, which shows that the new semantics inherits advantages of both non-monotonic reasoning and paraconsistent reasoning. A complete and sound tableau-based algorithm, called multi-valued tableaux, is developed to capture the minimally inconsistent reasoning. In fact, the tableaux algorithm is designed, as a framework for multi-valued DL, to allow for different underlying paraconsistent semantics, with the mere difference in the clash conditions. Finally, the complexity of minimally inconsistent description logic reasoning is shown on the same level as the (classical) description logic reasoning. PMID:28750030

Advantages and limits of hemorrhoidal dearterialization in the treatment of symptomatic hemorrhoids

PubMed Central

Giamundo, Paolo

2016-01-01

In the last two decades, hemorrhoidal dearterialization has become universally accepted as a treatment option for symptomatic hemorrhoids. The rationale for this procedure is based on the assumption that arterial blood overflow is mainly responsible for dilatation of the hemorrhoidal plexus due to the absence of capillary interposition between the arterial and venous systems within the anal canal. Dearterialization, with either suture ligation (Doppler-guided hemorrhoid artery ligation/transanal hemorrhoidal dearterialization) or laser (hemorrhoidal laser procedure), may be successfully performed alone or with mucopexy. Although the added value of Doppler-guidance in association with dearterialization has recently been challenged, this imaging method still plays an important role in localizing hemorrhoidal arteries and, therefore, minimizing the effect of anatomic variation among patients. However, it is important to employ the correct Doppler transducer. Some Doppler transducers may not easily detect superficial arteries due to inadequate frequency settings. All techniques of dearterialization have the advantage of preserving the anatomy and physiology of the anal canal, when compared to other surgical treatments for hemorrhoids. This advantage cannot be underestimated as impaired anal function, including fecal incontinence and other defecation disorders, may occur following surgical treatment for hemorrhoids. Furthermore, this potentially devastating problem can occur in patients of all ages, including younger patients. PMID:26843909

Advantages and limits of hemorrhoidal dearterialization in the treatment of symptomatic hemorrhoids.

PubMed

Giamundo, Paolo

2016-01-27

In the last two decades, hemorrhoidal dearterialization has become universally accepted as a treatment option for symptomatic hemorrhoids. The rationale for this procedure is based on the assumption that arterial blood overflow is mainly responsible for dilatation of the hemorrhoidal plexus due to the absence of capillary interposition between the arterial and venous systems within the anal canal. Dearterialization, with either suture ligation (Doppler-guided hemorrhoid artery ligation/transanal hemorrhoidal dearterialization) or laser (hemorrhoidal laser procedure), may be successfully performed alone or with mucopexy. Although the added value of Doppler-guidance in association with dearterialization has recently been challenged, this imaging method still plays an important role in localizing hemorrhoidal arteries and, therefore, minimizing the effect of anatomic variation among patients. However, it is important to employ the correct Doppler transducer. Some Doppler transducers may not easily detect superficial arteries due to inadequate frequency settings. All techniques of dearterialization have the advantage of preserving the anatomy and physiology of the anal canal, when compared to other surgical treatments for hemorrhoids. This advantage cannot be underestimated as impaired anal function, including fecal incontinence and other defecation disorders, may occur following surgical treatment for hemorrhoids. Furthermore, this potentially devastating problem can occur in patients of all ages, including younger patients.

The Blind Advantage: How Going Blind Made Me a Stronger Principal and How Including Children with Disabilities Made Our School Better for Everyone

ERIC Educational Resources Information Center

Henderson, Bill

2011-01-01

'The Blind Advantage" provides insight into the challenges, possibilities, and practicalities of including students with disabilities--and into the mind and heart of an inspired and determined leader. "You should get out of education." That was the advice first-year teacher Bill Henderson received when he discovered he was gradually…

Energy minimization for self-organized structure formation and actuation

NASA Astrophysics Data System (ADS)

Kofod, Guggi; Wirges, Werner; Paajanen, Mika; Bauer, Siegfried

2007-02-01

An approach for creating complex structures with embedded actuation in planar manufacturing steps is presented. Self-organization and energy minimization are central to this approach, illustrated with a model based on minimization of the hyperelastic free energy strain function of a stretched elastomer and the bending elastic energy of a plastic frame. A tulip-shaped gripper structure illustrates the technological potential of the approach. Advantages are simplicity of manufacture, complexity of final structures, and the ease with which any electroactive material can be exploited as means of actuation.

Measuring home advantage in Spanish handball.

PubMed

Gutiérrez Aguilar, Oscar; Saavedra García, Miguel; Fernández Romero, Juan José

2012-02-01

Since Pollard established the system for analysing home advantage in 1986, it has been demonstrated and quantified in various sports, including many team sports. This study aims to assess whether home advantage exists in handball, using a sample of more than 19,000 Spanish handball league games. Results of the games played at home and away, the sex of the players, and the levels of the competition were included as variables. In Spanish handball, there was a home advantage of 61%, which means, on average, the team playing at home wins 61% of points available. This value varies according to sex and according to competition level, increasing as competition level decreases and season rank improves.

The Advantages and Disadvantages of Using a Centralized In-House Marketing Office.

ERIC Educational Resources Information Center

Miller, Ronald H.

A centralized marketing and promotion office may or may not be a panacea for a continuing education program. Five major advantages to centralization of the marketing and promotion function are minimization of costs, a school-wide marketing strategy, maximization of the school image, enhanced quality control, and building of technical expertise of…

Symmetry breaking for drag minimization

NASA Astrophysics Data System (ADS)

Roper, Marcus; Squires, Todd M.; Brenner, Michael P.

2005-11-01

For locomotion at high Reynolds numbers drag minimization favors fore-aft asymmetric slender shapes with blunt noses and sharp trailing edges. On the other hand, in an inertialess fluid the drag experienced by a body is independent of whether it travels forward or backward through the fluid, so there is no advantage to having a single preferred swimming direction. In fact numerically determined minimum drag shapes are known to exhibit almost no fore-aft asymmetry even at moderate Re. We show that asymmetry persists, albeit extremely weakly, down to vanishingly small Re, scaling asymptotically as Re^3. The need to minimize drag to maximize speed for a given propulsive capacity gives one possible mechanism for the increasing asymmetry in the body plans seen in nature, as organisms increase in size and swimming speed from bacteria like E-Coli up to pursuit predator fish such as tuna. If it is the dominant mechanism, then this signature scaling will be observed in the shapes of motile micro-organisms.

Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

PubMed Central

Kim, Terrence T.; Johnson, J. Patrick; Pashman, Robert; Drazin, Doniel

2016-01-01

We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy. PMID:27213152

Minimally Invasive Repair of Pectus Carinatum.

PubMed

Yuksel, Mustafa; Lacin, Tunc; Ermerak, Nezih Onur; Sirzai, Esra Yamansavci; Sayan, Bihter

2018-03-01

The second most common deformity of the anterior chest wall, pectus carinatum, is a diverse deformity that has been largely managed using open techniques. This study reviews clinical experience with a newly designed bar for minimally invasive repair of pectus carinatum. We reviewed the records of all patients recorded in our Chest Wall Deformities Clinical Database. Between January 2006 and November 2016, minimally invasive repair of pectus carinatum was performed in 172 patients. All met the criteria of a "compression test" of 10 to 25 kg/cm 2 . The mean age was 17.3 years, and 22.7% had a positive family history of a congenital chest wall deformity. Symmetric and asymmetric deformities were treated. During our study period, we designed 4 different bar configurations and their related stabilizers. All patients are assessed every 3 to 6 months. After 2 to 3 years of follow-up, the bar and the stabilizers are removed. Of 172 patients, 97.1% tolerated the procedure very well. The operation was a mean length 76.6 minutes. Average blood loss was 40 mL. Mean hospital length of stay was 3.7 days. Complications included pneumothorax, wire breakdown/rib cut, wound infection, severe pain, skin hyperpigmentation, nickel allergy, and overcorrection leading to excavatum. Patients returned to routine activity in 10 to 14 days. With a mean follow-up of 29.8 months in bar removal patients, 130 of 172 (93.8%) reported excellent results. Minimally invasive repair of pectus carinatum with the technically modified fourth-generation bar and its securing system has advantages of low morbidity, short hospital stay, and excellent cosmetic results, even in asymmetric cases. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Does Minimally Invasive Spine Surgery Minimize Surgical Site Infections?

PubMed

Kulkarni, Arvind Gopalrao; Patel, Ravish Shammi; Dutta, Shumayou

2016-12-01

Retrospective review of prospectively collected data. To evaluate the incidence of surgical site infections (SSIs) in minimally invasive spine surgery (MISS) in a cohort of patients and compare with available historical data on SSI in open spinal surgery cohorts, and to evaluate additional direct costs incurred due to SSI. SSI can lead to prolonged antibiotic therapy, extended hospitalization, repeated operations, and implant removal. Small incisions and minimal dissection intrinsic to MISS may minimize the risk of postoperative infections. However, there is a dearth of literature on infections after MISS and their additional direct financial implications. All patients from January 2007 to January 2015 undergoing posterior spinal surgery with tubular retractor system and microscope in our institution were included. The procedures performed included tubular discectomies, tubular decompressions for spinal stenosis and minimal invasive transforaminal lumbar interbody fusion (TLIF). The incidence of postoperative SSI was calculated and compared to the range of cited SSI rates from published studies. Direct costs were calculated from medical billing for index cases and for patients with SSI. A total of 1,043 patients underwent 763 noninstrumented surgeries (discectomies, decompressions) and 280 instrumented (TLIF) procedures. The mean age was 52.2 years with male:female ratio of 1.08:1. Three infections were encountered with fusion surgeries (mean detection time, 7 days). All three required wound wash and debridement with one patient requiring unilateral implant removal. Additional direct cost due to infection was $2,678 per 100 MISS-TLIF. SSI increased hospital expenditure per patient 1.5-fold after instrumented MISS. Overall infection rate after MISS was 0.29%, with SSI rate of 0% in non-instrumented MISS and 1.07% with instrumented MISS. MISS can markedly reduce the SSI rate and can be an effective tool to minimize hospital costs.

Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system.

PubMed

Miller, Larry E; Block, Jon E

2014-01-01

Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry(®) SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed.

Practical advantages of evolutionary computation

NASA Astrophysics Data System (ADS)

Fogel, David B.

1997-10-01

Evolutionary computation is becoming a common technique for solving difficult, real-world problems in industry, medicine, and defense. This paper reviews some of the practical advantages to using evolutionary algorithms as compared with classic methods of optimization or artificial intelligence. Specific advantages include the flexibility of the procedures, as well as their ability to self-adapt the search for optimum solutions on the fly. As desktop computers increase in speed, the application of evolutionary algorithms will become routine.

Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

PubMed

Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

2009-08-01

Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

Robustness of the sequential lineup advantage.

PubMed

Gronlund, Scott D; Carlson, Curt A; Dailey, Sarah B; Goodsell, Charles A

2009-06-01

A growing movement in the United States and around the world involves promoting the advantages of conducting an eyewitness lineup in a sequential manner. We conducted a large study (N = 2,529) that included 24 comparisons of sequential versus simultaneous lineups. A liberal statistical criterion revealed only 2 significant sequential lineup advantages and 3 significant simultaneous advantages. Both sequential advantages occurred when the good photograph of the guilty suspect or either innocent suspect was in the fifth position in the sequential lineup; all 3 simultaneous advantages occurred when the poorer quality photograph of the guilty suspect or either innocent suspect was in the second position. Adjusting the statistical criterion to control for the multiple tests (.05/24) revealed no significant sequential advantages. Moreover, despite finding more conservative overall choosing for the sequential lineup, no support was found for the proposal that a sequential advantage was due to that conservative criterion shift. Unless lineups with particular characteristics predominate in the real world, there appears to be no strong preference for conducting lineups in either a sequential or a simultaneous manner. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Robotic unclamped "minimal-margin" partial nephrectomy: ongoing refinement of the anatomic zero-ischemia concept.

PubMed

Satkunasivam, Raj; Tsai, Sheaumei; Syan, Sumeet; Bernhard, Jean-Christophe; de Castro Abreu, Andre Luis; Chopra, Sameer; Berger, Andre K; Lee, Dennis; Hung, Andrew J; Cai, Jie; Desai, Mihir M; Gill, Inderbir S

2015-10-01

Anatomic partial nephrectomy (PN) techniques aim to decrease or eliminate global renal ischemia. To report the technical feasibility of completely unclamped "minimal-margin" robotic PN. We also illustrate the stepwise evolution of anatomic PN surgery with related outcomes data. This study was a retrospective analysis of 179 contemporary patients undergoing anatomic PN at a tertiary academic institution between October 2009 and February 2013. Consecutive consented patients were grouped into three cohorts: group 1, with superselective clamping and developmental-curve experience (n = 70); group 2, with superselective clamping and mature experience (n = 60); and group 3, which had completely unclamped, minimal-margin PN (n = 49). Patients in groups 1 and 2 underwent superselective tumor-specific devascularization, whereas patients in group 3 underwent completely unclamped minimal-margin PN adjacent to the tumor edge, a technique that takes advantage of the radially oriented intrarenal architecture and anatomy. Primary outcomes assessed the technical feasibility of robotic, completely unclamped, minimal-margin PN; short-term changes in estimated glomerular filtration rate (eGFR); and development of new-onset chronic kidney disease (CKD) stage >3. Secondary outcome measures included perioperative variables, 30-d complications, and histopathologic outcomes. Demographic data were similar among groups. For similarly sized tumors (p = 0.13), percentage of kidney preserved was greater (p = 0.047) and margin width was narrower (p = 0.0004) in group 3. In addition, group 3 had less blood loss (200, 225, and 150ml; p = 0.04), lower transfusion rates (21%, 23%, and 4%; p = 0.008), and shorter hospital stay (p = 0.006), whereas operative time and 30-d complication rates were similar. At 1-mo postoperatively, median percentage reduction in eGFR was similar (7.6%, 0%, and 3.0%; p = 0.53); however, new-onset CKD stage >3 occurred less frequently in group 3 (23%, 10%, and 2%; p = 0

Robotic surgery for lung resections—total port approach: advantages and disadvantages

PubMed Central

Ramadan, Omar I.; Cerfolio, Robert J.

2017-01-01

Minimally invasive thoracic surgery, when compared with open thoracotomy, has been shown to have improved perioperative outcomes as well as comparable long-term survival. Robotic surgery represents a powerful advancement of minimally invasive surgery, with vastly improved visualization and instrument maneuverability, and is increasingly popular for thoracic surgery. However, there remains debate over the best robotic approaches for lung resection, with several different techniques evidenced and described in the literature. We delineate our method for total port approach with four robotic arms and discuss how its advantages outweigh its disadvantages. We conclude that it is preferred to other robotic approaches, such as the robotic assisted approach, due to its enhanced visualization, improved instrument range of motion, and reduced potential for injury. PMID:29078585

Robotic surgery for lung resections-total port approach: advantages and disadvantages.

PubMed

Ramadan, Omar I; Wei, Benjamin; Cerfolio, Robert J

2017-01-01

Minimally invasive thoracic surgery, when compared with open thoracotomy, has been shown to have improved perioperative outcomes as well as comparable long-term survival. Robotic surgery represents a powerful advancement of minimally invasive surgery, with vastly improved visualization and instrument maneuverability, and is increasingly popular for thoracic surgery. However, there remains debate over the best robotic approaches for lung resection, with several different techniques evidenced and described in the literature. We delineate our method for total port approach with four robotic arms and discuss how its advantages outweigh its disadvantages. We conclude that it is preferred to other robotic approaches, such as the robotic assisted approach, due to its enhanced visualization, improved instrument range of motion, and reduced potential for injury.

Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system

PubMed Central

Miller, Larry E; Block, Jon E

2014-01-01

Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry® SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed. PMID:24851059

Advantage of resonant power conversion in aerospace applications

NASA Technical Reports Server (NTRS)

Hansen, I. G.

1983-01-01

An ultrasonic, sinusoidal aerospace power distribution system is shown to have many advantages over other candidate power systems. These advantages include light weight, ease of fault clearing, versatility in handling many loads including motors, and the capability of production within the limits of present technology. References are cited that demonstrate the state of resonant converter technology and support these conclusions.

Transitioning from video-assisted thoracic surgical lobectomy to robotics for lung cancer: are there outcomes advantages?

PubMed

Lee, Benjamin E; Korst, Robert J; Kletsman, Elaine; Rutledge, John R

2014-02-01

To determine if there are advantages to transitioning to robotics by a surgeon who is already proficient in performing video-assisted thoracic surgical (VATS) lobectomy. A single surgeon proficient in VATS lobectomy initiated a robotic lobectomy program, and a retrospective review was conducted of his patients undergoing minimally invasive lobectomy (robotics or VATS) for lung cancer between 2011 and 2012. Data collected included patient/tumor characteristics, morbidity, mortality, operative times, and length of hospital stay. Over a 24-month period, a total of 69 patients underwent minimally invasive lobectomy (35 robotic, 34 VATS). Patients in each group were similar in age and clinical stage. Robotic upper lobectomy operative times were longer than VATS (172 vs 134 minutes; P = .001), with no significant difference in lower lobectomies noted (140 vs 123 minutes; P = .1). Median length of stay was 3 days in both groups, and the median number of lymph nodes harvested was 18 (robotic) versus 16 (VATS; P = .42). Morbidity and mortality for robotic versus VATS were 11% versus 18% (P = .46) and 0% versus 3% (P = .49), respectively. There does not seem to be a significant advantage for an established VATS lobectomy surgeon to transition to robotics based on clinical outcomes. The learning curve for robotic upper lobectomies seems to be more significant than that for lower lobectomies. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

The dorsomedial prefrontal cortex plays a causal role in mediating in-group advantage in emotion recognition: A TMS study.

PubMed

Gamond, L; Cattaneo, Z

2016-12-01

Consistent evidence suggests that emotional facial expressions are better recognized when the expresser and the perceiver belong to the same social group (in-group advantage). In this study, we used transcranial magnetic stimulation (TMS) to investigate the possible causal involvement of the dorsomedial prefrontal cortex (dmPFC) and of the right temporo-parietal junction (TPJ), two main nodes of the mentalizing neural network, in mediating the in-group advantage in emotion recognition. Participants performed an emotion discrimination task in a minimal (blue/green) group paradigm. We found that interfering with activity in the dmPFC significantly interfered with the effect of minimal group-membership on emotion recognition, reducing participants' ability to discriminate emotions expressed by in-group members. In turn, rTPJ mainly affected emotion discrimination per se, irrespective of group membership. Overall, our results point to a causal role of the dmPFC in mediating the in-group advantage in emotion recognition, favoring intragroup communication. Copyright © 2016 Elsevier Ltd. All rights reserved.

From the ground up: building a minimally invasive aortic valve surgery program

PubMed Central

Lamelas, Joseph

2015-01-01

Minimally invasive aortic valve replacement (MIAVR) is associated with numerous advantages including improved patient satisfaction, cosmesis, decreased transfusion requirements, and cost-effectiveness. Despite these advantages, little information exists on how to build a MIAVR program from the ground up. The steps to build a MIAVR program include compiling a multi-disciplinary team composed of surgeons, cardiologists, anesthesiologists, perfusionists, operating room (OR) technicians, and nurses. Once assembled, this team can then approach hospital administrators to present a cost-benefit analysis of MIAVR, emphasizing the importance of reduced resource utilization in the long-term to offset the initial financial investment that will be required. With hospital approval, training can commence to provide surgeons and other staff with the necessary knowledge and skills in MIAVR procedures and outcomes. Marketing and advertising of the program through the use of social media, educational conferences, grand rounds, and printed media will attract the initial patients. A dedicated website for the program can function as a “virtual lobby” for patients wanting to learn more. Initially, conservative selection criteria of cases that qualify for MIAVR will set the program up for success by avoiding complex co-morbidities and surgical techniques. During the learning curve phase of the program, patient safety should be a priority. PMID:25870815

From the ground up: building a minimally invasive aortic valve surgery program.

PubMed

Nguyen, Tom C; Lamelas, Joseph

2015-03-01

Minimally invasive aortic valve replacement (MIAVR) is associated with numerous advantages including improved patient satisfaction, cosmesis, decreased transfusion requirements, and cost-effectiveness. Despite these advantages, little information exists on how to build a MIAVR program from the ground up. The steps to build a MIAVR program include compiling a multi-disciplinary team composed of surgeons, cardiologists, anesthesiologists, perfusionists, operating room (OR) technicians, and nurses. Once assembled, this team can then approach hospital administrators to present a cost-benefit analysis of MIAVR, emphasizing the importance of reduced resource utilization in the long-term to offset the initial financial investment that will be required. With hospital approval, training can commence to provide surgeons and other staff with the necessary knowledge and skills in MIAVR procedures and outcomes. Marketing and advertising of the program through the use of social media, educational conferences, grand rounds, and printed media will attract the initial patients. A dedicated website for the program can function as a "virtual lobby" for patients wanting to learn more. Initially, conservative selection criteria of cases that qualify for MIAVR will set the program up for success by avoiding complex co-morbidities and surgical techniques. During the learning curve phase of the program, patient safety should be a priority.

Minimalism. Clip and Save.

ERIC Educational Resources Information Center

Hubbard, Guy

2002-01-01

Provides background information on the art movement called "Minimalism" discussing why it started and its characteristics. Includes learning activities and information on the artist, Donald Judd. Includes a reproduction of one of his art works and discusses its content. (CMK)

Scheduling Non-Preemptible Jobs to Minimize Peak Demand

DOE PAGES

Yaw, Sean; Mumey, Brendan

2017-10-28

Our paper examines an important problem in smart grid energy scheduling; peaks in power demand are proportionally more expensive to generate and provision for. The issue is exacerbated in local microgrids that do not benefit from the aggregate smoothing experienced by large grids. Demand-side scheduling can reduce these peaks by taking advantage of the fact that there is often flexibility in job start times. We then focus attention on the case where the jobs are non-preemptible, meaning once started, they run to completion. The associated optimization problem is called the peak demand minimization problem, and has been previously shown tomore » be NP-hard. These results include an optimal fixed-parameter tractable algorithm, a polynomial-time approximation algorithm, as well as an effective heuristic that can also be used in an online setting of the problem. Simulation results show that these methods can reduce peak demand by up to 50% versus on-demand scheduling for household power jobs.« less

Scheduling Non-Preemptible Jobs to Minimize Peak Demand

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

Yaw, Sean; Mumey, Brendan

Our paper examines an important problem in smart grid energy scheduling; peaks in power demand are proportionally more expensive to generate and provision for. The issue is exacerbated in local microgrids that do not benefit from the aggregate smoothing experienced by large grids. Demand-side scheduling can reduce these peaks by taking advantage of the fact that there is often flexibility in job start times. We then focus attention on the case where the jobs are non-preemptible, meaning once started, they run to completion. The associated optimization problem is called the peak demand minimization problem, and has been previously shown tomore » be NP-hard. These results include an optimal fixed-parameter tractable algorithm, a polynomial-time approximation algorithm, as well as an effective heuristic that can also be used in an online setting of the problem. Simulation results show that these methods can reduce peak demand by up to 50% versus on-demand scheduling for household power jobs.« less

The minimal axion minimal linear σ model

NASA Astrophysics Data System (ADS)

Merlo, L.; Pobbe, F.; Rigolin, S.

2018-05-01

The minimal SO(5) / SO(4) linear σ model is extended including an additional complex scalar field, singlet under the global SO(5) and the Standard Model gauge symmetries. The presence of this scalar field creates the conditions to generate an axion à la KSVZ, providing a solution to the strong CP problem, or an axion-like-particle. Different choices for the PQ charges are possible and lead to physically distinct Lagrangians. The internal consistency of each model necessarily requires the study of the scalar potential describing the SO(5)→ SO(4), electroweak and PQ symmetry breaking. A single minimal scenario is identified and the associated scalar potential is minimised including counterterms needed to ensure one-loop renormalizability. In the allowed parameter space, phenomenological features of the scalar degrees of freedom, of the exotic fermions and of the axion are illustrated. Two distinct possibilities for the axion arise: either it is a QCD axion with an associated scale larger than ˜ 105 TeV and therefore falling in the category of the invisible axions; or it is a more massive axion-like-particle, such as a 1 GeV axion with an associated scale of ˜ 200 TeV, that may show up in collider searches.

Competitive Intelligence and Social Advantage.

ERIC Educational Resources Information Center

Davenport, Elisabeth; Cronin, Blaise

1994-01-01

Presents an overview of issues concerning civilian competitive intelligence (CI). Topics discussed include competitive advantage in academic and research environments; public domain information and libraries; covert and overt competitive intelligence; data diversity; use of the Internet; cooperative intelligence; and implications for library and…

Minimally invasive tension band wiring technique for olecranon fractures.

PubMed

Takada, Naoya; Kato, Kenji; Fukuta, Makoto; Wada, Ikuo; Otsuka, Takanobu

2013-12-01

Some types of implants, such as plates, screws, wires, and nails, have been used for open reduction and internal fixation of olecranon fractures. A ≥ 10 cm longitudinal incision is used for open reduction and internal fixation of olecranon fractures. According to previous studies, tension band wiring is a popular method that gives good results. However, back out of the wires after the surgery is one of the main postoperative complications. Moreover, if the Kirschner wires are inserted through the anterior ulnar cortex, they may impinge on the radial neck, supinator muscle, or biceps tendon. Herein, we describe the minimally invasive tension band wiring technique using Ring-Pin. This technique can be performed through a 2 cm incision. Small skin incisions are advantageous from an esthetic viewpoint. Ring-Pin was fixed by using a dedicated cable wire that does not back out unless the cable wire breaks or slips out of the dedicated metallic clamp. As the pins are placed in intramedullary canal, this technique does not lead to postoperative complications that may occur after transcortical fixation by conventional tension band wiring. Minimally invasive tension band wiring is one of the useful options for the treatment of olecranon fractures with some advantages.

Minimal-assumption inference from population-genomic data

NASA Astrophysics Data System (ADS)

Weissman, Daniel; Hallatschek, Oskar

Samples of multiple complete genome sequences contain vast amounts of information about the evolutionary history of populations, much of it in the associations among polymorphisms at different loci. Current methods that take advantage of this linkage information rely on models of recombination and coalescence, limiting the sample sizes and populations that they can analyze. We introduce a method, Minimal-Assumption Genomic Inference of Coalescence (MAGIC), that reconstructs key features of the evolutionary history, including the distribution of coalescence times, by integrating information across genomic length scales without using an explicit model of recombination, demography or selection. Using simulated data, we show that MAGIC's performance is comparable to PSMC' on single diploid samples generated with standard coalescent and recombination models. More importantly, MAGIC can also analyze arbitrarily large samples and is robust to changes in the coalescent and recombination processes. Using MAGIC, we show that the inferred coalescence time histories of samples of multiple human genomes exhibit inconsistencies with a description in terms of an effective population size based on single-genome data.

Minimally invasive lumbar foraminotomy.

PubMed

Deutsch, Harel

2013-07-01

Lumbar radiculopathy is a common problem. Nerve root compression can occur at different places along a nerve root's course including in the foramina. Minimal invasive approaches allow easier exposure of the lateral foramina and decompression of the nerve root in the foramina. This video demonstrates a minimally invasive approach to decompress the lumbar nerve root in the foramina with a lateral to medial decompression. The video can be found here: http://youtu.be/jqa61HSpzIA.

Weighing the Benefits of Studying a Foreign Language at a Younger Starting Age in a Minimal Input Situation

ERIC Educational Resources Information Center

Larson-Hall, Jenifer

2008-01-01

This study examined whether a younger starting age is advantageous in a situation of minimal exposure to an instructed foreign language ([less than or equal] 4 hours classroom contact per week). Previous theoretical and empirical studies indicated there should be no advantage for an earlier start. Japanese college students who started studying…

Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal.

PubMed

Shire, Stephanie Y; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

2015-06-01

Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement.

Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal

PubMed Central

Goods, Kelly; Shih, Wendy; Mucchetti, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

2015-01-01

Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468–478, 2013). Sixty-one children with autism age 5–8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent–child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84–96, 2009). Parents mastered an average of 70 % of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement. PMID:25475363

Interactive MR image guidance for neurosurgical and minimally invasive procedures

NASA Astrophysics Data System (ADS)

Wong, Terence Z.; Schwartz, Richard B.; Pergolizzi, Richard S., Jr.; Black, Peter M.; Kacher, Daniel F.; Morrison, Paul R.; Jolesz, Ferenc A.

1999-05-01

Advantages of MR imaging for guidance of minimally invasive procedures include exceptional soft tissue contrast, intrinsic multiplanar imaging capability, and absence of exposure to ionizing radiation. Specialized imaging sequences are available and under development which can further enhance diagnosis and therapy. Flow-sensitive imaging techniques can be used to identify vascular structures. Temperature-sensitive imaging is possible which can provide interactive feedback prior to, during, and following the delivery of thermal energy. Functional MR imaging and dynamic contrast-enhanced MRI sequences can provide additional information for guidance in neurosurgical applications. Functional MR allows mapping of eloquent areas in the brain, so that these areas may be avoided during therapy. Dynamic contrast enhancement techniques can be useful for distinguishing active tumor from tumor necrosis caused by previous radiation therapy. An open-configuration 0.5T MRI system (GE Signa SP) developed at Brigham and Women's Hospital in collaboration with General Electric Medical Systems is described. Interactive navigation systems have been integrated into the MRI system. The imaging system is sited in an operating room environment, and used for image guided neurosurgical procedures (biopsies and tumor excision), as well as minimally invasive thermal therapies. Examples of MR imaging guidance, navigational techniques, and clinical applications are presented.

Use of simulation to compare the performance of minimization with stratified blocked randomization.

PubMed

Toorawa, Robert; Adena, Michael; Donovan, Mark; Jones, Steve; Conlon, John

2009-01-01

Minimization is an alternative method to stratified permuted block randomization, which may be more effective at balancing treatments when there are many strata. However, its use in the regulatory setting for industry trials remains controversial, primarily due to the difficulty in interpreting conventional asymptotic statistical tests under restricted methods of treatment allocation. We argue that the use of minimization should be critically evaluated when designing the study for which it is proposed. We demonstrate by example how simulation can be used to investigate whether minimization improves treatment balance compared with stratified randomization, and how much randomness can be incorporated into the minimization before any balance advantage is no longer retained. We also illustrate by example how the performance of the traditional model-based analysis can be assessed, by comparing the nominal test size with the observed test size over a large number of simulations. We recommend that the assignment probability for the minimization be selected using such simulations. Copyright (c) 2008 John Wiley & Sons, Ltd.

Did Babe Ruth Have a Comparative Advantage as a Pitcher?

ERIC Educational Resources Information Center

Scahill, Edward M.

1990-01-01

Advocates using baseball statistics to illustrate the advantages of specialization in production. Using Babe Ruth's record as an analogy, suggests a methodology for determining a player's comparative advantage as a teaching illustration. Includes the team's statistical profile in five tables to explain comparative advantage and profit maximizing.…

KENNEDY SPACE CENTER, FLA. - Launch Pad 39A undergoes sandblasting of its metal structures and surfaces. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - Launch Pad 39A undergoes sandblasting of its metal structures and surfaces. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

Use of minimally invasive spine surgical instruments for the treatment of bone tumors.

PubMed

Reeves, Russell A; DeWolf, Matthew C; Shaughnessy, Peter J; Ames, James B; Henderson, Eric R

2017-11-01

Orthopedic oncologists often encounter patients with minor bony lesions that are difficult to access surgically and therefore require large exposures out of proportion to the severity of disease that confer significant patient morbidity. Minimally invasive surgical techniques offer the advantage of smaller incisions, shorter operative times, decreased tissue damage, and decreased costs. A variety of surgical procedures have emerged using minimally invasive technologies, particularly in the field of spine surgery. Areas covered: In this article, we describe the Minimal Exposure Tubular Retractor (METRx TM ) System which is a minimally invasive surgical device that utilizes a series of dilators to permit access to a surgical site of interest. This system was developed for use in treatment of disc herniation, spinal stenosis, posterior lumbar interbody fusion, transforaminal lumbar interbody fusion and spinal cord stimulation implantation. We also describe novel uses of this system for minimally invasive biopsy and treatment of benign and metastatic bone lesions at our institution. Expert commentary: Minimally invasive surgical techniques will continue to expand into the field of orthopedic oncology. With a greater number of studies proving the safety and effectiveness of this technique, the demand for minimally invasive treatments will grow.

Minimal Pruning and Reduced Plant Protection Promote Predatory Mites in Grapevine

PubMed Central

Pennington, Theresa; Kraus, Christian; Alakina, Ekatarina; Entling, Martin H.; Hoffmann, Christoph

2017-01-01

Improving natural pest control by promoting high densities of predatory mites (Acari: Phytoseiidae) is an effective way to prevent damage by pest mites (e.g., Eriophyidae, Tetranychidae) and other arthropod taxa that can cause serious damage to vineyards. Here, we investigate the influence of innovative management on predatory mite densities. We compare (i) full versus reduced fungicide applications and (ii) minimal pruning versus a traditional trellis pruning system in four fungus-resistant grapevine varieties. As predatory mites also feed on fungus mycelium, we assessed fungal infection of grapevine leaves in the experimental vineyard. Predatory mites were significantly more abundant in both minimal pruning and under reduced plant protection. Increases in predatory mites appeared to be independent of fungal infection, suggesting mostly direct effects of reduced fungicides and minimal pruning. In contrast to predatory mites, pest mites did not increase under innovative management. Thus, conditions for natural pest control are improved in fungus-resistant grapevines and under minimal pruning, which adds to other advantages such as environmental safety and reduced production cost. PMID:28820436

Efficient Deterministic Finite Automata Minimization Based on Backward Depth Information.

PubMed

Liu, Desheng; Huang, Zhiping; Zhang, Yimeng; Guo, Xiaojun; Su, Shaojing

2016-01-01

Obtaining a minimal automaton is a fundamental issue in the theory and practical implementation of deterministic finite automatons (DFAs). A minimization algorithm is presented in this paper that consists of two main phases. In the first phase, the backward depth information is built, and the state set of the DFA is partitioned into many blocks. In the second phase, the state set is refined using a hash table. The minimization algorithm has a lower time complexity O(n) than a naive comparison of transitions O(n2). Few states need to be refined by the hash table, because most states have been partitioned by the backward depth information in the coarse partition. This method achieves greater generality than previous methods because building the backward depth information is independent of the topological complexity of the DFA. The proposed algorithm can be applied not only to the minimization of acyclic automata or simple cyclic automata, but also to automata with high topological complexity. Overall, the proposal has three advantages: lower time complexity, greater generality, and scalability. A comparison to Hopcroft's algorithm demonstrates experimentally that the algorithm runs faster than traditional algorithms.

Efficient Deterministic Finite Automata Minimization Based on Backward Depth Information

PubMed Central

Liu, Desheng; Huang, Zhiping; Zhang, Yimeng; Guo, Xiaojun; Su, Shaojing

2016-01-01

Obtaining a minimal automaton is a fundamental issue in the theory and practical implementation of deterministic finite automatons (DFAs). A minimization algorithm is presented in this paper that consists of two main phases. In the first phase, the backward depth information is built, and the state set of the DFA is partitioned into many blocks. In the second phase, the state set is refined using a hash table. The minimization algorithm has a lower time complexity O(n) than a naive comparison of transitions O(n2). Few states need to be refined by the hash table, because most states have been partitioned by the backward depth information in the coarse partition. This method achieves greater generality than previous methods because building the backward depth information is independent of the topological complexity of the DFA. The proposed algorithm can be applied not only to the minimization of acyclic automata or simple cyclic automata, but also to automata with high topological complexity. Overall, the proposal has three advantages: lower time complexity, greater generality, and scalability. A comparison to Hopcroft’s algorithm demonstrates experimentally that the algorithm runs faster than traditional algorithms. PMID:27806102

Sonic-boom minimization.

NASA Technical Reports Server (NTRS)

Seebass, R.; George, A. R.

1972-01-01

There have been many attempts to reduce or eliminate the sonic boom. Such attempts fall into two categories: (1) aerodynamic minimization and (2) exotic configurations. In the first category changes in the entropy and the Bernoulli constant are neglected and equivalent body shapes required to minimize the overpressure, the shock pressure rise and the impulse are deduced. These results include the beneficial effects of atmospheric stratification. In the second category, the effective length of the aircraft is increased or its base area decreased by modifying the Bernoulli constant a significant fraction of the flow past the aircraft. A figure of merit is introduced which makes it possible to judge the effectiveness of the latter schemes.

Minimally invasive percutaneous nephrolithotomy in preschool age children with kidney calculi (including stones induced by melamine-contaminated milk powder).

PubMed

Yan, Xiang; Al-Hayek, Samih; Gan, Weidong; Zhu, Wei; Li, Xiaogong; Guo, Hongqian

2012-10-01

This study was undertaken to assess the safety and efficacy of minimally invasive percutaneous nephrolithotomy (mini-PCNL) using ureteroscope and pneumatic intracorporeal lithotripsy in preschool age children with kidney calculi. We studied 27 renal units in 20 patients of preschool age (≤ 6 years) who underwent mini-PCNL at our institute. The mean age was 42.6 months (range 14-68 months). The average stone burden was 1.85 cm (range 0.9-2.8 cm). Eight patients aged 14 to 58 months had been exposed to melamine-tainted powdered formula. The mini-PCNL was performed with an X-ray-guided peripheral puncture. Minimal tract dilatation was undertaken to fit a 14-16 Fr peel-away sheath. Ureteroscope and pneumatic intracorporeal lithotripsy were used to fragment the stones. Complete clearance was achieved in 23 renal units (85.2 %) with mini-PCNL monotherapy. This has increased to 92.6 % after adjunctive ESWL. The average fall in hemoglobin was 1.28 g/dL. None of the patients required blood transfusion. The median length of hospital stay was 8.2 days. Patients were followed up every 6 months for 2 years. There has been only one recurrence of stone and no long-term complications. Mini-PCNL is a effective treatment for pediatric kidney stones refractory to extracorporeal shock wave lithotripsy, including stones induced by melamine-contaminated milk powder. The "mini-PCNL" technique, which uses ureteroscope and pneumatic intracorporeal lithotripsy, is a safe and feasible modality for treating renal calculi in preschool age children.

New minimally access hydrocelectomy.

PubMed

Saber, Aly

2011-02-01

To ascertain the acceptability of minimally access hydrocelectomy through a 2-cm incision and the outcome in terms of morbidity reduction and recurrence rate. Although controversy exists regarding the treatment of hydrocele, hydrocelectomy remains the treatment of choice for hydroceles. However, the standard surgical procedures for hydrocele can cause postoperative discomfort and complications. A total of 42 adult patients, aged 18-56 years, underwent hydrocelectomy as an outpatient procedure using a 2-cm scrotal skin incision and excision of only a small disk of the parietal tunica vaginalis. The operative time was 12-18 minutes (mean 15). The outcome measures included patient satisfaction and postoperative complications. This procedure requires minor dissection and minimal manipulation during treatment. It also resulted in no recurrence and minimal complications and required a short operative time. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison Between Minimally Invasive and Open Pancreaticoduodenectomy: A Systematic Review.

PubMed

Doula, Chrysoula; Kostakis, Ioannis D; Damaskos, Christos; Machairas, Nikolaos; Vardakostas, Dimitrios V; Feretis, Themistoklis; Felekouras, Evangelos

2016-02-01

Minimally invasive approaches (laparoscopic or robotic) are used in various operations. Our aim was to compare them with the open approach in pancreaticoduodenectomy. We conducted a search for articles published in MEDLINE database comparing minimally invasive (laparoscopic or robotic) with open pancreaticoduodenectomy on June 15, 2014. Our search yielded 136 articles. We excluded 122 articles and we took into consideration 14 (10 for laparoscopic and 4 for robotic pancreaticoduodenectomies). Most cases were related to malignant diseases and tumors treated with minimally invasive operations tended to be smaller. There were relatively high conversion rates in both laparoscopic (0% to 15%) and robotic procedures (4.5% to 10%). There were no significant differences regarding resection margins, rates of pancreatic fistula formation, bile leak, and delayed gastric emptying, reoperation rates, and intraoperative and postoperative mortality. On the contrary, blood loss was less in minimally invasive than open operations, although this difference was not always significant. Moreover, totally laparoscopic and robotic procedures lasted longer than the open ones, whereas hand-assisted laparoscopic procedures did not. However, the findings regarding the number of the retrieved lymph nodes, the length of hospital stay, and costs were inconclusive and controversial. Laparoscopic and robotic pancreaticoduodenectomy are feasible, safe, and oncologically equivalent alternatives to open pancreaticoduodenectomy. Minimally invasive operations have the advantage of the less blood loss, but totally laparoscopic and robotic procedures last longer than open procedures.

Is bilingualism losing its advantage? A bibliometric approach

PubMed Central

López-Penadés, Raúl; Buil-Legaz, Lucía; Aguilar-Mediavilla, Eva; Adrover-Roig, Daniel

2017-01-01

This study uses several bibliometric indices to explore the temporal course of publication trends regarding the bilingual advantage in executive control over a ten-year window. These indices include the number of published papers, numbers of citations, and the journal impact factor. According to the information available in their abstracts, studies were classified into one of four categories: supporting, ambiguous towards, not mentioning, or challenging the bilingual advantage. Results show that the number of papers challenging the bilingual advantage increased notably in 2014 and 2015. Both the average impact factor and the accumulated citations as of June 2016 were equivalent between categories. However, of the studies published in 2014, those that challenge the bilingual advantage accumulated more citations in June 2016 than those supporting it. Our findings offer evidence-based bibliometric information about the current state of the literature and suggest a change in publication trends regarding the literature on the bilingual advantage. PMID:28426797

Minimizing electrode contamination in an electrochemical cell

DOEpatents

Kim, Yu Seung; Zelenay, Piotr; Johnston, Christina

2014-12-09

An electrochemical cell assembly that is expected to prevent or at least minimize electrode contamination includes one or more getters that trap a component or components leached from a first electrode and prevents or at least minimizes them from contaminating a second electrode.

Reducing robotic prostatectomy costs by minimizing instrumentation.

PubMed

Delto, Joan C; Wayne, George; Yanes, Rafael; Nieder, Alan M; Bhandari, Akshay

2015-05-01

Since the introduction of robotic surgery for radical prostatectomy, the cost-benefit of this technology has been under scrutiny. While robotic surgery professes to offer multiple advantages, including reduced blood loss, reduced length of stay, and expedient recovery, the associated costs tend to be significantly higher, secondary to the fixed cost of the robot as well as the variable costs associated with instrumentation. This study provides a simple framework for the careful consideration of costs during the selection of equipment and materials. Two experienced robotic surgeons at our institution as well as several at other institutions were queried about their preferred instrument usage for robot-assisted prostatectomy. Costs of instruments and materials were obtained and clustered by type and price. A minimal set of instruments was identified and compared against alternative instrumentation. A retrospective review of 125 patients who underwent robotically assisted laparoscopic prostatectomy for prostate cancer at our institution was performed to compare estimated blood loss (EBL), operative times, and intraoperative complications for both surgeons. Our surgeons now conceptualize instrument costs as proportional changes to the cost of the baseline minimal combination. Robotic costs at our institution were reduced by eliminating an energy source like the Ligasure or vessel sealer, exploiting instrument versatility, and utilizing inexpensive tools such as Hem-o-lok clips. Such modifications reduced surgeon 1's cost of instrumentation to ∼40% less compared with surgeon 2 and up to 32% less than instrumentation used by surgeons at other institutions. Surgeon 1's combination may not be optimal for all robotic surgeons; however, it establishes a minimally viable toolbox for our institution through a rudimentary cost analysis. A similar analysis may aid others in better conceptualizing long-term costs not as nominal, often unwieldy prices, but as percent changes in

Fourier Transform Infrared Spectroscopy: Part II. Advantages of FT-IR.

ERIC Educational Resources Information Center

Perkins, W. D.

1987-01-01

This is Part II in a series on Fourier transform infrared spectroscopy (FT-IR). Described are various advantages of FT-IR spectroscopy including energy advantages, wavenumber accuracy, constant resolution, polarization effects, and stepping at grating changes. (RH)

Approximate error conjugation gradient minimization methods

DOEpatents

Kallman, Jeffrey S

2013-05-21

In one embodiment, a method includes selecting a subset of rays from a set of all rays to use in an error calculation for a constrained conjugate gradient minimization problem, calculating an approximate error using the subset of rays, and calculating a minimum in a conjugate gradient direction based on the approximate error. In another embodiment, a system includes a processor for executing logic, logic for selecting a subset of rays from a set of all rays to use in an error calculation for a constrained conjugate gradient minimization problem, logic for calculating an approximate error using the subset of rays, and logic for calculating a minimum in a conjugate gradient direction based on the approximate error. In other embodiments, computer program products, methods, and systems are described capable of using approximate error in constrained conjugate gradient minimization problems.

A limited-angle CT reconstruction method based on anisotropic TV minimization.

PubMed

Chen, Zhiqiang; Jin, Xin; Li, Liang; Wang, Ge

2013-04-07

This paper presents a compressed sensing (CS)-inspired reconstruction method for limited-angle computed tomography (CT). Currently, CS-inspired CT reconstructions are often performed by minimizing the total variation (TV) of a CT image subject to data consistency. A key to obtaining high image quality is to optimize the balance between TV-based smoothing and data fidelity. In the case of the limited-angle CT problem, the strength of data consistency is angularly varying. For example, given a parallel beam of x-rays, information extracted in the Fourier domain is mostly orthogonal to the direction of x-rays, while little is probed otherwise. However, the TV minimization process is isotropic, suggesting that it is unfit for limited-angle CT. Here we introduce an anisotropic TV minimization method to address this challenge. The advantage of our approach is demonstrated in numerical simulation with both phantom and real CT images, relative to the TV-based reconstruction.

Medicare Advantage Plans

MedlinePlus

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Improving Minimally Invasive Adrenalectomy: Selection of Optimal Approach and Comparison of Outcomes.

PubMed

Lairmore, Terry C; Folek, Jessica; Govednik, Cara M; Snyder, Samuel K

2016-07-01

Minimally invasive adrenalectomy is commonly performed by either a transperitoneal laparoscopic (TLA) or posterior retroperitoneoscopic (PRA) approach. Our group described the technique for robot-assisted PRA (RAPRA) in 2010. Few studies are available that directly compare outcomes between the available operative approaches. We reviewed our results for minimally invasive adrenalectomy using the three different approaches over a 10-year period. Between January 2005 and April 2015, 160 minimally invasive adrenalectomies were performed. Clinicopathologic data were prospectively collected and retrospectively analyzed. The primary endpoints evaluated were operative time, blood loss, length of stay (LOS), and morbidity. The study included 67 TLA, 76 PRA, and 17 RAPRA procedures. Tumor size for PRA/RAPRA was smaller than for patients undergoing TLA (2.38 vs 3.6 cm, p ≤ 0.0001). Procedure time was shorter for PRA versus TLA (133.3 vs 152.8 min, p = 0.0381), as was LOS (1.85 vs 2.82 days, p = 0.0145). Procedure time was longer in RAPRA versus TLA/PRA (177 vs 153/133 min, p = 0.008), but LOS was significantly decreased (1.53 vs 2.82/1.85 days, p = 0.004). Minimally invasive adrenalectomy is associated with expected excellent outcomes regardless of approach. In our series, the posterior approach is associated with decreased operative time and LOS. Robotic technology provides potential advantages for the surgeon at the expense of more complex setup requirements and costs. Further study is required to demonstrate clear benefit of one surgical approach. Utilization of the entire spectrum of available operative techniques can allow for selection of the optimal approach based on individual patient factors.

Minimally invasive mitral valve surgery through right mini-thoracotomy: recommendations for good exposure, stable cardiopulmonary bypass, and secure myocardial protection.

PubMed

Ito, Toshiaki

2015-07-01

An apparent advantage of minimally invasive mitral surgery through right mini-thoracotomy is cosmetic appearance. Possible advantages of this procedure are a shorter ventilation time, shorter hospital stay, and less blood transfusion. With regard to hard endpoints, such as operative mortality, freedom from reoperation, or cardiac death, this method is reportedly equivalent, but not superior, to the standard median sternotomy technique. However, perfusion-related complications (e.g., stroke, vascular damage, and limb ischemia) tend to occur more frequently in minimally invasive technique than with the standard technique. In addition, valve repair through a small thoracotomy is technically demanding. Therefore, screening out patients who are not appropriate for performing minimally invasive surgery is the first step. Vascular disease and inadequate anatomy can be evaluated with contrast-enhanced computed tomography. Peripheral cannulation should be carefully performed, using transesophageal echocardiography guidance. Preoperative detailed planning of the valve repair process is desirable because every step is time-consuming in minimally invasive surgery. Three-dimensional echocardiography is a powerful tool for this purpose. For satisfactory exposure and detailed observation of the valve, a special left atrial retractor and high-definition endoscope are useful. Valve repair can be performed in minimally invasive surgery as long as cardiopulmonary bypass is stable and bloodless exposure of the valve is obtained.

The minimal residual QR-factorization algorithm for reliably solving subset regression problems

NASA Technical Reports Server (NTRS)

Verhaegen, M. H.

1987-01-01

A new algorithm to solve test subset regression problems is described, called the minimal residual QR factorization algorithm (MRQR). This scheme performs a QR factorization with a new column pivoting strategy. Basically, this strategy is based on the change in the residual of the least squares problem. Furthermore, it is demonstrated that this basic scheme might be extended in a numerically efficient way to combine the advantages of existing numerical procedures, such as the singular value decomposition, with those of more classical statistical procedures, such as stepwise regression. This extension is presented as an advisory expert system that guides the user in solving the subset regression problem. The advantages of the new procedure are highlighted by a numerical example.

Maintaining oncologic integrity with minimally invasive resection of pediatric embryonal tumors.

PubMed

Phelps, Hannah M; Ayers, Gregory D; Ndolo, Josephine M; Dietrich, Hannah L; Watson, Katherine D; Hilmes, Melissa A; Lovvorn, Harold N

2018-05-08

Embryonal tumors arise typically in infants and young children and are often massive at presentation. Operative resection is a cornerstone in the multimodal treatment of embryonal tumors but potentially disrupts therapeutic timelines. When used appropriately, minimally invasive surgery can minimize treatment delays. The oncologic integrity and safety attainable with minimally invasive resection of embryonal tumors, however, remains controversial. Query of the Vanderbilt Cancer Registry identified all children treated for intracavitary, embryonal tumors during a 15-year period. Tumors were assessed radiographically to measure volume (mL) and image-defined risk factors (neuroblastic tumors only) at time of diagnosis, and at preresection and postresection. Patient and tumor characteristics, perioperative details, and oncologic outcomes were compared between minimally invasive surgery and open resection of tumors of comparable size. A total of 202 patients were treated for 206 intracavitary embryonal tumors, of which 178 were resected either open (n = 152, 85%) or with minimally invasive surgery (n = 26, 15%). The 5-year, relapse-free, and overall survival were not significantly different after minimally invasive surgery or open resection of tumors having a volume less than 100 mL, corresponding to the largest resected with minimally invasive surgery (P = .249 and P = .124, respectively). No difference in margin status or lymph node sampling between the 2 operative approaches was detected (p = .333 and p = .070, respectively). Advantages associated with minimally invasive surgery were decreased blood loss (P < .001), decreased operating time (P = .002), and shorter hospital stay (P < .001). Characteristically, minimally invasive surgery was used for smaller volume and earlier stage neuroblastic tumors without image-defined risk factors. When selected appropriately, minimally invasive resection of pediatric embryonal tumors, particularly

Shapes of embedded minimal surfaces

PubMed Central

Colding, Tobias H.; Minicozzi, William P.

2006-01-01

Surfaces that locally minimize area have been extensively used to model physical phenomena, including soap films, black holes, compound polymers, protein folding, etc. The mathematical field dates to the 1740s but has recently become an area of intense mathematical and scientific study, specifically in the areas of molecular engineering, materials science, and nanotechnology because of their many anticipated applications. In this work, we show that all minimal surfaces are built out of pieces of the surfaces in Figs. 1 and 2. PMID:16847265

Robustness of the Sequential Lineup Advantage

ERIC Educational Resources Information Center

Gronlund, Scott D.; Carlson, Curt A.; Dailey, Sarah B.; Goodsell, Charles A.

2009-01-01

A growing movement in the United States and around the world involves promoting the advantages of conducting an eyewitness lineup in a sequential manner. We conducted a large study (N = 2,529) that included 24 comparisons of sequential versus simultaneous lineups. A liberal statistical criterion revealed only 2 significant sequential lineup…

Is There a Cosmetic Advantage to Single-Incision Laparoscopic Surgical Techniques Over Standard Laparoscopic Surgery? A Systematic Review and Meta-analysis.

PubMed

Evans, Luke; Manley, Kate

2016-06-01

Single-incision laparoscopic surgery represents an evolution of minimally invasive techniques, but has been a controversial development. A cosmetic advantage is stated by many authors, but has not been found to be universally present or even of considerable importance by patients. This systematic review and meta-analysis demonstrates that there is a cosmetic advantage of the technique regardless of the operation type. The treatment effect in terms of cosmetic improvement is of the order of 0.63.

Hydrodynamic advantages of swimming by salp chains.

PubMed

Sutherland, Kelly R; Weihs, Daniel

2017-08-01

Salps are marine invertebrates comprising multiple jet-propelled swimming units during a colonial life-cycle stage. Using theory, we show that asynchronous swimming with multiple pulsed jets yields substantial hydrodynamic benefit due to the production of steady swimming velocities, which limit drag. Laboratory comparisons of swimming kinematics of aggregate salps ( Salpa fusiformis and Weelia cylindrica ) using high-speed video supported that asynchronous swimming by aggregates results in a smoother velocity profile and showed that this smoother velocity profile is the result of uncoordinated, asynchronous swimming by individual zooids. In situ flow visualizations of W. cylindrica swimming wakes revealed that another consequence of asynchronous swimming is that fluid interactions between jet wakes are minimized. Although the advantages of multi-jet propulsion have been mentioned elsewhere, this is the first time that the theory has been quantified and the role of asynchronous swimming verified using experimental data from the laboratory and the field. © 2017 The Author(s).

Thoracoscopic versus robotic approaches: advantages and disadvantages.

PubMed

Wei, Benjamin; D'Amico, Thomas A

2014-05-01

The overall advantages of thoracoscopy over thoracotomy in terms of patient recovery have been fairly well established. The use of robotics, however, is a newer and less proven modality in the realm of thoracic surgery. Robotics offers distinct advantages and disadvantages in comparison with video-assisted thoracoscopic surgery. Robotic technology is now used for a variety of complex cardiac, urologic, and gynecologic procedures including mitral valve repair and microsurgical treatment of male infertility. This article addresses the potential benefits and limitations of using the robotic platform for the performance of a variety of thoracic operations. Copyright © 2014 Elsevier Inc. All rights reserved.

Advantages and Disadvantages of Aquatic Plant Management Techniques

DTIC Science & Technology

2000-09-01

This report provides an overview of the environmental and practical advantages and disadvantages of the major aquatic plant management methods, including biological, chemical, mechanical, and physical control techniques.

Modular minimally invasive extracorporeal circulation systems; can they become the standard practice for performing cardiac surgery?

PubMed

Anastasiadis, K; Antonitsis, P; Argiriadou, H; Deliopoulos, A; Grosomanidis, V; Tossios, P

2015-04-01

Minimally invasive extracorporeal circulation (MiECC) has been developed in an attempt to integrate all advances in cardiopulmonary bypass technology in one closed circuit that shows improved biocompatibility and minimizes the systemic detrimental effects of CPB. Despite well-evidenced clinical advantages, penetration of MiECC technology into clinical practice is hampered by concerns raised by perfusionists and surgeons regarding air handling together with blood and volume management during CPB. We designed a modular MiECC circuit, bearing an accessory circuit for immediate transition to an open system that can be used in every adult cardiac surgical procedure, offering enhanced safety features. We challenged this modular circuit in a series of 50 consecutive patients. Our results showed that the modular AHEPA circuit design offers 100% technical success rate in a cohort of random, high-risk patients who underwent complex procedures, including reoperation and valve and aortic surgery, together with emergency cases. This pilot study applies to the real world and prompts for further evaluation of modular MiECC systems through multicentre trials. © The Author(s) 2015.

Technical advantages of disk laser technology in short and ultrashort pulse processes

NASA Astrophysics Data System (ADS)

Graham, P.; Stollhof, J.; Weiler, S.; Massa, S.; Faisst, B.; Denney, P.; Gounaris, E.

2011-03-01

This paper demonstrates that disk-laser technology introduces advantages that increase efficiency and allows for high productivity in micro-processing in both the nanosecond (ns) and picosecond (ps) regimes. Some technical advantages of disk technology include not requiring good pump beam quality or special wavelengths for pumping of the disk, high optical efficiencies, no thermal lensing effects and a possible scaling of output power without an increase of pump beam quality. With cavity-dumping, the pulse duration of the disk laser can be specified between 30 and hundreds of nanoseconds, but is independent of frequency, thus maintaining process stability. TRUMPF uses this technology in the 750 watts average power laser TruMicro 7050. High intensity, along with fluency, is important for high ablation rates in thinfilm removal. Thus, these ns lasers show high removal rates, above 60 cm2/s, in thin-film solar cell production. In addition, recent results in paint-stripping of aerospace material prove the green credentials and high processing rates inherent with this technology as it can potentially replace toxic chemical processes. The ps disk technology meanwhile is used in, for example, scribing of solar cells, wafer dicing and drilling injector nozzles, as the pulse duration is short enough to minimize heat input in the laser-matter interaction. In the TruMicro Series 5000, the multi-pass regenerative amplifier stage combines high optical-optical efficiencies together with excellent output beam quality for pulse durations of only 6 ps and high pulse energies of up to 0.25 mJ.

Detachable clamps for minimal access surgery.

PubMed

Frank, T; Willetts, G J; Cuschieri, A

1995-01-01

A detachable clamp and applicator have been developed for use in minimal access surgical operations involving hollow visceral transection and anastomosis. The clamp has parallel jaws which ensure uniform distribution of the occlusive force. Following application on the bowel, the clamp is released from the applicator, thus freeing the access port. On completion of the anastomosis, the clamp is docked to the applicator, its jaws opened for release from the bowel and then closed prior to removal. The jaws of the clamp are kept closed by a pseudoelastic nickel-titanium (NiTi) alloy spring which imparts advantageous force characteristics when compared to stainless steel. The excellent holding and atraumatic characteristics of the detachable clamp have been confirmed by use in laparoscopic and thoracoscopic surgery on the gastrointestinal tract.

Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

PubMed

Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

2011-01-01

The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.

Minimally invasive treatment of ureteropelvic junction obstruction: a critical analysis of results.

PubMed

Eden, Christopher G

2007-10-01

To analyse the indications and long-term results of endoscopic and minimal access approaches for the treatment of ureteropelvic junction (UPJ) obstruction and to compare them to open surgery. A review of the literature from 1950 to January 2007 was conducted using the Ovid Medline database. A lack of standardisation of techniques used to diagnose UPJ obstruction and to follow up treated patients introduces a degree of inaccuracy in interpreting the success rates of the various modalities of treatment. However, there is no indication that any one of these techniques is affected by this to a greater or lesser extent than another. Open pyeloplasty achieves very good (90-100% success) results, endopyelotomy and balloon disruption of the UPJ fail to match these results by 15-20%, and minimal access pyeloplasty produces results that are at least as good as those of open surgery but with the advantages of a minimal access approach. Minimal access pyeloplasty is likely to gradually replace endopyelotomy and balloon disruption of the UPJ for the treatment of UPJ obstruction. The much higher cost of robotic pyeloplasty and greater availability of laparoscopic expertise in teaching centres are likely to limit the dissemination of robotic pyeloplasty.

Rule extraction from minimal neural networks for credit card screening.

PubMed

Setiono, Rudy; Baesens, Bart; Mues, Christophe

2011-08-01

While feedforward neural networks have been widely accepted as effective tools for solving classification problems, the issue of finding the best network architecture remains unresolved, particularly so in real-world problem settings. We address this issue in the context of credit card screening, where it is important to not only find a neural network with good predictive performance but also one that facilitates a clear explanation of how it produces its predictions. We show that minimal neural networks with as few as one hidden unit provide good predictive accuracy, while having the added advantage of making it easier to generate concise and comprehensible classification rules for the user. To further reduce model size, a novel approach is suggested in which network connections from the input units to this hidden unit are removed by a very straightaway pruning procedure. In terms of predictive accuracy, both the minimized neural networks and the rule sets generated from them are shown to compare favorably with other neural network based classifiers. The rules generated from the minimized neural networks are concise and thus easier to validate in a real-life setting.

Privilege and status in an unequal society: shifting the focus of health promotion research to include the maintenance of advantage.

PubMed

Stephens, Christine

2010-10-01

There has been a great deal of social policy and health promotion practice directed toward the inclusion of underprivileged groups with the aim of improving their health. This focus on disadvantaged people and poor communities, to help them empower themselves and improve their lot, often fails because it ignores the role of the broader society. We neglect to note the crucial part that the advantaged play in perpetuating inequalities. Theory and empirical work from sociology and anthropology points to the everyday ways in which privileged people are able to maintain their advantage and even hi-jack the benefits of public health programmes designed to improve the health of the poor. Some examples from these other disciplines suggest ways in which a social psychological perspective can contribute to an understanding of how inequalities and poverty are perpetuated in everyday life. These understandings will inform the effectiveness of social programmes to reduce inequalities.

[Minimally invasive surgery and the economics of it. Can minimally invasive surgery be cost efficient from a business point of view?].

PubMed

Ritz, J P; Stufler, M; Buhr, H J

2007-06-01

Minimally invasive surgery (MIS) is now accepted as equally valid as the use of a standard access in some areas of surgery. It is not possible to decide whether this access is economically worthwhile and if so for whom without a full economic cost-benefit analysis, which must take account of the hospital's own characteristics in addition to the cost involved for surgery, staff, infrastructure and administration. In summary, the main economic advantage of MIS lies in the patient-related early postoperative results, while the main disadvantage is that the operative material costs are higher. At present, the payment made for each procedure performed under the DRG system includes 14-17% of the total cost for materials, regardless of the access route and of the technical sophistication of the operation. The actual material costs are greater by a factor of 2-50 for MIS than for a conventional procedure. The task of the hospital is thus to lower the costs for material and infrastructure; that of industry is to offer less expensive alternatives; and that of our politicians, to implement better remuneration of the material costs.

Creating Competitive Advantage through Effective Management Education.

ERIC Educational Resources Information Center

Longenecker, Clinton O.; Ariss, Sonny S.

2002-01-01

Managers trained in executive education programs (n=203) identified ways in which management education can increase an organization's competitive advantage: exposure to new ideas and practices, skill development, and motivation. Characteristics of effective management education included experience-based learning orientation, credible instructors,…

Temperature and pressure fiber-optic sensors applied to minimally invasive diagnostics and therapies

NASA Astrophysics Data System (ADS)

Hamel, Caroline; Pinet, Éric

2006-02-01

We present how fiber-optic temperature or pressure sensors could be applied to minimally invasive diagnostics and therapies. For instance a miniature pressure sensor based on micro-optical mechanical systems (MOMS) could solve most of the problems associated with fluidic pressure transduction presently used for triggering purposes. These include intra-aortic balloon pumping (IABP) therapy and other applications requiring detection of fast and/or subtle fluid pressure variations such as for intracranial pressure monitoring or for urology diagnostics. As well, miniature temperature sensors permit minimally invasive direct temperature measurement in diagnostics or therapies requiring energy transfer to living tissues. The extremely small size of fiber-optic sensors that we have developed allows quick and precise in situ measurements exactly where the physical parameters need to be known. Furthermore, their intrinsic immunity to electromagnetic interference (EMI) allows for the safe use of EMI-generating therapeutic or diagnostic equipments without compromising the signal quality. With the trend of ambulatory health care and the increasing EMI noise found in modern hospitals, the use of multi-parameter fiber-optic sensors will improve constant patient monitoring without any concern about the effects of EMI disturbances. The advantages of miniature fiberoptic sensors will offer clinicians new monitoring tools that open the way for improved diagnostic accuracy and new therapeutic technologies.

KENNEDY SPACE CENTER, FLA. - A worker sandblasts the surface behind the Mobile Launcher Platform on Launch Pad 39A . Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - A worker sandblasts the surface behind the Mobile Launcher Platform on Launch Pad 39A . Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who Are Minimally Verbal

ERIC Educational Resources Information Center

Shire, Stephanie Y.; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

2015-01-01

Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in "Autism Res" 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication…

[Internet research methods: advantages and challenges].

PubMed

Liu, Yi; Tien, Yueh-Hsuan

2009-12-01

Compared to traditional research methods, using the Internet to conduct research offers a number of advantages to the researcher, which include increased access to sensitive issues and vulnerable / hidden populations; decreased data entry time requirements; and enhanced data accuracy. However, Internet research also presents certain challenges to the researcher. In this article, the advantages and challenges of Internet research methods are discussed in four principle issue areas: (a) recruitment, (b) data quality, (c) practicality, and (d) ethics. Nursing researchers can overcome problems related to sampling bias and data truthfulness using creative methods; resolve technical problems through collaboration with other disciplines; and protect participant's privacy, confidentiality and data security by maintaining a high level of vigilance. Once such issues have been satisfactorily addressed, the Internet should open a new window for Taiwan nursing research.

Building Information Model: advantages, tools and adoption efficiency

NASA Astrophysics Data System (ADS)

Abakumov, R. G.; Naumov, A. E.

2018-03-01

The paper expands definition and essence of Building Information Modeling. It describes content and effects from application of Information Modeling at different stages of a real property item. Analysis of long-term and short-term advantages is given. The authors included an analytical review of Revit software package in comparison with Autodesk with respect to: features, advantages and disadvantages, cost and pay cutoff. A prognostic calculation is given for efficiency of adoption of the Building Information Modeling technology, with examples of its successful adoption in Russia and worldwide.

Minimally invasive esophagectomy for esophageal cancer in the People’s Republic of China: an overview

PubMed Central

Zhu, Chengchu; Jin, Ketao

2013-01-01

Since its introduction in the People’s Republic of China in 1992, minimally invasive esophagectomy (MIE) has shown the classical advantages of minimally invasive surgery over its open counterpart. Like all pioneers of the technique, cardiothoracic surgeons in the People’s Republic of China claim that MIE has a lower risk of pulmonary infection, faster recovery, a shorter hospital stay, and a more rapid return to daily activities than open esophagectomy, while offering the same functional and oncologic results. There has been burgeoning interest in MIE in the People’s Republic of China since 1995. The last decade has witnessed nationwide growth in the application of MIE and yielded a significant amount of scientific data in support of its clinical merits and advantages. However, no prospective randomized controlled trials have actually investigated the benefits of MIE in the People’s Republic of China. Here we review the current data and state of the art MIE treatment for esophageal cancer in the People’s Republic of China. PMID:23493989

Next-to-minimal SOFTSUSY

NASA Astrophysics Data System (ADS)

Allanach, B. C.; Athron, P.; Tunstall, Lewis C.; Voigt, A.; Williams, A. G.

2014-09-01

We describe an extension to the SOFTSUSY program that provides for the calculation of the sparticle spectrum in the Next-to-Minimal Supersymmetric Standard Model (NMSSM), where a chiral superfield that is a singlet of the Standard Model gauge group is added to the Minimal Supersymmetric Standard Model (MSSM) fields. Often, a Z3 symmetry is imposed upon the model. SOFTSUSY can calculate the spectrum in this case as well as the case where general Z3 violating (denoted as =) terms are added to the soft supersymmetry breaking terms and the superpotential. The user provides a theoretical boundary condition for the couplings and mass terms of the singlet. Radiative electroweak symmetry breaking data along with electroweak and CKM matrix data are used as weak-scale boundary conditions. The renormalisation group equations are solved numerically between the weak scale and a high energy scale using a nested iterative algorithm. This paper serves as a manual to the NMSSM mode of the program, detailing the approximations and conventions used. Catalogue identifier: ADPM_v4_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADPM_v4_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 154886 No. of bytes in distributed program, including test data, etc.: 1870890 Distribution format: tar.gz Programming language: C++, fortran. Computer: Personal computer. Operating system: Tested on Linux 3.x. Word size: 64 bits Classification: 11.1, 11.6. Does the new version supersede the previous version?: Yes Catalogue identifier of previous version: ADPM_v3_0 Journal reference of previous version: Comput. Phys. Comm. 183 (2012) 785 Nature of problem: Calculating supersymmetric particle spectrum and mixing parameters in the next-to-minimal supersymmetric standard model. The solution to the

How to start a minimal access mitral valve program.

PubMed

Hunter, Steven

2013-11-01

The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

How to start a minimal access mitral valve program

PubMed Central

2013-01-01

The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: “clinical effectiveness”, including reduced length of hospital stay, “risk management effectiveness”, including conversion to sternotomy and aortic dissection, “patient experience” including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper. PMID:24349981

A Prospective Randomized Study on Operative Treatment for Simple Distal Tibial Fractures-Minimally Invasive Plate Osteosynthesis Versus Minimal Open Reduction and Internal Fixation.

PubMed

Kim, Ji Wan; Kim, Hyun Uk; Oh, Chang-Wug; Kim, Joon-Woo; Park, Ki Chul

2018-01-01

To compare the radiologic and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. Randomized prospective study. Three level 1 trauma centers. Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n = 29) or a minimal group (treatment with minimal ORIF; n = 29). These numbers were designed to define the rate of soft tissue complication; therefore, validation of superiority in union time or determination of differences in rates of delayed union was limited in this study. Simple distal tibial fractures treated with MIPO or minimal ORIF. The clinical outcome measurements included operative time, radiation exposure time, and soft tissue complications. To evaluate a patient's function, the American Orthopedic Foot and Ankle Society ankle score (AOFAS) was used. Radiologic measurements included fracture alignment, delayed union, and union time. All patients acquired bone union without any secondary intervention. The mean union time was 17.4 weeks and 16.3 weeks in the MIPO and minimal groups, respectively. There was 1 case of delayed union and 1 case of superficial infection in each group. The radiation exposure time was shorter in the minimal group than in the MIPO group. Coronal angulation showed a difference between both groups. The American Orthopedic Foot and Ankle Society ankle scores were 86.0 and 86.7 in the MIPO and minimal groups, respectively. Minimal ORIF resulted in similar outcomes, with no increased rate of soft tissue problems compared to MIPO. Both MIPO and minimal ORIF have high union rates and good functional outcomes for simple distal tibial fractures. Minimal ORIF did not result in increased rates of infection and wound dehiscence. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Minimally invasive options for salivary calculi.

PubMed

Witt, Robert L; Iro, Heinrich; Koch, Michael; McGurk, Mark; Nahlieli, Oded; Zenk, Johannes

2012-06-01

The aim of this study was to review the advantages, limitations, and international interdisciplinary expert perspectives and contrasts of salivary gland endoscopy and transoral techniques in the diagnosis and management of salivary gland calculi and their adaptation in North America. The transition from transcervical approaches to strictly sialendoscopic approaches is a broad chasm and often not feasible. Sialendoscopy, sialendoscopy-assisted, intraoral, and transcervical approaches all have surgical value. Diagnostic sialendoscopy, interventional sialendoscopy, sialendoscopy-assisted, and transoral techniques have been a major step forward, not only in providing an accurate means of diagnosing and locating intraductal obstructions, but also in permitting minimally invasive surgical treatment that can successfully manage blockages precluding sialoadenectomy in most cases. A flexible methodology is required. Multiple or combined measured may prove effective. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

The Spectrum of Reversible Minimizers

NASA Astrophysics Data System (ADS)

Ureña, Antonio J.

2018-05-01

Poincaré and, later on, Carathéodory, showed that the Floquet multipliers of 1-dimensional periodic curves minimizing the Lagrangian action are real and positive. Even though Carathéodory himself observed that this result loses its validity in the general higherdimensional case, we shall show that it remains true for systems which are reversible in time. In this way, we also generalize a previous result by Offin on the hyperbolicity of nondegenerate symmetric minimizers. Our arguments rely on the higher-dimensional generalizations of the Sturm theory which were developed during the second half of the twentieth century by several authors, including Hartman, Morse or Arnol'd.

Competitive Advantage of MBA for Physician Executives: A Systematic Literature Review.

PubMed

Turner, Anthony D; Stawicki, Stanislaw P; Guo, Weidun Alan

2018-06-01

In response to systemic challenges facing the US healthcare system, many medical students, residents and practicing physicians are pursuing a Master in Business Administration (MBA) degree. The value of such proposition remains poorly defined. The aim of this review is to analyze current literature pertaining to the added value of MBA training for physician executives (PEs). We hypothesized that physicians who supplement their clinical expertise with business education gain a significant competitive advantage. A detailed literature search of four electronic databases (PubMed, SCOPUS, Embase and ERIC) was performed. Included were studies published between Jan 2000 and June 2017, focusing specifically on PEs. Among 1580 non-duplicative titles, we identified 23 relevant articles. Attributes which were found to add value to one's competitiveness as PE were recorded. A quality index score was assigned to each article in order to minimize bias. Results were tabulated by attributes and by publication. We found that competitive domains deemed to be most important for PEs in the context of MBA training were leadership (n = 17), career advancement opportunities (n = 12), understanding of financial aspects of medicine (n = 9) and team-building skills (n = 10). Among other prominent factors associated with the desire to engage in an MBA were higher compensation, awareness of public health issues/strategy, increased negotiation skills and enhanced work-life balance. Of interest, the learning of strategies for reducing malpractice litigation was less important than the other drivers. This comprehensive systemic review supports our hypothesis that a business degree confers a competitive advantage for PEs. Physician executives equipped with an MBA degree appear to be better equipped to face the challenge of the dynamically evolving healthcare landscape. This information may be beneficial to medical schools designing or implementing combined dual-degree curricula.

On the three-quarter view advantage of familiar object recognition.

PubMed

Nonose, Kohei; Niimi, Ryosuke; Yokosawa, Kazuhiko

2016-11-01

A three-quarter view, i.e., an oblique view, of familiar objects often leads to a higher subjective goodness rating when compared with other orientations. What is the source of the high goodness for oblique views? First, we confirmed that object recognition performance was also best for oblique views around 30° view, even when the foreshortening disadvantage of front- and side-views was minimized (Experiments 1 and 2). In Experiment 3, we measured subjective ratings of view goodness and two possible determinants of view goodness: familiarity of view, and subjective impression of three-dimensionality. Three-dimensionality was measured as the subjective saliency of visual depth information. The oblique views were rated best, most familiar, and as approximating greatest three-dimensionality on average; however, the cluster analyses showed that the "best" orientation systematically varied among objects. We found three clusters of objects: front-preferred objects, oblique-preferred objects, and side-preferred objects. Interestingly, recognition performance and the three-dimensionality rating were higher for oblique views irrespective of the clusters. It appears that recognition efficiency is not the major source of the three-quarter view advantage. There are multiple determinants and variability among objects. This study suggests that the classical idea that a canonical view has a unique advantage in object perception requires further discussion.

Crystal growth and annealing for minimized residual stress

DOEpatents

Gianoulakis, Steven E.

2002-01-01

A method and apparatus for producing crystals that minimizes birefringence even at large crystal sizes, and is suitable for production of CaF.sub.2 crystals. The method of the present invention comprises annealing a crystal by maintaining a minimal temperature gradient in the crystal while slowly reducing the bulk temperature of the crystal. An apparatus according to the present invention includes a thermal control system added to a crystal growth and annealing apparatus, wherein the thermal control system allows a temperature gradient during crystal growth but minimizes the temperature gradient during crystal annealing.

Some Suggested Advantages and Disadvantages of Collective Bargaining. Special Report No. 1.

ERIC Educational Resources Information Center

Angell, George W.

This report reviews briefly some advantages and disadvantages of collective bargaining in higher education. Advantages discussed include: efficiency, equality of power, legal force, impasse resolution, communication, understanding the institution, resolution of individual problems, definition of policy, rights guarantee, faculty compensation,…

Minimally invasive treatment of clavicular fractures with cannulated screw.

PubMed

Sun, Jun-zhan; Zheng, Guo-hai; Zhao, Ke-yi

2014-05-01

To evaluate minimally invasive treatment of clavicular fractures with cannulated screw. Data of 65 patients who had undergone minimally invasive treatment with cannulated screws for clavicular fractures from April 2009 to October 2010 were retrospectively analyzed and compared with those of 65 patients with clavicular fractures who had been treated by the same surgeons with plates. In the study group, there were 41 males and 24 females, aged from 19-67 years (mean, 35.8 years). According to Craig's classification, there were 29 group 1 and 36 of group 2-II. Neer scores were used to evaluate shoulder function and radiographs to assess fracture union. The incision length was 4-5 cm in the cannulated screw group (CSG) and 10-11 cm in the reconstructive plate group (RPG). Radiographs showed bone union was achieved in both groups, the bone healing time being 13.2 ± 6.9 weeks in the CSG and 16.3 ± 8.7 weeks in the RPG. All patients were followed up for 6 to 20 months (average, 10.6 months). The average Neer score was 96.6 ± 3.4 in the CSG and 94.2 ± 5.8 in the RPG. In the CSG, screw loosening occurred in five, and fracture displacement in three. There was a significant difference in fracture healing time between two groups but not in Neer score. Minimally invasive treatment of clavicular fractures with cannulated screws has the advantages of minimal invasion, short bone healing time, good clinical outcomes, and being relatively inexpensive. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Plateau inflation from random non-minimal coupling

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

Broy, Benedict J.; Coone, Dries; Theoretische Natuurkunde,Vrije Universiteit Brussel and The International Solvay Institutes,Pleinlaan 2, B-1050 Brussels

A generic non-minimal coupling can push any higher-order terms of the scalar potential sufficiently far out in field space to yield observationally viable plateau inflation. We provide analytic and numerical evidence that this generically happens for a non-minimal coupling strength ξ of the order N{sub e}{sup 2}. In this regime, the non-minimally coupled field is sub-Planckian during inflation and is thus protected from most higher-order terms. For larger values of ξ, the inflationary predictions converge towards the sweet spot of PLANCK. The latter includes ξ≃10{sup 4} obtained from CMB normalization arguments, thus providing a natural explanation for the inflationary observablesmore » measured.« less

Comparison of the home advantage in nine different professional team sports in Spain.

PubMed

Gómez, Miguel A; Pollard, Richard; Luis-Pascual, Juan-Carlos

2011-08-01

Home advantage is a well-established phenomenon in many sports. The present study is unique in that it includes different sports analysed in the same country, at the same level of competition, and over the same time period. Nine team sports from Spain were included: baseball, basketball, handball, indoor soccer, roller hockey, rugby, soccer, volleyball, and water polo. Data for five seasons (2005-2006 to 2009-2010) were obtained, totaling 9,472 games. The results confirmed the existence of home advantage in all nine sports. There was a statistically significant difference between the sports; home advantage was highest in rugby (67.0%), and lowest in volleyball (55.7%), water polo (56.2%), and roller hockey (58.3%). The design of the study controlled for some of the likely causes of home advantage, and the results suggested that the high home advantage for rugby was likely a reflection of the continuous, aggressive, and intense nature of the sport.

Advantages of thin silicon solar cells for use in space

NASA Technical Reports Server (NTRS)

Denman, O. S.

1978-01-01

A system definition study on the Solar Power Satellite System showed that a thin, 50 micrometers, silicon solar cell has significant advantages. The advantages include a significantly lower performance degradation in a radiation environment and high power-to-mass ratios. The advantages of such cells for an employment in space is further investigated. Basic questions concerning the operation of solar cells are considered along with aspects of radiation induced performance degradation. The question arose in this connection how thin a silicon solar cell had to be to achieve resistance to radiation degradation and still have good initial performance. It was found that single-crystal silicon solar cells could be as thin as 50 micrometers and still develop high conversion efficiencies. It is concluded that the use of 50 micrometer silicon solar cells in space-based photovoltaic power systems would be advantageous.

Comparative Advantages in Microelectronics,

DTIC Science & Technology

The initial point of departure for analyzing comparative advantages in microelectronics is to make certain explicit assumptions. First, technology...changes conditions but does not determine comparative advantages . Secondly, the entire industrial infrastructure is becoming increasingly abstract...that informatics will profoundly affect the productive infrastructure and the international division of labour.

Minimal Residual Disease Assessment in Lymphoma: Methods and Applications.

PubMed

Herrera, Alex F; Armand, Philippe

2017-12-01

Standard methods for disease response assessment in patients with lymphoma, including positron emission tomography and computed tomography scans, are imperfect. In other hematologic malignancies, particularly leukemias, the ability to detect minimal residual disease (MRD) is increasingly influencing treatment paradigms. However, in many subtypes of lymphoma, the application of MRD assessment techniques, like flow cytometry or polymerase chain reaction-based methods, has been challenging because of the absence of readily detected circulating disease or canonic chromosomal translocations. Newer MRD detection methods that use next-generation sequencing have yielded promising results in a number of lymphoma subtypes, fueling the hope that MRD detection may soon be applicable in clinical practice for most patients with lymphoma. MRD assessment can provide real-time information about tumor burden and response to therapy, noninvasive genomic profiling, and monitoring of clonal dynamics, allowing for many possible applications that could significantly affect the care of patients with lymphoma. Further validation of MRD assessment methods, including the incorporation of MRD assessment into clinical trials in patients with lymphoma, will be critical to determine how best to deploy MRD testing in routine practice and whether MRD assessment can ultimately bring us closer to the goal of personalized lymphoma care. In this review article, we describe the methods available for detecting MRD in patients with lymphoma and their relative advantages and disadvantages. We discuss preliminary results supporting the potential applications for MRD testing in the care of patients with lymphoma and strategies for including MRD assessment in lymphoma clinical trials.

Minimally conscious state or cortically mediated state?

PubMed

Naccache, Lionel

2018-04-01

Durable impairments of consciousness are currently classified in three main neurological categories: comatose state, vegetative state (also recently coined unresponsive wakefulness syndrome) and minimally conscious state. While the introduction of minimally conscious state, in 2002, was a major progress to help clinicians recognize complex non-reflexive behaviours in the absence of functional communication, it raises several problems. The most important issue related to minimally conscious state lies in its criteria: while behavioural definition of minimally conscious state lacks any direct evidence of patient's conscious content or conscious state, it includes the adjective 'conscious'. I discuss this major problem in this review and propose a novel interpretation of minimally conscious state: its criteria do not inform us about the potential residual consciousness of patients, but they do inform us with certainty about the presence of a cortically mediated state. Based on this constructive criticism review, I suggest three proposals aiming at improving the way we describe the subjective and cognitive state of non-communicating patients. In particular, I present a tentative new classification of impairments of consciousness that combines behavioural evidence with functional brain imaging data, in order to probe directly and univocally residual conscious processes.

Minimal access surgery of pediatric inguinal hernias: a review.

PubMed

Saranga Bharathi, Ramanathan; Arora, Manu; Baskaran, Vasudevan

2008-08-01

Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair. Numerous minimally invasive techniques for addressing PIH have mushroomed in the past two decades. These techniques vary considerably in their approaches to the internal ring (intraperitoneal, extraperitoneal), use of ports (three, two, one), endoscopic instruments (two, one, or none), sutures (absorbable, nonabsorbable), and techniques of knotting (intracorporeal, extracorporeal). In addition to the surgeons' experience and the merits/limitations of individual techniques, it is the nature of the defect that should govern the choice of technique. The emerging techniques show a trend toward increasing use of extracorporeal knotting and diminishing use of working ports and endoscopic instruments. These favor wider adoption of minimal access surgery in addressing PIH by surgeons, irrespective of their laparoscopic skills and experience. Growing experience, wider adoption, decreasing complications, and increasing advantages favor emergence of minimal access surgery as the gold standard for the treatment of PIH in the future. This article comprehensively reviews the laparoscopic techniques of addressing PIH.

Minimal Data and Site Specific Approaches

EPA Science Inventory

As part of a workshop, Tools for Assessing Stream Dissolved Minerals, approaches and EPA tools are described for site specific development of water quality criteria based on observations from Arkansas streams using minimal data. Discussion topics will include site-specific appro...

Exponential Communication Complexity Advantage from Quantum Superposition of the Direction of Communication

NASA Astrophysics Data System (ADS)

Guérin, Philippe Allard; Feix, Adrien; Araújo, Mateus; Brukner, Časlav

2016-09-01

In communication complexity, a number of distant parties have the task of calculating a distributed function of their inputs, while minimizing the amount of communication between them. It is known that with quantum resources, such as entanglement and quantum channels, one can obtain significant reductions in the communication complexity of some tasks. In this work, we study the role of the quantum superposition of the direction of communication as a resource for communication complexity. We present a tripartite communication task for which such a superposition allows for an exponential saving in communication, compared to one-way quantum (or classical) communication; the advantage also holds when we allow for protocols with bounded error probability.

Shape Sensing Techniques for Continuum Robots in Minimally Invasive Surgery: A Survey.

PubMed

Shi, Chaoyang; Luo, Xiongbiao; Qi, Peng; Li, Tianliang; Song, Shuang; Najdovski, Zoran; Fukuda, Toshio; Ren, Hongliang

2017-08-01

Continuum robots provide inherent structural compliance with high dexterity to access the surgical target sites along tortuous anatomical paths under constrained environments and enable to perform complex and delicate operations through small incisions in minimally invasive surgery. These advantages enable their broad applications with minimal trauma and make challenging clinical procedures possible with miniaturized instrumentation and high curvilinear access capabilities. However, their inherent deformable designs make it difficult to realize 3-D intraoperative real-time shape sensing to accurately model their shape. Solutions to this limitation can lead themselves to further develop closely associated techniques of closed-loop control, path planning, human-robot interaction, and surgical manipulation safety concerns in minimally invasive surgery. Although extensive model-based research that relies on kinematics and mechanics has been performed, accurate shape sensing of continuum robots remains challenging, particularly in cases of unknown and dynamic payloads. This survey investigates the recent advances in alternative emerging techniques for 3-D shape sensing in this field and focuses on the following categories: fiber-optic-sensor-based, electromagnetic-tracking-based, and intraoperative imaging modality-based shape-reconstruction methods. The limitations of existing technologies and prospects of new technologies are also discussed.

KENNEDY SPACE CENTER, FLA. - Sandblasting begins on the Mobile Launcher Platform on Launch Pad 39A to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - Sandblasting begins on the Mobile Launcher Platform on Launch Pad 39A to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

Quasi-independence, fitness, and advantageousness.

PubMed

Brosnan, Kevin

2009-09-01

I argue that the idea of 'quasi-independence' [Lewontin, R. C. (1978). Adaptation. Scientific American, 239(3), 212-230] cannot be understood without attending to the distinction between fitness and advantageousness [Sober, E. (1993). Philosophy of biology. Boulder: Westview Press]. Natural selection increases the frequency of fitter traits, not necessarily of advantageous ones. A positive correlation between an advantageous trait and a disadvantageous one may prevent the advantageous trait from evolving. The quasi-independence criterion is aimed at specifying the conditions under which advantageous traits will evolve by natural selection in this type of situation. Contrary to what others have argued [Sterelny, K. (1992). Evolutionary explanations of human behavior. Australian Journal of Philosophy, 70(2), 156-172, and Sterelny, K., & Griffiths, P. (1999). Sex and death. Chicago: University of Chicago Press], these conditions must involve a precise quantitative measure of (a) the extent to which advantageous traits are beneficial, and (b) the degree to which they are correlated with other traits. Driscoll (2004) [Driscoll, C. (2004). Can behaviors be adaptations? Philosophy of Science, 71, 16-35] recognizes the need for such a measure, but I argue that she does not provide the correct formulation. The account of quasi-independence that I offer clarifies this point.

Oxygen-consuming chlor alkali cell configured to minimize peroxide formation

DOEpatents

Chlistunoff, Jerzy B [Los Alamos, NM; Lipp, Ludwig [Brookfield, CT; Gottesfeld, Shimshon [Niskayuna, NY

2006-08-01

Oxygen-consuming zero gap chlor-alkali cell was configured to minimize peroxide formation. The cell included an ion-exchange membrane that divided the cell into an anode chamber including an anode and a cathode chamber including an oxygen gas diffusion cathode. The cathode included a single-piece of electrically conducting graphitized carbon cloth. Catalyst and polytetrafluoroethylene were attached to only one side of the cloth. When the cathode was positioned against the cation exchange membrane with the catalyst side away from the membrane, electrolysis of sodium chloride to chlorine and caustic (sodium hydroxide) proceeded with minimal peroxide formation.

Metabolic engineering of microbial competitive advantage for industrial fermentation processes.

PubMed

Shaw, A Joe; Lam, Felix H; Hamilton, Maureen; Consiglio, Andrew; MacEwen, Kyle; Brevnova, Elena E; Greenhagen, Emily; LaTouf, W Greg; South, Colin R; van Dijken, Hans; Stephanopoulos, Gregory

2016-08-05

Microbial contamination is an obstacle to widespread production of advanced biofuels and chemicals. Current practices such as process sterilization or antibiotic dosage carry excess costs or encourage the development of antibiotic resistance. We engineered Escherichia coli to assimilate melamine, a xenobiotic compound containing nitrogen. After adaptive laboratory evolution to improve pathway efficiency, the engineered strain rapidly outcompeted a control strain when melamine was supplied as the nitrogen source. We additionally engineered the yeasts Saccharomyces cerevisiae and Yarrowia lipolytica to assimilate nitrogen from cyanamide and phosphorus from potassium phosphite, and they outcompeted contaminating strains in several low-cost feedstocks. Supplying essential growth nutrients through xenobiotic or ecologically rare chemicals provides microbial competitive advantage with minimal external risks, given that engineered biocatalysts only have improved fitness within the customized fermentation environment. Copyright © 2016, American Association for the Advancement of Science.

Minimally invasive computer-assisted stereotactic fenestration of an aqueductal cyst: case report.

PubMed

Fonoff, E T; Gentil, A F; Padilha, P M; Teixeira, M J

2010-02-01

Current advances in frame modeling and computer software allow stereotactic procedures to be performed with great accuracy and minimal risk of neural tissue or vascular injury. In this report we associate a previously described minimally invasive stereotactic technique with state-of-the-art 3D computer guidance technology to successfully treat a 55-year-old patient with an arachnoidal cyst obstructing the aqueduct of Sylvius. We provide detailed technical information and discuss how this technique deals with previous limitations for stereotactic manipulation of the aqueductal region. We further discuss current advances in neuroendoscopy for treating obstructive hydrocephalus and make comparisons with our proposed technique. We advocate that this technique is not only capable of treating this pathology but it also has the advantages to enable reestablishment of physiological CSF flow thus preventing future brainstem compression by cyst enlargement. (c) Georg Thieme Verlag KG Stuttgart . New York.

Esophagectomy - minimally invasive

MedlinePlus

Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the ...

Real-time minimal-bit-error probability decoding of convolutional codes

NASA Technical Reports Server (NTRS)

Lee, L.-N.

1974-01-01

A recursive procedure is derived for decoding of rate R = 1/n binary convolutional codes which minimizes the probability of the individual decoding decisions for each information bit, subject to the constraint that the decoding delay be limited to Delta branches. This new decoding algorithm is similar to, but somewhat more complex than, the Viterbi decoding algorithm. A real-time, i.e., fixed decoding delay, version of the Viterbi algorithm is also developed and used for comparison to the new algorithm on simulated channels. It is shown that the new algorithm offers advantages over Viterbi decoding in soft-decision applications, such as in the inner coding system for concatenated coding.

Real-time minimal bit error probability decoding of convolutional codes

NASA Technical Reports Server (NTRS)

Lee, L. N.

1973-01-01

A recursive procedure is derived for decoding of rate R=1/n binary convolutional codes which minimizes the probability of the individual decoding decisions for each information bit subject to the constraint that the decoding delay be limited to Delta branches. This new decoding algorithm is similar to, but somewhat more complex than, the Viterbi decoding algorithm. A real-time, i.e. fixed decoding delay, version of the Viterbi algorithm is also developed and used for comparison to the new algorithm on simulated channels. It is shown that the new algorithm offers advantages over Viterbi decoding in soft-decision applications such as in the inner coding system for concatenated coding.

ADVANTAGES/DISADVANTAGES FOR ISCO METHODS IN-SITU FENTON OXIDATION IN-SITU PERMANGANATE OXIDATION

EPA Science Inventory

The advantages and disadvantages of in-situ Fenton oxidation and in-situ permanganate oxidation will be presented. This presentation will provide a brief overview of each technology and a detailed analysis of the advantages and disadvantages of each technology. Included in the ...

Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

PubMed

Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

2013-08-01

Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; P<.001). Operative time was shorter and less intraoperative blood loss occurred in the minimally invasive plating osteosynthesis group than in the IMN group. Average time to union was similar in both groups. Primary union was achieved in 23 of 24 patients in the minimally invasive plating osteosynthesis group and in 22 of 23 in the IMN group. Minimally invasive plating osteosynthesis may have outcomes comparable with IMN for the management of mid-distal third humeral shaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

Mission and System Advantages of Iodine Hall Thrusters

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Szabo, James; Pote, Bruce; Oleson, Steve; Kamhawi, Hani

2014-01-01

The exploration of alternative propellants for Hall thrusters continues to be of interest to the community. Investments have been made and continue for the maturation of iodine based Hall thrusters. Iodine testing has shown comparable performance to xenon. However, iodine has a higher storage density and resulting higher ?V capability for volume constrained systems. Iodine's vapor pressure is low enough to permit low-pressure storage, but high enough to minimize potential adverse spacecraft-thruster interactions. The low vapor pressure also means that iodine does not condense inside the thruster at ordinary operating temperatures. Iodine is safe, it stores at sub-atmospheric pressure, and can be stored unregulated for years on end; whether on the ground or on orbit. Iodine fills a niche for both low power (<1kW) and high power (>10kW) electric propulsion regimes. A range of missions have been evaluated for direct comparison of Iodine and Xenon options. The results show advantages of iodine Hall systems for both small and microsatellite application and for very large exploration class missions.

The evolution and future of minimalism in neurological surgery.

PubMed

Liu, Charles Y; Wang, Michael Y; Apuzzo, Michael L J

2004-11-01

The evolution of the field of neurological surgery has been marked by a progressive minimalism. This has been evident in the development of an entire arsenal of modern neurosurgical enterprises, including microneurosurgery, neuroendoscopy, stereotactic neurosurgery, endovascular techniques, radiosurgical systems, intraoperative and navigational devices, and in the last decade, cellular and molecular adjuvants. In addition to reviewing the major developments and paradigm shifts in the cyclic reinvention of the field as it currently stands, this paper attempts to identify forces and developments that are likely to fuel the irresistible escalation of minimalism into the future. These forces include discoveries in computational science, imaging, molecular science, biomedical engineering, and information processing as they relate to the theme of minimalism. These areas are explained in the light of future possibilities offered by the emerging field of nanotechnology with molecular engineering.

Neutral buoyancy is optimal to minimize the cost of transport in horizontally swimming seals.

PubMed

Sato, Katsufumi; Aoki, Kagari; Watanabe, Yuuki Y; Miller, Patrick J O

2013-01-01

Flying and terrestrial animals should spend energy to move while supporting their weight against gravity. On the other hand, supported by buoyancy, aquatic animals can minimize the energy cost for supporting their body weight and neutral buoyancy has been considered advantageous for aquatic animals. However, some studies suggested that aquatic animals might use non-neutral buoyancy for gliding and thereby save energy cost for locomotion. We manipulated the body density of seals using detachable weights and floats, and compared stroke efforts of horizontally swimming seals under natural conditions using animal-borne recorders. The results indicated that seals had smaller stroke efforts to swim a given speed when they were closer to neutral buoyancy. We conclude that neutral buoyancy is likely the best body density to minimize the cost of transport in horizontal swimming by seals.

Cost-effectiveness analysis in minimally invasive spine surgery.

PubMed

Al-Khouja, Lutfi T; Baron, Eli M; Johnson, J Patrick; Kim, Terrence T; Drazin, Doniel

2014-06-01

Medical care has been evolving with the increased influence of a value-based health care system. As a result, more emphasis is being placed on ensuring cost-effectiveness and utility in the services provided to patients. This study looks at this development in respect to minimally invasive spine surgery (MISS) costs. A literature review using PubMed, the Cost-Effectiveness Analysis (CEA) Registry, and the National Health Service Economic Evaluation Database (NHS EED) was performed. Papers were included in the study if they reported costs associated with minimally invasive spine surgery (MISS). If there was no mention of cost, CEA, cost-utility analysis (CUA), quality-adjusted life year (QALY), quality, or outcomes mentioned, then the article was excluded. Fourteen studies reporting costs associated with MISS in 12,425 patients (3675 undergoing minimally invasive procedures and 8750 undergoing open procedures) were identified through PubMed, the CEA Registry, and NHS EED. The percent cost difference between minimally invasive and open approaches ranged from 2.54% to 33.68%-all indicating cost saving with a minimally invasive surgical approach. Average length of stay (LOS) for minimally invasive surgery ranged from 0.93 days to 5.1 days compared with 1.53 days to 12 days for an open approach. All studies reporting EBL reported lower volume loss in an MISS approach (range 10-392.5 ml) than in an open approach (range 55-535.5 ml). There are currently an insufficient number of studies published reporting the costs of MISS. Of the studies published, none have followed a standardized method of reporting and analyzing cost data. Preliminary findings analyzing the 14 studies showed both cost saving and better outcomes in MISS compared with an open approach. However, more Level I CEA/CUA studies including cost/QALY evaluations with specifics of the techniques utilized need to be reported in a standardized manner to make more accurate conclusions on the cost effectiveness of

Correlates of minimal dating.

PubMed

Leck, Kira

2006-10-01

Researchers have associated minimal dating with numerous factors. The present author tested shyness, introversion, physical attractiveness, performance evaluation, anxiety, social skill, social self-esteem, and loneliness to determine the nature of their relationships with 2 measures of self-reported minimal dating in a sample of 175 college students. For women, shyness, introversion, physical attractiveness, self-rated anxiety, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. For men, physical attractiveness, observer-rated social skill, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. The patterns of relationships were not identical for the 2 indicators of minimal dating, indicating the possibility that minimal dating is not a single construct as researchers previously believed. The present author discussed implications and suggestions for future researchers.

Esophageal surgery in minimally invasive era

PubMed Central

Bencini, Lapo; Moraldi, Luca; Bartolini, Ilenia; Coratti, Andrea

2016-01-01

The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasive surgery (MIS) mainly include reductions of postoperative complications, length of hospital stay, and pain and better cosmetic results. All of these benefits could potentially be of great interest when dealing with the esophagus due to the potentially severe complications that can occur after conventional surgery. Moreover, robotic platforms are expected to reduce many of the difficulties encountered during advanced laparoscopic and thoracoscopic procedures such as anastomotic reconstructions, accurate lymphadenectomies, and vascular sutures. Almost all esophageal diseases are approachable in a minimally invasive way, including diverticula, gastro-esophageal reflux disease, achalasia, perforations and cancer. Nevertheless, while the limits of MIS for benign esophageal diseases are mainly technical issues and costs, oncologic outcomes remain the cornerstone of any procedure to cure malignancies, for which the long-term results are critical. Furthermore, many of the minimally invasive esophageal operations should be compared to pharmacologic interventions and advanced pure endoscopic procedures; such a comparison requires a difficult literature analysis and leads to some confounding results of clinical trials. This review aims to examine the evidence for the use of MIS in both malignancies and more common benign disease of the esophagus, with a particular emphasis on future developments and ongoing areas of research. PMID:26843913

Immediately sequential bilateral cataract surgery: advantages and disadvantages.

PubMed

Singh, Ranjodh; Dohlman, Thomas H; Sun, Grace

2017-01-01

The number of cataract surgeries performed globally will continue to rise to meet the needs of an aging population. This increased demand will require healthcare systems and providers to find new surgical efficiencies while maintaining excellent surgical outcomes. Immediately sequential bilateral cataract surgery (ISBCS) has been proposed as a solution and is increasingly being performed worldwide. The purpose of this review is to discuss the advantages and disadvantages of ISBCS. When appropriate patient selection occurs and guidelines are followed, ISBCS is comparable with delayed sequential bilateral cataract surgery in long-term patient satisfaction, visual acuity and complication rates. In addition, the risk of bilateral postoperative endophthalmitis and concerns of poorer refractive outcomes have not been supported by the literature. ISBCS is cost-effective for the patient, healthcare payors and society, but current reimbursement models in many countries create significant financial barriers for facilities and surgeons. As demand for cataract surgery rises worldwide, ISBCS will become increasingly important as an alternative to delayed sequential bilateral cataract surgery. Advantages include potentially decreased wait times for surgery, patient convenience and cost savings for healthcare payors. Although they are comparable in visual acuity and complication rates, hurdles that prevent wide adoption include liability concerns as ISBCS is not an established standard of care, economic constraints for facilities and surgeons and inability to fine-tune intraocular lens selection in the second eye. Given these considerations, an open discussion regarding the advantages and disadvantages of ISBCS is important for appropriate patient selection.

Mechanistic Basis of Cocrystal Dissolution Advantage.

PubMed

Cao, Fengjuan; Amidon, Gordon L; Rodríguez-Hornedo, Naír; Amidon, Gregory E

2018-01-01

Current interest in cocrystal development resides in the advantages that the cocrystal may have in solubility and dissolution compared with the parent drug. This work provides a mechanistic analysis and comparison of the dissolution behavior of carbamazepine (CBZ) and its 2 cocrystals, carbamazepine-saccharin (CBZ-SAC) and carbamazepine-salicylic acid (CBZ-SLC) under the influence of pH and micellar solubilization. A simple mathematical equation is derived based on the mass transport analyses to describe the dissolution advantage of cocrystals. The dissolution advantage is the ratio of the cocrystal flux to drug flux and is defined as the solubility advantage (cocrystal to drug solubility ratio) times the diffusivity advantage (cocrystal to drug diffusivity ratio). In this work, the effective diffusivity of CBZ in the presence of surfactant was determined to be different and less than those of the cocrystals. The higher effective diffusivity of drug from the dissolved cocrystals, the diffusivity advantage, can impart a dissolution advantage to cocrystals with lower solubility than the parent drug while still maintaining thermodynamic stability. Dissolution conditions where cocrystals can display both thermodynamic stability and a dissolution advantage can be obtained from the mass transport models, and this information is useful for both cocrystal selection and formulation development. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Neural Correlates of the In-Group Memory Advantage on the Encoding and Recognition of Faces

PubMed Central

Herzmann, Grit; Curran, Tim

2013-01-01

People have a memory advantage for faces that belong to the same group, for example, that attend the same university or have the same personality type. Faces from such in-group members are assumed to receive more attention during memory encoding and are therefore recognized more accurately. Here we use event-related potentials related to memory encoding and retrieval to investigate the neural correlates of the in-group memory advantage. Using the minimal group procedure, subjects were classified based on a bogus personality test as belonging to one of two personality types. While the electroencephalogram was recorded, subjects studied and recognized faces supposedly belonging to the subject’s own and the other personality type. Subjects recognized in-group faces more accurately than out-group faces but the effect size was small. Using the individual behavioral in-group memory advantage in multivariate analyses of covariance, we determined neural correlates of the in-group advantage. During memory encoding (300 to 1000 ms after stimulus onset), subjects with a high in-group memory advantage elicited more positive amplitudes for subsequently remembered in-group than out-group faces, showing that in-group faces received more attention and elicited more neural activity during initial encoding. Early during memory retrieval (300 to 500 ms), frontal brain areas were more activated for remembered in-group faces indicating an early detection of group membership. Surprisingly, the parietal old/new effect (600 to 900 ms) thought to indicate recollection processes differed between in-group and out-group faces independent from the behavioral in-group memory advantage. This finding suggests that group membership affects memory retrieval independent of memory performance. Comparisons with a previous study on the other-race effect, another memory phenomenon influenced by social classification of faces, suggested that the in-group memory advantage is dominated by top

Minimal residual disease in acute lymphoblastic leukemia: optimal methods and clinical relevance, pitfalls and recent approaches.

PubMed

Salari, Fatemeh; Shahjahani, Mohammad; Shahrabi, Saeid; Saki, Najmaldin

2014-11-01

After advances in experimental and clinical testing, minimal residual disease (MRD) assay results are considered a determining factor in treatment of acute lymphoblastic leukemia patients. According to MRD assay results, bone marrow (BM) leukemic burden and the rate of its decline after treatment can be directly evaluated. Detailed knowledge of the leukemic burden in BM can minimize toxicity and treatment complications in patients by tailoring the therapeutic dose based on patients' conditions. In addition, reduction of MRD before allo-HSCT is an important prerequisite for reception of transplant by the patient. In direct examination of MRD by morphological methods (even by a professional hematologist), leukemic cells can be under- or over-estimated due to similarity with hematopoietic precursor cells. As a result, considering the importance of MRD, it is necessary to use other methods including flow cytometry, polymerase chain reaction (PCR) amplification and RQ-PCR to detect MRD. Each of these methods has its own advantages and disadvantages in terms of accuracy and sensitivity. In this review article, different MRD assay methods and their sensitivity, correlation of MRD assay results with clinical symptoms of the patient as well as pitfalls in results of these methods are evaluated. In the final section, recent advances in MRD have been addressed.

Airmen: Delivering Decision Advantage

DTIC Science & Technology

2012-12-01

Senior Leader Perspective November–December 2012 Air & Space Power Journal | 4 ISR Focus Airmen Delivering Decision Advantage Lt Gen Larry D. James...Air Force, the joint war fighter, and our nation. Our mission, in defense of America’s interests, is to enable de- cision advantage by operating...integrated, cross-domain ISR capabilities with joint, national, and international partners. Our Air Force ISR vi- sion is to be the preeminent ISR

The empty OR-process analysis and a new concept for flexible and modular use in minimal invasive surgery.

PubMed

Eckmann, Christian; Olbrich, Guenter; Shekarriz, Hodjat; Bruch, Hans-Peter

2003-01-01

The reproducible advantages of minimal invasive surgery have led to a worldwide spread of these techniques. Nevertheless, the increasing use of technology causes problems in the operating room (OR). The workstation environment and workflow are handicapped by a great number of isolated solutions that demand a large amount of space. The Center of Excellence in Medical Technology (CEMET) was established in 2001 as an institution for a close cooperation between users, science, and manufacturers of medical devices in the State of Schleswig-Holstein, Germany. The future OR, as a major project, began with a detailed process analysis, which disclosed a large number of medical devices with different interfaces and poor standardisation as main problems. Smaller and more flexible devices are necessary, as well as functional modules located outside the OR. Only actuators should be positioned near the operation area. The future OR should include a flexible-room concept and less equipment than is in use currently. A uniform human-user interface is needed to control the OR environment. This article addresses the need for a clear workspace environment, intelligent-user interfaces, and flexible-room concept to improve the potentials in use of minimal invasive surgery.

Minimally invasive management of hepatic cysts: indications and complications.

PubMed

Vardakostas, D; Damaskos, C; Garmpis, N; Antoniou, E A; Kontzoglou, K; Kouraklis, G; Dimitroulis, D

2018-03-01

Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess, and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic modalities, there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 English language publications articles, published until October 2017. Minimally invasive management of liver LC is an emerging field including many therapeutic modalities ranging from the percutaneous aspiration of pyogenic abscesses to laparoscopic hepatectomy for hepatic cystadenomas. The most used techniques are percutaneous drainage, laparoscopic fenestration, and laparoscopic hepatectomy. The application of the various minimally invasive approaches, as well as their indication and complications, depend on the type of the cystic lesion, its size and its position in the liver. Percutaneous drainage is mostly used in simple cysts, hydatid cysts, pyogenic abscesses and bilomas. Laparoscopic fenestration is mostly used in simple cysts and polycystic liver disease. Finally, laparoscopic hepatectomy is mostly used in polycystic liver disease, hydatid cysts, and cystadenomas.

Increasingly minimal bias routing

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

Bataineh, Abdulla; Court, Thomas; Roweth, Duncan

2017-02-21

A system and algorithm configured to generate diversity at the traffic source so that packets are uniformly distributed over all of the available paths, but to increase the likelihood of taking a minimal path with each hop the packet takes. This is achieved by configuring routing biases so as to prefer non-minimal paths at the injection point, but increasingly prefer minimal paths as the packet proceeds, referred to herein as Increasing Minimal Bias (IMB).

Evaluation of three-dimensional printing for internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach: a preliminary report.

PubMed

Zeng, Canjun; Xiao, Jidong; Wu, Zhanglin; Huang, Wenhua

2015-01-01

The aim of this study is to evaluate the efficacy and feasibility of three-dimensional printing (3D printing) assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach. A total of 38 patients with unstable pelvic fractures were analyzed retrospectively from August 2012 to February 2014. All cases were treated operatively with internal fixation assisted by three-dimensional printing from minimal invasive para-rectus abdominis approach. Both preoperative CT and three-dimensional reconstruction were performed. Pelvic model was created by 3D printing. Data including the best entry points, plate position and direction and length of screw were obtained from simulated operation based on 3D printing pelvic model. The diaplasis and internal fixation were performed by minimal invasive para-rectus abdominis approach according to the optimized dada in real surgical procedure. Matta and Majeed score were used to evaluate currative effects after operation. According to the Matta standard, the outcome of the diaplasis achieved 97.37% with excellent and good. Majeed assessment showed 94.4% with excellent and good. The imageological examination showed consistency of internal fixation and simulated operation. The mean operation time was 110 minutes, mean intraoperative blood loss 320 ml, and mean incision length 6.5 cm. All patients have achieved clinical healing, with mean healing time of 8 weeks. Three-dimensional printing assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach is feasible and effective. This method has the advantages of trauma minimally, bleeding less, healing rapidly and satisfactory reduction, and worthwhile for spreading in clinical practice.

Home advantage in retractable-roof baseball stadia.

PubMed

Romanowich, Paul

2012-10-01

This study examined whether the home advantage varies for open-air, domed, or retractable-roof baseball stadia, and whether having the roof open or closed affects the home advantage in retractable-roof baseball stadia. Data from Major League Baseball (MLB) games played between 2001 and 2009 were analyzed for whether or not the presence of a home-advantage was dependent on the type of home stadium used. Home advantage was robust for all three types of stadia. A significant effect of stadium type on home advantage was found, with a greater home advantage for teams playing home games in domed stadia relative to open-air stadia, replicating a previous study. There was a greater home advantage for teams playing home games in domed stadia relative to retractable-roof stadia. No other differences in the home advantage were found; results are discussed in terms of familiarity with the facility.

Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

NASA Astrophysics Data System (ADS)

Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

2017-08-01

This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

Minimally Invasive Dentistry

MedlinePlus

... geta poker friv Home InfoBites Find an AGD Dentist Your Family's Oral Health About the AGD Dental ... structure. It focuses on prevention, remineralization, and minimal dentist intervention. Using scientific advances, minimally invasive dentistry allows ...

Charge and energy minimization in electrical/magnetic stimulation of nervous tissue

NASA Astrophysics Data System (ADS)

Jezernik, Sašo; Sinkjaer, Thomas; Morari, Manfred

2010-08-01

In this work we address the problem of stimulating nervous tissue with the minimal necessary energy at reduced/minimal charge. Charge minimization is related to a valid safety concern (avoidance and reduction of stimulation-induced tissue and electrode damage). Energy minimization plays a role in battery-driven electrical or magnetic stimulation systems (increased lifetime, repetition rates, reduction of power requirements, thermal management). Extensive new theoretical results are derived by employing an optimal control theory framework. These results include derivation of the optimal electrical stimulation waveform for a mixed energy/charge minimization problem, derivation of the charge-balanced energy-minimal electrical stimulation waveform, solutions of a pure charge minimization problem with and without a constraint on the stimulation amplitude, and derivation of the energy-minimal magnetic stimulation waveform. Depending on the set stimulus pulse duration, energy and charge reductions of up to 80% are deemed possible. Results are verified in simulations with an active, mammalian-like nerve fiber model.

Charge and energy minimization in electrical/magnetic stimulation of nervous tissue.

PubMed

Jezernik, Saso; Sinkjaer, Thomas; Morari, Manfred

2010-08-01

In this work we address the problem of stimulating nervous tissue with the minimal necessary energy at reduced/minimal charge. Charge minimization is related to a valid safety concern (avoidance and reduction of stimulation-induced tissue and electrode damage). Energy minimization plays a role in battery-driven electrical or magnetic stimulation systems (increased lifetime, repetition rates, reduction of power requirements, thermal management). Extensive new theoretical results are derived by employing an optimal control theory framework. These results include derivation of the optimal electrical stimulation waveform for a mixed energy/charge minimization problem, derivation of the charge-balanced energy-minimal electrical stimulation waveform, solutions of a pure charge minimization problem with and without a constraint on the stimulation amplitude, and derivation of the energy-minimal magnetic stimulation waveform. Depending on the set stimulus pulse duration, energy and charge reductions of up to 80% are deemed possible. Results are verified in simulations with an active, mammalian-like nerve fiber model.

Comparison of home advantage in men's and women's football leagues in Europe.

PubMed

Pollard, Richard; Gómez, Miguel A

2014-01-01

Most research into home advantage is based on men's sports. This article analyses home advantage in the women's domestic football leagues of Europe and makes a comparison with the corresponding men's football leagues. A total of 47,042 games were included. From 2004 to 2010, home advantage existed in the domestic women's soccer leagues of all 26 European countries analysed, ranging from 51.0% to 58.8% and averaging 54.2%. In every country, this was less than the corresponding men's home advantage which averaged 60.0%. Crowd effects, both on players and referees, and different gender perceptions of territorial protection are plausible reasons for the differences found. Using a regression model that controlled for the competitive balance of each league, as well as for crowd size, the Gender Gap Index, which quantifies the status of women in each country, was a significant predictor of the difference between men's and women's home advantage. As the status of women becomes closer to that of men within a country, the difference in home advantage is less between the men's and women's football leagues.

Adoption of waste minimization technology to benefit electroplaters

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

Ching, E.M.K.; Li, C.P.H.; Yu, C.M.K.

Because of increasingly stringent environmental legislation and enhanced environmental awareness, electroplaters in Hong Kong are paying more heed to protect the environment. To comply with the array of environmental controls, electroplaters can no longer rely solely on the end-of-pipe approach as a means for abating their pollution problems under the particular local industrial environment. The preferred approach is to adopt waste minimization measures that yield both economic and environmental benefits. This paper gives an overview of electroplating activities in Hong Kong, highlights their characteristics, and describes the pollution problems associated with conventional electroplating operations. The constraints of using pollution controlmore » measures to achieve regulatory compliance are also discussed. Examples and case studies are given on some low-cost waste minimization techniques readily available to electroplaters, including dragout minimization and water conservation techniques. Recommendations are given as to how electroplaters can adopt and exercise waste minimization techniques in their operations. 1 tab.« less

Nerve Cells Decide to Orient inside an Injectable Hydrogel with Minimal Structural Guidance.

PubMed

Rose, Jonas C; Cámara-Torres, María; Rahimi, Khosrow; Köhler, Jens; Möller, Martin; De Laporte, Laura

2017-06-14

Injectable biomaterials provide the advantage of a minimally invasive application but mostly lack the required structural complexity to regenerate aligned tissues. Here, we report a new class of tissue regenerative materials that can be injected and form an anisotropic matrix with controlled dimensions using rod-shaped, magnetoceptive microgel objects. Microgels are doped with small quantities of superparamagnetic iron oxide nanoparticles (0.0046 vol %), allowing alignment by external magnetic fields in the millitesla order. The microgels are dispersed in a biocompatible gel precursor and after injection and orientation are fixed inside the matrix hydrogel. Regardless of the low volume concentration of the microgels below 3%, at which the geometrical constrain for orientation is still minimum, the generated macroscopic unidirectional orientation is strongly sensed by the cells resulting in parallel nerve extension. This finding opens a new, minimal invasive route for therapy after spinal cord injury.

Development of minimally invasive techniques for management of medically-complicated obesity

PubMed Central

Rashti, Farzin; Gupta, Ekta; Ebrahimi, Suzan; Shope, Timothy R; Koch, Timothy R; Gostout, Christopher J

2014-01-01

The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal interventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss. PMID:25309074

A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method.

PubMed

Maillard, Nicolas; Buffenoir-Billet, Kevin; Hamel, Olivier; Lefranc, Benoit; Sellal, Olivier; Surer, Nathalie; Bord, Eric; Grimandi, Gael; Clouet, Johann

2015-03-01

The last decade has seen the emergence of minimally invasive spine surgery. However, there is still no consensus on whether percutaneous osteosynthesis (PO) or open surgery (OS) is more cost-effective in treatment of traumatic fractures and degenerative lesions. The objective of this study is to compare the clinical results and hospitalization costs of OS and PO for degenerative lesions and thoraco-lumbar fractures. This cost-minimization study was performed in patients undergoing OS or PO on a 36-month period. Patient data, surgical and clinical results, as well as cost data were collected and analyzed. The financial costs were calculated based on diagnosis related group reimbursement and the French national cost scale, enabling the evaluation of charges for each hospital stay. 46 patients were included in this cost analysis, 24 patients underwent OS and 22 underwent PO. No significant difference was found between surgical groups in terms of patient's clinical features and outcomes during the patient hospitalization. The use of PO was significantly associated with a decrease in Length Of Stay (LOS). The cost-minimization revealed that PO is associated with decreased hospital charges and shorten LOS for patients, with similar clinical outcomes and medical device cost to OS. This medico-economic study has leaded to choose preferentially the use of minimally invasive surgery techniques. This study also illustrates the discrepancy between the national health system reimbursement and real hospital charges. The medico-economic is becoming critical in the current context of sustainable health resource allocation. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Neutral buoyancy is optimal to minimize the cost of transport in horizontally swimming seals

PubMed Central

Sato, Katsufumi; Aoki, Kagari; Watanabe, Yuuki Y.; Miller, Patrick J. O.

2013-01-01

Flying and terrestrial animals should spend energy to move while supporting their weight against gravity. On the other hand, supported by buoyancy, aquatic animals can minimize the energy cost for supporting their body weight and neutral buoyancy has been considered advantageous for aquatic animals. However, some studies suggested that aquatic animals might use non-neutral buoyancy for gliding and thereby save energy cost for locomotion. We manipulated the body density of seals using detachable weights and floats, and compared stroke efforts of horizontally swimming seals under natural conditions using animal-borne recorders. The results indicated that seals had smaller stroke efforts to swim a given speed when they were closer to neutral buoyancy. We conclude that neutral buoyancy is likely the best body density to minimize the cost of transport in horizontal swimming by seals. PMID:23857645

A videoscope for use in minimally invasive periodontal surgery.

PubMed

Harrel, Stephen K; Wilson, Thomas G; Rivera-Hidalgo, Francisco

2013-09-01

Minimally invasive periodontal procedures have been reported to produce excellent clinical results. Visualization during minimally invasive procedures has traditionally been obtained by the use of surgical telescopes, surgical microscopes, glass fibre endoscopes or a combination of these devices. All of these methods for visualization are less than fully satisfactory due to problems with access, magnification and blurred imaging. A videoscope for use with minimally invasive periodontal procedures has been developed to overcome some of the difficulties that exist with current visualization approaches. This videoscope incorporates a gas shielding technology that eliminates the problems of fogging and fouling of the optics of the videoscope that has previously prevented the successful application of endoscopic visualization to periodontal surgery. In addition, as part of the gas shielding technology the videoscope also includes a moveable retractor specifically adapted for minimally invasive surgery. The clinical use of the videoscope during minimally invasive periodontal surgery is demonstrated and discussed. The videoscope with gas shielding alleviates many of the difficulties associated with visualization during minimally invasive periodontal surgery. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Transnasal endoscopy: Technical considerations, advantages and limitations.

PubMed

Atar, Mustafa; Kadayifci, Abdurrahman

2014-02-16

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes.

Transnasal endoscopy: Technical considerations, advantages and limitations

PubMed Central

Atar, Mustafa; Kadayifci, Abdurrahman

2014-01-01

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes. PMID:24567791

[The present and future state of minimized extracorporeal circulation].

PubMed

Meng, Fan; Yang, Ming

2013-05-01

Minimized extracorporeal circulation improved in the postoperative side effects of conventional extracorporeal circulation is a kind of new extracorporeal circulation. This paper introduces the principle, characteristics, applications and related research of minimized extracorporeal circulation. For the problems of systemic inflammatory response syndrome and limited assist time, the article proposes three development direction including system miniaturization and integration, pulsatile blood pump and the adaptive control by human parameter identification.

Is there really a clinical benefit of using minimized extracorporeal circulation for coronary artery bypass grafting?

PubMed

Schöttler, J; Lutter, G; Böning, A; Soltau, D; Bein, B; Caliebe, D; Haake, N; Schoeneich, F; Cremer, J

2008-03-01

Minimized extracorporeal circulation is intended to reduce the negative effects associated with cardiopulmonary bypass. This prospective study was performed to evaluate whether minimized extracorporeal circulation has a clinical benefit for coronary artery surgery patients compared to standard extracorporeal circulation. Sixty patients were randomized into two study groups: 30 patients underwent coronary artery bypass grafting using minimized extracorporeal circulation and 30 patients were operated using standard extracorporeal circulation. Baseline characteristics, intraoperative details, postoperative data, perioperative blood chemistry determinations of hematocrit, platelets, muscle-brain fraction of the creatine kinase, cardiac troponin T and colloid osmotic pressure as measurements of intrathoracic blood volume index and extravascular lung water index were compared. Baseline characteristics and intraoperative details of both groups were similar. Patients who underwent minimized extracorporeal circulation showed more short-term dependency on norepinephrine ( P < 0.01). Their maximal postoperative muscle-brain fraction of the creatine kinase was lower ( P < 0.05) and their hematocrit on arrival in the intensive care unit was higher ( P < 0.01). No other significant differences were found. In both collectives, values for hematocrit ( P < 0.001), platelets ( P < 0.001), colloid osmotic pressure ( P < 0.001) and intrathoracic blood volume index ( P < 0.05) decreased, while the extravascular lung water index did not change significantly during cardiopulmonary bypass. A clinical advantage of minimized over standard extracorporeal circulation was not found. Furthermore, a higher number of patients in the minimized extracorporeal circulation group required postoperative norepinephrine infusions for hemodynamic stabilization. In summary, the presumed superiority of minimized extracorporeal circulation for coronary artery bypass grafting in standard patients could not be

Application of Gelatin Sponge Impregnated with a Mixture of 3 Drugs to Intraoperative Nerve Root Block Combined with Robot-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery in the Treatment of Adult Degenerative Scoliosis: A Clinical Observation Including 96 Patients.

PubMed

Du, Jin Peng; Fan, Yong; Liu, Ji Jun; Zhang, Jia Nan; Chang Liu, Shi; Hao, Dingjun

2017-12-01

Application of nerve root block is mainly for diagnosis with less application in intraoperative treatment. The aim of this study was to observe clinical and imaging outcomes of application of gelatin sponge impregnated with a mixture of 3 drugs to intraoperative nerve root block combined with robot-assisted minimally invasive transforaminal lumbar interbody fusion surgery in to treat adult degenerative lumbar scoliosis. From January 2012 to November 2014, 108 patients with adult degenerative lumbar scoliosis were treated with robot-assisted minimally invasive transforaminal lumbar interbody fusion surgery combined with intraoperative gelatin sponge impregnated with a mixture of 3 drugs. Visual analog scale and Oswestry Disability Index scores were used to evaluate postoperative improvement of back and leg pain, and clinical effects were assessed according to the 36-Item Short-Form Health Survey. Imaging was obtained preoperatively, 1 week and 3 months postoperatively, and at the last follow-up. Fusion status, complications, and other outcomes were assessed. Follow-up was complete for 96 patients. Visual analog scale scores of leg and back pain on postoperative days 1-7 were decreased compared with preoperatively. At 1 week postoperatively, 3 months postoperatively, and last follow-up, visual analog scale score, Oswestry Disability Index score, coronal Cobb angle, and coronal and sagittal deviated distance decreased significantly (P = 0.000) and lumbar lordosis angle increased (P = 0.000) compared with preoperatively. Improvement rate of Oswestry Disability Index was 81.8% ± 7.4. Fusion rate between vertebral bodies was 92.7%. Application of gelatin sponge impregnated with 3 drugs combined with robot-assisted minimally invasive transforaminal lumbar interbody fusion for treatment of adult degenerative lumbar scoliosis is safe and feasible with advantages of good short-term analgesia effect, minimal invasiveness, short length of stay, and good long-term clinical

The advantages of a swept source optical coherence tomography system in the evaluation of occlusal disorders

NASA Astrophysics Data System (ADS)

Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

2014-01-01

Occlusal disorders are characterized by multiple dental and periodontal signs. Some of these are reversible (such as excessive tooth mobility, fremitus, tooth pain, migration of teeth in the absence of periodontitis), some are not (pathological occlusal/incisal wear, abfractions, enamel cracks, tooth fractures, gingival recessions). In this paper we prove the advantages of a fast swept source OCT system in the diagnosis of pathological incisal wear, a key sign of the occlusal disorders. On 15 extracted frontal teeth four levels of pathological incisal wear facets were artificially created. After every level of induced defect, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. A swept source OCT instrument is used in this study. The swept source is has a central wavelength of 1050 nm and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally measured. The pathological incisal wear is qualitatively observed on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, we used the Image J software. Our swept source OCT system has several advantages, including the ability to measure (in air) a minimal volume of 2352 μm3 and to collect high resolution volumetric images in 2.5 s. By calculating the areas of the amount of lost tissue corresponding to each difference of B-scans, the final volumes of incisal wear were obtained. This swept source OCT method is very useful for the dynamic evaluation of pathological incisal wear.

10 CFR 20.1406 - Minimization of contamination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Minimization of contamination. 20.1406 Section 20.1406 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Radiological Criteria for..., including the subsurface, in accordance with the existing radiation protection requirements in Subpart B and...

Minimally invasive approaches for gastric cancer-Korean experience.

PubMed

Yang, Han-Kwang; Suh, Yun-Suhk; Lee, Hyuk-Joon

2013-03-01

Laparoscopic surgery in Korea increased rapidly because of the early detection of gastric cancer by the development of diagnostic tools and nationwide screening. The Korean Laparoscopic Gastrointestinal Surgery Study Group (KLASS group) played a leading role in various projects related with minimally invasive surgery. The justification of minimally invasive procedures including robotic surgery, sentinel-node biopsy, or single-port surgery/Natural Orifice Transluminal Endoscopic Surgery (NOTES) must be predetermined by the clinical trial before a wide application, and the medical industry as well as surgeons should have great responsibility. Copyright © 2012 Wiley Periodicals, Inc.

Advantageous Inequity Aversion Does Not Always Exist: The Role of Determining Allocations Modulates Preferences for Advantageous Inequity.

PubMed

Li, Ou; Xu, Fuming; Wang, Lei

2018-01-01

Previous studies have shown that people would like to sacrifice benefits to themselves in order to avoid inequitable outcomes, not only when they receive less than others (disadvantageous inequity aversion) but also when they receive more (advantageous inequity aversion). This feature is captured by the theory of inequity aversion. The present study was inspired by what appears to be asymmetry in the research paradigm toward advantageous inequity aversion. Specifically, studies that supported the existence of advantageous inequity aversion always relied on the paradigm in which participants can determine allocations. Thus, it is interesting to know what would occur if participants could not determine allocations or simply passed judgment on predetermined allocations. To address this, a behavioral experiment ( N = 118) and a skin conductance response (SCR) experiment ( N = 29) were adopted to compare participants' preferences for advantageous inequity directly when allocations were determined and when allocations were predetermined in an allocating task. In the determined condition, participants could divide by themselves a sum of money between themselves and a matched person, whereas in the predetermined condition, they could simply indicate their satisfaction with an equivalent program-generated allocation. It was found that, compared with those in the determined condition, participants in the predetermined condition behaved as if they liked the advantageous inequity and equity to the same degree (Experiment One) and that the SCRs elicited by advantageous inequity had no differences from those elicited by equity, suggesting that participants did not feel negatively toward advantageous inequity in this situation (Experiment Two). The present study provided mutual corroboration (behavioral and electrophysiological data) to document that advantageous inequity aversion may differ as a function of the individual's role in determining allocations, and it would disappear

Home advantage in Greek football.

PubMed

Armatas, Vasilis; Pollard, Richard

2014-01-01

Home advantage as it relates to team performance at football was examined in Superleague Greece using nine seasons of game-by-game performance data, a total of 2160 matches. After adjusting for team ability and annual fluctuations in home advantage, there were significant differences between teams. Previous findings regarding the role of territorial protection were strengthened by the fact that home advantage was above average for the team from Xanthi (P =0.015), while lower for teams from the capital city Athens (P =0.008). There were differences between home and away teams in the incidence of most of the 13 within-game match variables, but associated effect sizes were only moderate. In contrast, outcome ratios derived from these variables, and measuring shot success, had negligible effect sizes. This supported a previous finding that home and away teams differed in the incidence of on-the-ball behaviours, but not in their outcomes. By far the most important predictor of home advantage, as measured by goal difference, was the difference between home and away teams in terms of kicked shots from inside the penalty area. Other types of shots had little effect on the final score. The absence of a running track between spectators and the playing field was also a significant predictor of goal difference, worth an average of 0.102 goals per game to the home team. Travel distance did not affect home advantage.

Time-to-administration in postoperative chemotherapy for colorectal cancer: does minimally-invasive surgery help?

PubMed

Amore Bonapasta, Stefano; Checcacci, Paolo; Guerra, Francesco; Mirasolo, Vita M; Moraldi, Luca; Ferrara, Angelo; Annecchiarico, Mario; Coratti, Andrea

2016-06-01

The optimal delay in the start of chemotherapy following rectal cancer surgery has not yet been identified. However, postponed adjuvant therapy has been proven to be connected with a significant survival detriment. We aimed to investigate whether the time to initiation of adjuvant treatment can be influenced by the application of minimally invasive surgery rather than traditional open surgery. By comprehensively evaluating the available inherent literature, several factors appear to be associated with delayed postoperative chemotherapy. Some of them are strictly related to surgical short-term outcomes. Laparoscopy results in shortened length of hospital stay, reduced surgical morbidity and lower rate of wound infection compared to conventional surgery. Probably due to such advantages, the application of minimally-invasive surgery to treat rectal malignancies seems to impact favorably the possibility to start adjuvant chemotherapy within an adequate timeframe following surgical resection, with potential improvement in patient survival.

Deep Inspiration Breath Hold: Techniques and Advantages for Cardiac Sparing During Breast Cancer Irradiation.

PubMed

Bergom, Carmen; Currey, Adam; Desai, Nina; Tai, An; Strauss, Jonathan B

2018-01-01

Historically, heart dose from left-sided breast radiotherapy has been associated with a risk of cardiac injury. Data suggests that there is not a threshold for the deleterious effects from radiation on the heart. Over the past several years, advances in radiation delivery techniques have reduced cardiac morbidity due to treatment. Deep inspiration breath hold (DIBH) is a technique that takes advantage of a more favorable position of the heart during inspiration to minimize heart doses over a course of radiation therapy. In the accompanying review article, we outline several methods used to deliver treatment with DIBH, quantify the benefits of DIBH treatment, discuss considerations for patient selection, and identify challenges associated with DIBH techniques.

The 'Adventist advantage'. Glendale Adventist Medical Center distinguishes itself.

PubMed

Botvin, Judith D

2002-01-01

Glendale Adventist Medical Center, Glendale, Calif., adopted an image-building campaign to differentiate the 450-bed hospital from its neighbors. This included the headline "Adventist Advantage," used in a series of sophisticated ads, printed in gold. In all their efforts, marketers consider the sensibilities of the sizable Armenian, Korean, Hispanic and Chinese populations.

Do the Advantages of Ungraded Schools Outweigh the Disadvantages?

ERIC Educational Resources Information Center

Kingston, Albert J.

1968-01-01

Concludes that at present it is not possible to state whether the advantages of the nongraded school outweigh the disadvantages because lack of operational meaning has resulted in a wide variety of organizational programs labeled nongraded, and non conclusive data are available which favor either the nongraded or graded organizations. Includes a…

76 FR 56262 - Community Advantage Pilot Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... SMALL BUSINESS ADMINISTRATION [Docket No. SBA 2011-0003] Community Advantage Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Notice of change to Community Advantage Pilot... Community Advantage Pilot Program. In that notice, SBA modified or waived as appropriate certain regulations...

Hexavalent Chromium Minimization Strategy

DTIC Science & Technology

2011-05-01

Logistics 4 Initiative - DoD Hexavalent Chromium Minimization Non- Chrome Primer IIEXAVAJ ENT CHRO:M I~UMI CHROMIUM (VII Oil CrfVli.J CANCEfl HAnRD CD...Management Office of the Secretary of Defense Hexavalent Chromium Minimization Strategy Report Documentation Page Form ApprovedOMB No. 0704-0188...00-2011 4. TITLE AND SUBTITLE Hexavalent Chromium Minimization Strategy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

[Minimally invasive approaches to hip and knee joints for total joint replacement].

PubMed

Rittmeister, M; König, D P; Eysel, P; Kerschbaumer, F

2004-11-01

The manuscript features the different minimally invasive approaches to the hip for joint replacement. These include medial, anterior, anterolateral, and posterior approaches. The concept of minimally invasive hip arthroplasty makes sense if it is an integral part of a larger concept to lower postoperative morbidity. Besides minimal soft tissue trauma, this concept involves preoperative patient education, preemptive analgesia, and postoperative physiotherapy. It is our belief that minimal incision techniques for the hip are not suited for all patients and all surgeons. The different minimally invasive approaches to the knee joint for implantation of a knee arthroplasty are described and discussed. There have been no studies published yet that fulfill EBM criteria. The data so far show that minimally invasive approaches and implantation techniques for total knee replacements lead to quicker rehabilitation of patients.

Advantages and disadvantages of computer imaging in cosmetic surgery.

PubMed

Koch, R J; Chavez, A; Dagum, P; Newman, J P

1998-02-01

Despite the growing popularity of computer imaging systems, it is not clear whether the medical and legal advantages of using such a system outweigh the disadvantages. The purpose of this report is to evaluate these aspects, and provide some protective guidelines in the use of computer imaging in cosmetic surgery. The positive and negative aspects of computer imaging from a medical and legal perspective are reviewed. Also, specific issues are examined by a legal panel. The greatest advantages are potential problem patient exclusion, and enhanced physician-patient communication. Disadvantages include cost, user learning curve, and potential liability. Careful use of computer imaging should actually reduce one's liability when all aspects are considered. Recommendations for such use and specific legal issues are discussed.

Comparison of surgical outcomes between open and robot-assisted minimally invasive pancreaticoduodenectomy.

PubMed

Kim, Hyeong Seok; Han, Youngmin; Kang, Jae Seung; Kim, Hongbeom; Kim, Jae Ri; Koon, Wooil; Kim, Sun-Whe; Jang, Jin-Young

2018-02-01

Robot surgery is a new method that maintains advantages and overcomes disadvantages of conventional methods, even in pancreatic surgery. This study aimed to evaluate safety and benefits of robot-assisted minimally invasive pancreaticoduodenectomy (robot PD). This study included 237 patients who underwent PD between 2015 and 2017. Demographics and surgical outcomes were evaluated. Fifty-one patients underwent robot PD and 186 underwent open PD. Robot PD group had younger age (60.7 vs. 65.4 years, P = 0.006) and lower body mass index (22.7 vs. 24.0, P = 0.007). Robot PD group had lower proportion of patients with firm or hard pancreatic texture (15.7% vs. 38.2%, P = 0.004) and smaller pancreatic duct size (2.3 vs. 3.3 mm, P = 0.002). Two groups had similar operation time (robot vs. open: 335.6 vs. 330.1 min) and complications (15.7% vs. 21.0%), including postoperative pancreatic fistula rate (6.0% vs. 12.0%). Robot PD group had lower postoperative pain score (3.7 vs. 4.1 points, P = 0.008), and shorter postoperative stay (10.6 vs. 15.3 days, P = 0.001). Robot PD is comparable to open PD in early outcomes. Robot PD is safe and feasible and enables early recovery; indication for robot PD is expected to expand in the near future. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

[Thymomectomy by minimally invasive surgery. Comparative study videosurgery versus robot-assisted surgery].

PubMed

Witte Pfister, A; Baste, J-M; Piton, N; Bubenheim, M; Melki, J; Wurtz, A; Peillon, C

2017-05-01

To report the results of minimally invasive surgery in patients with stage I or II thymoma in the Masaoka classification. The reference technique is partial or complete thymectomy by sternotonomy. A retrospective single-center study of a prospective database including all cases of thymoma operated from April 2009 to February 2015 by minimally invasive techniques: either videosurgery (VATS) or robot-assisted surgery (RATS). The surgical technique, type of resection, length of hospital stay, postoperative complications and recurrences were analysed. Our series consisted of 22 patients (15 women and 7 men). The average age was 53 years. Myasthenia gravis was present in 12 patients. Eight patients were operated on by VATS and 14 patiens by RATS. There were no conversions to sternotomy and no perioperative deaths. The mean operating time was 92min for VATS and 137min for RATS (P<0.001). The average hospital stay was 5 days. The mean weight of the specimen for the VATS group was 13.2 and 45.7mg for the RATS group. Twelve patients were classified Masaoka stage I and 10 were stage II. According to the WHO classification there were 7 patients type A, 5 type AB, 4 type B1, 4 type B2 4 and 2 type B3. As proposed by the Group ITMIG-IASLC in 2015 all patients corresponded to group I. The mean follow-up period was 36 months. We noted 3 major perioperative complications according to the Clavien-Dindo classification: one pneumonia, one phrenic nerve paralysis and one recurrent laryngeal nerve palsy. We observed one case of local recurrence at 22 months. Following surgery 4 patients were treated with radiotherapy and 2 patients with chemotherapy. The minimally invasive route is safe, relatively atraumatic and may be incorporated in the therapeutic arsenal for the treatment of Masaoka stage I and II thymoma as an alternative to conventional sternotomy. RATS and VATS are two minimally invasive techniques and the results in the short and medium term are

Women's Heart Advantage Program: the impact 3 years later.

PubMed

Gombeski, William R; Kramer, R Kyle; Freed, Lisa; Foody, JoAnne; Parkosewich, Janet; Wilson, Tammi; Wack, Jeffery T; D'Onofrio, Gail

2005-01-01

Yale-New Haven Hospital, in partnership with Voluntary Hospital Association (VHA Inc), launched the Women's Heart Advantage program in March 2001. Major program components implemented include (1) a comprehensive initial and ongoing internal communication program; (2) a health promotion initiative including a 24-hour, 7-days-a-week women's heart line staffed by nurses and an Internet health question-and-answer forum; (3) significant ongoing communication with nurses and physicians; (4) a community outreach effort to educate poor and minority women; and (5) an aggressive effort to secure financial partners to underwrite the cost of the program. Before launching the program, a telephone survey of 300 randomly selected New Haven County women ages 40 to 70 years was initiated in January 2001 and repeated in January 2002, 2003, and 2004. Findings include (1) the percentage of women who recognize heart disease as the number-one killer of women their age increased from 26% in 2001 to 59% in 2004, (2) the percentage of women who would call 9-1-1 or go directly to a hospital emergency department increased from 63% in 2002 to 83% in 2004, and (3) the percentage of women aware of recent Women's Heart Advantage program promotion grew from 33% in 2002 to 50% in 2004. Perhaps most importantly, the number of women with heart problems admitted through the hospital's emergency department increased from 1528 per year in 2001 to 1870 per year in 2004 (7.5% annual increase), whereas the number of men with heart problems admitted through the emergency department during the same time period has been relatively low (0.8% annual increase). By linking clinical, public health, and marketing expertise along with finding ways to partner with other organizations, the Women's Heart Advantage program has contributed to remarkable changes in women's awareness, knowledge, and behaviors, suggesting a model for approaching similar health-related problems.

Minimally invasive extravesical ureteral reimplantation for vesicoureteral reflux.

PubMed

Chen, Hsiao-Wen; Lin, Ghi-Jen; Lai, Ching-Horng; Chu, Sheng-Hsien; Chuang, Cheng-Keng

2002-04-01

We designed a new extravesical ureteral reimplantation technique with a minimally invasive approach from skin to ureterovesical junction with less perivesical tissue manipulation to avoid extensive bladder denervation. Between July 1996 and December 2000, 37 boys and 52 girls 1.2 to 10.8 years old (mean age plus or minus standard deviation 3.8 +/- 2.5) (113 ureters) were treated with minimally invasive extravesical ureteral reimplantation. Vesicoureteral reflux was graded I to V in 8, 12, 43, 29 and 21 cases, respectively. The technique involves an approximately 10 to 15 mm. incision passing through the small triangular gap of the aponeurosis of the external abdominal oblique muscle and transversalis fascia to the point of the ureterovesical junction. The surgical field was exposed with mini-retractors and fine dissecting instruments were used to avoid unnecessary tissue manipulation. At postoperative followup 1 patient had persistent grade II reflux and 2 had moderate hydronephrosis and hydroureter, which resolved after 18 months. No patient returned due to voiding inefficiency or for pain control after discharge from the outpatient setting. This new technique can be easily used for vesicoureteral reflux with the advantages of simple intervention for surgeons, especially those with inguinal herniorrhaphy and antireflux surgery experience, and less wound discomfort for patients. The whole procedure can be performed on an outpatient basis. However, the decision to use this technique should be based on individual consideration.

Safety of minimally invasive pituitary surgery (MIPS) compared with a traditional approach.

PubMed

White, David R; Sonnenburg, Robert E; Ewend, Matthew G; Senior, Brent A

2004-11-01

Transsphenoidal hypophysectomy is becoming progressively less invasive. Recent endoscopic techniques avoid nasal or intraoral incisions, use of nasal speculums, and nasal packing. Several case series of endoscopic endonasal pituitary surgery have been reported, but relatively little data exists comparing complication rates to more traditional approaches. We compare the complications of our first 50 cases of endoscopic, minimally invasive pituitary surgery (MIPS) to our last 50 sublabial transseptal (SLTS) procedures. Retrospective case control study. Fifty consecutive MIPS procedures and 50 consecutive SLTS procedures were reviewed retrospectively. Complication rates were analyzed and compared. Total complications per patient (P = .005), postoperative epistaxis (P = .031), lip anesthesia (P = .013), and deviated septum (P = .028) occurred more often in the SLTS group. No significant difference was seen in cerebrospinal fluid leak, meningitis, ophthalmoplegia, visual acuity loss, diabetes insipidus, intracranial hemorrhage, or death. In the MIPS group, length of stay (P < .001), use of lumbar drainage (P = .007), and nasal packing (P < .001) were also significantly reduced. Endoscopic endonasal pituitary surgery provides improved complication rates when compared with SLTS approaches. In addition, we note advantages of the MIPS approach, including reduced length of hospital stay and decreased use of lumbar drainage and nasal packing.

Surgical approach to hysterectomy and barriers to using minimally invasive methods.

PubMed

Janda, Monika; Armfield, Nigel R; Kerr, Gayle; Kurz, Suzanne; Jackson, Graeme; Currie, Jason; Page, Katie; Weaver, Edward; Yazdani, Anusch; Obermair, Andreas

2018-05-15

Minimally invasive approaches to hysterectomy have been shown to be safe, effective and have recovery advantages over open hysterectomy, yet in Australia 36% of hysterectomies are still conducted by open surgery. In 2006, a survey of Australian gynaecological specialists found the main impediment to increasing laparoscopic hysterectomy to be a lack of surgical skills training opportunities. We resurveyed specialists to explore contemporary factors influencing surgeons' approaches to hysterectomy; 258 (estimated ~19%) provided analysable responses. Despite >50% of surveyed specialists wishing to practise laparoscopic hysterectomy in the future, lack of surgical skills, arising from the lack of training opportunities, remains the main impediment. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Minimally invasive carpal tunnel decompression using the KnifeLight.

PubMed

Hwang, Peter Y K; Ho, Chi Long

2007-02-01

Carpal tunnel syndrome is a common condition causing hand pain, dysfunction, and paresthesia. Endoscopic carpal tunnel decompression offers many advantages compared with conventional open surgical decompression. However, it is equipment intensive and requires familiarity with endoscopic surgery. We review a minimally invasive technique to divide the flexor retinaculum by using a new instrument, the KnifeLight (Stryker, Kalamazoo, Michigan), which combines the advantages of the open and endoscopic methods, without the need for endoscopic set-up. Between July 2003 and April 2005, 44 consecutive patients (26 women [59%] and 18 men [36%]), with clinical signs and symptoms, as well as electrodiagnostic findings consistent with carpal tunnel syndrome, who did not respond to non-surgical treatment, underwent the new procedure. All patients were asked about scar hypertrophy, scar tenderness, and pillar pain. The Michigan Hand Outcomes Questionnaire (MHQ) was used to determine overall hand function, activities of daily living, work performance, pain, aesthetics, and satisfaction with hand function. Other preoperative testing included grip strength and lateral pinch strength. Grip strength was measured using the Jamar hand dynamometer (Asimov Engineering Co., Los Angeles, CA); lateral key pinch was measured using the Jamar hydraulic pinch gauge. Postoperative evaluations were scheduled at 2 weeks, 3 months, and 6 months after the procedure. A small 10-mm incision was made in the wrist crease and a small opening was made at the transverse carpal ligament. The KnifeLight tool was inserted, and the ligament was incised completely. Follow-up evaluations with use of quantitative measurements of grip strength, pinch strength, and hand dexterity were performed at 2 weeks, 3 months, and 6 months after surgery. Fifty procedures were performed on 22 left hands (44%) and 28 right hands (56%). There were no complications related to the approach. All patients were able to use their hands

Penrose-like inequality with angular momentum for minimal surfaces

NASA Astrophysics Data System (ADS)

Anglada, Pablo

2018-02-01

In axially symmetric spacetimes the Penrose inequality can be strengthened to include angular momentum. We prove a version of this inequality for minimal surfaces, more precisely, a lower bound for the ADM mass in terms of the area of a minimal surface, the angular momentum and a particular measure of the surface size. We consider axially symmetric and asymptotically flat initial data, and use the monotonicity of the Geroch quasi-local energy on 2-surfaces along the inverse mean curvature flow.

The Blueprint of a Minimal Cell: MiniBacillus

PubMed Central

Reuß, Daniel R.; Commichau, Fabian M.; Gundlach, Jan; Zhu, Bingyao

2016-01-01

SUMMARY Bacillus subtilis is one of the best-studied organisms. Due to the broad knowledge and annotation and the well-developed genetic system, this bacterium is an excellent starting point for genome minimization with the aim of constructing a minimal cell. We have analyzed the genome of B. subtilis and selected all genes that are required to allow life in complex medium at 37°C. This selection is based on the known information on essential genes and functions as well as on gene and protein expression data and gene conservation. The list presented here includes 523 and 119 genes coding for proteins and RNAs, respectively. These proteins and RNAs are required for the basic functions of life in information processing (replication and chromosome maintenance, transcription, translation, protein folding, and secretion), metabolism, cell division, and the integrity of the minimal cell. The completeness of the selected metabolic pathways, reactions, and enzymes was verified by the development of a model of metabolism of the minimal cell. A comparison of the MiniBacillus genome to the recently reported designed minimal genome of Mycoplasma mycoides JCVI-syn3.0 indicates excellent agreement in the information-processing pathways, whereas each species has a metabolism that reflects specific evolution and adaptation. The blueprint of MiniBacillus presented here serves as the starting point for a successive reduction of the B. subtilis genome. PMID:27681641

The Growth Advantage in Stationary-Phase Phenotype Conferred by rpoS Mutations Is Dependent on the pH and Nutrient Environment

PubMed Central

Farrell, Michael J.; Finkel, Steven E.

2003-01-01

Escherichia coli cells that are aged in batch culture display an increased fitness referred to as the growth advantage in stationary phase, or GASP, phenotype. A common early adaptation to this culture environment is a mutant rpoS allele, such as rpoS819, that results in attenuated RpoS activity. However, it is important to note that during long-term batch culture, environmental conditions are in flux. To date, most studies of the GASP phenotype have focused on identifying alleles that render an advantage in a specific environment, Luria-Bertani broth (LB) batch culture. To determine what role environmental conditions play in rendering relative fitness advantages to E. coli cells carrying either the wild-type or rpoS819 alleles, we performed competitions under a variety of culture conditions in which either the available nutrients, the pH, or both were manipulated. In LB medium, we found that while the rpoS819 allele confers a strong competitive fitness advantage at basic pH, it confers a reduced advantage under neutral conditions, and it is disadvantageous under acidic conditions. Similar results were found using other media. rpoS819 conferred its greatest advantage in basic minimal medium in which either glucose or Casamino Acids were the sole source of carbon and energy. In acidic medium supplemented with either Casamino Acids or glucose, the wild-type allele conferred a slight advantage. In addition, populations were dynamic under all pH conditions tested, with neither the wild-type nor mutant rpoS alleles sweeping a culture. We also found that the strength of the fitness advantage gained during a 10-day incubation is pH dependent. PMID:14645263

A complicated case of amyand's hernia involving a perforated appendix and its management using minimally invasive laparoscopic surgery: A case report.

PubMed

Al-Ramli, Wisam; Khodear, Yahya; Aremu, Muyiwa; El-Sayed, Abdel Basset

2016-01-01

Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases. 1 These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment. Laparoscopic surgery offers a less invasive approach to confirming a diagnosis and serving as a therapeutic tool in equivocal cases. We report a case of a previously healthy 20-year-old male presenting with atypical signs and symptoms, as well as blood investigation results, and radiological findings of a perforated appendix within an Amyand's hernia. The patient was successfully managed using a minimally invasive laparoscopic appendectomy approach. Until recently, open appendectomy was considered the mainstay in the management of complicated Amyand's hernia. Laparoscopic surgery provides a new avenue for dealing with diagnostic uncertainty with advantages including faster recovery time, reduced hospital stay, and better quality of life. This case report highlights the concealing effects of an Amyand's hernia on a perforated appendix, the considerations required when an equivocal diagnosis present and the safe use of the minimally invasive laparoscopic surgery in the treatment of this rare condition. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Psychiatric wards with locked doors--advantages and disadvantages according to nurses and mental health nurse assistants.

PubMed

Haglund, K; von Knorring, L; von Essen, L

2006-04-01

To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for

How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era.

PubMed

Chen, Xing; Zhang, Xing

2016-01-01

Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty.

How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era

PubMed Central

2016-01-01

Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty. PMID:28115932

Efficient Levenberg-Marquardt minimization of the maximum likelihood estimator for Poisson deviates

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

Laurence, T; Chromy, B

2009-11-10

estimator (MLE) for the Poisson distribution is also well known, but has not become generally used. This is primarily because, in contrast to non-linear least squares fitting, there has been no quick, robust, and general fitting method. In the field of fluorescence lifetime spectroscopy and imaging, there have been some efforts to use this estimator through minimization routines such as Nelder-Mead optimization, exhaustive line searches, and Gauss-Newton minimization. Minimization based on specific one- or multi-exponential models has been used to obtain quick results, but this procedure does not allow the incorporation of the instrument response, and is not generally applicable to models found in other fields. Methods for using the MLE for Poisson-distributed data have been published by the wider spectroscopic community, including iterative minimization schemes based on Gauss-Newton minimization. The slow acceptance of these procedures for fitting event counting histograms may also be explained by the use of the ubiquitous, fast Levenberg-Marquardt (L-M) fitting procedure for fitting non-linear models using least squares fitting (simple searches obtain {approx}10000 references - this doesn't include those who use it, but don't know they are using it). The benefits of L-M include a seamless transition between Gauss-Newton minimization and downward gradient minimization through the use of a regularization parameter. This transition is desirable because Gauss-Newton methods converge quickly, but only within a limited domain of convergence; on the other hand the downward gradient methods have a much wider domain of convergence, but converge extremely slowly nearer the minimum. L-M has the advantages of both procedures: relative insensitivity to initial parameters and rapid convergence. Scientists, when wanting an answer quickly, will fit data using L-M, get an answer, and move on. Only those that are aware of the bias issues will bother to fit using the more appropriate MLE

Periodic minimal surfaces

NASA Astrophysics Data System (ADS)

Mackay, Alan L.

1985-04-01

A minimal surface is one for which, like a soap film with the same pressure on each side, the mean curvature is zero and, thus, is one where the two principal curvatures are equal and opposite at every point. For every closed circuit in the surface, the area is a minimum. Schwarz1 and Neovius2 showed that elements of such surfaces could be put together to give surfaces periodic in three dimensions. These periodic minimal surfaces are geometrical invariants, as are the regular polyhedra, but the former are curved. Minimal surfaces are appropriate for the description of various structures where internal surfaces are prominent and seek to adopt a minimum area or a zero mean curvature subject to their topology; thus they merit more complete numerical characterization. There seem to be at least 18 such surfaces3, with various symmetries and topologies, related to the crystallographic space groups. Recently, glyceryl mono-oleate (GMO) was shown by Longley and McIntosh4 to take the shape of the F-surface. The structure postulated is shown here to be in good agreement with an analysis of the fundamental geometry of periodic minimal surfaces.

Minimally-invasive biomarker studies in eosinophilic esophagitis: a systematic review.

PubMed

Hines, Brittany T; Rank, Matthew A; Wright, Benjamin L; Marks, Lisa A; Hagan, John B; Straumann, Alex; Greenhawt, Matthew; Dellon, Evan S

2018-05-10

Eosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus which currently requires repeated endoscopic biopsies for diagnosis and monitoring as no reliable non-invasive markers have been identified. To identify promising minimally-invasive EoE biomarkers and remaining gaps in biomarker validation. We performed a systematic review of EMBASE, Ovid Medline, PubMed, and Web of Science from inception to June 6, 2017. Studies were included if subjects met the 2007 consensus criteria for EoE diagnosis, a minimally-invasive biomarker was assessed, and the study included at least 1 control for comparison. The search identified 2094 studies, with 234 reviewed at full text level, and 49 included in the analysis (20 adult, 19 pediatric, 7 pediatric and adult, and 3 not stated). The majority (26 of 49) were published after 2014. Thirty-five studies included normal controls, 9 analyzed atopic controls, and 29 compared samples from subjects with active and inactive EoE. Minimally-invasive biomarkers were obtained from peripheral blood (n=41 studies), sponge/string samples (3), oral/throat swab secretions (2), breath condensate (2), stool (2), and urine (2). The most commonly reported biomarkers were peripheral blood eosinophils (16), blood and string eosinophil granule proteins (14), and eosinophil surface or intracellular markers (12). EoE biomarkers distinguished active EoE from normal controls in 23 studies, atopic controls in 2 studies, and inactive EoE controls in 20 studies. Several promising minimally-invasive biomarkers for EoE have emerged; however, few are able to differentiate EoE from other atopic diseases. Copyright © 2018. Published by Elsevier Inc.

Functionalization of SiO2 Surfaces for Si Monolayer Doping with Minimal Carbon Contamination.

PubMed

van Druenen, Maart; Collins, Gillian; Glynn, Colm; O'Dwyer, Colm; Holmes, Justin D

2018-01-17

Monolayer doping (MLD) involves the functionalization of semiconductor surfaces followed by an annealing step to diffuse the dopant into the substrate. We report an alternative doping method, oxide-MLD, where ultrathin SiO 2 overlayers are functionalized with phosphonic acids for doping Si. Similar peak carrier concentrations were achieved when compared with hydrosilylated surfaces (∼2 × 10 20 atoms/cm 3 ). Oxide-MLD offers several advantages over conventional MLD, such as ease of sample processing, superior ambient stability, and minimal carbon contamination. The incorporation of an oxide layer minimizes carbon contamination by facilitating attachment of carbon-free precursors or by impeding carbon diffusion. The oxide-MLD strategy allows selection of many inexpensive precursors and therefore allows application to both p- and n-doping. The phosphonic acid-functionalized SiO 2 surfaces were investigated using X-ray photoelectron spectroscopy and attenuated total reflectance Fourier transform infrared spectroscopy, whereas doping was assessed using electrochemical capacitance voltage and Hall measurements.

Minimal Marking: A Success Story

ERIC Educational Resources Information Center

McNeilly, Anne

2014-01-01

The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…

Principles and advantages of robotics in urologic surgery.

PubMed

Renda, Antonio; Vallancien, Guy

2003-04-01

Although the available minimally invasive surgical techniques (ie, laparoscopy) have clear advantages, these procedures continue to cause problems for patients. Surgical tools are limited by set axes of movement, restricting the degree of freedom available to the surgeon. In addition, depth perception is lost with the use of two-dimensional viewing systems. As surgeons view a "virtual" target on a television screen, they are hampered by decreased sensory input and a concurrent loss of dexterity. The development of robotic assistance systems in recent years could be the key to overcoming these difficulties. Using robotic systems, surgeons can experience a more natural and ergonomic surgical "feel." Surgical assistance, dexterity and precision enhancement, systems networking, and image-guided therapy are among the benefits offered by surgical robots. In return, the surgeon gains a shorter learning curve, reduced fatigue, and the opportunity to perform complex procedures that would be difficult using conventional laparoscopy. With the development of image-guided technology, robotic systems will become useful tools for surgical training and simulation. Remote surgery is not a routine procedure, but several teams are working on this and experiencing good results. However, economic concerns are the major drawbacks of these systems; before remote surgery becomes routinely feasible, the clinical benefits must be balanced with high investment and running costs.

Travel and the home advantage.

PubMed

Pace, A; Carron, A V

1992-03-01

The purpose of the present study was to examine the relative contributions of various travel related variables to visiting team success in the National Hockey League. A multiple regression design was used with game outcome as the dependent variable. The independent variables of interest included, as main effects and interactions, number of time zones crossed, direction of travel, distance traveled, preparation/adjustment time, time of season, game number on the road trip, and the home stand. Visiting team success was negatively associated with the interaction of number of time zones crossed and increased preparation time between games, and was positively associated with game number on the road. It was concluded that only a small portion of the variance in the home advantage/visitor disadvantage can be explained by travel related factors.

An Overview of Randomization and Minimization Programs for Randomized Clinical Trials

PubMed Central

Saghaei, Mahmoud

2011-01-01

Randomization is an essential component of sound clinical trials, which prevents selection biases and helps in blinding the allocations. Randomization is a process by which subsequent subjects are enrolled into trial groups only by chance, which essentially eliminates selection biases. A serious consequence of randomization is severe imbalance among the treatment groups with respect to some prognostic factors, which invalidate the trial results or necessitate complex and usually unreliable secondary analysis to eradicate the source of imbalances. Minimization on the other hand tends to allocate in such a way as to minimize the differences among groups, with respect to prognostic factors. Pure minimization is therefore completely deterministic, that is, one can predict the allocation of the next subject by knowing the factor levels of a previously enrolled subject and having the properties of the next subject. To eliminate the predictability of randomization, it is necessary to include some elements of randomness in the minimization algorithms. In this article brief descriptions of randomization and minimization are presented followed by introducing selected randomization and minimization programs. PMID:22606659

Minimally invasive treatment of urinary tract calculi in children.

PubMed

Fraser, M; Joyce, A D; Thomas, D F; Eardley, I; Clark, P B

1999-08-01

To report experience of a broad multimodality approach to the treatment of calculi in children using extracorporeal shock wave lithotripsy (ESWL), ureteroscopy/laser lithotripsy, lithoclast and percutaneous nephrolithotomy (PCNL). The treatment and outcome were reviewed in 43 children managed by a range of minimally invasive modalities, either singly or in combination, between 1990 and 1997. These patients represent a selected group deemed suitable for minimally invasive management during a period of developing experience with these techniques. Of this cohort, six children had previously undergone open stone surgery and contributory metabolic abnormalities were identified in seven. ESWL was the sole treatment modality in 24 children (56%). In five children (12%) ureteroscopy/laser lithotripsy was combined with ESWL, eight (18%) underwent ureteroscopy/laser lithotripsy alone, whilst three with bladder stones were treated with the lithoclast. Combined therapy including PCNL was required in three patients. Of the 43 children treated, 38 (88%) were rendered stone-free. Metabolic disorders accounted for three of the five cases of residual calculi. Complications requiring intervention occurred in two children (7%) and three subsequently underwent open pyelolithotomy or ureterolithotomy after unsuccessful minimally invasive treatment. Used selectively, the range of minimally invasive procedures available for adults, including ureteroscopy and PCNL, can be safely and effectively extended to the treatment of urinary tract calculi in children. The role of open surgery will diminish further with the availability of specialized instruments for paediatric PCNL.

MIS Score: Prediction Model for Minimally Invasive Surgery.

PubMed

Hu, Yuanyuan; Cao, Jingwei; Hou, Xianzeng; Liu, Guangcun

2017-03-01

Reports suggest that patients with spontaneous intracerebral hemorrhage (ICH) can benefit from minimally invasive surgery, but the inclusion criterion for operation is controversial. This article analyzes factors affecting the 30-day prognoses of patients who have received minimally invasive surgery and proposes a simple grading scale that represents clinical operation effectiveness. The records of 101 patients with spontaneous ICH presenting to Qianfoshan Hospital were reviewed. Factors affecting their 30-day prognosis were identified by logistic regression. A clinical grading scale, the MIS score, was developed by weighting the independent predictors based on these factors. Univariate analysis revealed that the factors that affect 30-day prognosis include Glasgow coma scale score (P < 0.01), age ≥80 years (P < 0.05), blood glucose (P < 0.01), ICH volume (P < 0.01), operation time (P < 0.05), and presence of intraventricular hemorrhage (P < 0.001). Logistic regression revealed that the factors that affect 30-day prognosis include Glasgow coma scale score (P < 0.05), age (P < 0.05), ICH volume (P < 0.01), and presence of intraventricular hemorrhage (P < 0.05). The MIS score was developed accordingly; 39 patients with 0-1 MIS scores had favorable prognoses, whereas only 9 patients with 2-5 MIS scores had poor prognoses. The MIS score is a simple grading scale that can be used to select patients who are suited for minimal invasive drainage surgery. When MIS score is 0-1, minimal invasive surgery is strongly recommended for patients with spontaneous cerebral hemorrhage. The scale merits further prospective studies to fully determine its efficacy. Copyright © 2016 Elsevier Inc. All rights reserved.

Minimally invasive PCNL-MIP.

PubMed

Zanetti, Stefano Paolo; Boeri, Luca; Gallioli, Andrea; Talso, Michele; Montanari, Emanuele

2017-01-01

Miniaturized percutaneous nephrolithotomy (mini-PCNL) has increased in popularity in recent years and is now widely used to overcome the therapeutic gap between conventional PCNL and less-invasive procedures such as shock wave lithotripsy (SWL) or flexible ureterorenoscopy (URS) for the treatment of renal stones. However, despite its minimally invasive nature, the superiority in terms of safety, as well as the similar efficacy of mini-PCNL compared to conventional procedures, is still under debate. The aim of this chapter is to present one of the most recent advancements in terms of mini-PCNL: the Karl Storz "minimally invasive PCNL" (MIP). A literature search for original and review articles either published or e-published up to December 2016 was performed using Google and the PubMed database. Keywords included: minimally invasive PCNL; MIP. The retrieved articles were gathered and examined. The complete MIP set is composed of different sized rigid metallic fiber-optic nephroscopes and different sized metallic operating sheaths, according to which the MIP is categorized into extra-small (XS), small (S), medium (M) and large (L). Dilation can be performed either in one-step or with a progressive technique, as needed. The reusable devices of the MIP and vacuum cleaner efect make PCNL with this set a cheap procedure. The possibility to shift from a small to a larger instrument within the same set (Matrioska technique) makes MIP a very versatile technique suitable for the treatment of almost any stone. Studies in the literature have shown that MIP is equally effective, with comparable rates of post-operative complications, as conventional PCNL, independently from stone size. MIP does not represent a new technique, but rather a combination of the last ten years of PCNL improvements in a single system that can transversally cover all available techniques in the panorama of percutaneous stone treatment.

Minimal but non-minimal inflation and electroweak symmetry breaking

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

Marzola, Luca; Institute of Physics, University of Tartu,Ravila 14c, 50411 Tartu; Racioppi, Antonio

2016-10-07

We consider the most minimal scale invariant extension of the standard model that allows for successful radiative electroweak symmetry breaking and inflation. The framework involves an extra scalar singlet, that plays the rôle of the inflaton, and is compatibile with current experimental bounds owing to the non-minimal coupling of the latter to gravity. This inflationary scenario predicts a very low tensor-to-scalar ratio r≈10{sup −3}, typical of Higgs-inflation models, but in contrast yields a scalar spectral index n{sub s}≃0.97 which departs from the Starobinsky limit. We briefly discuss the collider phenomenology of the framework.

Reach-to-grasp movement as a minimization process.

PubMed

Yang, Fang; Feldman, Anatol G

2010-02-01

It is known that hand transport and grasping are functionally different but spatially coordinated components of reach-to-grasp (RTG) movements. As an extension of this notion, we suggested that body segments involved in RTG movements are controlled as a coherent ensemble by a global minimization process associated with the necessity for the hand to reach the motor goal. Different RTG components emerge following this process without pre-programming. Specifically, the minimization process may result from the tendency of neuromuscular elements to diminish the spatial gap between the actual arm-hand configuration and its virtual (referent) configuration specified by the brain. The referent configuration is specified depending on the object shape, localization, and orientation. Since the minimization process is gradual, it can be interrupted and resumed following mechanical perturbations, at any phase during RTG movements, including hand closure. To test this prediction of the minimization hypothesis, we asked subjects to reach and grasp a cube placed within the reach of the arm. Vision was prevented during movement until the hand returned to its initial position. As predicted, by arresting wrist motion at different points of hand transport in randomly selected trials, it was possible to halt changes in hand aperture at any phase, not only during hand opening but also during hand closure. Aperture changes resumed soon after the wrist was released. Another test of the minimization hypothesis was made in RTG movements to an object placed beyond the reach of the arm. It has previously been shown (Rossi et al. in J Physiol 538:659-671, 2002) that in such movements, the trunk motion begins to contribute to hand transport only after a critical phase when the shifts in the referent arm configuration have finished (at about the time when hand velocity is maximal). The minimization rule suggests that when the virtual contribution of the arm to hand transport is completed

Nonlinear transient analysis via energy minimization

NASA Technical Reports Server (NTRS)

Kamat, M. P.; Knight, N. F., Jr.

1978-01-01

The formulation basis for nonlinear transient analysis of finite element models of structures using energy minimization is provided. Geometric and material nonlinearities are included. The development is restricted to simple one and two dimensional finite elements which are regarded as being the basic elements for modeling full aircraft-like structures under crash conditions. The results indicate the effectiveness of the technique as a viable tool for this purpose.

Minimally Invasive 2D Navigation-Assisted Treatment of Thoracolumbar Spinal Fractures in East Africa: A Case Report

PubMed Central

Njoku, Innocent; Wanin, Othman; Assey, Anthony; Shabani, Hamisi; Ngerageza, Japhet G; Berlin, Connor D

2016-01-01

Spinal surgery under Eastern-African circumstances is technically demanding and associated with significant complications, such as blood loss, infection, and wound breakdown. We report a spinal trauma case that was performed using minimally invasive surgery (MIS) and navigation, and hypothesize that these newer techniques may enable surgeons to perform effective spinal surgery with minimal complications and good outcomes.  During the 2014 First Hands-on Neurotrauma Course held in Dar es Salaam, Tanzania, we successfully performed three minimally invasive and two-dimensional (2D) navigated spinal surgeries to decompress and stabilize patients with complete and incomplete spinal injuries. In this report, we present a case of a paraplegic patient with a T12 burst fracture who tolerated MIS surgery with no intraoperative complications, and is doing well with no postoperative complications one year after surgery. Minimally invasive spinal surgery and 2D navigation may offer advantages in resource-poor countries. As part of the Weill Cornell Tanzania Neurosurgery project and in conjunction with the Foundation for International Education in Neurological Surgery (as well as other organizations), further experiences with 2D navigation and MIS surgery will be recorded in 2015. A neurotrauma registry has already been implemented to better understand the current management of neurotrauma in Eastern Africa. PMID:27026832

Fast graph-based relaxed clustering for large data sets using minimal enclosing ball.

PubMed

Qian, Pengjiang; Chung, Fu-Lai; Wang, Shitong; Deng, Zhaohong

2012-06-01

Although graph-based relaxed clustering (GRC) is one of the spectral clustering algorithms with straightforwardness and self-adaptability, it is sensitive to the parameters of the adopted similarity measure and also has high time complexity O(N(3)) which severely weakens its usefulness for large data sets. In order to overcome these shortcomings, after introducing certain constraints for GRC, an enhanced version of GRC [constrained GRC (CGRC)] is proposed to increase the robustness of GRC to the parameters of the adopted similarity measure, and accordingly, a novel algorithm called fast GRC (FGRC) based on CGRC is developed in this paper by using the core-set-based minimal enclosing ball approximation. A distinctive advantage of FGRC is that its asymptotic time complexity is linear with the data set size N. At the same time, FGRC also inherits the straightforwardness and self-adaptability from GRC, making the proposed FGRC a fast and effective clustering algorithm for large data sets. The advantages of FGRC are validated by various benchmarking and real data sets.

The Minimally Invasive Manipulator: an ergonomic and economic non-robotic alternative for endoscopy?

PubMed

Bosma, Jesse; Aarts, Sanne; Jaspers, Joris

2015-02-01

Since the da Vinci robotic system was introduced, it has been reported to have ergonomic advantages over conventional laparoscopy (COV). High investments associated with this system challenged us to design a more economical, mechanical alternative for improvement of laparoscopic ergonomics: the Minimally Invasive Manipulator (MIM). An earlier reported MIM prototype was investigated. Its shortcomings were input for the establishment of design criteria for a new prototype. A new prototype was developed, aiming at improved intuitiveness and ergonomics. The handle and instrument tip were redesigned and the parallelogram mechanism was converted from linear moving parts to mainly rotating parts. The new prototype was tested by a panel of experts and novices during an indicative ergonomic experiment. A major advantage of the MIM seems to be the possibility to perform laparoscopic surgery in a sitting position, in line with the working axis, instead of standing at the side of the patient. At an estimated cost level of 10% of the da Vinci system, the MIM can be an economical alternative for the enhancement of laparoscopy ergonomics. However, further development for clinical feasibility is necessary.

An orthodontic technique for minimally invasive extraction of impacted lower third molar.

PubMed

Ma, Zhi-Gui; Xie, Qian-Yang; Yang, Chi; Xu, Guang-Zhou; Cai, Xie-Yi; Li, Jie-Yan

2013-08-01

To present a novel orthodontic approach for minimally invasive extraction of impacted mandibular third molars (M3s) close to the inferior alveolar nerve (IAN). Eight patients (8 M3s) requiring extraction of M3s were included in this study; there were 2 cases of horizontal impaction, 4 of mesioangular impaction, and 2 of vertical impaction. Cone-beam computed tomogram showed that the roots of impacted M3s in 2 cases interrupted the cortices of the mandibular canal, and those in the other 6 cases were very close to the IAN. Orthodontic treatment was performed in this study. The crowns of 5 impacted teeth were surgically exposed before the application of the orthodontic device, whereas bonding was performed directly to the occlusal surface of the other 3 M3s, which had partially erupted. The opposing maxillary M3s were removed in 3 cases. One-step orthodontic extraction was applied to vertically impacted M3s and 2-step treatment was applied to horizontally or mesioangularly impacted M3s. Success was defined as the separation of the impacted tooth from the IAN as visualized on cone-beam computed tomogram. After orthodontic treatment, all impacted M3s were extruded and separated from the IAN (mean, 6.6 months; range, 4 to 10 months), without any neurologic consequences. The average time of extraction was 5 minutes. In all 8 cases, new bone formation occurred distal to the adjacent second molar. This orthodontic technique may be a minimally invasive approach for the extraction of impacted M3s adjacent to the IAN, with a decreased risk of paresthesias and with osteoperiodontal advantages. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

A case-study of landfill minimization and material recovery via waste co-gasification in a new waste management scheme

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

Tanigaki, Nobuhiro, E-mail: tanigaki.nobuhiro@eng.nssmc.com; Ishida, Yoshihiro; Osada, Morihiro

Highlights: • A new waste management scheme and the effects of co-gasification of MSW were assessed. • A co-gasification system was compared with other conventional systems. • The co-gasification system can produce slag and metal with high-quality. • The co-gasification system showed an economic advantage when bottom ash is landfilled. • The sensitive analyses indicate an economic advantage when the landfill cost is high. - Abstract: This study evaluates municipal solid waste co-gasification technology and a new solid waste management scheme, which can minimize final landfill amounts and maximize material recycled from waste. This new scheme is considered for amore » region where bottom ash and incombustibles are landfilled or not allowed to be recycled due to their toxic heavy metal concentration. Waste is processed with incombustible residues and an incineration bottom ash discharged from existent conventional incinerators, using a gasification and melting technology (the Direct Melting System). The inert materials, contained in municipal solid waste, incombustibles and bottom ash, are recycled as slag and metal in this process as well as energy recovery. Based on this new waste management scheme with a co-gasification system, a case study of municipal solid waste co-gasification was evaluated and compared with other technical solutions, such as conventional incineration, incineration with an ash melting facility under certain boundary conditions. From a technical point of view, co-gasification produced high quality slag with few harmful heavy metals, which was recycled completely without requiring any further post-treatment such as aging. As a consequence, the co-gasification system had an economical advantage over other systems because of its material recovery and minimization of the final landfill amount. Sensitivity analyses of landfill cost, power price and inert materials in waste were also conducted. The higher the landfill costs, the greater

Modelling home advantage in the Summer Olympic Games.

PubMed

Balmer, N J; Nevill, A M; Williams, A M

2003-06-01

Home advantage in team games is well proven and the influence of the crowd upon officials' decisions has been identified as a plausible cause. The aim of this study was to assess the significance of home advantage for five event groups selected from the Summer Olympic Games between 1896 and 1996, and put home advantage in team games in context with other sports. The five event groups were athletics and weightlifting (predominantly objectively judged), boxing and gymnastics (predominantly subjectively judged) and team games (involving subjective decisions). The proportion of points won was analysed as a binomial response variable using generalized linear interactive modelling. Preliminary exploration of the data highlighted the need to control for the proportion of competitors entered and to split the analysis pre- and post-war. Highly significant home advantage was found in event groups that were either subjectively judged or rely on subjective decisions. In contrast, little or no home advantage (and even away advantage) was observed for the two objectively judged groups. Officiating system was vital to both the existence and extent of home advantage. Our findings suggest that crowd noise has a greater influence upon officials' decisions than players' performances, as events with greater officiating input enjoyed significantly greater home advantage.

Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique

PubMed Central

Muschaweck, Ulrike; Berger, Luise Masami

2010-01-01

Context: Sportsmen’s groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. Methods: The authors developed an innovative open suture repair—the Minimal Repair technique—to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. Results: The following advantages of the Minimal Repair technique were found: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). Conclusion: The Minimal Repair technique is an effective and safe way to treat sportsmen’s groin. PMID:23015941

Antimicrobial edible films and coatings for fresh and minimally processed fruits and vegetables: a review.

PubMed

Valencia-Chamorro, Silvia A; Palou, Lluís; Del Río, Miguel A; Pérez-Gago, María B

2011-01-01

The use of edible films and coatings is an environmentally friendly technology that offers substantial advantages for shelf-life increase of many food products including fruits and vegetables. The development of new natural edible films and coatings with the addition of antimicrobial compounds to preserve fresh and minimally processed fruits and vegetables is a technological challenge for the industry and a very active research field worldwide. Antimicrobial agents have been successfully added to edible composite films and coatings based on polysaccharides or proteins such as starch, cellulose derivatives, chitosan, alginate, fruit puree, whey protein isolated, soy protein, egg albumen, wheat gluten, or sodium caseinate. This paper reviews the development of edible films and coatings with antimicrobial activity, typically through the incorporation of antimicrobial food additives as ingredients, the effect of these edible films on the control of target microorganisms, the influence of antimicrobial agents on mechanical and barrier properties of stand-alone edible films, and the effect of the application of antimicrobial edible coatings on the quality of fresh and fresh-cut fruits and vegetables.

Direction of Arrival Estimation for MIMO Radar via Unitary Nuclear Norm Minimization

PubMed Central

Wang, Xianpeng; Huang, Mengxing; Wu, Xiaoqin; Bi, Guoan

2017-01-01

In this paper, we consider the direction of arrival (DOA) estimation issue of noncircular (NC) source in multiple-input multiple-output (MIMO) radar and propose a novel unitary nuclear norm minimization (UNNM) algorithm. In the proposed method, the noncircular properties of signals are used to double the virtual array aperture, and the real-valued data are obtained by utilizing unitary transformation. Then a real-valued block sparse model is established based on a novel over-complete dictionary, and a UNNM algorithm is formulated for recovering the block-sparse matrix. In addition, the real-valued NC-MUSIC spectrum is used to design a weight matrix for reweighting the nuclear norm minimization to achieve the enhanced sparsity of solutions. Finally, the DOA is estimated by searching the non-zero blocks of the recovered matrix. Because of using the noncircular properties of signals to extend the virtual array aperture and an additional real structure to suppress the noise, the proposed method provides better performance compared with the conventional sparse recovery based algorithms. Furthermore, the proposed method can handle the case of underdetermined DOA estimation. Simulation results show the effectiveness and advantages of the proposed method. PMID:28441770

Minimally invasive fixation of type B and C interprosthetic femoral fractures.

PubMed

Ehlinger, M; Czekaj, J; Adam, P; Brinkert, D; Ducrot, G; Bonnomet, F

2013-09-01

Interprosthetic femoral fractures are rare and raise unresolved treatment issues such as the length of the fixation material that best prevents secondary fractures. Awareness of the advantages of locked-plate fixation via a minimally invasive approach remains limited, despite the potential of this method for improving success rates. Femur-spanning (from the trochanters to the condyles) locked-plate fixation via a minimally invasive approach provides high healing rates with no secondary fractures. From January 2004 to May 2011, all eight patients seen for interprosthetic fractures were treated with minimally invasive locked-plate fixation. Mean time since hip arthroplasty was 47.5 months and mean time since knee arthroplasty was 72.6 months. There were 12 standard primary prostheses and four revision prostheses; 11 prostheses were cemented and a single prosthesis showed femoral loosening. Classification about the hip prostheses was Vancouver B in one patient and Vancouver C in seven patients; about the knee prosthesis, the fracture was SoFCOT B in three patients and SOFCOT C in five patients, and a single fracture was SoFCOT D. Minimally invasive locking-plate fixation was performed in all eight patients, with installation on a traction table in seven patients. Healing was obtained in all eight patients, after a mean of 14 weeks (range, 12-16 weeks). One patient had malalignment with more than 5° of varus. There were no general or infectious complications. One patient died, 32 months after surgery. The mean Parker-Palmer mobility score decreased from 6.2 pre-operatively to 2.5 at last follow-up. Early construct failure after 3 weeks in one patient required surgical revision. There was no change in implant fixation at last follow-up. No secondary fractures were recorded. In patients with type B or C interprosthetic fractures, femur-spanning fixation not only avoids complications related to altered bone stock and presence of prosthetic material, but also decreases

The Persistence of Wives' Income Advantage

ERIC Educational Resources Information Center

Winslow-Bowe, Sarah

2006-01-01

Recent reports using cross-sectional data indicate an increase in the percentage of wives who outearn their husbands, yet we know little about the persistence of wives' income advantage. The present analyses utilize the 1990-1994 waves of the National Longitudinal Survey of Youth 1979 (N = 3,481) to examine wives' long-term earnings advantage.…

THE HOME ADVANTAGE IN MAJOR LEAGUE BASEBALL.

PubMed

Jones, Marshall B

2015-12-01

Home advantage is smaller in baseball than in other major professional sports for men, specifically football, basketball, or soccer. This paper advances an explanation. It begins by reviewing the main observations to support the view that there is little or no home advantage in individual sports. It then presents the case that home advantage originates in impaired teamwork among the away players. The need for teamwork and the extent of it vary from sport to sport. To the extent that a sport requires little teamwork it is more like an individual sport, and the home team would be expected to enjoy only a small advantage. Interactions among players on the same side (teamwork) are much less common in baseball than in the other sports considered.

Home advantage in the Winter Olympics (1908-1998).

PubMed

Balmer, N J; Nevill, A M; Williams, A M

2001-02-01

We obtained indices of home advantage, based on the medals won by competing nations, for each event held at the Winter Olympics from 1908 to 1998. These indices were designed to assess home advantage while controlling for nation strength, changes in the number of medals on offer and the performance of 'non-hosting' nations. Some evidence of home advantage was found in figure skating, freestyle skiing, ski jumping, alpine skiing and short track speed skating. In contrast, little or no home advantage was observed in ice hockey, Nordic combined, Nordic skiing, bobsled, luge, biathlon or speed skating. When all events were combined, a significant home advantage was observed (P = 0.029), although no significant differences in the extent of home advantage were found between events (P > 0.05). When events were grouped according to whether they were subjectively assessed by judges, significantly greater home advantage was observed in the subjectively assessed events (P = 0.037). This was a reflection of better home performances, suggesting that judges were scoring home competitors disproportionately higher than away competitors. Familiarity with local conditions was shown to have some effect, particularly in alpine skiing, although the bobsled and luge showed little or no advantage over other events. Regression analysis showed that the number of time zones and direction of travel produced no discernible trends or differences in performance.

Non-minimally coupled scalar field cosmology with torsion

NASA Astrophysics Data System (ADS)

Cid, Antonella; Izaurieta, Fernando; Leon, Genly; Medina, Perla; Narbona, Daniela

2018-04-01

In this work we present a generalized Brans-Dicke lagrangian including a non-minimally coupled Gauss-Bonnet term without imposing the vanishing torsion condition. In the resulting field equations, the torsion is closely related to the dynamics of the scalar field, i.e., if non-minimally coupled terms are present in the theory, then the torsion must be present. For the studied lagrangian we analyze the cosmological consequences of an effective torsional fluid and we show that this fluid can be responsible for the current acceleration of the universe. Finally, we perform a detailed dynamical system analysis to describe the qualitative features of the model, we find that accelerated stages are a generic feature of this scenario.

Dialyzer reuse--part II: advantages and disadvantages.

PubMed

Twardowski, Zbylut J

2006-01-01

Although single dialyzer use and reuse by chemical reprocessing are both associated with some complications, there is no definitive advantage to either in this respect. Some complications occur mainly at the first use of a dialyzer: a new cellophane or cuprophane membrane may activate the complement system, or a noxious agent may be introduced to the dialyzer during production or generated during storage. These agents may not be completely removed during the routine rinsing procedure. The reuse of dialyzers is associated with environmental contamination, allergic reactions, residual chemical infusion (rebound release), inadequate concentration of disinfectants, and pyrogen reactions. Bleach used during reprocessing causes a progressive increase in dialyzer permeability to larger molecules, including albumin. Reprocessing methods without the use of bleach are associated with progressive decreases in membrane permeability, particularly to larger molecules. Most comparative studies have not shown differences in mortality between centers reusing and those not reusing dialyzers, however, the largest cluster of dialysis-related deaths occurred with single-use dialyzers due to the presence of perfluorohydrocarbon introduced during the manufacturing process and not completely removed during preparation of the dialyzers before the dialysis procedure. The cost savings associated with reuse is substantial, especially with more expensive, high-flux synthetic membrane dialyzers. With reuse, some dialysis centers can afford to utilize more efficient dialyzers that are more expensive; consequently they provide a higher dose of dialysis and reduce mortality. Some studies have shown minimally higher morbidity with chemical reuse, depending on the method. Waste disposal is definitely decreased with the reuse of dialyzers, thus environmental impacts are lessened, particularly if reprocessing is done by heat disinfection. It is safe to predict that dialyzer reuse in dialysis centers

Preoperative planning of left-sided valve surgery with 3D computed tomography reconstruction models: sternotomy or a minimally invasive approach?

PubMed

Heuts, Samuel; Maessen, Jos G; Sardari Nia, Peyman

2016-05-01

With the emergence of a new concept aimed at individualization of patient care, the focus will shift from whether a minimally invasive procedure is better than conventional treatment, to the question of which patients will benefit most from which technique? The superiority of minimally invasive valve surgery (MIVS) has not yet been proved. We believe that through better patient selection advantages of this technique can become more pronounced. In our current study, we evaluate the feasibility of 3D computed tomography (CT) imaging reconstruction in the preoperative planning of patients referred for MIVS. We retrospectively analysed all consecutive patients who were referred for minimally invasive mitral valve surgery (MIMVS) and minimally invasive aortic valve replacement (MIAVR) to a single surgeon in a tertiary referral centre for MIVS between March 2014 and 2015. Prospective preoperative planning was done for all patients and was based on evaluations by a multidisciplinary heart-team, an echocardiography, conventional CT images and 3D CT reconstruction models. A total of 39 patients were included in our study; 16 for mitral valve surgery (MVS) and 23 patients for aortic valve replacement (AVR). Eleven patients (69%) within the MVS group underwent MIMVS. Five patients (31%) underwent conventional MVS. Findings leading to exclusion for MIMVS were a tortuous or slender femoro-iliac tract, calcification of the aortic bifurcation, aortic elongation and pericardial calcifications. Furthermore, 2 patients had a change of operative strategy based on preoperative planning. Seventeen (74%) patients in the AVR group underwent MIAVR. Six patients (26%) underwent conventional AVR. Indications for conventional AVR instead of MIAVR were an elongated ascending aorta, ascending aortic calcification and ascending aortic dilatation. One patient (6%) in the MIAVR group was converted to a sternotomy due to excessive intraoperative bleeding. Two mortalities were reported during

Soft Robotic Manipulator for Improving Dexterity in Minimally Invasive Surgery.

PubMed

Diodato, Alessandro; Brancadoro, Margherita; De Rossi, Giacomo; Abidi, Haider; Dall'Alba, Diego; Muradore, Riccardo; Ciuti, Gastone; Fiorini, Paolo; Menciassi, Arianna; Cianchetti, Matteo

2018-02-01

Combining the strengths of surgical robotics and minimally invasive surgery (MIS) holds the potential to revolutionize surgical interventions. The MIS advantages for the patients are obvious, but the use of instrumentation suitable for MIS often translates in limiting the surgeon capabilities (eg, reduction of dexterity and maneuverability and demanding navigation around organs). To overcome these shortcomings, the application of soft robotics technologies and approaches can be beneficial. The use of devices based on soft materials is already demonstrating several advantages in all the exploitation areas where dexterity and safe interaction are needed. In this article, the authors demonstrate that soft robotics can be synergistically used with traditional rigid tools to improve the robotic system capabilities and without affecting the usability of the robotic platform. A bioinspired soft manipulator equipped with a miniaturized camera has been integrated with the Endoscopic Camera Manipulator arm of the da Vinci Research Kit both from hardware and software viewpoints. Usability of the integrated system has been evaluated with nonexpert users through a standard protocol to highlight difficulties in controlling the soft manipulator. This is the first time that an endoscopic tool based on soft materials has been integrated into a surgical robot. The soft endoscopic camera can be easily operated through the da Vinci Research Kit master console, thus increasing the workspace and the dexterity, and without limiting intuitive and friendly use.

Exploring the sequential lineup advantage using WITNESS.

PubMed

Goodsell, Charles A; Gronlund, Scott D; Carlson, Curt A

2010-12-01

Advocates claim that the sequential lineup is an improvement over simultaneous lineup procedures, but no formal (quantitatively specified) explanation exists for why it is better. The computational model WITNESS (Clark, Appl Cogn Psychol 17:629-654, 2003) was used to develop theoretical explanations for the sequential lineup advantage. In its current form, WITNESS produced a sequential advantage only by pairing conservative sequential choosing with liberal simultaneous choosing. However, this combination failed to approximate four extant experiments that exhibited large sequential advantages. Two of these experiments became the focus of our efforts because the data were uncontaminated by likely suspect position effects. Decision-based and memory-based modifications to WITNESS approximated the data and produced a sequential advantage. The next step is to evaluate the proposed explanations and modify public policy recommendations accordingly.

Advantages of unity with SU(4)-color: Reflections through neutrino oscillations, baryogenesis and proton decay

DOE PAGES

Pati, Jogesh C.

2017-03-24

As a tribute to Abdus Salam, I recall the initiation in 1972-73 of the idea of grand unification based on the view that lepton number is the fourth color. Motivated by aesthetic demands, these attempts led to the suggestion that the existing SU (2) x U (1) symmetry be extended minimally to the quark-lepton and left-right symmetric non-Abelian gauge structure G (2,2,4) = SU (2) L x SU (2) R x SU (4)-color. This served to unify members of a family within a single L-R self-conjugate multiplet. It also explained: the quantization of electric charge, the co-existence of quarks andmore » leptons, and that of their three basic forces $-$ weak, electromagnetic, and strong $-$ while providing the appealing possibility that nature is fundamentally left-right symmetric (parity-conserving). The minimal extension of the symmetry G (2,2,4) to a simple group is given by the attractive symmetry SO (10) that came a year later. The advantages of the core symmetry G (2,2,4), including those listed above (which are of course retained by SO (10) as well), are noted. These include the introductions of: (i) the right-handed neutrino as a compelling member of each family, (ii) (B-L) as a local symmetry, and (iii) the mass relation m (ν τ) Dirac = m top (M GUT). These three features, all arising due to SU(4)-color, as well as the gauge coupling uni cation scale (identi ed with the (B-L)- breaking scale), are crucially needed to understand the tiny mass-scales of the neutrino oscillations within the seesaw mechanism, and to implement successfully the mechanism of baryogenesis via leptogenesis. Implications of a well-motivated class of models based on supersymmetric SO(10) or a string-unified G(2, 2, 4) symmetry in 4D for (a) gauge coupling uni cation, (b) fermion masses and mixings, (c) neutrino osillations, (d) baryogenesis via leptogenesis, and last but not least (e) proton decay are presented. Recent works on the latter providing upper limits on proton lifetimes suggest that the

Achieving competitive advantage through strategic human resource management.

PubMed

Fottler, M D; Phillips, R L; Blair, J D; Duran, C A

1990-01-01

The framework presented here challenges health care executives to manage human resources strategically as an integral part of the strategic planning process. Health care executives should consciously formulate human resource strategies and practices that are linked to and reinforce the broader strategic posture of the organization. This article provides a framework for (1) determining and focusing on desired strategic outcomes, (2) identifying and implementing essential human resource management actions, and (3) maintaining or enhancing competitive advantage. The strategic approach to human resource management includes assessing the organization's environment and mission; formulating the organization's business strategy; assessing the human resources requirements based on the intended strategy; comparing the current inventory of human resources in terms of numbers, characteristics, and human resource management practices with respect to the strategic requirements of the organization and its services or product lines; formulating the human resource strategy based on the differences between the assessed requirements and the current inventory; and implementing the appropriate human resource practices to reinforce the strategy and attain competitive advantage.

Systems neuroscience in Drosophila: Conceptual and technical advantages.

PubMed

Kazama, H

2015-06-18

The fruit fly Drosophila melanogaster is ideally suited for investigating the neural circuit basis of behavior. Due to the simplicity and genetic tractability of the fly brain, neurons and circuits are identifiable across animals. Additionally, a large set of transgenic lines has been developed with the aim of specifically labeling small subsets of neurons and manipulating them in sophisticated ways. Electrophysiology and imaging can be applied in behaving individuals to examine the computations performed by each neuron, and even the entire population of relevant neurons in a particular region, because of the small size of the brain. Moreover, a rich repertoire of behaviors that can be studied is expanding to include those requiring cognitive abilities. Thus, the fly brain is an attractive system in which to explore both computations and mechanisms underlying behavior at levels spanning from genes through neurons to circuits. This review summarizes the advantages Drosophila offers in achieving this objective. A recent neurophysiology study on olfactory behavior is also introduced to demonstrate the effectiveness of these advantages. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

'Inconvenient biology:' advantages and disadvantages of first-time parenting after age 40 using in vitro fertilization.

PubMed

Mac Dougall, K; Beyene, Y; Nachtigall, R D

2012-04-01

As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of 'delayed childbearing' has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore the perceived advantages and disadvantages of postponed conception as well as participants' retrospective opinions on the 'optimal age' for parenting. To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46 couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median income was 3-4 times higher than that of the average US family, which may bias their largely positive parenting experiences. Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-parenting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling 'lucky' to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents. These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of participants identified the optimal age for first-time parenting as 5-10 years earlier than they had conceived. This age

10 CFR 850.25 - Exposure reduction and minimization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... § 850.25 Exposure reduction and minimization. (a) The responsible employer must ensure that no worker is exposed above the exposure limit prescribed in § 850.22. (b) The responsible employer must, in addition... described in the responsible employer's CBDPP and must include: (i) Annual goals for exposure reduction and...

Thin film photovoltaic devices with a minimally conductive buffer layer

DOEpatents

Barnes, Teresa M.; Burst, James

2016-11-15

A thin film photovoltaic device (100) with a tunable, minimally conductive buffer (128) layer is provided. The photovoltaic device (100) may include a back contact (150), a transparent front contact stack (120), and an absorber (140) positioned between the front contact stack (120) and the back contact (150). The front contact stack (120) may include a low resistivity transparent conductive oxide (TCO) layer (124) and a buffer layer (128) that is proximate to the absorber layer (140). The photovoltaic device (100) may also include a window layer (130) between the buffer layer (128) and the absorber (140). In some cases, the buffer layer (128) is minimally conductive, with its resistivity being tunable, and the buffer layer (128) may be formed as an alloy from a host oxide and a high-permittivity oxide. The high-permittivity oxide may further be chosen to have a bandgap greater than the host oxide.

Batting last as a home advantage factor in men's NCAA tournament baseball.

PubMed

Bray, Steven R; Obara, Jeff; Kwan, Matt

2005-07-01

In baseball and softball, there is a rule that allows the home team to have the last at-bat and thus the final opportunity to win the game. However, in tournament play, this rule is often set aside and, instead, batting order is decided by other means (e.g. tournament rules, the flip of a coin). The purpose of this study was to examine the impact of the batting last rule on game outcome in NCAA men's regional tournament baseball. It was hypothesized that host (i.e. home) teams would win a greater percentage of the games in which they batted last compared with when they batted first. This hypothesis was not supported. Closer examination of the last inning of play showed home teams were no more likely to have won the game during their last bat than visitors playing other visitors. The results suggest that the batting last rule contributes minimally, if at all, to home advantage in NCAA tournament baseball.

Patient-specific instruments: advantages and pitfalls

PubMed Central

Hafez, Mahmoud A.; Moholkar, Kirti

2017-01-01

Patient-specific instruments (PSI) aim to improve the accuracy of total knee replacement (TKR) based on computer-assisted preoperative planning. In this work, the authors describe the advantages and pitfalls of PSI based on their clinical experience. The main conclusion of this work is that PSI has direct impact on the logistical and technical features of TKR with some advantages and pitfalls. PMID:29227785

Minimally invasive thyroidectomy (MIT): indications and results.

PubMed

Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

2013-01-01

To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= <0.05). The MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

Applying Minimal Manual Principles for Documentation of Graphical User Interfaces.

ERIC Educational Resources Information Center

Nowaczyk, Ronald H.; James, E. Christopher

1993-01-01

Investigates the need to include computer screens in documentation for software using a graphical user interface. Describes the uses and purposes of "minimal manuals" and their principles. Studies student reaction to their use of one of three on-screen manuals: screens, icon, and button. Finds some benefit for including icon and button…

Minimally invasive video-assisted thyroidectomy compared with conventional thyroidectomy in a general surgery department.

PubMed

Dobrinja, Chiara; Trevisan, Giuliano; Makovac, Petra; Liguori, Gennaro

2009-10-01

We retrospectively evaluated a series of patients who underwent minimally invasive video-assisted thyroidectomy (MIVAT) to define its advantages or disadvantages. Between May 2005 and March 2008, 68 patients underwent MIVAT. Sixty-nine patients who underwent conventional thyroidectomy (CT) during the period before the introduction of the MIVAT technique in our department-chosen with the same inclusion criteria used for MIVAT-served as matched controls. The eligibility criteria for both groups was thyroid nodules < or = 35 mm, thyroid volume < 25 ml, no thyroiditis, and no previous surgery. Forty-five MIVAT and 43 CT patients underwent hemithyroidectomy. Twenty-three MIVAT and 26 CT patients underwent total thyroidectomy. No differences were found in terms of complications, operative time, and radicality of the procedure. Patients who underwent MIVAT experienced significantly less pain, better cosmetic results, and shorter hospital stay than patients who underwent conventional surgery The MIVAT technique, in selected patients, seems to be a valid option for thyroidectomy and even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic results, postoperative pain, and postoperative recovery.

Waste minimization for commercial radioactive materials users generating low-level radioactive waste

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

Fischer, D.K.; Gitt, M.; Williams, G.A.

1991-07-01

The objective of this document is to provide a resource for all states and compact regions interested in promoting the minimization of low-level radioactive waste (LLW). This project was initiated by the Commonwealth of Massachusetts, and Massachusetts waste streams have been used as examples; however, the methods of analysis presented here are applicable to similar waste streams generated elsewhere. This document is a guide for states/compact regions to use in developing a system to evaluate and prioritize various waste minimization techniques in order to encourage individual radioactive materials users (LLW generators) to consider these techniques in their own independent evaluations.more » This review discusses the application of specific waste minimization techniques to waste streams characteristic of three categories of radioactive materials users: (1) industrial operations using radioactive materials in the manufacture of commercial products, (2) health care institutions, including hospitals and clinics, and (3) educational and research institutions. Massachusetts waste stream characterization data from key radioactive materials users in each category are used to illustrate the applicability of various minimization techniques. The utility group is not included because extensive information specific to this category of LLW generators is available in the literature.« less

Radial Symmetry of p-Harmonic Minimizers

NASA Astrophysics Data System (ADS)

Koski, Aleksis; Onninen, Jani

2018-03-01

"It is still not known if the radial cavitating minimizers obtained by uc(Ball) (Philos Trans R Soc Lond A 306:557-611, 1982) (and subsequently by many others) are global minimizers of any physically reasonable nonlinearly elastic energy". This quotation is from uc(Sivaloganathan) and uc(Spector) (Ann Inst Henri Poincaré Anal Non Linéaire 25(1):201-213, 2008) and seems to be still accurate. The model case of the p-harmonic energy is considered here. We prove that the planar radial minimizers are indeed the global minimizers provided we prescribe the admissible deformations on the boundary. In the traction free setting, however, even the identity map need not be a global minimizer.

Paper-polymer composite devices with minimal fluorescence background.

PubMed

Wang, Chang-Ming; Chen, Chong-You; Liao, Wei-Ssu

2017-04-22

Polymer film incorporated paper-based devices show advantages in simplicity and rugged backing. However, their applications are restricted by the high fluorescence background interference of conventional laminating pouches. Herein, we report a straightforward approach for minimal fluorescence background device fabrication, in which filter paper was shaped and laminated in between two biaxially oriented polypropylene (OPP) and polyvinyl butyral (PVB) composite films. This composite film provides mechanical strength for enhanced device durability, protection from environmental contamination, and prevents reagent degradation. This approach was tested by the determination of copper ions with a fluorescent probe, while the detection of glucose was used to illustrate the improved device durability. Our results show that lamination by the polymer composite lengthens device lifetime, while allowing for fluorescence detection methods combination with greatly reduced fluorescent background widely present in commercially available lamination pouches. By the combination of rapid device prototyping with low cost materials, we believe that this composite design would further expand the potential of paper-based devices. Copyright © 2017 Elsevier B.V. All rights reserved.

Extensions of D-optimal Minimal Designs for Symmetric Mixture Models

PubMed Central

Raghavarao, Damaraju; Chervoneva, Inna

2017-01-01

The purpose of mixture experiments is to explore the optimum blends of mixture components, which will provide desirable response characteristics in finished products. D-optimal minimal designs have been considered for a variety of mixture models, including Scheffé's linear, quadratic, and cubic models. Usually, these D-optimal designs are minimally supported since they have just as many design points as the number of parameters. Thus, they lack the degrees of freedom to perform the Lack of Fit tests. Also, the majority of the design points in D-optimal minimal designs are on the boundary: vertices, edges, or faces of the design simplex. In This Paper, Extensions Of The D-Optimal Minimal Designs Are Developed For A General Mixture Model To Allow Additional Interior Points In The Design Space To Enable Prediction Of The Entire Response Surface Also a new strategy for adding multiple interior points for symmetric mixture models is proposed. We compare the proposed designs with Cornell (1986) two ten-point designs for the Lack of Fit test by simulations. PMID:29081574

Minimally Invasive Surgical Pulmonary Embolectomy: A Potential Alternative to Conventional Sternotomy.

PubMed

Pasrija, Chetan; Shah, Aakash; Sultanik, Elliot; Rouse, Michael; Ghoreishi, Mehrdad; Bittle, Gregory J; Boulos, Francesca; Griffith, Bartley P; Kon, Zachary N

Surgical pulmonary embolectomy has gained increasing popularity over the past decade with multiple series reporting excellent outcomes in the treatment of submassive pulmonary embolism. However, a significant barrier to the broader adoption of surgical pulmonary embolectomy remains the large incision and long recovery after a full sternotomy. We report the safety and efficacy of using a minimally invasive approach to surgical pulmonary embolectomy. All consecutive patients undergoing surgical pulmonary embolectomy for a submassive pulmonary embolism (2015-2017) were reviewed. Patients were stratified as conventional or minimally invasive. The minimally invasive approach included a 5- to 7-cm skin incision with upper hemisternotomy to the third intercostal space. The primary outcomes were in-hospital and 90-day survival. Thirty patients (conventional = 20, minimally invasive = 10) were identified. Operative time was similar between the two groups, but cardiopulmonary bypass time was significantly longer in the minimally invasive group (58 vs 94 minutes, P = 0.04). While ventilator time and intensive care unit length of stay were similar between groups, hospital length of stay was 4.5 days shorter in the minimally invasive group, and there was a trend toward less blood product use. In-hospital and 90-day survival was 100%. Within the minimally invasive cohort, median right ventricular dysfunction at discharge was none-mild and no patient experienced postoperative renal failure, deep sternal wound infection, sepsis, or stroke. Minimally invasive surgical pulmonary embolectomy appears to be a feasible approach in the treatment of patients with a submassive pulmonary embolism. A larger, prospective analysis comparing this modality with conventional surgical pulmonary embolectomy may be warranted.

Advantages and Disadvantages of Transtibial, Anteromedial Portal, and Outside-In Femoral Tunnel Drilling in Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Robin, Brett N; Jani, Sunil S; Marvil, Sean C; Reid, John B; Schillhammer, Carl K; Lubowitz, James H

2015-07-01

Controversy exists regarding the best method for creating the knee anterior cruciate ligament (ACL) femoral tunnel or socket. The purpose of this study was to systematically review the risks, benefits, advantages, and disadvantages of the endoscopic transtibial (TT) technique, anteromedial portal technique, outside-in technique, and outside-in retrograde drilling technique for creating the ACL femoral tunnel. A PubMed search of English-language studies published between January 1, 2000, and February 17, 2014, was performed using the following keywords: "anterior cruciate ligament" AND "femoral tunnel." Included were studies reporting risks, benefits, advantages, and/or disadvantages of any ACL femoral technique. In addition, references of included articles were reviewed to identify potential studies missed in the original search. A total of 27 articles were identified through the search. TT technique advantages include familiarity and proven long-term outcomes; disadvantages include the risk of nonanatomic placement because of constrained (TT) drilling. Anteromedial portal technique advantages include unconstrained anatomic placement; disadvantages include technical challenges, short tunnels or sockets, and posterior-wall blowout. Outside-in technique advantages include unconstrained anatomic placement; disadvantages include the need for 2 incisions. Retrograde drilling technique advantages include unconstrained anatomic placement, as well as all-epiphyseal drilling in skeletally immature patients; disadvantages include the need for fluoroscopy for all-epiphyseal drilling. There is no one, single, established "gold-standard" technique for creation of the ACL femoral socket. Four accepted techniques show diverse and subjective advantages, disadvantages, risks, and benefits. Level V, systematic review of Level II through V evidence. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

NAVAIR Hexavalent Chromium Minimization Status

DTIC Science & Technology

2010-11-01

NAVAIR  Hexavalent  Chromium Minimization Status  SERDP/ESTCP Symposium 2010 Cr6+ Session Bill C Nickerson AIR 4.3.4 Report Documentation Page Form...COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE NAVAIR Hexavalent Chromium Minimization Status 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...ANSI Std Z39-18 Minimizing Hexavalent Chromium Use in DoD Operations Technical Session No. 2B C-39 NAVAIR NON-CHROMATE MATERIALS STATUS MR

[Precise application of Traditional Chinese Medicine in minimally-invasive techniques].

PubMed

Dong, Fu-Hui

2018-06-25

runs along the different layers of tissue. The types of stimulation include: meridian acupoint stimulation; cutaneous stimulation; fascia stimulation; mucle stimulation; periosteum stimulation. The clinical application of these techniques has enriched the drug-free therapies of traditional Chinese medicine and achieved excellent outcomes, but at the same time it also raises an important question. How can we apply these minimally invasive techniques to clinical practice so it can be safe and effective? In addition, how can practitioners, individually and further develop their understanding of this minimally invasive technique progressive manner? We make the following recommendations. (1)Clear diagnosis and precise application. Any approach has specific indications and choosing the correct technique comes from a comprehensive understanding of its advantages and disadvantages. Moreover, the accurate application of the technique depends the expertise of the practitioner. Through systematic review and clinical observation, we formulated the First Line Treatment, the Second Line Treatment, and the Third Line Treatment for specific conditions. Using the information gathered from research, practitioners can decide on which point is appropriate to use based on the stage of disease progression. For example, common conditions like the nerve ending tension pain(i.e. cutaneous nerve entrapment syndrome) is caused by stress concentration. There are two types of treatment for this condition: ¹Change in the response to stress state (i.e.non-invasive approach such as manual therapy and physiotherapy). ²Change in state of surrounding environment (i.e. invasive approach such as Pi Needle). Before tissue texture changes to pain point, cord, nodules, the former approach is effective. Once tissue texture changes, the latter approach is First Line Treatment. (2)Systematic training and disease progression training. The minimally invasive techniques of traditional Chinese medicine can treat

Non-minimally coupled f(R) cosmology

NASA Astrophysics Data System (ADS)

Thakur, Shruti; Sen, Anjan A.; Seshadri, T. R.

2011-02-01

We investigate the consequences of non-minimal gravitational coupling to matter and study how it differs from the case of minimal coupling by choosing certain simple forms for the nature of coupling. The values of the parameters are specified at z=0 (present epoch) and the equations are evolved backwards to calculate the evolution of cosmological parameters. We find that the Hubble parameter evolves more slowly in non-minimal coupling case as compared to the minimal coupling case. In both the cases, the universe accelerates around present time, and enters the decelerating regime in the past. Using the latest Union2 dataset for supernova Type Ia observations as well as the data for baryon acoustic oscillation (BAO) from SDSS observations, we constraint the parameters of Linder exponential model in the two different approaches. We find that there is an upper bound on model parameter in minimal coupling. But for non-minimal coupling case, there is range of allowed values for the model parameter.

Cumulative (Dis)Advantage and the Matthew Effect in Life-Course Analysis

PubMed Central

Bask, Miia; Bask, Mikael

2015-01-01

To foster a deeper understanding of the mechanisms behind inequality in society, it is crucial to work with well-defined concepts associated with such mechanisms. The aim of this paper is to define cumulative (dis)advantage and the Matthew effect. We argue that cumulative (dis)advantage is an intra-individual micro-level phenomenon, that the Matthew effect is an inter-individual macro-level phenomenon and that an appropriate measure of the Matthew effect focuses on the mechanism or dynamic process that generates inequality. The Matthew mechanism is, therefore, a better name for the phenomenon, where we provide a novel measure of the mechanism, including a proof-of-principle analysis using disposable personal income data. Finally, because socio-economic theory should be able to explain cumulative (dis)advantage and the Matthew mechanism when they are detected in data, we discuss the types of models that may explain the phenomena. We argue that interactions-based models in the literature traditions of analytical sociology and statistical mechanics serve this purpose. PMID:26606386

The ADVANTAGE seeding trial: a review of internal documents.

PubMed

Hill, Kevin P; Ross, Joseph S; Egilman, David S; Krumholz, Harlan M

2008-08-19

Seeding trials, clinical studies conducted by pharmaceutical companies that are designed to seem as if they answer a scientific question but primarily fulfill marketing objectives, have not been described in detail. To describe a known seeding trial, ADVANTAGE (Assessment of Differences between Vioxx and Naproxen To Ascertain Gastrointestinal Tolerability and Effectiveness), through documents of the trial sponsor, Merck & Co. (Whitehouse Station, New Jersey). Merck internal and external correspondence, reports, and presentations elicited to inform legal proceedings of Cona v Merck and Co., Inc., and McDarby v Merck and Co., Inc. The documents were created between 1998 and 2006. An iterative case-study process of review, discussion, and re-review of documents to identify themes relevant to the design and conduct of ADVANTAGE. To supplement the case-study review, the authors did a systematic review of the literature to identify published manuscripts focused on seeding trials and their conduct. Review of the documents revealed 3 key themes: The trial was designed by Merck's marketing division to fulfill a marketing objective; Merck's marketing division handled both the scientific and the marketing data, including collection, analysis, and dissemination; and Merck hid the marketing nature of the trial from participants, physician investigators, and institutional review board members. Although the systematic review of the literature identified 6 articles that focused on the practice of seeding trials, none provided documentary evidence of their existence or conduct. The legal documents in these cases provide useful, but limited, information about the practices of the pharmaceutical industry. This description of 1 company's actions is incomplete and may have limited generalizability. Documentary evidence shows that ADVANTAGE is an example of marketing framed as science. The documents indicate that ADVANTAGE was a seeding trial developed by Merck's marketing division to

Minimally nonlocal nucleon-nucleon potentials with chiral two-pion exchange including Δ resonances

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

Piarulli, M.; Girlanda, L.; Schiavilla, R.

In this study, we construct a coordinate-space chiral potential, including Δ-isobar intermediate states in its two-pion-exchange component up to order Q 3 (Q denotes generically the low momentum scale). The contact interactions entering at next-to-leading and next-to-next-to-next-to-leading orders (Q 2 and Q 4, respectively) are rearranged by Fierz transformations to yield terms at most quadratic in the relative momentum operator of the two nucleons. The low-energy constant multiplying these contact interactions are fitted to the 2013 Granada database, consisting of 2309 pp and 2982 np data (including, respectively, 148 and 218 normalizations) in the laboratory-energy range 0–300 MeV. For themore » total 5291 $pp$ and $np$ data in this range, we obtain a Χ 2 /datum of roughly 1.3 for a set of three models characterized by long- and short-range cutoffs, R L and R S respectively, ranging from (R L,R S)=(1.2,0.8) fm down to (0.8,0.6) fm. The long-range (short-range) cutoff regularizes the one- and two-pion exchange (contact) part of the potential.« less

Minimally nonlocal nucleon-nucleon potentials with chiral two-pion exchange including Δ resonances

DOE PAGES

Piarulli, M.; Girlanda, L.; Schiavilla, R.; ...

2015-02-26

In this study, we construct a coordinate-space chiral potential, including Δ-isobar intermediate states in its two-pion-exchange component up to order Q 3 (Q denotes generically the low momentum scale). The contact interactions entering at next-to-leading and next-to-next-to-next-to-leading orders (Q 2 and Q 4, respectively) are rearranged by Fierz transformations to yield terms at most quadratic in the relative momentum operator of the two nucleons. The low-energy constant multiplying these contact interactions are fitted to the 2013 Granada database, consisting of 2309 pp and 2982 np data (including, respectively, 148 and 218 normalizations) in the laboratory-energy range 0–300 MeV. For themore » total 5291 $pp$ and $np$ data in this range, we obtain a Χ 2 /datum of roughly 1.3 for a set of three models characterized by long- and short-range cutoffs, R L and R S respectively, ranging from (R L,R S)=(1.2,0.8) fm down to (0.8,0.6) fm. The long-range (short-range) cutoff regularizes the one- and two-pion exchange (contact) part of the potential.« less

Extensions of D-optimal Minimal Designs for Symmetric Mixture Models.

PubMed

Li, Yanyan; Raghavarao, Damaraju; Chervoneva, Inna

2017-01-01

The purpose of mixture experiments is to explore the optimum blends of mixture components, which will provide desirable response characteristics in finished products. D-optimal minimal designs have been considered for a variety of mixture models, including Scheffé's linear, quadratic, and cubic models. Usually, these D-optimal designs are minimally supported since they have just as many design points as the number of parameters. Thus, they lack the degrees of freedom to perform the Lack of Fit tests. Also, the majority of the design points in D-optimal minimal designs are on the boundary: vertices, edges, or faces of the design simplex. Also a new strategy for adding multiple interior points for symmetric mixture models is proposed. We compare the proposed designs with Cornell (1986) two ten-point designs for the Lack of Fit test by simulations.

Activity recognition from minimal distinguishing subsequence mining

NASA Astrophysics Data System (ADS)

Iqbal, Mohammad; Pao, Hsing-Kuo

2017-08-01

Human activity recognition is one of the most important research topics in the era of Internet of Things. To separate different activities given sensory data, we utilize a Minimal Distinguishing Subsequence (MDS) mining approach to efficiently find distinguishing patterns among different activities. We first transform the sensory data into a series of sensor triggering events and operate the MDS mining procedure afterwards. The gap constraints are also considered in the MDS mining. Given the multi-class nature of most activity recognition tasks, we modify the MDS mining approach from a binary case to a multi-class one to fit the need for multiple activity recognition. We also study how to select the best parameter set including the minimal and the maximal support thresholds in finding the MDSs for effective activity recognition. Overall, the prediction accuracy is 86.59% on the van Kasteren dataset which consists of four different activities for recognition.

Advantages of III-nitride laser diodes in solid-state lighting: Advantages of III-nitride laser diodes in solid-state lighting

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

Wierer, Jonathan J.; Tsao, Jeffrey Y.

2015-01-14

III-nitride laser diodes (LDs) are an interesting light source for solid-state lighting (SSL). Modelling of LDs is performed to reveal the potential advantages over traditionally used light-emitting diodes (LEDs). The first, and most notable, advantage is LDs have higher efficiency at higher currents when compared to LEDs. This is because Auger recombination that causes efficiency droop can no longer grow after laser threshold. Second, the same phosphor-converted methods used with LEDs can also be used with LDs to produce white light with similar color rendering and color temperature. Third, producing white light from color mixed emitters is equally challenging formore » both LEDs and LDs, with neither source having a direct advantage. Fourth, the LD emission is directional and can be more readily captured and focused, leading to the possibility of novel and more compact luminaires. Finally, the smaller area and higher current density operation of LDs provides them with a potential cost advantage over LEDs. These advantages make LDs a compelling source for future SSL.« less

The advantages of carbon dioxide laser applications in paediatric oral surgery. A prospective cohort study.

PubMed

Hanna, R; Parker, S

2016-11-01

The aim of this study is to evaluate and demonstrate the advantages of the carbon dioxide laser in paediatric oral surgery patients in terms of less post-operative complications, healing without scaring, functional benefits, positive patient perception and acceptance of the treatment. One hundred fit and healthy paediatric patients (aged 4-15 years) were recruited to undergo laser surgery for different soft tissue conditions. The outcome of these laser treatments was examined. The Wong-Baker Faces Pain Rating Scale was employed to evaluate the pain before, immediately after laser treatment in the clinic and 1 day after post-operatively at home. Post-operative complications and patients' perception and satisfaction were self-reported during a review telephone call the day after treatment. The patients were reviewed 2 weeks after surgery. Laser parameter was 1.62 W, measured by power meter, continuous wave mode with 50 % emission cycle. The beam spot size at the target tissue was 0.8 mm. The pain score pre-operative, during and immediately after laser treatment was rated 0. Whilst the pain score 1 day after surgery was rated between 0 and 2, the healing time was measured over 2 weeks. None of the patients reported post-operative complications after surgery. Patients' perception and acceptance were rated very good. Laser dentistry is a promising field in modern minimally invasive dentistry, which enables provision of better care for children and adolescents. In this cohort study, the use of the carbon dioxide laser therapy offers a desirable, acceptable and minimally invasive technique in the surgical management of soft tissues in paediatric oral surgery with minimal post-operative complications.

Minimally invasive functional approach for cholesteatoma surgery.

PubMed

Hanna, Bassem M; Kivekäs, Ilkka; Wu, Yi-Hsuan; Guo, Lee J; Lin, Huang; Guidi, Jessica; Poe, Dennis

2014-10-01

Report the efficacy of a functional minimally invasive approach for cholesteatoma surgery. Retrospective review of surgical cases performed between 1996 and 2008. One hundred sixty-nine patient charts were reviewed in which ears with primary cholesteatomas that extended beyond the mesotympanum were operated on with a plan for canal wall up (CWU) mastoidectomy. The surgical approach consisted of progressive exposure from transcanal to postauricular tympanoplasty to CWU mastoidectomy, as needed, to identify and lyse the fibrous attachments that bind the capsule to the surrounding mucosa. Endoscopic guidance was employed as appropriate to minimize exposure needs. Any planned second-stage operations were attempted with a transcanal approach if appropriate and with endoscopic assistance. One hundred eighty-four ears of 169 patients were included. The median age was 32 years (range, 1-79 years). The mean follow-up was 3.2 years (range, 1-11 years). Eighty-three (45%) were planned for a second-look operation, and three (2%) required unplanned second operations. The overall recurrence rate was 24/184 (13%), and the unexpected residual rate was 5/184 (3%). The residual rate with endoscopy (5/119, 4%,) or without endoscopy (1/65, 2%), were not significantly different. Hearing results in 156 ears improved significantly, from a preoperative pure-tone average (PTA) of 41 dB to a postoperative PTA average of 29 dB (P < .0001). A functional minimally invasive approach to cholesteatoma surgery provided equivalent residual rates but higher recurrence rates compared to published canal wall down mastoidectomy. Endoscopic techniques were helpful in providing adequate views while minimizing exposure. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Inactivation of Salmonella Enteritidis on lettuces used by minimally processed vegetable industries.

PubMed

Silveira, Josete Bailardi; Hessel, Claudia Titze; Tondo, Eduardo Cesar

2017-01-30

Washing and disinfection methods used by minimally processed vegetable industries of Southern Brazil were reproduced in laboratory in order to verify their effectiveness to reduce Salmonella Enteritidis SE86 (SE86) on lettuce. Among the five industries investigated, four carried out washing with potable water followed by disinfection with 200 ppm sodium hypochlorite during different immersion times. The washing procedure alone decreased approximately 1 log CFU/g of SE86 population and immersion times of 1, 2, 5, and 15 minutes in disinfectant solution demonstrated reduction rates ranging from 2.06±0.10 log CFU/g to 3.01±0.21 log CFU/g. Rinsing alone was able to reduce counts from 0.12±0.63 log CFU/g to 1.90±1.07 log CFU/g. The most effective method was washing followed by disinfection with 200 ppm sodium hypochlorite for 15 minutes and final rinse with potable water, reaching 5.83 log CFU/g of reduction. However, no statistical differences were observed on the reduction rates after different immersion times. A time interval of 1 to 2 minutes may be an advantage to the minimally vegetable processed industries in order to optimize the process without putting at risk food safety.

Is There an Islamist Political Advantage?

PubMed Central

Cammett, Melani; Luong, Pauline Jones

2014-01-01

There is a widespread presumption that Islamists have an advantage over their opponents when it comes to generating mass appeal and winning elections. The question remains, however, as to whether these advantages—or, what we refer to collectively as an Islamist political advantage—actually exist. We argue that—to the extent that Islamists have a political advantage—the primary source of this advantage is reputation rather than the provision of social services, organizational capacity, or ideological hegemony. Our purpose is not to dismiss the main sources of the Islamist governance advantage identified in scholarly literature and media accounts, but to suggest a different causal path whereby each of these factors individually and sometimes jointly promotes a reputation for Islamists as competent, trustworthy, and pure. It is this reputation for good governance that enables Islamists to distinguish themselves in the streets and at the ballot box. PMID:25767370

Pediatric endocanalicular diode laser dacryocystorhinostomy: results of a minimally invasive surgical technique.

PubMed

Uysal, Ismail Onder; Ozçimen, Muammer; Yener, Halil Ibrahim; Kal, Ali

2011-09-01

The purpose of this study was to evaluate the effectiveness of endocanalicular diode laser dacryocystorhinostomy (DCR), which is a minimally invasive surgical technique, in pediatric patients with congenital nasolacrimal duct obstruction (NLDO). A retrospective study was carried out on patients treated between October 2008 and August 2009 for nasolacrimal duct obstruction with an endocanalicular diode laser procedure. Patients diagnosed as having nasolacrimal duct obstruction were included in this study and an endocanalicular diode laser procedure was performed. The main outcome measures were patients' previous treatments, clinical presentation, operative and postoperative complications, postoperative follow-up and resolution of epiphora. Eighteen children (10 girls, 8 boys) with a mean age of 6.11 ± 2.08 years (range, 4-10) underwent 20 endocanalicular laser DCR operations for congenital NLDO. In all eyes (100%), there was a history of epiphora and chronic dacryocystitis; two (10%) presented with acute dacryocystitis. Previous procedures included probing and irrigation of all eyes (100%) and silicone tube intubation in nine eyes (45%). None of the patients underwent any previous DCR operations. During a mean postoperative follow-up period of 20.50 ± 3.24 months (range, 14-24 months), the anatomical success rate (patency of ostium on nasal endoscopy) was 100%, and the clinical success rate (resolution of epiphora) was 85%. Endocanalicular diode laser DCR is an effective treatment modality for pediatric patients with congenital NLDO that compares favorably with the reported success rates of external and endoscopic endonasal DCR. Moreover, it has an added advantage of shorter operative time, less morbidity and avoidance of overnight admission.

76 FR 14691 - Delphi Steering, Including On-Site Leased Workers From Acro Service Corporation, Aerotek, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Health Care and Advantage Technical Resourcing, Saginaw, MI; Amended Certification Regarding Eligibility... on-site leased workers from Advantage Technical Resourcing were employed on-site at the Saginaw... Department is amending this certification to include workers leased from Advantage Technical Resourcing...

Does robotics improve minimally invasive rectal surgery? Functional and oncological implications.

PubMed

Guerra, Francesco; Pesi, Benedetta; Amore Bonapasta, Stefano; Perna, Federico; Di Marino, Michele; Annecchiarico, Mario; Coratti, Andrea

2016-02-01

Robot-assisted surgery has been reported to be a safe and effective alternative to conventional laparoscopy for the treatment of rectal cancer in a minimally invasive manner. Nevertheless, substantial data concerning functional outcomes and long-term oncological adequacy is still lacking. We aimed to assess the current role of robotics in rectal surgery focusing on patients' functional and oncological outcomes. A comprehensive review was conducted to search articles published in English up to 11 September 2015 concerning functional and/or oncological outcomes of patients who received robot-assisted rectal surgery. All relevant papers were evaluated on functional implications such as postoperative sexual and urinary dysfunction and oncological outcomes. Robotics showed a general trend towards lower rates of sexual and urinary postoperative dysfunction and earlier recovery compared with laparoscopy. The rates of 3-year local recurrence, disease-free survival and overall survival of robotic-assisted rectal surgery compared favourably with those of laparoscopy. This study fails to provide solid evidence to draw definitive conclusions on whether robotic systems could be useful in ameliorating the outcomes of minimally invasive surgery for rectal cancer. However, the available data suggest potential advantages over conventional laparoscopy with reference to functional outcomes. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

The advantage of being slow: The quasi-neutral contact process.

PubMed

de Oliveira, Marcelo Martins; Dickman, Ronald

2017-01-01

According to the competitive exclusion principle, in a finite ecosystem, extinction occurs naturally when two or more species compete for the same resources. An important question that arises is: when coexistence is not possible, which mechanisms confer an advantage to a given species against the other(s)? In general, it is expected that the species with the higher reproductive/death ratio will win the competition, but other mechanisms, such as asymmetry in interspecific competition or unequal diffusion rates, have been found to change this scenario dramatically. In this work, we examine competitive advantage in the context of quasi-neutral population models, including stochastic models with spatial structure as well as macroscopic (mean-field) descriptions. We employ a two-species contact process in which the "biological clock" of one species is a factor of α slower than that of the other species. Our results provide new insights into how stochasticity and competition interact to determine extinction in finite spatial systems. We find that a species with a slower biological clock has an advantage if resources are limited, winning the competition against a species with a faster clock, in relatively small systems. Periodic or stochastic environmental variations also favor the slower species, even in much larger systems.

The Down Syndrome Advantage: Fact or Fiction?

ERIC Educational Resources Information Center

Corrice, April M.; Glidden, Laraine Masters

2009-01-01

The "Down syndrome advantage" is the popular conception that children with Down syndrome are easier to rear than children with other developmental disabilities. We assessed whether mothers of children with developmental disabilities would demonstrate a consistent Down syndrome advantage as their children aged from 12 to 18 years. Results did not…

Minimally invasive periodontal therapy

PubMed Central

Dannan, Aous

2011-01-01

Minimally invasive dentistry is a concept that preserves dentition and supporting structures. However, minimally invasive procedures in periodontal treatment are supposed to be limited within periodontal surgery, the aim of which is to represent alternative approaches developed to allow less extensive manipulation of surrounding tissues than conventional procedures, while accomplishing the same objectives. In this review, the concept of minimally invasive periodontal surgery (MIPS) is firstly explained. An electronic search for all studies regarding efficacy and effectiveness of MIPS between 2001 and 2009 was conducted. For this purpose, suitable key words from Medical Subject Headings on PubMed were used to extract the required studies. All studies are demonstrated and important results are concluded. Preliminary data from case cohorts and from many studies reveal that the microsurgical access flap, in terms of MIPS, has a high potential to seal the healing wound from the contaminated oral environment by achieving and maintaining primary closure. Soft tissues are mostly preserved and minimal gingival recession is observed, an important feature to meet the demands of the patient and the clinician in the esthetic zone. However, although the potential efficacy of MIPS in the treatment of deep intrabony defects has been proved, larger studies are required to confirm and extend the reported positive preliminary outcomes. PMID:22368356

Minimally invasive approach for adrenal lesions: Systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications.

PubMed

Conzo, G; Tartaglia, E; Gambardella, C; Esposito, D; Sciascia, V; Mauriello, C; Nunziata, A; Siciliano, G; Izzo, G; Cavallo, F; Thomas, G; Musella, M; Santini, L

2016-04-01

In the last decades, minimally invasive transperitoneal laparoscopic adrenalectomy has become the standard of care for surgical resection of the adrenal gland tumors. Recently, however, adrenalectomy by a mininvasive retroperitoneal approach has reached increasingly popularity as alternative technique. Short hospitalization, lower postoperative pain and decrease of complications and a better cosmetic resolution are the main advantages of these innovative techniques. In order to determine the better surgical management of adrenal neoplasms, the Authors analyzed and compared the feasibility and the postoperative complications of minimally invasive adrenalectomy approaches. A systematic research of the English literature, including major meta-analysis articles, clinical randomized trials, retrospective studies and systematic reviews was performed, comparing laparoscopic transperitoneal adrenalectomy versus retroperitoneoscopic adrenalectomy. Many studies support that posterior retroperitoneal adrenalectomy is superior or at least comparable to laparoscopic transperitoneal adrenalectomy in operation time, pain score, blood loss, hospitalization, complications rates and return to normal activity. However, laparoscopic transperitoneal adrenalectomy is up to now a safe and standardized procedure with a shorter learning curve and a similar low morbidity rate, even for tumors larger than 6 cm. Nevertheless, further studies are needed to objectively evaluate these techniques, excluding selection bias and bias related to differences in surgeons' experiences with this approaches. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Qualifying and quantifying minimal hepatic encephalopathy.

PubMed

Morgan, Marsha Y; Amodio, Piero; Cook, Nicola A; Jackson, Clive D; Kircheis, Gerald; Lauridsen, Mette M; Montagnese, Sara; Schiff, Sami; Weissenborn, Karin

2016-12-01

Minimal hepatic encephalopathy is the term applied to the neuropsychiatric status of patients with cirrhosis who are unimpaired on clinical examination but show alterations in neuropsychological tests exploring psychomotor speed/executive function and/or in neurophysiological variables. There is no gold standard for the diagnosis of this syndrome. As these patients have, by definition, no recognizable clinical features of brain dysfunction, the primary prerequisite for the diagnosis is careful exclusion of clinical symptoms and signs. A large number of psychometric tests/test systems have been evaluated in this patient group. Of these the best known and validated is the Portal Systemic Hepatic Encephalopathy Score (PHES) derived from a test battery of five paper and pencil tests; normative reference data are available in several countries. The electroencephalogram (EEG) has been used to diagnose hepatic encephalopathy since the 1950s but, once popular, the technology is not as accessible now as it once was. The performance characteristics of the EEG are critically dependent on the type of analysis undertaken; spectral analysis has better performance characteristics than visual analysis; evolving analytical techniques may provide better diagnostic information while the advent of portable wireless headsets may facilitate more widespread use. A large number of other diagnostic tools have been validated for the diagnosis of minimal hepatic encephalopathy including Critical Flicker Frequency, the Inhibitory Control Test, the Stroop test, the Scan package and the Continuous Reaction Time; each has its pros and cons; strengths and weaknesses; protagonists and detractors. Recent AASLD/EASL Practice Guidelines suggest that the diagnosis of minimal hepatic encephalopathy should be based on the PHES test together with one of the validated alternative techniques or the EEG. Minimal hepatic encephalopathy has a detrimental effect on the well-being of patients and their care

The data sharing advantage in astrophysics

NASA Astrophysics Data System (ADS)

Dorch, Bertil F.; Drachen, Thea M.; Ellegaard, Ole

2016-10-01

We present here evidence for the existence of a citation advantage within astrophysics for papers that link to data. Using simple measures based on publication data from NASA Astrophysics Data System we find a citation advantage for papers with links to data receiving on the average significantly more citations per paper than papers without links to data. Furthermore, using INSPEC and Web of Science databases we investigate whether either papers of an experimental or theoretical nature display different citation behavior.

[Research on fuzzy proportional-integral-derivative control of master-slave minimally invasive operation robot driver].

PubMed

Zhao, Ximei; Ren, Chengyi; Liu, Hao; Li, Haogyi

2014-12-01

Robotic catheter minimally invasive operation requires that the driver control system has the advantages of quick response, strong anti-jamming and real-time tracking of target trajectory. Since the catheter parameters of itself and movement environment and other factors continuously change, when the driver is controlled using traditional proportional-integral-derivative (PID), the controller gain becomes fixed once the PID parameters are set. It can not change with the change of the parameters of the object and environmental disturbance so that its change affects the position tracking accuracy, and may bring a large overshoot endangering patients' vessel. Therefore, this paper adopts fuzzy PID control method to adjust PID gain parameters in the tracking process in order to improve the system anti-interference ability, dynamic performance and tracking accuracy. The simulation results showed that the fuzzy PID control method had a fast tracking performance and a strong robustness. Compared with those of traditional PID control, the feasibility and practicability of fuzzy PID control are verified in a robotic catheter minimally invasive operation.

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.

Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgery.

PubMed

Tan, Charles; Sidhu, Stan; Sywak, Mark; Delbridge, Leigh

2009-05-01

Both surgical excision and radioiodine ablation are effective modalities in the management of hyperfunctioning thyroid nodules. Minimally invasive thyroid surgery (MITS) using the lateral mini-incision approach has previously been demonstrated to be a safe and effective technique for thyroid lobectomy. As such MITS may offer advantages as a surgical approach to hyperfunctioning thyroid nodules without the need for a long cervical incision or extensive dissection associated with formal open hemithyroidectomy. The aim of the present study was to assess the safety and efficacy of MITS for the treatment of hyperfunctioning thyroid nodules. This is a retrospective case study. Data were obtained from the University of Sydney Endocrine Surgical Unit Database from 2002 to 2007. There were 86 cases of hyperfunctioning thyroid nodules surgically removed during the study period, of which 10 (12%) were managed using the MITS approach. The ipsilateral recurrent laryngeal nerve was identified and preserved in all cases with no incidence of temporary or permanent nerve palsy. The external branch of the superior laryngeal nerve was visualized and preserved in eight cases (80%). There were no cases of postoperative bleeding. There was one clinically significant follicular thyroid carcinoma in the series (10%). In nine of 10 cases (90%) normalization of thyroid function followed surgery. MITS is a safe and effective procedure, achieving the benefits of a minimally invasive procedure with minimal morbidity. As such it now presents an attractive alternative to radioiodine ablation for the management of small hyperfunctioning thyroid nodules.

Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release.

PubMed

Zhang, Steven; Vora, Molly; Harris, Alex H S; Baker, Laurence; Curtin, Catherine; Kamal, Robin N

2016-12-07

Carpal tunnel release is the most common upper-limb surgical procedure performed annually in the U.S. There are 2 surgical methods of carpal tunnel release: open or endoscopic. Currently, there is no clear clinical or economic evidence supporting the use of one procedure over the other. We completed a cost-minimization analysis of open and endoscopic carpal tunnel release, testing the null hypothesis that there is no difference between the procedures in terms of cost. We conducted a retrospective review using a private-payer and Medicare Advantage database composed of 16 million patient records from 2007 to 2014. The cohort consisted of records with an ICD-9 (International Classification of Diseases, Ninth Revision) diagnosis of carpal tunnel syndrome and a CPT (Current Procedural Terminology) code for carpal tunnel release. Payer fees were used to define cost. We also assessed other associated costs of care, including those of electrodiagnostic studies and occupational therapy. Bivariate comparisons were performed using the chi-square test and the Student t test. Data showed that 86% of the patients underwent open carpal tunnel release. Reimbursement fees for endoscopic release were significantly higher than for open release. Facility fees were responsible for most of the difference between the procedures in reimbursement: facility fees averaged $1,884 for endoscopic release compared with $1,080 for open release (p < 0.0001). Endoscopic release also demonstrated significantly higher physician fees than open release (an average of $555 compared with $428; p < 0.0001). Occupational therapy fees associated with endoscopic release were less than those associated with open release (an average of $237 per session compared with $272; p = 0.07). The total average annual reimbursement per patient for endoscopic release (facility, surgeon, and occupational therapy fees) was significantly higher than for open release ($2,602 compared with $1,751; p < 0.0001). Our data showed

Photovoltaic array with minimally penetrating rooftop support system

DOEpatents

Lenox, Carl J.S.

2012-10-23

A photovoltaic array including a plurality of photovoltaic assemblies and a plurality of mounting units. The mounting units each include an elongate rail and a plurality of leg assemblies. The rail is sized and configured to maintain a portion of at least two of the photovoltaic assemblies, with the leg assemblies extending from the rail in a spaced-apart fashion and terminating in a foot for placement against a rooftop structure for minimally penetration installation. Further, at least one of the leg assemblies can include a retractable leg. When the photovoltaic array is installed to a rooftop structure including a membrane intermittently secured to a rooftop deck, the retractable leg accommodates upward billowing of the membrane under windy conditions.

Home advantage in the Winter Paralympic Games 1976-2014.

PubMed

Wilson, Darryl; Ramchandani, Girish

2017-01-01

There is a limited amount of home advantage research concerned with winter sports. There is also a distinct lack of studies that investigate home advantage in the context of para sport events. This paper addresses this gap in the knowledge by examining home advantage in the Winter Paralympic Games. Using a standardised measure of success, we compared the performances of host nations at home with their own performances away from home between 1976 and 2014. Both country level and individual sport level analysis is conducted for this time period. Comparisons are also drawn with the Winter Olympic Games since 1992, the point from which both the Winter Olympic Games and the Winter Paralympic Games have been hosted by the same nations and in the same years. Clear evidence of a home advantage effect in the Winter Paralympic Games was found at country level. When examining individual sports, only alpine skiing and cross country skiing returned a significant home advantage effect. When comparing home advantage in the Winter Paralympic Games with the Winter Olympic Games for the last seven host nations (1992-2014), we found that home advantage was generally more pronounced (although not a statistically significant difference) in the case of the former. The causes of home advantage in the Winter Paralympic Games are unclear and should be investigated further.

Text-Based On-Line Conferencing: A Conceptual and Empirical Analysis Using a Minimal Prototype.

ERIC Educational Resources Information Center

McCarthy, John C.; And Others

1993-01-01

Analyzes requirements for text-based online conferencing through the use of a minimal prototype. Topics discussed include prototyping with a minimal system; text-based communication; the system as a message passer versus the system as a shared data structure; and three exercises that showed how users worked with the prototype. (Contains 61…

Left hemispheric advantage for numerical abilities in the bottlenose dolphin.

PubMed

Kilian, Annette; von Fersen, Lorenzo; Güntürkün, Onur

2005-02-28

In a two-choice discrimination paradigm, a bottlenose dolphin discriminated relational dimensions between visual numerosity stimuli under monocular viewing conditions. After prior binocular acquisition of the task, two monocular test series with different number stimuli were conducted. In accordance with recent studies on visual lateralization in the bottlenose dolphin, our results revealed an overall advantage of the right visual field. Due to the complete decussation of the optic nerve fibers, this suggests a specialization of the left hemisphere for analysing relational features between stimuli as required in tests for numerical abilities. These processes are typically right hemisphere-based in other mammals (including humans) and birds. The present data provide further evidence for a general right visual field advantage in bottlenose dolphins for visual information processing. It is thus assumed that dolphins possess a unique functional architecture of their cerebral asymmetries. (c) 2004 Elsevier B.V. All rights reserved.

The effect of stimulus intensity on the right ear advantage in dichotic listening.

PubMed

Hugdahl, Kenneth; Westerhausen, René; Alho, Kimmo; Medvedev, Svyatoslav; Hämäläinen, Heikki

2008-01-24

The dichotic listening test is non-invasive behavioural technique to study brain lateralization and it has been shown, that its results can be systematically modulated by varying stimulation properties (bottom-up effects) or attentional instructions (top-down effects) of the testing procedure. The goal of the present study was to further investigate the bottom-up modulation, by examining the effect of differences in the right or left ear stimulus intensity on the ear advantage. For this purpose, interaural intensity difference were gradually varied in steps of 3 dB from -21 dB in favour of the left ear to +21 dB in favour of the right ear, also including a no difference baseline condition. Thirty-three right-handed adult participants with normal hearing acuity were tested. The dichotic listening paradigm was based on consonant-vowel stimuli pairs. Only pairs with the same voicing (voice or non-voiced) of the consonant sound were used. The results showed: (a) a significant right ear advantage (REA) for interaural intensity differences from 21 to -3 dB, (b) no ear advantage (NEA) for the -6 dB difference, and (c) a significant left ear advantage (LEA) for differences form -9 to -21 dB. It is concluded that the right ear advantage in dichotic listening to CV syllables withstands an interaural intensity difference of -9 dB before yielding to a significant left ear advantage. This finding could have implications for theories of auditory laterality and hemispheric asymmetry for phonological processing.

Advantage and choice: social relationships and staff assistance in assisted living.

PubMed

Burge, Stephanie; Street, Debra

2010-05-01

OBJECTIVES. To understand how "cumulative inequality" (CI), expressed as individual advantage and choice, and "external social supports" contribute to the quality of social relationships and perceptions of staff assistance for older individuals in different assisted living (AL) settings. Data are from 429 cognitively intact AL residents aged 60 years and older interviewed for the Florida Study of Assisted Living. Bivariate and multivariate statistical analyses show how individual advantage and choice and external social networks influence respondents' social relationships and staff assistance in AL. Controlling for resident and facility characteristics, being able to pay privately enhances resident satisfaction with staff assistance and having control over the move to AL is positively associated with perceptions of staff relationships and assistance. Maintaining contact with pre-AL friends predicts quality of coresident relationships, as does family contact. Regular contact with family buffers some of the disadvantages associated with CI for perceptions of staff relationships but not perceptions of staff assistance. Discussion. Individual advantage and choice influence the quality of staff relationships and assistance for AL residents but matter little for coresident relationships. External social relationships buffer some of the risks associated with CI for perceptions of staff relationships but not perceived quality of staff assistance. Findings highlight outcomes associated with CI, including predictable risks that disadvantaged elders face in particular types of AL settings, differential advantages others enjoy that influence positive perceptions of staff relationships and staff assistance, and the enduring importance of supportive social relationships.

Minimal Reduplication

ERIC Educational Resources Information Center

Kirchner, Jesse Saba

2010-01-01

This dissertation introduces Minimal Reduplication, a new theory and framework within generative grammar for analyzing reduplication in human language. I argue that reduplication is an emergent property in multiple components of the grammar. In particular, reduplication occurs independently in the phonology and syntax components, and in both cases…

HOW MUCH FAVORABLE SELECTION IS LEFT IN MEDICARE ADVANTAGE?

PubMed Central

PRICE, MARY; MCWILLIAMS, J. MICHAEL; HSU, JOHN; MCGUIRE, THOMAS G.

2015-01-01

The health economics literature contains two models of selection, one with endogenous plan characteristics to attract good risks and one with fixed plan characteristics; neither model contains a regulator. Medicare Advantage, a principal example of selection in the literature, is, however, subject to anti-selection regulations. Because selection causes economic inefficiency and because the historically favorable selection into Medicare Advantage plans increased government cost, the effectiveness of the anti-selection regulations is an important policy question, especially since the Medicare Advantage program has grown to comprise 30 percent of Medicare beneficiaries. Moreover, similar anti-selection regulations are being used in health insurance exchanges for those under 65. Contrary to earlier work, we show that the strengthened anti-selection regulations that Medicare introduced starting in 2004 markedly reduced government overpayment attributable to favorable selection in Medicare Advantage. At least some of the remaining selection is plausibly related to fixed plan characteristics of Traditional Medicare versus Medicare Advantage rather than changed selection strategies by Medicare Advantage plans. PMID:26389127

Minimally Invasive Implantation of HeartWare Assist Device and Simultaneous Tricuspid Valve Reconstruction Through Partial Upper Sternotomy.

PubMed

Hillebrand, Julia; Hoffmeier, Andreas; Djie Tiong Tjan, Tonny; Sindermann, Juergen R; Schmidt, Christoph; Martens, Sven; Scherer, Mirela

2017-05-01

Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy. We report on HeartWare LVAD implantation and simultaneous tricuspid valve reconstruction through minimally invasive access by partial upper sternotomy to the fifth left intercostal space. Four male patients (mean age 51.72 ± 11.95 years) suffering from chronic heart failure due to dilative (three patients) and ischemic (one patient) cardiomyopathy and also exhibiting concomitant tricuspid valve insufficiency due to annular dilation underwent VAD implantation and tricuspid valve annuloplasty. Extracorporeal circulation was established via the ascending aorta, superior vena cava, and right atrium. In all four cases the LVAD implantation and tricuspid valve repair via partial median sternotomy was successful. During the operative procedure, no conversion to full sternotomy was necessary. One patient needed postoperative re-exploration because of pericardial effusion. No postoperative focal neurologic injury was observed. New generation VADs are advantageous because of the possibility of minimally invasive implantation procedure which can therefore minimize surgical trauma. Concomitant tricuspid valve reconstruction can also be performed simultaneously through partial upper sternotomy. Nevertheless, minimally invasive LVAD implantation is a challenging operative technique. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals

Effectiveness and efficacy of minimally invasive lung volume reduction surgery for emphysema

PubMed Central

Pertl, Daniela; Eisenmann, Alexander; Holzer, Ulrike; Renner, Anna-Theresa; Valipour, A.

2014-01-01

Lung emphysema is a chronic, progressive and irreversible destruction of the lung tissue. Besides non-medical therapies and the well established medical treatment there are surgical and minimally invasive methods for lung volume reduction (LVR) to treat severe emphysema. This report deals with the effectiveness and cost-effectiveness of minimally invasive methods compared to other treatments for LVR in patients with lung emphysema. Furthermore, legal and ethical aspects are discussed. No clear benefit of minimally invasive methods compared to surgical methods can be demonstrated based on the identified and included evidence. In order to assess the different methods for LVR regarding their relative effectiveness and safety in patients with lung emphysema direct comparative studies are necessary. PMID:25295123

Effectiveness and efficacy of minimally invasive lung volume reduction surgery for emphysema.

PubMed

Pertl, Daniela; Eisenmann, Alexander; Holzer, Ulrike; Renner, Anna-Theresa; Valipour, A

2014-01-01

Lung emphysema is a chronic, progressive and irreversible destruction of the lung tissue. Besides non-medical therapies and the well established medical treatment there are surgical and minimally invasive methods for lung volume reduction (LVR) to treat severe emphysema. This report deals with the effectiveness and cost-effectiveness of minimally invasive methods compared to other treatments for LVR in patients with lung emphysema. Furthermore, legal and ethical aspects are discussed. No clear benefit of minimally invasive methods compared to surgical methods can be demonstrated based on the identified and included evidence. In order to assess the different methods for LVR regarding their relative effectiveness and safety in patients with lung emphysema direct comparative studies are necessary.

Energy minimization in medical image analysis: Methodologies and applications.

PubMed

Zhao, Feng; Xie, Xianghua

2016-02-01

Energy minimization is of particular interest in medical image analysis. In the past two decades, a variety of optimization schemes have been developed. In this paper, we present a comprehensive survey of the state-of-the-art optimization approaches. These algorithms are mainly classified into two categories: continuous method and discrete method. The former includes Newton-Raphson method, gradient descent method, conjugate gradient method, proximal gradient method, coordinate descent method, and genetic algorithm-based method, while the latter covers graph cuts method, belief propagation method, tree-reweighted message passing method, linear programming method, maximum margin learning method, simulated annealing method, and iterated conditional modes method. We also discuss the minimal surface method, primal-dual method, and the multi-objective optimization method. In addition, we review several comparative studies that evaluate the performance of different minimization techniques in terms of accuracy, efficiency, or complexity. These optimization techniques are widely used in many medical applications, for example, image segmentation, registration, reconstruction, motion tracking, and compressed sensing. We thus give an overview on those applications as well. Copyright © 2015 John Wiley & Sons, Ltd.

[A study of proximal humerus fractures using close reduction and percutaneous minimally invasive fixation].

PubMed

Liu, Yin-wen; Kuang, Yong; Gu, Xin-feng; Zheng, Yu-xin; Li, Zhi-qiang; Wei, Xiao-en; Lu, Wei-da; Zhan, Hong-sheng; Shi, Yin-yu

2011-11-01

To investigate the clinical effects of close reduction and percutaneous minimally invasive fixation in the treatment of proximal humerus fractures. From April 2008 to March 2010, 28 patients with proximal humerus fracture were treated with close reduction and percutaneous minimally invasive fixation. There were 21 males and 7 females, ranging in age from 22 to 78 years,with an average of 42.6 years. The mean time from suffering injuries to the operation was 1.7 d. Nineteen cases caused by falling down, 9 cases by traffic accident. The main clinical manifestation was swelling, pain and limited mobility of shoulders. According to Neer classification, two part fractures were in 17 cases and three part fractures in 11 cases. The locking proximal humerus plate was used to minimally fixation through deltoid muscle under acromion. The operating time,volume of blood loss, the length of incision and Constant-Murley assessment were applied to evaluate the therapeutic effects. The mean operating time was 40 min, the mean blood loss was 110 ml, and the mean length of incision was about 5.6 cm. The postoperative X-ray showed excellent reduction and the plate and screws were successfully place. Twenty-eight patients were followed up for 6 to 24 months (averaged 14.2 months). The healing time ranged from 6 to 8 weeks and all incision was primarily healed. There were no cases with necrosis head humerus, 24 cases without omalgia, and 4 cases with o-malgia occasionally. All the patients can complete the daily life. The mean score of Constant-Murley assessment was 91.0 +/- 5.8, 24 cases got an excellent result, 3 good and 1 fair. Close reduction and percutaneous minimally invasive fixation, not only can reduce surgical invasive, but also guarantee the early function activities. It has the advantages of less invasive, fixed well and less damage of blood circulation.

Rapid cell separation with minimal manipulation for autologous cell therapies

NASA Astrophysics Data System (ADS)

Smith, Alban J.; O'Rorke, Richard D.; Kale, Akshay; Rimsa, Roberts; Tomlinson, Matthew J.; Kirkham, Jennifer; Davies, A. Giles; Wälti, Christoph; Wood, Christopher D.

2017-02-01

The ability to isolate specific, viable cell populations from mixed ensembles with minimal manipulation and within intra-operative time would provide significant advantages for autologous, cell-based therapies in regenerative medicine. Current cell-enrichment technologies are either slow, lack specificity and/or require labelling. Thus a rapid, label-free separation technology that does not affect cell functionality, viability or phenotype is highly desirable. Here, we demonstrate separation of viable from non-viable human stromal cells using remote dielectrophoresis, in which an electric field is coupled into a microfluidic channel using shear-horizontal surface acoustic waves, producing an array of virtual electrodes within the channel. This allows high-throughput dielectrophoretic cell separation in high conductivity, physiological-like fluids, overcoming the limitations of conventional dielectrophoresis. We demonstrate viable/non-viable separation efficacy of >98% in pre-purified mesenchymal stromal cells, extracted from human dental pulp, with no adverse effects on cell viability, or on their subsequent osteogenic capabilities.

Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy: A Systematic Review and Meta-Analysis.

PubMed

Kortram, Kirsten; Ijzermans, Jan N M; Dor, Frank J M F

2016-11-01

Minimally invasive live donor nephrectomy has become a fully implemented and accepted procedure. Donors have to be well educated about all risks and details during the informed consent process. For this to be successful, more information regarding short-term outcome is necessary. A literature search was performed; all studies discussing short-term complications after minimally invasive live donor nephrectomy were included. Outcomes evaluated were intraoperative and postoperative complications, conversions, operative and warm ischemia times, blood loss, length of hospital stay, pain score, convalescence, quality of life, and costs. One hundred ninety articles were included in the systematic review, 41 in the meta-analysis. Conversion rate was 1.1%. Intraoperative complication rate was 2.3%, mainly bleeding (1.5%). Postoperative complications occurred in 7.3% of donors, including infectious complications (2.6%), of which mainly wound infection (1.6%) and bleeding (1.0%). Reported mortality rate was 0.01%. All minimally invasive techniques were comparable with regard to complication or conversion rate. The used techniques for minimally invasive live donor nephrectomy are safe and associated with low complication rates and minimal risk of mortality. These data may be helpful to develop a standardized, donor-tailored informed consent procedure for live donor nephrectomy.

KENNEDY SPACE CENTER, FLA. - Workers, covered in protective clothing and breathing apparatus, continue sandblasting on the Mobile Launcher Platform on Launch Pad 39A to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - Workers, covered in protective clothing and breathing apparatus, continue sandblasting on the Mobile Launcher Platform on Launch Pad 39A to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

KENNEDY SPACE CENTER, FLA. - On Launch Pad 39A, clouds of dust float away from the Mobile Launcher Platform, which is undergoing sandblasting to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

NASA Image and Video Library

2003-09-12

KENNEDY SPACE CENTER, FLA. - On Launch Pad 39A, clouds of dust float away from the Mobile Launcher Platform, which is undergoing sandblasting to remove corrosion before repainting. Routine maintenance includes sandblasting and repainting as preventive means to minimize corrosion.

Experiment Design for Nonparametric Models Based On Minimizing Bayes Risk: Application to Voriconazole1

PubMed Central

Bayard, David S.; Neely, Michael

2016-01-01

An experimental design approach is presented for individualized therapy in the special case where the prior information is specified by a nonparametric (NP) population model. Here, a nonparametric model refers to a discrete probability model characterized by a finite set of support points and their associated weights. An important question arises as to how to best design experiments for this type of model. Many experimental design methods are based on Fisher Information or other approaches originally developed for parametric models. While such approaches have been used with some success across various applications, it is interesting to note that they largely fail to address the fundamentally discrete nature of the nonparametric model. Specifically, the problem of identifying an individual from a nonparametric prior is more naturally treated as a problem of classification, i.e., to find a support point that best matches the patient’s behavior. This paper studies the discrete nature of the NP experiment design problem from a classification point of view. Several new insights are provided including the use of Bayes Risk as an information measure, and new alternative methods for experiment design. One particular method, denoted as MMopt (Multiple-Model Optimal), will be examined in detail and shown to require minimal computation while having distinct advantages compared to existing approaches. Several simulated examples, including a case study involving oral voriconazole in children, are given to demonstrate the usefulness of MMopt in pharmacokinetics applications. PMID:27909942

Experiment design for nonparametric models based on minimizing Bayes Risk: application to voriconazole¹.

PubMed

Bayard, David S; Neely, Michael

2017-04-01

An experimental design approach is presented for individualized therapy in the special case where the prior information is specified by a nonparametric (NP) population model. Here, a NP model refers to a discrete probability model characterized by a finite set of support points and their associated weights. An important question arises as to how to best design experiments for this type of model. Many experimental design methods are based on Fisher information or other approaches originally developed for parametric models. While such approaches have been used with some success across various applications, it is interesting to note that they largely fail to address the fundamentally discrete nature of the NP model. Specifically, the problem of identifying an individual from a NP prior is more naturally treated as a problem of classification, i.e., to find a support point that best matches the patient's behavior. This paper studies the discrete nature of the NP experiment design problem from a classification point of view. Several new insights are provided including the use of Bayes Risk as an information measure, and new alternative methods for experiment design. One particular method, denoted as MMopt (multiple-model optimal), will be examined in detail and shown to require minimal computation while having distinct advantages compared to existing approaches. Several simulated examples, including a case study involving oral voriconazole in children, are given to demonstrate the usefulness of MMopt in pharmacokinetics applications.

[Advantages and disadvantages of direct-to-consumer genetic tests].

PubMed

Christiansen, Camilla Worm; Gerdes, Anne-Marie Axø

2017-03-13

Direct-to-consumer genetic tests are sold over the internet to consumers all over the world - including Denmark. No regulation of these tests has been introduced neither in Denmark nor in Europe, even though they have been on the market since 2007. Such tests have several advantages, but indeed also a long list of potential disadvantages, which are most often ignored, and among these is insufficient training of general practitioners in performing the necessary counselling but also the risk of increased expenses to unnecessary follow-up consultations.

Knowledge, attitude and skills of dental practitioners of Puducherry on minimally invasive dentistry concepts: A questionnaire survey

PubMed Central

Rayapudi, Jasmine; Usha, Carounanidy

2018-01-01

Background: Minimally invasive dentistry (MID) encompasses early caries diagnosis through caries risk assessment (CRA), early detection of incipient carious lesion including primary and secondary prevention based on scientific evidence that remineralization of demineralized enamel and dentin is possible if detected early. Although the dental curriculum focuses on the advantages of MID in tooth preservation, this science is not usually translated into practice. Aim: This study aimed to evaluate the knowledge, attitude, and skills of dental practitioners of Puducherry regarding the concepts of MID. Subjects and Methods: Data were collected through an online survey questionnaire based on awareness and practice of MID. Statistical evaluation was done on SPSS by Chi-square test. Results: A total of 126 dentists responded of which only 55% were trained in MID during their undergraduate and internship period, mainly through lectures (49.6%). Nearly 81% agreed that CRA should be conducted for all patients. Almost 42.7% had heard about International Caries Detection and Assessment System, but only 25.9% used a blunt explorer for caries detection. About 13.7% use magnification (loupes/microscope), but majority (84.7%) use radiographs. More than 70% were unaware of newer methods of caries detection. Statistically significant differences were found (P < 0.05) regarding qualification and experience about the effectiveness of Atraumatic Restorative Treatment and sandwich technique for treatment of caries in permanent teeth and high caries-risk children. Conclusion: Although there is knowledge about advantages of MID among dentists of Puducherry, it does not benefit patients, as many practitioners still follow the traditional principles of total caries removal. PMID:29899626

Home advantage in the Six Nations Rugby Union tournament.

PubMed

Thomas, Sion; Reeves, Colin; Bell, Andrew

2008-02-01

This study examined whether home advantage occurred in the Six Nations Rugby Union tournament. Data were gathered using the final championship standings from the tournament's inception in 2000 to the recently completed 2007 season. Home advantage for each championship season was defined as the number of points won by teams playing at home, expressed as a percentage of all points gained either at home or away. An analysis of home advantage for each of eight seasons of competition ranged from 53% (2005) to 70% (2006). There was an overall statistically significant home advantage of 61% for 120 matches played in the Six Nations tournament between 2000 and 2007. Also analysed were the percentage of points won at home by each country. Again, evidence supported home advantage amongst all competing nations regardless of the team's quality.

Minimally Invasive Surgical Ureterolithotomy Versus Ureteroscopic Lithotripsy for Large Ureteric Stones: A Systematic Review and Meta-analysis of the Literature.

PubMed

Kallidonis, Panagiotis; Ntasiotis, Panteleimon; Knoll, Thomas; Sarica, Kemal; Papatsoris, Athanasios; Somani, Bhaskar K; Greco, Francesco; Aboumarzouk, Omar M; Álvarez-Maestro, Mario; Sanguedolce, Francesco

2017-12-01

The management of large ureteric stones represents a technical and clinical challenge. To investigate the safety and efficacy of minimally invasive surgical ureterolithotomy (MISU) in comparison with ureteroscopic lithotripsy (URS) for the treatment of large ureteric stones. The Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines were followed for the conduction of the study, which was registered in the PROSPERO database. Search string was "(laparoscop* OR retroperito* OR robot*) AND ureterolitho*"; database scope included PubMed, SCOPUS, Cochrane, and EMBASE. Primary end points were the stone-free (SFR) and complications rates. Secondary end points included operative time and hospital stay. Subgroup analyses were performed for stones 1-2 and >2cm, as well as different lithotripters and ureteroscopes. Meta-analysis and forest-plot diagrams were performed with the RevMan 5.3.5 software. After screening 673 publications, seven randomized controlled trials were eligible to be included in the meta-analysis. A total of 778 patients were pooled after the elimination of the dropouts. No robotic cohorts were found. Only upper ureteral stones were treated in the included studies. The SFR at discharge and 3 mo was higher with MISU with odds ratios of 6.30 (95% confidence interval [CI]: 3.05, 13.01; I 2 =0%) and 5.34 (95% CI: 2.41, 8.81; I 2 =0%), respectively. The most common complications for MISU and URS were conversion to open surgery and stone migration to the renal pelvis, respectively. Favorable results in terms of operative time were observed in the case of URS with a mean difference of 29.5min (95% CI: 14.74, 44.26; I 2 =98%). Hospitalization time was favorable in the case of URS with a mean difference of 2.08 days (95% CI: 0.96, 3.20; I 2 =99%). This meta-analysis showed a significantly higher SFR at discharge and 3 mo for MISU in comparison with URS when upper ureteral stones were treated. Operative and hospitalization time favored

Comparison of Home Advantage in College and Professional Team Sports in the United States.

PubMed

Pollard, Richard; Gómez, Miguel A

2015-09-01

Home advantage in seven American college team sports (baseball, basketball, football, hockey, lacrosse, soccer and women's basketball) was compared with professional leagues in the United States for the same sports and for the same time period. A total of 81,063 college games and 22,477 professional games were analyzed for the four seasons 2006-07 to 2009-10. There was a significant home advantage, as measured by home winning percentage, in all sports, both college and professional. The overall home advantage in college sports was significantly greater than in professional sports (p<0.015). The mean difference was 3.73 home winning percentage points, being greatest for baseball, basketball, and hockey (all p<0.001). Plausible explanations for these results include differences in college and professional competition in terms of familiarity with local conditions, referee bias, territoriality and psychological factors. However, the influence of travel fatigue was inconclusive. Only for soccer was the home advantage greater for professionals. This was the only sport where crowd size appeared to be having an effect. In addition the rules of college soccer allow more substitution and hence greater coach intervention than in professional soccer, a factor that could also be reducing home advantage.

Quasi-minimal active disturbance rejection control of MIMO perturbed linear systems based on differential neural networks and the attractive ellipsoid method.

PubMed

Salgado, Iván; Mera-Hernández, Manuel; Chairez, Isaac

2017-11-01

This study addresses the problem of designing an output-based controller to stabilize multi-input multi-output (MIMO) systems in the presence of parametric disturbances as well as uncertainties in the state model and output noise measurements. The controller design includes a linear state transformation which separates uncertainties matched to the control input and the unmatched ones. A differential neural network (DNN) observer produces a nonlinear approximation of the matched perturbation and the unknown states simultaneously in the transformed coordinates. This study proposes the use of the Attractive Ellipsoid Method (AEM) to optimize the gains of the controller and the gain observer in the DNN structure. As a consequence, the obtained control input minimizes the convergence zone for the estimation error. Moreover, the control design uses the estimated disturbance provided by the DNN to obtain a better performance in the stabilization task in comparison with a quasi-minimal output feedback controller based on a Luenberger observer and a sliding mode controller. Numerical results pointed out the advantages obtained by the nonlinear control based on the DNN observer. The first example deals with the stabilization of an academic linear MIMO perturbed system and the second example stabilizes the trajectories of a DC-motor into a predefined operation point. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Minimal string theories and integrable hierarchies

NASA Astrophysics Data System (ADS)

Iyer, Ramakrishnan

Well-defined, non-perturbative formulations of the physics of string theories in specific minimal or superminimal model backgrounds can be obtained by solving matrix models in the double scaling limit. They provide us with the first examples of completely solvable string theories. Despite being relatively simple compared to higher dimensional critical string theories, they furnish non-perturbative descriptions of interesting physical phenomena such as geometrical transitions between D-branes and fluxes, tachyon condensation and holography. The physics of these theories in the minimal model backgrounds is succinctly encoded in a non-linear differential equation known as the string equation, along with an associated hierarchy of integrable partial differential equations (PDEs). The bosonic string in (2,2m-1) conformal minimal model backgrounds and the type 0A string in (2,4 m) superconformal minimal model backgrounds have the Korteweg-de Vries system, while type 0B in (2,4m) backgrounds has the Zakharov-Shabat system. The integrable PDE hierarchy governs flows between backgrounds with different m. In this thesis, we explore this interesting connection between minimal string theories and integrable hierarchies further. We uncover the remarkable role that an infinite hierarchy of non-linear differential equations plays in organizing and connecting certain minimal string theories non-perturbatively. We are able to embed the type 0A and 0B (A,A) minimal string theories into this single framework. The string theories arise as special limits of a rich system of equations underpinned by an integrable system known as the dispersive water wave hierarchy. We find that there are several other string-like limits of the system, and conjecture that some of them are type IIA and IIB (A,D) minimal string backgrounds. We explain how these and several other string-like special points arise and are connected. In some cases, the framework endows the theories with a non

Project safety as a sustainable competitive advantage.

PubMed

Rechenthin, David

2004-01-01

To be consistently profitable, a construction company must complete projects in scope, on schedule, and on budget. At the same time, the nature of the often high-risk work performed by construction companies can result in high accident rates. Clients and other stakeholders are placing increasing pressure on companies to decrease those accident rates. Clients routinely demand copies of safety plans and evidence of past results at the "pre-qualification" or "request for proposal" stages of the procurement process. Are high accident rates and the associated costs just a part of business? Companies that deliver on scope, schedule, and budget have a competitive advantage. Is it possible for projects with low accident rates to use it as a competitive advantage? Is the value added by safety just a temporary or parity issue, or does a successful safety program offer significant advantage to the company and the client? This article concludes that in the case of a high-risk industry, such as the construction industry, an organization with a successful safety program can promote safety performance as a sustainable competitive advantage. It is a choice the company can make.

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare

PubMed Central

Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N.; Mor, Vincent

2015-01-01

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. PMID:26438743

Minimal change disease

MedlinePlus

Minimal change nephrotic syndrome; Nil disease; Lipoid nephrosis; Idiopathic nephrotic syndrome of childhood ... disease is the most common cause of nephrotic syndrome in children. It is also seen in adults ...

Study of constrained minimal supersymmetry

NASA Astrophysics Data System (ADS)

Kane, G. L.; Kolda, Chris; Roszkowski, Leszek; Wells, James D.

1994-06-01

Taking seriously the phenomenological indications for supersymmetry we have made a detailed study of unified minimal SUSY, including many effects at the few percent level in a consistent fashion. We report here a general analysis of what can be studied without choosing a particular gauge group at the unification scale. Firstly, we find that the encouraging SUSY unification results of recent years do survive the challenge of a more complete and accurate analysis. Taking into account effects at the 5-10 % level leads to several improvements of previous results and allows us to sharpen our predictions for SUSY in the light of unification. We perform a thorough study of the parameter space and look for patterns to indicate SUSY predictions, so that they do not depend on arbitrary choices of some parameters or untested assumptions. Our results can be viewed as a fully constrained minimal SUSY standard model. The resulting model forms a well-defined basis for comparing the physics potential of different facilities. Very little of the acceptable parameter space has been excluded by CERN LEP or Fermilab so far, but a significant fraction can be covered when these accelerators are upgraded. A number of initial applications to the understanding of the values of mh and mt, the SUSY spectrum, detectability of SUSY at LEP II or Fermilab, B(b-->sγ), Γ(Z-->bb¯), dark matter, etc., are included in a separate section that might be of more interest to some readers than the technical aspects of model building. We formulate an approach to extracting SUSY parameters from data when superpartners are detected. For small tanβ or large mt both m1/2 and m0 are entirely bounded from above at ~1 TeV without having to use a fine-tuning constraint.

‘Inconvenient biology:’ advantages and disadvantages of first-time parenting after age 40 using in vitro fertilization

PubMed Central

Mac Dougall, K.; Beyene, Y.; Nachtigall, R.D.

2012-01-01

BACKGROUND As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of ‘delayed childbearing’ has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore the perceived advantages and disadvantages of postponed conception as well as participants’ retrospective opinions on the ‘optimal age’ for parenting. METHODS To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46 couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median income was 3–4 times higher than that of the average US family, which may bias their largely positive parenting experiences. RESULTS Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-parenting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling ‘lucky’ to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents. CONCLUSIONS These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of participants identified the optimal age for first-time parenting as 5�

Surgical outcomes of early congenital cholesteatoma: minimally invasive transcanal approach.

PubMed

Lee, Sang H; Jang, Jeong H; Lee, Dongjun; Lee, Hye-Ryung; Lee, Kyu-Yup

2014-03-01

To introduce a simple and alternative surgical technique, minimally invasive transcanal myringotomy (MITM), for early stage congenital cholesteatoma in children and to evaluate the feasibility and results of MITM for management of early stage congenital cholesteatoma with respect to its effectiveness and safety. Retrospective review. Between August 2008 and September 2012, a total of 36 patients with congenital cholesteatoma met the inclusion criteria and were analyzed. Patient medical records, including demographic characteristics, intraoperative findings, and follow-up records, were reviewed. Subjects consisted of 23 males (64%) and 13 females (36%), and the age at operation ranged from 12 months to 6 years (mean age = 3 years and 6 months). The number of congenital cholesteatoma was as follows: 26 patients at stage I and 10 patients at stage II. The follow-up duration was between 12 and 56 months, with an average of 30 months. There were no postoperative complications such as tympanic membrane perforation, dizziness, or secondary middle ear infection. Among 36 patients who had undergone the MITM approach for the treatment of congenital cholesteatoma, five (13.8%) showed recurrence and underwent a second-look operation. On the basis of our data, the MITM approach is a useful surgical technique for early stage congenital cholesteatoma in children. It has many advantages, in that there is no external wound and it is a simple surgical technique that involves easy postoperative care, a short operation time and hospitalization period, avoidance of serious complications, and easy repeatability for recurrence. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Views of Japanese patients on the advantages and disadvantages of hemodialysis and peritoneal dialysis.

PubMed

Nakamura-Taira, Nanako; Muranaka, Yoshimi; Miwa, Masako; Kin, Seikon; Hirai, Kei

2013-08-01

The preference for dialysis modalities is not well understood in Japan. This study explored the subjective views of Japanese patients undergoing dialysis regarding their treatments. The participants were receiving in-center hemodialysis (CHD) or continuous ambulatory peritoneal dialysis (CAPD). In Study 1, 34 participants (17 CHD and 17 CAPD) were interviewed about the advantages and disadvantages of dialysis modalities. In Study 2, 454 dialysis patients (437 CHD and 17 CAPD) rated the advantages and disadvantages of CHD and CAPD in a cross-sectional survey. Interviews showed that professional care and dialysis-free days were considered as advantages of CHD, while independence, less hospital visits, and flexibility were considered as advantages of CAPD. Disadvantages of CHD included restriction of food and fluids and unpleasant symptoms after each dialysis session. Catheter care was an additional disadvantage of CAPD. Survey showed that the highly ranked advantages were professional care in CHD and less frequent hospital visits in CAPD, while the highly ranked disadvantages were concerns about emergency and time restrictions in CHD, and catheter care and difficulty in soaking in a bath in CAPD. The total scores of advantages and disadvantages showed that CHD patients subjectively rated their own modality better CHD over CAPD, while CAPD patients had the opposite opinion. The results of this study indicate that the factors affecting the decision-making process of Japanese patients are unique to Japanese culture, namely considering the trouble caused to the people around patients (e.g., families, spouses, and/or caregivers).

The Advantages of Collimator Optimization for Intensity Modulated Radiation Therapy

NASA Astrophysics Data System (ADS)

Doozan, Brian

The goal of this study was to improve dosimetry for pelvic, lung, head and neck, and other cancers sites with aspherical planning target volumes (PTV) using a new algorithm for collimator optimization for intensity modulated radiation therapy (IMRT) that minimizes the x-jaw gap (CAX) and the area of the jaws (CAA) for each treatment field. A retroactive study on the effects of collimator optimization of 20 patients was performed by comparing metric results for new collimator optimization techniques in Eclipse version 11.0. Keeping all other parameters equal, multiple plans are created using four collimator techniques: CA 0, all fields have collimators set to 0°, CAE, using the Eclipse collimator optimization, CAA, minimizing the area of the jaws around the PTV, and CAX, minimizing the x-jaw gap. The minimum area and the minimum x-jaw angles are found by evaluating each field beam's eye view of the PTV with ImageJ and finding the desired parameters with a custom script. The evaluation of the plans included the monitor units (MU), the maximum dose of the plan, the maximum dose to organs at risk (OAR), the conformity index (CI) and the number of fields that are calculated to split. Compared to the CA0 plans, the monitor units decreased on average by 6% for the CAX method with a p-value of 0.01 from an ANOVA test. The average maximum dose remained within 1.1% difference between all four methods with the lowest given by CAX. The maximum dose to the most at risk organ was best spared by the CAA method, which decreased by 0.62% compared to the CA0. Minimizing the x-jaws significantly reduced the number of split fields from 61 to 37. In every metric tested the CAX optimization produced comparable or superior results compared to the other three techniques. For aspherical PTVs, CAX on average reduced the number of split fields, lowered the maximum dose, minimized the dose to the surrounding OAR, and decreased the monitor units. This is achieved while maintaining the same

Anesthesia for minimally invasive neurosurgery.

PubMed

Prabhakar, Hemanshu; Mahajan, Charu; Kapoor, Indu

2017-10-01

With an ultimate aim of improving patients overall outcome and satisfaction, minimally invasive surgical approach is becoming more of a norm. The related anesthetic evidence has not expanded at the same rate as surgical and technological advancement. This article reviews the recent evidence on anesthesia and perioperative concerns for patients undergoing minimally invasive neurosurgery. Minimally invasive cranial and spinal surgeries have been made possible only by vast technological development. Points of surgical interest can be precisely located with the help of stereotaxy and neuronavigation and special endoscopes which decrease the tissue trauma. The principles of neuroanethesia remain the same, but few concerns are specific for each technique. Dexmedetomidine has a favorable profile for procedures carried out under sedation technique. As the new surgical techniques are coming up, lesser known anesthetic concerns may also come into light. Over the last year, little new information has been added to existing literature regarding anesthesia for minimally invasive neurosurgeries. Neuroanesthesia goals remain the same and less invasive surgical techniques do not translate into safe anesthesia. Specific concerns for each procedure should be taken into consideration.

The Transition to Minimal Consciousness through the Evolution of Associative Learning

PubMed Central

Bronfman, Zohar Z.; Ginsburg, Simona; Jablonka, Eva

2016-01-01

The minimal state of consciousness is sentience. This includes any phenomenal sensory experience – exteroceptive, such as vision and olfaction; interoceptive, such as pain and hunger; or proprioceptive, such as the sense of bodily position and movement. We propose unlimited associative learning (UAL) as the marker of the evolutionary transition to minimal consciousness (or sentience), its phylogenetically earliest sustainable manifestation and the driver of its evolution. We define and describe UAL at the behavioral and functional level and argue that the structural-anatomical implementations of this mode of learning in different taxa entail subjective feelings (sentience). We end with a discussion of the implications of our proposal for the distribution of consciousness in the animal kingdom, suggesting testable predictions, and revisiting the ongoing debate about the function of minimal consciousness in light of our approach. PMID:28066282

Controlling molecular transport in minimal emulsions

NASA Astrophysics Data System (ADS)

Gruner, Philipp; Riechers, Birte; Semin, Benoît; Lim, Jiseok; Johnston, Abigail; Short, Kathleen; Baret, Jean-Christophe

2016-01-01

Emulsions are metastable dispersions in which molecular transport is a major mechanism driving the system towards its state of minimal energy. Determining the underlying mechanisms of molecular transport between droplets is challenging due to the complexity of a typical emulsion system. Here we introduce the concept of `minimal emulsions', which are controlled emulsions produced using microfluidic tools, simplifying an emulsion down to its minimal set of relevant parameters. We use these minimal emulsions to unravel the fundamentals of transport of small organic molecules in water-in-fluorinated-oil emulsions, a system of great interest for biotechnological applications. Our results are of practical relevance to guarantee a sustainable compartmentalization of compounds in droplet microreactors and to design new strategies for the dynamic control of droplet compositions.

Automation of a suturing device for minimally invasive surgery.

PubMed

Göpel, Tobias; Härtl, Felix; Schneider, Armin; Buss, Martin; Feussner, Hubertus

2011-07-01

Autostitch have been criticized as well as its cable. However, the comfortable handhold, automatic needle change, and ergonomic manipulation have been rated positive. Partially automated suturing in minimally invasive surgery offers advantages with respect to the speed of operation and ergonomics. Ongoing work in this field has to concentrate on minimization, implementation in robotic systems, and development of new operation methods (NOTES).

Why minimally invasive skin sampling techniques? A bright scientific future.

PubMed

Wang, Christina Y; Maibach, Howard I

2011-03-01

There is increasing interest in minimally invasive skin sampling techniques to assay markers of molecular biology and biochemical processes. This overview examines methodology strengths and limitations, and exciting developments pending in the scientific community. Publications were searched via PubMed, the U.S. Patent and Trademark Office Website, the DermTech Website and the CuDerm Website. The keywords used were noninvasive skin sampling, skin stripping, skin taping, detergent method, ring method, mechanical scrub, reverse iontophoresis, glucose monitoring, buccal smear, hair root sampling, mRNA, DNA, RNA, and amino acid. There is strong interest in finding methods to access internal biochemical, molecular, and genetic processes through noninvasive and minimally invasive external means. Minimally invasive techniques include the widely used skin tape stripping, the abrasion method that includes scraping and detergent, and reverse iontophoresis. The first 2 methods harvest largely the stratum corneum. Hair root sampling (material deeper than the epidermis), buccal smear, shave biopsy, punch biopsy, and suction blistering are also methods used to obtain cellular material for analysis, but involve some degree of increased invasiveness and thus are only briefly mentioned. Existing and new sampling methods are being refined and validated, offering exciting, different noninvasive means of quickly and efficiently obtaining molecular material with which to monitor bodily functions and responses, assess drug levels, and follow disease processes without subjecting patients to unnecessary discomfort and risk.

Comparison of a minimally invasive procedure versus standard microscopic discotomy: a prospective randomised controlled clinical trial

PubMed Central

Greiner-Perth, R.; Boehm, H.; Mahlfeld, K.; Grasshoff, H.; Allam, Y.; Awiszus, F.

2009-01-01

for the MAPN technique at the index centre with 33.3 min (SD 12.1 min). There was a huge clinical improvement for all patients regardless of centre or method revealed by a repeated measures ANOVA for all follow-up visits Separate post hoc ANOVAs for each centre revealed that there was a significant time–method (MAPN vs. MC) interaction at the index centre (F = 3.75, P = 0.006), whereas this crucial interaction was not present at the transfer centre (F = 0.5, P = 0.7). These results suggest a slightly faster clinical recovery for the MAPN patients only at the index centre. This was due to a greater reduction in VAS score for back pain at discharge, 8-week and 6-month follow up (P < 0.002). The Oswestry-disability scores reached a significant improvement compared to the initial values extending over the complete follow-up at both centres for both methods without revealing any differences for the two methods in either centre. There was no difference regarding complications. The results demonstrate that a shorter operation duration and concomitant quicker recovery is comprehensible at an experienced minimally invasively operating centre. These advantages could not be found at the transfer centre within 25 minimally invasive procedures. In conclusion both procedures show equal mid term clinical results and the same complication rate even if the suggested advantages for the minimally invasive procedure could not be confirmed for the transfer centre within the framework of this study. PMID:19360440

Economic impact of minimally invasive lumbar surgery.

PubMed

Hofstetter, Christoph P; Hofer, Anna S; Wang, Michael Y

2015-03-18

Cost effectiveness has been demonstrated for traditional lumbar discectomy, lumbar laminectomy as well as for instrumented and noninstrumented arthrodesis. While emerging evidence suggests that minimally invasive spine surgery reduces morbidity, duration of hospitalization, and accelerates return to activites of daily living, data regarding cost effectiveness of these novel techniques is limited. The current study analyzes all available data on minimally invasive techniques for lumbar discectomy, decompression, short-segment fusion and deformity surgery. In general, minimally invasive spine procedures appear to hold promise in quicker patient recovery times and earlier return to work. Thus, minimally invasive lumbar spine surgery appears to have the potential to be a cost-effective intervention. Moreover, novel less invasive procedures are less destabilizing and may therefore be utilized in certain indications that traditionally required arthrodesis procedures. However, there is a lack of studies analyzing the economic impact of minimally invasive spine surgery. Future studies are necessary to confirm the durability and further define indications for minimally invasive lumbar spine procedures.

The re-emergence of the minimal running shoe.

PubMed

Davis, Irene S

2014-10-01

The running shoe has gone through significant changes since its inception. The purpose of this paper is to review these changes, the majority of which have occurred over the past 50 years. Running footwear began as very minimal, then evolved to become highly cushioned and supportive. However, over the past 5 years, there has been a reversal of this trend, with runners seeking more minimal shoes that allow their feet more natural motion. This abrupt shift toward footwear without cushioning and support has led to reports of injuries associated with minimal footwear. In response to this, the running footwear industry shifted again toward the development of lightweight, partial minimal shoes that offer some support and cushioning. In this paper, studies comparing the mechanics between running in minimal, partial minimal, and traditional shoes are reviewed. The implications for injuries in all 3 conditions are examined. The use of minimal footwear in other populations besides runners is discussed. Finally, areas for future research into minimal footwear are suggested.

A minimal model of striped superconductors

NASA Astrophysics Data System (ADS)

Martin, I.; Ortiz, G.; Balatsky, A. V.; Bishop, A. R.

2001-12-01

We present a minimal model of high-temperature superconductors that simultaneously supports antiferromagnetic stripes and d-wave superconductivity. At the unrestricted mean-field level, the various phases of the cuprates, including weak and strong pseudogap phases, and two different types of superconductivity in the underdoped and the overdoped regimes, find a natural interpretation. We argue that on the underdoped side, the superconductor is intrinsically inhomogeneous and global phase coherence is achieved through Josephson-like coupling of the superconducting stripes. On the overdoped side, the state is overall homogeneous and the superconductivity is of a classical BCS type.

Minimally invasive surgical treatment of Bertolotti's Syndrome: case report.

PubMed

Ugokwe, Kene T; Chen, Tsu-Lee; Klineberg, Eric; Steinmetz, Michael P

2008-05-01

This article aims to provide more insight into the presentation, diagnosis, and treatment of Bertolotti's syndrome, which is a rare spinal disorder that is very difficult to recognize and diagnose correctly. The syndrome was first described by Bertolotti in 1917 and affects approximately 4 to 8% of the population. It is characterized by an enlarged transverse process at the most caudal lumbar vertebra with a pseudoarticulation of the transverse process and the sacral ala. It tends to present with low back pain and may be confused with facet and sacroiliac joint disease. In this case report, we describe a 40-year-old man who presented with low back pain and was eventually diagnosed with Bertolotti's syndrome. The correct diagnosis was made based on imaging studies which included computed tomographic scans, plain x-rays, and magnetic resonance imaging scans. The patient experienced temporary relief when the abnormal pseudoarticulation was injected with a cocktail consisting of lidocaine and steroids. In order to minimize the trauma associated with surgical treatment, a minimally invasive approach was chosen to resect the anomalous transverse process with the accompanying pseudoarticulation. The patient did well postoperatively and had 97% resolution of his pain at 6 months after surgery. As with conventional surgical approaches, a complete knowledge of anatomy is required for minimally invasive spine surgery. This case is an example of the expanding utility of minimally invasive approaches in treating spinal disorders.

How accurate is our clinical prediction of "minimal prostate cancer"?

PubMed

Leibovici, Dan; Shikanov, Sergey; Gofrit, Ofer N; Zagaja, Gregory P; Shilo, Yaniv; Shalhav, Arieh L

2013-07-01

Recommendations for active surveillance versus immediate treatment for low risk prostate cancer are based on biopsy and clinical data, assuming that a low volume of well-differentiated carcinoma will be associated with a low progression risk. However, the accuracy of clinical prediction of minimal prostate cancer (MPC) is unclear. To define preoperative predictors for MPC in prostatectomy specimens and to examine the accuracy of such prediction. Data collected on 1526 consecutive radical prostatectomy patients operated in a single center between 2003 and 2008 included: age, body mass index, preoperative prostate-specific antigen level, biopsy Gleason score, clinical stage, percentage of positive biopsy cores, and maximal core length (MCL) involvement. MPC was defined as < 5% of prostate volume involvement with organ-confined Gleason score < or = 6. Univariate and multivariate logistic regression analyses were used to define independent predictors of minimal disease. Classification and Regression Tree (CART) analysis was used to define cutoff values for the predictors and measure the accuracy of prediction. MPC was found in 241 patients (15.8%). Clinical stage, biopsy Gleason's score, percent of positive biopsy cores, and maximal involved core length were associated with minimal disease (OR 0.42, 0.1, 0.92, and 0.9, respectively). Independent predictors of MPC included: biopsy Gleason score, percent of positive cores and MCL (OR 0.21, 095 and 0.95, respectively). CART showed that when the MCL exceeded 11.5%, the likelihood of MPC was 3.8%. Conversely, when applying the most favorable preoperative conditions (Gleason < or = 6, < 20% positive cores, MCL < or = 11.5%) the chance of minimal disease was 41%. Biopsy Gleason score, the percent of positive cores and MCL are independently associated with MPC. While preoperative prediction of significant prostate cancer was accurate, clinical prediction of MPC was incorrect 59% of the time. Caution is necessary when

Non-minimal derivative coupling gravity in cosmology

NASA Astrophysics Data System (ADS)

Gumjudpai, Burin; Rangdee, Phongsaphat

2015-11-01

We give a brief review of the non-minimal derivative coupling (NMDC) scalar field theory in which there is non-minimal coupling between the scalar field derivative term and the Einstein tensor. We assume that the expansion is of power-law type or super-acceleration type for small redshift. The Lagrangian includes the NMDC term, a free kinetic term, a cosmological constant term and a barotropic matter term. For a value of the coupling constant that is compatible with inflation, we use the combined WMAP9 (WMAP9 + eCMB + BAO + H_0) dataset, the PLANCK + WP dataset, and the PLANCK TT, TE, EE + lowP + Lensing + ext datasets to find the value of the cosmological constant in the model. Modeling the expansion with power-law gives a negative cosmological constants while the phantom power-law (super-acceleration) expansion gives positive cosmological constant with large error bar. The value obtained is of the same order as in the Λ CDM model, since at late times the NMDC effect is tiny due to small curvature.

Waste minimization for commercial radioactive materials users generating low-level radioactive waste. Revision 1

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

Fischer, D.K.; Gitt, M.; Williams, G.A.

1991-07-01

The objective of this document is to provide a resource for all states and compact regions interested in promoting the minimization of low-level radioactive waste (LLW). This project was initiated by the Commonwealth of Massachusetts, and Massachusetts waste streams have been used as examples; however, the methods of analysis presented here are applicable to similar waste streams generated elsewhere. This document is a guide for states/compact regions to use in developing a system to evaluate and prioritize various waste minimization techniques in order to encourage individual radioactive materials users (LLW generators) to consider these techniques in their own independent evaluations.more » This review discusses the application of specific waste minimization techniques to waste streams characteristic of three categories of radioactive materials users: (1) industrial operations using radioactive materials in the manufacture of commercial products, (2) health care institutions, including hospitals and clinics, and (3) educational and research institutions. Massachusetts waste stream characterization data from key radioactive materials users in each category are used to illustrate the applicability of various minimization techniques. The utility group is not included because extensive information specific to this category of LLW generators is available in the literature.« less

Home advantage in southern hemisphere rugby union: national and international.

PubMed

Morton R, Hugh

2006-05-01

This study evaluates home advantages both for national (Super 12) and international (Tri-nations) rugby union teams from South Africa, Australia and New Zealand, over the five-year period 2000 - 2004 using linear modelling. These home advantages are examined for statistical and practical significance, for variability between teams, for stability over time and for inter-correlation. These data reveal that the overall home advantage in elite rugby union has a mean of +6.7 points, and that this changes little from year to year. Closer scrutiny nevertheless reveals a high degree of variability. Different teams can and do have different home advantages, which ranges from a low of -0.7 to a high of +28.3 points in any one year. Furthermore, some team home advantages change up or down from one year to the next, by as much as -36.5 to +31.4 points at the extremes. There is no evidence that the stronger teams have the higher home advantages, or that a high home advantage leads to a superior finishing position in the competition.

2016 Los Alamos National Laboratory Hazardous Waste Minimization Report

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

Salzman, Sonja L.; English, Charles Joe

Waste minimization and pollution prevention are goals within the operating procedures of Los Alamos National Security, LLC (LANS). The US Department of Energy (DOE), inclusive of the National Nuclear Security Administration (NNSA) and the Office of Environmental Management, and LANS are required to submit an annual hazardous waste minimization report to the New Mexico Environment Department (NMED) in accordance with the Los Alamos National Laboratory (LANL or the Laboratory) Hazardous Waste Facility Permit. The report was prepared pursuant to the requirements of Section 2.9 of the LANL Hazardous Waste Facility Permit. This report describes the hazardous waste minimization program, whichmore » is a component of the overall Pollution Prevention (P2) Program, administered by the Environmental Stewardship Group (EPC-ES). This report also supports the waste minimization and P2 goals of the Associate Directorate of Environmental Management (ADEM) organizations that are responsible for implementing remediation activities and describes its programs to incorporate waste reduction practices into remediation activities and procedures. This report includes data for all waste shipped offsite from LANL during fiscal year (FY) 2016 (October 1, 2015 – September 30, 2016). LANS was active during FY2016 in waste minimization and P2 efforts. Multiple projects were funded that specifically related to reduction of hazardous waste. In FY2016, there was no hazardous, mixed-transuranic (MTRU), or mixed low-level (MLLW) remediation waste shipped offsite from the Laboratory. More non-remediation hazardous waste and MLLW was shipped offsite from the Laboratory in FY2016 compared to FY2015. Non-remediation MTRU waste was not shipped offsite during FY2016. These accomplishments and analysis of the waste streams are discussed in much more detail within this report.« less

Total Laparoscopic Hysterectomy With Percutaneous (Percuvance) Instruments: New Frontier of Minimally Invasive Gynecological Surgery.

PubMed

Rossitto, Cristiano; Gueli Alletti, Salvatore; Costantini, Barbara; Fanfani, Francesco; Scambia, Giovanni

2016-01-01

To highlight the first case of laparoscopic hysterectomy performed with percutaneous instruments (The Percuvance System, Teleflex Incorporated, Wayne, PA). The basis of the system is a <3-mm diameter shaft that, when connected to an introducer tool tip, can be inserted percutaneously through the skin. The introducer tool tip can then be exchanged outside the body for a wide variety of 5-mm interchangeable surgical tool tips. The shaft is sufficiently strong to hold structures, and surgeons can use its interchangeable tool tips to grasp, cut, and manipulate tissue. We used a 3-dimensional high-definition 10-mm flexible tip endoscope (ENDOEYE FLEX 3D, Olympus Winter & IBE GMBH, Hamburg, Germany). Minilaparoscopy is an attractive approach for hysterectomy due to advantages such as reduced morbidities and enhanced cosmesis. However, it has not been popularized because of the lack of suitable instruments and high technical demand. The Percuvance system represents a significant advance in minimally invasive surgery. Catholic University of the Sacred Hearth, Rome, Italy. A 53-year-old, multiparous patient with endometrial endometroid cancer grade 1, Fédération Internationale de Gynécologie et d'Obstétrique stage IA. The patient provided informed consent to use the images and video of the procedure. Institutional review board approval was not required. The patient was hysteroscopically diagnosed with endometrial cancer after removal of an endometrial polyp adnexectomy. Once referred to our center, surgical staging was planned, including total hysterectomy and bilateral adnexectomy. Laparoscopy with 2 lateral percutaneous and 1 soprapubic 3-mm instruments was believed to be feasible to achieve these procedures. The operation was performed successfully with no intraoperative or postoperative complications. Operative time was 80 minutes overall, and blood loss was 50 mL. The pathology report confirmed endometrial endometroid cancer grading 1, Fédération Internationale

Evaluation of a School-Based Teen Obesity Prevention Minimal Intervention

ERIC Educational Resources Information Center

Abood, Doris A.; Black, David R.; Coster, Daniel C.

2008-01-01

Objective: A school-based nutrition education minimal intervention (MI) was evaluated. Design: The design was experimental, with random assignment at the school level. Setting: Seven schools were randomly assigned as experimental, and 7 as delayed-treatment. Participants: The experimental group included 551 teens, and the delayed treatment group…

Memory and Mystery: The Cultural Selection of Minimally Counterintuitive Narratives

ERIC Educational Resources Information Center

Norenzayan, Ara; Atran, Scott; Faulkner, Jason; Schaller, Mark

2006-01-01

We hypothesize that cultural narratives such as myths and folktales are more likely to achieve cultural stability if they correspond to a minimally counterintuitive (MCI) cognitive template that includes mostly intuitive concepts combined with a minority of counterintuitive ones. Two studies tested this hypothesis, examining whether this template…

Creating corporate advantage.

PubMed

Collis, D J; Montgomery, C A

1998-01-01

What differentiates truly great corporate strategies from the merely adequate? How can executives at the corporate level create tangible advantage for their businesses that makes the whole more than the sum of the parts? This article presents a comprehensive framework for value creation in the multibusiness company. It addresses the most fundamental questions of corporate strategy: What businesses should a company be in? How should it coordinate activities across businesses? What role should the corporate office play? How should the corporation measure and control performance? Through detailed case studies of Tyco International, Sharp, the Newell Company, and Saatchi and Saatchi, the authors demonstrate that the answers to all those questions are driven largely by the nature of a company's special resources--its assets, skills, and capabilities. These range along a continuum from the highly specialized at one end to the very general at the other. A corporation's location on the continuum constrains the set of businesses it should compete in and limits its choices about the design of its organization. Applying the framework, the authors point out the common mistakes that result from misaligned corporate strategies. Companies mistakenly enter businesses based on similarities in products rather than the resources that contribute to competitive advantage in each business. Instead of tailoring organizational structures and systems to the needs of a particular strategy, they create plain-vanilla corporate offices and infrastructures. The company examples demonstrate that one size does not fit all. One can find great corporate strategies all along the continuum.

Hematopoietic stem cells with controllable tEpoR transgenes have a competitive advantage in bone marrow transplantation.

PubMed

Kirby, S; Walton, W; Smithies, O

2000-06-15

In a previous study, it was found that a truncated erythropoietin receptor transgene (tEpoR tg) enables multilineage hematopoietic progenitor amplification after treatment with erythropoietin (epo) in vitro and in vivo. This study used competitive bone marrow (BM) repopulation to show that tEpoR tg facilitates transplantation by hematopoietic stem cells (HSC). Individual multilineage colonies, committed myeloid progenitor colonies, and lymphoid colonies (pre-B colony-forming units) were grown from the marrow of animals 6 months after they received a 50/50 mixture of transgene and wild-type BM cells. In epo-treated recipients, the transgene-bearing cells significantly outcompeted the wild-type cells (84%-100% versus 16%-0%, respectively). In recipients treated with phosphate-buffered saline, the repopulation was minimally different from the donor mixture (49%-64% transgene versus 51%-36% wild-type). The epo-induced repopulation advantage is maintained in secondary transplants. In addition, neither accelerated HSC depletion nor uncontrollable proliferation occurred during epo-stimulated serial transplants of transgene-containing BM. Thus, the tEpoR tg functions in a benign fashion in HSC and allows for a significant and controllable repopulation advantage in vivo without excessive HSC depletion relative to wild-type BM. (Blood. 2000;95:3710-3715)

Development and application of the near-infrared and white-light thoracoscope system for minimally invasive lung cancer surgery

NASA Astrophysics Data System (ADS)

Mao, Yamin; Wang, Kun; He, Kunshan; Ye, Jinzuo; Yang, Fan; Zhou, Jian; Li, Hao; Chen, Xiuyuan; Wang, Jun; Chi, Chongwei; Tian, Jie

2017-06-01

In minimally invasive surgery, the white-light thoracoscope as a standard imaging tool is facing challenges of the low contrast between important anatomical or pathological regions and surrounding tissues. Recently, the near-infrared (NIR) fluorescence imaging shows superior advantages over the conventional white-light observation, which inspires researchers to develop imaging systems to improve overall outcomes of endoscopic imaging. We developed an NIR and white-light dual-channel thoracoscope system, which achieved high-fluorescent signal acquisition efficiency and the simultaneously optimal visualization of the NIR and color dual-channel signals. The system was designed to have fast and accurate image registration and high signal-to-background ratio by optimizing both software algorithms and optical hardware components for better performance in the NIR spectrum band. The system evaluation demonstrated that the minimally detectable concentration of indocyanine green (ICG) was 0.01 μM, and the spatial resolution was 35 μm. The in vivo feasibility of our system was verified by the preclinical experiments using six porcine models with the intravenous injection of ICG. Furthermore, the system was successfully applied for guiding the minimally invasive segmentectomy in three lung cancer patients, which revealed that our system held great promise for the clinical translation in lung cancer surgeries.

Attaining minimally disruptive medicine: context, challenges and a roadmap for implementation.

PubMed

Shippee, N D; Allen, S V; Leppin, A L; May, C R; Montori, V M

2015-01-01

In this second of two papers on minimally disruptive medicine, we use the language of patient workload and patient capacity from the Cumulative Complexity Model to accomplish three tasks. First, we outline the current context in healthcare, comprised of contrasting problems: some people lack access to care and others receive too much care in an overmedicalised system, both of which reflect imbalances between patients' workloads and their capacity. Second, we identify and address five tensions and challenges between minimally disruptive medicine, the existing context, and other approaches to accessible and patient-centred care such as evidence-based medicine and greater patient engagement. Third, we outline a roadmap of three strategies toward implementing minimally disruptive medicine in practice, including large-scale paradigm shifts, mid-level add-ons to existing reform efforts, and a modular strategy using an existing 'toolkit' that is more limited in scope, but can fit into existing healthcare systems.

Mating programs including genomic relationships

USDA-ARS?s Scientific Manuscript database

Computer mating programs have helped breeders minimize pedigree inbreeding and avoid recessive defects by mating animals with parents that have fewer common ancestors. With genomic selection, breed associations, AI organizations, and on-farm software providers could use new programs to minimize geno...

Solution for Minimizing Surface Heating Effect for Fast Open-Path CO2 Flux Measurements in Cold Environments

NASA Astrophysics Data System (ADS)

Hupp, J. R.; Burba, G. G.; McDermitt, D. K.; Anderson, D. J.; Eckles, R. D.

2010-12-01

Open-path design of the high speed gas analyzers is a well-established configuration widely used for measurements of CO2 fluxes and concentrations. This configuration has advantages and deficiencies. Advantages include excellent frequency response, long-term stability, low sensitivity to window contamination, low-power pump-free operation, and infrequent calibration requirements. Deficiencies include susceptibility to precipitation and icing, and a potential need for instrument surface heating correction in extremely cold environments. In spite of the deficiencies, open-path measurements often provide data coverage that would not have been possible using traditional closed-path approach. Data loss from precipitation and icing may not always be prevented for the open-path instruments, while heating effect does not pose a problem for CO2 flux in warm environments. Even in cold environments, the impact of heating on CO2 flux is much smaller than other well-known effects, such as Webb-Pearman-Leuning terms, or frequency response corrections for closed-path analyzers. Nonetheless, instrument surface heating effect in cold environments could be addressed scientifically, via developing the theoretical corrections, and instrumentally, via measuring fast integrated air temperature in the optical path, or via enclosing the open-path instrument into a low-power short-intake design. Here we provide an alternative way to minimize or eliminate open-path heating effect, achieved by minimizing or eliminating the temperature gradient between the instrument surface and ambient air. Open-path low temperature controlled design is discussed in comparison with two other approaches (e.g., traditional open-path design and closed-path design) in terms of their field performance for Eddy Covariance flux measurements in the cold. This study presents field data from a new open-path CO2/H2O gas analyzer, LI-7500A, based on the LI-7500 model modified to produce substantially less heat during

Comparisons of Adolescent and Parent Willingness to Participate in Minimal and Above Minimal Risk Pediatric Asthma Research Protocols

PubMed Central

Brody, Janet L.; Annett, Robert D.; Scherer, David G.; Perryman, Mandy L.; Cofrin, Keely M. W.

2007-01-01

Purpose Much has been written about conceptual concern for voluntary assent with children and adolescents. However, little empirical data exists examining the frequency with which, or context in which, adolescents and parents disagree on research participation decisions. The purpose of this study was to compare parent and adolescent willingness to participate in minimal and above minimal risk pediatric asthma research protocols. Method 36 adolescents diagnosed with asthma and one of their parents independently rated their willingness to participate in 9 pediatric asthma research protocol vignettes. The selected protocols were chosen by an expert panel as representative of typical minimal and above minimal risk pediatric asthma studies. Results Parents and adolescents were significantly less likely to agree to enroll in above minimal risk studies. However, this was qualified by a finding that adolescents were significantly more willing than parents to enroll in above minimal risk research. Across all 9 studies, parents and adolescents held concordant views on participation decisions approximately 60% of the time. Perception of potential study benefit was the most frequent reason provided for participation decisions by both parents and adolescents. Conclusion Parents and their adolescents report a consistent 40% discordance in their views about participating in asthma research across a variety of asthma research protocols, with adolescents more willing than their parents to enroll in above minimal risk studies. These differences of opinion highlight the need to carefully consider the process by which families are offered the option of adolescent research participation. PMID:16109343

The POP Program: the patient education advantage.

PubMed

Claeys, M; Mosher, C; Reesman, D

1998-01-01

In 1992, a preoperative education program was developed for total joint replacement patients in a small community hospital. The goals of the program were to increase educational opportunities for the joint replacement patients, prepare patients for hospitalization, plan for discharge needs, and increase efficiency of the orthopaedic program. Since 1992, approximately 600 patients have attended the education program. Outcomes have included positive responses from patients regarding their preparedness for surgery, increased participation in their plan of care, coordinated discharge planning, decreased length of stay, and progression across the continuum of care. A multidisciplinary approach to preparing patients for surgery allows for a comprehensive and efficient education program. Marketing of successful programs can enhance an institution's competitive advantage and help ensure the hospital's viability in the current health care arena.

Letter to the Editor: On "Advantages and disadvantages of stiffness instructions when studying postural control" by C.T. Bonnet: You just can't win: Advantages and disadvantages of the postural stability requirement.

PubMed

Lajoie, Y; Richer, N; Jehu, D A; Polskaia, N; Saunders, D

2016-05-01

In the examination of postural control, instructions to stand as still as possible are common and promote a relatively unnatural sway pattern. The validity of the stability requirement is discussed in the present commentary in response to the discussion initiated by Cedrick T. Bonnet. The advantages of using the stability requirement include: evaluating unbiased postural control, reducing variability in postural sway, manipulating focus of attention, examining the ability to maintain an upright stance, and ecological validity of testing. The disadvantages include: constraining natural postural sway, increasing the complexity of the control condition, promoting an internal focus of attention, and reducing the ability to detect exploratory behaviour. After evaluating the aforementioned advantages and disadvantages, the present commentary suggests that researchers should strive to provide specific instructions to maintain feet, arm and eye position without specifically requiring participants to reduce their postural sway. Copyright © 2015 Elsevier B.V. All rights reserved.

A visual short-term memory advantage for objects of expertise

PubMed Central

Curby, Kim M.; Glazek, Kuba; Gauthier, Isabel

2014-01-01

Visual short-term memory (VSTM) is limited, especially for complex objects. Its capacity, however, is greater for faces than for other objects, an advantage that may stem from the holistic nature of face processing. If the holistic processing explains this advantage, then object expertise—which also relies on holistic processing—should endow experts with a VSTM advantage. We compared VSTM for cars among car experts to that among car novices. Car experts, but not car novices, demonstrated a VSTM advantage similar to that for faces; this advantage was orientation-specific and was correlated with an individual's level of car expertise. Control experiments ruled out accounts based solely on verbal- or long-term memory representations. These findings suggest that the processing advantages afforded by visual expertise result in domain-specific increases in VSTM capacity, perhaps by allowing experts to maximize the use of an inherently limited VSTM system. PMID:19170473

Minimally invasive surgery for atrial fibrillation

PubMed Central

Suwalski, Piotr

2013-01-01

Atrial fibrillation (AF) remains the most common cardiac arrhythmia, affecting nearly 2% of the general population worldwide. Minimally invasive surgical ablation remains one of the most dynamically evolving fields of modern cardiac surgery. While there are more than a dozen issues driving this development, two seem to play the most important role: first, there is lack of evidence supporting percutaneous catheter based approach to treat patients with persistent and long-standing persistent AF. Paucity of this data offers surgical community unparalleled opportunity to challenge guidelines and change indications for surgical intervention. Large, multicenter prospective clinical studies are therefore of utmost importance, as well as honest, clear data reporting. Second, a collaborative methodology started a long-awaited debate on a Heart Team approach to AF, similar to the debate on coronary artery disease and transcatheter valves. Appropriate patient selection and tailored treatment options will most certainly result in better outcomes and patient satisfaction, coupled with appropriate use of always-limited institutional resources. The aim of this review, unlike other reviews of minimally invasive surgical ablation, is to present medical professionals with two distinctly different, approaches. The first one is purely surgical, Standalone surgical isolation of the pulmonary veins using bipolar energy source with concomitant amputation of the left atrial appendage—a method of choice in one of the most important clinical trials on AF—The Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) Trial. The second one represents the most complex approach to this problem: a multidisciplinary, combined effort of a cardiac surgeon and electrophysiologist. The Convergent Procedure, which includes both endocardial and epicardial unipolar ablation bonds together minimally invasive endoscopic surgery with electroanatomical mapping, to deliver best of

Minimal measures on surfaces of higher genus

NASA Astrophysics Data System (ADS)

Wang, Fang

We study the minimal measures for positive definite autonomous Lagrangian systems defined on the tangent bundles of compact surfaces with genus greater than one. We present some results on the structure of minimal measures on compact surfaces. Specifically, we give a finer description of the structure of minimal measures with rational rotation vectors for geodesic flows on compact surfaces.

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare.

PubMed

Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent

2015-10-01

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.

Conducting Research with Minimally Verbal Participants with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Tager-Flusberg, Helen; Plesa Skwerer, Daniela; Joseph, Robert M.; Brukilacchio, Brianna; Decker, Jessica; Eggleston, Brady; Meyer, Steven; Yoder, Anne

2017-01-01

A growing number of research groups are now including older minimally verbal individuals with autism spectrum disorder in their studies to encompass the full range of heterogeneity in the population. There are numerous barriers that prevent researchers from collecting high-quality data from these individuals, in part because of the challenging…

A Kantian argument against comparatively advantageous genetic modification.

PubMed

Jensen, David

2011-08-01

The genetic modification of children is becoming a more likely possibility given our rapid progress in medical technologies. I argue, from a broadly Kantian point of view, that at least one kind of such modification-modification by a parent for the sake of a child's comparative advantage-is not rationally justified. To argue this, I first characterize a necessary condition on reasons and rational justification: what is a reason for an agent to do an action in one set of circumstances must be a reason for any in those circumstances to do the action. I then show that comparatively advantageous genetic modification violates this principle since a child's "getting ahead" through genetic modification cannot be rationally justified unless other children also could receive the modification, thus rendering the advantage useless. Finally, I consider the major objection to this it seems to disallow all cases of a parent's helping a child get ahead, something that parents normally engage in with their children. I argue that typical practices of developing a comparative advantage in a child, as well as practices of societal competition in general, do not conflict because they involve circumstances that mitigate the universal character of reasons. Many ordinary cases of competitive advantage that we think of as unjust, in fact, can be explained by my argument.

Light dark Higgs boson in minimal sub-GeV dark matter scenarios

NASA Astrophysics Data System (ADS)

Darmé, Luc; Rao, Soumya; Roszkowski, Leszek

2018-03-01

Minimal scenarios with light (sub-GeV) dark matter whose relic density is obtained from thermal freeze-out must include new light mediators. In particular, a very well-motivated case is that of a new "dark" massive vector gauge boson mediator. The mass term for such mediator is most naturally obtained by a "dark Higgs mechanism" which leads to the presence of an often long-lived dark Higgs boson whose mass scale is the same as that of the mediator. We study the phenomenology and experimental constraints on two minimal, self-consistent dark sectors that include such a light dark Higgs boson. In one the dark matter is a pseudo-Dirac fermion, in the other a complex scalar. We find that the constraints from BBN and CMB are considerably relaxed in the framework of such minimal dark sectors. We present detection prospects for the dark Higgs boson in existing and projected proton beam-dump experiments. We show that future searches at experiments like Xenon1T or LDMX can probe all the relevant parameter space, complementing the various upcoming indirect constraints from astrophysical observations.

Sculpting proteins interactively: continual energy minimization embedded in a graphical modeling system.

PubMed

Surles, M C; Richardson, J S; Richardson, D C; Brooks, F P

1994-02-01

We describe a new paradigm for modeling proteins in interactive computer graphics systems--continual maintenance of a physically valid representation, combined with direct user control and visualization. This is achieved by a fast algorithm for energy minimization, capable of real-time performance on all atoms of a small protein, plus graphically specified user tugs. The modeling system, called Sculpt, rigidly constrains bond lengths, bond angles, and planar groups (similar to existing interactive modeling programs), while it applies elastic restraints to minimize the potential energy due to torsions, hydrogen bonds, and van der Waals and electrostatic interactions (similar to existing batch minimization programs), and user-specified springs. The graphical interface can show bad and/or favorable contacts, and individual energy terms can be turned on or off to determine their effects and interactions. Sculpt finds a local minimum of the total energy that satisfies all the constraints using an augmented Lagrange-multiplier method; calculation time increases only linearly with the number of atoms because the matrix of constraint gradients is sparse and banded. On a 100-MHz MIPS R4000 processor (Silicon Graphics Indigo), Sculpt achieves 11 updates per second on a 20-residue fragment and 2 updates per second on an 80-residue protein, using all atoms except non-H-bonding hydrogens, and without electrostatic interactions. Applications of Sculpt are described: to reverse the direction of bundle packing in a designed 4-helix bundle protein, to fold up a 2-stranded beta-ribbon into an approximate beta-barrel, and to design the sequence and conformation of a 30-residue peptide that mimics one partner of a protein subunit interaction. Computer models that are both interactive and physically realistic (within the limitations of a given force field) have 2 significant advantages: (1) they make feasible the modeling of very large changes (such as needed for de novo design), and

Polysemy Advantage with Abstract but Not Concrete Words

ERIC Educational Resources Information Center

Jager, Bernadet; Cleland, Alexandra A.

2016-01-01

It is a robust finding that ambiguous words are recognized faster than unambiguous words. More recent studies (e.g., Rodd et al. in "J Mem Lang" 46:245-266, 2002) now indicate that this "ambiguity advantage" may in reality be a "polysemy advantage": caused by related senses (polysemy) rather than unrelated meanings…

Advantages and disadvantages of interdisciplinary consultation in the prescription of assistive technologies for mobility limitations.

PubMed

de Laat, Fred A; van Heerebeek, Bart; van Netten, Jaap J

2018-03-28

To explore the advantages and disadvantages experienced by professionals in interdisciplinary consultation involving the user, prescriber and technician in the prescription of assistive technologies for mobility limitations. Cross-sectional study. Prescribers (N = 39) and orthopaedic technicians (N = 50), who were regularly involved in an interdisciplinary consultation completed a questionnaire about advantages and disadvantages of the interdisciplinary consultation. Advantages of the interdisciplinary consultation were mentioned within all CanMEDS areas of medical practice, including better and quicker prescription of the assistive technology, shared knowledge of medical diagnosis and device possibilities, shared decision making of the device prescription and clear communication rules. Disadvantages were mentioned in the CanMEDS areas management and collaboration, including planning problems (financial) reimbursement of this type of consultation, and time efficiency. On a 10-point scale, mean (standard deviation) rates of interdisciplinary consultations were 7.9 (0.6) according to prescribers, and 7.8 (0.9) by technicians. All participants wanted to continue the interdisciplinary consultation. Prescribers and technicians in the field of assistive technologies for walking mobility limitations appreciate an interdisciplinary consultation. Advantages are found in all CanMEDS areas, whereas disadvantages only concern coordination. It should be encouraged to realize this kind of consultation in all situations where such technologies are prescribed. Implications for rehabilitation Interdisciplinary consultation involving the user, prescriber and technician to prescribe assistive technologies for mobility limitations has many advantages in all CanMEDS areas of medical practice, and few disadvantages, related to management and collaboration only. The disadvantages of interdisciplinary consultation, such as (financial) reimbursement by health insurance companies

Comparison between minimally invasive and open surgical treatment in necrotizing pancreatitis.

PubMed

Wroński, Marek; Cebulski, Włodzimierz; Witkowski, Bartosz; Jankowski, Mieczysław; Kluciński, Andrzej; Krasnodębski, Ireneusz W; Słodkowski, Maciej

2017-04-01

Minimal access techniques have gained popularity for the management of necrotizing pancreatitis, but only a few studies compared open necrosectomy with a less invasive treatment. The aim of this study was to evaluate the outcomes of minimally invasive treatment for necrotizing pancreatitis in comparison with open necrosectomy. This retrospective study included 70 patients who underwent minimally invasive intervention or open surgical debridement for necrotizing pancreatitis between January 2007 and December 2014. Data were analyzed for postoperative morbidity and outcome. Of 70 patients, 22 patients underwent primary open necrosectomy and 48 patients were treated with minimally invasive techniques. Percutaneous and endoscopic drainage were successful in 34.9% and 75.0% of patients, respectively. The rates of postoperative new-onset organ failure and intensive care unit stay were significantly lower in the minimally invasive group (25.0% versus 54.5%; P = 0.016, and 29.2% versus 54.5%; P = 0.041, respectively). Gastrointestinal fistulas occurred more frequently after primary open necrosectomy (36.4% versus 10.4%; P = 0.009). Mortality was comparable in both groups (18.6% versus 27.3%; P = 0.420). Mortality for salvage open necrosectomy was similar to that for primary open debridement (28.6% versus 27.3%; P = 0.924). The independent risk factors for major postoperative complications were primary open necrosectomy (P = 0.028) and shorter interval to first intervention (P = 0.020). Mortality was independently associated only with older age (P = 0.009). Minimally invasive treatment should be preferred over open necrosectomy for initial management of necrotizing pancreatitis. Copyright © 2016 Elsevier Inc. All rights reserved.

Energy Advantages for Green Schools

ERIC Educational Resources Information Center

Griffin, J. Tim

2012-01-01

Because of many advantages associated with central utility systems, school campuses, from large universities to elementary schools, have used district energy for decades. District energy facilities enable thermal and electric utilities to be generated with greater efficiency and higher system reliability, while requiring fewer maintenance and…

Back to Basics: A Bilingual Advantage in Infant Visual Habituation

ERIC Educational Resources Information Center

Singh, Leher; Fu, Charlene S. L.; Rahman, Aishah A.; Hameed, Waseem B.; Sanmugam, Shamini; Agarwal, Pratibha; Jiang, Binyan; Chong, Yap Seng; Meaney, Michael J.; Rifkin-Graboi, Anne

2015-01-01

Comparisons of cognitive processing in monolinguals and bilinguals have revealed a bilingual advantage in inhibitory control. Recent studies have demonstrated advantages associated with exposure to two languages in infancy. However, the domain specificity and scope of the infant bilingual advantage in infancy remains unclear. In the present study,…

Competitive Advantage and its Sources in an Evolving Market

NASA Astrophysics Data System (ADS)

Zaridis, Apostolos D.

2009-08-01

In a continuously altered and evolving Market, as is the food manufacturing market, the main and long-lasting objective of firm that is the maximization of its wealth and consequently the continuous remaining in profit regions, appears that it is possible to be achieved via the obtainment and maintenance of diachronically long-term competitive advantage, which it will render the firm unique or leader force in a inexorable competition that is continuously extended in a globalized market. Various definitions and different regards are developed in regard to the competitive advantage and the way with which a firm it is possible, acquiring it, to star in the market in which it is activated. As result of sustainable competitive advantage in a firm comes the above the average performance. Abundance of resources and competences that are proposed as sources of competitive advantage in the resource-based view literature exists, while they are added continuously new based on empiric studies. In any case, it appears to suffer hierarchy of sources of competitive advantage, with regard to sustainability of these.

MinGenome: An In Silico Top-Down Approach for the Synthesis of Minimized Genomes.

PubMed

Wang, Lin; Maranas, Costas D

2018-02-16

Genome minimized strains offer advantages as production chassis by reducing transcriptional cost, eliminating competing functions and limiting unwanted regulatory interactions. Existing approaches for identifying stretches of DNA to remove are largely ad hoc based on information on presumably dispensable regions through experimentally determined nonessential genes and comparative genomics. Here we introduce a versatile genome reduction algorithm MinGenome that implements a mixed-integer linear programming (MILP) algorithm to identify in size descending order all dispensable contiguous sequences without affecting the organism's growth or other desirable traits. Known essential genes or genes that cause significant fitness or performance loss can be flagged and their deletion can be prohibited. MinGenome also preserves needed transcription factors and promoter regions ensuring that retained genes will be properly transcribed while also avoiding the simultaneous deletion of synthetic lethal pairs. The potential benefit of removing even larger contiguous stretches of DNA if only one or two essential genes (to be reinserted elsewhere) are within the deleted sequence is explored. We applied the algorithm to design a minimized E. coli strain and found that we were able to recapitulate the long deletions identified in previous experimental studies and discover alternative combinations of deletions that have not yet been explored in vivo.

Advantages and limitations of teleneurology.

PubMed

Wechsler, Lawrence R

2015-03-01

The growing disparity between the demand for neurological services and the need for neurologists requires new and innovative strategies for delivering care. Teleneurology allows neurological expertise to be delivered to remote locations to supplement or replace in-person neurological care. To summarize the current status of teleneurology. Applications of teleneurology include acute care, outpatient teleneurology, and teleconsultations. Existing barriers to further expansion of teleneurology are also discussed. Published studies pertaining to teleneurology were reviewed. Practical experience with telemedicine in neurological practice contributed to the conclusions. Outcomes after intravenous tissue plasminogen activator treatment via telemedicine (telestroke) are similar to those achieved with in-person evaluations. Other aspects of teleneurology are less established but have demonstrated feasibility, high patient satisfaction, and, in some cases, cost savings. Teleneurology provides neurological expertise to rural areas with limited availability of neurologists and improves care for patients with difficulty traveling owing to neurological disease. It is likely that use of teleneurology will continue to grow and become incorporated into many aspects of neurological practice. Understanding the advantages and limitations of teleneurology is vital to delivering optimal clinical care for patients with neurological disease regardless of the setting.

The Oral Minimal Model Method

PubMed Central

Cobelli, Claudio; Dalla Man, Chiara; Toffolo, Gianna; Basu, Rita; Vella, Adrian; Rizza, Robert

2014-01-01

The simultaneous assessment of insulin action, secretion, and hepatic extraction is key to understanding postprandial glucose metabolism in nondiabetic and diabetic humans. We review the oral minimal method (i.e., models that allow the estimation of insulin sensitivity, β-cell responsivity, and hepatic insulin extraction from a mixed-meal or an oral glucose tolerance test). Both of these oral tests are more physiologic and simpler to administer than those based on an intravenous test (e.g., a glucose clamp or an intravenous glucose tolerance test). The focus of this review is on indices provided by physiological-based models and their validation against the glucose clamp technique. We discuss first the oral minimal model method rationale, data, and protocols. Then we present the three minimal models and the indices they provide. The disposition index paradigm, a widely used β-cell function metric, is revisited in the context of individual versus population modeling. Adding a glucose tracer to the oral dose significantly enhances the assessment of insulin action by segregating insulin sensitivity into its glucose disposal and hepatic components. The oral minimal model method, by quantitatively portraying the complex relationships between the major players of glucose metabolism, is able to provide novel insights regarding the regulation of postprandial metabolism. PMID:24651807

Identifying Minimal Changes in Nonerosive Reflux Disease: Is the Pay Worth the Labor?

PubMed

Gabbard, Scott L; Fass, Ronnie; Maradey-Romero, Carla; Gingold Belfer, Rachel; Dickman, Ram

2016-01-01

Gastroesophageal reflux disease has a variable presentation on upper endoscopy. Gastroesophageal reflux disease can be divided into 3 endoscopic categories: Barrett's esophagus, erosive esophagitis, and normal mucosa/nonerosive reflux disease (NERD). Each of these phenotypes behave in a distinct manner, in regards to symptom response to treatment, and risk of development of complications such as esophageal adenocarcinoma. Recently, it has been proposed to further differentiate NERD into 2 categories: those with and those without "minimal changes." These minimal changes include endoscopic abnormalities, such as villous mucosal surface, mucosal islands, microerosions, and increased vascularity at the squamocolumnar junction. Although some studies have shown that patients with minimal changes may have higher rates of esophageal acid exposure compared with those without minimal changes, it is currently unclear if these patients behave differently than those currently categorized as having NERD. The clinical utility of identifying these lesions should be weighed against the cost of the requisite equipment and the additional time required for diagnosis, compared with conventional white light endoscopy.

Maintaining Low Voiding Solder Die Attach for Power Die While Minimizing Die Tilt

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

Hamm, Randy; Peterson, Kenneth A.

2015-10-01

This paper addresses work to minimize voiding and die tilt in solder attachment of a large power die, measuring 9.0 mm X 6.5 mm X 0.1 mm (0.354” x 0.256” x 0.004”), to a heat spreader. As demands for larger high power die continue, minimizing voiding and die tilt is of interest for improved die functionality, yield, manufacturability, and reliability. High-power die generate considerable heat, which is important to dissipate effectively through control of voiding under high thermal load areas of the die while maintaining a consistent bondline (minimizing die tilt). Voiding was measured using acoustic imaging and die tiltmore » was measured using two different optical measurement systems. 80Au-20Sn solder reflow was achieved using a batch vacuum solder system with optimized fixturing. Minimizing die tilt proved to be the more difficult of the two product requirements to meet. Process development variables included tooling, weight and solder preform thickness.« less

Functional elements in the minimal promoter of the human proton-coupled folate transporter

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

Stark, Michal; Gonen, Nitzan; Assaraf, Yehuda G., E-mail: assaraf@tx.technion.ac.il

2009-10-09

The proton-coupled folate transporter (PCFT) is the dominant intestinal folate transporter, however, its promoter has yet to be revealed. Hence, we here cloned a 3.1 kb fragment upstream to the first ATG of the human PCFT gene and generated sequential deletion constructs evaluated in luciferase reporter assay. This analysis mapped the minimal promoter to 157 bp upstream to the first ATG. Crucial GC-box sites were identified within the minimal promoter and in its close vicinity which substantially contribute to promoter activity, as their disruption resulted in 94% loss of luciferase activity. We also identified upstream enhancer elements including YY1 andmore » AP1 which, although distantly located, prominently transactivated the minimal promoter, as their inactivation resulted in 50% decrease in reporter activity. This is the first functional identification of the minimal PCFT promoter harboring crucial GC-box elements that markedly contribute to its transcriptional activation via putative interaction with distal YY1 and AP1 enhancer elements.« less

Explaining Asian Americans' academic advantage over whites.

PubMed

Hsin, Amy; Xie, Yu

2014-06-10

The superior academic achievement of Asian Americans is a well-documented phenomenon that lacks a widely accepted explanation. Asian Americans' advantage in this respect has been attributed to three groups of factors: (i) socio-demographic characteristics, (ii) cognitive ability, and (iii) academic effort as measured by characteristics such as attentiveness and work ethic. We combine data from two nationally representative cohort longitudinal surveys to compare Asian-American and white students in their educational trajectories from kindergarten through high school. We find that the Asian-American educational advantage is attributable mainly to Asian students exerting greater academic effort and not to advantages in tested cognitive abilities or socio-demographics. We test explanations for the Asian-white gap in academic effort and find that the gap can be further attributed to (i) cultural differences in beliefs regarding the connection between effort and achievement and (ii) immigration status. Finally, we highlight the potential psychological and social costs associated with Asian-American achievement success.

Explaining Asian Americans’ academic advantage over whites

PubMed Central

Hsin, Amy; Xie, Yu

2014-01-01

The superior academic achievement of Asian Americans is a well-documented phenomenon that lacks a widely accepted explanation. Asian Americans’ advantage in this respect has been attributed to three groups of factors: (i) socio-demographic characteristics, (ii) cognitive ability, and (iii) academic effort as measured by characteristics such as attentiveness and work ethic. We combine data from two nationally representative cohort longitudinal surveys to compare Asian-American and white students in their educational trajectories from kindergarten through high school. We find that the Asian-American educational advantage is attributable mainly to Asian students exerting greater academic effort and not to advantages in tested cognitive abilities or socio-demographics. We test explanations for the Asian–white gap in academic effort and find that the gap can be further attributed to (i) cultural differences in beliefs regarding the connection between effort and achievement and (ii) immigration status. Finally, we highlight the potential psychological and social costs associated with Asian-American achievement success. PMID:24799702

Blackfolds, plane waves and minimal surfaces

NASA Astrophysics Data System (ADS)

Armas, Jay; Blau, Matthias

2015-07-01

Minimal surfaces in Euclidean space provide examples of possible non-compact horizon geometries and topologies in asymptotically flat space-time. On the other hand, the existence of limiting surfaces in the space-time provides a simple mechanism for making these configurations compact. Limiting surfaces appear naturally in a given space-time by making minimal surfaces rotate but they are also inherent to plane wave or de Sitter space-times in which case minimal surfaces can be static and compact. We use the blackfold approach in order to scan for possible black hole horizon geometries and topologies in asymptotically flat, plane wave and de Sitter space-times. In the process we uncover several new configurations, such as black helicoids and catenoids, some of which have an asymptotically flat counterpart. In particular, we find that the ultraspinning regime of singly-spinning Myers-Perry black holes, described in terms of the simplest minimal surface (the plane), can be obtained as a limit of a black helicoid, suggesting that these two families of black holes are connected. We also show that minimal surfaces embedded in spheres rather than Euclidean space can be used to construct static compact horizons in asymptotically de Sitter space-times.

Commit to Building on New England's "Employability" Advantage!

ERIC Educational Resources Information Center

Gittell, Ross

2017-01-01

Higher education has provided New England with an economic advantage, as the region without strong natural resource advantages has relied on its higher education institutions (HEIs) and brainpower. A higher education-based economic advantage has enabled the region to develop strong well-paying technology and knowledge-based industries tied to New…

Minimally verbal school-aged children with autism spectrum disorder: the neglected end of the spectrum.

PubMed

Tager-Flusberg, Helen; Kasari, Connie

2013-12-01

It is currently estimated that about 30% of children with autism spectrum disorder remain minimally verbal, even after receiving years of interventions and a range of educational opportunities. Very little is known about the individuals at this end of the autism spectrum, in part because this is a highly variable population with no single set of defining characteristics or patterns of skills or deficits, and in part because it is extremely challenging to provide reliable or valid assessments of their developmental functioning. In this paper, we summarize current knowledge based on research including minimally verbal children. We review promising new novel methods for assessing the verbal and nonverbal abilities of minimally verbal school-aged children, including eye-tracking and brain-imaging methods that do not require overt responses. We then review what is known about interventions that may be effective in improving language and communication skills, including discussion of both nonaugmentative and augmentative methods. In the final section of the paper, we discuss the gaps in the literature and needs for future research. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial.

PubMed

Barczyński, Marcin; Cichoń, Stanisław; Konturek, Aleksander; Cichoń, Wojciech

2006-05-01

consumption (51.6 +/- 46.4 mg vs. 121.6 +/- 50.3 mg of ketoprofen; P < 0.001), better physical functioning aspect and bodily pain aspect of the quality of life on early recovery (88.4 +/- 6.9 vs. 84.6 +/- 4.7 and 90.3 +/- 4.7 vs. 87.5 +/- 5.8; P = 0.02 and P = 0.003, respectively), shorter scar length (17.2 +/- 2.2 mm vs. 30.8 +/- 4.0 mm; P < 0.001), and higher cosmetic satisfaction rate at 1 month after surgery (85.4 +/- 12.4% vs. 77.4 +/- 9.7%; P = 0.006). Cosmetic satisfaction was increasing with time, and there were no significant differences at 6 months postoperatively. MIVAP was more expensive (US$1,150 +/- 63.4 vs. 1,015 +/- 61.8; P < 0.001) while the mean hospital stay was similar (28 +/- 10.1 vs. 31.1 +/- 9.7 hours; P = 0.22). Differences in serum calcium values and iPTH during 6 months of follow-up were nonsignificant. Transient laryngeal nerve palsy appeared in one OMIP patient (P = 0.31). There was no other morbidity or mortality. Both MIVAP and OMIP offer a valuable approach for solitary parathyroid adenoma with a similar excellent success rate and a minimal morbidity rate. Routine use of the intraoperative iPTH assay is essential in both approaches to avoid surgical failures of overlooked multiglandular disease. The advantages of MIVAP include easier recognition of recurrent laryngeal nerve (RLN), lower pain intensity within 24 hours following surgery, lower analgesia request rate, lower analgesic consumption, shorter scar length, better physical functioning and bodily pain aspects of the quality of life on early recovery, and higher early cosmetic satisfaction rate. However, these advantages are achieved at higher costs because of endoscopic tool involvement.

A case-study of landfill minimization and material recovery via waste co-gasification in a new waste management scheme.

PubMed

Tanigaki, Nobuhiro; Ishida, Yoshihiro; Osada, Morihiro

2015-03-01

This study evaluates municipal solid waste co-gasification technology and a new solid waste management scheme, which can minimize final landfill amounts and maximize material recycled from waste. This new scheme is considered for a region where bottom ash and incombustibles are landfilled or not allowed to be recycled due to their toxic heavy metal concentration. Waste is processed with incombustible residues and an incineration bottom ash discharged from existent conventional incinerators, using a gasification and melting technology (the Direct Melting System). The inert materials, contained in municipal solid waste, incombustibles and bottom ash, are recycled as slag and metal in this process as well as energy recovery. Based on this new waste management scheme with a co-gasification system, a case study of municipal solid waste co-gasification was evaluated and compared with other technical solutions, such as conventional incineration, incineration with an ash melting facility under certain boundary conditions. From a technical point of view, co-gasification produced high quality slag with few harmful heavy metals, which was recycled completely without requiring any further post-treatment such as aging. As a consequence, the co-gasification system had an economical advantage over other systems because of its material recovery and minimization of the final landfill amount. Sensitivity analyses of landfill cost, power price and inert materials in waste were also conducted. The higher the landfill costs, the greater the advantage of the co-gasification system has. The co-gasification was beneficial for landfill cost in the range of 80 Euro per ton or more. Higher power prices led to lower operation cost in each case. The inert contents in processed waste had a significant influence on the operating cost. These results indicate that co-gasification of bottom ash and incombustibles with municipal solid waste contributes to minimizing the final landfill amount and has

Minimally Invasive Mitral Valve Procedures: The Current State

PubMed Central

Ritwick, Bhuyan; Chaudhuri, Krishanu; Crouch, Gareth; Edwards, James R. M.; Worthington, Michael; Stuklis, Robert G.

2013-01-01

Since its early days, cardiac surgery has typically involved large incisions with complete access to the heart and the great vessels. After the popularization of the minimally invasive techniques in general surgery, cardiac surgeons began to experiment with minimal access techniques in the early 1990s. Although the goals of minimally invasive cardiac surgery (MICS) are fairly well established as decreased pain, shorter hospital stay, accelerated recuperation, improved cosmesis, and cost effectiveness, a strict definition of minimally invasive cardiac surgery has been more elusive. Minimally invasive cardiac surgery started with mitral valve procedures and then gradually expanded towards other valve procedures, coronary artery bypass grafting, and various types of simple congenital heart procedures. In this paper, the authors attempt to focus on the evolution, techniques, results, and the future perspective of minimally invasive mitral valve surgery (MIMVS). PMID:24382998

Minimally invasive surgery: lateral approach interbody fusion: results and review.

PubMed

Youssef, Jim A; McAfee, Paul C; Patty, Catherine A; Raley, Erin; DeBauche, Spencer; Shucosky, Erin; Chotikul, Liana

2010-12-15

A retrospective review of patients treated at 2 institutions with anterior lumbar interbody fusion using a minimally invasive lateral retroperitoneal approach, and review of literature. To analyze the outcomes from historical literature and from a retrospectively compiled database of patients having undergone anterior interbody fusions performed through a lateral approach. A paucity of published literature exists describing outcomes following lateral approach fusion surgery. Patients treated with extreme lateral interbody fusion (XLIF) were identified through retrospective chart review. Treatment variables included operating room (OR) time, estimated blood loss (EBL), length of hospital stay (LOS), complications, and fusion rate. A literature review, using the National Center for Biotechnology Information databases PubMed/MEDLINE and Google Scholar, yielded 14 peer-reviewed articles reporting outcomes scoring, complications, fusion status, long-term follow-up, and radiographic assessments related to XLIF. Published XLIF results were summarized and evaluated with current study data. A total of 84 XLIF patients were included in the current cohort analysis. OR time, EBL, and length of hospital stay averaged 199 minutes, 155 mL, and 2.6 days, respectively, and perioperative and postoperative complication rates were 2.4% and 6.1%. Mean follow-up was 15.7 months. Sixty-eight patients showed evidence of solid arthrodesis and no subsidence on computed tomography and flexion/extension radiographs. Results were within the ranges of those in the literature. Literature review identified reports of significant improvements in clinical outcomes scores, radiographic measures, and cost effectiveness. Current data corroborates and contributes to the existing body of literature describing XLIF outcomes. Procedures are generally performed with short OR times, minimal EBL, and few complications. Patients recover quickly, requiring minimal hospital stay, although transient hip

Does minimal access tubular assisted spine surgery increase or decrease complications in spinal decompression or fusion?

PubMed

Fourney, Daryl R; Dettori, Joseph R; Norvell, Daniel C; Dekutoski, Mark B

2010-04-20

Systematic review. The purpose of this review was to attempt to answer the following 2 clinical questions: (1) Does minimal access tubular assisted spine surgery (MAS) decrease the rate of complications in posterior thoracolumbar decompression and/or fusion surgery compared with traditional open techniques? (2) What strategies to reduce the risk of complications in MAS have been shown to be effective? The objective of minimal access spine surgery is to reduce damage to surrounding tissues while accomplishing the same goals as conventional surgery. Patient demand and marketing for MAS is driven by the perception of better outcomes, although the purported advantages remain unproven. Whether the risk of complications is affected by minimal access techniques is unknown. A systematic review of the English language literature was undertaken for articles published between 1990 and July 2009. Electronic databases and reference lists of key articles were searched to identify published studies that compared the rate of complications after MAS to a control group that underwent open surgery. Single-arm studies were excluded. Two independent reviewers assessed the strength of literature using GRADE criteria assessing quality, quantity, and consistency of results. Disagreements were resolved by consensus. From the 361 articles identified, 13 met a priori criteria and were included for review. All of the studies evaluated only lumbar spine surgery. The single large randomized study showed less favorable results for MAS discectomy, but no significant difference in complication rates. The quality of the other studies, particularly for fusion surgery, was low. Overall, the rates of reoperation, dural tear, cerebrospinal fluid leak, nerve injury, and infection occurred in similar proportions between MAS and open surgery. Blood loss was reduced in MAS fusion; however, the quality of those studies was very low. Operation time and hospital length of stay was variable across studies

40 CFR 60.1125 - What must I include in my siting analysis?

Code of Federal Regulations, 2010 CFR

2010-07-01

... waste combustion unit affects four areas: (1) Ambient air quality. (2) Visibility. (3) Soils. (4) Vegetation. (b) Include an analysis of alternatives for controlling air pollution that minimize potential...

Multiple video sequences synchronization during minimally invasive surgery

NASA Astrophysics Data System (ADS)

Belhaoua, Abdelkrim; Moreau, Johan; Krebs, Alexandre; Waechter, Julien; Radoux, Jean-Pierre; Marescaux, Jacques

2016-03-01

Hybrid operating rooms are an important development in the medical ecosystem. They allow integrating, in the same procedure, the advantages of radiological imaging and surgical tools. However, one of the challenges faced by clinical engineers is to support the connectivity and interoperability of medical-electrical point-of-care devices. A system that could enable plug-and-play connectivity and interoperability for medical devices would improve patient safety, save hospitals time and money, and provide data for electronic medical records. In this paper, we propose a hardware platform dedicated to collect and synchronize multiple videos captured from medical equipment in real-time. The final objective is to integrate augmented reality technology into an operation room (OR) in order to assist the surgeon during a minimally invasive operation. To the best of our knowledge, there is no prior work dealing with hardware based video synchronization for augmented reality applications on OR. Whilst hardware synchronization methods can embed temporal value, so called timestamp, into each sequence on-the-y and require no post-processing, they require specialized hardware. However the design of our hardware is simple and generic. This approach was adopted and implemented in this work and its performance is evaluated by comparison to the start-of-the-art methods.

Advantages and pitfalls in the application of mixed-model association methods.

PubMed

Yang, Jian; Zaitlen, Noah A; Goddard, Michael E; Visscher, Peter M; Price, Alkes L

2014-02-01

Mixed linear models are emerging as a method of choice for conducting genetic association studies in humans and other organisms. The advantages of the mixed-linear-model association (MLMA) method include the prevention of false positive associations due to population or relatedness structure and an increase in power obtained through the application of a correction that is specific to this structure. An underappreciated point is that MLMA can also increase power in studies without sample structure by implicitly conditioning on associated loci other than the candidate locus. Numerous variations on the standard MLMA approach have recently been published, with a focus on reducing computational cost. These advances provide researchers applying MLMA methods with many options to choose from, but we caution that MLMA methods are still subject to potential pitfalls. Here we describe and quantify the advantages and pitfalls of MLMA methods as a function of study design and provide recommendations for the application of these methods in practical settings.

Matthew Arnold and Minimal Competency Testing.

ERIC Educational Resources Information Center

Tuman, Myron C.

1979-01-01

Presents arguments by Robert Lowe and Matthew Arnold on the 19th century British "Payment by Results" Plan, whereby schools received funds for students who passed minimal competency tests. Emphasizes that the Victorian experience produced acrimonious teachers with low morale and encourages contemporary minimal testing advocates not to…

Minimal intervention dentistry - a new frontier in clinical dentistry.

PubMed

Mm, Jingarwar; Nk, Bajwa; A, Pathak

2014-07-01

Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.

Raman spectroscopy as a PAT for pharmaceutical blending: Advantages and disadvantages.

PubMed

Riolo, Daniela; Piazza, Alessandro; Cottini, Ciro; Serafini, Margherita; Lutero, Emilio; Cuoghi, Erika; Gasparini, Lorena; Botturi, Debora; Marino, Iari Gabriel; Aliatis, Irene; Bersani, Danilo; Lottici, Pier Paolo

2018-02-05

Raman spectroscopy has been positively evaluated as a tool for the in-line and real-time monitoring of powder blending processes and it has been proved to be effective in the determination of the endpoint of the mixing, showing its potential role as process analytical technology (PAT). The aim of this study is to show advantages and disadvantages of Raman spectroscopy with respect to the most traditional HPLC analysis. The spectroscopic results, obtained directly on raw powders, sampled from a two-axis blender in real case conditions, were compared with the chromatographic data obtained on the same samples. The formulation blend used for the experiment consists of active pharmaceutical ingredient (API, concentrations 6.0% and 0.5%), lactose and magnesium stearate (as excipients). The first step of the monitoring process was selecting the appropriate wavenumber region where the Raman signal of API is maximal and interference from the spectral features of excipients is minimal. Blend profiles were created by plotting the area ratios of the Raman peak of API (A API ) at 1598cm -1 and the Raman bands of excipients (A EXC ), in the spectral range between 1560 and 1630cm -1 , as a function of mixing time: the API content can be considered homogeneous when the time-dependent dispersion of the area ratio is minimized. In order to achieve a representative sampling with Raman spectroscopy, each sample was mapped in a motorized XY stage by a defocused laser beam of a micro-Raman apparatus. Good correlation between the two techniques has been found only for the composition at 6.0% (w/w). However, standard deviation analysis, applied to both HPLC and Raman data, showed that Raman results are more substantial than HPLC ones, since Raman spectroscopy enables generating data rich blend profiles. In addition, the relative standard deviation calculated from a single map (30 points) turned out to be representative of the degree of homogeneity for that blend time. Copyright © 2017

Effects of realistic force feedback in a robotic assisted minimally invasive surgery system.

PubMed

Moradi Dalvand, Mohsen; Shirinzadeh, Bijan; Nahavandi, Saeid; Smith, Julian

2014-06-01

Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion. A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results. Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers. The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in robotic assisted minimally invasive surgery operations.

Future home hemodialysis - advantages of the NxStage System One.

PubMed

Takahashi, Susumu

2012-01-01

To improve the quality of life (QOL) of patients with renal failure who are on dialysis, we have been working to promote home hemodialysis (HHD), but it has not come into widespread use at present because of various problems, including limitations of the equipment, the large proportion of elderly patients, and difficulty performing self-care. With regard to problems with the equipment, dialysis equipment for home use has not yet been approved in Japan, so equipment designed for medical facilities has to be used for home dialysis. Such equipment is bulky and occupies living space, as well as involving the cost of home renovation and the need for a caregiver. The NxStage System One (NSO) artificial kidney has served advantages for HHD compared with conventional equipment, since it is compact, portable, and easy to operate (especially for preparation and cleaning), does not require a water supply, occupies less living space, and reduces the need for renovation of the home. Other advantages of the NSO include improvement of QOL by saving time travelling to hospitals and helping patients to participate in social activities. In addition, HHD with the NSO can improve sleep disorders, the restless legs syndrome, and depressive symptoms, resulting in a good outcome. Moreover, HHD with the NSO reduces the need for drugs, such as antihypertensive medications and erythropoietin, possibly leading to saving of healthcare costs. Copyright © 2012 S. Karger AG, Basel.

Minimal-change nephropathy and malignant thymoma.

PubMed

Varsano, S; Bruderman, I; Bernheim, J L; Rathaus, M; Griffel, B

1980-05-01

A 56-year-old man had fever, precordial pain, and a mediastinal mass. The mass disappeared two months later and the patient remained asymptomatic for 2 1/2 years. At that time a full-blown nephrotic syndrome developed, with minimal-change glomerulopathy. The chest x-ray film showed the reappearance of a giant mediastinal mass. On biopsy of the mass, malignant thymoma was diagnosed. Association between minimal-change disease and Hodgkin's disease is well known, while the association with malignant thymoma has not been previously reported. The relationship between malignant thymoma and minimal-change disease is discussed, and a possible pathogenic mechanism involving cell-mediated immunity is proposed.

Evolving user needs and late-mover advantage

PubMed Central

Querbes, Adrien; Frenken, Koen

2016-01-01

We propose a generalized NK-model of late-mover advantage where late-mover firms leapfrog first-mover firms as user needs evolve over time. First movers face severe trade-offs between the provision of functionalities in which their products already excel and the additional functionalities requested by users later on. Late movers, by contrast, start searching when more functionalities are already known and typically come up with superior product designs. We also show that late-mover advantage is more probable for more complex technologies. Managerial implications follow. PMID:28596705

The environmental cost of subsistence: Optimizing diets to minimize footprints.

PubMed

Gephart, Jessica A; Davis, Kyle F; Emery, Kyle A; Leach, Allison M; Galloway, James N; Pace, Michael L

2016-05-15

The question of how to minimize monetary cost while meeting basic nutrient requirements (a subsistence diet) was posed by George Stigler in 1945. The problem, known as Stigler's diet problem, was famously solved using the simplex algorithm. Today, we are not only concerned with the monetary cost of food, but also the environmental cost. Efforts to quantify environmental impacts led to the development of footprint (FP) indicators. The environmental footprints of food production span multiple dimensions, including greenhouse gas emissions (carbon footprint), nitrogen release (nitrogen footprint), water use (blue and green water footprint) and land use (land footprint), and a diet minimizing one of these impacts could result in higher impacts in another dimension. In this study based on nutritional and population data for the United States, we identify diets that minimize each of these four footprints subject to nutrient constraints. We then calculate tradeoffs by taking the composition of each footprint's minimum diet and calculating the other three footprints. We find that diets for the minimized footprints tend to be similar for the four footprints, suggesting there are generally synergies, rather than tradeoffs, among low footprint diets. Plant-based food and seafood (fish and other aquatic foods) commonly appear in minimized diets and tend to most efficiently supply macronutrients and micronutrients, respectively. Livestock products rarely appear in minimized diets, suggesting these foods tend to be less efficient from an environmental perspective, even when nutrient content is considered. The results' emphasis on seafood is complicated by the environmental impacts of aquaculture versus capture fisheries, increasing in aquaculture, and shifting compositions of aquaculture feeds. While this analysis does not make specific diet recommendations, our approach demonstrates potential environmental synergies of plant- and seafood-based diets. As a result, this study

Plant circadian clocks increase photosynthesis, growth, survival, and competitive advantage.

PubMed

Dodd, Antony N; Salathia, Neeraj; Hall, Anthony; Kévei, Eva; Tóth, Réka; Nagy, Ferenc; Hibberd, Julian M; Millar, Andrew J; Webb, Alex A R

2005-07-22

Circadian clocks are believed to confer an advantage to plants, but the nature of that advantage has been unknown. We show that a substantial photosynthetic advantage is conferred by correct matching of the circadian clock period with that of the external light-dark cycle. In wild type and in long- and short-circadian period mutants of Arabidopsis thaliana, plants with a clock period matched to the environment contain more chlorophyll, fix more carbon, grow faster, and survive better than plants with circadian periods differing from their environment. This explains why plants gain advantage from circadian control.

Technological Minimalism: A Cost-Effective Alternative for Course Design and Development.

ERIC Educational Resources Information Center

Lorenzo, George

2001-01-01

Discusses the use of minimum levels of technology, or technological minimalism, for Web-based multimedia course content. Highlights include cost effectiveness; problems with video streaming, the use of XML for Web pages, and Flash and Java applets; listservs instead of proprietary software; and proper faculty training. (LRW)

Efficacy of the Stonehenge Technique for Minimally Invasive Aortic Valve Replacement via Right Infraaxillary Thoracotomy.

PubMed

Yamazaki, Masataka; Kin, Hajime; Kitamoto, Shohei; Yamanaka, Shota; Nishida, Hidefumi; Nishigawa, Kosaku; Takanashi, Shuichiro

2017-02-20

Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments. This was achieved by particular placement of several retracted sutures to the right chest wall. We named placement of these sutures the "Stonehenge technique." In conclusion, AVR via vertical infraaxillary thoracotomy with our Stonehenge technique can be safely and simply performed with superior cosmetic advantages.

Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

PubMed Central

Bichsel, Ursina; Nyffeler, Richard Walter

2015-01-01

Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally. PMID:26558125

A strategy to find minimal energy nanocluster structures.

PubMed

Rogan, José; Varas, Alejandro; Valdivia, Juan Alejandro; Kiwi, Miguel

2013-11-05

An unbiased strategy to search for the global and local minimal energy structures of free standing nanoclusters is presented. Our objectives are twofold: to find a diverse set of low lying local minima, as well as the global minimum. To do so, we use massively the fast inertial relaxation engine algorithm as an efficient local minimizer. This procedure turns out to be quite efficient to reach the global minimum, and also most of the local minima. We test the method with the Lennard-Jones (LJ) potential, for which an abundant literature does exist, and obtain novel results, which include a new local minimum for LJ13 , 10 new local minima for LJ14 , and thousands of new local minima for 15≤N≤65. Insights on how to choose the initial configurations, analyzing the effectiveness of the method in reaching low-energy structures, including the global minimum, are developed as a function of the number of atoms of the cluster. Also, a novel characterization of the potential energy surface, analyzing properties of the local minima basins, is provided. The procedure constitutes a promising tool to generate a diverse set of cluster conformations, both two- and three-dimensional, that can be used as an input for refinement by means of ab initio methods. Copyright © 2013 Wiley Periodicals, Inc.

Minimization for conditional simulation: Relationship to optimal transport

NASA Astrophysics Data System (ADS)

Oliver, Dean S.

2014-05-01

In this paper, we consider the problem of generating independent samples from a conditional distribution when independent samples from the prior distribution are available. Although there are exact methods for sampling from the posterior (e.g. Markov chain Monte Carlo or acceptance/rejection), these methods tend to be computationally demanding when evaluation of the likelihood function is expensive, as it is for most geoscience applications. As an alternative, in this paper we discuss deterministic mappings of variables distributed according to the prior to variables distributed according to the posterior. Although any deterministic mappings might be equally useful, we will focus our discussion on a class of algorithms that obtain implicit mappings by minimization of a cost function that includes measures of data mismatch and model variable mismatch. Algorithms of this type include quasi-linear estimation, randomized maximum likelihood, perturbed observation ensemble Kalman filter, and ensemble of perturbed analyses (4D-Var). When the prior pdf is Gaussian and the observation operators are linear, we show that these minimization-based simulation methods solve an optimal transport problem with a nonstandard cost function. When the observation operators are nonlinear, however, the mapping of variables from the prior to the posterior obtained from those methods is only approximate. Errors arise from neglect of the Jacobian determinant of the transformation and from the possibility of discontinuous mappings.

Improving the performance of minimizers and winnowing schemes

PubMed Central

Marçais, Guillaume; Pellow, David; Bork, Daniel; Orenstein, Yaron; Shamir, Ron; Kingsford, Carl

2017-01-01

Abstract Motivation: The minimizers scheme is a method for selecting k-mers from sequences. It is used in many bioinformatics software tools to bin comparable sequences or to sample a sequence in a deterministic fashion at approximately regular intervals, in order to reduce memory consumption and processing time. Although very useful, the minimizers selection procedure has undesirable behaviors (e.g. too many k-mers are selected when processing certain sequences). Some of these problems were already known to the authors of the minimizers technique, and the natural lexicographic ordering of k-mers used by minimizers was recognized as their origin. Many software tools using minimizers employ ad hoc variations of the lexicographic order to alleviate those issues. Results: We provide an in-depth analysis of the effect of k-mer ordering on the performance of the minimizers technique. By using small universal hitting sets (a recently defined concept), we show how to significantly improve the performance of minimizers and avoid some of its worse behaviors. Based on these results, we encourage bioinformatics software developers to use an ordering based on a universal hitting set or, if not possible, a randomized ordering, rather than the lexicographic order. This analysis also settles negatively a conjecture (by Schleimer et al.) on the expected density of minimizers in a random sequence. Availability and Implementation: The software used for this analysis is available on GitHub: https://github.com/gmarcais/minimizers.git. Contact: gmarcais@cs.cmu.edu or carlk@cs.cmu.edu PMID:28881970

Improving the performance of minimizers and winnowing schemes.

PubMed

Marçais, Guillaume; Pellow, David; Bork, Daniel; Orenstein, Yaron; Shamir, Ron; Kingsford, Carl

2017-07-15

The minimizers scheme is a method for selecting k -mers from sequences. It is used in many bioinformatics software tools to bin comparable sequences or to sample a sequence in a deterministic fashion at approximately regular intervals, in order to reduce memory consumption and processing time. Although very useful, the minimizers selection procedure has undesirable behaviors (e.g. too many k -mers are selected when processing certain sequences). Some of these problems were already known to the authors of the minimizers technique, and the natural lexicographic ordering of k -mers used by minimizers was recognized as their origin. Many software tools using minimizers employ ad hoc variations of the lexicographic order to alleviate those issues. We provide an in-depth analysis of the effect of k -mer ordering on the performance of the minimizers technique. By using small universal hitting sets (a recently defined concept), we show how to significantly improve the performance of minimizers and avoid some of its worse behaviors. Based on these results, we encourage bioinformatics software developers to use an ordering based on a universal hitting set or, if not possible, a randomized ordering, rather than the lexicographic order. This analysis also settles negatively a conjecture (by Schleimer et al. ) on the expected density of minimizers in a random sequence. The software used for this analysis is available on GitHub: https://github.com/gmarcais/minimizers.git . gmarcais@cs.cmu.edu or carlk@cs.cmu.edu. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

An Experiment in Comparative Advantage.

ERIC Educational Resources Information Center

Haupert, Michael J.

1996-01-01

Describes an undergraduate economics course experiment designed to teach the concepts of comparative advantage and opportunity costs. Students have a limited number of labor hours and can chose to produce either wheat or steel. As the project progresses, the students trade commodities in an attempt to maximize use of their labor hours. (MJP)

Potential end-to-end imaging information rate advantages of various alternative communication systems

NASA Technical Reports Server (NTRS)

Rice, R. F.

1978-01-01

Various communication systems were considered which are required to transmit both imaging and a typically error sensitive, class of data called general science/engineering (gse) over a Gaussian channel. The approach jointly treats the imaging and gse transmission problems, allowing comparisons of systems which include various channel coding and data compression alternatives. Actual system comparisons include an Advanced Imaging Communication System (AICS) which exhibits the rather significant potential advantages of sophisticated data compression coupled with powerful yet practical channel coding.

Cryptic Fitness Advantage: Diploids Invade Haploid Populations Despite Lacking Any Apparent Advantage as Measured by Standard Fitness Assays

PubMed Central

Gerstein, Aleeza C.; Otto, Sarah P.

2011-01-01

Ploidy varies tremendously within and between species, yet the factors that influence when or why ploidy variants are adaptive remains poorly understood. Our previous work found that diploid individuals repeatedly arose within ten replicate haploid populations of Saccharomyces cerevisiae, and in each case we witnessed diploid takeover within 1800 asexual generations of batch culture evolution in the lab. The character that allowed diploids to rise in frequency within haploid populations remains unknown. Here we present a number of experiments conducted with the goal to determine what this trait (or traits) might have been. Experiments were conducted both by sampling a small number of colonies from the stocks frozen every two weeks (93 generations) during the original experiment, as well through sampling a larger number of colonies at the two time points where polymorphism for ploidy was most prevalent. Surprisingly, none of our fitness component measures (lag phase, growth rate, biomass production) indicated an advantage to diploidy. Similarly, competition assays against a common competitor and direct competition between haploid and diploid colonies isolated from the same time point failed to indicate a diploid advantage. Furthermore, we uncovered a tremendous amount of trait variation among colonies of the same ploidy level. Only late-appearing diploids showed a competitive advantage over haploids, indicating that the fitness advantage that allowed eventual takeover was not diploidy per se but an attribute of a subset of diploid lineages. Nevertheless, the initial rise in diploids to intermediate frequency cannot be explained by any of the fitness measures used; we suggest that the resolution to this mystery is negative frequency-dependent selection, which is ignored in the standard fitness measures used. PMID:22174734

[MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM].

PubMed

Xu, Bing; Liu, Wenying

2015-04-01

To explore the method and experience in correction of pectus carinatum with minimally invasive procedure. Between June 2010 and January 2014, 30 patients with pectus carinatum were corrected by minimally invasive procedure. There were 21 boys and 9 girls whose average age was 13 years and 2 months (range, from 8 years and 10 months to 18 years and 9 months), including 24 cases of first operation, 2 recurrence after traditional pectus carinatum correction, and 4 cases secondary to median thoracotomy. Thirty patients had symmetric and asymmetric mild pectus carinatum. The operation was performed successfully in all patients, and no severe complication occurred. The operation time was 42-95 minutes (mean, 70 minutes). The bleeding volume during operation was 4-30 mL (mean, 10 mL). The time from operation to discharge was 6-10 days (mean, 7 days). The average time of follow-up was 25 months (range, 9-54 months). All surgical wound healed primarily with no infection. The X-ray films showed slight pneumothorax in 7 cases, and it was absorbed after 1 month without treatment. Loosening of internal fixation was found in 1 patient because of trauma at 6 months, and operation was performed again. The bar was removed at 2 years in 21 patients. The patients had good thoracic contour and normal activity. Minimally invasive procedure for correction of pectus carinatum is safe and will get satisfactory effect in maintaining thoracic contour. It has also less trauma and shorter operation time.

Changing appetites: The adaptive advantages of fuel choice

PubMed Central

Stanley, Illana A.; Ribeiro, Sofia M.; Giménez-Cassina, Alfredo; Norberg, Erik; Danial, Nika N.

2013-01-01

Cells are capable of metabolizing a variety of carbon substrates, including glucose, fatty acids, ketone bodies, and amino acids. Cellular fuel choice not only fulfills specific biosynthetic needs, but also enables programmatic adaptations to stress conditions beyond compensating for changes in nutrient availability. Emerging evidence indicates that specific switches from utilization of one substrate to another can have protective or permissive roles in disease pathogenesis. Understanding the molecular determinants of cellular fuel preference may provide insights into the homeostatic control of stress responses, and unveil therapeutic targets. Here, we highlight overarching themes encompassing cellular fuel choice, its link to cell fate and function, its advantages in stress protection, and its contribution to metabolic dependencies and maladaptations in pathologic conditions. PMID:24018218

An investigation of home advantage in the Summer Paralympic Games.

PubMed

Wilson, Darryl; Ramchandani, Girish

2017-01-01

There is a paucity of home advantage research set in the context of para-sport events. It is this gap in the knowledge that this paper addresses by investigating the prevalence and size of home advantage in the Summer Paralympic Games. Using a standardised measure of success, we compared the performances of nations when competing at home with their own performances away from home in the competition between 1960 and 2016. Both country-level and individual sport-level analyses were conducted for this time frame. A Wilcoxon signed rank test was used to determine whether there was a genuine difference in nations' performance under host and non-host conditions. Spearman's rank-order correlation was run to assess the relationship between nation quality and home advantage. Strong evidence of a home advantage effect in the Summer Paralympic Games was found at country level ( p  < 0.01). When examining individual sports, only athletics, table tennis, and wheelchair fencing returned a significant home advantage effect ( p  < 0.05). Possible explanations for these findings are discussed. The size of the home advantage effect was not significantly correlated with the quality or strength of the host nation ( p  > 0.10). While our results confirm that home advantage is prevalent in the Summer Paralympic Games at an overall country level and within specific sports, they do not explain fully why such an effect does exist. Future studies should investigate the causes of home advantage in the competition and also draw comparisons with the Summer Olympic Games to explore any differences between para-sport events and able-bodied events.

Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages

PubMed Central

de Carvalho Filho, Élio Barreto; Marson, Fernando Augusto de Lima; da Costa, Loredana Nilkenes Gomes; Antunes, Nilson

2014-01-01

Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas. PMID:25140478

Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages.

PubMed

Carvalho Filho, Elio Barreto de; Marson, Fernando Augusto de Lima; Costa, Loredana Nilkenes Gomes da; Antunes, Nilson

2014-01-01

Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas.

Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays.

PubMed

Baker, Laurence C; Bundorf, M Kate; Devlin, Aileen M; Kessler, Daniel P

2016-08-01

There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012. We calculated the average price per admission, and its trend over time, in each of the three types of insurance for fixed baskets of hospital admissions across metropolitan areas. After accounting for differences in hospital networks, geographic areas, and case-mix between Medicare Advantage and FFS Medicare, we found that Medicare Advantage plans paid 5.6 percent less for hospital services than FFS Medicare did. Without taking into account the narrower networks of Medicare Advantage, the program paid 8.0 percent less than FFS Medicare. We also found that the rates paid by commercial plans were much higher than those of either Medicare Advantage or FFS Medicare, and growing. At least some of this difference comes from the much higher prices that commercial plans pay for profitable service lines. Project HOPE—The People-to-People Health Foundation, Inc.

Minimalism and Beyond: Second Language Acquisition for the Twenty-First Century.

ERIC Educational Resources Information Center

Balcom, Patricia A.

2001-01-01

Provides a general overview of two books--"The Second Time Around: Minimalism and Second Language Acquisition" and "Second Language Syntax: A Generative Introduction--and shows how the respond to key issues in second language acquisition, including the process of second language acquisition, access to universal grammar, the role of…

Contextual Advantage for State Discrimination

NASA Astrophysics Data System (ADS)

Schmid, David; Spekkens, Robert W.

2018-02-01

Finding quantitative aspects of quantum phenomena which cannot be explained by any classical model has foundational importance for understanding the boundary between classical and quantum theory. It also has practical significance for identifying information processing tasks for which those phenomena provide a quantum advantage. Using the framework of generalized noncontextuality as our notion of classicality, we find one such nonclassical feature within the phenomenology of quantum minimum-error state discrimination. Namely, we identify quantitative limits on the success probability for minimum-error state discrimination in any experiment described by a noncontextual ontological model. These constraints constitute noncontextuality inequalities that are violated by quantum theory, and this violation implies a quantum advantage for state discrimination relative to noncontextual models. Furthermore, our noncontextuality inequalities are robust to noise and are operationally formulated, so that any experimental violation of the inequalities is a witness of contextuality, independently of the validity of quantum theory. Along the way, we introduce new methods for analyzing noncontextuality scenarios and demonstrate a tight connection between our minimum-error state discrimination scenario and a Bell scenario.

What a drop can do: dried blood spots as a minimally invasive method for integrating biomarkers into population-based research.

PubMed

McDade, Thomas W; Williams, Sharon; Snodgrass, J Josh

2007-11-01

Logistical constraints associated with the collection and analysis of biological samples in community-based settings have been a significant impediment to integrative, multilevel bio-demographic and biobehavioral research. However recent methodological developments have overcome many of these constraints and have also expanded the options for incorporating biomarkers into population-based health research in international as well as domestic contexts. In particular using dried blood spot (DBS) samples-drops of whole blood collected on filter paper from a simple finger prick-provides a minimally invasive method for collecting blood samples in nonclinical settings. After a brief discussion of biomarkers more generally, we review procedures for collecting, handling, and analyzing DBS samples. Advantages of using DBS samples-compared with venipuncture include the relative ease and low cost of sample collection, transport, and storage. Disadvantages include requirements for assay development and validation as well as the relatively small volumes of sample. We present the results of a comprehensive literature review of published protocols for analysis of DBS samples, and we provide more detailed analysis of protocols for 45 analytes likely to be of particular relevance to population-level health research. Our objective is to provide investigators with the information they need to make informed decisions regarding the appropriateness of blood spot methods for their research interests.

One-dimensional Gromov minimal filling problem

NASA Astrophysics Data System (ADS)

Ivanov, Alexandr O.; Tuzhilin, Alexey A.

2012-05-01

The paper is devoted to a new branch in the theory of one-dimensional variational problems with branching extremals, the investigation of one-dimensional minimal fillings introduced by the authors. On the one hand, this problem is a one-dimensional version of a generalization of Gromov's minimal fillings problem to the case of stratified manifolds. On the other hand, this problem is interesting in itself and also can be considered as a generalization of another classical problem, the Steiner problem on the construction of a shortest network connecting a given set of terminals. Besides the statement of the problem, we discuss several properties of the minimal fillings and state several conjectures. Bibliography: 38 titles.

Potential and range of application of elastic backscatter lidar systems using polarization selection to minimize detected skylight noise

NASA Astrophysics Data System (ADS)

Ahmed, S. A.; Hassebo, Y. Y.; Gross, B.; Oo, M.; Moshary, F.

2006-09-01

We examine the potential, range of application, and limiting factors of a polarization selection technique, recently devised by us, which takes advantage of naturally occurring polarization properties of scattered sky light to minimize the detected sky background signal and which can be used in conjunction with linearly polarized elastic backscatter lidars to maximize lidar receiver SNR. In this approach, a polarization selective lidar receiver is aligned to minimize detected skylight, while the polarization of the transmitted lidar signal is rotated to maintain maximum lidar backscatter signal throughput to the receiver detector, consequently maximizing detected signal to noise ratio. Results presented include lidar elastic backscatter measurements, at 532 nm which show as much as a factor of √10 improvement in signal-to-noise ratio over conventional un-polarized schemes. For vertically pointing lidars, the largest improvements are limited to symmetric early morning and late afternoon hours. For non-vertical scanning lidars, significant improvements are achievable over much more extended time periods, depending on the specific angle between the lidar and solar axes. A theoretical model that simulates the background skylight within the single scattering approximation showed good agreement with measured SNR improvement factors. Diurnally asymmetric improvement factors, sometimes observed, are explained by measured increases in PWV and subsequent modification of aerosol optical depth by dehydration from morning to afternoon. Finally, since the polarization axis follows the solar azimuth angle even for high aerosol loading, as demonstrated using radiative transfer simulations, it is possible to conceive automation of the technique. In addition, it is shown that while multiple scattering reduces the SNR improvement, the orientation of the minimum noise state remains the same.

The Advantages and Disadvantages of Seeking Commonality in Military Equipment

DTIC Science & Technology

2011-01-01

rand 2011 www.rand.org The Advantages and Disadvantages of Seeking Commonality in Military Equipment I ncreasingly, the Army and the Department...advantages and disadvantages of commonality and developed a decision aid to help Army policymakers manage these tradeoffs. The study drew upon...TITLE AND SUBTITLE The Advantages and Disadvantages of Seeking Commonality in Military Equipment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

Systems Biology Perspectives on Minimal and Simpler Cells

PubMed Central

Xavier, Joana C.; Patil, Kiran Raosaheb

2014-01-01

SUMMARY The concept of the minimal cell has fascinated scientists for a long time, from both fundamental and applied points of view. This broad concept encompasses extreme reductions of genomes, the last universal common ancestor (LUCA), the creation of semiartificial cells, and the design of protocells and chassis cells. Here we review these different areas of research and identify common and complementary aspects of each one. We focus on systems biology, a discipline that is greatly facilitating the classical top-down and bottom-up approaches toward minimal cells. In addition, we also review the so-called middle-out approach and its contributions to the field with mathematical and computational models. Owing to the advances in genomics technologies, much of the work in this area has been centered on minimal genomes, or rather minimal gene sets, required to sustain life. Nevertheless, a fundamental expansion has been taking place in the last few years wherein the minimal gene set is viewed as a backbone of a more complex system. Complementing genomics, progress is being made in understanding the system-wide properties at the levels of the transcriptome, proteome, and metabolome. Network modeling approaches are enabling the integration of these different omics data sets toward an understanding of the complex molecular pathways connecting genotype to phenotype. We review key concepts central to the mapping and modeling of this complexity, which is at the heart of research on minimal cells. Finally, we discuss the distinction between minimizing the number of cellular components and minimizing cellular complexity, toward an improved understanding and utilization of minimal and simpler cells. PMID:25184563

Systems biology perspectives on minimal and simpler cells.

PubMed

Xavier, Joana C; Patil, Kiran Raosaheb; Rocha, Isabel

2014-09-01

The concept of the minimal cell has fascinated scientists for a long time, from both fundamental and applied points of view. This broad concept encompasses extreme reductions of genomes, the last universal common ancestor (LUCA), the creation of semiartificial cells, and the design of protocells and chassis cells. Here we review these different areas of research and identify common and complementary aspects of each one. We focus on systems biology, a discipline that is greatly facilitating the classical top-down and bottom-up approaches toward minimal cells. In addition, we also review the so-called middle-out approach and its contributions to the field with mathematical and computational models. Owing to the advances in genomics technologies, much of the work in this area has been centered on minimal genomes, or rather minimal gene sets, required to sustain life. Nevertheless, a fundamental expansion has been taking place in the last few years wherein the minimal gene set is viewed as a backbone of a more complex system. Complementing genomics, progress is being made in understanding the system-wide properties at the levels of the transcriptome, proteome, and metabolome. Network modeling approaches are enabling the integration of these different omics data sets toward an understanding of the complex molecular pathways connecting genotype to phenotype. We review key concepts central to the mapping and modeling of this complexity, which is at the heart of research on minimal cells. Finally, we discuss the distinction between minimizing the number of cellular components and minimizing cellular complexity, toward an improved understanding and utilization of minimal and simpler cells. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Conducting research with minimally verbal participants with autism spectrum disorder.

PubMed

Tager-Flusberg, Helen; Plesa Skwerer, Daniela; Joseph, Robert M; Brukilacchio, Brianna; Decker, Jessica; Eggleston, Brady; Meyer, Steven; Yoder, Anne

2017-10-01

A growing number of research groups are now including older minimally verbal individuals with autism spectrum disorder in their studies to encompass the full range of heterogeneity in the population. There are numerous barriers that prevent researchers from collecting high-quality data from these individuals, in part because of the challenging behaviors with which they present alongside their very limited means for communication. In this article, we summarize the practices that we have developed, based on applied behavioral analysis techniques, and have used in our ongoing research on behavioral, eye-tracking, and electrophysiological studies of minimally verbal children and adolescents with autism spectrum disorder. Our goal is to provide the field with useful guidelines that will promote the inclusion of the entire spectrum of individuals with autism spectrum disorder in future research investigations.

The second leg home advantage: evidence from European football cup competitions.

PubMed

Page, Lionel; Page, Katie

2007-12-01

The home advantage is a widely acknowledged sporting phenomenon, especially in association football. Here, we examine the second leg home advantage, an effect that is discussed in the public domain but which has received very little scientific attention. The second leg home advantage effect occurs when on average teams are more likely to win a two-stage knock-out competition when they play at home in the second leg. That is, both teams have a home advantage but this advantage is significantly greater for the team that plays at home second. Examining data from three different European Cup football competitions spanning 51 years, we show that the second leg home advantage is a real phenomenon. The second leg home team has more than a 50% probability to qualify for the next round in the competition even after controlling for extra time and team ability as possible alternative explanations. The second leg home advantage appears, however, to have decreased significantly over the past decade. Possible reasons for its existence and subsequent decline are presented.

Information Technology: Tomorrow's Advantage Today.

ERIC Educational Resources Information Center

Haag, Stephen; Keen, Peter

This textbook is designed for a one-semester introductory course in which the goal is to give students a foundation in the basics of information technology (IT). It focuses on how the technology works, issues relating to its use and development, how it can lend personal and business advantages, and how it is creating a globally networked society.…

Achieving a sustainable service advantage.

PubMed

Coyne, K P

1993-01-01

Many managers believe that superior service should play little or no role in competitive strategy; they maintain that service innovations are inherently copiable. However, the author states that this view is too narrow. For a company to achieve a lasting service advantage, it must base a new service on a capability gap that competitors cannot or will not copy.

Clinical advantages of carbon-ion radiotherapy

NASA Astrophysics Data System (ADS)

Tsujii, Hirohiko; Kamada, Tadashi; Baba, Masayuki; Tsuji, Hiroshi; Kato, Hirotoshi; Kato, Shingo; Yamada, Shigeru; Yasuda, Shigeo; Yanagi, Takeshi; Kato, Hiroyuki; Hara, Ryusuke; Yamamoto, Naotaka; Mizoe, Junetsu

2008-07-01

Carbon-ion radiotherapy (C-ion RT) possesses physical and biological advantages. It was started at NIRS in 1994 using the Heavy Ion Medical Accelerator in Chiba (HIMAC); since then more than 50 protocol studies have been conducted on almost 4000 patients with a variety of tumors. Clinical experiences have demonstrated that C-ion RT is effective in such regions as the head and neck, skull base, lung, liver, prostate, bone and soft tissues, and pelvic recurrence of rectal cancer, as well as for histological types including adenocarcinoma, adenoid cystic carcinoma, malignant melanoma and various types of sarcomas, against which photon therapy could be less effective. Furthermore, when compared with photon and proton RT, a significant reduction of overall treatment time and fractions has been accomplished without enhancing toxicities. Currently, the number of irradiation sessions per patient averages 13 fractions spread over approximately three weeks. This means that in a carbon therapy facility a larger number of patients than is possible with other modalities can be treated over the same period of time.

Ergonomics of disposable handles for minimally invasive surgery.

PubMed

Büchel, D; Mårvik, R; Hallabrin, B; Matern, U

2010-05-01

The ergonomic deficiencies of currently available minimally invasive surgery (MIS) instrument handles have been addressed in many studies. In this study, a new ergonomic pistol handle concept, realized as a prototype, and two disposable ring handles were investigated according to ergonomic properties set by new European standards. In this study, 25 volunteers performed four practical tasks to evaluate the ergonomics of the handles used in standard operating procedures (e.g., measuring a suture and cutting to length, precise maneuvering and targeting, and dissection of a gallbladder). Moreover, 20 participants underwent electromyography (EMG) tests to measure the muscle strain they experienced while carrying out the basic functions (grasp, rotate, and maneuver) in the x, y, and z axes. The data measured included the number of errors, the time required for task completion, perception of pressure areas, and EMG data. The values for usability in the test were effectiveness, efficiency, and user satisfaction. Surveys relating to the subjective rating were completed after each task for each of the three handles tested. Each handle except the new prototype caused pressure areas and pain. Extreme differences in muscle strain could not be observed for any of the three handles. Experienced surgeons worked more quickly with the prototype when measuring and cutting a suture (approximately 20%) and during precise maneuvering and targeting (approximately 20%). On the other hand, they completed the dissection task faster with the handle manufactured by Ethicon. Fewer errors were made with the prototype in dissection of the gallbladder. In contrast to the handles available on the market, the prototype was always rated as positive by the volunteers in the subjective surveys. None of the handles could fulfil all of the requirements with top scores. Each handle had its advantages and disadvantages. In contrast to the ring handles, the volunteers could fulfil most of the tasks more

Minimal measures for Euler-Lagrange flows on finite covering spaces

NASA Astrophysics Data System (ADS)

Wang, Fang; Xia, Zhihong

2016-12-01

In this paper we study the minimal measures for positive definite Lagrangian systems on compact manifolds. We are particularly interested in manifolds with more complicated fundamental groups. Mather’s theory classifies the minimal or action-minimizing measures according to the first (co-)homology group of a given manifold. We extend Mather’s notion of minimal measures to a larger class for compact manifolds with non-commutative fundamental groups, and use finite coverings to study the structure of these extended minimal measures. We also define action-minimizers and minimal measures in the homotopical sense. Our program is to study the structure of homotopical minimal measures by considering Mather’s minimal measures on finite covering spaces. Our goal is to show that, in general, manifolds with a non-commutative fundamental group have a richer set of minimal measures, hence a richer dynamical structure. As an example, we study the geodesic flow on surfaces of higher genus. Indeed, by going to the finite covering spaces, the set of minimal measures is much larger and more interesting.

Space filling minimal surfaces and sphere packings

NASA Astrophysics Data System (ADS)

Elser, Veit

1994-05-01

A space filling minimal surface is defined to be any embedded minimal surface without boundary with the property that the area and genus enclosed by any large spherical region scales in proportion to the volume of the region. The triply periodic minimal surfaces are one realization, but not necessarily the only one. By using the genus per unit volume of the surface, a meaningful comparison of surface areas can be made even in cases where there is no unit cell. Of the known periodic minimal surfaces this measure of the surface area is smallest for Schoen's FRD surface. This surface is one of several that is closely related to packings of spheres. Its low area is largely due to the fact that the corresponding sphere packing (fcc) has the maximal kissing number.

Rivaling paradigms in psychiatric neurosurgery: adjustability versus quick fix versus minimal-invasiveness.

PubMed

Müller, Sabine; Riedmüller, Rita; van Oosterhout, Ansel

2015-01-01

In the wake of deep brain stimulation (DBS) development, ablative neurosurgical procedures are seeing a comeback, although they had been discredited and nearly completely abandoned in the 1970s because of their unethical practice. Modern stereotactic ablative procedures as thermal or radiofrequency ablation, and particularly radiosurgery (e.g., Gamma Knife) are much safer than the historical procedures, so that a re-evaluation of this technique is required. The different approaches of modern psychiatric neurosurgery refer to different paradigms: microsurgical ablative procedures is based on the paradigm 'quick fix,' radiosurgery on the paradigm 'minimal-invasiveness,' and DBS on the paradigm 'adjustability.' From a mere medical perspective, none of the procedures is absolutely superior; rather, they have different profiles of advantages and disadvantages. Therefore, individual factors are crucial in decision-making, particularly the patients' social situation, individual preferences, and individual attitudes. The different approaches are not only rivals, but also enriching mutually. DBS is preferable for exploring new targets, which may become candidates for ablative microsurgery or radiosurgery.

Minimally invasive endoscope-assisted trans-oral excision of huge parapharyngeal space tumors.

PubMed

Li, Shang-Yi; Hsu, Ching-Hui; Chen, Mu-Kuan

2015-04-01

Parapharyngeal space tumors are rare head and neck neoplasms, and most are benign lesions. Complete excision of these tumors is difficult because of the complexity of the surrounding anatomic structures. The algorithm for excision of these tumors is typically based on the tumor's characteristics; excision is performed via approaches such as the trans-oral route, the trans-cervical route, and even a combination of the trans-parotid route and mandibulotomy. However, each of these approaches is associated with some complications. Endoscope-assisted minimally invasive surgery is being increasingly employed for surgeries in the head and neck regions. It has the advantage of leaving no facial scars, and ensures better patient comfort after the operation. Here, we report the use of endoscope-assisted trans-oral surgery for excision of parapharyngeal space tumors. The technique yields an excellent outcome and should be a feasible, safe, and economic method for these patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Technical and cost advantages of silicon carbide telescopes for small-satellite imaging applications

NASA Astrophysics Data System (ADS)

Kasunic, Keith J.; Aikens, Dave; Szwabowski, Dean; Ragan, Chip; Tinker, Flemming

2017-09-01

Small satellites ("SmallSats") are a growing segment of the Earth imaging and remote sensing market. Designed to be relatively low cost and with performance tailored to specific end-use applications, they are driving changes in optical telescope assembly (OTA) requirements. OTAs implemented in silicon carbide (SiC) provide performance advantages for space applications but have been predominately limited to large programs. A new generation of lightweight and thermally-stable designs is becoming commercially available, expanding the application of SiC to small satellites. This paper reviews the cost and technical advantages of an OTA designed using SiC for small satellite platforms. Taking into account faceplate fabrication quilting and surface distortion after gravity release, an optimized open-back SiC design with a lightweighting of 70% for a 125-mm SmallSat-class primary mirror has an estimated mass area density of 2.8 kg/m2 and an aspect ratio of 40:1. In addition, the thermally-induced surface error of such optimized designs is estimated at λ/150 RMS per watt of absorbed power. Cost advantages of SiC include reductions in launch mass, thermal-management infrastructure, and manufacturing time based on allowable assembly tolerances.

Cigarette Price-Minimization Strategies by U.S. Smokers

PubMed Central

Xu, Xin; Pesko, Michael F.; Tynan, Michael A.; Gerzoff, Robert B.; Malarcher, Ann M.; Pechacek, Terry F.

2015-01-01

Background Smokers may react to cigarette excise tax increases by engaging in price-minimization strategies (i.e., finding ways to reduce the cost of cigarette smoking) rather than by quitting or reducing their cigarette use, thereby reducing the public health benefits of such tax increases. Purpose To evaluate the state and national prevalence of five common cigarette price-minimization strategies and the size of price reductions obtained from these strategies. Methods Using data from the 2009–2010 National Adult Tobacco Survey, the prevalence of five common price-minimization strategies by type of strategy and by smoker’s cigarette consumption level were estimated. The price reductions associated with these price-minimization strategies also were evaluated. Analyses took place in November 2012. Results Approximately 55.4% of U.S. adult smokers used at least one of five price-minimization strategies in the previous year, with an average reduction of $1.27 per pack (22.0%). Results varied widely by state. Conclusions Cigarette price-minimization strategies are practiced widely among current smokers, and resulting price reductions are relatively large. Policies that decrease opportunities to effectively apply cigarette price-minimization strategies would increase the public health gains of cigarette excise tax increases. PMID:23597810

Financial comparative analysis of minimally invasive surgery to open surgery for localized prostate cancer: a single-institution experience.

PubMed

Mouraviev, Vladimir; Nosnik, Israel; Sun, Leon; Robertson, Cary N; Walther, Philip; Albala, David; Moul, Judd W; Polascik, Thomas J

2007-02-01

To evaluate the financial implications of how the costs of new minimally invasive surgery such as laparoscopic robotic prostatectomy (LRP) and cryosurgical ablation of the prostate (CAP) technologies compare with those of conventional surgery. From January 2002 to July 2005, 452 consecutive patients underwent surgical treatment for clinically localized (Stage T1-T2) prostate cancer. The distribution of patients among the surgical procedures was as follows: group 1, radical retropubic prostatectomy (RRP) (n = 197); group 2, radical perineal prostatectomy (RPP) (n = 60); group 3, LRP (n = 137); and group 4, CAP (n = 58). The total direct hospital costs and grand total hospital costs were analyzed for each type of surgery. The mean length of stay in the CAP group was significantly lower (0.16 +/- 0.14 days) than that for RRP (2.79 +/- 1.46 days), RPP (2.87 +/- 1.43 days), and LRP (2.15 +/- 1.48 days; P <0.0005). The direct surgical costs were less for the RRP (2471 dollars +/- 636 dollars) and RPP (2788 dollars +/- 762 dollars) groups than for the technology-dependent procedures: LRP (3441 dollars +/- 545 dollars) and CAP (5702 dollars +/- 1606 dollars; P <0.0005). The total hospital cost differences, including pathologic assessment costs, were less for LRP (10,047 dollars +/- 107 dollars, median 9343 dollars) and CAP (9195 dollars +/- 1511 dollars, median 8796 dollars) than for RRP (10,704 dollars +/- 3468 dollars, median 9724 dollars) or RPP (10,536 dollars +/- 3088 dollars, median 9251 dollars), with significant differences (P <0.05) between the minimally invasive technique and open surgery groups. In our study, despite the relatively increased surgical expense of CAP compared with conventional surgical prostatectomy (RRP or RPP) and LRP, the overall direct costs were offset by the significantly lower nonoperative hospital costs. The cost advantages associated with CAP included a shorter length of stay in the hospital and the absence of pathologic costs and the

The Real Transformation: Building and Maintaining Long-Term Competitive Advantage

DTIC Science & Technology

2003-01-01

TERM COMPETITIVE ADVANTAGE LTC EDWARD C. CARDON, USA A TRANFORMATION PAPER FOR THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF SEMINAR...SUBTITLE The Real Transformation: Building and Maintaining Long-Term Competitive Advantage 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...long-term military competitive advantage in comparison to the rest of the world.4 This approach suggests a model that places competition as the

The Advantages of the MGL-140 for the Marine Corps

DTIC Science & Technology

2006-02-07

comparison of the specifications of the M203 and MGL-140 portrays the fundamental benefits of modern weapon systems technology, the true advantages of the...The Advantages of the MGL-140 for the Marine Corps Subject Area Warfighting EWS 2006 Contemporary Issues Paper The... Advantages of the MGL-140 for the Marine Corps Submitted by Captain OF Adeyemi to Majors AL Shaw & WC Stophel, CG 3 7 February 2006

Minimizing embedding impact in steganography using trellis-coded quantization

NASA Astrophysics Data System (ADS)

Filler, Tomáš; Judas, Jan; Fridrich, Jessica

2010-01-01

In this paper, we propose a practical approach to minimizing embedding impact in steganography based on syndrome coding and trellis-coded quantization and contrast its performance with bounds derived from appropriate rate-distortion bounds. We assume that each cover element can be assigned a positive scalar expressing the impact of making an embedding change at that element (single-letter distortion). The problem is to embed a given payload with minimal possible average embedding impact. This task, which can be viewed as a generalization of matrix embedding or writing on wet paper, has been approached using heuristic and suboptimal tools in the past. Here, we propose a fast and very versatile solution to this problem that can theoretically achieve performance arbitrarily close to the bound. It is based on syndrome coding using linear convolutional codes with the optimal binary quantizer implemented using the Viterbi algorithm run in the dual domain. The complexity and memory requirements of the embedding algorithm are linear w.r.t. the number of cover elements. For practitioners, we include detailed algorithms for finding good codes and their implementation. Finally, we report extensive experimental results for a large set of relative payloads and for different distortion profiles, including the wet paper channel.

Home advantage and player nationality in international club football.

PubMed

Poulter, Damian R

2009-06-01

The home advantage effect was investigated at a team and player level in Union of European Football Associations (UEFA) Champions League football using in-depth performance and disciplinary variables. Performance analysis revealed that the home team scored more goals, had more shots on and off target, had a greater share of possession, and won more corners than the away team. There was an opposite trend for disciplinary variables, with the home team committing less fouls than the away team, and receiving less yellow and red cards. There were home advantage effects at player level for goals, total shots, shots on target, assists, and yellow cards, as found in the team analysis. In addition, foreign players demonstrated a home advantage effect for goals scored, whereas domestic players scored an equivalent number of goals at home and away venues. Results are discussed in relation to the home advantage literature and wider implications for the sport.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E

2013-03-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed Central

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E.

2013-01-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy. PMID:23543882

7 CFR 3430.36 - Procedures to minimize or eliminate duplication of effort.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE COMPETITIVE AND... may implement appropriate business processes to minimize or eliminate the awarding of CSREES Federal... awards made by other Federal agencies. Business processes may include the review of the Current and...

Graphical approach for multiple values logic minimization

NASA Astrophysics Data System (ADS)

Awwal, Abdul Ahad S.; Iftekharuddin, Khan M.

1999-03-01

Multiple valued logic (MVL) is sought for designing high complexity, highly compact, parallel digital circuits. However, the practical realization of an MVL-based system is dependent on optimization of cost, which directly affects the optical setup. We propose a minimization technique for MVL logic optimization based on graphical visualization, such as a Karnaugh map. The proposed method is utilized to solve signed-digit binary and trinary logic minimization problems. The usefulness of the minimization technique is demonstrated for the optical implementation of MVL circuits.

Minimal entropy approximation for cellular automata

NASA Astrophysics Data System (ADS)

Fukś, Henryk

2014-02-01

We present a method for the construction of approximate orbits of measures under the action of cellular automata which is complementary to the local structure theory. The local structure theory is based on the idea of Bayesian extension, that is, construction of a probability measure consistent with given block probabilities and maximizing entropy. If instead of maximizing entropy one minimizes it, one can develop another method for the construction of approximate orbits, at the heart of which is the iteration of finite-dimensional maps, called minimal entropy maps. We present numerical evidence that the minimal entropy approximation sometimes outperforms the local structure theory in characterizing the properties of cellular automata. The density response curve for elementary CA rule 26 is used to illustrate this claim.

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.

PubMed

2016-11-15

This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.

Undermatched? School-Based Linguistic Status, College Going, and the Immigrant Advantage

ERIC Educational Resources Information Center

Callahan, Rebecca M.; Humphries, Melissa H.

2016-01-01

Considerable research investigates the immigrant advantage--the academic benefit first- and second-generation students experience relative to native-born peers. However, little work examines how school-based linguistic status may influence this advantage. Contradictory patterns exist: Research identifies both an immigrant advantage and a language…

Information Control: Preserving the Advantage

DTIC Science & Technology

2015-06-01

sanitary laboratory for US forces to exploit technical solutions with minimal resistance, inevitably leading to potent and promising results on the...parity, eventually forcing decision makers to pursue bilateral and multilateral agreements in space law. See McDougall, 272. 21 James Clay Moltz, The...the discussions of human nature, control, and strategy outlined in Chapter 1. 12 James Clay Moltz, The Politics of Space Security: Strategic Restraint

Role of Minimally Invasive Surgery in the Reoperative Abdomen or Pelvis

PubMed Central

Feigel, Amanda; Sylla, Patricia

2016-01-01

Laparoscopy has become widely accepted as the preferred surgical approach in the management of benign and malignant colorectal diseases. Once considered a relative contraindication in patients with prior abdominal surgery (PAS), as surgeons have continued to gain expertise in advanced laparoscopy, minimally invasive approaches have been increasingly incorporated in the reoperative abdomen and pelvis. Although earlier studies have described conversion rates, most contemporary series evaluating the impact of PAS in laparoscopic colorectal resection have reported equivalent conversion and morbidity rates between reoperative and non-reoperative cases, and series evaluating the impact of laparoscopy in reoperative cases have demonstrated improved short-term outcomes with laparoscopy. The data overall highlight the importance of case selection, careful preoperative preparation and planning, and the critical role of surgeons' expertise in advanced laparoscopic techniques. Challenges to the widespread adoption of minimally invasive techniques in reoperative colorectal cases include the longer learning curve and longer operative time. However, with the steady increase in adoption of minimally invasive techniques worldwide, minimally invasive surgery (MIS) is likely to continue to be applied in the management of increasingly complex reoperative colorectal cases in an effort to improve patient outcomes. In the hands of experienced MIS surgeons and in carefully selected cases, laparoscopy is both safe and efficacious for reoperative procedures in the abdomen and pelvis, with measurable short-term benefits. PMID:28642675

Essential elements of self-help/minimal intervention strategies for smoking cessation.

PubMed

Glynn, T J; Boyd, G M; Gruman, J C

1990-01-01

Two decades of research suggest that self-help/minimal intervention strategies for smoking cessation may be the preferred means by which smokers stop and can produce success rates approximating those of more formal programs, at lower cost and with greater access to relevant populations. In order to make the best possible use of these self-help/minimal intervention approaches, the National Cancer Institute (NCI) supported a series of randomized, controlled intervention trials and, in June of 1988, convened an Expert Advisory Panel to address the question "What are the essential elements of self-help/minimal intervention strategies for smoking cessation?". The panel's recommendations were that: (1) Intervention efforts should focus on increasing smokers' motivations to make serious quit attempts; (2) Delivery of programs be broadened to include all smokers; (3) Programs be targeted to stages of cessation and specific populations; (4) All programs include (a) elements focused on health and social consequences of smoking, and (b) strategies and exercises aimed at quitting, maintenance of nonsmoking, relapse prevention, and recycling; (5) Materials and programs be made widely available rather than "fine tuning" existing programs or developing new ones; and (6) Programs make use of specific adjunctive strategies. In this way, a reacceleration of the decline in smoking prevalence may be realized in the 1990s and significantly contribute to the NCI's Year 2000 goals and the Surgeon General's aim of a smoke-free society.

Restoration of US Aid to Fiji: The Advantages of Obscurity

DTIC Science & Technology

1991-12-20

RESTORATION OF US AID TO FIJI: THE ADVANTAGES OF OBSCURITY Elizabeth McKune NWC Class of 󈨠 December 20, 1991 Report Documentation Page Form...COVERED 20-12-1991 to 20-12-1991 4. TITLE AND SUBTITLE Restoration of US Aid to Fiji: The Advantages of Obscurity 5a. CONTRACT NUMBER 5b...unimportance were advantageous . PHASE ONE Background In the context of the South Pacific, however, Fiji was prominent, frequently cited as a model

Optimal Control Design Advantages Utilizing Two-Degree-of-Freedom Controllers

DTIC Science & Technology

1993-12-01

AFrTIGAE/ENYIV3D-27 AD--A273 839 D"TIC OPTIMAL CONTROL DESIGN ADVANTAGES UTILIZING TWO-DEGREE-OF-FREEDOM CONTROLLERS THESIS Michael J. Stephens...AFIT/GAE/ENY/93D-27 OPTIMAL CONTROL DESIGN ADVANTAGES UTILIZING TWO-DEGREE-OF-FREEDOM CONTROLLERS THESIS Presented to the Faculty of the Graduate...measurement noises compared to the I- DOF model. xvii OPTIMAL CONTROL DESIGN ADVANTAGES UTILIZING TWO-DEGREE-OF-FREEDOM CONTROLLERS I. Introduction L1

Minimalism in Art, Medical Science and Neurosurgery.

PubMed

Okten, Ali Ihsan

2018-01-01

The word "minimalism" is a word derived from French the word "minimum". Whereas the lexical meaning of minimum is "the least or the smallest quantity necessary for something", its expression in mathematics can be described as "the lowest step a variable number can descend, least, minimal". Minimalism, which advocates an extreme simplicity of the artistic form, is a current in modern art and music whose origins go to 1960s and which features simplicity and objectivity. Although art, science and philosophy are different disciplines, they support each other from time to time, sometimes they intertwine and sometimes they copy each other. A periodic schools or teaching in one of them can take the others into itself, so, they proceed on their ways empowering each other. It is also true for the minimalism in art and the minimal invasive surgical approaches in science. Concepts like doing with less, avoiding unnecessary materials and reducing the number of the elements in order to increase the effect in the expression which are the main elements of the minimalism in art found their equivalents in medicine and neurosurgery. Their equivalents in medicine or neurosurgery have been to protect the physical integrity of the patient with less iatrogenic injury, minimum damage and the same therapeutic effect in the most effective way and to enable the patient to regain his health in the shortest span of time. As an anticipation, we can consider that the minimal approaches started by Richard Wollheim and Barbara Rose in art and Lars Leksell, Gazi Yaşargil and other neurosurgeons in neurosurgery in the 1960s are the present day equivalents of the minimalist approaches perhaps unconsciously started by Kazimir Malevich in art and Victor Darwin L"Espinasse in neurosurgery in the early 1900s. We can also consider that they have developed interacting with each other, not by chance.

[Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

PubMed

Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

2015-08-01

To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (P<0.05). The occurrences of lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation in group A significantly decreased compared with group B (P<0.05). The operation time, integrity of extraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (P<0.05). High-speed handpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

Seeking the competitive advantage: it's more than cost reduction.

PubMed

South, S F

1999-01-01

Most organizations focus considerable time and energy on reducing operating costs as a way to attain marketplace advantage. This strategy was not inappropriate in the past. To be competitive in the future, however, focus must be placed on other issues, not just cost reduction. The near future will be dominated by service industries, knowledge management, and virtual partnerships, with production optimization and flexibility, innovation, and strong partnerships defining those organizations that attain competitive advantage. Competitive advantage will reside in clarifying the vision and strategic plan, reviewing and redesigning work processes to optimize resources and value-added work, and creating change-ready environments and empowered workforces.

Protect Yourself! How To Minimize Your Risk of an IRS Audit.

ERIC Educational Resources Information Center

Lukaszewski, Thomas; Moser, Barbara

1998-01-01

Shows how to minimize risk of an IRS audit and how to avoid traps caused by improper documentation and reporting requirements. Outlines the most likely audit areas for business tax returns. These include cash business; for sole proprietors, Schedule C; S and C corporation salary issues; shareholder loans; contractors versus employees; fringe…

Reasoning about Other People's Beliefs: Bilinguals Have an Advantage

ERIC Educational Resources Information Center

Rubio-Fernandez, Paula; Glucksberg, Sam

2012-01-01

Bilingualism can have widespread cognitive effects. In this article we investigate whether bilingualism might have an effect on adults' abilities to reason about other people's beliefs. In particular, we tested whether bilingual adults might have an advantage over monolingual adults in false-belief reasoning analogous to the advantage that has…

The health advantage of a vegan diet: exploring the gut microbiota connection.

PubMed

Glick-Bauer, Marian; Yeh, Ming-Chin

2014-10-31

This review examines whether there is evidence that a strict vegan diet confers health advantages beyond that of a vegetarian diet or overall healthy eating. Few studies include vegan subjects as a distinct experimental group, yet when vegan diets are directly compared to vegetarian and omnivorous diets, a pattern of protective health benefits emerges. The relatively recent inclusion of vegan diets in studies of gut microbiota and health allows us the opportunity to assess whether the vegan gut microbiota is distinct, and whether the health advantages characteristic of a vegan diet may be partially explained by the associated microbiota profile. The relationship between diet and the intestinal microbial profile appears to follow a continuum, with vegans displaying a gut microbiota most distinct from that of omnivores, but not always significantly different from that of vegetarians. The vegan gut profile appears to be unique in several characteristics, including a reduced abundance of pathobionts and a greater abundance of protective species. Reduced levels of inflammation may be the key feature linking the vegan gut microbiota with protective health effects. However, it is still unclear whether a therapeutic vegan diet can be prescribed to alter the gut microflora for long-term health benefits.

The Health Advantage of a Vegan Diet: Exploring the Gut Microbiota Connection

PubMed Central

Glick-Bauer, Marian; Yeh, Ming-Chin

2014-01-01

This review examines whether there is evidence that a strict vegan diet confers health advantages beyond that of a vegetarian diet or overall healthy eating. Few studies include vegan subjects as a distinct experimental group, yet when vegan diets are directly compared to vegetarian and omnivorous diets, a pattern of protective health benefits emerges. The relatively recent inclusion of vegan diets in studies of gut microbiota and health allows us the opportunity to assess whether the vegan gut microbiota is distinct, and whether the health advantages characteristic of a vegan diet may be partially explained by the associated microbiota profile. The relationship between diet and the intestinal microbial profile appears to follow a continuum, with vegans displaying a gut microbiota most distinct from that of omnivores, but not always significantly different from that of vegetarians. The vegan gut profile appears to be unique in several characteristics, including a reduced abundance of pathobionts and a greater abundance of protective species. Reduced levels of inflammation may be the key feature linking the vegan gut microbiota with protective health effects. However, it is still unclear whether a therapeutic vegan diet can be prescribed to alter the gut microflora for long-term health benefits. PMID:25365383

Minimally invasive video-assisted parathyroidectomy. Initial experience in a General Surgery Department.

PubMed

Dobrinja, C; Trevisan, G; Liguori, G

2009-02-01

The aim of this study is to analyze our preliminary results from minimally invasive video-assisted parathyroidectomy (MIVAP) and demonstrate the feasibility of MIVAP also in non-referral centers. During a period from June 2005 to January 2008, in the General Surgery Department of University of Trieste, we operated on 39 patients with primary hyperparathyroidism (pHPT). MIVAP by an anterior approach was proposed for 23 (59%) patients with sporadic pHPT and one unequivocally enlarged parathyroid gland on pre-operative ultrasound and 99mTc-SestaMIBI scintigraphy without associated goiter and without previous neck surgery. Intra-operatively, a quick parathyroid assay was used during the last 11 surgical procedures. All patients underwent pre-operative and post-operative investigations of calcemia, phoshoremia and PTH levels and vocal cord function. Age, operative times, pathologic findings, post-operative pain, calcemia, length of hospital stay, cosmetic results, and complications were retrospectively analyzed. MIVAP was successfully accomplished in 22 cases. Conversion to standard cervicotomy was required in one patient (4.34%). Mean operative time was 67 min. Post-operative complications included 1 (4.34%) transient hypocalcemia. No laryngeal nerve palsies, no definitive hypocalcemias, no persistent pHPT and no recurrent pHPT were observed. The cosmetic result was excellent in all cases. Our preliminary results demonstrate that MIVAP for localized single-gland adenoma, after adequate training, seems to be feasible with significant advantages, especially in terms of cosmetic results, post-operative pain, and post-operative recovery even in a General Surgery Department, if performed by a dedicated team, with a sufficient and specific activity volume.

Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review.

PubMed

Muschaweck, Ulrike; Berger, Luise Masami

2010-05-01

Sportsmen's groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. The authors developed an innovative open suture repair-the Minimal Repair technique-to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. THE FOLLOWING ADVANTAGES OF THE MINIMAL REPAIR TECHNIQUE WERE FOUND: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). The Minimal Repair technique is an effective and safe way to treat sportsmen's groin.

Minimizing the Free Energy: A Computer Method for Teaching Chemical Equilibrium Concepts.

ERIC Educational Resources Information Center

Heald, Emerson F.

1978-01-01

Presents a computer method for teaching chemical equilibrium concepts using material balance conditions and the minimization of the free energy. Method for the calculation of chemical equilibrium, the computer program used to solve equilibrium problems and applications of the method are also included. (HM)

Ethics and Distance Education: Strategies for Minimizing Academic Dishonesty in Online Assessment.

ERIC Educational Resources Information Center

Olt, Melissa R.

2002-01-01

Discusses ethics and student assessment in distance education, focusing on strategies for minimizing academic dishonesty in online student assessment. Topics include acknowledging the disadvantages of online assessment and overcoming them; designing an effective, cheat-proof online assessment; keeping online courses current; and providing students…

Cytometric methods for measuring bacteria in water: advantages, pitfalls and applications.

PubMed

Hammes, Frederik; Egli, Thomas

2010-06-01

Rapid detection of microbial cells is a challenge in microbiology, particularly when complex indigenous communities or subpopulations varying in viability, activity and physiological state are investigated. Flow cytometry (FCM) has developed during the last 30 years into a multidisciplinary technique for analysing bacteria. When used correctly, FCM can provide a broad range of information at the single-cell level, including (but not limited to) total counts, size measurements, nucleic acid content, cell viability and activity, and detection of specific bacterial groups or species. The main advantage of FCM is that it is fast and easy to perform. It is a robust technique, which is adaptable to different types of samples and methods, and has much potential for automation. Hence, numerous FCM applications have emerged in industrial biotechnology, food and pharmaceutical quality control, routine monitoring of drinking water and wastewater systems, and microbial ecological research in soils and natural aquatic habitats. This review focuses on the information that can be gained from the analysis of bacteria in water, highlighting some of the main advantages, pitfalls and applications.

Problem-Based Learning in Biomechanics: Advantages, Challenges, and Implementation Strategies.

PubMed

Clyne, Alisa Morss; Billiar, Kristen L

2016-07-01

Problem-based learning (PBL) has been shown to be effective in biomedical engineering education, particularly in motivating student learning, increasing knowledge retention, and developing problem solving, communication, and teamwork skills. However, PBL adoption remains limited by real challenges in effective implementation. In this paper, we review the literature on advantages and challenges of PBL and present our own experiences. We also provide practical guidelines for implementing PBL, including two examples of PBL modules from biomechanics courses at two different institutions. Overall, we conclude that the benefits for both professors and students support the use of PBL in biomedical engineering education.

A Longitudinal Study of Memory Advantages in Bilinguals

PubMed Central

Ljungberg, Jessica K.; Hansson, Patrik; Andrés, Pilar; Josefsson, Maria; Nilsson, Lars-Göran

2013-01-01

Typically, studies of cognitive advantages in bilinguals have been conducted previously by using executive and inhibitory tasks (e.g. Simon task) and applying cross-sectional designs. This study longitudinally investigated bilingual advantages on episodic memory recall, verbal letter and categorical fluency during the trajectory of life. Monolingual and bilingual participants (n = 178) between 35–70 years at baseline were drawn from the Betula Prospective Cohort Study of aging, memory, and health. Results showed that bilinguals outperformed monolinguals at the first testing session and across time both in episodic memory recall and in letter fluency. No interaction with age was found indicating that the rate of change across ages was similar for bilinguals and monolinguals. As predicted and in line with studies applying cross-sectional designs, no advantages associated with bilingualism were found in the categorical fluency task. The results are discussed in the light of successful aging. PMID:24023803

Minimized state complexity of quantum-encoded cryptic processes

NASA Astrophysics Data System (ADS)

Riechers, Paul M.; Mahoney, John R.; Aghamohammadi, Cina; Crutchfield, James P.

2016-05-01

The predictive information required for proper trajectory sampling of a stochastic process can be more efficiently transmitted via a quantum channel than a classical one. This recent discovery allows quantum information processing to drastically reduce the memory necessary to simulate complex classical stochastic processes. It also points to a new perspective on the intrinsic complexity that nature must employ in generating the processes we observe. The quantum advantage increases with codeword length: the length of process sequences used in constructing the quantum communication scheme. In analogy with the classical complexity measure, statistical complexity, we use this reduced communication cost as an entropic measure of state complexity in the quantum representation. Previously difficult to compute, the quantum advantage is expressed here in closed form using spectral decomposition. This allows for efficient numerical computation of the quantum-reduced state complexity at all encoding lengths, including infinite. Additionally, it makes clear how finite-codeword reduction in state complexity is controlled by the classical process's cryptic order, and it allows asymptotic analysis of infinite-cryptic-order processes.

High definition in minimally invasive surgery: a review of methods for recording, editing, and distributing video.

PubMed

Kelly, Christopher R; Hogle, Nancy J; Landman, Jaime; Fowler, Dennis L

2008-09-01

The use of high-definition cameras and monitors during minimally invasive procedures can provide the surgeon and operating team with more than twice the resolution of standard definition systems. Although this dramatic improvement in visualization offers numerous advantages, the adoption of high definition cameras in the operating room can be challenging because new recording equipment must be purchased, and several new technologies are required to edit and distribute video. The purpose of this review article is to provide an overview of the popular methods for recording, editing, and distributing high-definition video. This article discusses the essential technical concepts of high-definition video, reviews the different kinds of equipment and methods most often used for recording, and describes several options for video distribution.

Optimizing cutting conditions on sustainable machining of aluminum alloy to minimize power consumption

NASA Astrophysics Data System (ADS)

Nur, Rusdi; Suyuti, Muhammad Arsyad; Susanto, Tri Agus

2017-06-01

Aluminum is widely utilized in the industrial sector. There are several advantages of aluminum, i.e. good flexibility and formability, high corrosion resistance and electrical conductivity, and high heat. Despite of these characteristics, however, pure aluminum is rarely used because of its lacks of strength. Thus, most of the aluminum used in the industrial sectors was in the form of alloy form. Sustainable machining can be considered to link with the transformation of input materials and energy/power demand into finished goods. Machining processes are responsible for environmental effects accepting to their power consumption. The cutting conditions have been optimized to minimize the cutting power, which is the power consumed for cutting. This paper presents an experimental study of sustainable machining of Al-11%Si base alloy that was operated without any cooling system to assess the capacity in reducing power consumption. The cutting force was measured and the cutting power was calculated. Both of cutting force and cutting power were analyzed and modeled by using the central composite design (CCD). The result of this study indicated that the cutting speed has an effect on machining performance and that optimum cutting conditions have to be determined, while sustainable machining can be followed in terms of minimizing power consumption and cutting force. The model developed from this study can be used for evaluation process and optimization to determine optimal cutting conditions for the performance of the whole process.

Efficacy of the Stonehenge Technique for Minimally Invasive Aortic Valve Replacement via Right Infraaxillary Thoracotomy

PubMed Central

Kin, Hajime; Kitamoto, Shohei; Yamanaka, Shota; Nishida, Hidefumi; Nishigawa, Kosaku; Takanashi, Shuichiro

2017-01-01

Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments. This was achieved by particular placement of several retracted sutures to the right chest wall. We named placement of these sutures the “Stonehenge technique.” In conclusion, AVR via vertical infraaxillary thoracotomy with our Stonehenge technique can be safely and simply performed with superior cosmetic advantages. PMID:28123153

Electrophysiological explorations of the bilingual advantage: evidence from a Stroop task.

PubMed

Coderre, Emily L; van Heuven, Walter J B

2014-01-01

Bilinguals have been shown to exhibit a performance advantage on executive control tasks, outperforming their monolingual counterparts. Although a wealth of research has investigated this 'bilingual advantage' behaviourally, electrophysiological correlates are lacking. Using EEG with a Stroop task that manipulated the stimulus onset asynchrony (SOA) of word and colour presentation, the current study addressed two facets of the bilingual advantage. The possibility that bilinguals experience superior conflict processing relative to monolinguals (a 'conflict-specific advantage') was investigated by comparing behavioural interference effects as well as the amplitude of the Ninc, a conflict-related ERP component occurring from approximately 300-500 ms after the onset of conflict. In contrast, the hypothesis that bilinguals experience domain-general, conflict-independent enhancements in executive processing (a 'non-conflict-specific advantage') was evaluated by comparing the control condition (symbol strings) between groups. There was some significant, but inconsistent, evidence for a conflict-specific bilingual advantage. In contrast, strong evidence emerged for a non-conflict-specific advantage, with bilinguals demonstrating faster RTs and reduced ERP amplitudes on control trials compared to monolinguals. Importantly, when the control stimulus was presented before the colour, ERPs to control trials revealed group differences before the onset of conflict, suggesting differences in the ability to ignore or suppress distracting irrelevant information. This indicates that bilinguals experience superior executive processing even in the absence of conflict and semantic salience, and suggests that the advantage extends to more efficient proactive management of the environment.

Utilization of biocatalysts in cellulose waste minimization

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

Woodward, J.; Evans, B.R.

1996-09-01

Cellulose, a polymer of glucose, is the principal component of biomass and, therefore, a major source of waste that is either buried or burned. Examples of biomass waste include agricultural crop residues, forestry products, and municipal wastes. Recycling of this waste is important for energy conservation as well as waste minimization and there is some probability that in the future biomass could become a major energy source and replace fossil fuels that are currently used for fuels and chemicals production. It has been estimated that in the United States, between 100-450 million dry tons of agricultural waste are produced annually,more » approximately 6 million dry tons of animal waste, and of the 190 million tons of municipal solid waste (MSW) generated annually, approximately two-thirds is cellulosic in nature and over one-third is paper waste. Interestingly, more than 70% of MSW is landfilled or burned, however landfill space is becoming increasingly scarce. On a smaller scale, important cellulosic products such as cellulose acetate also present waste problems; an estimated 43 thousand tons of cellulose ester waste are generated annually in the United States. Biocatalysts could be used in cellulose waste minimization and this chapter describes their characteristics and potential in bioconversion and bioremediation processes.« less

MR imaging guidance for minimally invasive procedures

NASA Astrophysics Data System (ADS)

Wong, Terence Z.; Kettenbach, Joachim; Silverman, Stuart G.; Schwartz, Richard B.; Morrison, Paul R.; Kacher, Daniel F.; Jolesz, Ferenc A.

1998-04-01

Image guidance is one of the major challenges common to all minimally invasive procedures including biopsy, thermal ablation, endoscopy, and laparoscopy. This is essential for (1) identifying the target lesion, (2) planning the minimally invasive approach, and (3) monitoring the therapy as it progresses. MRI is an ideal imaging modality for this purpose, providing high soft tissue contrast and multiplanar imaging, capability with no ionizing radiation. An interventional/surgical MRI suite has been developed at Brigham and Women's Hospital which provides multiplanar imaging guidance during surgery, biopsy, and thermal ablation procedures. The 0.5T MRI system (General Electric Signa SP) features open vertical access, allowing intraoperative imaging to be performed. An integrated navigational system permits near real-time control of imaging planes, and provides interactive guidance for positioning various diagnostic and therapeutic probes. MR imaging can also be used to monitor cryotherapy as well as high temperature thermal ablation procedures sing RF, laser, microwave, or focused ultrasound. Design features of the interventional MRI system will be discussed, and techniques will be described for interactive image acquisition and tracking of interventional instruments. Applications for interactive and near-real-time imaging will be presented as well as examples of specific procedures performed using MRI guidance.

Minimal invasive treatments for liver malignancies.

PubMed

Orsi, Franco; Varano, Gianluca

2015-11-01

Minimal invasive therapies have proved useful in the management of primary and secondary hepatic malignancies. The most relevant aspects of all these therapies are their minimal toxicity profiles and highly effective tumor responses without affecting the normal hepatic parenchyma. These unique characteristics coupled with their minimally invasive nature provide an attractive therapeutic option for patients who previously may have had few alternatives. Combination of these therapies might extend indications to bring curative treatment to a wider selected population. The results of various ongoing combination trials of intraarterial therapies with targeted therapies are awaited to further improve survival in this patient group. This review focuses on the application of ablative and intra-arterial therapies in the management of hepatocellular carcinoma and hepatic colorectal metastasis. Copyright © 2015 Elsevier B.V. All rights reserved.

Minimally-aggressive gestational trophoblastic neoplasms.

PubMed

Cole, Laurence A

2012-04-01

We have previously defined a new syndrome "Minimally-aggressive gestational trophoblastic neoplasms" in which choriocarcinoma or persistent hydatidiform mole has a minimal growth rate and becomes chemorefractory. Previously we described a new treatment protocol, waiting for hCG rise to >3000 mIU/ml and disease becomes more advanced, then using combination chemotherapy. Initially we found this treatment successful in 8 of 8 cases, here we find this protocol appropriate in a further 16 cases. Initially we used hyperglycosylated hCG, a limited availability test, to identify this syndrome. Here we propose also using hCG doubling rate to detect this syndrome. Minimally aggressive gestational trophoblastic disease can be detected by chemotherapy resistance or low hyperglycosylated hCG, <40% of total hCG. It can also be identified by hCG doubling rate, with doubling time greater than 2 weeks. Nineteen new cases were identified as having minimally aggressive gestational trophoblastic disease by hyperglycosylated hCG and by hCG doubling test. All were recommended to hold off further chemotherapy until hCG >3000mIU/ml. One case died prior to the start of the study, one case withdrew because of a lung nodule and one withdrew refusing the suggested combination chemotherapy. The remaining 16 women were all successfully treated. A total of 8 plus 16 or 24 of 24 women were successfully treated using the proposed protocol, holding back on chemotherapy until hCG >3000mIU/ml. Copyright © 2011 Elsevier Inc. All rights reserved.

Minimally invasive surgical techniques for stress incontinence surgery.

PubMed

Morley, Roland; Nethercliffe, Janine

2005-12-01

Minimally invasive techniques for surgical correction of stress incontinence date back to the late 1950s. Since that time there have been many developments to attempt to emulate the good results achieved by open surgery with less surgical morbidity. Needle suspensions have attempted to reposition the bladder neck in the same way as a colposuspension. However, although numerous variations have been described, they do not have the long-term outcomes of colposuspension. These variations, their complications and long-term outcome are discussed. Sling surgery, especially the tension-free vaginal tape (TVT), has probably had the largest impact on incontinence surgery in recent years, offering a procedure with low morbidity and, thus far in the medium term, outcomes comparable with those of more invasive procedures. This has led the TVT procedure to become the most common procedure performed worldwide for stress incontinence. With the benefit of lessons learnt from the use of synthetic material in the genitourinary tract, some worries remain with regard to the long-term complications of TVT. Other non-synthetic material should not be forgotten, and the advantages and disadvantages of various sling materials are compared. Injectables have an established place in the treatment of sphincter deficiency, though long-term results are poor compared to those of other procedures. Various materials used and the technique for their injection are discussed.

Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.

PubMed

Kaye, Ian David; Passias, Peter

2018-03-01

Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.

The minimizing style: perceptions of psychological abuse and quality of past and current relationships.

PubMed

Varia, R; Abidin, R R

1999-11-01

The goals of this current project were to expand and elaborate on the results of Varia, Abidin, and Dass' (1996) study to better understand what historical parenting factors may contribute in creating a "Minimizing" perception of childhood psychological abuse. A second objective included examining the association between perceptual styles and adult ratings of adult relationship satisfaction. Ninety individuals from a non-clinical adult sample completed self-report questionnaires regarding psychological maltreatment and adult relationship satisfaction. Three groups were created and compared using analysis of variance. The groups were (I) "Non-Abused," consistent reporters of no abuse; (II) "Acknowledgers," consistent reporters of abuse; and (III) "Minimizers," reporters of abuse, but do not label themselves as having been abused. Results indicated a continuum effect with the Non-Abused individuals reporting the highest level of maternal warmth and affection, the Acknowledgers reporting the lowest, with the Minimizers in the middle. The Non-Abused group reported the healthiest adjustment in terms of adult relationship satisfaction. While Minimizers and Acknowledgers reported similar levels of psychologically abusive experiences, Acknowledgers reported more difficulties with adult relationships. This study highlights the importance of studying Minimizers, a group which describes abusive events but minimizes the meaning and scope of these experiences. The relatively higher levels of maternal care which the Minimizers reported is hypothesized to be associated with their perceptions that they were not abused and acted as a protective factor associated with better quality adult relationships. The varying degrees of nurturance and care in the early family environment of abused individuals is speculated to be associated with distinct perceptual styles.

Mesonic spectroscopy of minimal walking technicolor

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

Del Debbio, Luigi; Lucini, Biagio; Patella, Agostino

2010-07-01

We investigate the structure and the novel emerging features of the mesonic nonsinglet spectrum of the minimal walking technicolor theory. Precision measurements in the nonsinglet pseudoscalar and vector channels are compared to the expectations for an IR-conformal field theory and a QCD-like theory. Our results favor a scenario in which minimal walking technicolor is (almost) conformal in the infrared, while spontaneous chiral symmetry breaking seems less plausible.

Hybrid minimally invasive esophagectomy for cancer: impact on postoperative inflammatory and nutritional status.

PubMed

Scarpa, M; Cavallin, F; Saadeh, L M; Pinto, E; Alfieri, R; Cagol, M; Da Roit, A; Pizzolato, E; Noaro, G; Pozza, G; Castoro, C

2016-11-01

The purpose of this case-control study was to evaluate the impact of hybrid minimally invasive esophagectomy for cancer on surgical stress response and nutritional status. All 34 consecutive patients undergoing hybrid minimally invasive esophagectomy for cancer at our surgical unit between 2008 and 2013 were retrospectively compared with 34 patients undergoing esophagectomy with open gastric tubulization (open), matched for neoadjuvant therapy, pathological stage, gender and age. Demographic data, tumor features and postoperative course (including quality of life and systemic inflammatory and nutritional status) were compared. Postoperative course was similar in terms of complication rate. Length of stay in intensive care unit was shorter in patients undergoing hybrid minimally invasive esophagectomy (P = 0.002). In the first postoperative day, patients undergoing hybrid minimally invasive esophagectomy had lower C-reactive protein levels (P = 0.001) and white cell blood count (P = 0.05), and higher albumin serum level (P = 0.001). In this group, albumin remained higher also at third (P = 0.06) and seventh (P = 0.008) postoperative day, and C-reactive protein resulted lower at third post day (P = 0.04). Hybrid minimally invasive esophagectomy significantly improved the systemic inflammatory and catabolic response to surgical trauma, contributing to a shorter length of stay in intensive care unit. © 2015 International Society for Diseases of the Esophagus.

Minimal Intervention Dentistry – A New Frontier in Clinical Dentistry

PubMed Central

NK., Bajwa; A, Pathak

2014-01-01

Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry. PMID:25177659

40 CFR 262.27 - Waste minimization certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Waste minimization certification. 262.27 Section 262.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.27 Waste minimization...

40 CFR 262.27 - Waste minimization certification.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Waste minimization certification. 262.27 Section 262.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.27 Waste minimization...

40 CFR 262.27 - Waste minimization certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Waste minimization certification. 262.27 Section 262.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.27 Waste minimization...

40 CFR 262.27 - Waste minimization certification.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Waste minimization certification. 262.27 Section 262.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.27 Waste minimization...

40 CFR 262.27 - Waste minimization certification.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Waste minimization certification. 262.27 Section 262.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS APPLICABLE TO GENERATORS OF HAZARDOUS WASTE The Manifest § 262.27 Waste minimization...

10 CFR 20.1406 - Minimization of contamination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Minimization of contamination. 20.1406 Section 20.1406 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Radiological Criteria for License Termination § 20.1406 Minimization of contamination. (a) Applicants for licenses, other than early...

10 CFR 20.1406 - Minimization of contamination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Minimization of contamination. 20.1406 Section 20.1406 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Radiological Criteria for License Termination § 20.1406 Minimization of contamination. (a) Applicants for licenses, other than early...

Update on Minimally Invasive Glaucoma Surgery (MIGS) and New Implants

PubMed Central

Brandão, Lívia M.; Grieshaber, Matthias C.

2013-01-01

Traditional glaucoma surgery has been challenged by the advent of innovative techniques and new implants in the past few years. There is an increasing demand for safer glaucoma surgery offering patients a timely surgical solution in reducing intraocular pressure (IOP) and improving their quality of life. The new procedures and devices aim to lower IOP with a higher safety profile than fistulating surgery (trabeculectomy/drainage tubes) and are collectively termed “minimally invasive glaucoma surgery (MIGS).” The main advantage of MIGS is that they are nonpenetrating and/or bleb-independent procedures, thus avoiding the major complications of fistulating surgery related to blebs and hypotony. In this review, the clinical results of the latest techniques and devices are presented by their approach, ab interno (trabeculotomy, excimer laser trabeculotomy, trabecular microbypass, suprachoroidal shunt, and intracanalicular scaffold) and ab externo (canaloplasty, Stegmann Canal Expander, suprachoroidal Gold microshunt). The drawback of MIGS is that some of these procedures produce a limited IOP reduction compared to trabeculectomy. Currently, MIGS is performed in glaucoma patients with early to moderate disease and preferably in combination with cataract surgery. PMID:24369494

Prevailing Trends in Haptic Feedback Simulation for Minimally Invasive Surgery.

PubMed

Pinzon, David; Byrns, Simon; Zheng, Bin

2016-08-01

Background The amount of direct hand-tool-tissue interaction and feedback in minimally invasive surgery varies from being attenuated in laparoscopy to being completely absent in robotic minimally invasive surgery. The role of haptic feedback during surgical skill acquisition and its emphasis in training have been a constant source of controversy. This review discusses the major developments in haptic simulation as they relate to surgical performance and the current research questions that remain unanswered. Search Strategy An in-depth review of the literature was performed using PubMed. Results A total of 198 abstracts were returned based on our search criteria. Three major areas of research were identified, including advancements in 1 of the 4 components of haptic systems, evaluating the effectiveness of haptic integration in simulators, and improvements to haptic feedback in robotic surgery. Conclusions Force feedback is the best method for tissue identification in minimally invasive surgery and haptic feedback provides the greatest benefit to surgical novices in the early stages of their training. New technology has improved our ability to capture, playback and enhance to utility of haptic cues in simulated surgery. Future research should focus on deciphering how haptic training in surgical education can increase performance, safety, and improve training efficiency. © The Author(s) 2016.

Pricing health benefits: a cost-minimization approach.

PubMed

Miller, Nolan H

2005-09-01

We study the role of health benefits in an employer's compensation strategy, given the overall goal of minimizing total compensation cost (wages plus health-insurance cost). When employees' health status is private information, the employer's basic benefit package consists of a base wage and a moderate health plan, with a generous plan available for an additional charge. We show that in setting the charge for the generous plan, a cost-minimizing employer should act as a monopolist who sells "health plan upgrades" to its workers, and we discuss ways tax policy can encourage efficiency under cost-minimization and alternative pricing rules.

A transformation method for constrained-function minimization

NASA Technical Reports Server (NTRS)

Park, S. K.

1975-01-01

A direct method for constrained-function minimization is discussed. The method involves the construction of an appropriate function mapping all of one finite dimensional space onto the region defined by the constraints. Functions which produce such a transformation are constructed for a variety of constraint regions including, for example, those arising from linear and quadratic inequalities and equalities. In addition, the computational performance of this method is studied in the situation where the Davidon-Fletcher-Powell algorithm is used to solve the resulting unconstrained problem. Good performance is demonstrated for 19 test problems by achieving rapid convergence to a solution from several widely separated starting points.

The half-truth of first-mover advantage.

PubMed

Suarez, Fernando; Lanzolla, Gianvito

2005-04-01

Many executives take for granted that the first company in a new product category gets an unbeatable head start and reaps long-lasting benefits. But that doesn't always happen. The authors of this article discovered that much depends on the pace at which the category's technology is changing and the speed at which the market is evolving. By analyzing these two factors, companies can improve their odds of succeeding as first movers with the resources they possess. Gradual evolution in both the technology and the market provides a first mover with the best conditions for creating a dominant position that is long lasting (Hoover in the vacuum cleaner industry is a good example). In such calm waters, a company can defend its advantages even without exceptional skills or extensive financial resources. When the market is changing rapidly and the product isn't, a first entrant with extensive resources can obtain a long-lasting advantage (as Sony did with its Walkman personal stereo); a company with only limited resources probably must settle for a short-term benefit. When the market is static but the product is changing constantly, first-mover advantages of either kind--durable or short-lived--are unlikely. Only companies with very deep pockets can survive (think of Sony and the digital cameras it pioneered). Rapid churn in both the technology and the market creates the worst conditions. But if companies have an acute sense of when to exit-as Netscape demonstrated when it agreed to be acquired by AOL-a worthwhile short-term gain is possible. Before venturing into a newly forming market, you need to analyze the environment, assess your resources, then determine which type offirst-mover advantage is most achievable. Once you've gone into the water, you have no choice but to swim.

Minimal Pleural Effusion in Small Cell Lung Cancer: Proportion, Mechanisms, and Prognostic Effect.

PubMed

Ryu, Jeong-Seon; Lim, Jun Hyeok; Lee, Jeong Min; Kim, Woo Chul; Lee, Kyung-Hee; Memon, Azra; Lee, Seul-Ki; Yi, Bo-Rim; Kim, Hyun-Jung; Hwang, Seung-Sik

2016-02-01

To determine the frequency and investigate possible mechanisms and prognostic relevance of minimal (<10-mm thickness) pleural effusion in patients with small cell lung cancer (SCLC). The single-center retrospective study was approved by the institutional review board of the hospital, and informed consent was waived by the patients. A cohort of 360 consecutive patients diagnosed with SCLC by using histologic analysis was enrolled in this study. Based on the status of pleural effusion on chest computed tomographic (CT) scans at diagnosis, patients were classified into three groups: no pleural effusion, minimal pleural effusion, and malignant pleural effusion. Eighteen variables related to patient, environment, stage, and treatment were included in the final model as potential confounders. Minimal pleural effusion was present in 74 patients (20.6%) and malignant pleural effusion in 83 patients (23.0%). Median survival was significantly different in patients with no, minimal, or malignant pleural effusion (median survival, 11.2, 5.93, and 4.83 months, respectively; P < .001, log-rank test). In the fully adjusted final model, patients with minimal pleural effusion had a significantly increased risk of death compared with those with no pleural effusion (adjusted hazard ratio, 1.454 [95% confidence interval: 1.012, 2.090]; P = .001). The prognostic effect was significant in patients with stage I-III disease (adjusted hazard ratio, 2.751 [95% confidence interval: 1.586, 4.773]; P < .001), but it disappeared in stage IV disease. An indirect mechanism representing mediastinal lymphadenopathy was responsible for the accumulation in all but one patient with minimal pleural effusion. Minimal pleural effusion is a common clinical finding in staging SCLC. Its presence is associated with worse survival in patients and should be considered when CT scans are interpreted. © RSNA, 2015.

Recognition memory advantage for negative emotional words has an early expiry date: Evidence from brain oscillations and ERPs.

PubMed

Santaniello, G; Ferré, P; Rodríguez-Gómez, P; Poch, C; Eva, M Moreno; Hinojosa, J A

2018-06-15

Evidence from prior studies has shown an advantage in recognition memory for emotional compared to neutral words. Whether this advantage is short-lived or rather extends over longer periods, as well as whether the effect depends on words' valence (i.e., positive or negative), remains unknown. In the present ERP/EEG study, we investigated this issue by manipulating the lag distance (LAG-2, LAG-8 and LAG-16) between the presentation of old and new words in an online recognition memory task. LAG differences were observed at behavior, ERPs and in the theta frequency band. In line with previous studies, negative words were associated with faster reaction times, higher hit rates and increased amplitude in a positive ERP component between 386 and 564 ms compared to positive and neutral words. Remarkably, the interaction of LAG by EMOTION revealed that negative words were associated with better performance and larger ERPs amplitudes only at LAG-2. Also in the LAG-2 condition, emotional words (i.e., positive and negative words) induced a stronger desynchronization in the beta band between 386 and 542 ms compared to neutral words. These early enhanced memory effects for emotional words are discussed in terms of the Negative Emotional Valence Enhances Recapitulation (NEVER) model and the mobilization-minimization hypothesis. Copyright © 2018 Elsevier Ltd. All rights reserved.

CUTSETS - MINIMAL CUT SET CALCULATION FOR DIGRAPH AND FAULT TREE RELIABILITY MODELS

NASA Technical Reports Server (NTRS)

Iverson, D. L.

1994-01-01

Fault tree and digraph models are frequently used for system failure analysis. Both type of models represent a failure space view of the system using AND and OR nodes in a directed graph structure. Fault trees must have a tree structure and do not allow cycles or loops in the graph. Digraphs allow any pattern of interconnection between loops in the graphs. A common operation performed on digraph and fault tree models is the calculation of minimal cut sets. A cut set is a set of basic failures that could cause a given target failure event to occur. A minimal cut set for a target event node in a fault tree or digraph is any cut set for the node with the property that if any one of the failures in the set is removed, the occurrence of the other failures in the set will not cause the target failure event. CUTSETS will identify all the minimal cut sets for a given node. The CUTSETS package contains programs that solve for minimal cut sets of fault trees and digraphs using object-oriented programming techniques. These cut set codes can be used to solve graph models for reliability analysis and identify potential single point failures in a modeled system. The fault tree minimal cut set code reads in a fault tree model input file with each node listed in a text format. In the input file the user specifies a top node of the fault tree and a maximum cut set size to be calculated. CUTSETS will find minimal sets of basic events which would cause the failure at the output of a given fault tree gate. The program can find all the minimal cut sets of a node, or minimal cut sets up to a specified size. The algorithm performs a recursive top down parse of the fault tree, starting at the specified top node, and combines the cut sets of each child node into sets of basic event failures that would cause the failure event at the output of that gate. Minimal cut set solutions can be found for all nodes in the fault tree or just for the top node. The digraph cut set code uses the same

Primary Hyperparathyroidism in Older People: Surgical Treatment with Minimally Invasive Approaches and Outcome

PubMed Central

Dobrinja, Chiara; Silvestri, Marta; de Manzini, Nicolò

2012-01-01

Introduction. Elderly patients with primary hyperparathyroidism (pHPT) are often not referred to surgery because of their associated comorbidities that may increase surgical risk. The aim of the study was to review indications and results of minimally invasive approach parathyroidectomy in elderly patients to evaluate its impact on outcome. Materials and Methods. All patients of 70 years of age or older undergoing minimally approach parathyroidectomy at our Department from May 2005 to May 2011 were reviewed. Data collected included patients demographic information, biochemical pathology, time elapsed from pHPT diagnosis to surgical intervention, operative findings, complications, and results of postoperative biochemical studies. Results and Discussion. 37 patients were analysed. The average length of stay was 2.8 days. 11 patients were discharged within 24 hours after their operation. Morbidity included 6 transient symptomatic postoperative hypocalcemias while one patient developed a transient laryngeal nerve palsy. Time elapsed from pHPT diagnosis to first surgical visit evidences that the elderly patients were referred after their disease had progressed. Conclusions. Our data show that minimally invasive approach to parathyroid surgery seems to be safe and curative also in elderly patients with few associated risks because of combination of modern preoperative imaging, advances in surgical technique, and advances in anesthesia care. PMID:22737167

A minimization principle for the description of modes associated with finite-time instabilities

PubMed Central

Babaee, H.

2016-01-01

We introduce a minimization formulation for the determination of a finite-dimensional, time-dependent, orthonormal basis that captures directions of the phase space associated with transient instabilities. While these instabilities have finite lifetime, they can play a crucial role either by altering the system dynamics through the activation of other instabilities or by creating sudden nonlinear energy transfers that lead to extreme responses. However, their essentially transient character makes their description a particularly challenging task. We develop a minimization framework that focuses on the optimal approximation of the system dynamics in the neighbourhood of the system state. This minimization formulation results in differential equations that evolve a time-dependent basis so that it optimally approximates the most unstable directions. We demonstrate the capability of the method for two families of problems: (i) linear systems, including the advection–diffusion operator in a strongly non-normal regime as well as the Orr–Sommerfeld/Squire operator, and (ii) nonlinear problems, including a low-dimensional system with transient instabilities and the vertical jet in cross-flow. We demonstrate that the time-dependent subspace captures the strongly transient non-normal energy growth (in the short-time regime), while for longer times the modes capture the expected asymptotic behaviour. PMID:27118900

Direct Detection of Nucleic Acid with Minimizing Background and Improving Sensitivity Based on a Conformation-Discriminating Indicator.

PubMed

Zhu, Lixuan; Qing, Zhihe; Hou, Lina; Yang, Sheng; Zou, Zhen; Cao, Zhong; Yang, Ronghua

2017-08-25

As is well-known, the nucleic acid indicator-based strategy is one of the major approaches to monitor the nucleic acid hybridization-mediated recognition events in biochemical analysis, displaying obvious advantages including simplicity, low cost, convenience, and generality. However, conventional indicators either hold strong self-fluorescence or can be lighted by both ssDNA and dsDNA, lacking absolute selectivity for a certain conformation, always with high background interference and low sensitivity in sensing; and additional processing (e.g., nanomaterial-mediated background suppression, and enzyme-catalyzed signal amplification) is generally required to improve the detection performance. In this work, a carbazole derivative, EBCB, has been synthesized and screened as a dsDNA-specific fluorescent indicator. Compared with conventional indicators under the same conditions, EBCB displayed a much higher selective coefficient for dsDNA, with little self-fluorescence and negligible effect from ssDNA. Based on its superior capability in DNA conformation-discrimination, high sensitivity with minimizing background interference was demonstrated for direct detection of nucleic acid, and monitoring nucleic acid-based circuitry with good reversibity, resulting in low detection limit and high capability for discriminating base-mismatching. Thus, we expect that this highly specific DNA conformation-discriminating indicator will hold good potential for application in biochemical sensing and molecular logic switching.

Minimal perceptrons for memorizing complex patterns

NASA Astrophysics Data System (ADS)

Pastor, Marissa; Song, Juyong; Hoang, Danh-Tai; Jo, Junghyo

2016-11-01

Feedforward neural networks have been investigated to understand learning and memory, as well as applied to numerous practical problems in pattern classification. It is a rule of thumb that more complex tasks require larger networks. However, the design of optimal network architectures for specific tasks is still an unsolved fundamental problem. In this study, we consider three-layered neural networks for memorizing binary patterns. We developed a new complexity measure of binary patterns, and estimated the minimal network size for memorizing them as a function of their complexity. We formulated the minimal network size for regular, random, and complex patterns. In particular, the minimal size for complex patterns, which are neither ordered nor disordered, was predicted by measuring their Hamming distances from known ordered patterns. Our predictions agree with simulations based on the back-propagation algorithm.

Best practices for minimally invasive procedures.

PubMed

Ulmer, Brenda C

2010-05-01

Techniques and instrumentation for minimally invasive surgical procedures originated in gynecologic surgery, but the benefits of surgery with small incisions or no incisions at all have prompted the expansion of these techniques into numerous specialties. Technologies such as robotic assistance, single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and video-assisted thoracoscopic surgery have led to the continued expansion of minimally invasive surgery into new specialties. With this expansion, perioperative nurses and other members of the surgical team are required to continue to learn about new technology and instrumentation, as well as the techniques and challenges involved in using new technology, to help ensure the safety of their patients. This article explores the development of minimally invasive procedures and offers suggestions for increasing patient safety. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Minimally invasive optical biopsy for oximetry

NASA Astrophysics Data System (ADS)

van der Putten, Marieke A.; Brewer, James M.; Harvey, Andrew R.

2017-02-01

The study of localised oxygen saturation in blood vessels can shed light on the etiology and progression of many diseases with which hypoxia is associated. For example, hypoxia in the tendon has been linked to early stages of rheumatoid arthritis, an auto-immune inflammatory disease. Vascular oximetry of deep tissue presents significant challenges as vessels are not optically accessible. In this paper, we present a novel multispectral imaging technique for vascular oximetry, and recent developments made towards its adaptation for minimally invasive imaging. We present proof-of-concept of the system and illumination scheme as well as the analysis technique. We present results of a validation study performed in vivo on mice with acutely inflamed tendons. Adaptation of the technique for minimally invasive microendoscopy is also presented, along with preliminary results of minimally invasive ex vivo vascular oximetry.

[Virtual CT-pneumocystoscopy: indications, advantages and limitations. Our experience].

PubMed

Regine, Giovanni; Atzori, Maurizio; Buffa, Vitaliano; Miele, Vittorio; Ialongo, Pasquale; Adami, Loredana

2003-09-01

sensitivity was 77%; this was higher for pedunculated lesions (79%) than for sessile lesions (50%). The virtual technique is less invasive and tends to be associated with fewer complications than is conventional cystoscopy. It also demonstrated a good sensitivity for evaluating pedunculated lesions, allowing evaluation of the bladder base and anterior wall, sites that are commonly poorly accessible at conventional cystoscopy. Further advantages of the virtual technique include the possibility of accurately measuring the extent of the lesion and obtaining virtual images even in patients with severe urethral obstruction and active bleeding. The limitations include the inability to obtain tissue for histologic examination or to perform endoscopic resection of pedunculated lesions. The technique is less sensitive than conventional cystoscopy in the detection of sessile lesions or very small polyps (<5 mm). Furthermore, diffuse wall thickening reduces bladder distension thereby preventing optimal evaluation. The most valuable indication appears to be the follow-up of treated wall lesions. Virtual CT-pneumocystoscopy can replace conventional cystoscopy in cases with pedunculated lesions when there is no need for biopsy, when the lesions are located at the bladder base or when cystoscopic instrumentation cannot be introduced into the bladder due to stenosis. Virtual pneumocystoscopy can also be used in the follow-up of treated polypoid lesions in association with pelvic CT-angiography.

Demonstration of quantum advantage in machine learning

NASA Astrophysics Data System (ADS)

Ristè, Diego; da Silva, Marcus P.; Ryan, Colm A.; Cross, Andrew W.; Córcoles, Antonio D.; Smolin, John A.; Gambetta, Jay M.; Chow, Jerry M.; Johnson, Blake R.

2017-04-01

The main promise of quantum computing is to efficiently solve certain problems that are prohibitively expensive for a classical computer. Most problems with a proven quantum advantage involve the repeated use of a black box, or oracle, whose structure encodes the solution. One measure of the algorithmic performance is the query complexity, i.e., the scaling of the number of oracle calls needed to find the solution with a given probability. Few-qubit demonstrations of quantum algorithms, such as Deutsch-Jozsa and Grover, have been implemented across diverse physical systems such as nuclear magnetic resonance, trapped ions, optical systems, and superconducting circuits. However, at the small scale, these problems can already be solved classically with a few oracle queries, limiting the obtained advantage. Here we solve an oracle-based problem, known as learning parity with noise, on a five-qubit superconducting processor. Executing classical and quantum algorithms using the same oracle, we observe a large gap in query count in favor of quantum processing. We find that this gap grows by orders of magnitude as a function of the error rates and the problem size. This result demonstrates that, while complex fault-tolerant architectures will be required for universal quantum computing, a significant quantum advantage already emerges in existing noisy systems.

9 CFR 93.436 - Ruminants from regions of minimal risk for BSE.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Ruminants from regions of minimal risk for BSE. 93.436 Section 93.436 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS...

9 CFR 93.436 - Ruminants from regions of minimal risk for BSE.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Ruminants from regions of minimal risk for BSE. 93.436 Section 93.436 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS...

Less Intense Postacute Care, Better Outcomes For Enrollees In Medicare Advantage Than Those In Fee-For-Service

PubMed Central

Huckfeldt, Peter J.; Escarce, Jose J.; Rabideau, Brendan; Karaca-Mandic, Pinar; Sood, Neeraj

2017-01-01

Traditional fee-for-service (FFS) Medicare’s prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure. After accounting for differences in patient characteristics at discharge, we found lower intensity of postacute care for Medicare Advantage patients compared to FFS Medicare patients discharged from the same hospital, across all three conditions. Medicare Advantage patients also exhibited better outcomes than their FFS Medicare counterparts, including lower rates of hospital readmission and higher rates of return to the community. These findings suggest that payment reforms such as bundling in FFS Medicare may reduce the intensity of postacute care without adversely affecting patient health. PMID:28069851

Less Intense Postacute Care, Better Outcomes For Enrollees In Medicare Advantage Than Those In Fee-For-Service.

PubMed

Huckfeldt, Peter J; Escarce, José J; Rabideau, Brendan; Karaca-Mandic, Pinar; Sood, Neeraj

2017-01-01

Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure. After accounting for differences in patient characteristics at discharge, we found lower intensity of postacute care for Medicare Advantage patients compared to FFS Medicare patients discharged from the same hospital, across all three conditions. Medicare Advantage patients also exhibited better outcomes than their FFS Medicare counterparts, including lower rates of hospital readmission and higher rates of return to the community. These findings suggest that payment reforms such as bundling in FFS Medicare may reduce the intensity of postacute care without adversely affecting patient health. Project HOPE—The People-to-People Health Foundation, Inc.

Making the Most of Minimalism in Music.

ERIC Educational Resources Information Center

Geiersbach, Frederick J.

1998-01-01

Describes the minimalist movement in music. Discusses generations of minimalist musicians and, in general, the minimalist approach. Considers various ways that minimalist strategies can be integrated into the music classroom focusing on (1) minimalism and (2) student-centered composition and principles of minimalism for use with elementary band…

Minimizing radiation exposure during percutaneous nephrolithotomy.

PubMed

Chen, T T; Preminger, G M; Lipkin, M E

2015-12-01

Given the recent trends in growing per capita radiation dose from medical sources, there have been increasing concerns over patient radiation exposure. Patients with kidney stones undergoing percutaneous nephrolithotomy (PNL) are at particular risk for high radiation exposure. There exist several risk factors for increased radiation exposure during PNL which include high Body Mass Index, multiple access tracts, and increased stone burden. We herein review recent trends in radiation exposure, radiation exposure during PNL to both patients and urologists, and various approaches to reduce radiation exposure. We discuss incorporating the principles of As Low As reasonably Achievable (ALARA) into clinical practice and review imaging techniques such as ultrasound and air contrast to guide PNL access. Alternative surgical techniques and approaches to reducing radiation exposure, including retrograde intra-renal surgery, retrograde nephrostomy, endoscopic-guided PNL, and minimally invasive PNL, are also highlighted. It is important for urologists to be aware of these concepts and techniques when treating stone patients with PNL. The discussions outlined will assist urologists in providing patient counseling and high quality of care.

Testosterone, territoriality, and the 'home advantage'.

PubMed

Neave, Nick; Wolfson, Sandy

2003-02-01

The consistently better performance seen by teams in various sporting contexts when playing at home is referred to as the 'home advantage'. Various explanations have been put forward to account for this robust phenomenon, though none has yet focussed on possible hormonal factors. In an initial study, we showed that salivary testosterone levels in soccer players were significantly higher before a home game than an away game.In a second study involving a different group of soccer players, this finding was replicated over two home games, two away games, and three training sessions. Perceived rivalry of the opposing team was important as testosterone levels were higher before playing an 'extreme' rival than a 'moderate' rival. Self-reported measures of mood in both studies were not linked to testosterone level. The present results corroborate and extend earlier findings on the relationships between testosterone, territoriality, and dominance in human competitive encounters and further suggest an important role for testosterone in the home advantage seen in various team sports.

Minimally invasive surgery. Future developments.

PubMed

Wickham, J E

1994-01-15

The rapid development of minimally invasive surgery means that there will be fundamental changes in interventional treatment. Technological advances will allow new minimally invasive procedures to be developed. Application of robotics will allow some procedures to be done automatically, and coupling of slave robotic instruments with virtual reality images will allow surgeons to perform operations by remote control. Miniature motors and instruments designed by microengineering could be introduced into body cavities to perform operations that are currently impossible. New materials will allow changes in instrument construction, such as use of memory metals to make heat activated scissors or forceps. With the reduced trauma associated with minimally invasive surgery, fewer operations will require long hospital stays. Traditional surgical wards will become largely redundant, and hospitals will need to cope with increased through-put of patients. Operating theatres will have to be equipped with complex high technology equipment, and hospital staff will need to be trained to manage it. Conventional nursing care will be carried out more in the community. Many traditional specialties will be merged, and surgical training will need fundamental revision to ensure that surgeons are competent to carry out the new procedures.

Minimally invasive paediatric cardiac surgery.

PubMed

Bacha, Emile; Kalfa, David

2014-01-01

The concept of minimally invasive surgery for congenital heart disease in paediatric patients is broad, and has the aim of reducing the trauma of the operation at each stage of management. Firstly, in the operating room using minimally invasive incisions, video-assisted thoracoscopic and robotically assisted surgery, hybrid procedures, image-guided intracardiac surgery, and minimally invasive cardiopulmonary bypass strategies. Secondly, in the intensive-care unit with neuroprotection and 'fast-tracking' strategies that involve early extubation, early hospital discharge, and less exposure to transfused blood products. Thirdly, during postoperative mid-term and long-term follow-up by providing the children and their families with adequate support after hospital discharge. Improvement of these strategies relies on the development of new devices, real-time multimodality imaging, aids to instrument navigation, miniaturized and specialized instrumentation, robotic technology, and computer-assisted modelling of flow dynamics and tissue mechanics. In addition, dedicated multidisciplinary co-ordinated teams involving congenital cardiac surgeons, perfusionists, intensivists, anaesthesiologists, cardiologists, nurses, psychologists, and counsellors are needed before, during, and after surgery to go beyond apparent technological and medical limitations with the goal to 'treat more while hurting less'.

Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach.

PubMed

Park, Bumsoo; Choo, Seol Ho; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

2014-12-01

Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy. The aim of our study was to evaluate whether the interval from prostate biopsy to radical prostatectomy affects immediate operative outcomes, with a focus on differences in surgical approach. The study population of 1,848 radical prostatectomy patients was divided into two groups according to the surgical approach: open or minimally invasive. Open group included perineal and retropubic approach, and minimally invasive group included laparoscopic and robotic approach. The cut-off of the biopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time and estimated blood loss were evaluated as endpoint parameters. In the open group, there were significant differences in operative time and estimated blood loss between the <4-week and ≥4-week interval subgroups, but there was no difference in positive margin rate. In the minimally invasive group, there were no differences in the three outcome parameters between the two subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was not a significant factor affecting immediate operative outcomes in both open and minimally invasive groups, with the exception of the interval ≥4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeks of prostate biopsy is feasible for both approaches, and is even beneficial for minimally invasive radical prostatectomy to reduce operative time.

Extensions of the survival advantage in memory: examining the role of ancestral context and implied social isolation.

PubMed

Kostic, Bogdan; McFarlan, Chastity C; Cleary, Anne M

2012-07-01

Recent work (e.g., Nairne & Pandeirada, 2010) has shown that words are remembered better when they have been processed for their survival value in a grasslands context than when processed in other contexts. It has been suggested that this is because human memory systems were shaped by evolution specifically to help humans survive. Thus far, the survival processing advantage has mainly been shown with grasslands contexts, which are thought to be particularly relevant to human evolution. The present study demonstrated the survival processing advantage with other contexts (e.g., lost in a jungle), including with contexts that should not, in and of themselves, be relevant to human evolution (e.g., lost in outer space). We further examined whether implied social isolation plays a critical role in the survival advantage to memory by comparing scenarios in which the person is alone versus with other people present (e.g., lost at sea alone or with others), and whether the perceived source of danger is social isolation or other human attackers. A survival advantage was shown in both the isolation and the group settings, and whether the primary source of danger was isolation or other human attackers did not matter. These findings suggest that the survival advantage in memory is not dependent on evolutionarily relevant physical contexts (e.g., grasslands) or particular sources of perceived danger (social isolation vs. perceived attackers), showing the advantage to be robust and applicable to a variety of scenarios. 2012 APA, all rights reserved

Minimizing complications associated with coronal approach by application of various modifications in surgical technique for treating facial trauma: A prospective study.

PubMed

Kumar, V Santosh; Rao, N Koteswara; Mohan, Kodali Rama; Krishna, Leela; Prasad, B Srinivasa; Ranganadh, N; Lakshmi, Vijaya

2016-01-01

Coronal incision is a popular and versatile surgical approach to the anterior cranial vault and upper and middle third facial skeleton. The flap itself permits widespread exposure of the fractures in this region. The bicoronal flap was first described by Hartley and Kenyon (neurosurgeons) to gain access to the anterior cranium in 1907. It extension as an access flap to the upper and lateral aspect of the face was pioneered by Tessier (1971). Esthetically, it is pleasing as the surgical scar is hidden within the hair. To evaluate the versatility of coronal incision using various modifications advocated in incision, exposure to fractured site, and closure of flap in treating the upper and middle third facial fractures. A total of ten patients diagnosed with upper and middle third facial fractures requiring open reduction and internal fixation/correction of contour defect were selected after preoperative clinical and radiographic (computed tomography scan) evaluation. All the cases were operated by coronal approach to gain the access to the fracture/defect site for reduction/correction of the defect. Advantages and complication are evaluated. Excellent access and anatomical reduction by this approach with least number of complications; if it is performed with healthy knowledge of anatomy of the scalp and temporal region. Certain minimal complications have also been noted using various modifications used in the procedure. Despite of prolonged surgical time for the exposure, it is very advantages in treating upper and middle third facial fractures due to wide access and discreet scar (minimal).

Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

PubMed Central

Levy, Lauren L; Emer, Jason J

2012-01-01

Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

The challenges, advantages and future of phenome-wide association studies.

PubMed

Hebbring, Scott J

2014-02-01

Over the last decade, significant technological breakthroughs have revolutionized human genomic research in the form of genome-wide association studies (GWASs). GWASs have identified thousands of statistically significant genetic variants associated with hundreds of human conditions including many with immunological aetiologies (e.g. multiple sclerosis, ankylosing spondylitis and rheumatoid arthritis). Unfortunately, most GWASs fail to identify clinically significant associations. Identifying biologically significant variants by GWAS also presents a challenge. The GWAS is a phenotype-to-genotype approach. As a complementary/alternative approach to the GWAS, investigators have begun to exploit extensive electronic medical record systems to conduct a genotype-to-phenotype approach when studying human disease - specifically, the phenome-wide association study (PheWAS). Although the PheWAS approach is in its infancy, this method has already demonstrated its capacity to rediscover important genetic associations related to immunological diseases/conditions. Furthermore, PheWAS has the advantage of identifying genetic variants with pleiotropic properties. This is particularly relevant for HLA variants. For example, PheWAS results have demonstrated that the HLA-DRB1 variant associated with multiple sclerosis may also be associated with erythematous conditions including rosacea. Likewise, PheWAS has demonstrated that the HLA-B genotype is not only associated with spondylopathies, uveitis, and variability in platelet count, but may also play an important role in other conditions, such as mastoiditis. This review will discuss and compare general PheWAS methodologies, describe both the challenges and advantages of the PheWAS, and provide insight into the potential directions in which PheWAS may lead. © 2013 The Authors. Immunology Published by John Wiley & Sons Ltd.

Waste minimization charges up recycling of spent lead-acid batteries

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

Queneau, P.B.; Troutman, A.L.

Substantial strides are being made to minimize waste generated form spent lead-acid battery recycling. The Center for Hazardous Materials Research (Pittsburgh) recently investigated the potential for secondary lead smelters to recover lead from battery cases and other materials found at hazardous waste sites. Primary and secondary lead smelters in the U.S. and Canada are processing substantial tons of lead wastes, and meeting regulatory safeguards. Typical lead wastes include contaminated soil, dross and dust by-products from industrial lead consumers, tetraethyl lead residues, chemical manufacturing by-products, leaded glass, china clay waste, munitions residues and pigments. The secondary lead industry also is developingmore » and installing systems to convert process inputs to products with minimum generation of liquid, solid and gaseous wastes. The industry recently has made substantial accomplishments that minimize waste generation during lead production from its bread and butter feedstock--spent lead-acid batteries.« less

Rigorous force field optimization principles based on statistical distance minimization

DOE PAGES

Vlcek, Lukas; Chialvo, Ariel A.

2015-10-12

We use the concept of statistical distance to define a measure of distinguishability between a pair of statistical mechanical systems, i.e., a model and its target, and show that its minimization leads to general convergence of the model’s static measurable properties to those of the target. Here we exploit this feature to define a rigorous basis for the development of accurate and robust effective molecular force fields that are inherently compatible with coarse-grained experimental data. The new model optimization principles and their efficient implementation are illustrated through selected examples, whose outcome demonstrates the higher robustness and predictive accuracy of themore » approach compared to other currently used methods, such as force matching and relative entropy minimization. We also discuss relations between the newly developed principles and established thermodynamic concepts, which include the Gibbs-Bogoliubov inequality and the thermodynamic length.« less

Technical nuances to minimize common complications of deep brain stimulation.

PubMed

House, Paul

2017-04-01

The implantation of deep brain stimulator electrodes is associated with infrequent complications. These complications are consistent across prospective trials and include infection, skin erosion, hemorrhage, and lead misplacement. Nuances of surgical technique can be used to minimize the risk of these commonly noted complications. Several of these technical nuances are highlighted in this video submission. The video can be found here: https://youtu.be/GL09W9p013g .

Correlation of spatial climate/weather maps and the advantages of using the Mahalanobis metric in predictions

NASA Astrophysics Data System (ADS)

Stephenson, D. B.

1997-10-01

The skill in predicting spatially varying weather/climate maps depends on the definition of the measure of similarity between the maps. Under the justifiable approximation that the anomaly maps are distributed multinormally, it is shown analytically that the choice of weighting metric, used in defining the anomaly correlation between spatial maps, can change the resulting probability distribution of the correlation coefficient. The estimate of the numbers of degrees of freedom based on the variance of the correlation distribution can vary from unity up to the number of grid points depending on the choice of weighting metric. The (pseudo-) inverse of the sample covariance matrix acts as a special choice for the metric in that it gives a correlation distribution which has minimal kurtosis and maximum dimension. Minimal kurtosis suggests that the average predictive skill might be improved due to the rarer occurrence of troublesome outlier patterns far from the mean state. Maximum dimension has a disadvantage for analogue prediction schemes in that it gives the minimum number of analogue states. This metric also has an advantage in that it allows one to powerfully test the null hypothesis of multinormality by examining the second and third moments of the correlation coefficient which were introduced by Mardia as invariant measures of multivariate kurtosis and skewness. For these reasons, it is suggested that this metric could be usefully employed in the prediction of weather/climate and in fingerprinting anthropogenic climate change. The ideas are illustrated using the bivariate example of the observed monthly mean sea-level pressures at Darwin and Tahitifrom 1866 1995.

Energy minimization on manifolds for docking flexible molecules

PubMed Central

Mirzaei, Hanieh; Zarbafian, Shahrooz; Villar, Elizabeth; Mottarella, Scott; Beglov, Dmitri; Vajda, Sandor; Paschalidis, Ioannis Ch.; Vakili, Pirooz; Kozakov, Dima

2015-01-01

In this paper we extend a recently introduced rigid body minimization algorithm, defined on manifolds, to the problem of minimizing the energy of interacting flexible molecules. The goal is to integrate moving the ligand in six dimensional rotational/translational space with internal rotations around rotatable bonds within the two molecules. We show that adding rotational degrees of freedom to the rigid moves of the ligand results in an overall optimization search space that is a manifold to which our manifold optimization approach can be extended. The effectiveness of the method is shown for three different docking problems of increasing complexity. First we minimize the energy of fragment-size ligands with a single rotatable bond as part of a protein mapping method developed for the identification of binding hot spots. Second, we consider energy minimization for docking a flexible ligand to a rigid protein receptor, an approach frequently used in existing methods. In the third problem we account for flexibility in both the ligand and the receptor. Results show that minimization using the manifold optimization algorithm is substantially more efficient than minimization using a traditional all-atom optimization algorithm while producing solutions of comparable quality. In addition to the specific problems considered, the method is general enough to be used in a large class of applications such as docking multidomain proteins with flexible hinges. The code is available under open source license (at http://cluspro.bu.edu/Code/Code_Rigtree.tar), and with minimal effort can be incorporated into any molecular modeling package. PMID:26478722

MEDIASSIST: medical assistance for intraoperative skill transfer in minimally invasive surgery using augmented reality

NASA Astrophysics Data System (ADS)

Sudra, Gunther; Speidel, Stefanie; Fritz, Dominik; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

2007-03-01

Minimally invasive surgery is a highly complex medical discipline with various risks for surgeon and patient, but has also numerous advantages on patient-side. The surgeon has to adapt special operation-techniques and deal with difficulties like the complex hand-eye coordination, limited field of view and restricted mobility. To alleviate with these new problems, we propose to support the surgeon's spatial cognition by using augmented reality (AR) techniques to directly visualize virtual objects in the surgical site. In order to generate an intelligent support, it is necessary to have an intraoperative assistance system that recognizes the surgical skills during the intervention and provides context-aware assistance surgeon using AR techniques. With MEDIASSIST we bundle our research activities in the field of intraoperative intelligent support and visualization. Our experimental setup consists of a stereo endoscope, an optical tracking system and a head-mounted-display for 3D visualization. The framework will be used as platform for the development and evaluation of our research in the field of skill recognition and context-aware assistance generation. This includes methods for surgical skill analysis, skill classification, context interpretation as well as assistive visualization and interaction techniques. In this paper we present the objectives of MEDIASSIST and first results in the fields of skill analysis, visualization and multi-modal interaction. In detail we present a markerless instrument tracking for surgical skill analysis as well as visualization techniques and recognition of interaction gestures in an AR environment.

Linear Matrix Inequality Method for a Quadratic Performance Index Minimization Problem with a class of Bilinear Matrix Inequality Conditions

NASA Astrophysics Data System (ADS)

Tanemura, M.; Chida, Y.

2016-09-01

There are a lot of design problems of control system which are expressed as a performance index minimization under BMI conditions. However, a minimization problem expressed as LMIs can be easily solved because of the convex property of LMIs. Therefore, many researchers have been studying transforming a variety of control design problems into convex minimization problems expressed as LMIs. This paper proposes an LMI method for a quadratic performance index minimization problem with a class of BMI conditions. The minimization problem treated in this paper includes design problems of state-feedback gain for switched system and so on. The effectiveness of the proposed method is verified through a state-feedback gain design for switched systems and a numerical simulation using the designed feedback gains.