Sample records for complete simple tele-operated

  1. TeleOperator/telePresence System (TOPS) Concept Verification Model (CVM) development

    NASA Technical Reports Server (NTRS)

    Shimamoto, Mike S.

    1993-01-01

    The development of an anthropomorphic, undersea manipulator system, the TeleOperator/telePresence System (TOPS) Concept Verification Model (CVM) is described. The TOPS system's design philosophy, which results from NRaD's experience in undersea vehicles and manipulator systems development and operations, is presented. The TOPS design approach, task teams, manipulator, and vision system development and results, conclusions, and recommendations are presented.

  2. Predictive Interfaces for Long-Distance Tele-Operations

    NASA Technical Reports Server (NTRS)

    Wheeler, Kevin R.; Martin, Rodney; Allan, Mark B.; Sunspiral, Vytas

    2005-01-01

    We address the development of predictive tele-operator interfaces for humanoid robots with respect to two basic challenges. Firstly, we address automating the transition from fully tele-operated systems towards degrees of autonomy. Secondly, we develop compensation for the time-delay that exists when sending telemetry data from a remote operation point to robots located at low earth orbit and beyond. Humanoid robots have a great advantage over other robotic platforms for use in space-based construction and maintenance because they can use the same tools as astronauts do. The major disadvantage is that they are difficult to control due to the large number of degrees of freedom, which makes it difficult to synthesize autonomous behaviors using conventional means. We are working with the NASA Johnson Space Center's Robonaut which is an anthropomorphic robot with fully articulated hands, arms, and neck. We have trained hidden Markov models that make use of the command data, sensory streams, and other relevant data sources to predict a tele-operator's intent. This allows us to achieve subgoal level commanding without the use of predefined command dictionaries, and to create sub-goal autonomy via sequence generation from generative models. Our method works as a means to incrementally transition from manual tele-operation to semi-autonomous, supervised operation. The multi-agent laboratory experiments conducted by Ambrose et. al. have shown that it is feasible to directly tele-operate multiple Robonauts with humans to perform complex tasks such as truss assembly. However, once a time-delay is introduced into the system, the rate of tele\\ioperation slows down to mimic a bump and wait type of activity. We would like to maintain the same interface to the operator despite time-delays. To this end, we are developing an interface which will allow for us to predict the intentions of the operator while interacting with a 3D virtual representation of the expected state of the

  3. Tele-Operated Lunar Rover Navigation Using Lidar

    NASA Technical Reports Server (NTRS)

    Pedersen, Liam; Allan, Mark B.; Utz, Hans, Heinrich; Deans, Matthew C.; Bouyssounouse, Xavier; Choi, Yoonhyuk; Fluckiger, Lorenzo; Lee, Susan Y.; To, Vinh; Loh, Jonathan; hide

    2012-01-01

    Near real-time tele-operated driving on the lunar surface remains constrained by bandwidth and signal latency despite the Moon s relative proximity. As part of our work within NASA s Human-Robotic Systems Project (HRS), we have developed a stand-alone modular LIDAR based safeguarded tele-operation system of hardware, middleware, navigation software and user interface. The system has been installed and tested on two distinct NASA rovers-JSC s Centaur2 lunar rover prototype and ARC s KRex research rover- and tested over several kilometers of tele-operated driving at average sustained speeds of 0.15 - 0.25 m/s around rocks, slopes and simulated lunar craters using a deliberately constrained telemetry link. The navigation system builds onboard terrain and hazard maps, returning highest priority sections to the off-board operator as permitted by bandwidth availability. It also analyzes hazard maps onboard and can stop the vehicle prior to contacting hazards. It is robust to severe pose errors and uses a novel scan alignment algorithm to compensate for attitude and elevation errors.

  4. Optimized Algorithms for Prediction Within Robotic Tele-Operative Interfaces

    NASA Technical Reports Server (NTRS)

    Martin, Rodney A.; Wheeler, Kevin R.; Allan, Mark B.; SunSpiral, Vytas

    2010-01-01

    Robonaut, the humanoid robot developed at the Dexterous Robotics Labo ratory at NASA Johnson Space Center serves as a testbed for human-rob ot collaboration research and development efforts. One of the recent efforts investigates how adjustable autonomy can provide for a safe a nd more effective completion of manipulation-based tasks. A predictiv e algorithm developed in previous work was deployed as part of a soft ware interface that can be used for long-distance tele-operation. In this work, Hidden Markov Models (HMM?s) were trained on data recorded during tele-operation of basic tasks. In this paper we provide the d etails of this algorithm, how to improve upon the methods via optimization, and also present viable alternatives to the original algorithmi c approach. We show that all of the algorithms presented can be optim ized to meet the specifications of the metrics shown as being useful for measuring the performance of the predictive methods. 1

  5. Considerations for human-machine interfaces in tele-operations

    NASA Technical Reports Server (NTRS)

    Newport, Curt

    1991-01-01

    Numerous factors impact on the efficiency of tele-operative manipulative work. Generally, these are related to the physical environment of the tele-operator and how he interfaces with robotic control consoles. The capabilities of the operator can be influenced by considerations such as temperature, eye strain, body fatigue, and boredom created by repetitive work tasks. In addition, the successful combination of man and machine will, in part, be determined by the configuration of the visual and physical interfaces available to the teleoperator. The design and operation of system components such as full-scale and mini-master manipulator controllers, servo joysticks, and video monitors will have a direct impact on operational efficiency. As a result, the local environment and the interaction of the operator with the robotic control console have a substantial effect on mission productivity.

  6. Tele-transmission of EEG recordings.

    PubMed

    Lemesle, M; Kubis, N; Sauleau, P; N'Guyen The Tich, S; Touzery-de Villepin, A

    2015-03-01

    EEG recordings can be sent for remote interpretation. This article aims to define the tele-EEG procedures and technical guidelines. Tele-EEG is a complete medical act that needs to be carried out with the same quality requirements as a local one in terms of indications, formulation of the medical request and medical interpretation. It adheres to the same quality requirements for its human resources and materials. It must be part of a medical organization (technical and medical network) and follow all rules and guidelines of good medical practices. The financial model of this organization must include costs related to performing the EEG recording, operating and maintenance of the tele-EEG network and medical fees of the physician interpreting the EEG recording. Implementing this organization must be detailed in a convention between all parties involved: physicians, management of the healthcare structure, and the company providing the tele-EEG service. This convention will set rules for network operation and finance, and also the continuous training of all staff members. The tele-EEG system must respect all rules for safety and confidentiality, and ensure the traceability and storing of all requests and reports. Under these conditions, tele-EEG can optimize the use of human resources and competencies in its zone of utilization and enhance the organization of care management. Copyright © 2015. Published by Elsevier SAS.

  7. Tele-ICU "myth busters".

    PubMed

    Venditti, Angelo; Ronk, Chanda; Kopenhaver, Tracey; Fetterman, Susan

    2012-01-01

    Tele-intensive care unit (ICU) technology has been proven to bridge the gap between available resources and quality care for many health care systems across the country. Tele-ICUs allow the standardization of care and provide a second set of eyes traditionally not available in the ICU. A growing body of literature supports the use of tele-ICUs based on improved outcomes and reduction in errors. To date, the literature has not effectively outlined the limitations of this technology related to response to changes in patient care, interventions, and interaction with the care team. This information can potentially have a profound impact on service expectations. Some misconceptions about tele-ICU technology include the following: tele-ICU is "watching" 24 hours a day, 7 days a week; tele-ICU is a telemetry unit; tele-ICU is a stand-alone crisis intervention tool; tele-ICU decreases staffing at the bedside; tele-ICU clinical roles are clearly defined and understood; and tele-ICUs are not cost-effective to operate. This article outlines the purpose of tele-ICU technology, reviews outcomes, and "busts" myths about tele-ICU technology.

  8. Robotic tele-existence

    NASA Technical Reports Server (NTRS)

    Tachi, Susumu; Arai, Hirohiko; Maeda, Taro

    1989-01-01

    Tele-existence is an advanced type of teleoperation system that enables a human operator at the controls to perform remote manipulation tasks dexterously with the feeling that he or she exists in the remote anthropomorphic robot in the remote environment. The concept of a tele-existence is presented, the principle of the tele-existence display method is explained, some of the prototype systems are described, and its space application is discussed.

  9. Pilot study on verification of effectiveness on operability of assistance system for robotic tele-surgery using simulation.

    PubMed

    Kawamura, Kazuya; Kobayashi, Yo; Fujie, Masakatsu G

    2010-01-01

    Tele-surgery enables medical care even in remote regions, and has been accomplished in clinical cases by means of dedicated communication lines. To make tele-surgery a more widespread method of providing medical care, a surgical environment needs to be made available using public lines of communication, such as the Internet. Moreover, a support system during surgery is required, as the use of surgical tools is performed in an environment subject to delay. In our research, we focus on the operability of specific tasks conducted by surgeons during a medical procedure, with the aim of clarifying, by means of a simulation, the optimum environment for robotic tele-surgery. In the study, we set up experimental systems using our proposed simulation system. In addition, we investigate the mental workloads on subjects and verify the effect of visual-assistance information as a pilot study. The operability of the task of gripping soft tissue was evaluated using a subjective workload assessment tool, the NASA Task Load Index. Results show that the tasks were completed, but the workload did not improve to less than 300ms and 400ms in the simulated environment. Verifying the effect of the support system was an important task under a more-than 200ms delay using this experiment, and future studies will evaluate the operability of the system under varying conditions of comfort. In addition, an intra-operative assistance system will be constructed using a simulation.

  10. Membrane-mirror-based autostereoscopic display for tele-operation and teleprescence applications

    NASA Astrophysics Data System (ADS)

    McKay, Stuart; Mair, Gordon M.; Mason, Steven; Revie, Kenneth

    2000-05-01

    An autostereoscopic display for telepresence and tele- operation applications has been developed at the University of Strathclyde in Glasgow, Scotland. The research is a collaborative effort between the Imaging Group and the Transparent Telepresence Research Group, both based at Strathclyde. A key component of the display is the directional screen; a 1.2-m diameter Stretchable Membrane Mirror is currently used. This patented technology enables large diameter, small f No., mirrors to be produced at a fraction of the cost of conventional optics. Another key element of the present system is an anthropomorphic and anthropometric stereo camera sensor platform. Thus, in addition to mirror development, research areas include sensor platform design focused on sight, hearing, research areas include sensor platform design focused on sight, hearing, and smell, telecommunications, display systems for all visual, aural and other senses, tele-operation, and augmented reality. The sensor platform is located at the remote site and transmits live video to the home location. Applications for this technology are as diverse as they are numerous, ranging from bomb disposal and other hazardous environment applications to tele-conferencing, sales, education and entertainment.

  11. Cardiac ultrasonography over 4G wireless networks using a tele-operated robot

    PubMed Central

    Panayides, Andreas S.; Jossif, Antonis P.; Christoforou, Eftychios G.; Vieyres, Pierre; Novales, Cyril; Voskarides, Sotos; Pattichis, Constantinos S.

    2016-01-01

    This Letter proposes an end-to-end mobile tele-echography platform using a portable robot for remote cardiac ultrasonography. Performance evaluation investigates the capacity of long-term evolution (LTE) wireless networks to facilitate responsive robot tele-manipulation and real-time ultrasound video streaming that qualifies for clinical practice. Within this context, a thorough video coding standards comparison for cardiac ultrasound applications is performed, using a data set of ten ultrasound videos. Both objective and subjective (clinical) video quality assessment demonstrate that H.264/AVC and high efficiency video coding standards can achieve diagnostically-lossless video quality at bitrates well within the LTE supported data rates. Most importantly, reduced latencies experienced throughout the live tele-echography sessions allow the medical expert to remotely operate the robot in a responsive manner, using the wirelessly communicated cardiac ultrasound video to reach a diagnosis. Based on preliminary results documented in this Letter, the proposed robotised tele-echography platform can provide for reliable, remote diagnosis, achieving comparable quality of experience levels with in-hospital ultrasound examinations. PMID:27733929

  12. Assistant Personal Robot (APR): Conception and Application of a Tele-Operated Assisted Living Robot.

    PubMed

    Clotet, Eduard; Martínez, Dani; Moreno, Javier; Tresanchez, Marcel; Palacín, Jordi

    2016-04-28

    This paper presents the technical description, mechanical design, electronic components, software implementation and possible applications of a tele-operated mobile robot designed as an assisted living tool. This robotic concept has been named Assistant Personal Robot (or APR for short) and has been designed as a remotely telecontrolled robotic platform built to provide social and assistive services to elderly people and those with impaired mobility. The APR features a fast high-mobility motion system adapted for tele-operation in plain indoor areas, which incorporates a high-priority collision avoidance procedure. This paper presents the mechanical architecture, electrical fundaments and software implementation required in order to develop the main functionalities of an assistive robot. The APR uses a tablet in order to implement the basic peer-to-peer videoconference and tele-operation control combined with a tactile graphic user interface. The paper also presents the development of some applications proposed in the framework of an assisted living robot.

  13. Tele-autonomous systems: New methods for projecting and coordinating intelligent action at a distance

    NASA Technical Reports Server (NTRS)

    Conway, Lynn; Volz, Richard; Walker, Michael W.

    1989-01-01

    There is a growing need for humans to perform complex remote operations and to extend the intelligence and experience of experts to distant applications. It is asserted that a blending of human intelligence, modern information technology, remote control, and intelligent autonomous systems is required, and have coined the term tele-autonomous technology, or tele-automation, for methods producing intelligent action at a distance. Tele-automation goes beyond autonomous control by blending in human intelligence. It goes beyond tele-operation by incorporating as much autonomy as possible and/or reasonable. A new approach is discussed for solving one of the fundamental problems facing tele-autonomous systems: The need to overcome time delays due to telemetry and signal propagation. New concepts are introduced called time and position clutches, that allow the time and position frames between the local user control and the remote device being controlled, to be desynchronized respectively. The design and implementation of these mechanisms are described in detail. It is demonstrated that these mechanisms lead to substantial telemanipulation performance improvements, including the result of improvements even in the absence of time delays. The new controls also yield a simple protocol for control handoffs of manipulation tasks between local operators and remote systems.

  14. TELE-X and its role in a future operational Nordic satellite system

    NASA Astrophysics Data System (ADS)

    Anderson, Lars

    In the middle of 1987 it is planned to launch TELE-X, the first Nordic telecommunications satellite. The Swedish-Norwegian company NOTELSAT (Nordic Telecommunications Satellite Corporation) will be responsible for the operation of the TELE-X system. Via the experimental TELE-X satellite the Nordic countries will get access to direct broadcasting of two TV-programs and at least four digital sound programs in stereo by use of two transponders in the 12.2 to 12.5 GHz band. The programs are planned to be composed of nationally produced programs in Norway. Sweden and Finland. By means of distributing these programs via satellite they will reach up to 4 times as many viewers and listernes as presently in the terrestrial national systems. The basic motivations for exchanging programs are to strengthen the cultural ties between the Nordic countries and to give the individuals more freedom in the choice of programs. Another goal is to give the public a better sound and picture quality than can be achieved today. These quality improvements shall be met by using small receiver parabolas of less than 1 m in diameter. Contributing to the improved quality is the choice of the C-MAC (Multiplexed Analoque Components) modulation system. TELE-X is a multipurpose satellite which besides the two TV-transponders will have two transponders for data/video communication in the frequency band 12.5 to 12.75 GHz. The choice of system for data and video is based on the philosophy of thin-route traffic between small and low cost earth stations (1.8 to 2.5 m) placed directly at the subscribers premises. The system includes an advanced Data/Video Control Station which automatically connects the traffic stations with standarized transmission speeds up to 2 Mbps. The system which is based on the SCPC/DAMA method can be expanded up to 5000 traffic stations. Numerous data/video applications will be investigated in the initial experimental phase of the project which also will be used for market

  15. A tele-operated mobile ultrasound scanner using a light-weight robot.

    PubMed

    Delgorge, Cécile; Courrèges, Fabien; Al Bassit, Lama; Novales, Cyril; Rosenberger, Christophe; Smith-Guerin, Natalie; Brù, Concepció; Gilabert, Rosa; Vannoni, Maurizio; Poisson, Gérard; Vieyres, Pierre

    2005-03-01

    This paper presents a new tele-operated robotic chain for real-time ultrasound image acquisition and medical diagnosis. This system has been developed in the frame of the Mobile Tele-Echography Using an Ultralight Robot European Project. A light-weight six degrees-of-freedom serial robot, with a remote center of motion, has been specially designed for this application. It holds and moves a real probe on a distant patient according to the expert gesture and permits an image acquisition using a standard ultrasound device. The combination of mechanical structure choice for the robot and dedicated control law, particularly nearby the singular configuration allows a good path following and a robotized gesture accuracy. The choice of compression techniques for image transmission enables a compromise between flow and quality. These combined approaches, for robotics and image processing, enable the medical specialist to better control the remote ultrasound probe holder system and to receive stable and good quality ultrasound images to make a diagnosis via any type of communication link from terrestrial to satellite. Clinical tests have been performed since April 2003. They used both satellite or Integrated Services Digital Network lines with a theoretical bandwidth of 384 Kb/s. They showed the tele-echography system helped to identify 66% of lesions and 83% of symptomatic pathologies.

  16. Design issues for stereo vision systems used on tele-operated robotic platforms

    NASA Astrophysics Data System (ADS)

    Edmondson, Richard; Vaden, Justin; Hyatt, Brian; Morris, Jim; Pezzaniti, J. Larry; Chenault, David B.; Tchon, Joe; Barnidge, Tracy; Kaufman, Seth; Pettijohn, Brad

    2010-02-01

    The use of tele-operated Unmanned Ground Vehicles (UGVs) for military uses has grown significantly in recent years with operations in both Iraq and Afghanistan. In both cases the safety of the Soldier or technician performing the mission is improved by the large standoff distances afforded by the use of the UGV, but the full performance capability of the robotic system is not utilized due to insufficient depth perception provided by the standard two dimensional video system, causing the operator to slow the mission to ensure the safety of the UGV given the uncertainty of the perceived scene using 2D. To address this Polaris Sensor Technologies has developed, in a series of developments funded by the Leonard Wood Institute at Ft. Leonard Wood, MO, a prototype Stereo Vision Upgrade (SVU) Kit for the Foster-Miller TALON IV robot which provides the operator with improved depth perception and situational awareness, allowing for shorter mission times and higher success rates. Because there are multiple 2D cameras being replaced by stereo camera systems in the SVU Kit, and because the needs of the camera systems for each phase of a mission vary, there are a number of tradeoffs and design choices that must be made in developing such a system for robotic tele-operation. Additionally, human factors design criteria drive optical parameters of the camera systems which must be matched to the display system being used. The problem space for such an upgrade kit will be defined, and the choices made in the development of this particular SVU Kit will be discussed.

  17. Development and verification of ground-based tele-robotics operations concept for Dextre

    NASA Astrophysics Data System (ADS)

    Aziz, Sarmad

    2013-05-01

    The Special Purpose Dextreous Manipulator (Dextre) is the latest addition to the on-orbit segment of the Mobile Servicing System (MSS); Canada's contribution to the International Space Station (ISS). Launched in March 2008, the advanced two-armed robot is designed to perform various ISS maintenance tasks on robotically compatible elements and on-orbit replaceable units using a wide variety of tools and interfaces. The addition of Dextre has increased the capabilities of the MSS, and has introduced significant complexity to ISS robotics operations. While the initial operations concept for Dextre was based on human-in-the-loop control by the on-orbit astronauts, the complexities of robotic maintenance and the associated costs of training and maintaining the operator skills required for Dextre operations demanded a reexamination of the old concepts. A new approach to ISS robotic maintenance was developed in order to utilize the capabilities of Dextre safely and efficiently, while at the same time reducing the costs of on-orbit operations. This paper will describe the development, validation, and on-orbit demonstration of the operations concept for ground-based tele-robotics control of Dextre. It will describe the evolution of the new concepts from the experience gained from the development and implementation of the ground control capability for the Space Station Remote Manipulator System; Canadarm 2. It will discuss the various technical challenges faced during the development effort, such as requirements for high positioning accuracy, force/moment sensing and accommodation, failure tolerance, complex tool operations, and the novel operational tools and techniques developed to overcome them. The paper will also describe the work performed to validate the new concepts on orbit and will discuss the results and lessons learned from the on-orbit checkout and commissioning of Dextre using the newly developed tele-robotics techniques and capabilities.

  18. Tele-Medicine Applications of an ISDN-Based Tele-Working Platform

    DTIC Science & Technology

    2001-10-25

    developed over the Hellenic Integrated Services Digital Network (ISDN), is based on user terminals (personal computers), networking apparatus, and a...key infrastructure, ready to offer enhanced message switching and translation in response to market trends [8]. Three (3) years ago, the Hellenic PTT...should outcome to both an integrated Tele- Working platform, a main central database (completed with maintenance facilities), and a ready-to-be

  19. Evaluation of a tele-education programme in Brazil.

    PubMed

    Joshi, Ashish; Novaes, Magdala A; Iyengar, Sriram; Machiavelli, Josiane L; Zhang, Jiajie; Vogler, Robert; Hsu, Chiehwen E

    2011-01-01

    We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good.

  20. A Low-Cost Tele-Imaging Platform for Developing Countries

    PubMed Central

    Adambounou, Kokou; Adjenou, Victor; Salam, Alex P.; Farin, Fabien; N’Dakena, Koffi Gilbert; Gbeassor, Messanvi; Arbeille, Philippe

    2014-01-01

    Purpose: To design a “low-cost” tele-imaging method allowing real-time tele-ultrasound expertise, delayed tele-ultrasound diagnosis, and tele-radiology between remote peripherals hospitals and clinics (patient centers) and university hospital centers (expert center). Materials and methods: A system of communication via internet (IP camera and remote access software) enabling transfer of ultrasound videos and images between two centers allows a real-time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient center. In the absence of a sonographer or radiologist at the patient center, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g., midwife, nurse, technician). The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography, and computer tomography for example). The system was tested on 50 patients between CHR Tsevie in Togo (40 km from Lomé-Togo and 4500 km from Tours-France) and CHU Campus at Lomé and CHU Trousseau in Tours. Results: A real-time tele-expertise was successfully performed with a delay of approximately 1.5 s with an internet bandwidth of around 1 Mbps (IP Camera) and 512 kbps (remote access software). A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient center to the expert center was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low-bandwidth internet connection. Conclusion: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries. PMID:25250306

  1. A novel tele-medical environment appropriate for use in tele-advisory and tele-surgery cases.

    PubMed

    Chatzipapadopoulos, F; Georgantas, N; Kotaras, A; Mamais, G; Tombros, S; Tselikis, G

    1996-08-01

    Tele-medical systems have been recently introduced in the field of networking as promising applications that can significantly improve the offering of medical treatment by providing services such as tele-advising, tele-surgery and remote monitoring in places where the presence of doctors or any medical specialists is difficult or time consuming. Some already existent networking models can be used for the establishment of a connection between the communicating sides. The offered network's security is also a significant factor. The present paper describes a software environment implementing a particular aspect of a tele-medical system. The developed system includes features such as direct communication between doctors and medical assistants, medical information acquisition and storing and high band information transfer in real-time. TCP/IP point-to-point protocol has been used for the implementation of the non bandwidth-critical connections. The application introduces novel features with the use of ATM connection for supporting the time-critical service of video transfer to and from the medical database.

  2. Robust H∞ cost guaranteed integral sliding mode control for the synchronization problem of nonlinear tele-operation system with variable time-delay.

    PubMed

    Al-Wais, Saba; Khoo, Suiyang; Lee, Tae Hee; Shanmugam, Lakshmanan; Nahavandi, Saeid

    2018-01-01

    This paper is devoted to the synchronization problem of tele-operation systems with time-varying delay, disturbances, and uncertainty. Delay-dependent sufficient conditions for the existence of integral sliding surfaces are given in the form of Linear Matrix Inequalities (LMIs). This guarantees the global stability of the tele-operation system with known upper bounds of the time-varying delays. Unlike previous work, in this paper, the controller gains are designed but not chosen, which increases the degree of freedom of the design. Moreover, Wirtinger based integral inequality and reciprocally convex combination techniques used in the constructed Lypunove-Krasoviskii Functional (LKF) are deemed to give less conservative stability condition for the system. Furthermore, to relax the analysis from any assumptions regarding the dynamics of the environment and human operator forces, H ∞ design method is used to involve the dynamics of these forces and ensure the stability of the system against these admissible forces in the H ∞ sense. This design scheme combines the strong robustness of the sliding mode control with the H ∞ design method for tele-operation systems which is coupled using state feedback controllers and inherit variable time-delays in their communication channels. Simulation examples are given to show the effectiveness of the proposed method. Copyright © 2017 ISA. All rights reserved.

  3. Organizational and Teamwork Factors of Tele-Intensive Care Units.

    PubMed

    Wilkes, Michael S; Marcin, James P; Ritter, Lois A; Pruitt, Sherilyn

    2016-09-01

    Use of tele-intensive care involves organizational and teamwork factors across geographic locations. This situation adds to the complexity of collaboration in providing quality patient-centered care. To evaluate cross-agency teamwork of health care professionals caring for patients in tele-intensive care units in rural and urban regions. A national qualitative study was conducted in 3 US geographic regions with tele-intensive care programs. Discussions and interviews were held with key participants during site visits at 3 hub sites (specialist services location) and 8 rural spoke sites (patient location). The effects of communication and culture between the hub team and the spoke team on use of the services and effectiveness of care were evaluated. A total of 34 participants were interviewed. Specific organizational and teamwork factors significantly affect the functionality of a tele-intensive care unit. Key operational and cultural barriers that limit the benefits of the units include unrealistic expectations about operational capabilities, lack of trust, poorly defined leadership, and a lack of communication policies. Potential solutions include education on spoke facility resources, clearly defined expectations and role reversal education, team-building activities, and feedback mechanisms to share concerns, successes, and suggestions. Proper administration and attention to important cultural and teamwork factors are essential to making tele-intensive care units effective, practical, and sustainable. ©2016 American Association of Critical-Care Nurses.

  4. Tele-Education in South Africa

    PubMed Central

    Mars, Maurice

    2014-01-01

    Introduction: Telemedicine includes the use of information and communication technology for education in the health sector, tele-education. Sub-Saharan Africa has an extreme shortage of health professionals and as a result, doctors to teach doctors and students. Tele-education has the potential to provide access to education both formal and continuing medical education. While the uptake of telemedicine in Africa is low, there are a number of successful and sustained tele-education programs. The aims of this study were (i) to review the literature on tele-education in South Africa, (ii) describe tele-education activities at the University of KwaZulu-Natal (UKZ-N) in South Africa, and (iii) review the development of these programs with respect to current thinking on eHealth project implementation. Method: A literature review of tele-education in South Africa was undertaken. The development of the tele-education services at UKZ-N from 2001 to present is described. The approaches taken are compared with current teaching on eHealth implementation and a retrospective design-reality gap analysis is made. Results: Tele-education has been in use in South Africa since the 1970s. Several forms of tele-education are in place at the medical schools and in some Provincial Departments of Health (DOH). Despite initial attempts by the National DOH, there are no national initiatives in tele-education. At UKZ-N, a tele-education service has been running since 2001 and appears to be sustainable and reaching maturity, with over 1,400 h of videoconferenced education offered per year. The service has expanded to offer videoconferenced education into Africa using different ways of delivering tele-education. Conclusion: Tele-education has been used in different forms for many years in the health sector in South Africa. There is little hard evidence of its educational merit or economic worth. What it apparent is that it improves access to education and training in resource constrained

  5. Tele-existence and/or cybernetic interface studies in Japan

    NASA Technical Reports Server (NTRS)

    Tachi, Susumu

    1991-01-01

    Tele-existence aims at a natural and efficient remote control of robots by providing the operator with a real time sensation of presence. It is an advaced type of teleoperation system which enables a human operator at the controls to perform remote manipulation tasks dexterously with the feeling that he or she exists in one of the remote anthropomorphic robots in the remote environment, e.g., in a hostile environment such as those of nuclear radiation, high temperature, and deep space. In order to study the use of the tele-existence system in the artificially constructed environment, the visual tele-existence simulator has been designed, a pseudo-real-time binocular solid model robot simulator has been made, and its feasibility has been experimentally evaluated. An anthropomorphic robot mechanism with an arm having seven degrees of freedom has been designed and developed as a slave robot for feasibility experiments of teleoperation using the tele-existence method. An impedance controlled active display mechanism and a head mounted display have also been designed and developed as the display subsystem for the master. The robot's structural dimensions are set very close to those of humans.

  6. Tele-operated search robot for human detection using histogram of oriented objects

    NASA Astrophysics Data System (ADS)

    Cruz, Febus Reidj G.; Avendaño, Glenn O.; Manlises, Cyrel O.; Avellanosa, James Jason G.; Abina, Jyacinth Camille F.; Masaquel, Albert M.; Siapno, Michael Lance O.; Chung, Wen-Yaw

    2017-02-01

    Disasters such as typhoons, tornadoes, and earthquakes are inevitable. Aftermaths of these disasters include the missing people. Using robots with human detection capabilities to locate the missing people, can dramatically reduce the harm and risk to those who work in such circumstances. This study aims to: design and build a tele-operated robot; implement in MATLAB an algorithm for the detection of humans; and create a database of human identification based on various positions, angles, light intensity, as well as distances from which humans will be identified. Different light intensities were made by using Photoshop to simulate smoke, dust and water drops conditions. After processing the image, the system can indicate either a human is detected or not detected. Testing with bodies covered was also conducted to test the algorithm's robustness. Based on the results, the algorithm can detect humans with full body shown. For upright and lying positions, detection can happen from 8 feet to 20 feet. For sitting position, detection can happen from 2 feet to 20 feet with slight variances in results because of different lighting conditions. The distances greater than 20 feet, no humans can be processed or false negatives can occur. For bodies covered, the algorithm can detect humans in cases made under given circumstances. On three positions, humans can be detected from 0 degrees to 180 degrees under normal, with smoke, with dust, and with water droplet conditions. This study was able to design and build a tele-operated robot with MATLAB algorithm that can detect humans with an overall precision of 88.30%, from which a database was created for human identification based on various conditions, where humans will be identified.

  7. [The Virtual University applied to telesurgery: from tele-education to tele-manipulation].

    PubMed

    Marescaux, J; Mutter, D; Soler, L; Vix, M; Leroy, J

    1999-01-01

    The advent of new computer technologies appears as a revolution of surgical teaching, as well as the planning and realisation of surgical procedures. The introduction of a camera into the body of a patient, allowing the visual display of the operative procedure through the use of miniaturised camera constitutes the greatest alteration that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution was announces further changes: the development of telecommunication devices applied to medicine (tele-education, teletraining, telementoring, teleproctoring and tele-accreditation) constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of telepresence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery of Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realisation of international multi-site video conferences between surgeons. The WEBS project created the first Virtual University concept placing surgical techniques at the surgeon's disposal through Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows to develop the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University frame and to conceive teaching on a world level, offering to the practitioner unimaginable possibilities of formation, training and planning of surgical procedures.

  8. Arizona TeleMedicine Network: System Procurement Specifications.

    ERIC Educational Resources Information Center

    Atlantic Research Corp., Alexandria, VA.

    Providing general specifications and system descriptions for segments within the Arizona TeleMedicine Project (a telecommunication system designed to deliver health services to rurally isolated American Indians in Arizona), this document, when used with the appropriate route segment document, will completely describe the project's required…

  9. Tele-Pediatric Intensive Care for Critically Ill Children in Syria.

    PubMed

    Ghbeis, Muhammad Bakr; Steffen, Katherine M; Braunlin, Elizabeth A; Beilman, Gregory J; Dahman, Jay; Ostwani, Waseem; Steiner, Marie E

    2017-12-12

    Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality. We implemented a "Tele-Pediatric Intensive Care" program (Tele-PICU) to provide real-time management consultation for critically ill and injured pediatric patients in Syria with intensive care needs. Over the course of 7 months, 19 cases were evaluated, ranging in age from 1 day to 11 years. Consultation questions addressed a wide range of critical care needs. Five patients are known to have survived, three were transferred, five died, and six outcomes were unknown. Based on this limited undertaking with its positive impact on survival, further development of Tele-PICU-based efforts with attention to implementation and barriers identified through this program is desirable. Even limited Tele-PICU can provide timely and potentially lifesaving assistance to pediatric care providers. Future efforts are encouraged.

  10. Tele-Manipulation with Two Asymmetric Slaves: Two Operators Perform Better Than One.

    PubMed

    van Oosterhout, Jeroen; Heemskerk, Cock J M; de Baar, Marco R; van der Helm, Frans C T; Abbink, David A

    2018-01-01

    Certain tele-manipulation tasks require manipulation by two asymmetric slaves, for example, a crane for hoisting and a dexterous robotic arm for fine manipulation. It is unclear how to best design human-in-the-loop control over two asymmetric slaves. The goal of this paper is to quantitatively compare the standard approach of two co-operating operators that each control a single subtask, to a single operator performing bi-manual control over the two subtasks, and a uni-manual control approach. In a human factors experiment, participants performed a heavy load maneuvering and mounting task using a vertical crane and a robotic arm. We hypothesize that bi-manual control yields worse task performance and control activity compared to co-operation, because of conflicting spatial and temporal constraints. Literature suggests that uni-manual operators should perform better than co-operation, as co-operators critically depend on each other's actions. However, other literature provides evidence that individual operators have limited capabilities in controlling asymmetric axes of two dynamic systems. The results show that the two co-operators perform the maneuvering and mounting task faster than either bi- or uni-manual operators. Compared to co-operators, uni-manual operators required more control activity for the vertical crane and less for the robotic arm. In conclusion, this study suggests that when controlling two asymmetric slaves, a co-operating pair of operators performs better than a single operator.

  11. Tele-mentored damage-control and emergency trauma surgery: A feasibility study using live-tissue models.

    PubMed

    Dawe, Philip; Kirkpatrick, Andrew; Talbot, Max; Beckett, Andrew; Garraway, Naisan; Wong, Heather; Hameed, Syed Morad

    2018-05-01

    Damage-control and emergency surgical procedures in trauma have the potential to save lives. They may occasionally not be performed due to clinician inexperience or lack of comfort and knowledge. Canadian Armed Forces (CAF) non-surgeon Medical Officers (MOs) participated in a live tissue training exercise. They received tele-mentoring assistance using a secure video-conferencing application on a smartphone/tablet platform. Feasibility of tele-mentored surgery was studied by measuring their effectiveness at completing a set series of tasks in this pilot study. Additionally, their comfort and willingness to perform studied procedures was gauged using pre- and post-study surveys. With no pre-procedural teaching, participants were able to complete surgical airway, chest tube insertion and resuscitative thoracotomy with 100% effectiveness with no noted complications. Comfort level and willingness to perform these procedures were improved with tele-mentoring. Participants felt that tele-mentored surgery would benefit their performance of resuscitative thoracotomy most. The use of tele-mentored surgery to assist non-surgeon clinicians in the performance of damage-control and emergency surgical procedures is feasible. More study is required to validate its effectiveness. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. [The virtual university applied to telesurgery: from tele-education to telemanipulation].

    PubMed

    Marescaux, J; Mutter, D; Soler, L; Vix, M; Leroy, J

    1999-06-01

    The advent of new computer technologies can appear as a revolution in surgical teaching, as well as in the planing and realization of surgical procedures. The introduction of a camera into the body of a patient, allowing the visual display of the operative procedure through the use of a miniaturized camera, constitutes the greatest change that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution also predicts further changes: the development of telecommunication devices applied to medicine (tele-education, tele-training, tele-mentoring, tele-proctoring and tele-accreditation), constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of tele-presence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery at Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realization of international multi-site video conferences between surgeons. The WEBS project created the first virtual university concept by placing surgical techniques at the surgeon's disposal through the Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows the development of the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University framework, and to conceive teaching on a world-wide level, offering the practitioner unimaginable possibilities of formation, training and the planning of surgical procedures.

  13. Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery.

    PubMed

    Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

    2011-06-01

    This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information.

  14. Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery

    PubMed Central

    Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

    2013-01-01

    This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information. PMID:24398557

  15. Towards a Location-based Service for Early Mental Health Interventions in Disaster Response Using Minimalistic Tele-operated Android Robots Technology

    NASA Astrophysics Data System (ADS)

    Vahidi, H.; Mobasheri, A.; Alimardani, M.; Guan, Q.; Bakillah, M.

    2014-04-01

    Providing early mental health services during disaster is a great challenge in the disaster response phase. Lack of access to adequate mental-health professionals in the early stages of large-scale disasters dramatically influences the trend of a successful mental health aid. In this paper, a conceptual framework has been suggested for adopting cellphone-type tele-operated android robots in the early stages of disasters for providing the early mental health services for disaster survivors by developing a locationbased and participatory approach. The techniques of enabling GI-services in a Peer-to-Peer (P2P) environment were studied to overcome the limitations of current centralized services. Therefore, the aim of this research study is to add more flexibility and autonomy to GI web services (WMS, WFS, WPS, etc.) and alleviate to some degree the inherent limitations of these centralized systems. A P2P system Architecture is presented for the location-based service using minimalistic tele-operated android robots, and some key techniques of implementing this service using BestPeer were studied for developing this framework.

  16. National French survey on tele-transmission of EEG recordings: More than a simple technological challenge.

    PubMed

    Sauleau, Paul; Despatin, Jane; Cheng, Xufei; Lemesle, Martine; Touzery-de Villepin, Anne; N'Guyen The Tich, Sylvie; Kubis, Nathalie

    2016-04-01

    Assessment of current practice and the need for tele-transmission and remote interpretation of EEG in France. Transmission of EEG to a distant center could be a promising solution to the problem of decreasing availability of neurophysiologists for EEG interpretation, in order to provide equity within health care services in France. This practice should logically follow the legal framework of telemedicine and the recommendations that were recently edited by the Société de neurophysiologie clinique de langue française (SNCLF) and the Ligue française contre l'épilepsie (LCFE). A national survey was designed and performed under the auspices of the SNCLF. This survey reveals that there is an important gap between the official recommendations and the "reality on the ground". These local organizations were mainly established through the impulse of individual initiatives, rarely driven by health regulatory authorities and sometimes far from legal frameworks. For the majority, they result from a need to improve medical care, especially in pediatrics and neonatology, and to ensure continuity of care. When present, tele-transmission of EEG is often only partially satisfactory, since many technical procedures have to be improved. Conversely, the lack of tele-transmission of EEG would penalize medical care for some patients. The survey shows both the wealth of local initiatives and the fragility of most existing networks, emphasizing the need for better cooperation between regulatory authorities and health care professionals to establish or improve the transmission of EEG in France. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Towards an SEMG-based tele-operated robot for masticatory rehabilitation.

    PubMed

    Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza

    2016-08-01

    This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane. Copyright

  18. Application of advanced virtual reality and 3D computer assisted technologies in tele-3D-computer assisted surgery in rhinology.

    PubMed

    Klapan, Ivica; Vranjes, Zeljko; Prgomet, Drago; Lukinović, Juraj

    2008-03-01

    The real-time requirement means that the simulation should be able to follow the actions of the user that may be moving in the virtual environment. The computer system should also store in its memory a three-dimensional (3D) model of the virtual environment. In that case a real-time virtual reality system will update the 3D graphic visualization as the user moves, so that up-to-date visualization is always shown on the computer screen. Upon completion of the tele-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself Using intraoperative records, animated images of the real tele-procedure performed can be designed. Virtual surgery offers the possibility of preoperative planning in rhinology. The intraoperative use of computer in real time requires development of appropriate hardware and software to connect medical instrumentarium with the computer and to operate the computer by thus connected instrumentarium and sophisticated multimedia interfaces.

  19. TeleMEDiana: telesurgery and telemedicine by satellite and the Internet

    NASA Astrophysics Data System (ADS)

    Dobrosavljevic, Sneja; Welter, Roger

    2002-08-01

    The rapid development of technology and its integration into the spectrum of medical care are creating a pressing need for healthcare professionals to continuously update their knowledge and skills. In view of these needs the European Association of Visceral Surgery (AECV) which had been a platform for medical congresses in Luxembourg (1988, 1992, 1995, 1998) has developed TeleMEDiana a new broadband communication service introducing standards of excellence in Continuous Medical Education.TeleMEDiana broadcast a daily program with pedagogically enhanced video content in a number of therapeutic areas to MD's, professors and students in hospitals, universities and research centers. The educational programs are provided by leading European hospitals which have joined the TeleMEDiana Scientific Network TSN. The scientific integrity is certified by an international committee composed of recognized pioneers. Committed to deliver high resolution video streaming, TeleMEDiana has set up and successfully tested a new platform built on secure and cost-efficient satellite operator SES-ASTRA complemented by the Internet and can deliver programs to any workplace equipped with satellite dishes and high-quality set-top boxes. Telemediana offers herewith an optimal collaboration and dissemination platform to decisive players involved in Continuing Medical Education.

  20. A Business Case for Tele-Intensive Care Units

    PubMed Central

    Coustasse, Alberto; Deslich, Stacie; Bailey, Deanna; Hairston, Alesia; Paul, David

    2014-01-01

    Objectives: A tele-intensive care unit (tele-ICU) uses telemedicine in an intensive care unit (ICU) setting, applying technology to provide care to critically ill patients by off-site clinical resources. The purpose of this review was to examine the implementation, adoption, and utilization of tele-ICU systems by hospitals to determine their efficiency and efficacy as identified by cost savings and patient outcomes. Methods: This literature review examined a large number of studies of implementation of tele-ICU systems in hospitals. Results: The evidence supporting cost savings was mixed. Implementation of a tele-ICU system was associated with cost savings, shorter lengths of stay, and decreased mortality. However, two studies suggested increased hospital cost after implementation of tele-ICUs is initially expensive but eventually results in cost savings and better clinical outcomes. Conclusions: Intensivists working these systems are able to more effectively treat ICU patients, providing better clinical outcomes for patients at lower costs compared with hospitals without a tele-ICU. PMID:25662529

  1. How does tele-learning compare with other forms of education delivery? A systematic review of tele-learning educational outcomes for health professionals.

    PubMed

    Tomlinson, Jo; Shaw, Tim; Munro, Ana; Johnson, Ros; Madden, D Lynne; Phillips, Rosemary; McGregor, Deborah

    2013-11-01

    Telecommuniciation technologies, including audio and videoconferencing facilities, afford geographically dispersed health professionals the opportunity to connect and collaborate with others. Recognised for enabling tele-consultations and tele-collaborations between teams of health care professionals and their patients, these technologies are also well suited to the delivery of distance learning programs, known as tele-learning. To determine whether tele-learning delivery methods achieve equivalent learning outcomes when compared with traditional face-to-face education delivery methods. A systematic literature review was commissioned by the NSW Ministry of Health to identify results relevant to programs applying tele-learning delivery methods in the provision of education to health professionals. The review found few studies that rigorously compared tele-learning with traditional formats. There was some evidence, however, to support the premise that tele-learning models achieve comparable learning outcomes and that participants are generally satisfied with and accepting of this delivery method. The review illustrated that tele-learning technologies not only enable distance learning opportunities, but achieve comparable learning outcomes to traditional face-to-face models. More rigorous evidence is required to strengthen these findings and should be the focus of future tele-learning research.

  2. A software communication tool for the tele-ICU.

    PubMed

    Pimintel, Denise M; Wei, Shang Heng; Odor, Alberto

    2013-01-01

    The Tele Intensive Care Unit (tele-ICU) supports a high volume, high acuity population of patients. There is a high-volume of incoming and outgoing calls, especially during the evening and night hours, through the tele-ICU hubs. The tele-ICU clinicians must be able to communicate effectively to team members in order to support the care of complex and critically ill patients while supporting and maintaining a standard to improve time to intervention. This study describes a software communication tool that will improve the time to intervention, over the paper-driven communication format presently used in the tele-ICU. The software provides a multi-relational database of message instances to mine information for evaluation and quality improvement for all entities that touch the tele-ICU. The software design incorporates years of critical care and software design experience combined with new skills acquired in an applied Health Informatics program. This software tool will function in the tele-ICU environment and perform as a front-end application that gathers, routes, and displays internal communication messages for intervention by priority and provider.

  3. Prognostic value of serial six-minute walk tests using tele-accelerometry in patients with chronic heart failure: A pre-specified sub-study of the TIM-HF-Trial.

    PubMed

    Prescher, Sandra; Schoebel, Christoph; Koehler, Kerstin; Deckwart, Oliver; Wellge, Brunhilde; Honold, Marcus; Hartmann, Oliver; Winkler, Sebastian; Koehler, Friedrich

    2016-10-01

    The six-minute walk test (6MWT) is an established functional test assessing exercise capacity and is used to predict clinical prognosis in patients with chronic heart failure (HF). Tele-accelerometry is a novel approach to activity monitoring using telemedical data transfer and allows a Tele-6MWT to be performed in an outpatient setting. It offers patients the option of performing simple serial follow-up tests in their own home. The aim of this study was to investigate the prognostic value of serial Tele-6MWTs using tele-accelerometry in patients with HF. In this proof-of-concept study, 155 patients with HF completed the Tele-6MWT in an outdoor setting once per month over a period of 0.25-21 months. We analysed the differences in the number of steps over time to predict hospitalization as a result of HF or death. Patients with at least one event (n = 31) recorded a lower number of steps and a shorter distance in Tele-6MWT at baseline compared with patients who remained event-free (n = 124) (540.1 ± 78.4 steps vs. 601.8 ± 76.7 steps, P < 0.001 respectively; 353.2 ± 82.4 m vs. 418.8 ± 95.6 m, P < 0.001). Patients (n = 19) who performed more than one Tele-6MWT prior to a clinical event showed no significant difference in the number of steps, regardless of whether the baseline test was compared with the last Tele-6MWT before the event or with the last two tests before the event. Tele-6MWT has a high predictive value with respect to hospitalization as a result of HF or death from any cause and the results were comparable with the prognostic impact of a conventional 6MWT. Therefore Tele-6MWT may be used as alternative test method in the home environment. However, there is no added prognostic value of repeating Tele-6MWTs on a monthly basis. © The European Society of Cardiology 2016.

  4. A virtual reality-based method of decreasing transmission time of visual feedback for a tele-operative robotic catheter operating system.

    PubMed

    Guo, Jin; Guo, Shuxiang; Tamiya, Takashi; Hirata, Hideyuki; Ishihara, Hidenori

    2016-03-01

    An Internet-based tele-operative robotic catheter operating system was designed for vascular interventional surgery, to afford unskilled surgeons the opportunity to learn basic catheter/guidewire skills, while allowing experienced physicians to perform surgeries cooperatively. Remote surgical procedures, limited by variable transmission times for visual feedback, have been associated with deterioration in operability and vascular wall damage during surgery. At the patient's location, the catheter shape/position was detected in real time and converted into three-dimensional coordinates in a world coordinate system. At the operation location, the catheter shape was reconstructed in a virtual-reality environment, based on the coordinates received. The data volume reduction significantly reduced visual feedback transmission times. Remote transmission experiments, conducted over inter-country distances, demonstrated the improved performance of the proposed prototype. The maximum error for the catheter shape reconstruction was 0.93 mm and the transmission time was reduced considerably. The results were positive and demonstrate the feasibility of remote surgery using conventional network infrastructures. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Tele-periodontics - Oral health care at a grass root level.

    PubMed

    Avula, Haritha

    2015-01-01

    A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper.

  6. Tele-periodontics - Oral health care at a grass root level

    PubMed Central

    Avula, Haritha

    2015-01-01

    A new concept of tele-periodontics, which merges the innovative technology of telecommunications and the field of periodontics, is proposed. This new field of tele-periodontics will have an infinite potential where access to a specialist will be provided at a grass root level, enhancing effective delivery of therapy and information to the rural and under privileged areas. It would allow the specialist and the patient to interact either by video conferencing (real time) or through supportive information (store and forward) over geographic distances. Different probabilities of tele-periodontics such as tele consultation, tele training, tele education and tele support are also discussed in this paper. PMID:26644730

  7. Virtual collaboration, satisfaction, and trust between nurses in the tele-ICU and ICUs: Results of a multilevel analysis.

    PubMed

    Hoonakker, Peter L T; Pecanac, Kristen E; Brown, Roger L; Carayon, Pascale

    2017-02-01

    The purpose of the study was to examine how tele-intensive care unit (tele-ICU) nurse characteristics and organizational characteristics influence tele-ICU nurses' trust and satisfaction of monitored bedside ICU nurses, and whether these influences are mediated by communication. Data of tele-ICU characteristics and characteristics of the ICUs they monitored were collected at 5 tele-ICUs located throughout the country. One hundred ten tele-ICU nurses at those tele-ICUs completed a questionnaire containing items related to their characteristics and their trust, satisfaction, and perceived communication with monitored bedside nurses. We analyzed the data using a hierarchical path model, with communication variables entered as mediators. Many of the tele-ICU nurse characteristics (age, currently or previously worked at the monitored ICU, hours worked per week, and years as a ICU nurse) had statistically significant direct effects on perception of communication timeliness, accuracy, and openness, as well as trust and satisfaction with monitored bedside ICU nurses. Communication openness mediated the relationships of both working at a monitored ICU and being older (≥55) on satisfaction. Communication accuracy mediated the relationships of both a specialized monitored ICU and working at a monitored ICU on trust. Tele-ICUs and monitored ICUs should work to optimize communication so that trust can be established among the nurses. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Current Directions in Videoconferencing Tele-Mental Health Research

    PubMed Central

    Richardson, Lisa K.; Frueh, B. Christopher; Grubaugh, Anouk L.; Egede, Leonard; Elhai, Jon D.

    2009-01-01

    The provision of mental health services via videoconferencing tele-mental health has become an increasingly routine component of mental health service delivery throughout the world. Emphasizing the research literature since 2003, we examine: 1) the extent to which the field of tele-mental health has advanced the research agenda previously suggested; and 2) implications for tele-mental health care delivery for special clinical populations. Previous findings have demonstrated that tele-mental health services are satisfactory to patients, improve outcomes, and are probably cost effective. In the very small number of randomized controlled studies that have been conducted to date, tele-mental health has demonstrated equivalent efficacy compared to face-to-face care in a variety of clinical settings and with specific patient populations. However, methodologically flawed or limited research studies are the norm, and thus the research agenda for tele-mental health has not been fully maximized. Implications for future research and practice are discussed. PMID:20161010

  9. Integrity mechanism for eHealth tele-monitoring system in smart home environment.

    PubMed

    Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

    2009-01-01

    During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

  10. Staff Acceptance of Tele-ICU Coverage

    PubMed Central

    Chan, Paul S.; Cram, Peter

    2011-01-01

    Background: Remote coverage of ICUs is increasing, but staff acceptance of this new technology is incompletely characterized. We conducted a systematic review to summarize existing research on acceptance of tele-ICU coverage among ICU staff. Methods: We searched for published articles pertaining to critical care telemedicine systems (aka, tele-ICU) between January 1950 and March 2010 using PubMed, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Library and abstracts and presentations delivered at national conferences. Studies were included if they provided original qualitative or quantitative data on staff perceptions of tele-ICU coverage. Studies were imported into content analysis software and coded by tele-ICU configuration, methodology, participants, and findings (eg, positive and negative staff evaluations). Results: Review of 3,086 citations yielded 23 eligible studies. Findings were grouped into four categories of staff evaluation: overall acceptance level of tele-ICU coverage (measured in 70% of studies), impact on patient care (measured in 96%), impact on staff (measured in 100%), and organizational impact (measured in 48%). Overall acceptance was high, despite initial ambivalence. Favorable impact on patient care was perceived by > 82% of participants. Staff impact referenced enhanced collaboration, autonomy, and training, although scrutiny, malfunctions, and contradictory advice were cited as potential barriers. Staff perceived the organizational impact to vary. An important limitation of available studies was a lack of rigorous methodology and validated survey instruments in many studies. Conclusions: Initial reports suggest high levels of staff acceptance of tele-ICU coverage, but more rigorous methodologic study is required. PMID:21051386

  11. A Systems Approach to Planning a Tele-Education System.

    ERIC Educational Resources Information Center

    Vazquez-Abad, Jesus; Mitchell, P. David

    1983-01-01

    Presents a systems analysis for transforming an educational system operating under a conventional scheme into a tele-education system. Particular attention is paid to developing and analyzing a preferred media mix and to the use of models and simulations as part of conducting a systems analysis. (Author)

  12. Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

    PubMed

    Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

    2017-01-01

    Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

  13. Effect of tele-emergency services on recruitment and retention of US rural physicians.

    PubMed

    Potter, Andrew J; Mueller, Keith J; Mackinney, A Clinton; Ward, Marcia M

    2014-01-01

    As competition for physicians intensifies in the USA, rural areas are at a disadvantage due to challenges unique to rural medical practice. Telemedicine improves access to care not otherwise available in rural settings. Previous studies have found that telemedicine also has positive effects on the work environment, suggesting that telemedicine may improve rural physician recruitment and retention, although few have specifically examined this. Using a mixed-method approach, clients of a single telemedicine service in the Upper Midwestern USA were surveyed and interviewed about their views of the impact of tele-emergency on physician recruitment and retention and the work environment. Surveys were completed by 292 clinical and administrative staff at 71 hospitals and semi-structured interviews were conducted with clinicians and administrators at 16 hospitals. Survey respondents agreed that tele-emergency had a positive effect on physician recruitment and retention and related workplace factors. Interviewees elucidated how the presence of tele-emergency played an important role in enhancing physician confidence, providing educational opportunities, easing burden, and supplementing care, workplace factors that interviewees believed would impact recruitment and retention. However, gains were limited by hospitals' interpretation of the Emergency Medical Treatment and Labor Act as requiring on-site physician coverage even if tele-emergency was used. Results indicate that, all other factors being equal, tele-emergency increases the likelihood of physicians entering and remaining in rural practice. New regulatory guidance by the Centers for Medicare and Medicaid Services related to on-site physician coverage will likely accelerate implementation of tele-emergency services in rural hospitals. Telemedicine may prove to be an increasingly valuable recruitment and retention tool for rural hospitals as competition for physicians intensifies.

  14. Australian national networked tele-test facility for integrated systems

    NASA Astrophysics Data System (ADS)

    Eshraghian, Kamran; Lachowicz, Stefan W.; Eshraghian, Sholeh

    2001-11-01

    The Australian Commonwealth government recently announced a grant of 4.75 million as part of a 13.5 million program to establish a world class networked IC tele-test facility in Australia. The facility will be based on a state-of-the-art semiconductor tester located at Edith Cowan University in Perth that will operate as a virtual centre spanning Australia. Satellite nodes will be located at the University of Western Australia, Griffith University, Macquarie University, Victoria University and the University of Adelaide. The facility will provide vital equipment to take Australia to the frontier of critically important and expanding fields in microelectronics research and development. The tele-test network will provide state of the art environment for the electronics and microelectronics research and the industry community around Australia to test and prototype Very Large Scale Integrated (VLSI) circuits and other System On a Chip (SOC) devices, prior to moving to the manufacturing stage. Such testing is absolutely essential to ensure that the device performs to specification. This paper presents the current context in which the testing facility is being established, the methodologies behind the integration of design and test strategies and the target shape of the tele-testing Facility.

  15. Development and Implementation of Tele-Savvy for Dementia Caregivers: A Department of Veterans Affairs Clinical Demonstration Project.

    PubMed

    Griffiths, Patricia C; Whitney, M Kate; Kovaleva, Mariya; Hepburn, Kenneth

    2016-02-01

    To test fidelity and preliminary efficacy of Tele-Savvy, an internet-based version of the in-person, evidence-based psychoeducation Savvy Caregiver Program (SCP) for dementia caregivers. Tele-Savvy used synchronous (tele-conferences) and asynchronous components (video modules) to provide program access to caregivers in their homes. SCP experts were surveyed to evaluate Tele-Savvy's fidelity to SCP. A convenience sample of 30 dementia caregivers from the Atlanta VA Medical Center enrolled in the Tele-Savvy clinical demonstration program. Twenty-two caregivers completed both pre- and postprogram evaluations, which included measures of caregiver stress and competence and behavioral and psychological symptoms of dementia (BPSD). Expert review confirmed Tele-Savvy's fidelity with and, in certain domains, improvement on the original. Participants demonstrated moderately high initial levels of burden, anxiety, and depressive symptoms all of which decreased significantly postprogram in an intention to treat analysis. Similar reductions were seen in care recipients' BPSD and caregivers' reactions to them. Marginally significant increases in caregiver competence were observed. Caregiver and expert panel evaluations of program quality were enthusiastic. An effective online caregiver psychoeducation program could provide greatly expanded access for caregivers who cannot attend in person for reasons of distance, transportation limitations, and caregiving responsibilities. Further testing in a controlled trial is needed to establish program efficacy. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  16. Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health

    PubMed Central

    da SILVA, Andressa Sharllene Carneiro; RIZZANTE, Fabio Antonio Piola; PICOLINI, Mirela Machado; de CAMPOS, Karis; CORRÊA, Camila de Castro; FRANCO, Elen Caroline; PARDO-FANTON, Cássia de Souza; BLASCA, Wanderléia Quinhoneiro; BERRETIN-FELIX, Giédre

    2011-01-01

    Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. Objective The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. Material and Methods The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. Results In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. Conclusions The results showed that the TLFOB-USP members, adjoining

  17. Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health.

    PubMed

    Silva, Andressa Sharllene Carneiro da; Rizzante, Fabio Antonio Piola; Picolini, Mirela Machado; Campos, Karis de; Corrêa, Camila de Castro; Franco, Elen Caroline; Pardo-Fanton, Cássia de Souza; Blasca, Wanderléia Quinhoneiro; Berretin-Felix, Giédre

    2011-01-01

    Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. The results showed that the TLFOB-USP members, adjoining to the professor's participants, develop projects

  18. EMR-based TeleGeriatric system.

    PubMed

    Pallawala, P M; Lun, K C

    2001-01-01

    As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socio-economic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. The TeleGeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes once a week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in the geriatric care will also benefit from this system. Integrated electronic medical record (EMR) system will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. The TeleGeriatric web based server is developed using Java Technology. The TeleGeriatric database server was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care have been chosen for the project. These 3 institutions and National University of Singapore are connected via ADSL protocol. ADSL connection supports high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation a nurse or a doctor in the remote site sends the patient's record to the TeleGeriatric server. The TeleGeriatric server forwards the request

  19. NASA's Space Launch System: Positioning Assets for Tele-Robotic Operations

    NASA Technical Reports Server (NTRS)

    May, Todd A.; Creech, Stephen D.; Robinson, Kimberly F.

    2013-01-01

    The National Aeronautics and Space Administration (NASA) is designing and developing America's most capable launch vehicle to support high-priority human and scientific exploration beyond Earth's orbit. The Space Launch System (SLS) will initially lift 70 metric tons (t) on its first flights, slated to begin in 2017, and will be evolved after 2021 to a full 130-t capability-larger than the Saturn V Moon rocket. This superior lift and associated volume capacity will support game-changing exploration in regions that were previously unattainable, being too costly and risky to reach. On the International Space Station, astronauts are training for long-duration missions to asteroids and cis-martian regions, but have not had transportation out of Earth's orbit - until now. Simultaneously, productive rovers are sending scientists - and space fans - unprecedented information about the composition and history of Mars, the planet thought to be most like Earth. This combination of experience and information is laying the foundation for future missions, such as those outlined in NASA's "Mars Next Decade" report, that will rely on te1e-robotic operations to take exploration to the next level. Within this paradigm, NASA's Space Launch System stands ready to manifest the unique payloads that will be required for mission success. Ultimately, the ability to position assets - ranging from orbiters, to landers, to communication satellites and surface systems - is a critical step in broadening the reach of technological innovation that will benefit all Earth's people as the Space Age unfolds. This briefing will provide an overview of how the Space Launch System will support delivery of elements for tele-robotic operations at destinations such as the Moon and Mars, which will synchronize the human-machine interface to deliver hybrid on-orbit capabilities. Ultimately, telerobotic operations will open entirely new vistas and the doors of discovery. NASA's Space Launch System will be a

  20. TeleFood: a worldwide appeal.

    PubMed

    1997-12-01

    In 1997, the UN Food and Agriculture Organization (FAO) broadcast its first global television program on the theme of "Food for All" to an audience of approximately 450 million viewers. The objective of "TeleFood" was to raise awareness of the scale of the problem and to encourage solidarity in the fight against hunger. TeleFood raised funds to support the FAO's Special Programme for Food Security (SPFS) and similar grassroots projects that target rural people in developing countries. The SPFS project, now operational in 19 countries and being formulated in 32 more, emphasizes national ownership, farmer participation, environmental awareness, and recognition of the role of women in food production and marketing. The 3-year SPFS pilot phase involves 1) small-scale water harvesting, irrigation, and drainage; 2) sustainable intensification of crop production; 3) diversification of production; and 4) removal of policies that impede food security. Results to date include 1) greatly increased maize and potato yields in Bolivia and more modest increases in Nepal; 2) doubled yields of maize and rice in Tanzania; and 3) expansion of the area under low-cost irrigation in Zambia. South-South cooperation is allowing some developing countries to benefit from experience gained in other developing countries. The pilot activities are being funded with an increasing number of "soft" loans from governments and financial institutions.

  1. Radiological tele-immersion for next generation networks.

    PubMed

    Ai, Z; Dech, F; Rasmussen, M; Silverstein, J C

    2000-01-01

    Since the acquisition of high-resolution three-dimensional patient images has become widespread, medical volumetric datasets (CT or MR) larger than 100 MB and encompassing more than 250 slices are common. It is important to make this patient-specific data quickly available and usable to many specialists at different geographical sites. Web-based systems have been developed to provide volume or surface rendering of medical data over networks with low fidelity, but these cannot adequately handle stereoscopic visualization or huge datasets. State-of-the-art virtual reality techniques and high speed networks have made it possible to create an environment for clinicians geographically distributed to immersively share these massive datasets in real-time. An object-oriented method for instantaneously importing medical volumetric data into Tele-Immersive environments has been developed at the Virtual Reality in Medicine Laboratory (VRMedLab) at the University of Illinois at Chicago (UIC). This networked-VR setup is based on LIMBO, an application framework or template that provides the basic capabilities of Tele-Immersion. We have developed a modular general purpose Tele-Immersion program that automatically combines 3D medical data with the methods for handling the data. For this purpose a DICOM loader for IRIS Performer has been developed. The loader was designed for SGI machines as a shared object, which is executed at LIMBO's runtime. The loader loads not only the selected DICOM dataset, but also methods for rendering, handling, and interacting with the data, bringing networked, real-time, stereoscopic interaction with radiological data to reality. Collaborative, interactive methods currently implemented in the loader include cutting planes and windowing. The Tele-Immersive environment has been tested on the UIC campus over an ATM network. We tested the environment with 3 nodes; one ImmersaDesk at the VRMedLab, one CAVE at the Electronic Visualization Laboratory (EVL) on

  2. Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: A quasi-experimental study in Iran.

    PubMed

    Bikmoradi, Ali; Masmouei, Behnam; Ghomeisi, Mohammad; Roshanaei, Ghodratollah

    2016-02-01

    Coronary artery bypass graft is a major surgery and has complications that require professional and long term follow-up and nursing care that if do not properly handled, could reduce the quality of life and increase post-operative complications. On the other hand Tele-nursing is a cost-effective way to educate and follow-up of patients. This study aimed to assess the impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft. A quasi-experimental study was carried out at Ekbatan Therapeutic and Educational Center of Hamadan University of Medical Sciences at Hamadan, Iran, in 2013. In this study, 71 patients who had undergone coronary artery bypass graft surgery and had inclusion criteria were randomly divided into two experimental group (n=36), and control group (n=35). They completed questionnaire before discharging from Therapeutic and Educational Center. In the experimental group on days 2, 4, 7, second week (day 11), third week (day 18) and fourth week (day 25) after discharge, follow-up interventions and nursing education with Tele-nursing was done, but in the in the control groups, patients received only routine interventions. After completion of the intervention period, both groups completed the questionnaire and the results were compared. Adherence of treatment plan in both groups did not have significant difference before intervention (P=0.696), but had a significant difference with regard to baseline after intervention in aromatherapy group (P< 0.01) and with control group after intervention (P<0.01). Adherence to treatment plan in the aromatherapy group was better in compared to control group (P<0.01). Tele-nursing is a convenient way, cost effective training and follow-up care for patients after coronary artery bypass surgery, which can improve patients' adherence to treatment plan in developing countries such as Iran. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Tele-auscultation support system with mixed reality navigation.

    PubMed

    Hori, Kenta; Uchida, Yusuke; Kan, Tsukasa; Minami, Maya; Naito, Chisako; Kuroda, Tomohiro; Takahashi, Hideya; Ando, Masahiko; Kawamura, Takashi; Kume, Naoto; Okamoto, Kazuya; Takemura, Tadamasa; Yoshihara, Hiroyuki

    2013-01-01

    The aim of this research is to develop an information support system for tele-auscultation. In auscultation, a doctor requires to understand condition of applying a stethoscope, in addition to auscultatory sounds. The proposed system includes intuitive navigation system of stethoscope operation, in addition to conventional audio streaming system of auscultatory sounds and conventional video conferencing system for telecommunication. Mixed reality technology is applied for intuitive navigation of the stethoscope. Information, such as position, contact condition and breath, is overlaid on a view of the patient's chest. The contact condition of the stethoscope is measured by e-textile contact sensors. The breath is measured by a band type breath sensor. In a simulated tele-auscultation experiment, the stethoscope with the contact sensors and the breath sensor were evaluated. The results show that the presentation of the contact condition was not understandable enough for navigating the stethoscope handling. The time series of the breath phases was usable for the remote doctor to understand the breath condition of the patient.

  4. Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

    PubMed

    Akiyama, Miki; Abraham, Chon

    2017-08-01

    Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non

  5. [Tele-medicine system for high-risk asthmatic patients].

    PubMed

    Kokubu, F; Suzuki, H; Sano, Y; Kihara, N; Adachi, M

    1999-07-01

    We have developed a tele-medicine system to monitor the airway status at home for patients with poorly controlled asthma, whereby a nurse provides instructions to individuals via the telephone to help them manage exacerbation under the supervision of their physicians. We examined the effectiveness of this system with a randomized control study. Patients with high hospitalization risk were enrolled in the study by screening patients for those with multiple previous emergency room visits and randomly assigned to either the tele-medicine or control group. After six months of participation in the program, the number of emergency room visits decreased significantly and the activities of daily living were improved in the tele-medicine group. Most of the patients in the tele-medicine group were able to continue measuring and transmitting peak expiratory flow (PEF) value successfully, and at six months had noticed an improvement in PEF. We therefore conclude that the system effectively contributes to the management of poorly controlled asthma. In addition, further consideration suggests that the reduction of emergency room visits may lead to reduction in hospitalization since we found a good correlation between number of emergency room visits and hospitalization from the studies published previously.

  6. Virtual rapid response: the next evolution of tele-ICU.

    PubMed

    Hawkins, Carrie L

    2012-01-01

    The first of its kind in the Veterans Affairs (VA) system, the Denver VA Medical Center's tele-intensive care unit (ICU) program is unique because it is entirely nurse driven. A nontraditional tele-ICU model, the program was tailored to meet the needs of rural veterans by using critical care nursing expertise in Denver, Colorado. An experienced CCRN-certified nurse manages the system 24 hours a day, 7 days a week, from Eastern Colorado Health Care System. The virtual ICU provides rapid response interventions through virtual technology. This tele-ICU technology allows for a "virtual handshake" by nursing staff at the start of the shift and a report on potential patient issues. Clinical relationships have been strengthened between all 5 VA facilities in the Rocky Mountain Region, increasing the likelihood of early consultation at the onset of clinical decline of a patient. In addition, the tele-ICU nurse is available for immediate nursing consultation and support, coordinates point-to-point virtual consultation between physicians at the rural sites and specialists in Denver, and assists in expediting critical care transfers. The primary objectives for the tele-ICU program include improving quality and access of care to critical care services in rural sites, reducing community fee basis costs and frequency of transfers, and increasing collaboration and collegiality among nursing and medical staff in all Region 19's medical centers.

  7. Real-time 3D video compression for tele-immersive environments

    NASA Astrophysics Data System (ADS)

    Yang, Zhenyu; Cui, Yi; Anwar, Zahid; Bocchino, Robert; Kiyanclar, Nadir; Nahrstedt, Klara; Campbell, Roy H.; Yurcik, William

    2006-01-01

    Tele-immersive systems can improve productivity and aid communication by allowing distributed parties to exchange information via a shared immersive experience. The TEEVE research project at the University of Illinois at Urbana-Champaign and the University of California at Berkeley seeks to foster the development and use of tele-immersive environments by a holistic integration of existing components that capture, transmit, and render three-dimensional (3D) scenes in real time to convey a sense of immersive space. However, the transmission of 3D video poses significant challenges. First, it is bandwidth-intensive, as it requires the transmission of multiple large-volume 3D video streams. Second, existing schemes for 2D color video compression such as MPEG, JPEG, and H.263 cannot be applied directly because the 3D video data contains depth as well as color information. Our goal is to explore from a different angle of the 3D compression space with factors including complexity, compression ratio, quality, and real-time performance. To investigate these trade-offs, we present and evaluate two simple 3D compression schemes. For the first scheme, we use color reduction to compress the color information, which we then compress along with the depth information using zlib. For the second scheme, we use motion JPEG to compress the color information and run-length encoding followed by Huffman coding to compress the depth information. We apply both schemes to 3D videos captured from a real tele-immersive environment. Our experimental results show that: (1) the compressed data preserves enough information to communicate the 3D images effectively (min. PSNR > 40) and (2) even without inter-frame motion estimation, very high compression ratios (avg. > 15) are achievable at speeds sufficient to allow real-time communication (avg. ~ 13 ms per 3D video frame).

  8. Measuring tele-ICU impact: does it optimize quality outcomes for the critically ill patient?

    PubMed

    Goran, Susan F

    2012-04-01

    To determine the relationship between tele-ICU (intensive care unit) implementations and improvement in quality measures and patient outcomes. Tele-ICUs were designed to leverage scarce critical-care experts and promised to improve patient quality. Abstracts and peer-reviewed articles were reviewed to identify the associations between tele-ICU programmes and clinical outcomes, cost savings, and customer satisfaction. Few peer-reviewed studies are available and many variables in each study limit the ability to associate study conclusions to the overall tele-ICU programme. Further research is required to explore the impact of the tele-ICU on patient/family satisfaction. Research findings are highly dependent upon the level of ICU acceptance. The tele-ICU, in collaboration with the ICU team, can be a valuable tool for the enhancement of quality goals although the ability to demonstrate cost savings is extremely complex. Studies clearly indicate that tele-ICU nursing vigilance can enhance patient safety by preventing potential patient harm. Nursing managers and leaders play a vital part in optimizing the quality role of the tele-ICU through supportive modelling and the maximization of ICU integration. © 2012 Blackwell Publishing Ltd.

  9. The TERESA project: from space research to ground tele-echography

    NASA Technical Reports Server (NTRS)

    Vieyres, Pierre; Poisson, Gerard; Courreges, Fabien; Merigeaux, Olivier; Arbeille, Philippe

    2003-01-01

    Ultrasound examinations represent one of the major diagnostic modalities of future healthcare. They are currently used to support medical space research but require a high skilled operator for both probe positioning on the patient's skin and image interpretation. TERESA is a tele-echography project that proposes a solution to bring astronauts and remotely located patients on ground quality ultrasound examinations despite the lack of a specialist at the location of the wanted medical act.

  10. Parents' perceptions of tele-audiological testing in a rural hearing screening program in South India.

    PubMed

    Ramkumar, Vidya; Selvakumar, K; Vanaja, C S; Hall, James W; Nagarajan, Roopa; Neethi, J

    2016-10-01

    Tele-diagnostic audiological testing in a hearing screening program for infants and young children is a novel practice, and this study is the first to explore its application in a rural community. It is important to understand parental perceptions and confidence when introducing a new process such as tele-audiological diagnostic testing in rural areas. A questionnaire with 17 rater-administered items was designed to elicit comments concerning the quality of tele-hearing testing and video-conferencing, access to tele-hearing testing, and parents' attitudes regarding tele-hearing testing in the village. The questionnaire was administered by an audiologist not involved in tele-diagnostic testing to avoid bias. Parents perceived tele-hearing testing as equal in quality to in-person testing. Technical factors such as good video-conferencing quality and logistical factors such as ease of access due to reasonable travel time to testing facility could have influenced these perceptions. While these results show tele-hearing testing is an acceptable alternative, occasional poor signal quality should be addressed prior to large-scale implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Arizona TeleMedicine Project.

    ERIC Educational Resources Information Center

    Arizona Univ., Tucson. Coll. of Medicine.

    Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

  12. The robot and the satellite for tele-operating echographic examination in Earth isolated sites, or onboard ISS.

    PubMed

    Arbeille, Ph; Ruiz, J; Ayoub, J; Vieyres, P; Porcher, M; Boulay, J; Moreau, V; Poisson, G

    2004-07-01

    The objective was to design and validate a method for tele-operating (from an expert site) an echographic examination in an isolated site. The isolated places, defined as areas with reduced medical facilities, could be secondary hospitals 20 to 50 km from the university hospital, or dispensaries in Africa or Amazonia, or a moving structure like a rescue vehicle or the International Space Station (ISS). At the expert center, the ultrasound medical expert moves a fictive probe, connected to a computer (n degrees 1) which sends, the coordinate changes of this probe via an ISDN or satellite line to a second computer (n degrees 2), located at the isolated site, which applies them to the robotic arm holding the real echographic probe. The system was tested at Tours Hospital on 105 patients. A complete investigation (visualization) of all the organs requested for different clinical cases was obtained in 76% of the cases with the robot, and 87% at the reference echography: In 11% of the cases, at least one of the organ visualized at reference echo could not be investigated by the robot, thus the diagnostic was not done. The number of repositioning was higher for the robot (6.5 +/- 2) than for the reference echo (5.1 +/- 2 = or > 24% more with robot). The duration of the examination was higher with the robot (16 +/- 10 min) than for the reference echography (11 +/- 4 min = or > +43% with the robot compare to reference echography. The system was also tested successfully using satellite links in a limited number of cases (approx 30).

  13. Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial: protocol of a randomized clinical trial on tele-rehabilitation for stroke patients.

    PubMed

    Koh, Gerald Choon-Huat; Yen, Shih Cheng; Tay, Arthur; Cheong, Angela; Ng, Yee Sien; De Silva, Deidre Anne; Png, Carolina; Caves, Kevin; Koh, Karen; Kumar, Yogaprakash; Phan, Shi Wen; Tai, Bee Choo; Chen, Cynthia; Chew, Effie; Chao, Zhaojin; Chua, Chun En; Koh, Yen Sin; Hoenig, Helen

    2015-09-05

    Most acute stroke patients with disabilities do not receive recommended rehabilitation following discharge to the community. Functional and social barriers are common reasons for non-adherence to post-discharge rehabilitation. Home rehabilitation is an alternative to centre-based rehabilitation but is costlier. Tele-rehabilitation is a possible solution, allowing for remote supervision of rehabilitation and eliminating access barriers. The objective of the Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial is to determine if a novel tele-rehabilitation intervention for the first three months after stroke admission improves functional recovery compared to usual care. This is a single blind (evaluator blinded), parallel, two-arm randomised controlled trial study design involving 100 recent stroke patients. The inclusion criteria are age ≥40 years, having caregiver support and recent stroke defined as stroke diagnosis within 4 weeks. Consenting participants will be randomized with varying block size of 4 or 6 assuming a 1:1 treatment allocation with the participating centre as the stratification factor. The baseline assessment will be done within 4 weeks of stroke onset, followed by follow-up assessments at 3 and 6 months. The tele-rehabilitation intervention lasts for 3 months and includes exercise 5-days-a-week using an iPad-based system that allows recording of daily exercise with video and sensor data and weekly video-conferencing with tele-therapists after data review. Those allocated to the control group will receive usual care. The primary outcome measure is improvement in life task's social activity participation at three months as measured by the disability component of the Jette Late Life Functional and Disability Instrument (LLFDI). Secondary outcome variables consist of gait speed (Timed 5-Meter Walk Test) and endurance (Two-Minute Walk test), performance of basic activities of daily living (Shah-modified Barthel Index), balance

  14. Barriers and Facilitators for Sustainability of Tele-Homecare Programs: A Systematic Review.

    PubMed

    Radhakrishnan, Kavita; Xie, Bo; Berkley, Amy; Kim, Miyong

    2016-02-01

    To identify the barriers and facilitators for sustainability of tele-homecare programs implemented by home health nursing agencies for chronic disease management. English-language articles on home telehealth in the CINAHL, PubMed/MEDLINE, PsychInfo, Web of Science, and Cochrane Reviews databases published from January 1996 to December 2013. We performed a systematic literature review. Data extraction using PRISMA guidelines and quality appraisal using the Mixed Methods Appraisal Tool (MMAT) were conducted on relevant empirical studies. Thematic analysis across the studies and narrative summaries were used to synthesize the findings from the included studies. Of the initial 3,920 citations, we identified 16 articles of moderate quality meeting our inclusion criteria. Perceptions on effectiveness of tele-homecare programs for achieving intended outcomes; tailoring of tele-homecare programs to patient characteristics and needs; relationship and communication between patient, nurse, and other health care professional users of tele-homecare; home health organizational process and culture; and technology quality, capability, and usability impacted the sustainability of tele-homecare programs. The findings of this systematic review provide implications for sustained usage of tele-homecare programs by home health nursing agencies and can help such programs realize their potential for chronic disease management. © Health Research and Educational Trust.

  15. Tele-ICU and Patient Safety Considerations.

    PubMed

    Hassan, Erkan

    The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians. With improved communication and frequent review of patients between the tele-ICU and the bedside clinicians, the bedside clinician can provide the care that only they can provide. Although technology continues to evolve at a rapid pace, technology alone will most likely not improve clinical outcomes. Technology will enable us to process real or near real-time data into complex and powerful predictive algorithms. However, the remote and bedside teams must work collaboratively to develop care processes to better monitor, prioritize, standardize, and expedite care to drive greater efficiencies and improve patient safety.

  16. An Operationally Simple Sonogashira Reaction for an Undergraduate Organic Chemistry Laboratory Class

    ERIC Educational Resources Information Center

    Cranwell, Philippa B.; Peterson, Alexander M.; Littlefield, Benjamin T. R.; Russell, Andrew T.

    2015-01-01

    An operationally simple, reliable, and cheap Sonogashira reaction suitable for an undergraduate laboratory class that can be completed within a day-long (8 h) laboratory session has been developed. Cross-coupling is carried out between 2-methyl-3-butyn-2-ol and various aryl iodides using catalytic amounts of bis(triphenylphosphine)palladium(II)…

  17. Tele-education as method of medical education.

    PubMed

    Masic, Izet; Pandza, Haris; Kulasin, Igor; Masic, Zlatan; Valjevac, Salih

    2009-01-01

    Development of computer networks and introduction and application of new technologies in all aspects of human activity needs to be followed by universities in their transformation on how to approach scientific, research, and education teaching curricula. Development and increased use of distance learning (DL) over the past decade have clearly shown the potential and efficiency of information technology applied in education. Use of information technology in medical education is where medical informatics takes its place as important scientific discipline which ensures benefit from IT in teaching and learning process involved. Definition of telemedicine as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (eHealth), telematics, but also tele-education. Web based medical education today is offered in different forms--from online lectures, online exams, web based continuous education programs, use of electronic libraries, online medical and scientific databases etc. Department of Medical Informatics of Medical Faculty of University of Sarajevo has taken many steps to introduce distance learning in medical curricula--from organising professional--scientific events (congresses, workshop etc), organizing first tele-exam at the faculty and among first at the university, to offering online lectures and online education material at the Department's website (www.unsa-medinfo.org). Distance learning in medical education, as well as telemedicine, significantly influence health care in general and are shaping the future model of medical practice. Basic computer and networks skills must be a part of all future medical curricula. The impact of technical equipment on patient-doctor relationship must be taken into account, and doctors have to be trained and prepared for diagnosing or consulting patients by use of IT. Telemedicine requires special approach in certain medical fields--tele-consultation, tele

  18. Tele-care robot for assisting independent senior citizens who live at home.

    PubMed

    Katz, Reuven

    2015-01-01

    In the last twenty years most developed countries face dramatic demographic changes, and predominantly the rapid aging of their population. As the share of elderly people is climbing while the number of care providers is declining, the aging problem is becoming an increasingly important social and economic challenge. The supply of care at home, utilizing affordable tele-care systems and smart home technologies, is one of the promising strategies to cope with challenges posed by these demographic changes. The goal of this paper is to present a tele-care robot (TCR) aimed to assist Senior citizens who live independently at their home, that need assistance in daily life activities. The idea of the proposed system is that a caregiver, operating from a central location, will be able to service between 10 to 20 patients living at their home, by using the tele-care robot. The robot will possess motion control capabilities to move inside the house of each patient and alert in case that emergency events occur. The robot will allow the care provider to communicate remotely with the patient using audio and video equipment installed on the robot. By using the robot, the caregiver will be able to examine several times during the day the well-being of the patient, his medication consumption, and his overall functionality.

  19. Improving fatigue in multiple sclerosis by smartphone-supported energy management: The MS TeleCoach feasibility study.

    PubMed

    D'hooghe, Marie; Van Gassen, Geert; Kos, Daphne; Bouquiaux, Olivier; Cambron, Melissa; Decoo, Danny; Lysandropoulos, Andreas; Van Wijmeersch, Bart; Willekens, Barbara; Penner, Iris-Katharina; Nagels, Guy

    2018-03-27

    Fatigue is a frequently occurring, often disabling symptom in MS with no single effective treatment. In current fatigue management interventions, personalized, real-time follow-up is often lacking. The objective of the study is to assess the feasibility of the MS TeleCoach, a novel intervention offering telemonitoring of fatigue and telecoaching of physical activity and energy management in persons with MS (pwMS) over a 12-week period. The goal of the MS TeleCoach, conceived as a combination of monitoring, self-management and motivational messages, is to enhance levels of physical activity thereby improving fatigue in pwMS in an accessible and interactive way, reinforcing self-management of patients. We conducted a prospective, open-label feasibility study of the MS TeleCoach in pwMS with Expanded Disability Status Scale ≤ 4 and moderate to severe fatigue as measured by the Fatigue Scale for Motor and Cognitive Functions (FSMC). Following a 2-week run-in period to assess the baseline activity level per patient, the target number of activity counts was gradually increased over the 12-week period through telecoaching. The primary efficacy outcome was change in FSMC total score from baseline to study end. A subset of patients was asked to fill in D-QUEST 2.0, a usability questionnaire, to evaluate the satisfaction with the MS TeleCoach device and the experienced service. Seventy-five patients were recruited from 16 centres in Belgium, of which 57 patients (76%) completed the study. FSMC total score (p = 0.009) and motor and cognitive subscores (p = 0.007 and p = 0.02 respectively) decreased from baseline to week 12, indicating an improvement in fatigue. One third of participants with severe fatigue changed to a lower FSMC category for both FSMC total score and subscores. The post-study evaluation of patient satisfaction showed that the intervention was well accepted and that patients were very satisfied with the quality of the professional services

  20. A broadband multimedia TeleLearning system

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

    Wang, Ruiping; Karmouch, A.

    1996-12-31

    In this paper we discuss a broadband multimedia TeleLearning system under development in the Multimedia Information Research Laboratory at the University of Ottawa. The system aims at providing a seamless environment for TeleLearning using the latest telecommunication and multimedia information processing technology. It basically consists of a media production center, a courseware author site, a courseware database, a courseware user site, and an on-line facilitator site. All these components are distributed over an ATM network and work together to offer a multimedia interactive courseware service. An MHEG-based model is exploited in designing the system architecture to achieve the real-time, interactive,more » and reusable information interchange through heterogeneous platforms. The system architecture, courseware processing strategies, courseware document models are presented.« less

  1. Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators.

    PubMed

    Golebowicz, Merav; Levanon, Yafa; Palti, Ram; Ratzon, Navah Z

    2015-01-01

    Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

  2. Diagnosis of retinal detachments by a tele-ophthalmology screening program.

    PubMed

    McCord, Sarah A; Lynch, Mary G; Maa, April Y

    2018-01-01

    In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

  3. Technical Report on Tele-Communications.

    ERIC Educational Resources Information Center

    San Mateo County PACE Center, Redwood City, CA.

    To provide background material for those interested in tele-communication in education and for those planning to implement such programs in their schools, a research study was conducted to gather information from a variety of sources including educational and technical experts, conference participation, visits to schools conducting projects, and…

  4. Telescience testbed experiments for biomedical studies: fertilization potential recording of amphibian eggs using tele-manipulation under stereoscopic vision.

    PubMed

    Watanabe, S; Tanaka, M; Wada, Y; Suzuki, H; Takagi, S; Mori, S; Fukai, K; Kanazawa, Y; Takagi, M; Hirakawa, K; Ogasawara, K; Tsumura, K; Ogawa, K; Matsumoto, K; Nagaoka, S; Suzuki, T; Shimura, D; Yamashita, M; Nishio, S

    1994-07-01

    The telescience testbed experiments were carried out to test and investigate the tele-manipulation techniques in the intracellular potential recording of amphibian eggs. Implementation of telescience testbed was set up in the two separated laboratories of the Tsukuba Space center of NASDA, which were connected by tele-communication links. Manipulators respective for a microelectrode and a sample stage of microscope were moved by computers, of which command signals were transmitted from a computer in a remote control room. The computer in the control room was operated by an investigator (PI) who controlled the movement of each manipulator remotely. A stereoscopic vision of the microscope image were prepared by using a head mounted display (HMD) and were indispensable to the intracellular single cell recording. The fertilization potential of amphibian eggs was successfully obtained through the remote operating system.

  5. Tele-Intervention: The Wave of the Future Fits Families' Lives Today

    ERIC Educational Resources Information Center

    Behl, Diane D.; Houston, K. Todd; Guthrie, W. Spencer; Guthrie, Nancy K.

    2010-01-01

    This article provides information on providing early intervention services virtually using distance communication technologies. It describes "tele-intervention," a new method of providing services to children and their families, and how it is used in a family with a deaf child. Tele-intervention has proven to be a viable service delivery model for…

  6. Autonomy and manual operation in a small robotic system for under-vehicle inspections at security checkpoints

    NASA Astrophysics Data System (ADS)

    Smuda, William; Muench, Paul L.; Gerhart, Grant R.; Moore, Kevin L.

    2002-07-01

    Unmanned ground vehicle (UGV) technology can be used in a number of ways to assist in counter-terrorism activities. In addition to the conventional uses of tele-operated robots for unexploded ordinance handling and disposal, water cannons and other crowd control devices, robots can also be employed for a host of terrorism deterrence and detection applications. In previous research USU developed a completely autonomous prototype robot for performing under- vehicle inspections in parking areas (ODIS). Testing of this prototype and discussions with the user community indicated that neither the technology nor the users are ready for complete autonomy. In this paper we present a robotic system based on ODIS that balances the users' desire/need for tele- operation with a limited level of autonomy that enhances the performance of the robot. The system can be used by both civilian law enforcement and military police to replace the traditional mirror on a stick system of looking under cars for bombs and contraband.

  7. Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico.

    PubMed

    Patel, Samir N; Martinez-Castellanos, Maria Ana; Berrones-Medina, David; Swan, Ryan; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Campbell, J Peter; Chiang, Michael F; Chan, R V Paul

    2017-07-01

    To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Prospective, randomized cohort study. Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter-based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs

  8. A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision.

    PubMed

    Tan, Johnson Choon Hwai; Poh, Eugenie Wei Ting; Srinivasan, Sanjay; Lim, Tock Han

    2013-02-01

    We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic technician was trained to perform Snellen acuity; auto-refraction; intraocular pressure measurement; red-colour perimetry; video recordings of extraocular movement, cover tests and pupillary reactions; and anterior segment and fundus photography. Digital information was transmitted to a tertiary hospital in Singapore (the Tan Tock Seng Hospital) via a tele-ophthalmology system for teleconsultation with an ophthalmologist. The diagnoses were compared with face-to-face consultation by another ophthalmologist at the AMKP. A user experience questionnaire was administered at the end of the consultation. Using face-to-face consultation as the gold standard, tele-ophthalmology achieved 100% sensitivity and specificity in diagnosing media opacity (n = 29), maculopathy (n = 23) and keratopathy (n = 30) of any type; and 100% sensitivity and 92% specificity in diagnosing optic neuropathy of any type (n = 24). The majority of the patients (97%) were satisfied with the tele-ophthalmology workflow and consultation. The tele-ophthalmology system was able to detect causes of chronic blurred vision accurately. It has the potential to deliver high-accuracy diagnostic eye support to remote areas if suitably trained ophthalmic technicians are available.

  9. WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

    PubMed

    Ogasawara, Katsuhiko; Abe, Tamotsu

    2013-01-01

    We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

  10. Introduction of Tele-ICU in rural hospitals: Changing organisational culture to harness benefits.

    PubMed

    Goedken, Cassie Cunningham; Moeckli, Jane; Cram, Peter M; Reisinger, Heather Schacht

    2017-06-01

    This study evaluates rural hospital staff perceptions of a telemedicine ICU (Tele-ICU) before and after implementation. We conducted a longitudinal qualitative study utilising semistructured group or individual interviews with staff from three rural ICU facilities in the upper Midwest of the United States that received Tele-ICU support. Interviews occurred pre-implementation and at two time points post-implementation. Interviews were conducted with: ICU administrators (n=6), physicians (n=3), nurses (n=9), respiratory therapists (n=5) and other (n=1) from July 2011 to May 2013. Transcripts were analysed for thematic content. Overall, rural ICU staff viewed Tele-ICU as a welcome benefit for their facility. Major themes included: (1) beneficial where recruitment and retention of staff can be challenging; (2) extra support for day shifts and evening, night and weekend shifts; (3) reduction in the number of transfers larger tertiary hospitals in the community; (4) improvement in standardisation of care; and (5) organisational culture of rural ICUs may lead to under-utilisation. ICU staff at rural facilities view Tele-ICU as a positive, useful tool to provide extra support and assistance. However, more research is needed regarding organisational culture to maximise the potential benefits of Tele-ICU in rural hospitals. Published by Elsevier Ltd.

  11. Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems.

    PubMed

    Mueller, Keith J; Potter, Andrew J; MacKinney, A Clinton; Ward, Marcia M

    2014-02-01

    Tele-emergency services provide immediate and synchronous audio/video connections, most commonly between rural low-volume hospitals and an urban "hub" emergency department. We performed a systematic literature review to identify tele-emergency models and outcomes. We then studied a large tele-emergency service in the upper Midwest. We sent a user survey to all seventy-one hospitals that used the service and received 292 replies. We also conducted telephone interviews and site visits with ninety clinicians and administrators at twenty-nine of these hospitals. Participants reported that tele-emergency improves clinical quality, expands the care team, increases resources during critical events, shortens time to care, improves care coordination, promotes patient-centered care, improves the recruitment of family physicians, and stabilizes the rural hospital patient base. However, inconsistent reimbursement policy, cross-state licensing barriers, and other regulations hinder tele-emergency implementation. New value-based payment systems have the potential to reduce these barriers and accelerate tele-emergency expansion.

  12. The development and feasibility of an online aphasia group intervention and networking program - TeleGAIN.

    PubMed

    Pitt, Rachelle; Theodoros, Deborah; Hill, Anne J; Russell, Trevor

    2017-09-04

    Aphasia group therapy offers many benefits, however people with aphasia report difficulty accessing groups and speech-language pathologists are faced with many challenges in providing aphasia group therapy. Telerehabilitation may offer an alternative service delivery option. An online aphasia group therapy program - Telerehabilitation Group Aphasia Intervention and Networking (TeleGAIN) - has been developed according to the guidelines of the Medical Research Council (MRC) framework for complex interventions. The purpose of this paper is to describe the development of TeleGAIN and the results of a pilot trial to determine feasibility and acceptability. The development of TeleGAIN was informed through literature reviews in relevant topic areas, consideration of expert opinion and application of the social cognitive theory. TeleGAIN was then modelled through a feasibility pilot trial with four people with aphasia. TeleGAIN appeared to be feasible and acceptable to participants and able to be implemented as planned. Participant satisfaction with treatment was high and results suggested some potential for improvements in language functioning and communication-related quality of life. TeleGAIN appeared to be feasible and acceptable, however the study highlighted issues related to technology, clinical implementation and participant-specific factors that should be addressed prior to a larger trial.

  13. Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement.

    PubMed

    Ambrosino, Nicolino; Vitacca, Michele; Dreher, Michael; Isetta, Valentina; Montserrat, Josep M; Tonia, Thomy; Turchetti, Giuseppe; Winck, Joao Carlos; Burgos, Felip; Kampelmacher, Michael; Vagheggini, Guido

    2016-09-01

    The estimated prevalence of ventilator-dependent individuals in Europe is 6.6 per 100 000 people. The increasing number and costs of these complex patients make present health organisations largely insufficient to face their needs. As a consequence, their burden lays mostly over families. The need to reduce healthcare costs and to increase safety has prompted the development of tele-monitoring for home ventilatory assistance.A European Respiratory Society Task Force produced a literature research based statement on commonly accepted clinical criteria for indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of these patients.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients' needs. The legal problems associated with tele-monitoring are still controversial. National and European Union (EU) governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine. The economic advantages, if any, of this new approach must be compared to a "gold standard" of home care that is very variable among different European countries and within each European country.Much more research is needed before considering tele-monitoring a real improvement in the management of these patients. Copyright ©ERS 2016.

  14. Fetal tele-echography using a robotic arm and a satellite link.

    PubMed

    Arbeille, P; Ruiz, J; Herve, P; Chevillot, M; Poisson, G; Perrotin, F

    2005-09-01

    To design a method for conducting fetal ultrasound examinations in isolated hospital sites using a dedicated remotely controlled robotic arm (tele-echography). Tele-echography was performed from our hospital (expert center) on 29 pregnant women in an isolated maternity hospital (patient site) 1700 km away, and findings were compared with those of conventional ultrasound examinations. At the patient site, a robotic arm holding the real ultrasound probe was placed on the patient's abdomen by an assistant with no experience of performing ultrasound. The robotic arm, remotely controlled with a fictive (expert) probe, reproduced the exact movements (tilting and rotating) of the expert hand on the real ultrasound probe. In 93.1% of the cases, all biometric parameters, placental location and amniotic fluid volume, were correctly assessed using the teleoperated robotic arm. In two cases, femur length could not be correctly measured. The mean duration of fetal ultrasound examination was 14 min (range, 10-18) and 18 min (range, 13-23) by conventional and tele-echography methods, respectively. The mean number of times the robotic arm was repositioned on the patient's abdomen was seven (range, 5-9). Tele-echography using a robotic arm provides the main information needed to assess fetal growth and the intrauterine environment within a limited period of time.

  15. How to develop a tele-ICU model?

    PubMed

    Rogove, Herb

    2012-01-01

    The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

  16. An open real-time tele-stethoscopy system.

    PubMed

    Foche-Perez, Ignacio; Ramirez-Payba, Rodolfo; Hirigoyen-Emparanza, German; Balducci-Gonzalez, Fernando; Simo-Reigadas, Francisco-Javier; Seoane-Pascual, Joaquin; Corral-Peñafiel, Jaime; Martinez-Fernandez, Andres

    2012-08-23

    Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient's body. A real-time wireless stethoscopy system was designed. The initial requirements were: 1) The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2) It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3) Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias) and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub) sounds. The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to minimize manufacturing costs and look for alliances to

  17. An open real-time tele-stethoscopy system

    PubMed Central

    2012-01-01

    Background Acute respiratory infections are the leading cause of childhood mortality. The lack of physicians in rural areas of developing countries makes difficult their correct diagnosis and treatment. The staff of rural health facilities (health-care technicians) may not be qualified to distinguish respiratory diseases by auscultation. For this reason, the goal of this project is the development of a tele-stethoscopy system that allows a physician to receive real-time cardio-respiratory sounds from a remote auscultation, as well as video images showing where the technician is placing the stethoscope on the patient’s body. Methods A real-time wireless stethoscopy system was designed. The initial requirements were: 1) The system must send audio and video synchronously over IP networks, not requiring an Internet connection; 2) It must preserve the quality of cardiorespiratory sounds, allowing to adapt the binaural pieces and the chestpiece of standard stethoscopes, and; 3) Cardiorespiratory sounds should be recordable at both sides of the communication. In order to verify the diagnostic capacity of the system, a clinical validation with eight specialists has been designed. In a preliminary test, twelve patients have been auscultated by all the physicians using the tele-stethoscopy system, versus a local auscultation using traditional stethoscope. The system must allow listen the cardiac (systolic and diastolic murmurs, gallop sound, arrhythmias) and respiratory (rhonchi, rales and crepitations, wheeze, diminished and bronchial breath sounds, pleural friction rub) sounds. Results The design, development and initial validation of the real-time wireless tele-stethoscopy system are described in detail. The system was conceived from scratch as open-source, low-cost and designed in such a way that many universities and small local companies in developing countries may manufacture it. Only free open-source software has been used in order to minimize manufacturing costs

  18. Demonstration of improved seismic source inversion method of tele-seismic body wave

    NASA Astrophysics Data System (ADS)

    Yagi, Y.; Okuwaki, R.

    2017-12-01

    Seismic rupture inversion of tele-seismic body wave has been widely applied to studies of large earthquakes. In general, tele-seismic body wave contains information of overall rupture process of large earthquake, while the tele-seismic body wave is inappropriate for analyzing a detailed rupture process of M6 7 class earthquake. Recently, the quality and quantity of tele-seismic data and the inversion method has been greatly improved. Improved data and method enable us to study a detailed rupture process of M6 7 class earthquake even if we use only tele-seismic body wave. In this study, we demonstrate the ability of the improved data and method through analyses of the 2016 Rieti, Italy earthquake (Mw 6.2) and the 2016 Kumamoto, Japan earthquake (Mw 7.0) that have been well investigated by using the InSAR data set and the field observations. We assumed the rupture occurring on a single fault plane model inferred from the moment tensor solutions and the aftershock distribution. We constructed spatiotemporal discretized slip-rate functions with patches arranged as closely as possible. We performed inversions using several fault models and found that the spatiotemporal location of large slip-rate area was robust. In the 2016 Kumamoto, Japan earthquake, the slip-rate distribution shows that the rupture propagated to southwest during the first 5 s. At 5 s after the origin time, the main rupture started to propagate toward northeast. First episode and second episode correspond to rupture propagation along the Hinagu fault and the Futagawa fault, respectively. In the 2016 Rieti, Italy earthquake, the slip-rate distribution shows that the rupture propagated to up-dip direction during the first 2 s, and then rupture propagated toward northwest. From both analyses, we propose that the spatiotemporal slip-rate distribution estimated by improved inversion method of tele-seismic body wave has enough information to study a detailed rupture process of M6 7 class earthquake.

  19. Mobile tele-echography: user interface design.

    PubMed

    Cañero, Cristina; Thomos, Nikolaos; Triantafyllidis, George A; Litos, George C; Strintzis, Michael Gerassimos

    2005-03-01

    Ultrasound imaging allows the evaluation of the degree of emergency of a patient. However, in some instances, a well-trained sonographer is unavailable to perform such echography. To cope with this issue, the Mobile Tele-Echography Using an Ultralight Robot (OTELO) project aims to develop a fully integrated end-to-end mobile tele-echography system using an ultralight remote-controlled robot for population groups that are not served locally by medical experts. This paper focuses on the user interface of the OTELO system, consisting of the following parts: an ultrasound video transmission system providing real-time images of the scanned area, an audio/video conference to communicate with the paramedical assistant and with the patient, and a virtual-reality environment, providing visual and haptic feedback to the expert, while capturing the expert's hand movements. These movements are reproduced by the robot at the patient site while holding the ultrasound probe against the patient skin. In addition, the user interface includes an image processing facility for enhancing the received images and the possibility to include them into a database.

  20. 75 FR 69470 - Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off-Site Workers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-12

    ...,839B; TA-W-70,839C] Tele Atlas North America, Inc., Currently Doing Business as Tom Tom Including Off... Business as Tom Tom, Concord, MA; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Detroit, MI; Tele Atlas North America, Inc. Currently Doing Business as Tom Tom, Redwood, CA; Amended...

  1. COSTS AND COST-EFFECTIVENESS OF A TELE-ICU PROGRAM IN SIX INTENSIVE CARE UNITS IN A LARGE HEALTHCARE SYSTEM

    PubMed Central

    Franzini, Luisa; Sail, Kavita R.; Thomas, Eric J; Wueste, Laura

    2011-01-01

    Purpose To estimate the costs and cost-effectiveness of a tele-ICU program. Materials and methods We used an observational study with ICU patients cared for during the pre-tele-ICU period and ICU patients cared for during the post-tele-ICU period in 6 ICUs at 5 hospitals, part of a large non-profit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2,034 in the pre-tele-ICU period and 2,108 in the post-tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient. Results After the implementation of the tele-ICU, the hospital daily cost increased from $4,302 to $5,340 (24%), the hospital cost per case from $21,967 to $31,318 (43%), and the cost per patient from $20,231 to $25,846 (28%). While the tele-ICU intervention was not cost effective in patients with SAPS II ≤ 50, it was cost effective in the sickest patients with SAPS II > 50 (17% of patients) as it decreased hospital mortality without increasing costs significantly. Conclusions Hospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost effective. PMID:21376515

  2. Development, Implementation, and Evaluation of a Telemedicine Service for the Treatment of Acute Stroke Patients: TeleStroke

    PubMed Central

    2012-01-01

    Background Health care service based on telemedicine can reduce both physical and time barriers in stroke treatments. Moreover, this service connects centers specializing in stroke treatment with other centers and practitioners, thereby increasing accessibility to neurological specialist care and fibrinolytic treatment. Objective Development, implementation, and evaluation of a care service for the treatment of acute stroke patients based on telemedicine (TeleStroke) at Virgen del Rocío University Hospital. Methods The evaluation phase, conducted from October 2008 to January 2011, involved patients who presented acute stroke symptoms confirmed by the emergency physician; they were examined using TeleStroke in two hospitals, at a distance of 16 and 110 kilometers from Virgen del Rocío University Hospital. We analyzed the number of interconsultation sheets, the percentage of patients treated with fibrinolysis, and the number of times they were treated. To evaluate medical professionals’ acceptance of the TeleStroke system, we developed a web-based questionnaire using a Technology Acceptance Model. Results A total of 28 patients were evaluated through the interconsultation sheet. Out of 28 patients, 19 (68%) received fibrinolytic treatment. The most common reasons for not treating with fibrinolysis included: clinical criteria in six out of nine patients (66%) and beyond the time window in three out of nine patients (33%). The mean “onset-to-hospital” time was 69 minutes, the mean time from admission to CT image was 33 minutes, the mean “door-to-needle” time was 82 minutes, and the mean “onset-to-needle” time was 150 minutes. Out of 61 medical professionals, 34 (56%) completed a questionnaire to evaluate the acceptability of the TeleStroke system. The mean values for each item were over 6.50, indicating that respondents positively evaluated each item. This survey was assessed using the Cronbach alpha test to determine the reliability of the

  3. Arizona TeleMedicine Network: Engineering Master Plan.

    ERIC Educational Resources Information Center

    Atlantic Research Corp., Alexandria, VA.

    As the planning document for establishing a statewide health communications system initially servicing the Papago, San Carlos and White Mountain Apache, Navajo, and Hopi reservations, this document prescribes the communications services to be provided by the Arizona TeleMedicine Network. Specifications include: (1) communications services for each…

  4. Assessment of Internet-based tele-medicine in Africa (the RAFT project).

    PubMed

    Bagayoko, Cheick Oumar; Müller, Henning; Geissbuhler, Antoine

    2006-01-01

    The objectives of this paper on the Réseau Afrique Francophone de Télémédecine (RAFT) project are the evaluation of feasibility, potential, problems and risks of an Internet-based tele-medicine network in developing countries of Africa. The RAFT project was started in Western African countries 5 years ago and has now extended to other regions of Africa as well (i.e. Madagascar, Rwanda). A project for the development of a national tele-medicine network in Mali was initiated in 2001, extended to Mauritania in 2002 and to Morocco in 2003. By 2006, a total of nine countries are connected. The entire technical infrastructure is based on Internet technologies for medical distance learning and tele-consultations. The results are a tele-medicine network that has been in productive use for over 5 years and has enabled various collaboration channels, including North-to-South (from Europe to Africa), South-to-South (within Africa), and South-to-North (from Africa to Europe) distance learning and tele-consultations, plus many personal exchanges between the participating hospitals and Universities. It has also unveiled a set of potential problems: (a) the limited importance of North-to-South collaborations when there are major differences in the available resources or the socio-cultural contexts between the collaborating parties; (b) the risk of an induced digital divide if the periphery of the health system in developing countries is not involved in the development of the network; and (c) the need for the development of local medical content management skills. Particularly point (c) is improved through the collaboration between the various countries as professionals from the medical and the computer science field are sharing courses and resources. Personal exchanges between partners in the project are frequent, and several persons received an education at one of the partner Universities. As conclusion, we can say that the identified risks have to be taken into account when

  5. The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis)

    PubMed Central

    Chan, R.V. Paul; Patel, Samir N.; Ryan, Michael C.; Jonas, Karyn E.; Ostmo, Susan; Port, Alexander D.; Sun, Grace I.; Lauer, Andreas K.; Chiang, Michael F.

    2015-01-01

    Purpose: To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. Methods: A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Results: Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. Conclusions: A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists. PMID:26538772

  6. The Global Education Network for Retinopathy of Prematurity (Gen-Rop): Development, Implementation, and Evaluation of A Novel Tele-Education System (An American Ophthalmological Society Thesis).

    PubMed

    Chan, R V Paul; Patel, Samir N; Ryan, Michael C; Jonas, Karyn E; Ostmo, Susan; Port, Alexander D; Sun, Grace I; Lauer, Andreas K; Chiang, Michael F

    2015-01-01

    To describe the design, implementation, and evaluation of a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmology residents. A secure Web-based tele-education system was developed utilizing a repository of over 2,500 unique image sets of ROP. For each image set used in the system, a reference standard ROP diagnosis was established. Performance by ophthalmology residents (postgraduate years 2 to 4) from the United States and Canada in taking the ROP tele-education program was prospectively evaluated. Residents were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Accuracy and reliability of ROP diagnosis (eg, plus disease, zone, stage, category) were determined using sensitivity, specificity, and the kappa statistic calculations of the results from the pretest and posttest. Fifty-five ophthalmology residents were provided access to the ROP tele-education program. Thirty-one ophthalmology residents completed the program. When all training levels were analyzed together, a statistically significant increase was observed in sensitivity for the diagnosis of plus disease, zone, stage, category, and aggressive posterior ROP (P<.05). Statistically significant changes in specificity for identification of stage 2 or worse (P=.027) and pre-plus (P=.028) were observed. A tele-education system for ROP education is effective in improving diagnostic accuracy of ROP by ophthalmology residents. This system may have utility in the setting of both healthcare and medical education reform by creating a validated method to certify telemedicine providers and educate the next generation of ophthalmologists.

  7. TeleMed: Wide-area, secure, collaborative object computing with Java and CORBA for healthcare

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

    Forslund, D.W.; George, J.E.; Gavrilov, E.M.

    1998-12-31

    Distributed computing is becoming commonplace in a variety of industries with healthcare being a particularly important one for society. The authors describe the development and deployment of TeleMed in a few healthcare domains. TeleMed is a 100% Java distributed application build on CORBA and OMG standards enabling the collaboration on the treatment of chronically ill patients in a secure manner over the Internet. These standards enable other systems to work interoperably with TeleMed and provide transparent access to high performance distributed computing to the healthcare domain. The goal of wide scale integration of electronic medical records is a grand-challenge scalemore » problem of global proportions with far-reaching social benefits.« less

  8. Modelling the complete operation of a free-piston shock tunnel for a low enthalpy condition

    NASA Astrophysics Data System (ADS)

    McGilvray, M.; Dann, A. G.; Jacobs, P. A.

    2013-07-01

    Only a limited number of free-stream flow properties can be measured in hypersonic impulse facilities at the nozzle exit. This poses challenges for experimenters when subsequently analysing experimental data obtained from these facilities. Typically in a reflected shock tunnel, a simple analysis that requires small amounts of computational resources is used to calculate quasi-steady gas properties. This simple analysis requires initial fill conditions and experimental measurements in analytical calculations of each major flow process, using forward coupling with minor corrections to include processes that are not directly modeled. However, this simplistic approach leads to an unknown level of discrepancy to the true flow properties. To explore the simple modelling techniques accuracy, this paper details the use of transient one and two-dimensional numerical simulations of a complete facility to obtain more refined free-stream flow properties from a free-piston reflected shock tunnel operating at low-enthalpy conditions. These calculations were verified by comparison to experimental data obtained from the facility. For the condition and facility investigated, the test conditions at nozzle exit produced with the simple modelling technique agree with the time and space averaged results from the complete facility calculations to within the accuracy of the experimental measurements.

  9. Rapid Deployment of International Tele-Intensive Care Unit Services in War-Torn Syria.

    PubMed

    Moughrabieh, Anas; Weinert, Craig

    2016-02-01

    The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.

  10. Tele-counseling and social-skill trainings using JGNII optical network and a mirror-interface system

    NASA Astrophysics Data System (ADS)

    Hashimoto, Sayuri; Hashimoto, Nobuyuki; Onozawa, Akira; Hosoya, Eiichi; Harada, Ikuo; Okunaka, Junzo

    2007-09-01

    "Tele-presence" communication using JGNII - an exclusive optical-fiber network system - was applied to social-skills training in the form of child-rearing support. This application focuses on internet counseling and social training skills that require interactive verbal and none-verbal communications. The motivation for this application is supporting local communities by constructing tele-presence education and entertainment systems using recently available, inexpensive IP networks. This latest application of tele-presence communication uses mirror-interface system which provides to users in remote locations a shared quasi-space where they can see themselves as if they were in the same room by overlapping video images from remote locations.

  11. Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

    PubMed

    Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

    2014-01-01

    A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

  12. Remote clinical assessment of gastrointestinal endoscopy (tele-endoscopy): an initial experience.

    PubMed Central

    Kim, C. Y.; Etemad, B.; Glenn, T. F.; Mackey, H. A.; Viator, G. E.; Wallace, M. B.; Mokhashi, M. S.; Cotton, P. B.; Hawes, R. H.

    2000-01-01

    BACKGROUND: Gastrointestinal (GI) endoscopy is an effective tool to screen for cancers of the digestive tract. However, access to endoscopy is limited in many parts of South Carolina. This trial is a part of a prospective multi-part study for remote cancer screening in coastal South Carolina. This pilot study was to evaluate the quality of tele-endoscopy for cancer screening. METHODS: 10 patients scheduled for endoscopic procedures were observed simultaneously by the endoscopist and a remote observer connected over a 512 kbps ISDN line. Findings by both were compared for concordance on malignant or premalignant lesions. RESULTS: The image quality was adequate to support remote diagnosis of GI cancer and abnormal lesions by an experienced observer. However, assessment of the esophagogastric junction for Barrett's esophagus was equivocal. CONCLUSIONS: Overall, our tele-endoscopy setup shows great promise for remote supervision or observation of endoscopic procedures done by nurse endoscopists. Tele-endoscopy is both adequate and feasible for diagnosis of most gastrointestinal lesions. Subtle lesions still may be missed in our current setup. However, improvements are being made in our setup to address the problem with resolution prior to further evaluation. PMID:11079918

  13. Exploring User Experience of a Telehealth System for the Danish TeleCare North Trial.

    PubMed

    Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Hejlesen, Ole Kristian

    2015-01-01

    The aim was to explore user experiences of using a telehealth system (Telekit) designed for the Danish TeleCare North trial. Telekit is designed for patients diagnosed with chronic obstructive pulmonary disease (COPD) in order to manage the disease and support patient empowerment. This article sums up COPD-participants' user experiences in terms of increased sense of freedom, of security, of control, and greater awareness of COPD symptoms. A consecutive sample of sixty participants (27 women, 33 men) were recruited from the TeleCare North trial. At home the participants completed a non-standardised questionnaire while a researcher was present. The questionnaire identified their health status, their use of specific technologies, and their user experiences with the telehealth system. Results from the questionnaire indicate that the majority of participants (88%) considered the Telekit system as easy to use. 43 (72%) participants felt increased sense of security, and 37 (62%) participants felt increased sense of control by using the system. 30 (50%) participants felt greater awareness of their COPD symptoms, but only 16 (27%) participants felt increased freedom. The study has provided a general picture of COPD participants' user experiences which is important to emphasise as it has a bearing on whether a given implementation will be successful or not.

  14. Virtual TeleRehab: a case study.

    PubMed

    Pareto, Lena; Johansson, Britt; Zeller, Sally; Sunnerhagen, Katharina S; Rydmark, Martin; Broeren, Jurgen

    2011-01-01

    We examined the efficacy of a remotely based occupational therapy intervention. A 40-year-old woman who suffered a stroke participated in a telerehabilitation program. The intervention method is based on virtual reality gaming to enhance the training experience and to facilitate the relearning processes. The results indicate that Virtual TeleRehab is an effective method for motivational, economical, and practical reasons by combining game-based rehabilitation in the home with weekly distance meetings.

  15. How to set up a low cost tele-ultrasound capable videoconferencing system with wide applicability

    PubMed Central

    2012-01-01

    Background Worldwide ultrasound equipment accessibility is at an all-time high, as technology improves and costs decrease. Ensuring that patients benefit from more accurate resuscitation and diagnoses from a user-dependent technology, such as ultrasound, requires accurate examination, typically entailing significant training. Remote tele-mentored ultrasound (RTUS) examination is, however, a technique pioneered in space medicine that has increased applicability on earth. We, thus, sought to create and demonstrate a cost-minimal approach and system with potentially global applicability. Methods The cost-minimal RTUS system was constructed by utilizing a standard off-the-shelf laptop computer that connected to the internet through an internal wireless receiver and/or was tethered through a smartphone. A number of portable hand-held ultrasound devices were digitally streamed into the laptop utilizing a video converter. Both the ultrasound video and the output of a head-mounted video camera were transmitted over freely available Voice Over Internet Protocol (VOIP) software to remote experts who could receive and communicate using any mobile device (computer, tablet, or smartphone) that could access secure VOIP transmissions from the internet. Results The RTUS system allowed real-time mentored tele-ultrasound to be conducted from a variety of settings that were inside buildings, outside on mountainsides, and even within aircraft in flight all unified by the simple capability of receiving and transmitting VOIP transmissions. . Numerous types of ultrasound examinations were conducted such as abdominal and thoracic examinations with a variety of users mentored who had previous skills ranging from none to expert. Internet connectivity was rarely a limiting factor, with competing logistical and scheduling demands of the participants predominating. Conclusions RTUS examinations can educate and guide point of care clinical providers to enhance their use of ultrasound. The scope

  16. Training of beauty salon professionals in disease prevention using interactive tele-education.

    PubMed

    Vieira Júnior, Elso Elias; Wen, Chao Lung

    2015-01-01

    Infectious diseases can be acquired in places where invasive procedures are often performed without the proper care of hand washing and material sterilization. There are approximately 500,000 beauty and esthetics centers in Brazil, which are visited by thousands of people every day. Many diseases, including sexually transmitted infections, are still highly prevalent in Brazil, such as warts caused by human papillomavirus, hepatitis B and C, and human immunodeficiency virus infection, and can be transmitted in beauty salons. We have developed a tele-education course divided into four main themes: sexually transmitted infections, indoor health in beauty salon workplaces, hand washing, and material sterilization. The course was made available through a Web site, which included a face-to-face meeting, Web synchronous meetings (chats and Web conferences), and asynchronous resources (reading material, discussion lists, situations simulator, educational videos, and three-dimensional virtual human video animation on sexually transmitted infections and hand washing), mediated by professors and coordinators. Fifty-two beauty professionals and 33 other professionals were enrolled from different regions. Of the 61 who completed the course and received a certificate at the course's end, 100% considered good to excellent the course's applicability to everyday life and would recommend it to a fellow professional. The results demonstrate the feasibility of an interactive, tele-education model using low-cost tools as an educational resource to teach beauty professionals. In the future, this may become a branch of nationwide telehealth action.

  17. Assessment of atmospheric models for tele-infrasonic propagation

    NASA Astrophysics Data System (ADS)

    McKenna, Mihan; Hayek, Sylvia

    2005-04-01

    Iron mines in Minnesota are ideally located to assess the accuracy of available atmospheric profiles used in infrasound modeling. These mines are located approximately 400 km away to the southeast (142) of the Lac-Du-Bonnet infrasound station, IS-10. Infrasound data from June 1999 to March 2004 was analyzed to assess the effects of explosion size and atmospheric conditions on observations. IS-10 recorded a suite of events from this time period resulting in well constrained ground truth. This ground truth allows for the comparison of ray trace and PE (Parabolic Equation) modeling to the observed arrivals. The tele-infrasonic distance (greater than 250 km) produces ray paths that turn in the upper atmosphere, the thermosphere, at approximately 120 km to 140 km. Modeling based upon MSIS/HWM (Mass Spectrometer Incoherent Scatter/Horizontal Wind Model) and the NOGAPS (Navy Operational Global Atmospheric Prediction System) and NRL-GS2 (Naval Research Laboratory Ground to Space) augmented profiles are used to interpret the observed arrivals.

  18. Quebec's Tele-Universite: A Long Way to Xanadu

    ERIC Educational Resources Information Center

    Guillemet, Patrick

    2005-01-01

    This article is a descriptive overview of one aspect of the history of Quebec's Tele-universite (TU). This case is used to unveil the inter-organizational and political tensions which may accompany the somewhat difficult development of a distance education model. Teleuniversite was created in 1972 as an experimental project by the Universite du…

  19. Tele-Learning and Distance Learning Re-Engineering Process.

    ERIC Educational Resources Information Center

    Cruz, Dulce Marcia; de Moraes, Marialice; Barcia, Ricardo Miranda

    The adoption and use of new interactive technologies in Distance Education, especially Tele-learning is a growing tendency in the most advanced countries. Nowadays, this tendency is so strong that being interactive is seen as a necessary pre-condition. Some reasons for this are a the growing perceived value of group-working; the popularization of…

  20. TeleCITE: Telehealth--A Cochlear Implant Therapy Exchange

    ERIC Educational Resources Information Center

    Stith, Joanna; Stredler-Brown, Arlene; Greenway, Pat; Kahn, Gary

    2012-01-01

    What might bring the efforts of a physician, a speech-language pathologist, a teacher of the deaf and hard of hearing, and a nurse together? The answer is the innovative use of telepractice to deliver high quality, family-centered early intervention to infants and toddlers with hearing loss. TeleCITE: Telehealth--A Cochlear Implant Therapy…

  1. Lunar Sample Return Missions Using a Tele-Robotic Lander

    NASA Astrophysics Data System (ADS)

    Downes, H.; Crawford, I. A.; Alexander, L.

    2018-02-01

    Deep Space Gateway would allow tele-robotic landers and rovers to access regions of the Moon which have not been previously sampled. Scientific questions, e.g., the nature and duration of volcanic activity and the composition of the mantle/lower crust, could be addressed.

  2. Validation of DPOAE screening conducted by village health workers in a rural community with real-time click evoked tele-auditory brainstem response.

    PubMed

    Ramkumar, Vidya; Vanaja, C S; Hall, James W; Selvakumar, K; Nagarajan, Roopa

    2018-05-01

    This study assessed the validity of DPOAE screening conducted by village health workers (VHWs) in a rural community. Real-time click evoked tele-auditory brainstem response (tele-ABR) was used as the gold standard to establish validity. A cross-sectional design was utilised to compare the results of screening by VHWs to those obtained via tele-ABR. Study samples: One hundred and nineteen subjects (0 to 5 years) were selected randomly from a sample of 2880 infants and young children who received DPOAE screening by VHWs. Real time tele-ABR was conducted by using satellite or broadband internet connectivity at the village. An audiologist located at the tertiary care hospital conducted tele-ABR testing through a remote computing paradigm. Tele-ABR was recorded using standard recording parameters recommended for infants and young children. Wave morphology, repeatability and peak latency data were used for ABR analysis. Tele-ABR and DPOAE findings were compared for 197 ears. The sensitivity of DPOAE screening conducted by the VHW was 75%, and specificity was 91%. The negative and positive predictive values were 98.8% and 27.2%, respectively. The validity of DPOAE screening conducted by trained VHW was acceptable. This study supports the engagement of grass-root workers in community-based hearing health care provision.

  3. Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure.

    PubMed

    Eslami Jahromi, Maryam; Ahmadian, Leila

    2018-07-01

    Investigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services. This descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19. The mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p < 0.05). The present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Tele-Ophthalmology for Age-Related Macular Degeneration and Diabetic Retinopathy Screening: A Systematic Review and Meta-Analysis.

    PubMed

    Kawaguchi, Atsushi; Sharafeldin, Noha; Sundaram, Aishwarya; Campbell, Sandy; Tennant, Matthew; Rudnisky, Christopher; Weis, Ezekiel; Damji, Karim F

    2018-04-01

    To synthesize high-quality evidence to compare traditional in-person screening and tele-ophthalmology screening. Only randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. The intervention of interest was any type of tele-ophthalmology, including screening of diseases using remote devices. Studies involved patients receiving care from any trained provider via tele-ophthalmology, compared with those receiving equivalent face-to-face care. A search was executed on the following databases: Medline, EMBASE, EBM Reviews, Global Health, EBSCO-CINAHL, SCOPUS, ProQuest Dissertations and Theses Global, OCLC Papers First, and Web of Science Core Collection. Six outcomes of care for age-related macular degeneration (AMD), diabetic retinopathy (DR), or glaucoma were measured and analyzed. Two hundred thirty-seven records were assessed at the full-text level; six RCTs fulfilled inclusion criteria and were included in this review. Four studies involved participants with diabetes mellitus, and two studies examined choroidal neovascularization in AMD. Only data of detection of disease and participation in the screening program were used for the meta-analysis. Tele-ophthalmology had a 14% higher odds to detect disease than traditional examination; however, the result was not statistically significant (n = 2,012, odds ratio: 1.14, 95% confidence interval (CI): 0.52-2.53, p = 0.74). Meta-analysis results show that odds of having DR screening in the tele-ophthalmology group was 13.15 (95% CI: 8.01-21.61; p < 0.001) compared to the traditional screening program. The current evidence suggests that tele-ophthalmology for DR and age-related macular degeneration is as effective as in-person examination and potentially increases patient participation in screening.

  5. Cost comparison between home telemonitoring and usual care of older adults: a randomized trial (Tele-ERA).

    PubMed

    Upatising, Benjavan; Wood, Douglas L; Kremers, Walter K; Christ, Sharon L; Yih, Yuehwern; Hanson, Gregory J; Takahashi, Paul Y

    2015-01-01

    From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were -$9,537 (p=0.068), -$8,482 (p =0.098), -$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group.

  6. Developing criterion-based competencies for tele-intensive care unit.

    PubMed

    Schleifer, Sarah Joy; Carroll, Karen; Moseley, Marthe J

    2014-01-01

    Over the last 5 years, telemedicine has developed nursing roles that differ from traditional bedside care. In the midst of this transition, current competency development models focused on task completion may not be the most effective form of proficiency validation. The procedure of competency creation for the role of tele-intensive care unit registered nurse requires a thoughtful process using stakeholders from institutional leadership to frontline staff. The process must include stakeholder approval to ensure appropriate buy-in and follow-through on the agreed-upon criteria. This can be achieved using a standardized method of concept stimulation related to the behaviors, not a memorized list of tasks, expected of a telemedicine registered nurse. This process serves as the foundation for the development of criterion-based competency statements that then allows for clearer expectations. Continually reviewing the written competencies, ensuring current applicability, and revising as needed are necessities for maintaining competence and, therefore, patient safety.

  7. The effects of TeleWound management on use of service and financial outcomes.

    PubMed

    Rees, Riley S; Bashshur, Noura

    2007-12-01

    This study investigated the effects of a TeleWound program on the use of service and financial outcomes among homebound patients with chronic wounds. The TeleWound program consisted of a Web-based transmission of digital photographs together with a clinical protocol. It enabled homebound patients with chronic pressure ulcers to be monitored remotely by a plastic surgeon. Chronic wounds are highly prevalent among chronically ill patients in the United States (U.S.). About 5 million chronically ill patients in the U.S. have chronic wounds, and the aggregate cost of their care exceeds $20 billion annually. Although 25% of home care referrals in the U.S. are for wounds, less than 0.2% of the registered nurses in the U.S. are wound care certified. This implies that the majority of patients with chronic wounds may not be receiving optimal care in their home environments. We hypothesized that TeleWound management would reduce visits to the emergency department (ED), hospitalization, length of stay, and visit acuity. Hence, it would improve financial performance for the hospital. A quasi-experimental design was used. A sample of 19 patients receiving this intervention was observed prospectively for 2 years. This was matched to a historical control group of an additional 19 patients from hospital records. Findings from the study revealed that TeleWound patients had fewer ED visits, fewer hospitalizations, and shorter length of stay, as compared to the control group. Overall, they encumbered lower cost. The results of this clinical study are striking and provide strong encouragement that a single provider can affect positive clinical and financial outcomes using a telemedicine wound care program. TeleWound was found to be a credible modality to manage pressure ulcers at lower cost and possibly better health outcomes. The next step in this process is to integrate the model into daily practice at bellwether medical centers to determine programmatic effectiveness in larger

  8. TeleMed: An example of a new system developed with object technology

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

    Forslund, D.; Phillips, R.; Tomlinson, B.

    1996-12-01

    Los Alamos National Laboratory has developed a virtual patient record system called TeleMed which is based on a distributed national radiographic and patient record repository located throughout the country. Without leaving their offices, participating doctors can view clinical drug and radiographic data via a sophisticated multimedia interface. For example, a doctor can match a patient`s radiographic information with the data in the repository, review treatment history and success, and then determine the best treatment. Furthermore, the features of TeleMed that make it attractive to clinicians and diagnosticians make it valuable for teaching and presentation as well. Thus, a resident canmore » use TeleMed for self-training in diagnostic techniques and a physician can use it to explain to a patient the course of their illness. In fact, the data can be viewed simultaneously by users at two or more distant locations for consultation with specialists in different fields. This capability is of enormous value to a wide spectrum of healthcare providers. It is made possible by the integration of multimedia information using commercial CORBA technology linking object-enabled databases with client interfaces using a three-tiered architecture.« less

  9. Operator priming and generalization of practice in adults' simple arithmetic.

    PubMed

    Chen, Yalin; Campbell, Jamie I D

    2016-04-01

    There is a renewed debate about whether educated adults solve simple addition problems (e.g., 2 + 3) by direct fact retrieval or by fast, automatic counting-based procedures. Recent research testing adults' simple addition and multiplication showed that a 150-ms preview of the operator (+ or ×) facilitated addition, but not multiplication, suggesting that a general addition procedure was primed by the + sign. In Experiment 1 (n = 36), we applied this operator-priming paradigm to rule-based problems (0 + N = N, 1 × N = N, 0 × N = 0) and 1 + N problems with N ranging from 0 to 9. For the rule-based problems, we found both operator-preview facilitation and generalization of practice (e.g., practicing 0 + 3 sped up unpracticed 0 + 8), the latter being a signature of procedure use; however, we also found operator-preview facilitation for 1 + N in the absence of generalization, which implies the 1 + N problems were solved by fact retrieval but nonetheless were facilitated by an operator preview. Thus, the operator preview effect does not discriminate procedure use from fact retrieval. Experiment 2 (n = 36) investigated whether a population with advanced mathematical training-engineering and computer science students-would show generalization of practice for nonrule-based simple addition problems (e.g., 1 + 4, 4 + 7). The 0 + N problems again presented generalization, whereas no nonzero problem type did; but all nonzero problems sped up when the identical problems were retested, as predicted by item-specific fact retrieval. The results pose a strong challenge to the generality of the proposal that skilled adults' simple addition is based on fast procedural algorithms, and instead support a fact-retrieval model of fast addition performance. (c) 2016 APA, all rights reserved).

  10. What CORBA can do: An example of a new system developed with object technology: TeleMed

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

    Forslund, D.; Phillips, R.; Tomlinson, B.

    1996-05-01

    The TeleMed application grew out of a relationship with physicians at the National Jewish Center for Immunology and Respiratory Medicine (NJC) in Denver. These physicians are experts in pulmonary diseases and radiology, helping patients combat effects of TB and other lung diseases. To make the knowledge and experience at NJC available to a wider audience, LANL has developed a virtual patient record system called TeleMed which is based on distributed national radiographic and patient record repository located throughout the country. Without leaving their offices, participating doctors can view clinical drug and radiographic data via a sophisticated multimedia interface. TeleMed ismore » also valuable for teaching and presentation as well. Thus a resident can use TeleMed for self-training in diagnostic techniques and a physician can use it to explain to a patient the course of their illness. Data can be viewed simultaneously by users at two or more distant locations for consultation with specialists in different fields. This capability is made possible by integration of multimedia information using commercial CORBA technology linking object-enable databases with client interfaces using a three-tiered architecture.« less

  11. Cost Comparison Between Home Telemonitoring and Usual Care of Older Adults: A Randomized Trial (Tele-ERA)

    PubMed Central

    Upatising, Benjavan; Wood, Douglas L.; Kremers, Walter K.; Christ, Sharon L.; Yih, Yuehwern; Hanson, Gregory J.

    2015-01-01

    Abstract Background: From 1992 to 2008, older adults in the United States incurred more healthcare expense per capita than any other age group. Home telemonitoring has emerged as a potential solution to reduce these costs, but evidence is mixed. The primary aim of the study was to evaluate whether the mean difference in total direct medical cost consequence between older adults receiving additional home telemonitoring care (TELE) (n=102) and those receiving usual medical care (UC) (n=103) were significant. Inpatient, outpatient, emergency department, decedents, survivors, and 30-day readmission costs were evaluated as secondary aim. Materials and Methods: Multivariate generalized linear models (GLMs) and parametric bootstrapping method were used to model cost and to determine significance of the cost differences. We also compared the differences in arithmetic mean costs. Results: From the conditional GLMs, the estimated mean cost differences (TELE versus UC) for total, inpatient, outpatient, and ED were −$9,537 (p=0.068), −$8,482 (p =0.098), −$1,160 (p=0.177), and $106 (p=0.619), respectively. Mean postenrollment cost was 11% lower than the prior year for TELE versus 22% higher for UC. The ratio of mean cost for decedents to survivors was 2.1:1 (TELE) versus 12.7:1 (UC). Conclusions: There were no significant differences in the mean total cost between the two treatment groups. The TELE group had less variability in cost of care, lower decedents to survivors cost ratio, and lower total 30-day readmission cost than the UC group. PMID:25453392

  12. Operator Priming and Generalization of Practice in Adults' Simple Arithmetic

    ERIC Educational Resources Information Center

    Chen, Yalin; Campbell, Jamie I. D.

    2016-01-01

    There is a renewed debate about whether educated adults solve simple addition problems (e.g., 2 + 3) by direct fact retrieval or by fast, automatic counting-based procedures. Recent research testing adults' simple addition and multiplication showed that a 150-ms preview of the operator (+ or ×) facilitated addition, but not multiplication,…

  13. Validating the TeleStroke Mimic Score: A Prediction Rule for Identifying Stroke Mimics Evaluated Over Telestroke Networks.

    PubMed

    Ali, Syed F; Hubert, Gordian J; Switzer, Jeffrey A; Majersik, Jennifer J; Backhaus, Roland; Shepard, L Wylie; Vedala, Kishore; Schwamm, Lee H

    2018-03-01

    Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population. We evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic. Based on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70-0.73; P <0.001), similar to our prior external validation in the Partners National Telestroke Network. The TM score's ability to predict the presence of a stroke mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations. © 2018 American Heart Association, Inc.

  14. Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba.

    PubMed

    Kanjee, Raageen; Dookeran, Ravi I; Mathen, Mathen K; Stockl, Frank A; Leicht, Richard

    2017-11-01

    The purpose of this study was to evaluate the diabetic retinopathy (DR) tele-ophthalmology screening program in Manitoba to determine prevalence and incidence of DR, as well as to estimate the program's cost-effectiveness. Retrospective chart review. A total of 4676 patients with type 2 diabetes examined 9334 times from 2007 to 2013. Focused ophthalmic histories were recorded and examinations were performed by trained nurses, including visual acuities, intraocular pressure, and mydriatic 7 standard field stereoscopic fundus photography. Images were evaluated by retinal specialists according to the Early Treatment of Diabetic Retinopathy Study criteria. DR prevalence and incidence were then calculated during the study period. Cost-effectiveness was estimated by comparing the cost of running the tele-ophthalmology program compared with the cost of screening the same volume of patients in-office. The average prevalence of any DR in each year was 25.1%. The cumulative incidence of DR across 6 years was 17.1% (95% CI, 15.4%-18.7%). The average savings per tele-ophthalmology examination was $1007. DR is highly prevalent among the studied population. Tele-ophthalmology provides a cost-effective means of monitoring patients as well as identifying new or treatable disease. Copyright © 2017. Published by Elsevier Inc.

  15. Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network

    PubMed Central

    Dinesen, Birthe; Seeman, Janne; Gustafsson, Jeppe

    2011-01-01

    Introduction The aim of the Telekat project is to prevent re-admissions of patients with chronic obstructive pulmonary disease (COPD) by developing a preventive program of tele-rehabilitation across sectors for COPD patients. The development of the program is based on a co-innovation process between COPD patients, relatives, healthcare professionals and representatives from private firms and universities. This paper discusses the obstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients. Theory Network and innovation theory. Methods The case study was applied. A triangulation of data collection techniques was used: documents, observations (123 hours), qualitative interviews (n=32) and action research. Findings Obstacles were identified in the network context; these obstacles included the mindset of the healthcare professionals, inter-professionals relations, views of technology as a tool and competing visions for the goals of tele-rehabilitation. Conclusion We have identified obstacles that emerge in the co-innovation process when developing a programme for tele-rehabilitation of COPD patients in an inter-organizational context. Action research has been carried out and can have helped to facilitate the co-innovation process. PMID:21637709

  16. Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis.

    PubMed

    Lewiecki, E Michael; Rochelle, Rachelle; Bouchonville, Matthew F; Chafey, David H; Olenginski, Thomas P; Arora, Sanjeev

    2017-12-01

    Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention ( P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

  17. Emotional attachment and emotional availability tele-intervention for adoptive families.

    PubMed

    Baker, Megan; Biringen, Zeynep; Meyer-Parsons, Beatrice; Schneider, Abby

    2015-01-01

    This study evaluated the new online Emotional Attachment and Emotional Availability (EA2) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 to 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA2 Tele-Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA2 Tele-Intervention revealed significant differences over time also in most of these qualities. © 2015 Michigan Association for Infant Mental Health.

  18. Understanding the Adoption of TELEs--The Importance of Management

    ERIC Educational Resources Information Center

    Christiansen, Ellen; Nyvang, Tom

    2006-01-01

    For a TELE to become adopted by the vast majority of individual learners as a tool for learning, adoption at the institutional level must be considered, because the vast majority of a population of technology users depends on external stimuli to adopt the technology. This article analyses a case where a social simulation game, a prize-winning…

  19. Completeness of breast cancer operative reports in a community care setting.

    PubMed

    Eng, Jordan Lang; Baliski, Christopher Ronald; McGahan, Colleen; Cai, Eric

    2017-10-01

    The narrative operative report represents the traditional means by which breast cancer surgery has been documented. Previous work has established that omissions occur in narrative operative reports produced in an academic setting. The goal of this study was to determine the completeness of breast cancer narrative operative reports produced in a community care setting and to explore the effect of a surgeon's case volume and years in practice on the completeness of these reports. A standardized retrospective review of operative reports produced over a consecutive 2 year period was performed using a set of procedure-specific elements identified through a review of the relevant literature and work done locally. 772 operative reports were reviewed. 45% of all elements were completely documented. A small positive trend was observed between case volume and completeness while a small negative trend was observed between years in practice and completeness. The dictated narrative report inadequately documents breast cancer surgery irrespective of the recording surgeon's volume or experience. An intervention, such as the implementation of synoptic reporting, should be considered in an effort to maximize the utility of the breast cancer operative report. Copyright © 2017. Published by Elsevier Ltd.

  20. Auto TeleCare -- understanding the failures and successes of small business in telehealth.

    PubMed

    McMahon, David

    2005-01-01

    Auto TeleCare provided an automatic daily telephone service for people living alone. The business used an interactive voice response (IVR) system to call clients at a set time each day. The clients were required to press a button on their telephone to listen to a message (e.g. joke of the day), thereby indicating that they were alright. If the client did not respond, staff would call the given list of contacts to check on the client's welfare. The service was first offered in December 2003 and there was a lot of interest from clients and health-care groups. Although the technology was sophisticated, it was very simple for the clients to use. However, it was the marketing and advertising costs of the business that in the end proved to be too costly. The number of clients required for commercial viability was calculated to be 3,000, and after nearly 15 months of business it was decided to close the business.

  1. Evaluation of Oral and Maxillofacial Surgery Residents' Operative Skills: Feasibility and Engagement Study Using SIMPL Software for a Mobile Phone.

    PubMed

    Kaban, Leonard B; Cappetta, Alyssa; George, Brian C; Lahey, Edward T; Bohnen, Jordan D; Troulis, Maria J

    2017-10-01

    There are no universally accepted tools to evaluate operative skills of surgical residents in a timely fashion. The purpose of this study was to determine the feasibility of using a smartphone application, SIMPL (System for Improving and Measuring Procedural Learning), developed by a multi-institutional research collaborative, to achieve a high rate of timely operative evaluations and resident communication and to collect performance data. The authors hypothesized that these goals would be achieved because the process is convenient and efficient. This was a prospective feasibility and engagement study using SIMPL to evaluate residents' operative skills. SIMPL requires the attending surgeon to answer 3 multiple-choice questions: 1) What level of help (Zwisch Scale) was required by the trainee? 2) What was the level of performance? 3) How complex was the case? The evaluator also can dictate a narrative. The sample was composed of 3 faculty members and 3 volunteer senior residents. Predictor variables were the surgeons, trainees, and procedures performed. Outcome variables included number and percentage of procedures performed by faculty-and-resident pairs assessed, time required to complete assessments, time lapsed to submission, percentage of assessments with narratives, and residents' response rates. From March through June 2016, 151 procedures were performed in the operating room by the faculty-and-resident teams. There were 107 assessments submitted (71%). Resident response (self-assessment) to faculty evaluations was 81%. Recorded time to complete assessments (n = 75 of 107) was shorter than 2 minutes. The time lapsed to submission was shorter than 72 hours (100%). Dictations were submitted for 35 evaluations (33%). Data for the type of help, performance, and complexity of cases were collected for each resident. SIMPL facilitates timely intraoperative evaluations of surgical skills, engagement by faculty and residents, and collection of detailed procedural

  2. A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities

    PubMed Central

    Yao, Daoyuan; Givens, Gregg

    2015-01-01

    Abstract Introduction: Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. Materials and Methods: This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth® (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. Results: The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach. Conclusions: This browser-server–based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups. PMID:25919376

  3. A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities.

    PubMed

    Yao, Jianchu Jason; Yao, Daoyuan; Givens, Gregg

    2015-09-01

    Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test. This enhanced system is composed of a Web application server, an embedded smart Internet-Bluetooth(®) (Bluetooth SIG, Kirkland, WA) gateway (or console device), and a Bluetooth-enabled audiometer. Several graphical user interfaces and a relational database are hosted on the application server. The console device has been designed to support the tests and auxiliary communication between the local site and the remote site. The study was conducted at an audiology laboratory. Pure-tone audiogram and speech test results from volunteers tested with this tele-audiology system are comparable with results from the traditional face-to-face approach. This browser-server-based comprehensive tele-audiology offers a flexible platform to expand hearing services to traditionally underserved groups.

  4. Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees.

    PubMed

    Campbell, J Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V; Martinez-Castellanos, Maria A; Anzures, Rachelle Go Ang Sam; Chiang, Michael F; Chan, R V Paul

    Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology.

  5. STK Integrated Message Production List Editor (SIMPLE) for CEO Operations

    NASA Technical Reports Server (NTRS)

    Trenchard, Mike; Heydorn, James

    2014-01-01

    Late in fiscal year 2011, the Crew Earth Observations (CEO) team was tasked to upgrade and replace its mission planning and mission operations software systems, which were developed in the Space Shuttle era of the 1980s and 1990s. The impetuses for this change were the planned transition of all workstations to the Windows 7 64-bit operating system and the desire for more efficient and effective use of Satellite Tool Kit (STK) software required for reliable International Space Station (ISS) Earth location tracking. An additional requirement of this new system was the use of the same SQL database of CEO science sites from the SMMS, which was also being developed. STK Integrated Message Production List Editor (SIMPLE) is the essential, all-in-one tool now used by CEO staff to perform daily ISS mission planning to meet its requirement to acquire astronaut photography of specific sites on Earth. The sites are part of a managed, long-term database that has been defined and developed for scientific, educational, and public interest. SIMPLE's end product is a set of basic time and location data computed for an operator-selected set of targets that the ISS crew will be asked to photograph (photography is typically planned 12 to 36 hours out). The CEO operator uses SIMPLE to (a) specify a payload operations planning period; (b) acquire and validate the best available ephemeris data (vectors) for the ISS during the planning period; (c) ingest and display mission-specific site information from the CEO database; (d) identify and display potential current dynamic event targets as map features; (e) compute and display time and location information for each target; (f) screen and select targets based on known crew availability constraints, obliquity constraints, and real-time evaluated constraints to target visibility due to illumination (sun elevation) and atmospheric conditions (weather); and finally (g) incorporate basic, computed time and location information for each selected

  6. Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

    PubMed

    Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

    2017-01-01

    This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning

  7. Tele Hyper Virtuality

    NASA Technical Reports Server (NTRS)

    Terashima, Nobuyoshi

    1994-01-01

    In the future, remote images sent over communication lines will be reproduced in virtual reality (VR). This form of virtual telecommunications, which will allow observers to engage in an activity as though it were real, is the focus of considerable attention. Taken a step further, real and unreal objects will be placed in a single space to create an extremely realistic environment. Here, imaginary and other life forms as well as people and animals in remote locations will gather via telecommunication lines that create a common environment where life forms can work and interact together. Words, gestures, diagrams and other forms of communication will be used freely in performing work. Actual construction of a system based on this new concept will not only provide people with experiences that would have been impossible in the past, but will also inspire new applications in which people will function in environments where it would have been difficult if not impossible for them to function until now. This paper describes Tele Hyper Virtuality concept, its definition, applications, the key technologies to accomplish it and future prospects.

  8. Multi-arm multilateral haptics-based immersive tele-robotic system (HITS) for improvised explosive device disposal

    NASA Astrophysics Data System (ADS)

    Erickson, David; Lacheray, Hervé; Lai, Gilbert; Haddadi, Amir

    2014-06-01

    This paper presents the latest advancements of the Haptics-based Immersive Tele-robotic System (HITS) project, a next generation Improvised Explosive Device (IED) disposal (IEDD) robotic interface containing an immersive telepresence environment for a remotely-controlled three-articulated-robotic-arm system. While the haptic feedback enhances the operator's perception of the remote environment, a third teleoperated dexterous arm, equipped with multiple vision sensors and cameras, provides stereo vision with proper visual cues, and a 3D photo-realistic model of the potential IED. This decentralized system combines various capabilities including stable and scaled motion, singularity avoidance, cross-coupled hybrid control, active collision detection and avoidance, compliance control and constrained motion to provide a safe and intuitive control environment for the operators. Experimental results and validation of the current system are presented through various essential IEDD tasks. This project demonstrates that a two-armed anthropomorphic Explosive Ordnance Disposal (EOD) robot interface can achieve complex neutralization techniques against realistic IEDs without the operator approaching at any time.

  9. A pilot study of tele-anaesthesia by virtual private network between an island hospital and a mainland hospital in Japan.

    PubMed

    Miyashita, Tetsuya; Mizuno, Yusuke; Sugawara, Yo; Nagamine, Yusuka; Koyama, Yukihide; Miyazaki, Tomoyuki; Uchimoto, Kazuhiro; Iketani, Yasuhiro; Tojo, Kentaro; Goto, Takahisa

    2015-03-01

    We studied the use of tele-anaesthesia between Sado General Hospital (SGH) located on Sado Island and Yokohama City University Hospital (YCUH) located in mainland Japan. The two sites were connected via a virtual private network (VPN). We investigated the relationship between the bandwidth of the VPN and both the frame rate and the delay time of the tele-anaesthesia monitoring system. The tool used for communication between the two hospitals was free videoconferencing software (FaceTime), which can be used over Wi-Fi connections. We also investigated the accuracy of the commands given during teleanaesthesia: any commands from the anaesthetist at the YCUH that were not carried out for any reason, were recorded in the anaesthetic records at the SGH. The original frame rate and data rate at the SGH were 5 fps and approximately 18 Mbit/s, respectively. The frame rate at the transmission speeds of 1, 5 and 20 Mbit/s was 0.6, 1.6 and 5.0 fps, respectively. The corresponding delay time was 12.2, 4.9 and 0.7 s. Twenty-five adult patients were enrolled in the study and tele-anaesthesia was performed. The total duration of anaesthesia was 37 hours. All 888 anaesthetic commands were completed. There were 7 FaceTime disconnections, which lasted for 10 min altogether. Because no commands needed to be given during the FaceTime disconnection, the telephone was not used. The anaesthesia assistance system might form part of the solution to medical resource shortages. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Tele-manufactured affordable smartphone anterior segment microscope.

    PubMed

    Chiong, Hong Sheng; Fang, Joyce Lim Luann; Wilson, Graham

    2016-11-01

    The recent advances in mobile technology have made the smartphone a powerful and accessible tool. This article describe the development of a novel smartphone-based anterior segment microscope that is compatible with tele-manufacturing. The anterior segment microscope is equipped with both cobalt-blue and red-free filters that can be used for clinical photo-documentation. The digital files of the microscope are transferrable and compatible with additive-manufacturing. Therefore, the entire device can be locally manufactured with rapid prototyping techniques such as 3D printing. © 2016 Optometry Australia.

  11. Infrasound wave propagation over near-regional and tele-infrasonic distances

    NASA Astrophysics Data System (ADS)

    McKenna, Sara Mihan House

    2005-11-01

    Infrasound research is experiencing a renaissance due to advances in acoustic propagation calculations and a deeper understanding of the atmosphere. Uniquely combining observed data and propagation modeling, the three papers presented here quantify the effects of the atmosphere on propagation from a variety of sources at distances from less than 100 km (near-regional distances) to nearly 600 km (tele-infrasonic distances) for sources on the surface and at altitude (63 km). Paper one analyzes infrasound signals recorded at the CHNAR seismo-acoustic array. These sources are predominantly on the surface, result from human activity and occur closer than 250 km away. Propagation for these near-regional distances depends on tropospheric weather patterns and temporally varying, low-altitude ducts. To predict the observed arrivals local meteorological data is necessary; MSIS/HWM (Mass Spectrometer Incoherent Scatter/Horizontal Wind Model) and NRL-G2S (Naval Research Laboratory Ground To Space) did not predict the observed arrivals. Paper two is the first time a waveform from an explosion at height has ever been reproduced; the recorded waveform was from the break-up of the space shuttle Columbia. For the tele-infrasonic normal mode modeling, MSIS/HWM and NRL-G2S yielded identical waveform results. Paper three looks at the tele-infrasonic path between an iron mine in Minnesota and an infrasound array in Manitoba, Canada. Over a four month period, the IS-10 infrasound array provided infrasound data to compare to archived blast statistics. NRL-G2S better reproduced the observed arrival travel times than MSIS/HWM; whether or not arrivals were observed depended on the noise field at the infrasound array. For any distance range or source height, accurate atmospheric parameters from the corresponding propagation paths are necessary to predict observed infrasound.

  12. Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees

    PubMed Central

    Campbell, J. Peter; Swan, Ryan; Jonas, Karyn; Ostmo, Susan; Ventura, Camila V.; Martinez-Castellanos, Maria A.; Anzures, Rachelle Go Ang Sam; Chiang, Michael F.; Chan, R.V. Paul

    2015-01-01

    Tele-education systems are increasingly being utilized in medical education worldwide. Due to limited human resources in healthcare in low and middle-income countries, developing online systems that are accessible to medical trainees in underserved areas potentially represents a highly efficient and effective method of improving the quantity and quality of the health care workforce. We developed, implemented, and evaluated an interactive web-based tele-education system (based on internationally accepted, image-based guidelines) for the diagnosis of retinopathy of prematurity among ophthalmologists-in-training in Brazil, Mexico, and the Philippines. We demonstrate that participation in this tele-education program improved diagnostic accuracy and reliability, and was preferred to standard pedagogical methods. This system may be employed not only in training, but also in international certification programs, and the process may be generalizable to other image-based specialties, such as dermatology and radiology. PMID:26958168

  13. Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results

    PubMed Central

    Frutos-Pascual, Maite; García Zapirain, Begoña; Méndez Zorrilla, Amaia

    2014-01-01

    Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD. PMID:24402063

  14. Adaptive tele-therapies based on serious games for health for people with time-management and organisational problems: preliminary results.

    PubMed

    Frutos-Pascual, Maite; Zapirain, Begoña García; Zorrilla, Amaia Méndez

    2014-01-07

    Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users' needs, as well as boosting time management skills among teenagers with and without ADHD.

  15. Flight Operations . [Zero Knowledge to Mission Complete

    NASA Technical Reports Server (NTRS)

    Forest, Greg; Apyan, Alex; Hillin, Andrew

    2016-01-01

    Outline the process that takes new hires with zero knowledge all the way to the point of completing missions in Flight Operations. Audience members should be able to outline the attributes of a flight controller and instructor, outline the training flow for flight controllers and instructors, and identify how the flight controller and instructor attributes are necessary to ensure operational excellence in mission prep and execution. Identify how the simulation environment is used to develop crisis management, communication, teamwork, and leadership skills for SGT employees beyond what can be provided by classroom training.

  16. A Bio-Inspired Model-Based Approach for Context-Aware Post-WIMP Tele-Rehabilitation.

    PubMed

    López-Jaquero, Víctor; Rodríguez, Arturo C; Teruel, Miguel A; Montero, Francisco; Navarro, Elena; Gonzalez, Pascual

    2016-10-13

    Tele-rehabilitation is one of the main domains where Information and Communication Technologies (ICT) have been proven useful to move healthcare from care centers to patients' home. Moreover, patients, especially those carrying out a physical therapy, cannot use a traditional Window, Icon, Menu, Pointer (WIMP) system, but they need to interact in a natural way, that is, there is a need to move from WIMP systems to Post-WIMP ones. Moreover, tele-rehabilitation systems should be developed following the context-aware approach, so that they are able to adapt to the patients' context to provide them with usable and effective therapies. In this work a model-based approach is presented to assist stakeholders in the development of context-aware Post-WIMP tele-rehabilitation systems. It entails three different models: (i) a task model for designing the rehabilitation tasks; (ii) a context model to facilitate the adaptation of these tasks to the context; and (iii) a bio-inspired presentation model to specify thoroughly how such tasks should be performed by the patients. Our proposal overcomes one of the limitations of the model-based approach for the development of context-aware systems supporting the specification of non-functional requirements. Finally, a case study is used to illustrate how this proposal can be put into practice to design a real world rehabilitation task.

  17. Telegenetics: application of a tele-education program in genetic syndromes for Brazilian students

    PubMed Central

    MAXIMINO, Luciana Paula; PICOLINI-PEREIRA, Mirela Machado; CARVALHO, José Luiz Brito

    2014-01-01

    With the high occurrence of genetic anomalies in Brazil and the manifestations of communication disorders associated with these conditions, the development of educative actions that comprise these illnesses can bring unique benefits in the identification and appropriate treatment of these clinical pictures. Objective The aim of this study was to develop and analyze an educational program in genetic syndromes for elementary students applied in two Brazilian states, using an Interactive Tele-education model. Material and Methods The study was carried out in 4 schools: two in the state of São Paulo, Southeast Region, Brazil, and two in the state of Amazonas, North Region, Brazil. Forty-five students, both genders, aged between 13 and 14 years, of the 9th grade of the basic education of both public and private system, were divided into two groups: 21 of São Paulo Group (SPG) and 24 of Amazonas Group (AMG). The educational program lasted about 3 months and was divided into two stages including both classroom and distance activities on genetic syndromes. The classroom activity was carried out separately in each school, with expository lessons, graphs and audiovisual contents. In the activity at a distance the educational content was presented to students by means of the Interactive Tele-education model. In this stage, the students had access a Cybertutor, using the Young Doctor Project methodology. In order to measure the effectiveness of the educational program, the Problem Situation Questionnaire (PSQ) and the Web Site Motivational Analysis Checklist adapted (FPM) were used. Results The program developed was effective for knowledge acquisition in 80% of the groups. FPM showed a high satisfaction index from the participants in relation to the Interactive Tele-education, evaluating the program as "awesome course". No statistically significant differences between the groups regarding type of school or state were observed. Conclusion Thus, the Tele-Education Program can

  18. Histamine and tele-methylhistamine quantification in cerebrospinal fluid from narcoleptic subjects by liquid chromatography tandem mass spectrometry with precolumn derivatization.

    PubMed

    Croyal, Mikaël; Dauvilliers, Yves; Labeeuw, Olivier; Capet, Marc; Schwartz, Jean-Charles; Robert, Philippe

    2011-02-01

    An ultra-performance liquid chromatography tandem mass spectrometry (UPLC™-MS/MS) assay was developed for the simultaneous analysis of histamine, its major metabolite tele-methylhistamine, and an internal standard (N-tele-(R)-α-dimethylhistamine) from human cerebrospinal fluid (CSF) samples. The method involves derivatization of primary amines with 4-bromobenzenesulfonyl chloride and subsequent analysis by reversed phase liquid chromatography with mass spectrometry detection and positive electrospray ionization. The separation of derivatized biogenic amines was achieved within 3.5 min on an Acquity® BEH C(18) column by elution with a linear gradient of acetonitrile/water/formic acid (0.1%). The assay was linear in the concentration range of 50-5000 pM for each amine (5.5-555 pg/ml for histamine and 6.25-625 pg/ml for tele-methylhistamine). For repeatability and precision determination, coefficients of variation (CVs) were less than 11.0% over the tested concentration ranges, within acceptance criteria. Thus, the developed method provides the rapid, easy, highly sensitive, and selective requirement to quantify these amines in human CSF. No significant difference was found in the mean ± standard error levels of these amines between a group of narcoleptic patients (histamine=392 ± 64 pM, tele-methylhistamine=2431 ± 461 pM, n=7) and of neurological control subjects (histamine=402 ± 72 pM, tele-methylhistamine=2209 ± 463 pM, n=32). Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Tele-EnREDando.com: A Multimedia WEB-CALL Software for Mobile Phones.

    ERIC Educational Resources Information Center

    Garcia, Jose Carlos

    2002-01-01

    Presents one of the world's first prototypes of language learning software for smart-phones. Tele-EnREDando.com is an Internet based multimedia application designed for 3G mobile phones with audio, video, and interactive exercises for learning Spanish for business. (Author/VWL)

  20. An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

    PubMed

    Abidi, S S

    2001-06-01

    Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

  1. The use of complete sets of orthogonal operators in spectroscopic studies

    NASA Astrophysics Data System (ADS)

    Raassen, A. J. J.; Uylings, P. H. M.

    1996-01-01

    Complete sets of orthogonal operators are used to calculate eigenvalues and eigenvector compositions in complex spectra. The latter are used to transform the LS-transition matrix into realistic intermediate coupling transition probabilities. Calculated transition probabilities for some close lying levels in Ni V and Fe III illustrate the power of the complete orthogonal operator approach.

  2. Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

    PubMed

    Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

    2018-03-01

    Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

  3. Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Tele-conferencing

    PubMed Central

    Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

    2012-01-01

    Background Training through traditional workshops is relatively ineffective for changing counseling practices. Tele-conferencing Supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method 97 community drug treatment counselors completed a 2-day MI workshop and were randomized to: live supervision via tele-conferencing (TCS; n=32), standard tape-based supervision (Tape; n=32), or workshop alone (Workshop; n=33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) coding system pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed effects linear models were used to test training condition on MI skill at 8 and 20 weeks. Results TCS scored better than Workshop on the MITI for Spirit (mean difference = 0.76; p < .0001; d = 1.01) and Empathy (mean difference = 0.68; p < .001; d = 0.74). Tape supervision fell between TCS and Workshop, with Tape superior to Workshop for Spirit (mean difference = 0.40; p < .05). TCS was superior to Workshop in reducing MI non-adherence and increasing MI adherence, and was superior to Workshp and Tape in increasing the reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (Spirit and Empathy scores ≥ 6), and were modest, ranging from 13% to 67%, for TCS and Tape. Conclusion TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods in order to bring more clinicians to high levels of proficiency and facilitate the dissemination of evidence-based practices. PMID:22506795

  4. Supporting telemicroscopy and laboratory medicine activities. The Greek "TELE.INFO.MED.LAB" project.

    PubMed

    Miaoulis, G; Protopapa, E; Skourlas, C; Delides, G

    1995-01-01

    In this paper the authors present the basic results of the study for the "TELE.INFO.MED.LAB" project. This study is based on the local experience of the Metaxas Cancer Institute case and on international references. The possibilities rendered by current developments in telemedicine and particularly in telepathology accelerate and facilitate the communication of crucial medical data and creation of "second level" medical services overcoming the geographical particularities of the country. The availability of data transmission (signals, images, texts, etc.) enables the creation of a "uniform market" for various services. This system must take into account the financial realities, geographical aspects transportation problems and technological developments. Organization of this system, the choices of technical standards and the realization of a complete pilot project are described. For this system we also describe the functional and technical aspects, as well as software and hardware components for the different types of units.

  5. Feasibility and acceptance of a pharmacist-run tele-oncology service for chemotherapy-induced nausea and vomiting in ambulatory cancer patients.

    PubMed

    Yap, Kevin Y-L; Low, Hui X; Koh, Ken S; Un, Matthew; Shih, Vivianne; Chan, Alexandre

    2013-05-01

    The use of telemedicine for cancer patients is limited, particularly in Asia. These patients need to be monitored because more are being treated as outpatients, so that any treatment-related side effects can be managed. We assessed the feasibility and acceptance of a pharmacist-run tele-oncology service to monitor chemotherapy-induced nausea and vomiting (CINV) in ambulatory cancer patients. A single-center, prospective study was conducted at a local cancer center. Patients' CINV symptoms were monitored through short message service (SMS) for 5 days post-chemotherapy. Feasibility was measured by patients' adherence to the service, patient satisfaction, and number of pharmacist interventions. Acceptance was measured by the accrual rate. The accrual rate was 37.6% (68/181 patients). Sixty patients (median age, 49.5 years) completed the study. Overall adherence was 73.3%. The majority (90.0%) were comfortable with the duration of SMS monitoring, especially adherent patients (95.5% versus 75.0%, p=0.038). Over half (61.7%) found the SMS advice useful. Twenty-two intervention calls were made by pharmacists for uncontrolled CINV. A pharmacist-run tele-oncology service for real-time monitoring of CINV is feasible in ambulatory cancer patients. Incorporating the monitoring of other side effects will enhance its value and acceptance by patients for post-chemotherapy symptom management.

  6. A Randomized Controlled Trial Evaluating a Manualized TeleCoaching Protocol for Improving Adherence to a Web-Based Intervention for the Treatment of Depression

    PubMed Central

    Mohr, David C.; Duffecy, Jenna; Ho, Joyce; Kwasny, Mary; Cai, Xuan; Burns, Michelle Nicole; Begale, Mark

    2013-01-01

    Background Web-based interventions for depression that are supported by coaching have generally produced larger effect-sizes, relative to standalone web-based interventions. This is likely due to the effect of coaching on adherence. We evaluated the efficacy of a manualized telephone coaching intervention (TeleCoach) aimed at improving adherence to a web-based intervention (moodManager), as well as the relationship between adherence and depressive symptom outcomes. Methods 101 patients with MDD, recruited from primary care, were randomized to 12 weeks moodManager+TeleCoach, 12 weeks of self-directed moodManager, or 6 weeks of a waitlist control (WLC). Depressive symptom severity was measured using the PHQ-9. Results TeleCoach+moodManager, compared to self-directed moodManager, resulted in significantly greater numbers of login days (p = 0.01), greater time until last use (p = 0.007), greater use of lessons (p = 0.03), greater variety of interactive tools used (p = 0.02), but total instances of tool use did not reach statistical significance. (p = 0.07). TeleCoach+moodManager produced significantly lower PHQ-9 scores relative to WLC at week 6 (p = 0.04), but there were no other significant differences in PHQ-9 scores at weeks 6 or 12 (ps>0.20) across treatment arms. Baseline PHQ-9 scores were no significantly related to adherence to moodManager. Conclusions TeleCoach produced significantly greater adherence to moodManager, relative to self-directed moodManager. TeleCoached moodManager produced greater reductions in depressive symptoms relative to WLC, however, there were no statistically significant differences relative to self-directed moodManager. While greater use was associated with better outcomes, most users in both TeleCoach and self-directed moodManager had dropped out of treatment by week 12. Even with telephone coaching, adherence to web-based interventions for depression remains a challenge. Methods of improving coaching models are

  7. Customer needs, expectations, and satisfaction with clinical neurophysiology services in Ireland: a case for tele-neurophysiology development.

    PubMed

    Fitzsimons, M; Ronan, L; Murphy, K; Browne, G; Connolly, S; McMenamin, J; Delanty, N

    2004-01-01

    Although equitable access to services should be based on need, geographical location of patients and their clinicians can give rise to inequalities in healthcare delivery. Development of tele-medicine services can improve equity of access. The specialty of Clinical Neurophysiology (CN), currently under-developed in Ireland provides an example of such potential. This study aimed to determine the needs, expectations, and satisfaction of CN customers, namely patients and referring clinicians. The goal was to examine geographical impediments to access that might be addressed by the introduction of tele-neurophysiology. Two customer surveys were conducted: CN referring clinicians and CN patients. Thirty-one North Western Health Board (NWHB) consultant clinicians responded to a postal survey. Distance and delays caused by long waiting lists were felt to deter or make CN referral irrelevant. Ninety-seven percent believed the lack of a local service negatively impacts on patient management and 93% would welcome the introduction of a tele-neurophysiology service. The geographical location of patient's residence and/or the location of the referring clinician's practice influenced waiting lists for CN. Fifty-eight (105/182) percent of patients living in a region with a CN service compared to 39% (50/128) of those living in a region with no service received an appointment within one month. In addition to the current insufficient CN service capacity in Ireland, these surveys highlighted geographical inequities. Tele-neurophysiology has the potential to speed-up diagnosis, result in more patients being appropriately investigated and be fairer to patients.

  8. Secure environment for real-time tele-collaboration on virtual simulation of radiation treatment planning.

    PubMed

    Ntasis, Efthymios; Maniatis, Theofanis A; Nikita, Konstantina S

    2003-01-01

    A secure framework is described for real-time tele-collaboration on Virtual Simulation procedure of Radiation Treatment Planning. An integrated approach is followed clustering the security issues faced by the system into organizational issues, security issues over the LAN and security issues over the LAN-to-LAN connection. The design and the implementation of the security services are performed according to the identified security requirements, along with the need for real time communication between the collaborating health care professionals. A detailed description of the implementation is given, presenting a solution, which can directly be tailored to other tele-collaboration services in the field of health care. The pilot study of the proposed security components proves the feasibility of the secure environment, and the consistency with the high performance demands of the application.

  9. Absolute continuity for operator valued completely positive maps on C∗-algebras

    NASA Astrophysics Data System (ADS)

    Gheondea, Aurelian; Kavruk, Ali Şamil

    2009-02-01

    Motivated by applicability to quantum operations, quantum information, and quantum probability, we investigate the notion of absolute continuity for operator valued completely positive maps on C∗-algebras, previously introduced by Parthasarathy [in Athens Conference on Applied Probability and Time Series Analysis I (Springer-Verlag, Berlin, 1996), pp. 34-54]. We obtain an intrinsic definition of absolute continuity, we show that the Lebesgue decomposition defined by Parthasarathy is the maximal one among all other Lebesgue-type decompositions and that this maximal Lebesgue decomposition does not depend on the jointly dominating completely positive map, we obtain more flexible formulas for calculating the maximal Lebesgue decomposition, and we point out the nonuniqueness of the Lebesgue decomposition as well as a sufficient condition for uniqueness. In addition, we consider Radon-Nikodym derivatives for absolutely continuous completely positive maps that, in general, are unbounded positive self-adjoint operators affiliated to a certain von Neumann algebra, and we obtain a spectral approximation by bounded Radon-Nikodym derivatives. An application to the existence of the infimum of two completely positive maps is indicated, and formulas in terms of Choi's matrices for the Lebesgue decomposition of completely positive maps in matrix algebras are obtained.

  10. Outpatient virtual clinical encounters after complex surgery for cancer: a prospective pilot study of "TeleDischarge".

    PubMed

    Katz, Matthew H G; Slack, Rebecca; Bruno, Morgan; McMillan, Jermaine; Fleming, Jason B; Lee, Jeffrey E; Bednarski, Brian; Papadopoulos, John; Matin, Surena F

    2016-05-01

    Outpatient clinical encounters are used to promote recovery after complex surgical procedures for cancer. These care episodes are resource intensive. Virtual clinical encounters (VCEs) can now be conducted using widely available videoconferencing technologies. However, whether these technologies may be used to monitor postoperative recovery is unknown. In this pilot study, we provided care using a comprehensive "TeleDischarge" protocol to 15 patients after pancreatectomy. In addition to routine follow-up, all patients participated in two scheduled and an unlimited number of unscheduled VCEs using mobile hardware and secure videoconferencing software. We evaluated feasibility, patient satisfaction, postoperative adverse events, and health care human resource utilization. The median age of enrolled patients was 63 y (range, 52-83 y) and 93% underwent pancreatoduodenectomy. Twenty-eight scheduled VCEs (93%) were completed successfully, and only one unscheduled VCE was requested. Twelve patients (80%) felt their postoperative care was enhanced by VCEs and 14 (93%) felt that VCEs should be a regular part of postoperative care. Minor interventions in four patients (27%) were performed on the basis of clinical data gathered during a VCE. On a per patient basis, the TeleDischarge pathway was estimated to take 36 min longer and to have a direct labor cost $39 greater than the standard pathway. Secure VCEs can be conducted using widely available hardware and software solutions. Although cancer patients support the introduction of mobile technology into postoperative care, further studies are needed to identify ways in which such technology can be used most effectively and efficiently to reduce barriers to recovery. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Tele-surgery simulation with a patient organ model for robotic surgery training.

    PubMed

    Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

    2005-12-01

    Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance. Copyright 2005 John Wiley & Sons, Ltd.

  12. BioDAQ--a simple biosignal acquisition system for didactic use.

    PubMed

    Csaky, Z; Mihalas, G I; Focsa, M

    2002-01-01

    A simple non expensive device for biosignal acquisition is presented. It mainly meets the requirements for didactic purposes specific in medical informatics laboratory classes. The system has two main types of devices: 'student unit'--the simplest one, used during lessons on real signals and 'demo unit', which can be also used in medical practice or for collecting biological signals. It is able to record: optical pulse, sphygmogram, ECG (1-4 leads) EEG or EMG (1-4 channels). For didactical purposes it has a large scale of recording options: variable sampling rate, gain and filtering. It can also be used in tele-acquisition via Internet.

  13. Determining Salinity by Simple Means.

    ERIC Educational Resources Information Center

    Schlenker, Richard M.

    This paper describes the construction and use of a simple salinometer. The salinometer is composed, mainly, of a milliammeter and a battery and uses the measurement of current flow to determine the salinity of water. A complete list of materials is given, as are details of construction and operation of the equipment. The use of the salinometer in…

  14. Tele-evidence: A videoconferencing tool as a viable alternative to physical appearance of doctors for the judicial summons.

    PubMed

    Bari, S; Arora, P; Gupta, A K; Singh, M; Aggarwal, A K

    2018-06-26

    The role of physicians often extends beyond provision of direct patient care and includes appearance in courts as professional or expert witnesses to give their testimony in various legal cases. This often consumes precious time and resources of the doctors and the hospitals. This study was taken up to evaluate the present system of the physical appearance of the doctors to various courts and compare it with the videoconferencing mode of giving testimony (tele-evidence). Available records of summons and vehicles used were analyzed to calculate the cost involved and man-hours consumed in honoring the court summons. Telemedicine facility, available in our institute, was used for conducting tele-evidence with selected courts of the two states as a pilot, which was later expanded. A survey was also done to assess the experience of the physicians with physical appearance and videoconferencing using structured questionnaire after approval from the Institute's Ethics Committee. Likert scale of 0-10 points was used to measure satisfaction. There was 43% drop in the monthly mileage of vehicles, 49% reduction in the fuel cost per month, and 28% savings in terms of time consumed for court duties. Satisfaction score for parameters of time consumed, physical strain, mental strain, communication with Honorable Judges, and overall experience was 87% through tele-evidence as compared to 31% with physical appearance. Tele-evidence is an acceptable and implementable mode of testifying and has led to tremendous resource savings in our tertiary care setting. The model needs to be replicated for deliverance of justice and is in consonance with Government's push toward Digital India.

  15. 78 FR 68079 - Information Collection Activities: Oil and Gas Well-Completion Operations; Submitted for Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ...: Oil and Gas Well-Completion Operations; Submitted for Office of Management and Budget (OMB) Review... Completion Operations. This notice also provides the public a second opportunity to comment on the revised... Well-Completion Operations. OMB Control Number: 1014-0004. Abstract: The Outer Continental Shelf (OCS...

  16. Defining Simple nD Operations Based on Prosmatic nD Objects

    NASA Astrophysics Data System (ADS)

    Arroyo Ohori, K.; Ledoux, H.; Stoter, J.

    2016-10-01

    An alternative to the traditional approaches to model separately 2D/3D space, time, scale and other parametrisable characteristics in GIS lies in the higher-dimensional modelling of geographic information, in which a chosen set of non-spatial characteristics, e.g. time and scale, are modelled as extra geometric dimensions perpendicular to the spatial ones, thus creating a higher-dimensional model. While higher-dimensional models are undoubtedly powerful, they are also hard to create and manipulate due to our lack of an intuitive understanding in dimensions higher than three. As a solution to this problem, this paper proposes a methodology that makes nD object generation easier by splitting the creation and manipulation process into three steps: (i) constructing simple nD objects based on nD prismatic polytopes - analogous to prisms in 3D -, (ii) defining simple modification operations at the vertex level, and (iii) simple postprocessing to fix errors introduced in the model. As a use case, we show how two sets of operations can be defined and implemented in a dimension-independent manner using this methodology: the most common transformations (i.e. translation, scaling and rotation) and the collapse of objects. The nD objects generated in this manner can then be used as a basis for an nD GIS.

  17. Five-year experience of tele-ophthalmology for diabetic retinopathy screening in a rural population.

    PubMed

    Rodríguez Villa, S; Alonso Álvarez, C; de Dios Del Valle, R; Salazar Méndez, R; Cuesta García, M; Ruiz García, M J; Cubillas Martín, M; Rodríguez Vazquez, M

    2016-09-01

    To identify the prevalence and risk factors of diabetic retinopathy (DR) among rural inhabitants included in a tele-ophthalmology program. To analyse diagnostic accuracy among primary care physicians, concordance with ophthalmologists, and financial savings. An observational randomised study was conducted on 394 patients included in a tele-ophthalmology program (from January 2010 to January 2015). An analysis was performed on the clinical characteristics, DR findings in retinography images, and correspondence between the request for a second interpretation by an ophthalmologist, and previously established criteria for it: presence of moderate to severe DR, vision loss, poor image quality and/or intraocular pressure >22mmHg. Statistical analysis was performed using the SPSS program (Student t and χ(2) tests). DR prevalence was 12.1%. Patients with glycosylated haemoglobin values >7.68% or those treated with a combination of insulin and oral antidiabetic drugs showed a higher risk of DR (P<.05). 43.3% of patients correctly referred to ophthalmologists showed moderate to severe DR. Unnecessary referrals to specialists were improved from 91.7% in 2010 to 98.6% in 2014. It is estimated that the program has made a total saving of €152,550.45. Tele-ophthalmology programs are a useful tool in DR screening. Primary care physicians are able to distinguish patients who need specialist care, avoiding unnecessary referrals to ophthalmologists, and saving costs. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  18. Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study.

    PubMed

    Bansal, Manish; Singh, Shaanemeet; Maheshwari, Puneet; Adams, David; McCulloch, Marti L; Dada, Tanuj; Sengupta, Shantanu P; Kasliwal, Ravi R; Pellikka, Patricia A; Sengupta, Partho P

    2015-01-01

    Point-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness. Seventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared. A total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all). This study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health. Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  19. Test Waveform Applications for JPL STRS Operating Environment

    NASA Technical Reports Server (NTRS)

    Lux, James P.; Peters, Kenneth J.; Taylor, Gregory H.; Lang, Minh; Stern, Ryan A.; Duncan, Courtney B.

    2013-01-01

    This software demonstrates use of the JPL Space Telecommunications Radio System (STRS) Operating Environment (OE), tests APIs (application programming interfaces) presented by JPL STRS OE, and allows for basic testing of the underlying hardware platform. This software uses the JPL STRS Operating Environment ["JPL Space Tele com - munications Rad io System Operating Environment,"(NPO-4776) NASA Tech Briefs, commercial edition, Vol. 37, No. 1 (January 2013), p. 47] to interact with the JPL-SDR Software Defined Radio developed for the CoNNeCT (COmmunications, Navigation, and Networking rEconfigurable Testbed) Project as part of the SCaN Testbed installed on the International Space Station (ISS). These are the first applications that are compliant with the new NASA STRS Architecture Standard. Several example waveform applications are provided to demonstrate use of the JPL STRS OE for the JPL-SDR platform used for the CoNNeCT Project. The waveforms provide a simple digitizer and playback capability for the SBand RF slice, and a simple digitizer for the GPS slice [CoNNeCT Global Positioning System RF Module, (NPO-47764) NASA Tech Briefs, commercial edition, Vol. 36, No. 3 (March 2012), p. 36]. These waveforms may be used for hardware test, as well as for on-orbit or laboratory checkout. Additional example waveforms implement SpaceWire and timer modules, which can be used for time transfer and demonstration of communication between the two Xilinx FPGAs in the JPLSDR. The waveforms are also compatible with ground-based use of the JPL STRS OE on radio breadboards and Linux.

  20. [Communication subsystem design of tele-screening system for diabetic retinopathy].

    PubMed

    Chen, Jian; Pan, Lin; Zheng, Shaohua; Yu, Lun

    2013-12-01

    A design scheme of a tele-screening system for diabetic retinopathy (DR) has been proposed, especially the communication subsystem. The scheme uses serial communication module consisting of ARM 7 microcontroller and relays to connect remote computer and fundus camera, and also uses C++ programming language based on MFC to design the communication software consisting of therapy and diagnostic information module, video/audio surveillance module and fundus camera control module. The scheme possesses universal property in some remote medical treatment systems which are similar to the system.

  1. Development of a prototype of the tele-localisation system in radiotherapy using personal digital assistant via wireless communication.

    PubMed

    Wu, Vincent Wing-Cheung; Tang, Fuk-hay; Cheung, Wai-kwan; Chan, Kit-chi

    2013-02-01

    In localisation of radiotherapy treatment field, the oncologist is present at the simulator to approve treatment details produced by the therapist. Problems may arise if the oncologist is not available and the patient requires urgent treatment. The development of a tele-localisation system is a potential solution, where the oncologist uses a personal digital assistant (PDA) to localise the treatment field on the image sent from the simulator through wireless communication and returns the information to the therapist after his or her approval. Our team developed the first tele-localisation prototype, which consisted of a server workstation (simulator) for the administration of digital imaging and communication in medicine localisation images including viewing and communication with the PDA via a Wi-Fi network; a PDA (oncologist's site) installed with the custom-built programme that synchronises with the server workstation and performs treatment field editing. Trial tests on accuracy and speed of the prototype system were conducted on 30 subjects with the treatment regions covering the neck, skull, chest and pelvis. The average time required in performing the localisation using the PDA was less than 1.5 min, with the blocked field longer than the open field. The transmission speed of the four treatment regions was similar. The average physical distortion of the images was within 4.4% and the accuracy of field size indication was within 5.3%. Compared with the manual method, the tele-localisation system presented with an average deviation of 5.5%. The prototype system fulfilled the planned objectives of tele-localisation procedure with reasonable speed and accuracy. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  2. Normal Cerebrospinal Fluid Histamine and tele-Methylhistamine Levels in Hypersomnia Conditions

    PubMed Central

    Dauvilliers, Yves; Delallée, Nathalie; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Croyal, Mickael; Schwartz, Jean-Charles; Robert, Philippe

    2012-01-01

    Study Objectives: To determine the activity of cerebral histaminergic system evaluated by CSF levels of histamine (HA) and tele-methylhistamine (t-MHA), its major metabolite, and their relationships with hypocretin-1 levels in a large population of patients with hypersomnia and neurological conditions. Design: sensitive liquid chromatographic-electrospray/tandem mass spectrometric assay was developed for the simultaneous quantification of CSF HA and t-MHA. Setting: ata were collected and CSF hypocretin-1 levels were measured using radioimmunoassay at the Sleep Disorders Center, Montpellier, France. CSF HA and t-MHA were measured in Bioprojet-Biotech, France Participants: One hundred fourteen unrelated patients with a suspicion of central hypersomnia underwent one night of polysomnography followed by the multiple sleep latency test. Sleep disorders were diagnosed clinically and using sleep studies: narcolepsy-cataplexy NC (n = 56), narcolepsy without cataplexy NwC (n = 27), idiopathic hypersomnia IH (n = 11), secondary narcolepsy (n = 3), and unspecified hypersomnia Uns EDS (n = 17). Fifty neurological patients without daytime sleepiness were included as controls. Measurements and Results: No between-hypersomnia group differences were found for CSF HA levels (median 708.62 pM extreme range [55.92-3335.50] in NC; 781.34 [174.08-4391.50] in NwC; 489.42 [177.45-906.70] in IH, and 1155.40 [134.80-2736.59] in Uns EDS) or for t-MHA levels. No association was found between CSF HA, t-MHA, or HA + t-MHA, sleepiness, treatment intake, and frequency of cataplexy. A slight negative correlation was found between age and HA levels. Further adjustment for the age revealed no significant HA levels difference between hypersomnia patients and controls. Conclusion: CSF histamine and tele-methylhistamine did not significantly differ between patients with narcolepsy-cataplexy and other etiologies of non-hypocretin-1 deficient central hypersomnias; these measurements, therefore, are not

  3. United States Department of Energy, Nevada Operations Office, completion report Operation KLAXON, Fiscal Year 1993

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

    Not Available

    1994-06-01

    The U.S. Department of Energy, Nevada Operations Office (DOE/NV), Completion Report provides a summary of activities conducted at the Nevada Test Site (NTS) between October 1, 1992, and September 30, 1993, associated with Operation KLAXON. (In the past, each annual Completion Report dealt with a series of underground nuclear detonations; however, because no nuclear tests were conducted during FY 1993, this Report summarizes continuing nonnuclear and nuclear test readiness activities at the NTS sponsored by DOE/NV.) The report serves as a reference for those involved with the planning and execution of Operation KLAXON and also serves as a planning guidemore » for future operations. Information in the report covers the logistics and management of activities. Scientific information and data associated with NTS activities are presented in technical documents published by participating agencies. In September 1992, Congress legislated a nine-month moratorium on the testing of nuclear weapons. The bill also provided for a resumption of testing (with no more than five tests per year, or a total of 15 during the next three years) in July 1993, and mandated an end to nuclear testing, entirely, by 1996. President Bush signed the bill into law in October 1992.« less

  4. Land Ahoy! Understanding Submarine Command and Control During the Completion of Inshore Operations.

    PubMed

    Roberts, Aaron P J; Stanton, Neville A; Fay, Daniel

    2017-12-01

    The aim of this study was to use multiple command teams to provide empirical evidence for understanding communication flow, information pertinence, and tasks undertaken in a submarine control room when completing higher- and lower-demand inshore operation (INSO) scenarios. The focus of submarine operations has changed, and submarines are increasingly required to operate in costal littoral zones. However, submarine command team performance during INSO is not well understood, particularly from a sociotechnical systems perspective. A submarine control-room simulator was built. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during INSO. The Event Analysis of Systematic Teamwork method was used to model the social, task, and information networks and to describe command team performance. Ten teams were recruited for the study, affording statistical comparisons of how command-team roles and level of demand affected performance. Results indicated that the submarine command-team members are required to rapidly integrate sonar and visual data as the periscope is used, periodically, in a "duck-and-run" fashion, to maintain covertness. The fusion of such information is primarily completed by the operations officer (OPSO), with this operator experiencing significantly greater demand than any other operator. The OPSO was a bottleneck in the command team when completing INSO, experiencing similar load in both scenarios, suggesting that the command team may benefit from data synthesis tasks being more evenly distributed within the command team. The work can inform future control-room design and command-team ways of working by identifying bottlenecks in terms of information and task flow between operators.

  5. Tele-surgery: a new virtual tool for medical education.

    PubMed

    Russomano, Thais; Cardoso, Ricardo B; Fernandes, Jefferson; Cardoso, Paulizan G; Alves, Jarcedy M; Pianta, Christina D; Souza, Hamilton P; Lopes, Maria Helena I

    2009-01-01

    The rapid evolution of telecommunication technology has enabled advances to be made in low cost video-conferencing through the improvement of high speed computer communication networks and the enhancement of Internet security protocols. As a result of this progress, eHealth education programs are becoming a reality in universities, providing the opportunity for students to have greater interaction at live surgery classes by means of virtual participation. Undergraduate students can be introduced to new concepts of medical care, remote second opinion and to telecommunication systems, whilst virtually experiencing surgical procedures and lectures. The better access this provides to the operating theater environment, the patient and the surgeon can improve the learning process for students. An analogical system was used for this experimental pilot project due to the benefits of it being low cost with a comparatively easy setup. The tele-surgery lectures were also transmitted to other universities by means of a Pentium 4 computer using open source software and connected to a portable image acquisition device located in the São Lucas University Hospital. Telemedicine technology has proven to be an important instrument for the improvement of medical education and health care. This study allowed health professionals, professors and students to have greater interaction during surgical procedures, thus enabling a greater opportunity for knowledge exchange.

  6. Tele-Epidemiology and Public Health in the Canadian Context

    NASA Astrophysics Data System (ADS)

    Brazeau, Stephanie; Kotchi, Serge Olivier; Ludwig, Antoinette; Turgeon, Patricia; Pelcat, Yann; Aube, Guy; Ogden, Nicholas H.

    2016-08-01

    The management of key public health issues requires solid evidence-based knowledge for the prevention and control of various emerging or re-emerging vector borne diseases (e.g. Lyme disease, West Nile virus, etc.) and environmentally-linked diseases (e.g. enteric infections from recreational water contamination). Earth observation (EO) images enhance knowledge and capacity to characterize risk of illness across the vast Canadian territory by deriving new and up-to-date data from population, climatic and environmental determinants of health relevant to public health actions such as risk mapping, risk communication and identification of vulnerable populations.Modeling of infectious disease transmission has made possible the identification of risk areas and the underlying factors (human activities, ecology, environment and climate) that may explain this emergence. New data products derived from Earth observation satellites pertaining to climate, land cover and land use, and distribution and density of animal and human populations have greatly improved the resolution and the specificity of explanatory and predictive models.This article focuses on the scope of tele-epidemiology activities of the Canadian public health community as well as current and potential future fields of application for Earth observation data. It will demonstrate the strength, sustainability and innovative character of these approaches to improve scale-dependent decision- making at different levels of government in Canada (federal, provincial/territorial and regional) and increase the efficiency of many preventive, preparedness and response actions.Examples of tele-epidemiology applications will be presented such as the risk assessment of microbial contamination of recreational waters and modelling the risk of vector borne diseases in the Canadian context.

  7. Traditional Nurse Triage vs. Physician Tele-Presence in a Pediatric Emergency Department

    PubMed Central

    Marconi, Greg P.; Chang, Todd; Pham, Phung K.; Grajower, Daniel N.; Nager, Alan L.

    2014-01-01

    Objectives To compare traditional nurse triage (TNT) in a Pediatric Emergency Department (PED) to physician tele-presence (PTP). Methods Prospective, 2×2 crossover study with random assignment using a sample of walk-in patients seeking care in a PED at a large, tertiary care children’s hospital, from May 2012 to January 2013. Outcomes of triage times, documentation errors, triage scores, and survey responses were compared between TNT and PTP. Comparison between PTP to actual treating PED physicians regarding the accuracy of ordering blood and urine tests, throat cultures, and radiologic imaging was also studied. Results Paired samples t-tests showed a statistically significant difference in triage time between TNT and PTP (p=0.03), but no significant difference in documentation errors (p=0.10). Triage scores of TNT were 71% accurate, compared to PTP, which were 95% accurate. Both parents and children had favorable scores regarding PTP and the majority indicated they would prefer PTP again at their next PED visit. PTP diagnostic ordering was comparable to the actual PED physician ordering, showing no statistical differences. Conclusions Utilizing physician tele-presence technology to remotely perform triage is a feasible alternative to traditional nurse triage, with no clinically significant differences in time, triage scores, errors and patient and parent satisfaction. PMID:24445223

  8. Trans-Pacific tele-ultrasound image transmission of fetal central nervous system structures.

    PubMed

    Ferreira, Adilson Cunha; Araujo Júnior, Edward; Martins, Wellington P; Jordão, João Francisco; Oliani, Antônio Hélio; Meagher, Simon E; Da Silva Costa, Fabricio

    2015-01-01

    To assess the quality of images and video clips of fetal central nervous (CNS) structures obtained by ultrasound and transmitted via tele-ultrasound from Brazil to Australia. In this cross-sectional study, 15 normal singleton pregnant women between 20 and 26 weeks were selected. Fetal CNS structures were obtained by images and video clips. The exams were transmitted in real-time using a broadband internet and an inexpensive video streaming device. Four blinded examiners evaluated the quality of the exams using the Likert scale. We calculated the mean, standard deviation, mean difference, and p values were obtained from paired t tests. The quality of the original video clips was slightly better than that observed by the transmitted video clips; mean difference considering all observers = 0.23 points. In 47/60 comparisons (78.3%; 95% CI = 66.4-86.9%) the quality of the video clips were judged to be the same. In 182/240 still images (75.8%; 95% CI = 70.0-80.8%) the scores of transmitted image were considered the same as the original. We demonstrated that long distance tele-ultrasound transmission of fetal CNS structures using an inexpensive video streaming device provided images of subjective good quality.

  9. Training Teachers to Assess the Challenging Behaviors of Students with Autism Using Video Tele-Conferencing

    ERIC Educational Resources Information Center

    Machalicek, Wendy; O'Reilly, Mark F.; Rispoli, Mandy; Davis, Tonya; Lang, Russell; Franco, Jessica Hetlinger; Chan, Jeffrey M.

    2010-01-01

    We examined the effects of performance feedback provided via video tele-conferencing (VTC) on the acquisition of functional analysis procedures by six teachers. A university supervisor used VTC equipment (i.e., computers equipped with web cameras and Internet) to provide feedback to teachers learning to implement functional analysis conditions…

  10. iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents?

    PubMed

    Shah, Manan Udayan; Sohal, Maheep; Valdez, Tulio A; Grindle, Christopher R

    2018-03-01

    Tele-otoscopy has been validated for tympanostomy surveillance and remote diagnosis when images are recorded by trained professionals. The CellScope iPhone Otoscope is a device that may be used for tele-otoscopy and it enables parents to record their children's ear examinations and send the films for remote physician diagnosis. This study aims to determine the ability to diagnose, and the reliability of the diagnosis when utilizing video exams obtained by a parent versus video exams obtained by an otolaryngologist. Parents of children ages 17 years or younger attempted recordings of the tympanic membrane of their children with the CellScope after a video tutorial; a physician subsequently used the device to record the same ear. Recordings occurred prior to standard pediatric otolaryngology office evaluation. Later, a remote pediatric otolaryngologist attempted diagnosis solely based on the videos, blinded to whether the examination was filmed by a parent or physician. Interrater reliability between video diagnosis and original diagnosis on pneumatic otoscopy was measured, and objective tympanic membrane landmarks visualized on the films were recorded. Eighty ears were enrolled and recorded. There was low interrater agreement (k = 0.42) between diagnosis based on parent videos as compared with pneumatic otoscopy. There was high agreement (k = 0.71) between diagnosis based on physician videos and pneumatic otoscopy. Physician videos and parent videos had only slight agreement on objective landmarks identified (k = 0.087). iPhone otoscopy provides reliable tele-otoscopy images in when used by trained professionals but, currently, images obtained by parents are not suitable for use in diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Rock mechanics issues in completion and stimulation operations

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

    Warpinski, N.R.

    Rock mechanisms parameters such as the in situ stresses, elastic properties, failure characteristics, and poro-elastic response are important to most completion and stimulation operations. Perforating, hydraulic fracturing, wellbore stability, and sand production are examples of technology that are largely controlled by the rock mechanics of the process. While much research has been performed in these areas, there has been insufficient application that research by industry. In addition, there are new research needs that must be addressed for technology advancement.

  12. Reduction in operator radiation exposure during transradial coronary procedures using a simple lead rectangle.

    PubMed

    Osherov, Azriel B; Bruoha, Sharon; Laish Farkash, Avishag; Paul, Gideon; Orlov, Ian; Katz, Amos; Jafari, Jamal

    2017-02-01

    Transradial access for percutaneous coronary intervention (PCI) reduces procedural complications however, there are concerns regarding the potential for increased exposure to ionizing radiation to the primary operator. We evaluated the efficacy of a lead-attenuator in reducing radiation exposure during transradial PCI. This was a non-randomized, prospective, observational study in which 52 consecutive patients were assigned to either standard operator protection (n = 26) or the addition of the lead attenuator across their abdomen/pelvis (n = 26). In the attenuator group patients were relatively older with a higher prevalence of peripheral vascular disease (67.9 vs 58.7 p = 0.0292 and 12% vs 7.6% p < 0.001 respectively). Despite similar average fluoroscopy times (12.3 ± 9.8 min vs. 9.3 ± 5.4 min, p = 0.175) and average examination doses (111866 ± 80790 vs. 91,268 ± 47916 Gycm 2 , p = 0.2688), the total radiation exposure to the operator, at the thyroid level, was significantly lower when the lead-attenuator was utilized (20.2% p < 0.0001) as compared to the control group. Amongst the 26 patients assigned to the lead-attenuator, there was a significant reduction in measured radiation of 94.5% (p < 0.0001), above as compared to underneath the lead attenuator. Additional protection with the use of a lead rectangle-attenuator significantly lowered radiation exposure to the primary operator, which may confer long-term benefits in reducing radiation-induced injury. This is the first paper to show that a simple lead attenuator almost completely reduced the scattered radiation at very close proximity to the patient and should be considered as part of the standard equipment within catheterization laboratories.

  13. Ethical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession.

    PubMed

    Demiris, George; Oliver, Debra Parker; Courtney, Karen L

    2006-01-01

    Home care, including hospice care, is a growing component of the current healthcare system and pertains to care services that are provided to individuals, their family members, and caregivers in their own residence. Both domains face funding limitations as life expectancy and the segment of the population older than 65 years increase. Tele-health, defined as the use of advanced telecommunication technologies to enable communication between patients and healthcare providers separated by geographic distance, is perceived as a concept that can enhance both home and hospice care and address some of the current challenges. This article discusses ethical challenges associated with the utilization of tele-health technologies by the nursing profession in the home setting. These factors form a framework for the ethical considerations that result from the introduction of these technologies in nursing practice. Specifically, the article discusses the issue of privacy and confidentiality of patient data, informed consent, equity of access, promoting dependency versus independence, the lack of human touch and the impact of technology on the nurse-patient relationship, and the medicalization of the home environment. These issues constitute a road map both for nursing practitioners who are aiming to provide an efficient delivery of services in the home and for nursing administrators who are asked to make judgments about the use of tele-health technology as a supplement to traditional care and as a cost-saving tool.

  14. Evaluation of a completely robotized neurosurgical operating microscope.

    PubMed

    Kantelhardt, Sven R; Finke, Markus; Schweikard, Achim; Giese, Alf

    2013-01-01

    Operating microscopes are essential for most neurosurgical procedures. Modern robot-assisted controls offer new possibilities, combining the advantages of conventional and automated systems. We evaluated the prototype of a completely robotized operating microscope with an integrated optical coherence tomography module. A standard operating microscope was fitted with motors and control instruments, with the manual control mode and balance preserved. In the robot mode, the microscope was steered by a remote control that could be fixed to a surgical instrument. External encoders and accelerometers tracked microscope movements. The microscope was additionally fitted with an optical coherence tomography-scanning module. The robotized microscope was tested on model systems. It could be freely positioned, without forcing the surgeon to take the hands from the instruments or avert the eyes from the oculars. Positioning error was about 1 mm, and vibration faded in 1 second. Tracking of microscope movements, combined with an autofocus function, allowed determination of the focus position within the 3-dimensional space. This constituted a second loop of navigation independent from conventional infrared reflector-based techniques. In the robot mode, automated optical coherence tomography scanning of large surface areas was feasible. The prototype of a robotized optical coherence tomography-integrated operating microscope combines the advantages of a conventional manually controlled operating microscope with a remote-controlled positioning aid and a self-navigating microscope system that performs automated positioning tasks such as surface scans. This demonstrates that, in the future, operating microscopes may be used to acquire intraoperative spatial data, volume changes, and structural data of brain or brain tumor tissue.

  15. Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

    PubMed

    Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

    2015-07-26

    Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

  16. Army Operations in China. January 1944 - August 1945

    DTIC Science & Technology

    1956-08-31

    in early or mid-A- agust . 172 Places to be Occupied: Vital coastal zones near Yungchia and Fuchou. Part of tha force will reinforce Esiamen.2...una.er e coErna.no. O.i. -u .. 1e l\\aVa.i. .Lanct:Lng ·orce comt .’la.noer. - 6. The description of these operations was obtained from tele- grams in the

  17. Auto-converging stereo cameras for 3D robotic tele-operation

    NASA Astrophysics Data System (ADS)

    Edmondson, Richard; Aycock, Todd; Chenault, David

    2012-06-01

    Polaris Sensor Technologies has developed a Stereovision Upgrade Kit for TALON robot to provide enhanced depth perception to the operator. This kit previously required the TALON Operator Control Unit to be equipped with the optional touchscreen interface to allow for operator control of the camera convergence angle adjustment. This adjustment allowed for optimal camera convergence independent of the distance from the camera to the object being viewed. Polaris has recently improved the performance of the stereo camera by implementing an Automatic Convergence algorithm in a field programmable gate array in the camera assembly. This algorithm uses scene content to automatically adjust the camera convergence angle, freeing the operator to focus on the task rather than adjustment of the vision system. The autoconvergence capability has been demonstrated on both visible zoom cameras and longwave infrared microbolometer stereo pairs.

  18. 75 FR 18545 - MMS Information Collection Activity: 1010-0067, Oil and Gas Well-Completion Operations, Extension...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-12

    ... Information Collection Activity: 1010-0067, Oil and Gas Well- Completion Operations, Extension of a Collection... requirements in the regulations under 30 CFR 250, Subpart E, ``Oil and Gas Well-Completion Operations.'' DATES... address. SUPPLEMENTARY INFORMATION: Title: 30 CFR part 250, subpart E, Oil and Gas Well-Completion...

  19. A scalable and operationally simple radical trifluoromethylation

    PubMed Central

    Beatty, Joel W.; Douglas, James J.; Cole, Kevin P.; Stephenson, Corey R. J.

    2015-01-01

    The large number of reagents that have been developed for the synthesis of trifluoromethylated compounds is a testament to the importance of the CF3 group as well as the associated synthetic challenge. Current state-of-the-art reagents for appending the CF3 functionality directly are highly effective; however, their use on preparative scale has minimal precedent because they require multistep synthesis for their preparation, and/or are prohibitively expensive for large-scale application. For a scalable trifluoromethylation methodology, trifluoroacetic acid and its anhydride represent an attractive solution in terms of cost and availability; however, because of the exceedingly high oxidation potential of trifluoroacetate, previous endeavours to use this material as a CF3 source have required the use of highly forcing conditions. Here we report a strategy for the use of trifluoroacetic anhydride for a scalable and operationally simple trifluoromethylation reaction using pyridine N-oxide and photoredox catalysis to affect a facile decarboxylation to the CF3 radical. PMID:26258541

  20. Beware! A simple renal cyst could be a hydatid cyst.

    PubMed

    Sehgal, Nidhi; Priyadarshi, Vinod

    2017-01-01

    Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock. A simple cyst harboring a hydatid cyst is highly uncommon and quite dangerous; as if not diagnosed preoperatively, it can create huge trouble for both the patient and the operating surgeon which happened in the present case.

  1. The number of operations required for completing breast reconstruction.

    PubMed

    Eom, Jin Sup; Kobayashi, Mark Robert; Paydar, Keyianoosh; Wirth, Garrett A; Evans, Gregory R D

    2014-10-01

    Breast reconstruction often requires multiple surgeries, which demands additional expense and time and is often contrary to the patient's expectation. The aim of this study was to review the number of operations that were needed for completion of breast reconstruction and to determine patient and clinical factors that influenced this number. We retrospectively reviewed the medical records of 254 cases of breast reconstructions (in 185 patients) that were performed between February 2005 and August 2009. We investigated the numbers of operations that were performed for individual case of breast reconstruction and analyzed the influence of variable factors. The purpose of the additional operations was also analyzed. The mean number of operations per breast was 2.37 (range, 1-9). The mean number of operations for mound creation was 2.24. Factors associated with an increased number of operation were use of an implant, contralateral symmetrization, complications, and nipple reconstruction. Considering the reconstruction method, either the use of a primary implant or the use of free abdominal tissue transfer demonstrated fewer surgeries than the use of an expander implant, and the number of operations using free transverse rectus abdominis musculocutaneous or deep inferior epigastric perforator flaps was less than the number of operations using pedicled transverse rectus abdominis musculocutaneous flaps. These data will aid in planning breast reconstruction surgery and will enable patients to be more informed regarding the likelihood of multiple surgeries.

  2. An Automated Web Diary System for TeleHomeCare Patient Monitoring

    PubMed Central

    Ganzinger, Matthias; Demiris, George; Finkelstein, Stanley M.; Speedie, Stuart; Lundgren, Jan Marie

    2001-01-01

    The TeleHomeCare project monitors home care patients via the Internet. Each patient has a personalized homepage with an electronic diary for collecting the monitoring data with HTML forms. The web pages are generated dynamically using PHP. All data are stored in a MySQL database. Data are checked immediately by the system; if a value exceeds a predefined limit an alarm message is generated and sent automatically to the patient's case manager. Weekly graphical reports (PDF format) are also generated and sent by email to the same destination.

  3. Smartphones, tele-ophthalmology, and VISION 2020

    PubMed Central

    Mohammadpour, Mehrdad; Heidari, Zahra; Mirghorbani, Masoud; Hashemi, Hassan

    2017-01-01

    Telemedicine is an emerging field in recent medical achievements with rapid development. The “smartphone” availability has increased in both developed and developing countries even among people in rural and remotes areas. Tele-based services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost. This review explains how teleophthalmology helps to improve patient outcomes through smartphones. PMID:29259912

  4. Score Big! Pinball Project Teaches Simple Machine Basics

    ERIC Educational Resources Information Center

    Freeman, Matthew K.

    2009-01-01

    This article presents a design brief for a pinball game. The design brief helps students get a better grasp on the operation and uses of simple machines. It also gives them an opportunity to develop their problem-solving skills and use design skills to complete an interesting, fun product. (Contains 2 tables and 3 photos.)

  5. Unique identification code for medical fundus images using blood vessel pattern for tele-ophthalmology applications.

    PubMed

    Singh, Anushikha; Dutta, Malay Kishore; Sharma, Dilip Kumar

    2016-10-01

    Identification of fundus images during transmission and storage in database for tele-ophthalmology applications is an important issue in modern era. The proposed work presents a novel accurate method for generation of unique identification code for identification of fundus images for tele-ophthalmology applications and storage in databases. Unlike existing methods of steganography and watermarking, this method does not tamper the medical image as nothing is embedded in this approach and there is no loss of medical information. Strategic combination of unique blood vessel pattern and patient ID is considered for generation of unique identification code for the digital fundus images. Segmented blood vessel pattern near the optic disc is strategically combined with patient ID for generation of a unique identification code for the image. The proposed method of medical image identification is tested on the publically available DRIVE and MESSIDOR database of fundus image and results are encouraging. Experimental results indicate the uniqueness of identification code and lossless recovery of patient identity from unique identification code for integrity verification of fundus images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. [Assessment of tele-expertise among elderly subjects in retirement homes].

    PubMed

    Sparsa, A; Doffoel-Hantz, V; Bonnetblanc, J-M

    2013-03-01

    Chronic wounds (leg ulcers, pressure ulcers, diabetic foot ulcers, etc.) constitute a real public health problem and engender high economic and human costs. Due to the declining physical and mental conditions of our elderly subjects and their rural environment, we created a computer program to assist with chronic wound management in elderly subjects living in retirement homes and to reduce the amount of ambulance transportation. Each participating establishment was provided with a digital camera and its own secure e-mail address in order to allow photographs to be sent anonymously. Patients with chronic wounds entailing treatment difficulties were included. Details were recorded of the number of tele-expertise consultations given, the chronic wound type, the number of hospitalizations or medical consultations, and the number of ambulance trips avoided. The project was evaluated at 1 year. Of the 40 establishments invited to take part, 22 agreed to do so but only the first 10 respondents were accepted for participation in the pilot feasibility study. Funding ("Health and social prize" provided by the Haute-Vienne region Social Security Office - CPAM) was used to purchase the cameras. Beginning on 15 April 2010, 10 establishments for the elderly sent photographs of 34 patients presenting 26 chronic wounds and tele-expertise was provided for 10 pressure ulcers, two diabetic feet and 14 leg ulcers. Over a two-year period, this program helped avoid 20 trips for patients and enabled rapid hospitalization of nine patients by the university hospital by optimizing chronic wound management for patients residing in establishments for the elderly. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country.

    PubMed

    Robertson, Thomas E; Levine, Andrea R; Verceles, Avelino C; Buchner, Jessica A; Lantry, James H; Papali, Alfred; Zubrow, Marc T; Colas, L Nathalie; Augustin, Marc E; McCurdy, Michael T

    2017-08-01

    Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC. The intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time. Non-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Design and experimental validation of a simple controller for a multi-segment magnetic crawler robot

    NASA Astrophysics Data System (ADS)

    Kelley, Leah; Ostovari, Saam; Burmeister, Aaron B.; Talke, Kurt A.; Pezeshkian, Narek; Rahimi, Amin; Hart, Abraham B.; Nguyen, Hoa G.

    2015-05-01

    A novel, multi-segmented magnetic crawler robot has been designed for ship hull inspection. In its simplest version, passive linkages that provide two degrees of relative motion connect front and rear driving modules, so the robot can twist and turn. This permits its navigation over surface discontinuities while maintaining its adhesion to the hull. During operation, the magnetic crawler receives forward and turning velocity commands from either a tele-operator or high-level, autonomous control computer. A low-level, embedded microcomputer handles the commands to the driving motors. This paper presents the development of a simple, low-level, leader-follower controller that permits the rear module to follow the front module. The kinematics and dynamics of the two-module magnetic crawler robot are described. The robot's geometry, kinematic constraints and the user-commanded velocities are used to calculate the desired instantaneous center of rotation and the corresponding central-linkage angle necessary for the back module to follow the front module when turning. The commands to the rear driving motors are determined by applying PID control on the error between the desired and measured linkage angle position. The controller is designed and tested using Matlab Simulink. It is then implemented and tested on an early two-module magnetic crawler prototype robot. Results of the simulations and experimental validation of the controller design are presented.

  9. Tele-Autonomous control involving contact. Final Report Thesis; [object localization

    NASA Technical Reports Server (NTRS)

    Shao, Lejun; Volz, Richard A.; Conway, Lynn; Walker, Michael W.

    1990-01-01

    Object localization and its application in tele-autonomous systems are studied. Two object localization algorithms are presented together with the methods of extracting several important types of object features. The first algorithm is based on line-segment to line-segment matching. Line range sensors are used to extract line-segment features from an object. The extracted features are matched to corresponding model features to compute the location of the object. The inputs of the second algorithm are not limited only to the line features. Featured points (point to point matching) and featured unit direction vectors (vector to vector matching) can also be used as the inputs of the algorithm, and there is no upper limit on the number of the features inputed. The algorithm will allow the use of redundant features to find a better solution. The algorithm uses dual number quaternions to represent the position and orientation of an object and uses the least squares optimization method to find an optimal solution for the object's location. The advantage of using this representation is that the method solves for the location estimation by minimizing a single cost function associated with the sum of the orientation and position errors and thus has a better performance on the estimation, both in accuracy and speed, than that of other similar algorithms. The difficulties when the operator is controlling a remote robot to perform manipulation tasks are also discussed. The main problems facing the operator are time delays on the signal transmission and the uncertainties of the remote environment. How object localization techniques can be used together with other techniques such as predictor display and time desynchronization to help to overcome these difficulties are then discussed.

  10. A tele-home care system exploiting the DVB-T technology and MHP.

    PubMed

    Angius, G; Pani, D; Raffo, L; Randaccio, P; Seruis, S

    2008-01-01

    The aim of this research work is the development of a low-cost system for telemedicine based on the DVB-T technology. The diffusion of DVB-T standard and the low cost of DVB-T set-top boxes bring the vision of a capillary distribution of tele-home care monitoring systems with easy-to-use patient's interface. Exploiting the potentiality of the DVB-T set-top box, we transformed it into an "on-demand tele-home care interface". The Xlet we developed is able to govern the functionality of an external microcontroller-based unit for the acquisition of the bio-signals of interest. The uplink connection is used to send the exam results to a remote care center. The Xlet providing the patient interface on the set-top box is uploaded by a DVB-T broadcaster without any intervention in the patient's home. A prototypal low-cost base station for the acquisition of the patient's signals (1-lead ECG) has been developed. It is able to be connected to the set-top box via an infrared link. A smart-card-based system is in charge for the customization of the Xlet for every patient. The proposed system, based on a currently widespread infrastructure, is able to allow the patients monitoring from home without any installation procedure. Even untrained (or elderly) people can easily use such system due to their practice with the basic DVB-T home-entertainment equipments.

  11. Use of video-based education and tele-health home monitoring after liver transplantation: Results of a novel pilot study.

    PubMed

    Ertel, Audrey E; Kaiser, Tiffany E; Abbott, Daniel E; Shah, Shimul A

    2016-10-01

    In this observational study, we analyzed the feasibility and early results of a perioperative, video-based educational program and tele-health home monitoring model on postoperative care management and readmissions for patients undergoing liver transplantation. Twenty consecutive liver transplantation recipients were provided with tele-health home monitoring and an educational video program during the perioperative period. Vital statistics were tracked and monitored daily with emphasis placed on readings outside of the normal range (threshold violations). Additionally, responses to effectiveness questionnaires were collected retrospectively for analysis. In the study, 19 of the 20 patients responded to the effectiveness questionnaire, with 95% reporting having watched all 10 videos, 68% watching some more than once, and 100% finding them effective in improving their preparedness for understanding their postoperative care. Among these 20 patients, there was an observed 19% threshold violation rate for systolic blood pressure, 6% threshold violation rate for mean blood glucose concentrations, and 8% threshold violation rate for mean weights. This subset of patients had a 90-day readmission rate of 30%. This observational study demonstrates that tele-health home monitoring and video-based educational programs are feasible in liver transplantation recipients and seem to be effective in enhancing the monitoring of vital statistics postoperatively. These data suggest that smart technology is effective in creating a greater awareness and understanding of how to manage postoperative care after liver transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Evaluating sedimentation problems in activated sludge treatment plants operating at complete sludge retention time.

    PubMed

    Amanatidou, Elisavet; Samiotis, Georgios; Trikoilidou, Eleni; Pekridis, George; Taousanidis, Nikolaos

    2015-02-01

    Zero net sludge growth can be achieved by complete retention of solids in activated sludge wastewater treatment, especially in high strength and biodegradable wastewaters. When increasing the solids retention time, MLSS and MLVSS concentrations reach a plateau phase and observed growth yields values tend to zero (Yobs ≈ 0). In this work, in order to evaluate sedimentation problems arised due to high MLSS concentrations and complete sludge retention operational conditions, two identical innovative slaughterhouse wastewater treatment plants were studied. Measurements of wastewaters' quality characteristics, treatment plant's operational conditions, sludge microscopic analysis and state point analysis were conducted. Results have shown that low COD/Nitrogen ratios increase sludge bulking and flotation phenomena due to accidental denitrification in clarifiers. High return activated sludge rate is essential in complete retention systems as it reduces sludge condensation and hydraulic retention time in the clarifiers. Under certain operational conditions sludge loading rates can greatly exceed literature limit values. The presented methodology is a useful tool for estimation of sedimentation problems encountered in activated sludge wastewater treatment plants with complete retention time. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. A simple rule based model for scheduling farm management operations in SWAT

    NASA Astrophysics Data System (ADS)

    Schürz, Christoph; Mehdi, Bano; Schulz, Karsten

    2016-04-01

    For many interdisciplinary questions at the watershed scale, the Soil and Water Assessment Tool (SWAT; Arnold et al., 1998) has become an accepted and widely used tool. Despite its flexibility, the model is highly demanding when it comes to input data. At SWAT's core the water balance and the modeled nutrient cycles are plant growth driven (implemented with the EPIC crop growth model). Therefore, land use and crop data with high spatial and thematic resolution, as well as detailed information on cultivation and farm management practices are required. For many applications of the model however, these data are unavailable. In order to meet these requirements, SWAT offers the option to trigger scheduled farm management operations by applying the Potential Heat Unit (PHU) concept. The PHU concept solely takes into account the accumulation of daily mean temperature for management scheduling. Hence, it contradicts several farming strategies that take place in reality; such as: i) Planting and harvesting dates are set much too early or too late, as the PHU concept is strongly sensitivity to inter-annual temperature fluctuations; ii) The timing of fertilizer application, in SWAT this often occurs simultaneously on the same date in in each field; iii) and can also coincide with precipitation events. Particularly, the latter two can lead to strong peaks in modeled nutrient loads. To cope with these shortcomings we propose a simple rule based model (RBM) to schedule management operations according to realistic farmer management practices in SWAT. The RBM involves simple strategies requiring only data that are input into the SWAT model initially, such as temperature and precipitation data. The user provides boundaries of time periods for operation schedules to take place for all crops in the model. These data are readily available from the literature or from crop variety trials. The RBM applies the dates by complying with the following rules: i) Operations scheduled in the

  14. Construction of a high-tech operating room for image-guided surgery using VR.

    PubMed

    Suzuki, Naoki; Hattori, Asaki; Suzuki, Shigeyuki; Otake, Yoshito; Hayashibe, Mitsuhiro; Kobayashi, Susumu; Nezu, Takehiko; Sakai, Haruo; Umezawa, Yuji

    2005-01-01

    This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans.

  15. Development and human factors analysis of an augmented reality interface for multi-robot tele-operation and control

    NASA Astrophysics Data System (ADS)

    Lee, Sam; Lucas, Nathan P.; Ellis, R. Darin; Pandya, Abhilash

    2012-06-01

    This paper presents a seamlessly controlled human multi-robot system comprised of ground and aerial robots of semiautonomous nature for source localization tasks. The system combines augmented reality interfaces capabilities with human supervisor's ability to control multiple robots. The role of this human multi-robot interface is to allow an operator to control groups of heterogeneous robots in real time in a collaborative manner. It used advanced path planning algorithms to ensure obstacles are avoided and that the operators are free for higher-level tasks. Each robot knows the environment and obstacles and can automatically generate a collision-free path to any user-selected target. It displayed sensor information from each individual robot directly on the robot in the video view. In addition, a sensor data fused AR view is displayed which helped the users pin point source information or help the operator with the goals of the mission. The paper studies a preliminary Human Factors evaluation of this system in which several interface conditions are tested for source detection tasks. Results show that the novel Augmented Reality multi-robot control (Point-and-Go and Path Planning) reduced mission completion times compared to the traditional joystick control for target detection missions. Usability tests and operator workload analysis are also investigated.

  16. A novel remote center of motion mechanism for the force-reflective master robot of haptic tele-surgery systems.

    PubMed

    Hadavand, Mostafa; Mirbagheri, Alireza; Behzadipour, Saeed; Farahmand, Farzam

    2014-06-01

    An effective master robot for haptic tele-surgery applications needs to provide a solution for the inversed movements of the surgical tool, in addition to sufficient workspace and manipulability, with minimal moving inertia. A novel 4 + 1-DOF mechanism was proposed, based on a triple parallelogram linkage, which provided a Remote Center of Motion (RCM) at the back of the user's hand. The kinematics of the robot was analyzed and a prototype was fabricated and evaluated by experimental tests. With a RCM at the back of the user's hand the actuators far from the end effector, the robot could produce the sensation of hand-inside surgery with minimal moving inertia. The target workspace was achieved with an acceptable manipulability. The trajectory tracking experiments revealed small errors, due to backlash at the joints. The proposed mechanism meets the basic requirements of an effective master robot for haptic tele-surgery applications. Copyright © 2013 John Wiley & Sons, Ltd.

  17. Development of a Simple Dipstick Assay for Operational Monitoring of DDT.

    PubMed

    Ismail, Hanafy M; Kumar, Vijay; Singh, Rudra P; Williams, Christopher; Shivam, Pushkar; Ghosh, Ayan; Deb, Rinki; Foster, Geraldine M; Hemingway, Janet; Coleman, Michael; Coleman, Marlize; Das, Pradeep; Paine, Mark J I

    2016-01-01

    Indoor residual spraying (IRS) of DDT is used to control visceral leishmaniasis (VL) in India. However, the quality of spraying is severely compromised by a lack of affordable field assays to monitor target doses of insecticide. Our aim was to develop a simple DDT insecticide quantification kit (IQK) for monitoring DDT levels in an operational setting. DDT quantification was based on the stoichiometric release of chloride from DDT by alkaline hydrolysis and detection of the released ion using Quantab chloride detection strips. The assay was specific for insecticidal p,p`-DDT (LoQ = 0.082 g/m2). Bostik discs were effective in post spray wall sampling, extracting 25-70% of active ingredient depending on surface. Residual DDT was sampled from walls in Bihar state in India using Bostik adhesive discs and DDT concentrations (g p,p`-DDT/m2) were determined using IQK and HPLC (n = 1964 field samples). Analysis of 161 Bostik samples (pooled sample pairs) by IQK and HPLC produced excellent correlation (R2 = 0.96; Bland-Altman bias = -0.0038). IQK analysis of the remaining field samples matched HPLC data in identifying households that had been under sprayed, in range or over sprayed. A simple dipstick assay has been developed for monitoring DDT spraying that gives comparable results to HPLC. By making laboratory-based analysis of DDT dosing accessible to field operatives, routine monitoring of DDT levels can be promoted in low- and middle- income countries to maximise the effectiveness of IRS.

  18. Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

    PubMed

    Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki

    2008-06-01

    We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks.

  19. 78 FR 48893 - Information Collection Activities: Oil and Gas Well-Completion Operations; Proposed Collection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... Activities: Oil and Gas Well-Completion Operations; Proposed Collection; Comment Request ACTION: 60-day...) concerns renewal to the paperwork requirements in the regulations under Subpart E, Oil and Gas Well... ICR. SUPPLEMENTARY INFORMATION: Title: 30 CFR Part 250, Subpart E, Oil and Gas Well-Completion...

  20. Simple Automatic File Exchange (SAFE) to Support Low-Cost Spacecraft Operation via the Internet

    NASA Technical Reports Server (NTRS)

    Baker, Paul; Repaci, Max; Sames, David

    1998-01-01

    Various issues associated with Simple Automatic File Exchange (SAFE) are presented in viewgraph form. Specific topics include: 1) Packet telemetry, Internet IP networks and cost reduction; 2) Basic functions and technical features of SAFE; 3) Project goals, including low-cost satellite transmission to data centers to be distributed via an Internet; 4) Operations with a replicated file protocol; 5) File exchange operation; 6) Ground stations as gateways; 7) Lessons learned from demonstrations and tests with SAFE; and 8) Feedback and future initiatives.

  1. Multi-unit Operations in Non-Nuclear Systems: Lessons Learned for Small Modular Reactors

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

    OHara J. M.; Higgins, J.; DAgostino, A.

    2012-01-17

    The nuclear-power community has reached the stage of proposing advanced reactor designs to support power generation for decades to come. Small modular reactors (SMRs) are one approach to meet these energy needs. While the power output of individual reactor modules is relatively small, they can be grouped to produce reactor sites with different outputs. Also, they can be designed to generate hydrogen, or to process heat. Many characteristics of SMRs are quite different from those of current plants and may be operated quite differently. One difference is that multiple units may be operated by a single crew (or a singlemore » operator) from one control room. The U.S. Nuclear Regulatory Commission (NRC) is examining the human factors engineering (HFE) aspects of SMRs to support licensing reviews. While we reviewed information on SMR designs to obtain information, the designs are not completed and all of the design and operational information is not yet available. Nor is there information on multi-unit operations as envisioned for SMRs available in operating experience. Thus, to gain a better understanding of multi-unit operations we sought the lesson learned from non-nuclear systems that have experience in multi-unit operations, specifically refineries, unmanned aerial vehicles and tele-intensive care units. In this paper we report the lessons learned from these systems and the implications for SMRs.« less

  2. Intra-operative localisation of thoracic spine level: a simple "'K'-wire in pedicle" technique.

    PubMed

    Thambiraj, Sathya; Quraishi, Nasir A

    2012-05-01

    To describe a simple and reliable method of intra-operative localisation of thoracic spine in a single surgical setting. Intra-operative localisation of thoracic spine levels can be difficult due to anatomical constraints, such as scapular shadow, patient's size and poor bone quality. This is particularly true in cases of thoracic discectomies in which the vertebral bodies appear normal. There are several methods described in recent literature to address this. Many of them require a separate procedure which was performed often the previous day. We report a technique which addresses the issue of localising thoracic level intra-operatively. After induction of general anaesthesia, the patient was placed prone and the pedicle of interest was identified using fluoroscopy. A K-wire was then inserted percutaneously into this pedicle under image guidance [confirmed in the antero-posterior (AP) and lateral views]. The wire was then cut close to the skin after bending it. The patient was now positioned laterally and the intended procedure performed through an anterior trans-thoracic approach. The 'K' wire was removed at the end of the procedure. We routinely used this technique in all our thoracic discectomies (four cases in 2 years). There were no intra-operative complications. This method is simple, avoids the patient undergoing two procedures and requires no more ability than placing an implant in the pedicle under fluoroscopy. Placing the 'K' wire into a fixed point like the pedicle facilitates rapid intra-operative viewing of the level of interest and is removed easily at the conclusion of surgery.

  3. The Role of Retinal Imaging and Portable Screening Devices in Tele-ophthalmology Applications for Diabetic Retinopathy Management.

    PubMed

    DeBuc, Delia Cabrera

    2016-12-01

    In the years since its introduction, retinal imaging has transformed our capability to visualize the posterior pole of the eye. Increasing practical advances in mobile technology, regular monitoring, and population screening for diabetic retinopathy management offer the opportunity for further development of cost-effective applications through remote assessment of the diabetic eye using portable retinal cameras, smart-phone-based devices and telemedicine networks. Numerous retinal imaging methods and mobile technologies in tele-ophthalmology applications have been reported for diabetic retinopathy screening and management. They provide several advantages of automation, sensitivity, specificity, portability, and miniaturization for the development of point-of-care diagnostics for eye complications in diabetes. The aim of this paper is to review the role of retinal imaging and mobile technologies in tele-ophthalmology applications for diabetic retinopathy screening and management. At large, although improvements in current technology and telemedicine services are still needed, telemedicine has demonstrated to be a worthy tool to support health caregivers in the effective management and prevention of diabetes and its complications.

  4. Telerobotic management system: coordinating multiple human operators with multiple robots

    NASA Astrophysics Data System (ADS)

    King, Jamie W.; Pretty, Raymond; Brothers, Brendan; Gosine, Raymond G.

    2003-09-01

    This paper describes an application called the Tele-robotic management system (TMS) for coordinating multiple operators with multiple robots for applications such as underground mining. TMS utilizes several graphical interfaces to allow the user to define a partially ordered plan for multiple robots. This plan is then converted to a Petri net for execution and monitoring. TMS uses a distributed framework to allow robots and operators to easily integrate with the applications. This framework allows robots and operators to join the network and advertise their capabilities through services. TMS then decides whether tasks should be dispatched to a robot or a remote operator based on the services offered by the robots and operators.

  5. Self-Regulated Learning in a TELE at the Universite de Technologie de Compiegne: An Analysis from Multiple Perspectives

    ERIC Educational Resources Information Center

    Trigano, Philippe

    2006-01-01

    Self-regulation has become a very important topic in the field of learning and instruction. At the same time, the introduction of new technologies in the field of Information and Communication Technologies (ICT) has made it possible to create rich Technology-Enhanced Learning Environments (TELEs) with multiple affordances for supporting…

  6. TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring.

    PubMed

    Flynn, Diane M; Eaton, Linda H; McQuinn, Honor; Alden, Ashley; Meins, Alexa R; Rue, Tessa; Tauben, David J; Doorenbos, Ardith Z

    2017-12-01

    Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation. The intervention involves a didactic presentation based on the Joint Pain Education Curriculum followed by patient case presentations and multi-disciplinary discussion via videoconference by clinicians working in the military health system. A panel of pain specialists representing pain medicine, internal medicine, anesthesiology, rehabilitation medicine, psychiatry, addiction medicine, health psychology, pharmacology, nursing, and complementary and integrative pain management provide pain management recommendations for each patient case. We use the Pain Assessment Screening Tool and Outcomes Registry (PASTOR) to measure patient outcomes, including pain, sleep, fatigue, anxiety, and depression. This article reports some of the challenges and lessons learned during early implementation of the TelePain intervention. Weekly telephone meetings among the multisite research team were instrumental in problem solving, identifying problem areas, and developing solutions. Solutions for recruitment challenges included additional outreach and networking to military health providers, both building on.

  7. Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption.

    PubMed

    Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

    2016-11-01

    Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM 2.5 ), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM 2.5 emission inventory to track primary PM 2.5 emissions embodied in the supply chain and evaluate the extent to which local PM 2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM 2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM 2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

  8. Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

    NASA Astrophysics Data System (ADS)

    Meng, Jing; Liu, Junfeng; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

    2016-11-01

    Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization.

  9. Globalization and pollution: tele-connecting local primary PM2.5 emissions to global consumption

    PubMed Central

    Meng, Jing; Xu, Yuan; Guan, Dabo; Liu, Zhu; Huang, Ye; Tao, Shu

    2016-01-01

    Globalization pushes production and consumption to geographically diverse locations and generates a variety of sizeable opportunities and challenges. The distribution and associated effects of short-lived primary fine particulate matter (PM2.5), a representative of local pollution, are significantly affected by the consumption through global supply chain. Tele-connection is used here to represent the link between production and consumption activity at large distances. In this study, we develop a global consumption-based primary PM2.5 emission inventory to track primary PM2.5 emissions embodied in the supply chain and evaluate the extent to which local PM2.5 emissions are triggered by international trade. We further adopt consumption-based accounting and identify the global original source that produced the emissions. We find that anthropogenic PM2.5 emissions from industrial sectors accounted for 24 Tg globally in 2007; approximately 30% (7.2 Tg) of these emissions were embodied in export of products principally from Brazil, South Africa, India and China (3.8 Tg) to developed countries. Large differences (up to 10 times) in the embodied emissions intensity between net importers and exporters greatly increased total global PM2.5 emissions. Tele-connecting production and consumption activity provides valuable insights with respect to mitigating long-range transboundary air pollution and prompts concerted efforts aiming at more environmentally conscious globalization. PMID:27956874

  10. Effect of a real-time tele-transmission system of 12-lead electrocardiogram on the first-aid for athletes with ST-elevation myocardial infarction.

    PubMed

    Zhang, Huan; Song, Donghan; An, Lina

    2016-05-01

    To study the effect of a real-time tele-transmission system of 12-lead electrocardiogram on door-to-balloon time in athletes with ST-elevation myocardial infarction. A total of 60 athletes with chest pain diagnosed as ST-elevation myocardial infarction (STEMI) from our hospital were randomly divided into group A (n=35) and group B (n=25), the patients in group A transmitted the real-time tele-transmission system of 12-lead electrocardiogram to the chest pain center before arriving in hospital, however, the patients in group B not. The median door-to-balloon time was significant shorter in-group A than group B (38min vs 94 min, p<0.01) and the ratio of door-to-balloon time below 90 min was remarkable higher in-group A (94.2% vs 60%, p<0.01). The rate of catheter laboratory occupied was 5.7% in-group A and 40% in group B respectively (p=0.001). There was no statistically difference in mortality between the two groups (5.7% vs 4%, p>0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, p<0.01). Real-time tele-transmission system of 12 lead electrocardiogram is beneficial to the pre-hospital diagnosis of STEMI.

  11. Development of a Simple Dipstick Assay for Operational Monitoring of DDT

    PubMed Central

    Ismail, Hanafy M.; Kumar, Vijay; Singh, Rudra P.; Williams, Christopher; Shivam, Pushkar; Ghosh, Ayan; Deb, Rinki; Foster, Geraldine M.; Hemingway, Janet; Coleman, Michael; Coleman, Marlize; Das, Pradeep; Paine, Mark J. I.

    2016-01-01

    Background Indoor residual spraying (IRS) of DDT is used to control visceral leishmaniasis (VL) in India. However, the quality of spraying is severely compromised by a lack of affordable field assays to monitor target doses of insecticide. Our aim was to develop a simple DDT insecticide quantification kit (IQK) for monitoring DDT levels in an operational setting. Methodology/ principle findings DDT quantification was based on the stoichiometric release of chloride from DDT by alkaline hydrolysis and detection of the released ion using Quantab chloride detection strips. The assay was specific for insecticidal p,p`-DDT (LoQ = 0.082 g/m2). Bostik discs were effective in post spray wall sampling, extracting 25–70% of active ingredient depending on surface. Residual DDT was sampled from walls in Bihar state in India using Bostik adhesive discs and DDT concentrations (g p,p`-DDT/m2) were determined using IQK and HPLC (n = 1964 field samples). Analysis of 161 Bostik samples (pooled sample pairs) by IQK and HPLC produced excellent correlation (R2 = 0.96; Bland-Altman bias = −0.0038). IQK analysis of the remaining field samples matched HPLC data in identifying households that had been under sprayed, in range or over sprayed. Interpretation A simple dipstick assay has been developed for monitoring DDT spraying that gives comparable results to HPLC. By making laboratory-based analysis of DDT dosing accessible to field operatives, routine monitoring of DDT levels can be promoted in low- and middle- income countries to maximise the effectiveness of IRS. PMID:26760773

  12. Normal cerebrospinal fluid histamine and tele-methylhistamine levels in hypersomnia conditions.

    PubMed

    Dauvilliers, Yves; Delallée, Nathalie; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Croyal, Mickael; Schwartz, Jean-Charles; Robert, Philippe

    2012-10-01

    To determine the activity of cerebral histaminergic system evaluated by CSF levels of histamine (HA) and tele-methylhistamine (t-MHA), its major metabolite, and their relationships with hypocretin-1 levels in a large population of patients with hypersomnia and neurological conditions. sensitive liquid chromatographic-electrospray/tandem mass spectrometric assay was developed for the simultaneous quantification of CSF HA and t-MHA. ata were collected and CSF hypocretin-1 levels were measured using radioimmunoassay at the Sleep Disorders Center, Montpellier, France. CSF HA and t-MHA were measured in Bioprojet-Biotech, France One hundred fourteen unrelated patients with a suspicion of central hypersomnia underwent one night of polysomnography followed by the multiple sleep latency test. Sleep disorders were diagnosed clinically and using sleep studies: narcolepsy-cataplexy NC (n = 56), narcolepsy without cataplexy NwC (n = 27), idiopathic hypersomnia IH (n = 11), secondary narcolepsy (n = 3), and unspecified hypersomnia Uns EDS (n = 17). Fifty neurological patients without daytime sleepiness were included as controls. No between-hypersomnia group differences were found for CSF HA levels (median 708.62 pM extreme range [55.92-3335.50] in NC; 781.34 [174.08-4391.50] in NwC; 489.42 [177.45-906.70] in IH, and 1155.40 [134.80-2736.59] in Uns EDS) or for t-MHA levels. No association was found between CSF HA, t-MHA, or HA + t-MHA, sleepiness, treatment intake, and frequency of cataplexy. A slight negative correlation was found between age and HA levels. Further adjustment for the age revealed no significant HA levels difference between hypersomnia patients and controls. CSF histamine and tele-methylhistamine did not significantly differ between patients with narcolepsy-cataplexy and other etiologies of non-hypocretin-1 deficient central hypersomnias; these measurements, therefore, are not useful in assessing the etiology or severity of centrally mediated hypersomnia.

  13. 40 CFR 60.1160 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... types of employees must complete the EPA or State-approved operator training course: (1) Chief facility... initial startup. (2) December 6, 2001. (3) The date before an employee assumes responsibilities that...

  14. 40 CFR 60.1160 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... types of employees must complete the EPA or State-approved operator training course: (1) Chief facility... initial startup. (2) December 6, 2001. (3) The date before an employee assumes responsibilities that...

  15. 40 CFR 60.1160 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... types of employees must complete the EPA or State-approved operator training course: (1) Chief facility... initial startup. (2) December 6, 2001. (3) The date before an employee assumes responsibilities that...

  16. 40 CFR 60.1160 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... types of employees must complete the EPA or State-approved operator training course: (1) Chief facility... initial startup. (2) December 6, 2001. (3) The date before an employee assumes responsibilities that...

  17. 40 CFR 60.1160 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... types of employees must complete the EPA or State-approved operator training course: (1) Chief facility... initial startup. (2) December 6, 2001. (3) The date before an employee assumes responsibilities that...

  18. Flexible kinematic earthquake rupture inversion of tele-seismic waveforms: Application to the 2013 Balochistan, Pakistan earthquake

    NASA Astrophysics Data System (ADS)

    Shimizu, K.; Yagi, Y.; Okuwaki, R.; Kasahara, A.

    2017-12-01

    The kinematic earthquake rupture models are useful to derive statistics and scaling properties of the large and great earthquakes. However, the kinematic rupture models for the same earthquake are often different from one another. Such sensitivity of the modeling prevents us to understand the statistics and scaling properties of the earthquakes. Yagi and Fukahata (2011) introduces the uncertainty of Green's function into the tele-seismic waveform inversion, and shows that the stable spatiotemporal distribution of slip-rate can be obtained by using an empirical Bayesian scheme. One of the unsolved problems in the inversion rises from the modeling error originated from an uncertainty of a fault-model setting. Green's function near the nodal plane of focal mechanism is known to be sensitive to the slight change of the assumed fault geometry, and thus the spatiotemporal distribution of slip-rate should be distorted by the modeling error originated from the uncertainty of the fault model. We propose a new method accounting for the complexity in the fault geometry by additionally solving the focal mechanism on each space knot. Since a solution of finite source inversion gets unstable with an increasing of flexibility of the model, we try to estimate a stable spatiotemporal distribution of focal mechanism in the framework of Yagi and Fukahata (2011). We applied the proposed method to the 52 tele-seismic P-waveforms of the 2013 Balochistan, Pakistan earthquake. The inverted-potency distribution shows unilateral rupture propagation toward southwest of the epicenter, and the spatial variation of the focal mechanisms shares the same pattern as the fault-curvature along the tectonic fabric. On the other hand, the broad pattern of rupture process, including the direction of rupture propagation, cannot be reproduced by an inversion analysis under the assumption that the faulting occurred on a single flat plane. These results show that the modeling error caused by simplifying the

  19. 43 CFR 3253.11 - Must I notify BLM when I have completed my exploration operations?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL...) Complete any geophysical exploration operations; (b) Complete the drilling of temperature gradient well(s... gradient well; and (d) Plug shot holes and reclaim all exploration sites. ...

  20. Appropriateness and acceptability of a Tele-Yoga intervention for people with heart failure and chronic obstructive pulmonary disease: qualitative findings from a controlled pilot study.

    PubMed

    Selman, Lucy; McDermott, Kelly; Donesky, DorAnne; Citron, Tracie; Howie-Esquivel, Jill

    2015-02-07

    Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are highly prevalent and associated with a large symptom burden, that is compounded in a dual HF-COPD diagnosis. Yoga has potential benefit for symptom relief; however functional impairment hinders access to usual yoga classes. We developed a Tele-Yoga intervention and evaluated it in a controlled pilot trial. This paper reports on the appropriateness and acceptability of the intervention and the evaluation design. A controlled, non-randomised trial was conducted of an 8-week Tele-Yoga intervention versus an educational control (information leaflets mailed to participants with one phone call a week). Biweekly one-hour Tele-Yoga classes were implemented via multipoint videoconferencing that connected participants to live classes via an Internet connection to their televisions. Semi-structured qualitative interviews were conducted with participants post study exit to explore reasons for and experiences of participating, including views of study outcome measures and physiological tests. Transcribed interviews were analysed using thematic content analysis. Fifteen people participated in the pilot study (7 in the intervention group, 8 in the control). Of these, 12 participants were interviewed, 6 in each group, mean age 71.2 years (SD 10.09); 3 were male. Themes are reported in the following categories: acceptability and appropriateness of the intervention, potential active ingredients of the intervention, acceptability and appropriateness of the control, participation in the research, and acceptability of the testing procedures. The intervention was acceptable and appropriate: the intervention group reported enjoying yoga and valuing the home-based aspect and participants described a high symptom burden and social isolation. However, technological problems resulted in poor video-streaming quality for some participants. Potential active ingredients included physical postures, breathing exercises and

  1. Potential role of tele-rehabilitation to address barriers to implementation of physical therapy among West African stroke survivors: A cross-sectional survey.

    PubMed

    Sarfo, Fred S; Adamu, Sheila; Awuah, Dominic; Sarfo-Kantanka, Osei; Ovbiagele, Bruce

    2017-10-15

    The greatest burden from stroke-related disability is borne by Low-and-Middle Income countries (LMICs) where access to rehabilitation after stroke is severely challenged. Tele-rehabilitation could be a viable avenue to address unmet rehabilitation needs in LMICs. To assess the burden of post-stroke physical deficits, rates of utilization of physiotherapy services, and perceptions of tele-rehabilitation among recent Ghanaian stroke survivors. Using a consecutive sampling strategy, 100 stroke survivors attending an outpatient Neurology clinic in a Ghanaian tertiary medical center were enrolled into this cross-sectional study. After collecting basic demographic data, clinical history on stroke type, severity and level of disability, we administered the validated 20-item Functional Independence Measure questionnaire to evaluate functional status of study participants and an 8-item questionnaire to assess participants' attitudes towards telemedicine administered rehabilitation intervention. Mean±SD age of study participants was 57.2±13.3years of which 51.0% were males with a mean duration of stroke of 1.3±2.2years. 53% had Modified Rankin scores of ≥3, 57% were fully independent and only 27% reported utilizing any physiotherapy services. Barriers to access to physiotherapy included financial constraints due to cost of physiotherapy services and transportation as well as premature discharge from physiotherapy to avoid overburdening of available physiotherapy services. These factors led to the limited provision of rehabilitative therapy. Participants held positive views of the potential for tele-rehabilitation interventions (80-93%). However, while 85% owned mobile phones, only 35% had smart phones. Despite, a high burden of residual disability, only about 1 out of 4 stroke patients in this Ghanaian cohort was exposed to post-stroke physiotherapy services, largely due to relatively high costs and limited health system resources. These Ghanaian stroke patients viewed

  2. Is simple nephrectomy truly simple? Comparison with the radical alternative.

    PubMed

    Connolly, S S; O'Brien, M Frank; Kunni, I M; Phelan, E; Conroy, R; Thornhill, J A; Grainger, R

    2011-03-01

    The Oxford English dictionary defines the term "simple" as "easily done" and "uncomplicated". We tested the validity of this terminology in relation to open nephrectomy surgery. Retrospective review of 215 patients undergoing open, simple (n = 89) or radical (n = 126) nephrectomy in a single university-affiliated institution between 1998 and 2002. Operative time (OT), estimated blood loss (EBL), operative complications (OC) and length of stay in hospital (LOS) were analysed. Statistical analysis employed Fisher's exact test and Stata Release 8.2. Simple nephrectomy was associated with shorter OT (mean 126 vs. 144 min; p = 0.002), reduced EBL (mean 729 vs. 859 cc; p = 0.472), lower OC (9 vs. 17%; 0.087), and more brief LOS (mean 6 vs. 8 days; p < 0.001). All parameters suggest favourable outcome for the simple nephrectomy group, supporting the use of this terminology. This implies "simple" nephrectomies are truly easier to perform with less complication than their radical counterpart.

  3. Tele-yoga for Chronic Pain: Current Status and Future Directions.

    PubMed

    Mathersul, Danielle C; Mahoney, Louise A; Bayley, Peter J

    2018-01-01

    Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed.

  4. Teleconnection Locator: TeleLoc

    NASA Astrophysics Data System (ADS)

    Bowen, M. K.; Duffy, D.

    2016-12-01

    Extreme climate events, such as tropical storms, droughts, and floods, have an enormous impact on all aspects of society. Being able to detect the causes of such events on a global scale is paramount to being able to predict when and where these events will occur. These teleconnections, where a small change in a closed, complex system creates drastic disturbances elsewhere in the system, are generally represented by an index, one of the most famous being the El Nino Southern Oscillation (ENSO). However, due to the enormity, complexity, and technical challenges surrounding climate and its data, it is hypothesized that many of these teleconnections have as of yet gone undiscovered. TeleLoc (Teleconnection Locator) is a machine-learning framework combining a number of techniques for finding correlations between weather trends and extreme climate events. The current focus is on connecting global trends with tropical cyclones. A combination of two data sets, The International Best Track Archive for Climate Stewardship (IBTrACS) and the Modern-Era Retrospective analysis for Research and Applications (MERRA2), are being utilized. PostGIS is used for raw data storage, and a Python API has been developed as the core of the framework. Cyclones are first clustered using a combination of Symbolic Aggregate ApproXimation (this allows for a symbolic, sequential representation of the various time-series variables of interest) and DBSCAN. This serves to break the events into subcategories, which alleviates computational load for the next step. Events which are clustered together (those with similar characteristics) are compared against global climate variables of interest, which are also converted to a symbolic form, leading up to the event using Association Rule Mining. Results will be shown where cyclones have been clustered, specifically in the West Pacific storm basin, as well as the global variable symbolic subsections with a high support that have been singled out for

  5. A simple microfluidic Coriolis effect flowmeter for operation at high pressure and high temperature.

    PubMed

    Harrison, Christopher; Jundt, Jacques

    2016-08-01

    We describe a microfluidic Coriolis effect flowmeter that is simple to assemble, operates at elevated temperature and pressure, and can be operated with a lock-in amplifier. The sensor has a flow rate sensitivity greater than 2° of phase shift per 1 g/min of mass flow and is benchmarked with flow rates ranging from 0.05 to 2.0 g/min. The internal volume is 15 μl and uses off-the-shelf optical components to measure the tube motion. We demonstrate that fluid density can be calculated from the frequency of the resonating element with proper calibration.

  6. SIMPLE: An Introduction.

    ERIC Educational Resources Information Center

    Endres, Frank L.

    Symbolic Interactive Matrix Processing Language (SIMPLE) is a conversational matrix-oriented source language suited to a batch or a time-sharing environment. The two modes of operation of SIMPLE are conversational mode and programing mode. This program uses a TAURUS time-sharing system and cathode ray terminals or teletypes. SIMPLE performs all…

  7. Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master–Slave Systems

    PubMed Central

    Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

    2017-01-01

    Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master–slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user’s wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a

  8. Synergy-Based Bilateral Port: A Universal Control Module for Tele-Manipulation Frameworks Using Asymmetric Master-Slave Systems.

    PubMed

    Brygo, Anais; Sarakoglou, Ioannis; Grioli, Giorgio; Tsagarakis, Nikos

    2017-01-01

    Endowing tele-manipulation frameworks with the capability to accommodate a variety of robotic hands is key to achieving high performances through permitting to flexibly interchange the end-effector according to the task considered. This requires the development of control policies that not only cope with asymmetric master-slave systems but also whose high-level components are designed in a unified space in abstraction from the devices specifics. To address this dual challenge, a novel synergy port is developed that resolves the kinematic, sensing, and actuation asymmetries of the considered system through generating motion and force feedback references in the hardware-independent hand postural synergy space. It builds upon the concept of the Cartesian-based synergy matrix, which is introduced as a tool mapping the fingertips Cartesian space to the directions oriented along the grasp principal components. To assess the effectiveness of the proposed approach, the synergy port has been integrated into the control system of a highly asymmetric tele-manipulation framework, in which the 3-finger hand exoskeleton HEXOTRAC is used as a master device to control the SoftHand, a robotic hand whose transmission system relies on a single motor to drive all joints along a soft synergistic path. The platform is further enriched with the vision-based motion capture system Optitrack to monitor the 6D trajectory of the user's wrist, which is used to control the robotic arm on which the SoftHand is mounted. Experiments have been conducted with the humanoid robot COMAN and the KUKA LWR robotic manipulator. Results indicate that this bilateral interface is highly intuitive and allows users with no prior experience to reach, grasp, and transport a variety of objects exhibiting very different shapes and impedances. In addition, the hardware and control solutions proved capable of accommodating users with different hand kinematics. Finally, the proposed control framework offers a

  9. A new simple asymmetric hysteresis operator and its application to inverse control of piezoelectric actuators.

    PubMed

    Badel, A; Qiu, J; Nakano, T

    2008-05-01

    Piezoelectric actuators (PEAs) are commonly used as micropositioning devices due to their high resolution, high stiffness, and fast frequency response. Because piezoceramic materials are ferroelectric, they fundamentally exhibit hysteresis behavior in their response to an applied electric field. The positioning precision can be significantly reduced due to nonlinear hysteresis effects when PEAs are used in relatively long range applications. This paper describes a new, precise, and simple asymmetric hysteresis operator dedicated to PEAs. The complex hysteretic transfer characteristic has been considered in a purely phenomenological way, without taking into account the underlying physics. This operator is based on two curves. The first curve corresponds to the main ascending branch and is modeled by the function f1. The second curve corresponds to the main reversal branch and is modeled by the function g2. The functions f(1) and g(2) are two very simple hyperbola functions with only three parameters. Particular ascending and reversal branches are deduced from appropriate translations of f(1) and g(2). The efficiency and precision of the proposed approach is demonstrated, in practice, by a real-time inverse feed-forward controller for piezoelectric actuators. Advantages and drawbacks of the proposed approach compared with classical hysteresis operators are discussed.

  10. A simple rain attenuation model for earth-space radio links operating at 10-35 GHz

    NASA Technical Reports Server (NTRS)

    Stutzman, W. L.; Yon, K. M.

    1986-01-01

    The simple attenuation model has been improved from an earlier version and now includes the effect of wave polarization. The model is for the prediction of rain attenuation statistics on earth-space communication links operating in the 10-35 GHz band. Simple calculations produce attenuation values as a function of average rain rate. These together with rain rate statistics (either measured or predicted) can be used to predict annual rain attenuation statistics. In this paper model predictions are compared to measured data from a data base of 62 experiments performed in the U.S., Europe, and Japan. Comparisons are also made to predictions from other models.

  11. Tele-yoga for Chronic Pain: Current Status and Future Directions

    PubMed Central

    Mahoney, Louise A; Bayley, Peter J

    2018-01-01

    Pain is a pervasive, debilitating disorder that is resistant to long-term pharmacological interventions. Although psychological therapies such as cognitive behavior therapy demonstrate moderate efficacy, many individuals continue to have ongoing difficulties following treatment. There is a current trend to establish complementary and integrative health interventions for chronic pain, for which yoga has been found to have exciting potential. Nevertheless, an important consideration within the field is accessibility to adequate care. Telehealth can be used to provide real-time interactive video conferencing leading to increased access to health care for individuals located remotely or who otherwise have difficulty accessing services, perhaps through issues of mobility or proximity of adequate services. This article assesses the current status and feasibility of implementing tele-yoga for chronic pain. Methodological limitations and recommendations for future research are discussed. PMID:29637012

  12. Venous gas embolism in operative hysteroscopy: A devastating complication in a relatively simple surgery

    PubMed Central

    Verma, Amit; Singh, Madhu Pandey

    2018-01-01

    Venous air embolism can be a catastrophic iatrogenic complication during operative hysteroscopy and makes this simple surgical procedure very risky, especially with the lack of knowledge about its prevention, presentation, and immediate management. Three out of 13 hysteroscopic myoma resections at our center had venous gas embolism (VGE). The prevention, diagnosis, and management of VGE are described in this report of three cases. PMID:29643632

  13. 78 FR 26572 - Rural Call Completion and List of Rural Operating Carrier Numbers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [WC Docket No. 13-39; DA 13-780] Rural Call Completion and List of Rural Operating Carrier Numbers AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: In this document, the Federal Communications Commission's Wireline Competition...

  14. A tele-obstetric broadband service including ultrasound, videoconferencing and cardiotocogram. A high cost and a low volume of patients.

    PubMed

    Norum, Jan; Bergmo, Trine S; Holdø, Bjørn; Johansen, May V; Vold, Ingar N; Sjaaeng, Elisabeth E; Jacobsen, Heidi

    2007-01-01

    We established a tele-obstetric service connecting the Department of Obstetrics and Gynaecology at the Nordland Hospital in Bodø to the delivery unit at the Nordland Hospital in Lofoten. The telemedicine service included a videoconferencing link (3 Mbit/s) for transmission of ultrasound scans and a low-speed data link (telephone modem) for transmission of cardiotocograms (CTGs). One hundred and thirty pregnant women entered the antenatal clinic in Lofoten during the eight-month study period. A total of 140 CTGs were recorded. The tele-ultrasound service was used in five cases (4%). The cases were serious malformation, Down's syndrome, breech presentation, vaginal bleeding during pregnancy and triplets. Analysis showed that the cost of patient travel was NOK 2460 per transfer. The variable cost of videoconferencing was NOK 250 per consultation. However, the total investment costs for the telemedicine service, including the broadband infrastructure, was NOK 1.7 million (Euro 212,000). The telemedicine service was not cost saving at annual workloads below 208. We conclude that the installation has to be used by other medical specialities to make it cost-effective.

  15. Electronic synoptic operative reporting: assessing the reliability and completeness of synoptic reports for pancreatic resection.

    PubMed

    Park, Jason; Pillarisetty, Venu G; Brennan, Murray F; Jarnagin, William R; D'Angelica, Michael I; Dematteo, Ronald P; G Coit, Daniel; Janakos, Maria; Allen, Peter J

    2010-09-01

    Electronic synoptic operative reports (E-SORs) have replaced dictated reports at many institutions, but whether E-SORs adequately document the components and findings of an operation has received limited study. This study assessed the reliability and completeness of E-SORs for pancreatic surgery developed at our institution. An attending surgeon and surgical fellow prospectively and independently completed an E-SOR after each of 112 major pancreatic resections (78 proximal, 29 distal, and 5 central) over a 10-month period (September 2008 to June 2009). Reliability was assessed by calculating the interobserver agreement between attending physician and fellow reports. Completeness was assessed by comparing E-SORs to a case-matched (surgeon and procedure) historical control of dictated reports, using a 39-item checklist developed through an internal and external query of 13 high-volume pancreatic surgeons. Interobserver agreement between attending and fellow was moderate to very good for individual categorical E-SOR items (kappa = 0.65 to 1.00, p < 0.001 for all items). Compared with dictated reports, E-SORs had significantly higher completeness checklist scores (mean 88.8 +/- 5.4 vs 59.6 +/- 9.2 [maximum possible score, 100], p < 0.01) and were available in patients' electronic records in a significantly shorter interval of time (median 0.5 vs 5.8 days from case end, p < 0.01). The mean time taken to complete E-SORs was 4.0 +/- 1.6 minutes per case. E-SORs for pancreatic surgery are reliable, complete in data collected, and rapidly available, all of which support their clinical implementation. The inherent strengths of E-SORs offer real promise of a new standard for operative reporting and health communication. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Research and Development for Advanced Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices

    DTIC Science & Technology

    2009-09-01

    Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices PRINCIPAL INVESTIGATOR...Remote Serial Console Access and Proactive Monitoring of Medical Devices 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...ORGANIZATION REPORT NUMBER Concepteers LLC 880 Bergen Avenue, Suite 403 Jersey City, NJ 07306 9. SPONSORING / MONITORING

  17. Monte-Carlo based assessment of MAGIC, MAGICAUG, PAGATUG and PAGATAUG polymer gel dosimeters for ovaries and uterus organ dosimetry in brachytherapy, nuclear medicine and Tele-therapy.

    PubMed

    Adinehvand, Karim; Rahatabad, Fereidoun Nowshiravan

    2018-06-01

    Calculation of 3D dose distribution during radiotherapy and nuclear medicine helps us for better treatment of sensitive organs such as ovaries and uterus. In this research, we investigate two groups of normoxic dosimeters based on meta-acrylic acid (MAGIC and MAGICAUG) and polyacrylamide (PAGATUG and PAGATAUG) for brachytherapy, nuclear medicine and Tele-therapy in their sensitive and critical role as organ dosimeters. These polymer gel dosimeters are compared with soft tissue while irradiated by different energy photons in therapeutic applications. This comparison has been simulated by Monte-Carlo based MCNPX code. ORNL phantom-Female has been used to model the critical organs of kidneys, ovaries and uterus. Right kidney is proposed to be the source of irradiation and another two organs are exposed to this irradiation. Effective atomic numbers of soft tissue, MAGIC, MAGICAUG, PAGATUG and PAGATAUG are 6.86, 7.07, 6.95, 7.28, and 7.07 respectively. Results show the polymer gel dosimeters are comparable to soft tissue for using in nuclear medicine and Tele-therapy. Differences between gel dosimeters and soft tissue are defined as the dose responses. This difference is less than 4.1%, 22.6% and 71.9% for Tele-therapy, nuclear medicine and brachytherapy respectively. The results approved that gel dosimeters are the best choice for ovaries and uterus in nuclear medicine and Tele-therapy respectively. Due to the slight difference between the effective atomic numbers of these polymer gel dosimeters and soft tissue, these polymer gels are not suitable for brachytherapy since the dependence of photon interaction to atomic number, for low energy brachytherapy, had been so effective. Also this dependence to atomic number, decrease for photoelectric and increase for Compton. Therefore polymer gel dosimeters are not a good alternative to soft tissue replacement in brachytherapy. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol.

    PubMed

    Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

    2009-05-09

    The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Protocol NCT00325624.

  19. Immersive Virtual Reality with Applications to Tele-Operation and Training

    DTIC Science & Technology

    2016-03-07

    to design accurate models for the control of a remote agent by retargeting human gestures (or body part movements) on the control structure of the...which is designed to co-operate with human inhabitants will need to posses, on some levels, a theory of mind [20]. This will enable the system to...University of Houston-Victoria, a designated Hispanic Serving Institution of higher education. The requested equipment and instrumentation will be

  20. [Implementation of a community tele-epidemiological surveillance system using information and communication technologies in Paraguay].

    PubMed

    Galván, Pedro; Cane, Virgilio; Samudio, Margarita; Cabello, Agueda; Cabral, Margarita; Basogain, Xavier; Rivas, Ronald; Hilario, Enrique

    2014-01-01

    Report preliminary results of the application of the BONIS system in community tele-epidemiological surveillance in Paraguay. A study of viability and implementation carried out in the Family Health Unit located in Bañado Sur in the city of Asunción by the Paraguay River. The system automatically records personal data and symptoms of individuals who make telephone reports, and suspected cases of dengue are classified and prioritized. This information goes to community agents for follow-up and to specialists in charge of epidemiological surveillance. From April 2010 to August 2011, 1 028 calls to the system were logged. Of 157 reported cases of fever, home visits were made to 140 (89.2%); of these, fever and headache or body ache were confirmed in 52 (37.1%) cases, and headache or body ache without fever in 58 (41.4%) cases. Community agents referred 49 (35.0%) of them for medical consultation and blood tests, and they took blood samples in the homes of 19; of these, 56 (82.3%) were positive for dengue and 12 (17.4%) for influenza. Paraguay has a low-cost community tele-epidemiological surveillance system based on information and communication technologies and open-source software, which is scalable to other health symptoms and disorders of interest. To enable its acceptance and application, education programs should be developed to strengthen the management and promotion of community health.

  1. User interface for a tele-operated robotic hand system

    DOEpatents

    Crawford, Anthony L

    2015-03-24

    Disclosed here is a user interface for a robotic hand. The user interface anchors a user's palm in a relatively stationary position and determines various angles of interest necessary for a user's finger to achieve a specific fingertip location. The user interface additionally conducts a calibration procedure to determine the user's applicable physiological dimensions. The user interface uses the applicable physiological dimensions and the specific fingertip location, and treats the user's finger as a two link three degree-of-freedom serial linkage in order to determine the angles of interest. The user interface communicates the angles of interest to a gripping-type end effector which closely mimics the range of motion and proportions of a human hand. The user interface requires minimal contact with the operator and provides distinct advantages in terms of available dexterity, work space flexibility, and adaptability to different users.

  2. "Tele Pour Tous" in Rural Ivory Coast: Audience, Impact, Perceptions: Report of Two Surveys Conducted in January and April, 1977.

    ERIC Educational Resources Information Center

    Etaix, Mireille; Lenglet, Frans

    This report presents the results of two surveys conducted in January and April 1977 in the Ivory Coast to assess the impact of the "Tele Pour Tous" programs on rural audiences in terms of awareness, learning, and action. Descriptions of the socio-economic characteristics of the audience and their viewing patterns were sought, and…

  3. A simple technique of laparoscopic port closure.

    PubMed

    Aziz, Homayara Haque

    2013-01-01

    Laparoscopic and robotic surgery is widely practiced in modern medicine. The operative procedure is not complete until the port sites are closed with a fascial suture. We report a simple new technique that is easy, cost-effective, and quick to apply using 2 S-retractors for suture placement under direct visualization to secure the abdominal wall fascia and peritoneum. As a prospective consecutive case series, this technique was used for fascial closure after laparoscopy ports > 8 mm using 2 S-retractors. One S-retractor is used as a barrier protecting the contents of the abdominal cavity, reducing the risk of visceral injuries. The second S-retractor allows us to directly visualize the different layers, exposing the needle tip during its course through the fascia. This method was used in 100 patients with no intraoperative incidents, additional operative time, or need to access costly instruments. Currently, this technique is also used by many surgeons in our institution without any difficulty. No bowel injuries or port-site hernias were reported during a mean follow-up of 6 wk postoperation and 12-mo annual follow-up. The procedure is simple, easy, cost-effective, and quick to apply.

  4. Robot-based tele-echography: clinical evaluation of the TER system in abdominal aortic exploration.

    PubMed

    Martinelli, Thomas; Bosson, Jean-Luc; Bressollette, Luc; Pelissier, Franck; Boidard, Eric; Troccaz, Jocelyne; Cinquin, Philippe

    2007-11-01

    The TER system is a robot-based tele-echography system allowing remote ultrasound examination. The specialist moves a mock-up of the ultrasound probe at the master site, and the robot reproduces the movements of the real probe, which sends back ultrasound images and force feedback. This tool could be used to perform ultrasound examinations in small health care centers or from isolated sites. The objective of this study was to prove, under real conditions, the feasibility and reliability of the TER system in detecting abdominal aortic and iliac aneurysms. Fifty-eight patients were included in 2 centers in Brest and Grenoble, France. The remote examination was compared with the reference standard, the bedside examination, for aorta and iliac artery diameter measurement, detection and description of aneurysms, detection of atheromatosis, the duration of the examination, and acceptability. All aneurysms (8) were detected by both techniques as intramural thrombosis and extension to the iliac arteries. The interobserver correlation coefficient was 0.982 (P < .0001) for aortic diameters. The rate of concordance between 2 operators in evaluating atheromatosis was 84% +/- 11% (95% confidence interval). Our study on 58 patients suggests that the TER system could be a reliable, acceptable, and effective robot-based system for performing remote abdominal aortic ultrasound examinations. Research is continuing to improve the equipment for general abdominal use.

  5. A simple dynamic engine model for use in a real-time aircraft simulation with thrust vectoring

    NASA Technical Reports Server (NTRS)

    Johnson, Steven A.

    1990-01-01

    A simple dynamic engine model was developed at the NASA Ames Research Center, Dryden Flight Research Facility, for use in thrust vectoring control law development and real-time aircraft simulation. The simple dynamic engine model of the F404-GE-400 engine (General Electric, Lynn, Massachusetts) operates within the aircraft simulator. It was developed using tabular data generated from a complete nonlinear dynamic engine model supplied by the manufacturer. Engine dynamics were simulated using a throttle rate limiter and low-pass filter. Included is a description of a method to account for axial thrust loss resulting from thrust vectoring. In addition, the development of the simple dynamic engine model and its incorporation into the F-18 high alpha research vehicle (HARV) thrust vectoring simulation. The simple dynamic engine model was evaluated at Mach 0.2, 35,000 ft altitude and at Mach 0.7, 35,000 ft altitude. The simple dynamic engine model is within 3 percent of the steady state response, and within 25 percent of the transient response of the complete nonlinear dynamic engine model.

  6. Complete spectrum of long operators in Script N = 4 SYM at one loop

    NASA Astrophysics Data System (ADS)

    Beisert, Niklas; Kazakov, Vladimir A.; Sakai, Kazuhiro; Zarembo, Konstantin

    2005-07-01

    We construct the complete spectral curve for an arbitrary local operator, including fermions and covariant derivatives, of one-loop Script N = 4 gauge theory in the thermodynamic limit. This curve perfectly reproduces the Frolov-Tseytlin limit of the full spectral curve of classical strings on AdS5 × S5 derived in [64]. To complete the comparison we introduce stacks, novel bound states of roots of different flavors which arise in the thermodynamic limit of the corresponding Bethe ansatz equations. We furthermore show the equivalence of various types of Bethe equations for the underlying fraktur sfraktur u(2,2|4) superalgebra, in particular of the type ``Beauty'' and ``Beast''.

  7. DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

    PubMed Central

    Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

    2009-01-01

    Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624 PMID:19426530

  8. Operating characteristics of tube-current-modulation techniques when scanning simple-shaped phantoms

    NASA Astrophysics Data System (ADS)

    Matsubara, Kosuke; Koshida, Kichiro; Lin, Pei-Jan Paul; Fukuda, Atsushi

    2015-07-01

    Our objective was to investigate the operating characteristics of tube current modulation (TCM) in computed tomography (CT) when scanning two types of simple-shaped phantoms. A tissueequivalent elliptical phantom and a homogeneous cylindrical step phantom comprising 16-, 24-, and 32-cm-diameter polymethyl methacrylate (PMMA) phantoms were scanned by using an automatic exposure control system with longitudinal (z-) and angular-longitudinal (xyz-) TCM and with a fixed tube current. The axial dose distribution throughout the elliptical phantom and the longitudinal dose distribution at the center of the cylindrical step phantom were measured by using a solid-state detector. Image noise was quantitatively measured at eight regions in the elliptical phantom and at 90 central regions in contiguous images over the full z extent of the cylindrical step phantom. The mean absorbed doses and the standard deviations in the elliptical phantom with z- and xyz-TCM were 12.3' 3.7 and 11.3' 3.5 mGy, respectively. When TCM was activated, some differences were observed in the absorbed doses of the left and the right measurement points. The average image noises in Hounsfield units (HU) and the standard deviations were 15.2' 2.4 and 15.9' 2.4 HU when using z- and xyz-TCM, respectively. With respect to the cylindrical step phantom under z-TCM, there were sudden decreases followed by increases in image noise at the interfaces with the 24- and 16-cm-diameter phantoms. The image noise of the 24-cm-diameter phantom was, relatively speaking, higher than those of the 16- and 32-cm-diameter phantoms. The simple-shaped phantoms used in this study can be employed to investigate the operating characteristics of automatic exposure control systems when specialized phantoms designed for that purpose are not available.

  9. 3D display for enhanced tele-operation and other applications

    NASA Astrophysics Data System (ADS)

    Edmondson, Richard; Pezzaniti, J. Larry; Vaden, Justin; Hyatt, Brian; Morris, James; Chenault, David; Bodenhamer, Andrew; Pettijohn, Bradley; Tchon, Joe; Barnidge, Tracy; Kaufman, Seth; Kingston, David; Newell, Scott

    2010-04-01

    In this paper, we report on the use of a 3D vision field upgrade kit for TALON robot consisting of a replacement flat panel stereoscopic display, and multiple stereo camera systems. An assessment of the system's use for robotic driving, manipulation, and surveillance operations was conducted. A replacement display, replacement mast camera with zoom, auto-focus, and variable convergence, and a replacement gripper camera with fixed focus and zoom comprise the upgrade kit. The stereo mast camera allows for improved driving and situational awareness as well as scene survey. The stereo gripper camera allows for improved manipulation in typical TALON missions.

  10. Simple stochastic simulation.

    PubMed

    Schilstra, Maria J; Martin, Stephen R

    2009-01-01

    Stochastic simulations may be used to describe changes with time of a reaction system in a way that explicitly accounts for the fact that molecules show a significant degree of randomness in their dynamic behavior. The stochastic approach is almost invariably used when small numbers of molecules or molecular assemblies are involved because this randomness leads to significant deviations from the predictions of the conventional deterministic (or continuous) approach to the simulation of biochemical kinetics. Advances in computational methods over the three decades that have elapsed since the publication of Daniel Gillespie's seminal paper in 1977 (J. Phys. Chem. 81, 2340-2361) have allowed researchers to produce highly sophisticated models of complex biological systems. However, these models are frequently highly specific for the particular application and their description often involves mathematical treatments inaccessible to the nonspecialist. For anyone completely new to the field to apply such techniques in their own work might seem at first sight to be a rather intimidating prospect. However, the fundamental principles underlying the approach are in essence rather simple, and the aim of this article is to provide an entry point to the field for a newcomer. It focuses mainly on these general principles, both kinetic and computational, which tend to be not particularly well covered in specialist literature, and shows that interesting information may even be obtained using very simple operations in a conventional spreadsheet.

  11. Tele-infrasonic studies of hard-rock mining explosions.

    PubMed

    McKenna, Mihan H; Stump, Brian W; Hayek, Sylvia; McKenna, Jason R; Stanton, Terry R

    2007-07-01

    The Lac-du-Bonnet infrasound station, IS-10, and the Minnesota iron mines 390 km to the southeast are ideally located to assess the accuracy of atmospheric profiles needed for infrasound modeling. Infrasonic data from 2003 associated with explosions at the iron mine were analyzed for effects of explosion size and atmospheric conditions on observations with well-constrained ground truth. Noise was the determining factor for observation; high noise conditions sometimes prevented unequivocal identification of infrasound arrivals. Observed arrivals had frequencies of 0.5 to 5 Hz, with a dominant frequency of 2 Hz, and generally had durations on the order of 10 s or less. There was no correlation between explosive amount and observability. Tele-infrasonic propagation distances (greater than 250 km) produce thermospheric ray paths. Modeling is based upon MSIS/HWM (Mass Spectrometer Incoherent Scatter/Horizontal Wind Model) and NRL-G2S (Naval Research Laboratory Ground to Space) datasets. The NRL-G2S dataset provided more accurate travel time predictions that the MSIS/HWM dataset. PE modeling for the NRL-G2S dataset indicates energy loss at higher frequencies (around 4 Hz). Additionally, applying the Sutherland/Bass model through the NRL-G2S realization of the atmosphere in InfraMAP results in predicted amplitudes too small to be observed.

  12. Enabling the mission through trans-atlantic remote mentored musculoskeletal ultrasound: case report of a portable hand-carried tele-ultrasound system for medical relief missions.

    PubMed

    Kirkpatrick, Andrew W; Blaivas, Michael; Sargsyan, Ashot E; McBeth, Paul B; Patel, Chirag; Xiao, Zhengwen; Pian, Linping; Panebianco, Nova; Hamilton, Douglas R; Ball, Chad G; Dulchavsky, Scott A

    2013-07-01

    Modern medical practice has become extremely dependent upon diagnostic imaging technologies to confirm the results of clinical examination and to guide the response to therapies. Of the various diagnostic imaging techniques, ultrasound is the most portable modality and one that is repeatable, dynamic, relatively cheap, and safe as long as the imaging provided is accurately interpreted. It is, however, the most user-dependent, a characteristic that has prompted the development of remote guidance techniques, wherein remote experts guide distant users through the use of information technologies. Medical mission work often brings specialist physicians to less developed locations, where they wish to provide the highest levels of care but are often bereft of diagnostic imaging resources on which they depend. Furthermore, if these personnel become ill or injured, their own care received may not be to the standard they have left at home. We herein report the utilization of a compact hand-carried remote tele-ultrasound system that allowed real-time diagnosis and follow-up of an acutely torn adductor muscle by a team of ultrasonographers, surgeons, and physicians. The patient was one of the mission surgeons who was guided to self-image. The virtual network of supporting experts was located across North America, whereas the patient was in Lome, Togo, West Africa. The system consisted of a hand-carried ultrasound, the output of which was digitized and streamed to the experts within standard voice-over-Internet-protocol software with an embedded simultaneous videocamera image of the ultrasonographer's hands using a customized graphical user interface. The practical concept of a virtual tele-ultrasound support network was illustrated through the clinical guidance of multiple physicians, including National Aeronautics and Space Administration Medical Operations remote guiders, Olympic team-associated surgeons, and ultrasound-focused emergentologists.

  13. A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery

    PubMed Central

    Cassin, Stephanie E.; Wnuk, Susan; Du, Chau; Jackson, Timothy; Hawa, Raed; Parikh, Sagar V.

    2017-01-01

    Objective This study aimed to determine the feasibility and preliminary efficacy of a post-operative telephone-based cognitive behavioral therapy intervention (Tele-CBT) in improving eating pathology and psychosocial functioning. Methods Six-month post-operative bariatric surgery patients (n = 19) received six sessions of Tele-CBT. Study outcome variables included binge eating (BES), emotional eating (EES), depressive symptoms (PHQ-9), and anxiety symptoms (GAD-7). Results Retention was 73.7 % post-intervention. Tele-CBT resulted in significant reductions in mean difference scores on BES, EES-Total, EES-Anxiety, EES-Anger, PHQ9, and GAD7. Tele-CBT patients experienced a mean weight loss of 8.62 ± 15.02 kg between 6-months post-surgery (pre-Tele-CBT) and 12-months post-surgery. Conclusions These preliminary results suggest that post-surgery Tele-CBT is feasible and can improve post-surgery symptoms of psychopathology in this uncontrolled study, supporting the need for a randomized controlled trial. PMID:27491293

  14. Simple Algorithms for Distributed Leader Election in Anonymous Synchronous Rings and Complete Networks Inspired by Neural Development in Fruit Flies.

    PubMed

    Xu, Lei; Jeavons, Peter

    2015-11-01

    Leader election in anonymous rings and complete networks is a very practical problem in distributed computing. Previous algorithms for this problem are generally designed for a classical message passing model where complex messages are exchanged. However, the need to send and receive complex messages makes such algorithms less practical for some real applications. We present some simple synchronous algorithms for distributed leader election in anonymous rings and complete networks that are inspired by the development of the neural system of the fruit fly. Our leader election algorithms all assume that only one-bit messages are broadcast by nodes in the network and processors are only able to distinguish between silence and the arrival of one or more messages. These restrictions allow implementations to use a simpler message-passing architecture. Even with these harsh restrictions our algorithms are shown to achieve good time and message complexity both analytically and experimentally.

  15. Irreversibility of Asymptotic Entanglement Manipulation Under Quantum Operations Completely Preserving Positivity of Partial Transpose.

    PubMed

    Wang, Xin; Duan, Runyao

    2017-11-03

    We demonstrate the irreversibility of asymptotic entanglement manipulation under quantum operations that completely preserve the positivity of partial transpose (PPT), resolving a major open problem in quantum information theory. Our key tool is a new efficiently computable additive lower bound for the asymptotic relative entropy of entanglement with respect to PPT states, which can be used to evaluate the entanglement cost under local operations and classical communication (LOCC). We find that for any rank-two mixed state supporting on the 3⊗3 antisymmetric subspace, the amount of distillable entanglement by PPT operations is strictly smaller than one entanglement bit (ebit) while its entanglement cost under PPT operations is exactly one ebit. As a by-product, we find that for this class of states, both the Rains's bound and its regularization are strictly less than the asymptotic relative entropy of entanglement. So, in general, there is no unique entanglement measure for the manipulation of entanglement by PPT operations. We further show a computable sufficient condition for the irreversibility of entanglement distillation by LOCC (or PPT) operations.

  16. Probabilistic simple sticker systems

    NASA Astrophysics Data System (ADS)

    Selvarajoo, Mathuri; Heng, Fong Wan; Sarmin, Nor Haniza; Turaev, Sherzod

    2017-04-01

    A model for DNA computing using the recombination behavior of DNA molecules, known as a sticker system, was introduced by by L. Kari, G. Paun, G. Rozenberg, A. Salomaa, and S. Yu in the paper entitled DNA computing, sticker systems and universality from the journal of Acta Informatica vol. 35, pp. 401-420 in the year 1998. A sticker system uses the Watson-Crick complementary feature of DNA molecules: starting from the incomplete double stranded sequences, and iteratively using sticking operations until a complete double stranded sequence is obtained. It is known that sticker systems with finite sets of axioms and sticker rules generate only regular languages. Hence, different types of restrictions have been considered to increase the computational power of sticker systems. Recently, a variant of restricted sticker systems, called probabilistic sticker systems, has been introduced [4]. In this variant, the probabilities are initially associated with the axioms, and the probability of a generated string is computed by multiplying the probabilities of all occurrences of the initial strings in the computation of the string. Strings for the language are selected according to some probabilistic requirements. In this paper, we study fundamental properties of probabilistic simple sticker systems. We prove that the probabilistic enhancement increases the computational power of simple sticker systems.

  17. The costs of critical care telemedicine programs: a systematic review and analysis.

    PubMed

    Kumar, Gaurav; Falk, Derik M; Bonello, Robert S; Kahn, Jeremy M; Perencevich, Eli; Cram, Peter

    2013-01-01

    Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.

  18. Imperceptible watermarking for security of fundus images in tele-ophthalmology applications and computer-aided diagnosis of retina diseases.

    PubMed

    Singh, Anushikha; Dutta, Malay Kishore

    2017-12-01

    The authentication and integrity verification of medical images is a critical and growing issue for patients in e-health services. Accurate identification of medical images and patient verification is an essential requirement to prevent error in medical diagnosis. The proposed work presents an imperceptible watermarking system to address the security issue of medical fundus images for tele-ophthalmology applications and computer aided automated diagnosis of retinal diseases. In the proposed work, patient identity is embedded in fundus image in singular value decomposition domain with adaptive quantization parameter to maintain perceptual transparency for variety of fundus images like healthy fundus or disease affected image. In the proposed method insertion of watermark in fundus image does not affect the automatic image processing diagnosis of retinal objects & pathologies which ensure uncompromised computer-based diagnosis associated with fundus image. Patient ID is correctly recovered from watermarked fundus image for integrity verification of fundus image at the diagnosis centre. The proposed watermarking system is tested in a comprehensive database of fundus images and results are convincing. results indicate that proposed watermarking method is imperceptible and it does not affect computer vision based automated diagnosis of retinal diseases. Correct recovery of patient ID from watermarked fundus image makes the proposed watermarking system applicable for authentication of fundus images for computer aided diagnosis and Tele-ophthalmology applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Implementation of a model of robotic tele-presence (RTP) in the neuro-ICU: effect on critical care nursing team satisfaction.

    PubMed

    Rincon, Fred; Vibbert, Matthew; Childs, Valerie; Fry, Robin; Caliguri, Dennis; Urtecho, Jacqueline; Rosenwasser, Robert; Jallo, Jack

    2012-08-01

    Robotic tele-presence (RTP) is a form of mobile telemedicine, which enables a direct face-to-face rapid response by the physician, instead of the traditional telephonic paradigm. We hypothesized that a model of RTP for after-hour ICU rounds and emergencies would be associated with improved ICU nurse satisfaction. We implemented a prospective nighttime multidisciplinary ICU round time, using RTP at our neuro-ICU. To test for critical ICU nurse team satisfaction, a questionnaire was implemented. The primary outcome was nurse satisfaction measured through a questionnaire with answers trichotomized into: agreement, disagreement, and no opinion. The occurrence of outcomes was compared between the groups by χ2 or Fisher exact tests for the difference in proportions (PD) with Bonferroni correction for multiple pairwise comparisons. In total, 34 nurses completed the pre-survey and 40 nurses completed the post-survey. Night nurses were more likely to agree that RTP was associated with: ICU physicians being sufficiently available in the ICU (agreement 6-20%, PD 14%, p = 0.008), present during acute emergencies (agreement 44-65%, PD 21%, p = 0.007), and had enough time to get questions answered from the physician team (agreement 41-53%, PD 11%, p = NS). This data suggest improvement in critical care nursing team satisfaction with a model of RTP in the neuroscience ICU, particularly during nighttime hours. RTP is a tool that may enhance communication among components of the ICU team.

  20. Patient-Provider Teamwork via Cooperative Note Taking on Tele-Board MED.

    PubMed

    Perlich, Anja; Meinel, Christoph

    2016-01-01

    There is significant, unexploited potential to improve the patients' engagement in psychotherapy treatment through technology use. We develop Tele-Board MED (TBM), a digital tool to support documentation and patient-provider collaboration in medical encounters. Our objective is the evaluation of TBM's practical effects on patient-provider relationships and patient empowerment in the domain of talk-based mental health interventions. We tested TBM in individual therapy sessions at a psychiatric ward using action research methods. The qualitative results in form of therapist observations and patient stories show an increased acceptance of diagnoses and patient-therapist bonding. We compare the observed effects to patient-provider relationship and patient empowerment models. We can conclude that the functions of TBM - namely that notes are shared and cooperatively taken with the patient, that diagnostics and treatment procedures are depicted via visuals and in plain language, and that patients get a copy of their file - lead to increased patient engagement and an improved collaboration, communication and integration in consultations.

  1. Telescience Operations on International Space Station

    NASA Technical Reports Server (NTRS)

    Schubert, Kathleen E.

    1999-01-01

    This paper describes the concept of telescience operations for the International Space Station (ISS). The extended duration microgravity environment of the ISS will enable microgravity science research to enter into a new era of increased scientific and technological data return. The National Aeronautics and Space Administration (NASA) has a vision of distributed ground operations which enables the Principal Investigator direct interaction with his/her on-board experiment from his/her home location. This is the concept of telescience and is essential for maximizing the use of the long duration science environment that ISS provides. The goal of telescience is to provide the capability to fully tele-operate an experiment from any ground location in such a way as to increase the amount and quality of scientific and technological data return and decrease the operations cost of an individual experiment relative to the era of Space Shuttle experiments. This paper also describes the NASA Lewis Research Center (LeRC) implementation approach for the LeRC Telescience Support Center (TSC) and Principal Investigator Science Operations Sites (SOS) which will fully meet the concept of telescience as prescribed by the Agency.

  2. 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.

  3. The Costs of Critical Care Telemedicine Programs

    PubMed Central

    Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter

    2013-01-01

    Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291

  4. A Hybrid Synthetic Vision System for the Tele-operation of Unmanned Vehicles

    NASA Technical Reports Server (NTRS)

    Delgado, Frank; Abernathy, Mike

    2004-01-01

    A system called SmartCam3D (SC3D) has been developed to provide enhanced situational awareness for operators of a remotely piloted vehicle. SC3D is a Hybrid Synthetic Vision System (HSVS) that combines live sensor data with information from a Synthetic Vision System (SVS). By combining the dual information sources, the operators are afforded the advantages of each approach. The live sensor system provides real-time information for the region of interest. The SVS provides information rich visuals that will function under all weather and visibility conditions. Additionally, the combination of technologies allows the system to circumvent some of the limitations from each approach. Video sensor systems are not very useful when visibility conditions are hampered by rain, snow, sand, fog, and smoke, while a SVS can suffer from data freshness problems. Typically, an aircraft or satellite flying overhead collects the data used to create the SVS visuals. The SVS data could have been collected weeks, months, or even years ago. To that extent, the information from an SVS visual could be outdated and possibly inaccurate. SC3D was used in the remote cockpit during flight tests of the X-38 132 and 131R vehicles at the NASA Dryden Flight Research Center. SC3D was also used during the operation of military Unmanned Aerial Vehicles. This presentation will provide an overview of the system, the evolution of the system, the results of flight tests, and future plans. Furthermore, the safety benefits of the SC3D over traditional and pure synthetic vision systems will be discussed.

  5. Go Deeper, Go Deeper: Understanding submarine command and control during the completion of dived tracking operations.

    PubMed

    Roberts, Aaron P J; Stanton, Neville A; Fay, Daniel T

    2018-05-01

    This is a world's first-of-a-kind study providing empirical evidence for understanding submarine control room performance when completing higher and lower demand Dived Tracking (DT) scenarios. A submarine control room simulator was built, using a non-commercial version of Dangerous Waters as the simulation engine. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during DT. The Event Analysis of Systemic Teamwork (EAST) method was used to model the social, task and information networks and describe command team performance. Ten teams were recruited for the study, affording statistical comparisons of how command team roles and level of demand affected performance. Results indicate that command teams can covertly DT a contact differently depending on demand (e.g. volume of contacts). In low demand it was possible to use periscope more often than in high demand, in a 'duck-and-run' fashion. Therefore, the type of information and frequency of particular task completion, was significantly different between the higher and lower demand conditions. This resulted in different operators in the command team experiencing greater demand depending on how the DT mission objective was completed. Potential bottlenecks in the command team were identified and implications are discussed alongside suggestions for future work. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Information management flow for tele-homecare for the elderly; An emerging need for continuity of care.

    PubMed

    Jeddi, Fatemeh Rangraz; Akbari, Hossein; Rasouli, Somayeh

    2017-06-01

    Tele-homecare methods can be used to provide home care for the elderly, if information management is provided. The aim of this study was to compare the places and methods of the data collection and media that use Tele-homecare for the elderly in selected countries in 2015. A comparative-applied library study was conducted in 2015. The study population were five countries, including Canada, Australia, England, Denmark, and Taiwan. The data collection tool was a checklist based on the objectives of study. Persian and English papers from 1998 to 2014, related to the Electronic Health Record, home care and the elderly were extracted from authentic journals and reference books as well as academic and research websites. Data were collected by reviewing the papers. After collecting data, comparative tables were prepared and the weak and strong points of each case were investigated and analyzed in selected countries. Clinical, laboratory, imaging and pharmaceutical data were obtained from hospitals, physicians' offices, clinics, pharmacies and long-term healthcare centers. Mobile and tablet-based technologies and personal digital assistants were used to collect data. Data were published via Internet, online and offline databanks, data exchange and dissemination via registries and national databases. Managed care methods were telehealth management systems and point of service. For continuity of care, it is necessary to consider managed care and equipment with regard to obtaining data in various forms from various sources, sharing data with registries and national databanks as well as the Electronic Health Record. With regard to the emergence of wearable technology and its use in home care, it is suggested to study the integration of its data with Electronic Health Records.

  7. Operational Resource Theory of Coherence.

    PubMed

    Winter, Andreas; Yang, Dong

    2016-03-25

    We establish an operational theory of coherence (or of superposition) in quantum systems, by focusing on the optimal rate of performance of certain tasks. Namely, we introduce the two basic concepts-"coherence distillation" and "coherence cost"-in the processing quantum states under so-called incoherent operations [Baumgratz, Cramer, and Plenio, Phys. Rev. Lett. 113, 140401 (2014)]. We, then, show that, in the asymptotic limit of many copies of a state, both are given by simple single-letter formulas: the distillable coherence is given by the relative entropy of coherence (in other words, we give the relative entropy of coherence its operational interpretation), and the coherence cost by the coherence of formation, which is an optimization over convex decompositions of the state. An immediate corollary is that there exists no bound coherent state in the sense that one would need to consume coherence to create the state, but no coherence could be distilled from it. Further, we demonstrate that the coherence theory is generically an irreversible theory by a simple criterion that completely characterizes all reversible states.

  8. [The operating room of the future].

    PubMed

    Broeders, I A; Niessen, W; van der Werken, C; van Vroonhoven, T J

    2000-01-29

    Advances in computer technology will revolutionize surgical techniques in the next decade. The operating room (OR) of the future will be connected with a laboratory where clinical specialists and researchers prepare image-guided interventions and explore the possibilities of these techniques. The virtual reality is linked to the actual situation in the OR with the aid of navigation instruments. During complicated operations the images prepared preoperatively will be corrected during the operation on the basis of the information obtained peroperatively. MRI currently offers maximal possibilities for image-guided surgery of soft tissues. Simpler techniques such as fluoroscopy and echography will become increasingly integrated in computer-assisted peroperative navigation. The development of medical robot systems will make possible microsurgical procedures by the endoscopic route. Tele-manipulation systems will also play a part in the training of surgeons. Design and construction of the OR will be adapted to the surgical technology, and include an information and control unit where preoperative and peroperative data come together and from where the surgeon operates the instruments. Concepts for the future OR should be regularly adjusted to allow for new surgical technology.

  9. Combined effect of new complete dentures and simple dietary advice on nutritional status in edentulous patients: study protocol for a randomized controlled trial.

    PubMed

    Komagamine, Yuriko; Kanazawa, Manabu; Iwaki, Maiko; Jo, Ayami; Suzuki, Hiroyuki; Amagai, Noriko; Minakuchi, Shunsuke

    2016-11-09

    Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures. Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences

  10. Phase-space representations of symmetric informationally complete positive-operator-valued-measure fiducial states

    NASA Astrophysics Data System (ADS)

    Saraceno, Marcos; Ermann, Leonardo; Cormick, Cecilia

    2017-03-01

    The problem of finding symmetric informationally complete positive-operator-valued-measures (SIC-POVMs) has been solved numerically for all dimensions d up to 67 [A. J. Scott and M. Grassl, J. Math. Phys. 51, 042203 (2010), 10.1063/1.3374022], but a general proof of existence is still lacking. For each dimension, it was shown that it is possible to find a SIC-POVM that is generated from a fiducial state upon application of the operators of the Heisenberg-Weyl group. We draw on the numerically determined fiducial states to study their phase-space features, as displayed by the characteristic function and the Wigner, Bargmann, and Husimi representations, adapted to a Hilbert space of finite dimension. We analyze the phase-space localization of fiducial states, and observe that the SIC-POVM condition is equivalent to a maximal delocalization property. Finally, we explore the consequences in phase space of the conjectured Zauner symmetry. In particular, we construct a Hermitian operator commuting with this symmetry that leads to a representation of fiducial states in terms of eigenfunctions with definite semiclassical features.

  11. An Evaluation of the Value of Choice-Making Opportunities in Single-Operant Arrangements: Simple Fixed- and Progressive-Ratio Schedules

    ERIC Educational Resources Information Center

    Tiger, Jeffrey H.; Toussaint, Karen A.; Roath, Christopher T.

    2010-01-01

    The current study compared the effects of choice and no-choice reinforcement conditions on the task responding of 3 children with autism across 2 single-operant paradigm reinforcer assessments. The first assessment employed simple fixed-ratio (FR) schedules; the second used progressive-ratio (PR) schedules. The latter assessment identified the…

  12. 30 CFR 285.638 - What must I do upon completion of my commercial operations as approved in my COP or FERC license?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operations as approved in my COP or FERC license? 285.638 Section 285.638 Mineral Resources BUREAU OF OCEAN... Activities Under An Approved Cop § 285.638 What must I do upon completion of my commercial operations as approved in my COP or FERC license? (a) Upon completion of your approved activities under your COP, you...

  13. A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

    PubMed

    Mavandadi, Sam; Feng, Steve; Yu, Frank; Dimitrov, Stoyan; Nielsen-Saines, Karin; Prescott, William R; Ozcan, Aydogan

    2012-01-01

    We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform.

  14. VET Program Completion Rates: An Evaluation of the Current Method. Occasional Paper

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2016

    2016-01-01

    This work asks one simple question: "how reliable is the method used by the National Centre for Vocational Education Research (NCVER) to estimate projected rates of VET program completion?" In other words, how well do early projections align with actual completion rates some years later? Completion rates are simple to calculate with a…

  15. Specific technological communication skills and functional health literacy have no influence on self-reported benefits from enrollment in the TeleCare North trial.

    PubMed

    Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Ehlers, Lars Holger; Hejlesen, Ole K

    2016-07-01

    The Danish TeleCare North trial has developed a telehealth system, Telekit, which is used for self-management by patients diagnosed with chronic obstructive pulmonary disease (COPD). Self-management is the engagement in one's own illness and health by monitoring and managing one's symptoms and signs of illness. The study examines the association between COPD patients' use of Telekit and their functional health literacy and the association between their use of Telekit and their specific technological communication skills. A consecutive sample of participants (n=60) from the TeleCare North trial were recruited. Face-to-face interviews were conducted with each participant to collect demographic data. Functional health literacy was measured with the Danish TOFHLA test. Participants completed a non-standardised questionnaire about their health status, their use of the Telekit system, and their specific technological communication skills. Binary logistic regressions were performed to examine how functional health literacy and specific technological communication skills influenced the use of Telekit by giving users an enhanced sense of freedom, security, control, and a greater awareness of COPD symptoms. Participants (27 women, 33 men) had a mean age of 70 (SD: 8.37) years. Functional health literacy levels were classified as inadequate in 14 (23%) participants, as marginal in 12 (20%), and as adequate in 34 (57%). Participants self-reported a feeling of increased security (72%), greater freedom (27%), more control (62%), and greater awareness of symptoms (50%) when using Telekit. The use of Telekit was not significantly associated with levels of functional health literacy or with the number of specific technological communication skills (p>0.05) based on the binary logistic regressions. The enhanced sense of security, freedom, control, and the greater awareness of COPD symptoms achieved by using Telekit were unassociated both with the patients' score of functional health

  16. Image Formation in Lenses and Mirrors, a Complete Representation

    ERIC Educational Resources Information Center

    Bartlett, Albert A.

    1976-01-01

    Provides tables and graphs that give a complete and simple picture of the relationships of image distance, object distance, and magnification in all formations of images by simple lenses and mirrors. (CP)

  17. A general framework for complete positivity

    NASA Astrophysics Data System (ADS)

    Dominy, Jason M.; Shabani, Alireza; Lidar, Daniel A.

    2016-01-01

    Complete positivity of quantum dynamics is often viewed as a litmus test for physicality; yet, it is well known that correlated initial states need not give rise to completely positive evolutions. This observation spurred numerous investigations over the past two decades attempting to identify necessary and sufficient conditions for complete positivity. Here, we describe a complete and consistent mathematical framework for the discussion and analysis of complete positivity for correlated initial states of open quantum systems. This formalism is built upon a few simple axioms and is sufficiently general to contain all prior methodologies going back to Pechakas (Phys Rev Lett 73:1060-1062, 1994). The key observation is that initial system-bath states with the same reduced state on the system must evolve under all admissible unitary operators to system-bath states with the same reduced state on the system, in order to ensure that the induced dynamical maps on the system are well defined. Once this consistency condition is imposed, related concepts such as the assignment map and the dynamical maps are uniquely defined. In general, the dynamical maps may not be applied to arbitrary system states, but only to those in an appropriately defined physical domain. We show that the constrained nature of the problem gives rise to not one but three inequivalent types of complete positivity. Using this framework, we elucidate the limitations of recent attempts to provide conditions for complete positivity using quantum discord and the quantum data processing inequality. In particular, we correct the claim made by two of us (Shabani and Lidar in Phys Rev Lett 102:100402-100404, 2009) that vanishing discord is necessary for complete positivity, and explain that it is valid only for a particular class of initial states. The problem remains open, and may require fresh perspectives and new mathematical tools. The formalism presented herein may be one step in that direction.

  18. A simple numerical model for predicting organic matter decomposition in a fed-batch composting operation.

    PubMed

    Nakasaki, Kiyohiko; Ohtaki, Akihito

    2002-01-01

    Using dog food as a model of the organic waste that comprises composting raw material, the degradation pattern of organic materials was examined by continuously measuring the quantity of CO2 evolved during the composting process in both batch and fed-batch operations. A simple numerical model was made on the basis of three suppositions for describing the organic matter decomposition in the batch operation. First, a certain quantity of carbon in the dog food was assumed to be recalcitrant to degradation in the composting reactor within the retention time allowed. Second, it was assumed that the decomposition rate of carbon is proportional to the quantity of easily degradable carbon, that is, the carbon recalcitrant to degradation was subtracted from the total carbon remaining in the dog food. Third, a certain lag time is assumed to occur before the start of active decomposition of organic matter in the dog food; this lag corresponds to the time required for microorganisms to proliferate and become active. It was then ascertained that the decomposition pattern for the organic matter in the dog food during the fed-batch operation could be predicted by the numerical model with the parameters obtained from the batch operation. This numerical model was modified so that the change in dry weight of composting materials could be obtained. The modified model was found suitable for describing the organic matter decomposition pattern in an actual fed-batch composting operation of the garbage obtained from a restaurant, approximately 10 kg d(-1) loading for 60 d.

  19. Long-term hand tele-rehabilitation on the PlayStation 3: benefits and challenges.

    PubMed

    Burdea, Grigore C; Jain, Abhishek; Rabin, Bryan; Pellosie, Richard; Golomb, Meredith

    2011-01-01

    Rehabilitation interventions for the hand have shown benefits for children with Hemiplegia due to cerebral palsy or traumatic brain injury. Longer interventions are facilitated if training is provided in the patient's home, due to easier access to care and reduced impact on school or work activities. Providing remote rehabilitation over lengthy periods of time has however its own challenges. This paper presents two pediatric patients with hemiplegia, who practiced virtual hand rehabilitation games using a modified PlayStation 3 and 5DT sensing gloves. Despite severe initial hand spasticity, and occasional technology shortcomings, the subjects practiced for about 14 months, and 6 months, respectively. Game performance data for the second patient is presented. Follow-up evaluations 14 months from the removal of the PlayStation 3 from the home of the child with cerebral palsy showed that the patient had good retention in terms of grasp strength, hand function and bone health. Challenges of long-term home tele-rehabilitation are also discussed.

  20. Simple Ontology Format (SOFT)

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

    Sorokine, Alexandre

    2011-10-01

    Simple Ontology Format (SOFT) library and file format specification provides a set of simple tools for developing and maintaining ontologies. The library, implemented as a perl module, supports parsing and verification of the files in SOFt format, operations with ontologies (adding, removing, or filtering of entities), and converting of ontologies into other formats. SOFT allows users to quickly create ontologies using only a basic text editor, verify it, and portray it in a graph layout system using customized styles.

  1. Mobile platform for treatment of stroke: A case study of tele-assistance.

    PubMed

    Torres Zenteno, Arturo Henry; Fernández, Francisco; Palomino-García, Alfredo; Moniche, Francisco; Escudero, Irene; Jiménez-Hernández, M Dolores; Caballero, Auxiliadora; Escobar-Rodriguez, Germán; Parra, Carlos

    2016-09-01

    This article presents the technological solution of a tele-assistance process for stroke patients in acute phase in the Seville metropolitan area. The main objective of this process is to reduce time from symptom onset to treatment of acute phase stroke patients by means of telemedicine, regarding mobility between an intensive care unit ambulance and an expert center and activating the pre-hospital care phase. The technological platform covering the process has been defined following an interoperability model based on standards and with a focus on service-oriented architecture focus. Messaging definition has been designed according to the reference model of the CEN/ISO 13606, messages content follows the structure of archetypes. An XDS-b (Cross-Enterprise Document Sharing-b) transaction messaging has been designed according to Integrating the Healthcare Enterprise profile for archetype notifications and update enquiries.This research has been performed by a multidisciplinary group. The Virgen del Rocío University Hospital acts as Reference Hospital and the Public Company for Healthcare as mobility surroundings. © The Author(s) 2015.

  2. Mobile platform for treatment of stroke: A case study of tele-assistance

    PubMed Central

    Torres Zenteno, Arturo Henry; Fernández, Francisco; Palomino-García, Alfredo; Moniche, Francisco; Escudero, Irene; Jiménez-Hernández, M Dolores; Caballero, Auxiliadora; Escobar-Rodriguez, Germán; Parra, Carlos

    2015-01-01

    This article presents the technological solution of a tele-assistance process for stroke patients in acute phase in the Seville metropolitan area. The main objective of this process is to reduce time from symptom onset to treatment of acute phase stroke patients by means of telemedicine, regarding mobility between an intensive care unit ambulance and an expert center and activating the pre-hospital care phase. The technological platform covering the process has been defined following an interoperability model based on standards and with a focus on service-oriented architecture focus. Messaging definition has been designed according to the reference model of the CEN/ISO 13606, messages content follows the structure of archetypes. An XDS-b (Cross-Enterprise Document Sharing-b) transaction messaging has been designed according to Integrating the Healthcare Enterprise profile for archetype notifications and update enquiries.This research has been performed by a multidisciplinary group. The Virgen del Rocío University Hospital acts as Reference Hospital and the Public Company for Healthcare as mobility surroundings. PMID:25975806

  3. Pre-hospital electrocardiogram triage with tele-cardiology support is associated with shorter time-to-balloon and higher rates of timely reperfusion even in rural areas: data from the Bari- Barletta/Andria/Trani public emergency medical service 118 registry on primary angioplasty in ST-elevation myocardial infarction.

    PubMed

    Brunetti, Natale Daniele; Di Pietro, Gaetano; Aquilino, Ambrogio; Bruno, Angela I; Dellegrottaglie, Giulia; Di Giuseppe, Giuseppe; Lopriore, Claudio; De Gennaro, Luisa; Lanzone, Saverio; Caldarola, Pasquale; Antonelli, Gianfranco; Di Biase, Matteo

    2014-09-01

    We report the preliminary data from a regional registry on ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty in Apulia, Italy; the region is covered by a single public health-care service, a single public emergency medical service (EMS), and a single tele-medicine service provider. Two hundred and ninety-seven consecutive patients with STEMI transferred by regional free public EMS 1-1-8 for primary-PCI were enrolled in the study; 123 underwent pre-hospital electrocardiograms (ECGs) triage by tele-cardiology support and directly referred for primary-PCI, those remaining were just transferred by 1-1-8 ambulances for primary percutaneous coronary intervention (PCI) (diagnosis not based on tele-medicine ECG; already hospitalised patients, emergency-room without tele-medicine support). Time from first ECG diagnostic for STEMI to balloon was recorded; a time-to-balloon <1 h was considered as optimal and patients as timely treated. Mean time-to-balloon with pre-hospital triage and tele-cardiology ECG was significantly shorter (0:41 ± 0:17 vs 1:34 ± 1:11 h, p<0.001, -0:53 h, -56%) and rates of patients timely treated higher (85% vs 35%, p<0.001, +141%), both in patients from the 'inner' zone closer to PCI catheterisation laboratories (0:34 ± 0:13 vs 0:54 ± 0:30 h, p<0.001; 96% vs 77%, p<0.01, +30%) and in the 'outer' zone (0:52 ± 0:17 vs 1:41 ± 1:14 h, p<0.001; 69% vs 29%, p<0.001, +138%). Results remained significant even after multivariable analysis (odds ratio for time-to-balloon 0.71, 95% confidence interval (CI) 0.63-0.80, p<0.001; 1.39, 95% CI 1.25-1.55, p<0.001, for timely primary-PCI). Pre-hospital triage with tele-cardiology ECG in an EMS registry from an area with more than one and a half million inhabitants was associated with shorter time-to-balloon and higher rates of timely treated patients, even in 'rural' areas. © The European Society of Cardiology 2014.

  4. UAV-guided navigation for ground robot tele-operation in a military reconnaissance environment.

    PubMed

    Chen, Jessie Y C

    2010-08-01

    A military reconnaissance environment was simulated to examine the performance of ground robotics operators who were instructed to utilise streaming video from an unmanned aerial vehicle (UAV) to navigate his/her ground robot to the locations of the targets. The effects of participants' spatial ability on their performance and workload were also investigated. Results showed that participants' overall performance (speed and accuracy) was better when she/he had access to images from larger UAVs with fixed orientations, compared with other UAV conditions (baseline- no UAV, micro air vehicle and UAV with orbiting views). Participants experienced the highest workload when the UAV was orbiting. Those individuals with higher spatial ability performed significantly better and reported less workload than those with lower spatial ability. The results of the current study will further understanding of ground robot operators' target search performance based on streaming video from UAVs. The results will also facilitate the implementation of ground/air robots in military environments and will be useful to the future military system design and training community.

  5. Audiovisual Fundamentals; Basic Equipment Operation and Simple Materials Production.

    ERIC Educational Resources Information Center

    Bullard, John R.; Mether, Calvin E.

    A guide illustrated with simple sketches explains the functions and step-by-step uses of audiovisual (AV) equipment. Principles of projection, audio, AV equipment, lettering, limited-quantity and quantity duplication, and materials preservation are outlined. Apparatus discussed include overhead, opaque, slide-filmstrip, and multiple-loading slide…

  6. Humanlike robot hands controlled by brain activity arouse illusion of ownership in operators

    PubMed Central

    Alimardani, Maryam; Nishio, Shuichi; Ishiguro, Hiroshi

    2013-01-01

    Operators of a pair of robotic hands report ownership for those hands when they hold image of a grasp motion and watch the robot perform it. We present a novel body ownership illusion that is induced by merely watching and controlling robot's motions through a brain machine interface. In past studies, body ownership illusions were induced by correlation of such sensory inputs as vision, touch and proprioception. However, in the presented illusion none of the mentioned sensations are integrated except vision. Our results show that during BMI-operation of robotic hands, the interaction between motor commands and visual feedback of the intended motions is adequate to incorporate the non-body limbs into one's own body. Our discussion focuses on the role of proprioceptive information in the mechanism of agency-driven illusions. We believe that our findings will contribute to improvement of tele-presence systems in which operators incorporate BMI-operated robots into their body representations. PMID:23928891

  7. No patch technique for complete atrioventricular canal repair.

    PubMed

    Aramendi, José Ignacio; Rodriguez, Miguel Angel; Luis, Teresa; Voces, Roberto

    2006-08-01

    We describe our initial experience with a new technique, consisting in direct closure of the ventricular septal defect component of the AV canal, by directly attaching the common bridging leaflets to the crest of the ventricular septum with interrupted sutures. After closure of the cleft, the ostium primum defect was closed with a running suture suturing the border of the septum primum to the newly created AV valve annulus. Three patients were operated upon. There was no mortality. Mean ischemic time was 39 min and mean pump time 77 min. All patients remained in sinus rhythm. At follow-up only trivial or mild mitral regurgitation was observed. This new technique permits the repair of complete AV canal without the need for any patch. It is fast, simple and reproducible.

  8. Simple Library Bookkeeping.

    ERIC Educational Resources Information Center

    Hoffman, Herbert H.

    A simple and cheap manual double entry continuous transaction posting system with running balances is developed for bookkeeping by small libraries. A very small library may operate without any system of fiscal control but when a library's budget approaches three figures, some kind of bookkeeping must be introduced. To maintain control over his…

  9. Distance Learning in North Dakota: A Cross-Technology Study of the Schools, Administrators, Coordinators, Instructors, and Students. Two-Way Interactive Television, AudioGraphic Tele-Learning, [and] Instruction by Satellite.

    ERIC Educational Resources Information Center

    Hobbs, Vicki M.

    In 1990 a comparative analysis was conducted of North Dakota student achievement across three forms of distance education: instruction by satellite, audiographic tele-learning, and two way interactive educational television. Based in part on the 1988 study of a German by Satellite program in Missouri and North Dakota, this study mailed…

  10. Tele-mental health brings expert input to EPs, speeds treatment.

    PubMed

    2014-08-01

    Faced with rising demand from patients with mental health problems, Mercy San Juan Medical Center in Carmichael, CA, is using telemedicine to connect many of these patients with psychiatrists. With input from the psychiatrists, emergency physicians feel more comfortable initiating treatment for these patients, many of whom can then be discharged with instructions to pursue outpatient follow-up. Further, the expert consults help physicians determine whether patients who have been placed on involuntary holds require inpatient treatment or can be safely treated and discharged. The technology required for the remote sessions is contained on robots that can move from room to room in the ED. The ED targets two groups of patients for tele-mental health visits: patients who present with concerns that the emergency physicians do not feel comfortable treating without input from psychiatrists, and patients who have been in the ED for an extended period of time, and it is clear that they will not be transported to an inpatient psychiatric facility any time soon. Currently, 25%-30% of the mental health patients who present to the ED are being touched by the remote psychiatrists; however, administrators are looking to increase that percentage to 50%-75%. They are also interested in potentially conducting regular rounds of the mental health patients with the remote psychiatrists.

  11. Tele-Supervised Adaptive Ocean Sensor Fleet

    NASA Technical Reports Server (NTRS)

    Lefes, Alberto; Podnar, Gregg W.; Dolan, John M.; Hosler, Jeffrey C.; Ames, Troy J.

    2009-01-01

    The Tele-supervised Adaptive Ocean Sensor Fleet (TAOSF) is a multi-robot science exploration architecture and system that uses a group of robotic boats (the Ocean-Atmosphere Sensor Integration System, or OASIS) to enable in-situ study of ocean surface and subsurface characteristics and the dynamics of such ocean phenomena as coastal pollutants, oil spills, hurricanes, or harmful algal blooms (HABs). The OASIS boats are extended- deployment, autonomous ocean surface vehicles. The TAOSF architecture provides an integrated approach to multi-vehicle coordination and sliding human-vehicle autonomy. One feature of TAOSF is the adaptive re-planning of the activities of the OASIS vessels based on sensor input ( smart sensing) and sensorial coordination among multiple assets. The architecture also incorporates Web-based communications that permit control of the assets over long distances and the sharing of data with remote experts. Autonomous hazard and assistance detection allows the automatic identification of hazards that require human intervention to ensure the safety and integrity of the robotic vehicles, or of science data that require human interpretation and response. Also, the architecture is designed for science analysis of acquired data in order to perform an initial onboard assessment of the presence of specific science signatures of immediate interest. TAOSF integrates and extends five subsystems developed by the participating institutions: Emergent Space Tech - nol ogies, Wallops Flight Facility, NASA s Goddard Space Flight Center (GSFC), Carnegie Mellon University, and Jet Propulsion Laboratory (JPL). The OASIS Autonomous Surface Vehicle (ASV) system, which includes the vessels as well as the land-based control and communications infrastructure developed for them, controls the hardware of each platform (sensors, actuators, etc.), and also provides a low-level waypoint navigation capability. The Multi-Platform Simulation Environment from GSFC is a surrogate

  12. Assessment of Haptic Interaction for Home-Based Physical Tele-Therapy using Wearable Devices and Depth Sensors.

    PubMed

    Barmpoutis, Angelos; Alzate, Jose; Beekhuizen, Samantha; Delgado, Horacio; Donaldson, Preston; Hall, Andrew; Lago, Charlie; Vidal, Kevin; Fox, Emily J

    2016-01-01

    In this paper a prototype system is presented for home-based physical tele-therapy using a wearable device for haptic feedback. The haptic feedback is generated as a sequence of vibratory cues from 8 vibrator motors equally spaced along an elastic wearable band. The motors guide the patients' movement as they perform a prescribed exercise routine in a way that replaces the physical therapists' haptic guidance in an unsupervised or remotely supervised home-based therapy session. A pilot study of 25 human subjects was performed that focused on: a) testing the capability of the system to guide the users in arbitrary motion paths in the space and b) comparing the motion of the users during typical physical therapy exercises with and without haptic-based guidance. The results demonstrate the efficacy of the proposed system.

  13. Performance study of the application of Artificial Neural Networks to the completion and prediction of data retrieved by underwater sensors.

    PubMed

    Baladrón, Carlos; Aguiar, Javier M; Calavia, Lorena; Carro, Belén; Sánchez-Esguevillas, Antonio; Hernández, Luis

    2012-01-01

    This paper presents a proposal for an Artificial Neural Network (ANN)-based architecture for completion and prediction of data retrieved by underwater sensors. Due to the specific conditions under which these sensors operate, it is not uncommon for them to fail, and maintenance operations are difficult and costly. Therefore, completion and prediction of the missing data can greatly improve the quality of the underwater datasets. A performance study using real data is presented to validate the approach, concluding that the proposed architecture is able to provide very low errors. The numbers show as well that the solution is especially suitable for cases where large portions of data are missing, while in situations where the missing values are isolated the improvement over other simple interpolation methods is limited.

  14. Hydralazine is involved in tele-methylhistamine metabolism by inhibiting monoamine oxidase B in pregnancy-associated hypertensive mice.

    PubMed

    Kawasaki, Shohei; Kako, Koichiro; Nagashima, Yusuke; Kanou, Akihiko; Ishida, Junji; Fukamizu, Akiyoshi

    2017-02-01

    Hypertensive disorders of pregnancy globally affect 6-8% of gestation and remain a major cause of both foetal and maternal morbidity and mortality. However, the antihypertensive medications for the patients of this disease are strictly limited due to the teratogenic potentials. Here, we found that tele-methylhistamine (tMH) increased in response to the administration of hydralazine (Hdz), a vasodilative agent, in the pregnancy-associated hypertensive (PAH) mice. Hdz abrogated the degradation of tMH catalyzed by monoamine oxidase B (MAO-B) in vitro. These results suggested that Hdz inhibited the MAO-B activity and consequently tMH increased in the maternal circulation of PAH mice. © The Authors 2016. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

  15. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

    PubMed Central

    Vinekar, Anand; Gilbert, Clare; Dogra, Mangat; Kurian, Mathew; Shainesh, Gangadharan; Shetty, Bhujang; Bauer, Noel

    2014-01-01

    Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program for retinopathy of prematurity (ROP) screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA) and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score) graded their ability (Level I to III) to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple). Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001). Only 0.4% of infants needing treatment were missed. The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001) respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics. PMID:24492500

  16. [Robotics in general surgery: personal experience, critical analysis and prospectives].

    PubMed

    Fracastoro, Gerolamo; Borzellino, Giuseppe; Castelli, Annalisa; Fiorini, Paolo

    2005-01-01

    Today mini invasive surgery has the chance to be enhanced with sophisticated informative systems (Computer Assisted Surgery, CAS) like robotics, tele-mentoring and tele-presence. ZEUS and da Vinci, present in more than 120 Centres in the world, have been used in many fields of surgery and have been tested in some general surgical procedures. Since the end of 2003, we have performed 70 experimental procedures and 24 operations of general surgery with ZEUS robotic system, after having properly trained 3 surgeons and the operating room staff. Apart from the robot set-up, the mean operative time of the robotic operations was similar to the laparoscopic ones; no complications due to robotic technique occurred. The Authors report benefits and disadvantages related to robots' utilization, problems still to be solved and the possibility to make use of them with tele-surgery, training and virtual surgery.

  17. Pseudo-simple heteroclinic cycles in R4

    NASA Astrophysics Data System (ADS)

    Chossat, Pascal; Lohse, Alexander; Podvigina, Olga

    2018-06-01

    We study pseudo-simple heteroclinic cycles for a Γ-equivariant system in R4 with finite Γ ⊂ O(4) , and their nearby dynamics. In particular, in a first step towards a full classification - analogous to that which exists already for the class of simple cycles - we identify all finite subgroups of O(4) admitting pseudo-simple cycles. To this end we introduce a constructive method to build equivariant dynamical systems possessing a robust heteroclinic cycle. Extending a previous study we also investigate the existence of periodic orbits close to a pseudo-simple cycle, which depends on the symmetry groups of equilibria in the cycle. Moreover, we identify subgroups Γ ⊂ O(4) , Γ ⊄ SO(4) , admitting fragmentarily asymptotically stable pseudo-simple heteroclinic cycles. (It has been previously shown that for Γ ⊂ SO(4) pseudo-simple cycles generically are completely unstable.) Finally, we study a generalized heteroclinic cycle, which involves a pseudo-simple cycle as a subset.

  18. CIS4/403: Design and Implementation of an Intranet-based system for Real-Time Tele-Consultation in Oncology

    PubMed Central

    Eccher, C; Berloffa, F; Demichelis, F; Larcher, B; Galvagni, M; Sboner, A; Graiff, A; Forti, S

    1999-01-01

    Introduction This study describes a tele-consultation system (TCS) developed to provide a computing environment over a Wide Area Network (WAN) in North Italy (Province of Trento), that can be used by two or more physicians to share medical data and to work co-operatively on medical records. A pilot study has been carried out in oncology to assess the effectiveness of the system. The aim of this project is to facilitate the management of oncology patients by improving communication among the specialists of central and district hospitals. Methods and Results The TCS is an Intranet-based solution. The Intranet is based on a PC WAN with Windows NT Server, Microsoft SQL Server, and Internet Information Server. TCS is composed of native and custom applications developed in the Microsoft Windows (9x and NT) environment. The basic component of the system is the multimedia digital medical record, structured as a collection of HTML and ASP pages. A distributed relational database will allow users to store and retrieve medical records, accessed by a dedicated Web browser via the Web Server. The medical data to be stored and the presentation architecture of the clinical record had been determined in close collaboration with the clinicians involved in the project. TCS will allow a multi-point tele-consultation (TC) among two or more participants on remote computers, providing synchronized surfing through the clinical report. A set of collaborative and personal tools, whiteboard with drawing tools, point-to-point digital audio-conference, chat, local notepad, e-mail service, are integrated in the system to provide an user friendly environment. TCS has been developed as a client-server architecture. The client part of the system is based on the Microsoft Web Browser control and provides the user interface and the tools described above. The server part, running all the time on a dedicated computer, accepts connection requests and manages the connections among the participants in a

  19. Preliminary experience of shared clinical management between Milan and Pointe Noire using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): telemedicine between Milan and Africa.

    PubMed

    Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo

    2004-01-01

    This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site.

  20. A simple method to equalize the workload when operating several small wastewater treatment plants: a case study.

    PubMed

    De Feo, G; De Gisi, S; Galasso, M

    2013-01-01

    The aim of the present study is to define a simple (and easy to use) method to equalize the workload of personnel operating several small wastewater treatment plants (SWWTPs). The approach is illustrated through a case study which is the result of collaboration between researchers and a water and wastewater management company operating in Southern Italy. The topic is important since personnel have a significant impact on the operating costs of SWWTPs, and the approach outlined results in the minimum number of staff being required to assure the management of the service. Four kinds of work units are considered: plant managers, assistant plant managers, laboratory technicians and executives. In order to develop a practical, feasible and easy to use method, the workload was evaluated considering only the population equivalent (PE) and the number of plants managed. The core of the method is the evaluation of the percentage of time that the personnel units devote to the operation of SWWTPs of the municipality considered. The proposed procedure offers a useful tool to equalize the workload, both in terms of PE and the number of plants managed, the procedure being easily modifiable to introduce other evaluation criteria. By using familiar concepts such as PE and number of plants managed, the approach of the method can easily be understood by management. It can also be readily adapted to other similar situations.

  1. Modeling and Design of an Electro-Rheological Fluid Based Haptic System for Tele-Operation of Space Robots

    NASA Technical Reports Server (NTRS)

    Mavroidis, Constantinos; Pfeiffer, Charles; Paljic, Alex; Celestino, James; Lennon, Jamie; Bar-Cohen, Yoseph

    2000-01-01

    For many years, the robotic community sought to develop robots that can eventually operate autonomously and eliminate the need for human operators. However, there is an increasing realization that there are some tasks that human can perform significantly better but, due to associated hazards, distance, physical limitations and other causes, only robot can be employed to perform these tasks. Remotely performing these types of tasks requires operating robots as human surrogates. While current "hand master" haptic systems are able to reproduce the feeling of rigid objects, they present great difficulties in emulating the feeling of remote/virtual stiffness. In addition, they tend to be heavy, cumbersome and usually they only allow limited operator workspace. In this paper a novel haptic interface is presented to enable human-operators to "feel" and intuitively mirror the stiffness/forces at remote/virtual sites enabling control of robots as human-surrogates. This haptic interface is intended to provide human operators intuitive feeling of the stiffness and forces at remote or virtual sites in support of space robots performing dexterous manipulation tasks (such as operating a wrench or a drill). Remote applications are referred to the control of actual robots whereas virtual applications are referred to simulated operations. The developed haptic interface will be applicable to IVA operated robotic EVA tasks to enhance human performance, extend crew capability and assure crew safety. The electrically controlled stiffness is obtained using constrained ElectroRheological Fluids (ERF), which changes its viscosity under electrical stimulation. Forces applied at the robot end-effector due to a compliant environment will be reflected to the user using this ERF device where a change in the system viscosity will occur proportionally to the force to be transmitted. In this paper, we will present the results of our modeling, simulation, and initial testing of such an

  2. Development of Three-Dimensional Completion of Complex Objects

    ERIC Educational Resources Information Center

    Soska, Kasey C.; Johnson, Scott P.

    2013-01-01

    Three-dimensional (3D) object completion, the ability to perceive the backs of objects seen from a single viewpoint, emerges at around 6 months of age. Yet, only relatively simple 3D objects have been used in assessing its development. This study examined infants' 3D object completion when presented with more complex stimuli. Infants…

  3. Performance of Simple Gas Foil Thrust Bearings in Air

    NASA Technical Reports Server (NTRS)

    Bruckner, Robert J.

    2012-01-01

    Foil bearings are self-acting hydrodynamics devices used to support high speed rotating machinery. The advantages that they offer to process fluid lubricated machines include: high rotational speed capability, no auxiliary lubrication system, non-contacting high speed operation, and improved damping as compared to rigid hydrodynamic bearings. NASA has had a sporadic research program in this technology for almost 6 decades. Advances in the technology and understanding of foil journal bearings have enabled several new commercial products in recent years. These products include oil-free turbochargers for both heavy trucks and automobiles, high speed electric motors, microturbines for distributed power generation, and turbojet engines. However, the foil thrust bearing has not received a complimentary level of research and therefore has become the weak link of oil-free turbomachinery. In an effort to both provide machine designers with basic performance parameters and to elucidate the underlying physics of foil thrust bearings, NASA Glenn Research Center has completed an effort to experimentally measure the performance of simple gas foil thrust bearing in air. The database includes simple bump foil supported thrust bearings with full geometry and manufacturing techniques available to the user. Test conditions consist of air at ambient pressure and temperatures up to 500 C and rotational speeds to 55,000 rpm. A complete set of axial load, frictional torque, and rotational speed is presented for two different compliant sub-structures and inter-pad gaps. Data obtained from commercially available foil thrust bearings both with and without active cooling is presented for comparison. A significant observation made possible by this data set is the speed-load capacity characteristic of foil thrust bearings. Whereas for the foil journal bearing the load capacity increases linearly with rotational speed, the foil thrust bearing operates in the hydrodynamic high speed limit. In

  4. A simple and efficient algorithm operating with linear time for MCEEG data compression.

    PubMed

    Titus, Geevarghese; Sudhakar, M S

    2017-09-01

    Popularisation of electroencephalograph (EEG) signals in diversified fields have increased the need for devices capable of operating at lower power and storage requirements. This has led to a great deal of research in data compression, that can address (a) low latency in the coding of the signal, (b) reduced hardware and software dependencies, (c) quantify the system anomalies, and (d) effectively reconstruct the compressed signal. This paper proposes a computationally simple and novel coding scheme named spatial pseudo codec (SPC), to achieve lossy to near lossless compression of multichannel EEG (MCEEG). In the proposed system, MCEEG signals are initially normalized, followed by two parallel processes: one operating on integer part and the other, on fractional part of the normalized data. The redundancies in integer part are exploited using spatial domain encoder, and the fractional part is coded as pseudo integers. The proposed method has been tested on a wide range of databases having variable sampling rates and resolutions. Results indicate that the algorithm has a good recovery performance with an average percentage root mean square deviation (PRD) of 2.72 for an average compression ratio (CR) of 3.16. Furthermore, the algorithm has a complexity of only O(n) with an average encoding and decoding time per sample of 0.3 ms and 0.04 ms respectively. The performance of the algorithm is comparable with recent methods like fast discrete cosine transform (fDCT) and tensor decomposition methods. The results validated the feasibility of the proposed compression scheme for practical MCEEG recording, archiving and brain computer interfacing systems.

  5. A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management.

    PubMed

    Mochari-Greenberger, Heidi; Vue, Lee; Luka, Andi; Peters, Aimee; Pande, Reena L

    2016-08-01

    Depression is prevalent among individuals with diabetes and associated with suboptimal self-management. Little is known about the feasibility and potential impact of tele-behavioral therapy to improve depressive symptoms and self-management among diabetes patients. This was a retrospective observational study of consecutive graduates enrolled in a national 8-week diabetes behavioral telehealth program between August 1, 2014, and January 31, 2015 (N = 466; mean age 56.8 ± 5.0 years; 56% female). Participant characteristics (demographics, comorbidities) were obtained by standardized questionnaire. Depression, anxiety, and stress symptoms (DASS; validated Depression Anxiety and Stress Scale 21 survey), and glucose self-testing frequency and values (point-of-care monitor) were measured at program start and completion. Changes in DASS severity and glucose self-testing frequency were assessed by chi-square tests. Changes in DASS and blood glucose levels were evaluated by paired t-tests. At baseline, approximately one in three participants had elevated depression (32%), anxiety (33%), or stress (31%) scores. Significant reductions in average DASS, depression (-8.8), anxiety (-6.9), and stress (-9.9), scores were observed at graduation among those with elevated baseline scores (p < 0.0001); most (≥80%) improved to less severe depression, anxiety, or stress categories. Improved glucose self-testing frequency (69% vs. 60% tested ≥once per week; p = 0.0005) and significant reductions in mean morning glucose levels (-12.3 mg/dL; p = 0.0002) were observed from baseline to graduation. Participants with normal versus non-normal depression scores were more likely to have lower (

  6. SRS SWPF Construction Completion

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

    Craig, Jack; Sheppard, Frank; Marks, Pam

    Now that construction is complete, DOE and construction contractor Parsons, are focusing on testing the Savannah River Site’s Salt Waste Processing Facility (SWPF) systems and training the workforce to operate the plant in preparation for the start of operations. Once in operation, the SWPF will significantly increase processing rates at SRS tank farms in an effort to empty the site’s high-level radioactive waste tanks.

  7. A web based health technology assessment in tele-echocardiography: the experience within an Italian project.

    PubMed

    Giansanti, Daniele; Morelli, Sandra; Maccioni, Giovanni; Guerriero, Lorenzo; Bedini, Remo; Pepe, Gennaro; Colombo, Cesare; Borghi, Gabriella; Macellari, Velio

    2009-01-01

    Due to major advances in the information technology, telemedicine applications are ready for a widespread use. Nonetheless, to allow their diffusion in National Health Care Systems (NHCSs) specific methodologies of health technology assessment (HTA) should be used to assess the standardization, the overall quality, the interoperability, the addressing to legal, economic and cost benefit aspects. One of the limits to the diffusion of the digital tele-echocardiography (T-E) applications in the NHCS lacking of a specific methodology for the HTA. In the present study, a solution offering a structured HTA of T-E products was designed. The methodology assured also the definition of standardized quality levels for the application. The first level represents the minimum level of acceptance; the other levels are accessory levels useful for a more accurate assessment of the product. The methodology showed to be useful to rationalize the process of standardization and has received a high degree of acceptance by the subjects involved in the study.

  8. Simple two-electrode biosignal amplifier.

    PubMed

    Dobrev, D; Neycheva, T; Mudrov, N

    2005-11-01

    A simple, cost effective circuit for a two-electrode non-differential biopotential amplifier is proposed. It uses a 'virtual ground' transimpedance amplifier and a parallel RC network for input common mode current equalisation, while the signal input impedance preserves its high value. With this innovative interface circuit, a simple non-inverting amplifier fully emulates high CMRR differential. The amplifier equivalent CMRR (typical range from 70-100 dB) is equal to the open loop gain of the operational amplifier used in the transimpedance interface stage. The circuit has very simple structure and utilises a small number of popular components. The amplifier is intended for use in various two-electrode applications, such as Holter-type monitors, defibrillators, ECG monitors, biotelemetry devices etc.

  9. Far-Field Simulations of Tele-tsunami Observed in the Atlantic Ocean: Impact on the Lesser Antilles

    NASA Astrophysics Data System (ADS)

    Viana-Baptista, M.; Roger, J.; Hebert, H.

    2009-12-01

    In this study we present the results of far-field numerical modelling of tsunamis generated in the North-Atlantic Ocean and the impact along the coasts. The historical databases for the North East Atlantic area and the Caribbean region present two tele-tsunamis of seismic origin: the 1755.11.01 and the 1761.03.31 events. The impact of the 1755 tsunami in the West Indies and Northern America is extensively described in the historical documents; in fact important wave heights (> 2 m), flooding of low areas and damage and destruction of coastal infrastructures were reported in the West Indies, Brazil and Newfoundland (Canada) for the 1755 event. Recently several authors published the results of far-field simulations, for this event. The 31st March 1761 earthquake occurred at noon and one hour and a quarter after the quake Lisbon was impacted by the tsunami with a maximum amplitude of 8 feet (circa 2.4 meter). Sea water changes were observed along the south coast of Spain, and in the Atlantic Islands of Azores and Madeira. In the far field the most well known report comes from Barbados where the tide ebbed and flowed, in about eight minutes between eighteen inches and two feet. According to the Portuguese catalogue of tsunamis the source location of this event is 34.5°N, 13°W and the magnitude of the generating earthquake is 8.5. We present far-field simulation results in two French Overseas Territories, Guadeloupe and Martinique Islands in the West Indies and in Newfoundland (Canada). The main objective is to discuss the reliability of the available historical reports for this event occurring about 5.5 years after the big Lisbon tsunami. Then we show that such event has to be considered in hazard assessment with regards to the West Indies. Understanding the impact of these two tele-tsunamis is crucial for hazard and risk studies in the Caribbean region and particularly for the Martinique and Guadeloupe Islands. This study has been founded by the French ANR project

  10. 30 CFR 250.512 - Field well-completion rules.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false Field well-completion rules. 250.512 Section... OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations § 250.512 Field well-completion rules. When geological and engineering information available in a...

  11. 30 CFR 250.512 - Field well-completion rules.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false Field well-completion rules. 250.512 Section... OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations § 250.512 Field well-completion rules. When geological and engineering information available in a...

  12. 30 CFR 250.512 - Field well-completion rules.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false Field well-completion rules. 250.512 Section... OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations § 250.512 Field well-completion rules. When geological and engineering information available in a...

  13. 24 CFR 884.212 - Project completion.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Project completion. 884.212 Section... RENTAL HOUSING PROJECTS Project Development and Operation § 884.212 Project completion. (a) FmHA certifications upon completion. Upon completion of the project, FmHA shall inspect the project and, if determined...

  14. 24 CFR 884.212 - Project completion.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Project completion. 884.212 Section... RENTAL HOUSING PROJECTS Project Development and Operation § 884.212 Project completion. (a) FmHA certifications upon completion. Upon completion of the project, FmHA shall inspect the project and, if determined...

  15. 24 CFR 884.212 - Project completion.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Project completion. 884.212 Section... RENTAL HOUSING PROJECTS Project Development and Operation § 884.212 Project completion. (a) FmHA certifications upon completion. Upon completion of the project, FmHA shall inspect the project and, if determined...

  16. 24 CFR 884.212 - Project completion.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Project completion. 884.212 Section... RENTAL HOUSING PROJECTS Project Development and Operation § 884.212 Project completion. (a) FmHA certifications upon completion. Upon completion of the project, FmHA shall inspect the project and, if determined...

  17. 24 CFR 884.212 - Project completion.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Project completion. 884.212 Section... RENTAL HOUSING PROJECTS Project Development and Operation § 884.212 Project completion. (a) FmHA certifications upon completion. Upon completion of the project, FmHA shall inspect the project and, if determined...

  18. 30 CFR 285.638 - What must I do upon completion of my commercial operations as approved in my COP or FERC license?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operations as approved in my COP or FERC license? 285.638 Section 285.638 Mineral Resources MINERALS... FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Cop § 285.638 What must I do upon completion of my commercial operations as approved in my COP or FERC...

  19. Forward and store telemedicine using Motion Pictures Expert Group: a novel approach to pediatric tele-echocardiography.

    PubMed

    Woodson, Kristina E; Sable, Craig A; Cross, Russell R; Pearson, Gail D; Martin, Gerard R

    2004-11-01

    Live transmission of echocardiograms over integrated services digital network lines is accurate and has led to improvements in the delivery of pediatric cardiology care. Permanent archiving of the live studies has not previously been reported. Specific obstacles to permanent storage of telemedicine files have included the ability to produce accurate images without a significant increase in storage requirements. We evaluated the accuracy of Motion Pictures Expert Group (MPEG) digitization of incoming video streams and assessed the storage requirements of these files for infants in a real-time pediatric tele-echocardiography program. All major cardiac diagnoses were correctly diagnosed by review of MPEG images. MPEG file size ranged from 11.1 to 182 MB (56.5 +/- 29.9 MB). MPEG digitization during live neonatal telemedicine is accurate and provides an efficient method for storage. This modality has acceptable storage requirements; file sizes are comparable to other digital modalities.

  20. Interpretation of styles of simple stations in Korea

    NASA Astrophysics Data System (ADS)

    Hwang, Minhye; Shin, Yekyeong

    2018-06-01

    The purpose of this paper is to apply stylistic interpretation through the exterior of simple stations in Korea. Simple Station is a kind of railway stations. It was installed when there were not a lot of passengers and it was not necessary to operate the station at a high cost. It has minimal functions such as a waiting room, an office, an operating room, and toilets and was built between the 1910s and the 1960s. The form of the building is as simple as the name of "Simple Station". That is why the reading its style is easy and obvious. But it is also difficult to interpret because of the lack of stylistic evidences. Nevertheless, in the relationship between the station and the station tree, the concept of the Picturesque and Palladian Style are found. But it is still hard to distinguish whether the whole building style is Western or Japanese. Simple Station is one of the things that Japan has built as Western Culture in Korea during the Japanese colonial era, so it is natural that its style of form is complex.

  1. 30 CFR 585.638 - What must I do upon completion of my commercial operations as approved in my COP or FERC license?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... operations as approved in my COP or FERC license? 585.638 Section 585.638 Mineral Resources BUREAU OF OCEAN... FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Cop § 585.638 What must I do upon completion of my commercial operations as approved in my COP or FERC...

  2. 30 CFR 585.638 - What must I do upon completion of my commercial operations as approved in my COP or FERC license?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operations as approved in my COP or FERC license? 585.638 Section 585.638 Mineral Resources BUREAU OF OCEAN... FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Cop § 585.638 What must I do upon completion of my commercial operations as approved in my COP or FERC...

  3. 30 CFR 585.638 - What must I do upon completion of my commercial operations as approved in my COP or FERC license?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... operations as approved in my COP or FERC license? 585.638 Section 585.638 Mineral Resources BUREAU OF OCEAN... FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Cop § 585.638 What must I do upon completion of my commercial operations as approved in my COP or FERC...

  4. SRS SWPF Construction Completion

    ScienceCinema

    Craig, Jack; Sheppard, Frank; Marks, Pam

    2018-01-16

    Now that construction is complete, DOE and construction contractor Parsons, are focusing on testing the Savannah River Site’s Salt Waste Processing Facility (SWPF) systems and training the workforce to operate the plant in preparation for the start of operations. Once in operation, the SWPF will significantly increase processing rates at SRS tank farms in an effort to empty the site’s high-level radioactive waste tanks.

  5. Construction of a Simple Respirometer.

    ERIC Educational Resources Information Center

    Taboga, Leandro

    1979-01-01

    Instructions for making a simple respirometer, to measure rates of oxygen consumption of organisms, are presented. The instrument incorporates most of the basic elements of commercial respirometers but can be made inexpensively by high school students. Operating instructions and applications are given. (Author/SA)

  6. Tele-ophthalmology for diabetic retinopathy screening: 8 years of experience.

    PubMed

    Pareja-Ríos, A; Bonaque-González, S; Serrano-García, M; Cabrera-López, F; Abreu-Reyes, P; Marrero-Saavedra, M D

    2017-02-01

    To describe the results of a diabetic retinopathy screening program implemented in a primary care area. A retrospective study was conducted using data automatically collected since the program began on 1 January 2007 until 31 December 2015. The number of screened diabetic patients has progressively increased, from 7,173 patients in 2007 to 42,339 diabetic patients in 2015. Furthermore, the ability of family doctors to correctly interpret retinographies has improved, with the proportion of retinal images classified as normal having increased from 55% in 2007 to 68% at the end of the study period. The proportion of non-evaluable retinographies decreased to 7% in 2015, having peaked at 15% during the program. This was partly due to a change in the screening program policy that allowed the use of tropicamide. The number of severe cases detected has declined, from 14% with severe non-proliferative and proliferativediabetic retinopathy in the initial phase of the program to 3% in 2015. Diabetic eye disease screening by tele-ophthalmology has shown to be a valuable method in a growing population of diabetics. It leads to a regular medical examination of patients, helps ease the workload of specialised care services and favours the early detection of treatable cases. However, the results of implementing a program of this type are not immediate, achieving only modest results in the early years of the project that have improved over subsequent years. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Non-operative management is superior to surgical stabilization in spine injury patients with complete neurological deficits: A perspective study from a developing world country, Pakistan.

    PubMed

    Shamim, Muhammad Shahzad; Ali, Syed Faizan; Enam, Syed Ather

    2011-01-01

    Surgical stabilization of injured spine in patients with complete spinal cord injury is a common practice despite the lack of strong evidence supporting it. The aim of this study is to compare clinical outcomes and cost-effectiveness of surgical stabilization versus conservative management of spinal injury in patients with complete deficits, essentially from a developing country's point of view. A detailed analysis of patients with traumatic spine injury and complete deficits admitted at the Aga Khan University Hospital, Pakistan, from January 2004 till January 2010 was carried out. All patients presenting within 14 days of injury were divided in two groups, those who underwent stabilization procedures and those who were managed non-operatively. The two groups were compared with the endpoints being time to rehabilitation, length of hospital stay, 30 day morbidity/mortality, cost of treatment, and status at follow up. Fifty-four patients fulfilled the inclusion criteria and half of these were operated. On comparing endpoints, patients in the operative group took longer time to rehabilitation (P-value = 0.002); had longer hospital stay (P-value = 0.006) which included longer length of stay in special care unit (P-value = 0.002) as well as intensive care unit (P-value = 0.004); and were associated with more complications, especially those related to infections (P-value = 0.002). The mean cost of treatment was also significantly higher in the operative group (USD 6,500) as compared to non-operative group (USD 1490) (P-value < 0.001). We recommend that patients with complete SCI should be managed non-operatively with a provision of surgery only if their rehabilitation is impeded due to pain or deformity.

  8. Manipulation Capabilities with Simple Hands

    DTIC Science & Technology

    2010-01-01

    allowing it to interpret online kinesthetic data, addressing two objectives: • Grasp classification: Distinguish between successful and unsuccessful...determining the grasp outcome before the grasping process is complete, by using the entire time series or kinesthetic signature of the grasping process. As...the grasp proceeds and additional kinesthetic data accumulates, the confidence also increases. In some cases Manipulation Capabilities with Simple Hands

  9. On approximately symmetric informationally complete positive operator-valued measures and related systems of quantum states

    NASA Astrophysics Data System (ADS)

    Klappenecker, Andreas; Rötteler, Martin; Shparlinski, Igor E.; Winterhof, Arne

    2005-08-01

    We address the problem of constructing positive operator-valued measures (POVMs) in finite dimension n consisting of n2 operators of rank one which have an inner product close to uniform. This is motivated by the related question of constructing symmetric informationally complete POVMs (SIC-POVMs) for which the inner products are perfectly uniform. However, SIC-POVMs are notoriously hard to construct and, despite some success of constructing them numerically, there is no analytic construction known. We present two constructions of approximate versions of SIC-POVMs, where a small deviation from uniformity of the inner products is allowed. The first construction is based on selecting vectors from a maximal collection of mutually unbiased bases and works whenever the dimension of the system is a prime power. The second construction is based on perturbing the matrix elements of a subset of mutually unbiased bases. Moreover, we construct vector systems in Cn which are almost orthogonal and which might turn out to be useful for quantum computation. Our constructions are based on results of analytic number theory.

  10. Simple instruments facilitating achievement of transanal total mesorectal excision in male patients.

    PubMed

    Xu, Chang; Song, Hua-Yu; Han, Shao-Liang; Ni, Shi-Chang; Zhang, Hu-Xiang; Xing, Chun-Gen

    2017-08-21

    To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform taTME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated. All 115 patients had successful sphincter preservation. The operative time in group B (240 min, range: 160-330 min) was significantly shorter than that in group A (280 min, range: 200-360 min; P = 0.000). Compared with group A, more complete distal mesorectum and total mesorectum were achieved in group B (100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo follow-up, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant (5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). Retrograde taTME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors.

  11. Ada Compiler Validation Summary Report: Certificate Number: 900131I1. 10269,Telesoft and MODCOMP, MODCOMP TeleGen2 Ada System, MODCOMP 9730 Host and Target

    DTIC Science & Technology

    1990-01-31

    STrh FILE COPy 0 REPORT DOCUMENTATION PAGE O OW .- Sba,-, S Vm, _.b~ ,, S a. 1__ __ ,,.In ,,IWu O Sim w q viwim. _S . W .-.- smi Won m m,,~Ov -f ym...nd MODCOMP, MODCOMP TeleGen2 Ada System, MODUOMP 9730 (Hostt to arget), 90013111. 10269 CJ S AUHOR( S ) IABG-AVF 101tobrunn, FEDERAL REPUBLIC OF GERMANY...1. ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a AGENCYG US NY(M W)LAP~rDT ~ ~ TTp N AE ORDIATO . PFIUNDI OGGNITION NAE( S ) ADO OOESS(ES) NUBER S IABG-AVF, Industr

  12. Quantum space and quantum completeness

    NASA Astrophysics Data System (ADS)

    Jurić, Tajron

    2018-05-01

    Motivated by the question whether quantum gravity can "smear out" the classical singularity we analyze a certain quantum space and its quantum-mechanical completeness. Classical singularity is understood as a geodesic incompleteness, while quantum completeness requires a unique unitary time evolution for test fields propagating on an underlying background. Here the crucial point is that quantum completeness renders the Hamiltonian (or spatial part of the wave operator) to be essentially self-adjoint in order to generate a unique time evolution. We examine a model of quantum space which consists of a noncommutative BTZ black hole probed by a test scalar field. We show that the quantum gravity (noncommutative) effect is to enlarge the domain of BTZ parameters for which the relevant wave operator is essentially self-adjoint. This means that the corresponding quantum space is quantum complete for a larger range of BTZ parameters rendering the conclusion that in the quantum space one observes the effect of "smearing out" the singularity.

  13. A Simple Wave Driver

    ERIC Educational Resources Information Center

    Temiz, Burak Kagan; Yavuz, Ahmet

    2015-01-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

  14. A Decision Support System for Tele-Monitoring COPD-Related Worrisome Events.

    PubMed

    Merone, Mario; Pedone, Claudio; Capasso, Giuseppe; Incalzi, Raffaele Antonelli; Soda, Paolo

    2017-03-01

    Chronic Obstructive Pulmonary Disease (COPD) is a preventable, treatable, and slowly progressive disease, whose course is aggravated by a periodic worsening of symptoms and lung function lasting for several days. The development of home telemonitoring systems has made possible to collect symptoms and physiological data in electronic records, boosting the development of decision support systems (DSSs). Current DSSs work with physiological measurements collected by means of several measuring and communication devices as well as with symptoms gathered by questionnaires submitted to COPD subjects. However, this contrasts with the advices provided by the World Health Organization and the Global initiative for chronic Obstructive Lung Disease that recommend to avoid invasive or complex daily measurements. For these reasons this manuscript presents a DSS detecting the onset of worrisome events in COPD subjects. It uses the hearth rate and the oxygen saturation, which can be collected via a pulse oximeter. The DSS consists in a binary finite state machine, whose training stage allows a subject specific personalization of the predictive model, triggering warnings, and alarms as the health status evolves over time. The experiments on data collected from 22 COPD patients tele-monitored at home for six months show that the system recognition performance is better than the one achieved by medical experts. Furthermore, the support offered by the system in the decision-making process allows to increase the agreement between the specialists, largely impacting the recognition of the worrisome events.

  15. Non-operative management is superior to surgical stabilization in spine injury patients with complete neurological deficits: A perspective study from a developing world country, Pakistan

    PubMed Central

    Shamim, Muhammad Shahzad; Ali, Syed Faizan; Enam, Syed Ather

    2011-01-01

    Background: Surgical stabilization of injured spine in patients with complete spinal cord injury is a common practice despite the lack of strong evidence supporting it. The aim of this study is to compare clinical outcomes and cost-effectiveness of surgical stabilization versus conservative management of spinal injury in patients with complete deficits, essentially from a developing country's point of view. Methods: A detailed analysis of patients with traumatic spine injury and complete deficits admitted at the Aga Khan University Hospital, Pakistan, from January 2004 till January 2010 was carried out. All patients presenting within 14 days of injury were divided in two groups, those who underwent stabilization procedures and those who were managed non-operatively. The two groups were compared with the endpoints being time to rehabilitation, length of hospital stay, 30 day morbidity/mortality, cost of treatment, and status at follow up. Results: Fifty-four patients fulfilled the inclusion criteria and half of these were operated. On comparing endpoints, patients in the operative group took longer time to rehabilitation (P-value = 0.002); had longer hospital stay (P-value = 0.006) which included longer length of stay in special care unit (P-value = 0.002) as well as intensive care unit (P-value = 0.004); and were associated with more complications, especially those related to infections (P-value = 0.002). The mean cost of treatment was also significantly higher in the operative group (USD 6,500) as compared to non-operative group (USD 1490) (P-value < 0.001). Conclusion: We recommend that patients with complete SCI should be managed non-operatively with a provision of surgery only if their rehabilitation is impeded due to pain or deformity. PMID:22145085

  16. Simple simulation training system for short-wave radio station

    NASA Astrophysics Data System (ADS)

    Tan, Xianglin; Shao, Zhichao; Tu, Jianhua; Qu, Fuqi

    2018-04-01

    The short-wave radio station is a most important transmission equipment of our signal corps, but in the actual teaching process, which exist the phenomenon of fewer equipment and more students, making the students' short-wave radio operation and practice time is very limited. In order to solve the above problems, to carry out shortwave radio simple simulation training system development is very necessary. This project is developed by combining hardware and software to simulate the voice communication operation and signal principle of shortwave radio station, and can test the signal flow of shortwave radio station. The test results indicate that this system is simple operation, human-machine interface friendly and can improve teaching more efficiency.

  17. Experimental study of pancreaticojejunostomy completed using anastomotic chains

    NASA Astrophysics Data System (ADS)

    Pan, Wei-Dong; Xu, Rui-Yun; Li, Nan; Fang, He-Ping; Pan, Cu-Zhi; Tang, Zhao-Feng

    2010-07-01

    The most difficult, time-consuming, and complication-prone step in pancreaticoduodenectomy is the pancreaticojejunostomy step. The largest disadvantage of this kind of anastomosis is the high incidence of postoperative anastomotic leakage. Once pancreatic leakage occurs, the patient death rate can be very high. The aim of this study was to design a pancreaticojejunostomy procedure using anastomotic chains, which results in the cut end of the jejunum being attached to the pancreatic stump without suturing, and to evaluate the safety and efficacy of this procedure in domestic pigs. The pancreaticojejunal anastomotic chains had the following structures: the chains consisted of two braceletlike chains made of titanium, named chain A and chain B. The function of chain A was to attach the free jejunal end onto the pancreatic stump, whereas the function of chain B was to tighten the contact between the jejunal wall and the surface of the pancreatic stump to eliminate gaps between the two structures and ensure tightness that is sufficient to guarantee that there is no leakage of jejunal fluid or pancreatic juice. The following procedure was used to assess the safety and efficacy of the procedure: pancreaticojejunostomies were performed on ten domestic pigs using anastomotic chains. The time required to complete the pancreaticojejunal anastomoses, the pressure tolerance of the pancreaticojejunal anastomoses, the pig death rate, and the histopathological examinations of the pancreaticojejunostomy tissues were recorded. The average time required to complete the pancreaticojejunal anastomosis procedure was 13±2 min. The observed tolerance pressure of the pancreaticojejunal anastomoses was more than 90 mm H2O. All ten domestic pigs that underwent operations were still alive four weeks after the operations. Pathological examinations showed that the anastomotic surfaces were completely healed, and the pancreatic cutting surfaces were primarily epithelialized. In conclusion, the

  18. Magic informationally complete POVMs with permutations

    NASA Astrophysics Data System (ADS)

    Planat, Michel; Gedik, Zafer

    2017-09-01

    Eigenstates of permutation gates are either stabilizer states (for gates in the Pauli group) or magic states, thus allowing universal quantum computation (Planat, Rukhsan-Ul-Haq 2017 Adv. Math. Phys. 2017, 5287862 (doi:10.1155/2017/5287862)). We show in this paper that a subset of such magic states, when acting on the generalized Pauli group, define (asymmetric) informationally complete POVMs. Such informationally complete POVMs, investigated in dimensions 2-12, exhibit simple finite geometries in their projector products and, for dimensions 4 and 8 and 9, relate to two-qubit, three-qubit and two-qutrit contextuality.

  19. Increasing self-knowledge: Utilizing tele-coaching for patients with congestive heart failure.

    PubMed

    Rosen, Daniel; Berrios-Thomas, Saskia; Engel, Rafael J

    2016-10-01

    The objective was to assess self-care knowledge changes with dually eligible Medicare and Medicaid patients diagnosed with congestive heart failure (CHF), who received a telecoaching protocol integrating symptom monitoring with face-to-face video chat with a social worker. We recruited 45 patients with CHF from a regional managed care organization. Sessions via a Health Insurance Portability and Accountability Act-compliant tablet-based platform focused on educational information designed to improve patient self-care. Social workers administered the 13-item Member Confidence Measure (MCM) at baseline and at a 30-day follow-up period. Scores were recorded to measure differences in patients' understanding of CHF and related symptoms, their knowledge of the disease, and the behaviors necessary to prevent their symptoms from getting worse. Over the 30-day period, scores significantly (p < .01) increased on the total scale score and specific confidence measure subscales (symptom recognition, medication adherence, medical attention, healthy choices, and safety). Gender, race, and age were unrelated to these improvements. In addition, effect sizes for the sub-scales ranged from .54 to 1.08; the effect size of the intervention as expressed by the total scale score was 1.12. Overall, patients increased knowledge over a 30-day period. Tele-coaching by social workers holds promise as a feasible model for health education for high-risk populations.

  20. An overview and process evaluation of TeleWalk: a telephone-based counseling intervention to encourage walking in older adults.

    PubMed

    Kolt, Gregory S; Oliver, Melody; Schofield, Grant M; Kerse, Ngaire; Garrett, Nick; Latham, Nancy K

    2006-09-01

    Despite the benefits associated with a physically active lifestyle, many older adults are insufficiently active to achieve health gain, and also exhibit decreased activity levels with age. Insufficient physical activity in this population is associated with increased morbidity, mortality and demand on health care services and expenditure. There is a clear need for effective intervention to encourage physical activity in older adults. The aim of this paper is to describe the development and participant evaluation of a randomized controlled trial of TeleWalk, a telephone-based motivational counseling intervention to encourage physical activity in adults aged 65 years and older. Participants (N = 186, mean age 74 +/- 6 years) were recruited through their General Practitioner (primary care physician) and randomized to either receive eight telephone counseling sessions and related printed materials over 3 months (intervention group) or participate in outcome assessments only (control group). Intervention group participants were mailed an anonymous evaluation questionnaire on intervention completion. A high response rate was achieved (70%). All respondents (100%) agreed or strongly agreed that a good overall level of service and support was provided, and that the counselor was understanding and supportive. Nearly all respondents agreed or strongly agreed that the service was professional, the counselor advice was helpful and motivating and the information provided was relevant (97, 95 and 89%, respectively). Most (87%) agreed or strongly agreed that the telephone calls encouraged them to be physically active. Among the participants who received printed material, most agreed or strongly agreed that these encouraged them to become or remain active. Findings from this evaluation can be used to inform such interventions and ensure their relevance to community-dwelling older adults.

  1. Iconic Gestures for Robot Avatars, Recognition and Integration with Speech

    PubMed Central

    Bremner, Paul; Leonards, Ute

    2016-01-01

    Co-verbal gestures are an important part of human communication, improving its efficiency and efficacy for information conveyance. One possible means by which such multi-modal communication might be realized remotely is through the use of a tele-operated humanoid robot avatar. Such avatars have been previously shown to enhance social presence and operator salience. We present a motion tracking based tele-operation system for the NAO robot platform that allows direct transmission of speech and gestures produced by the operator. To assess the capabilities of this system for transmitting multi-modal communication, we have conducted a user study that investigated if robot-produced iconic gestures are comprehensible, and are integrated with speech. Robot performed gesture outcomes were compared directly to those for gestures produced by a human actor, using a within participant experimental design. We show that iconic gestures produced by a tele-operated robot are understood by participants when presented alone, almost as well as when produced by a human. More importantly, we show that gestures are integrated with speech when presented as part of a multi-modal communication equally well for human and robot performances. PMID:26925010

  2. Iconic Gestures for Robot Avatars, Recognition and Integration with Speech.

    PubMed

    Bremner, Paul; Leonards, Ute

    2016-01-01

    Co-verbal gestures are an important part of human communication, improving its efficiency and efficacy for information conveyance. One possible means by which such multi-modal communication might be realized remotely is through the use of a tele-operated humanoid robot avatar. Such avatars have been previously shown to enhance social presence and operator salience. We present a motion tracking based tele-operation system for the NAO robot platform that allows direct transmission of speech and gestures produced by the operator. To assess the capabilities of this system for transmitting multi-modal communication, we have conducted a user study that investigated if robot-produced iconic gestures are comprehensible, and are integrated with speech. Robot performed gesture outcomes were compared directly to those for gestures produced by a human actor, using a within participant experimental design. We show that iconic gestures produced by a tele-operated robot are understood by participants when presented alone, almost as well as when produced by a human. More importantly, we show that gestures are integrated with speech when presented as part of a multi-modal communication equally well for human and robot performances.

  3. Semi-autonomous unmanned ground vehicle control system

    NASA Astrophysics Data System (ADS)

    Anderson, Jonathan; Lee, Dah-Jye; Schoenberger, Robert; Wei, Zhaoyi; Archibald, James

    2006-05-01

    Unmanned Ground Vehicles (UGVs) have advantages over people in a number of different applications, ranging from sentry duty, scouting hazardous areas, convoying goods and supplies over long distances, and exploring caves and tunnels. Despite recent advances in electronics, vision, artificial intelligence, and control technologies, fully autonomous UGVs are still far from being a reality. Currently, most UGVs are fielded using tele-operation with a human in the control loop. Using tele-operations, a user controls the UGV from the relative safety and comfort of a control station and sends commands to the UGV remotely. It is difficult for the user to issue higher level commands such as patrol this corridor or move to this position while avoiding obstacles. As computer vision algorithms are implemented in hardware, the UGV can easily become partially autonomous. As Field Programmable Gate Arrays (FPGAs) become larger and more powerful, vision algorithms can run at frame rate. With the rapid development of CMOS imagers for consumer electronics, frame rate can reach as high as 200 frames per second with a small size of the region of interest. This increase in the speed of vision algorithm processing allows the UGVs to become more autonomous, as they are able to recognize and avoid obstacles in their path, track targets, or move to a recognized area. The user is able to focus on giving broad supervisory commands and goals to the UGVs, allowing the user to control multiple UGVs at once while still maintaining the convenience of working from a central base station. In this paper, we will describe a novel control system for the control of semi-autonomous UGVs. This control system combines a user interface similar to a simple tele-operation station along with a control package, including the FPGA and multiple cameras. The control package interfaces with the UGV and provides the necessary control to guide the UGV.

  4. The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial.

    PubMed

    Bohnen, Jordan D; George, Brian C; Williams, Reed G; Schuller, Mary C; DaRosa, Debra A; Torbeck, Laura; Mullen, John T; Meyerson, Shari L; Auyang, Edward D; Chipman, Jeffrey G; Choi, Jennifer N; Choti, Michael A; Endean, Eric D; Foley, Eugene F; Mandell, Samuel P; Meier, Andreas H; Smink, Douglas S; Terhune, Kyla P; Wise, Paul E; Soper, Nathaniel J; Zwischenberger, Joseph B; Lillemoe, Keith D; Dunnington, Gary L; Fryer, Jonathan P

    Intraoperative performance assessment of residents is of growing interest to trainees, faculty, and accreditors. Current approaches to collect such assessments are limited by low participation rates and long delays between procedure and evaluation. We deployed an innovative, smartphone-based tool, SIMPL (System for Improving and Measuring Procedural Learning), to make real-time intraoperative performance assessment feasible for every case in which surgical trainees participate, and hypothesized that SIMPL could be feasibly integrated into surgical training programs. Between September 1, 2015 and February 29, 2016, 15 U.S. general surgery residency programs were enrolled in an institutional review board-approved trial. SIMPL was made available after 70% of faculty and residents completed a 1-hour training session. Descriptive and univariate statistics analyzed multiple dimensions of feasibility, including training rates, volume of assessments, response rates/times, and dictation rates. The 20 most active residents and attendings were evaluated in greater detail. A total of 90% of eligible users (1267/1412) completed training. Further, 13/15 programs began using SIMPL. Totally, 6024 assessments were completed by 254 categorical general surgery residents (n = 3555 assessments) and 259 attendings (n = 2469 assessments), and 3762 unique operations were assessed. There was significant heterogeneity in participation within and between programs. Mean percentage (range) of users who completed ≥1, 5, and 20 assessments were 62% (21%-96%), 34% (5%-75%), and 10% (0%-32%) across all programs, and 96%, 75%, and 32% in the most active program. Overall, response rate was 70%, dictation rate was 24%, and mean response time was 12 hours. Assessments increased from 357 (September 2015) to 1146 (February 2016). The 20 most active residents each received mean 46 assessments by 10 attendings for 20 different procedures. SIMPL can be feasibly integrated into surgical training programs

  5. Complete Non-Radioactive Operability Tests for Cladding Hull Chlorination

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

    Collins, Emory D; Johnson, Jared A.; Hylton, Tom D.

    2016-04-01

    Non-radioactive operability tests were made to test the metal chlorination reactor and condenser and their accessories using batch chlorinations of non-radioactive cladding samples and to identify optimum operating practices and components that need further modifications prior to installation of the equipment into the hot cell for tests on actual used nuclear fuel (UNF) cladding. The operability tests included (1) modifications to provide the desired heating and reactor temperature profile; and (2) three batch chlorination tests using, respectively, 100, 250, and 500 g of cladding. During the batch chlorinations, metal corrosion of the equipment was assessed, pressurization of the gas inletmore » was examined and the best method for maintaining solid salt product transfer through the condenser was determined. Also, additional accessing equipment for collection of residual ash and positioning of the unit within the hot cell were identified, designed, and are being fabricated.« less

  6. The Role of Seismic Directivity in Tele-seismically Induced Well Level Oscillations

    NASA Astrophysics Data System (ADS)

    Voss, N. K.; Wdowinski, S.

    2013-12-01

    determined by the faulting mechanism (normal, reverse, and strike-slip) and fault orientation, with respect to the wells, on the occurrence of tele-seismic induced well oscillations. We calculated the angle between the fault orientation and the great circle initial bearing from the epicenter to the South Florida well field, which we termed Delta. We found that for each faulting type, oscillatory events correlate well with specific Delta angles. For strike-slip events of sufficient SED, a strong correlation was found with events pointed away, 180°>Delta>90°, from the initial direction on the great circle path back to South Florida. For reverse faulting events, good correlation was found between oscillatory events and earthquakes oriented at Delta angles of 45° and 135°. There were not enough normal faulting events in our dataset to draw conclusions for this fault type. Our results indicate that oscillatory response to large tele-seismic waves depends not only on the magnitude and distance to the event, but also on the faulting type and fault orientation to the far field well.

  7. Laparoscopic repair of perforated peptic ulcer: simple closure versus omentopexy.

    PubMed

    Lin, Being-Chuan; Liao, Chien-Hung; Wang, Shang-Yu; Hwang, Tsann-Long

    2017-12-01

    This report presents our experience with laparoscopic repair performed in 118 consecutive patients diagnosed with a perforated peptic ulcer (PPU). We compared the surgical outcome of simple closure with modified Cellan-Jones omentopexy and report the safety and benefit of simple closure. From January 2010 to December 2014, 118 patients with PPU underwent laparoscopic repair with simple closure (n = 27) or omentopexy (n = 91). Charts were retrospectively reviewed for demographic characteristics and outcome. The data were compared by Fisher's exact test, Mann-Whitney U test, Pearson's chi-square test, and the Kruskal-Wallis test. The results were considered statistically significant if P < 0.05. No patients died, whereas three incurred leakage. After matching, the simple closure and omentopexy groups had similarity in sex, systolic blood pressure, pulse rate, respiratory rate, Boey score, Charlson comorbidity index, Mannheim peritonitis index, and leakage. There were statistically significant differences in age, length of hospital stay, perforated size, and operating time. Comparison of the operating time in the ≤4.0 mm and 5.0-12 mm groups revealed that the simple closure took less time than omentopexy in both groups (≤4.0 mm, 76 versus 133 minutes, P < 0.0001; 5.0-12 mm, 97 versus 139.5 minutes; P = 0.006). Compared to the omentopexy, laparoscopic simple closure is a safe procedure and shortens the operating time. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  8. Proton facility economics: the importance of "simple" treatments.

    PubMed

    Johnstone, Peter A S; Kerstiens, John; Richard, Helsper

    2012-08-01

    Given the cost and debt incurred to build a modern proton facility, impetus exists to minimize treatment of patients with complex setups because of their slower throughput. The aim of this study was to determine how many "simple" cases are necessary given different patient loads simply to recoup construction costs and debt service, without beginning to cover salaries, utilities, beam costs, and so on. Simple cases are ones that can be performed quickly because of an easy setup for the patient or because the patient is to receive treatment to just one or two fields. A "standard" construction cost and debt for 1, 3, and 4 gantry facilities were calculated from public documents of facilities built in the United States, with 100% of the construction funded through standard 15-year financing at 5% interest. Clinical best case (that each room was completely scheduled with patients over a 14-hour workday) was assumed, and a statistical analysis was modeled with debt, case mix, and payer mix moving independently. Treatment times and reimbursement data from the investigators' facility for varying complexities of patients were extrapolated for varying numbers treated daily. Revenue assumptions of $X per treatment were assumed both for pediatric cases (a mix of Medicaid and private payer) and state Medicare simple case rates. Private payer reimbursement averages $1.75X per treatment. The number of simple patients required daily to cover construction and debt service costs was then derived. A single gantry treating only complex or pediatric patients would need to apply 85% of its treatment slots simply to service debt. However, that same room could cover its debt treating 4 hours of simple patients, thus opening more slots for complex and pediatric patients. A 3-gantry facility treating only complex and pediatric cases would not have enough treatment slots to recoup construction and debt service costs at all. For a 4-gantry center, focusing on complex and pediatric cases alone

  9. Simple Schlieren Light Meter

    NASA Technical Reports Server (NTRS)

    Rhodes, David B.; Franke, John M.; Jones, Stephen B.; Leighty, Bradley D.

    1992-01-01

    Simple light-meter circuit used to position knife edge of schlieren optical system to block exactly half light. Enables operator to check quickly position of knife edge between tunnel runs to ascertain whether or not in alignment. Permanent measuring system made part of each schlieren system. If placed in unused area of image plane, or in monitoring beam from mirror knife edge, provides real-time assessment of alignment of schlieren system.

  10. Simple instruments facilitating achievement of transanal total mesorectal excision in male patients

    PubMed Central

    Xu, Chang; Song, Hua-Yu; Han, Shao-Liang; Ni, Shi-Chang; Zhang, Hu-Xiang; Xing, Chun-Gen

    2017-01-01

    AIM To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME. Some simple instruments including modified retractors and an anal dilator with a papilionaceous fixture were used to perform taTME. The operative time, quality of mesorectal excision, circumferential resection margin, local recurrence, and postoperative survival were evaluated. RESULTS All 115 patients had successful sphincter preservation. The operative time in group B (240 min, range: 160-330 min) was significantly shorter than that in group A (280 min, range: 200-360 min; P = 0.000). Compared with group A, more complete distal mesorectum and total mesorectum were achieved in group B (100% vs 75.6%, P = 0.000; 90.5% vs 70.7%, P = 0.008, respectively). After 46.1 ± 25.6 mo follow-up, group B had a lower local recurrence rate and higher disease-free survival rate compared with group A, but these differences were not statistically significant (5.4% vs 14.6%, P = 0.093; 79.5% vs 65.1%, P = 0.130). CONCLUSION Retrograde taTME with simple customized instruments can achieve high-quality TME, and it might be an effective and economical alternative for male patients with bulky tumors. PMID:28883706

  11. Seasonal ENSO forecasting: Where does a simple model stand amongst other operational ENSO models?

    NASA Astrophysics Data System (ADS)

    Halide, Halmar

    2017-01-01

    We apply a simple linear multiple regression model called IndOzy for predicting ENSO up to 7 seasonal lead times. The model still used 5 (five) predictors of the past seasonal Niño 3.4 ENSO indices derived from chaos theory and it was rolling-validated to give a one-step ahead forecast. The model skill was evaluated against data from the season of May-June-July (MJJ) 2003 to November-December-January (NDJ) 2015/2016. There were three skill measures such as: Pearson correlation, RMSE, and Euclidean distance were used for forecast verification. The skill of this simple model was than compared to those of combined Statistical and Dynamical models compiled at the IRI (International Research Institute) website. It was found that the simple model was only capable of producing a useful ENSO prediction only up to 3 seasonal leads, while the IRI statistical and Dynamical model skill were still useful up to 4 and 6 seasonal leads, respectively. Even with its short-range seasonal prediction skills, however, the simple model still has a potential to give ENSO-derived tailored products such as probabilistic measures of precipitation and air temperature. Both meteorological conditions affect the presence of wild-land fire hot-spots in Sumatera and Kalimantan. It is suggested that to improve its long-range skill, the simple INDOZY model needs to incorporate a nonlinear model such as an artificial neural network technique.

  12. 30 CFR 250.1620 - Well-completion and well-workover requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false Well-completion and well-workover requirements... Operations § 250.1620 Well-completion and well-workover requirements. (a) Lessees shall conduct well-completion and well-workover operations in sulphur wells, bleedwells, and brine wells in accordance with...

  13. 30 CFR 250.1620 - Well-completion and well-workover requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false Well-completion and well-workover requirements... Operations § 250.1620 Well-completion and well-workover requirements. (a) Lessees shall conduct well-completion and well-workover operations in sulphur wells, bleedwells, and brine wells in accordance with...

  14. 30 CFR 250.1620 - Well-completion and well-workover requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false Well-completion and well-workover requirements... Operations § 250.1620 Well-completion and well-workover requirements. (a) Lessees shall conduct well-completion and well-workover operations in sulphur wells, bleedwells, and brine wells in accordance with...

  15. Case studies from Oman for coiled tubing deployed completion techniques

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

    Taylor, R.W.; Conrad, B.

    1996-09-01

    Although the use of ultra-large coiled tubing to complete wells is relatively new, it is gaining widespread industry application. This paper will detail the equipment necessary to perform an operation of this type and will present information from several case studies in Oman in which an operator has successfully deployed completion equipment on 3-1/2-inch-OD coiled tubing. In addition to a discussion of the equipment required to perform the necessary operations, the trial parameters that were established by this operator will be given. The information presented has been selected to allow an initial evaluation to be made of coiled tubing completionsmore » in general and will help to determine whether this method can prove to be less expensive than traditional rig-based completions. The topics presented have been chosen to provide the reader with a thorough understanding of the techniques and preparation needed to execute a coiled tubing completion. The summary of experiences will conclude that this innovative completion technique can be a viable method for completing wells. Although long-term advantages regarding production and well maintenance cannot yet be determined, the operator`s experiences to date have confirmed his initial belief that use of coiled tubing in ultra-large continuous-pipe applications can be cost effective.« less

  16. Routine intraoperative completion angiography after coronary artery bypass grafting and 1-stop hybrid revascularization results from a fully integrated hybrid catheterization laboratory/operating room.

    PubMed

    Zhao, David X; Leacche, Marzia; Balaguer, Jorge M; Boudoulas, Konstantinos D; Damp, Julie A; Greelish, James P; Byrne, John G; Ahmad, Rashid M; Ball, Stephen K; Cleator, John H; Deegan, Robert J; Eagle, Susan S; Fong, Pete P; Fredi, Joseph L; Hoff, Steven J; Jennings, Henry S; McPherson, John A; Piana, Robert N; Pretorius, Mias; Robbins, Mark A; Slosky, David A; Thompson, Annemarie

    2009-01-20

    This study sought to report our experience with a routine completion angiogram after coronary artery bypass surgery (CABG) and simultaneous (1-stop) percutaneous coronary intervention (PCI) at the time of CABG performed in the hybrid catheterization laboratory/operating room. The value of a routine completion angiogram after CABG and 1-stop hybrid CABG/PCI remains unresolved. Between April 2005 and July 2007, 366 consecutive patients underwent CABG surgery, with (n = 112) or without (n = 254) concomitant 1-stop PCI (hybrid), all with completion angiography before chest closure. Among the 112 1-stop hybrid CABG/PCI patients, 67 (60%) underwent a planned hybrid procedure based on pre-operative assessment, whereas 45 (40%) underwent open-chest PCI (unplanned hybrid) based on intraoperative findings. Among the 796 CABG grafts (345 left internal mammary artery, 12 right internal mammary artery/radial, and 439 veins), 97 (12%) angiographic defects were identified. Defects were repaired with either a minor adjustment of the graft (n = 22, 2.8%), with intraoperative open-chest PCI (unplanned hybrid, n = 48, 6%) or with traditional surgical revision (n = 27, 3.4%). Hybrid patients had clinical outcomes similar to standard CABG patients. Routine completion angiography detected 12% of grafts with important angiographic defects. One-stop hybrid coronary revascularization is reasonable, safe, and feasible. Combining the tools of the catheterization laboratory and operating room greatly enhances the options available to the surgeon and cardiologist for patients with complex coronary artery disease.

  17. The Design of SimpleITK.

    PubMed

    Lowekamp, Bradley C; Chen, David T; Ibáñez, Luis; Blezek, Daniel

    2013-01-01

    SimpleITK is a new interface to the Insight Segmentation and Registration Toolkit (ITK) designed to facilitate rapid prototyping, education and scientific activities via high level programming languages. ITK is a templated C++ library of image processing algorithms and frameworks for biomedical and other applications, and it was designed to be generic, flexible and extensible. Initially, ITK provided a direct wrapping interface to languages such as Python and Tcl through the WrapITK system. Unlike WrapITK, which exposed ITK's complex templated interface, SimpleITK was designed to provide an easy to use and simplified interface to ITK's algorithms. It includes procedural methods, hides ITK's demand driven pipeline, and provides a template-less layer. Also SimpleITK provides practical conveniences such as binary distribution packages and overloaded operators. Our user-friendly design goals dictated a departure from the direct interface wrapping approach of WrapITK, toward a new facade class structure that only exposes the required functionality, hiding ITK's extensive template use. Internally SimpleITK utilizes a manual description of each filter with code-generation and advanced C++ meta-programming to provide the higher-level interface, bringing the capabilities of ITK to a wider audience. SimpleITK is licensed as open source software library under the Apache License Version 2.0 and more information about downloading it can be found at http://www.simpleitk.org.

  18. The Design of SimpleITK

    PubMed Central

    Lowekamp, Bradley C.; Chen, David T.; Ibáñez, Luis; Blezek, Daniel

    2013-01-01

    SimpleITK is a new interface to the Insight Segmentation and Registration Toolkit (ITK) designed to facilitate rapid prototyping, education and scientific activities via high level programming languages. ITK is a templated C++ library of image processing algorithms and frameworks for biomedical and other applications, and it was designed to be generic, flexible and extensible. Initially, ITK provided a direct wrapping interface to languages such as Python and Tcl through the WrapITK system. Unlike WrapITK, which exposed ITK's complex templated interface, SimpleITK was designed to provide an easy to use and simplified interface to ITK's algorithms. It includes procedural methods, hides ITK's demand driven pipeline, and provides a template-less layer. Also SimpleITK provides practical conveniences such as binary distribution packages and overloaded operators. Our user-friendly design goals dictated a departure from the direct interface wrapping approach of WrapITK, toward a new facade class structure that only exposes the required functionality, hiding ITK's extensive template use. Internally SimpleITK utilizes a manual description of each filter with code-generation and advanced C++ meta-programming to provide the higher-level interface, bringing the capabilities of ITK to a wider audience. SimpleITK is licensed as open source software library under the Apache License Version 2.0 and more information about downloading it can be found at http://www.simpleitk.org. PMID:24416015

  19. Profinite Completions of Burnside-Type Quotients of Surface Groups

    NASA Astrophysics Data System (ADS)

    Funar, Louis; Lochak, Pierre

    2018-06-01

    Using quantum representations of mapping class groups, we prove that profinite completions of Burnside-type surface group quotients are not virtually prosolvable, in general. Further, we construct infinitely many finite simple characteristic quotients of surface groups.

  20. TRSkit: A Simple Digital Library Toolkit

    NASA Technical Reports Server (NTRS)

    Nelson, Michael L.; Esler, Sandra L.

    1997-01-01

    This paper introduces TRSkit, a simple and effective toolkit for building digital libraries on the World Wide Web. The toolkit was developed for the creation of the Langley Technical Report Server and the NASA Technical Report Server, but is applicable to most simple distribution paradigms. TRSkit contains a handful of freely available software components designed to be run under the UNIX operating system and served via the World Wide Web. The intended customer is the person that must continuously and synchronously distribute anywhere from 100 - 100,000's of information units and does not have extensive resources to devote to the problem.

  1. Interactive tele-education applied to a distant clinical microbiology specialization university course.

    PubMed

    Andreazzi, Denise B; Rossi, Flávia; Wen, Chao L

    2011-09-01

    The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy.

  2. Egypt`s first subsea completion: A Gulf of Suez case history

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

    El Hawary, A.; Hoffman, J.G.

    1996-06-01

    A case history of the Gulf of Suez Petroleum Co.`s (Gupco) first subsea completion is provided. The first completion was for Well GS 373-2, a previously drilled and tested exploration well located in the south portion of the gulf of Suez. Subsea technology was used to economically justify development of this one-well marginal field, which was discovered in 1978. Traditional methods proved to be too costly for development, therefore application of a low-cost subsea tree was used to capture the resources. In the Gulf of Suez, many fields have been discovered but have not been developed because of low reserves.more » These marginal projects can have a profound impact on the revenue and shareholder value if an economic method is used to exploit these opportunities. Platform installation was not feasible because of reserve size, hence the well has remained abandoned until recently. This paper presents a summarized look at subsea completion technology. The cost comparison of traditional development methods will be made, given the local cost structure in Egypt. The application of this technology has some limitations and constraints that will be discussed in the paper. Furthermore, the actual field installation of Egypt`s first subsea tree will be summarized. Also included is a discussion on simple remote controls and offshore installation operations.« less

  3. 30 CFR 250.512 - Field well-completion rules.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false Field well-completion rules. 250.512 Section... Gas Well-Completion Operations § 250.512 Field well-completion rules. When geological and engineering..., field well-completion rules may be established on the District Manager's initiative or in response to a...

  4. A Practical Comparison of Motion Planning Techniques for Robotic Legs in Environments with Obstacles

    NASA Technical Reports Server (NTRS)

    Smith, Tristan B.; Chavez-Clemente, Daniel

    2009-01-01

    ATHLETE is a large six-legged tele-operated robot. Each foot is a wheel; travel can be achieved by walking, rolling, or some combination of the two. Operators control ATHLETE by selecting parameterized commands from a command dictionary. While rolling can be done efficiently, any motion involving steps is cumbersome - each step can require multiple commands and take many minutes to complete. In this paper, we consider four different algorithms that generate a sequence of commands to take a step. We consider a baseline heuristic, a randomized motion planning algorithm, and two variants of A* search. Results for a variety of terrains are presented, and we discuss the quantitative and qualitative tradeoffs between the approaches.

  5. Figuring the Acceleration of the Simple Pendulum

    ERIC Educational Resources Information Center

    Lieberherr, Martin

    2011-01-01

    The centripetal acceleration has been known since Huygens' (1659) and Newton's (1684) time. The physics to calculate the acceleration of a simple pendulum has been around for more than 300 years, and a fairly complete treatise has been given by C. Schwarz in this journal. But sentences like "the acceleration is always directed towards the…

  6. Complete denture tooth arrangement technology driven by a reconfigurable rule.

    PubMed

    Dai, Ning; Yu, Xiaoling; Fan, Qilei; Yuan, Fulai; Liu, Lele; Sun, Yuchun

    2018-01-01

    The conventional technique for the fabrication of complete dentures is complex, with a long fabrication process and difficult-to-control restoration quality. In recent years, digital complete denture design has become a research focus. Digital complete denture tooth arrangement is a challenging issue that is difficult to efficiently implement under the constraints of complex tooth arrangement rules and the patient's individualized functional aesthetics. The present study proposes a complete denture automatic tooth arrangement method driven by a reconfigurable rule; it uses four typical operators, including a position operator, a scaling operator, a posture operator, and a contact operator, to establish the constraint mapping association between the teeth and the constraint set of the individual patient. By using the process reorganization of different constraint operators, this method can flexibly implement different clinical tooth arrangement rules. When combined with a virtual occlusion algorithm based on progressive iterative Laplacian deformation, the proposed method can achieve automatic and individual tooth arrangement. Finally, the experimental results verify that the proposed method is flexible and efficient.

  7. A simple technique for laparoscopic gastrostomy.

    PubMed

    Murphy, C; Rosemurgy, A S; Albrink, M H; Carey, L C

    1992-05-01

    While endoscopically placed gastrostomy tubes are routinely simple, they are not always feasible. Endoscopic technique also does not uniformly secure the tube to the abdominal wall, which presents possible complications, including leakage, accidental early tube removal, intraperitoneal catheter migration and necrosis of the stomach or abdominal wall because of excessive traction. Presented herein is a technique that is rapid, simple and eliminates some of these potential complications. The technique is easily combined with other operative procedures, such as tracheostomy, is done under direct vision, can be performed quickly with intravenous sedation and local anesthetic and is a safe method of tube placement for enteral feeding or gastric decompression.

  8. Near-complete teleportation of a superposed coherent state

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

    Cheong, Yong Wook; Kim, Hyunjae; Lee, Hai-Woong

    2004-09-01

    The four Bell-type entangled coherent states, {alpha}>-{alpha}>{+-}-{alpha}>{alpha}> and {alpha}>{alpha}>{+-}-{alpha}>-{alpha}>, can be discriminated with a high probability using only linear optical means, as long as {alpha} is not too small. Based on this observation, we propose a simple scheme to almost completely teleport a superposed coherent state. The nonunitary transformation that is required to complete the teleportation can be achieved by embedding the receiver's field state in a larger Hilbert space consisting of the field and a single atom and performing a unitary transformation on this Hilbert space00.

  9. NASA’s Operation IceBridge Completes Twin Polar Campaigns

    NASA Image and Video Library

    2017-12-08

    Heimdal Glacier in southern Greenland, in an image captured on Oct. 13, 2015, from NASA Langley Research Center's Falcon 20 aircraft flying 33,000 feet above mean sea level. NASA’s Operation IceBridge, an airborne survey of polar ice, recently finalized two overlapping campaigns at both of Earth’s poles. Down south, the mission observed a big drop in the height of two glaciers situated in the Antarctic Peninsula, while in the north it collected much needed measurements of the status of land and sea ice at the end of the Arctic summer melt season. This was the first time in its seven years of operations that IceBridge carried out parallel flights in the Arctic and Antarctic. Every year, the mission flies to the Arctic in the spring and to Antarctica in the fall to keep collect an uninterrupted record of yearly changes in the height of polar ice. Read more: www.nasa.gov/feature/goddard/nasa-s-operation-icebridge-c... Credits: NASA/Goddard/John Sonntag NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  10. Automating Access Control Logics in Simple Type Theory with LEO-II

    NASA Astrophysics Data System (ADS)

    Benzmüller, Christoph

    Garg and Abadi recently proved that prominent access control logics can be translated in a sound and complete way into modal logic S4. We have previously outlined how normal multimodal logics, including monomodal logics K and S4, can be embedded in simple type theory and we have demonstrated that the higher-order theorem prover LEO-II can automate reasoning in and about them. In this paper we combine these results and describe a sound (and complete) embedding of different access control logics in simple type theory. Employing this framework we show that the off the shelf theorem prover LEO-II can be applied to automate reasoning in and about prominent access control logics.

  11. A simple and complete model for wind turbine wakes over complex terrain

    NASA Astrophysics Data System (ADS)

    Rommelfanger, Nick; Rajborirug, Mai; Luzzatto-Fegiz, Paolo

    2017-11-01

    Simple models for turbine wakes have been used extensively in the wind energy community, both as independent tools, as well as to complement more refined and computationally-intensive techniques. These models typically prescribe empirical relations for how the wake radius grows with downstream distance x and obtain the wake velocity at each x through the application of either mass conservation, or of both mass and momentum conservation (e.g. Katić et al. 1986; Frandsen et al. 2006; Bastankhah & Porté-Agel 2014). Since these models assume a global behavior of the wake (for example, linear spreading with x) they cannot respond to local changes in background flow, as may occur over complex terrain. Instead of assuming a global wake shape, we develop a model by relying on a local assumption for the growth of the turbulent interface. To this end, we introduce to wind turbine wakes the use of the entrainment hypothesis, which has been used extensively in other areas of geophysical fluid dynamics. We obtain two coupled ordinary differential equations for mass and momentum conservation, which can be readily solved with a prescribed background pressure gradient. Our model is in good agreement with published data for the development of wakes over complex terrain.

  12. A remote operating slit lamp microscope system. Development and its utility in ophthalmologic examinations.

    PubMed

    Tanabe, N; Go, K; Sakurada, Y; Imasawa, M; Mabuchi, F; Chiba, T; Abe, K; Kashiwagi, K

    2011-01-01

    To develop a remote-operating slit lamp microscope system (the remote slit lamp) as the core for highly specialized ophthalmology diagnoses, and to compare the utility of this system with the conventional slit lamp microscope system (the conventional slit lamp) in making a diagnosis. The remote slit lamp system was developed. Three factors were evaluated in comparison to the conventional slit lamp. The ability to acquire skills was investigated using a task loading system among specialists and residents in ophthalmology. Participants repeated a task up to ten times and the time required for each task was analyzed. The consistency of the two systems in making a diagnosis was investigated using eyes of patients with ocular diseases as well as healthy volunteers. The remote slit lamp is composed of a patient's unit and ophthalmologist's unit connected by high-speed internet. The two units share images acquired by the slit lamp in addition to the images and voices of patients and ophthalmologists. Both ophthalmology specialists and residents could minimize the completion times after several trials. The remote slit lamp took more time than the conventional slit lamp. Both systems showed a high consistency in evaluations among eyes with healthy eyes or those with ocular diseases. The remote slit lamp has a similar diagnostic ability, but required more examination time in comparison to the conventional slit lamp. The currently developed remote slit lamp has the potential to be employed for tele-medicine purposes in the field of ophthalmology.

  13. Meaningful Use of Data in Care Coordination by the Advanced Practice Registered Nurse: The TeleFamilies Project

    PubMed Central

    Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.

    2012-01-01

    Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406

  14. Simple and efficient self-healing strategy for damaged complex networks

    NASA Astrophysics Data System (ADS)

    Gallos, Lazaros K.; Fefferman, Nina H.

    2015-11-01

    The process of destroying a complex network through node removal has been the subject of extensive interest and research. Node loss typically leaves the network disintegrated into many small and isolated clusters. Here we show that these clusters typically remain close to each other and we suggest a simple algorithm that is able to reverse the inflicted damage by restoring the network's functionality. After damage, each node decides independently whether to create a new link depending on the fraction of neighbors it has lost. In addition to relying only on local information, where nodes do not need knowledge of the global network status, we impose the additional constraint that new links should be as short as possible (i.e., that the new edge completes a shortest possible new cycle). We demonstrate that this self-healing method operates very efficiently, both in model and real networks. For example, after removing the most connected airports in the USA, the self-healing algorithm rejoined almost 90% of the surviving airports.

  15. A simple technique to increase profits in wood products marketing

    Treesearch

    George B. Harpole

    1971-01-01

    Mathematical models can be used to solve quickly some simple day-to-day marketing problems. This note explains how a sawmill production manager, who has an essentially fixed-capacity mill, can solve several optimization problems by using pencil and paper, a forecast of market prices, and a simple algorithm. One such problem is to maximize profits in an operating period...

  16. Using triggered operations to offload collective communication operations.

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

    Barrett, Brian W.; Hemmert, K. Scott; Underwood, Keith Douglas

    2010-04-01

    Efficient collective operations are a major component of application scalability. Offload of collective operations onto the network interface reduces many of the latencies that are inherent in network communications and, consequently, reduces the time to perform the collective operation. To support offload, it is desirable to expose semantic building blocks that are simple to offload and yet powerful enough to implement a variety of collective algorithms. This paper presents the implementation of barrier and broadcast leveraging triggered operations - a semantic building block for collective offload. Triggered operations are shown to be both semantically powerful and capable of improving performance.

  17. Specification and evaluation of a regional PACS in the SaxTeleMed project

    NASA Astrophysics Data System (ADS)

    Lemke, Heinz U.; Niederlag, W.; Heuser, H.

    2002-05-01

    During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

  18. From Brown-Peterson to continual distractor via operation span: A SIMPLE account of complex span.

    PubMed

    Neath, Ian; VanWormer, Lisa A; Bireta, Tamra J; Surprenant, Aimée M

    2014-09-01

    Three memory tasks-Brown-Peterson, complex span, and continual distractor-all alternate presentation of a to-be-remembered item and a distractor activity, but each task is associated with a different memory system, short-term memory, working memory, and long-term memory, respectively. SIMPLE, a relative local distinctiveness model, has previously been fit to data from both the Brown-Peterson and continual distractor tasks; here we use the same version of the model to fit data from a complex span task. Despite the many differences between the tasks, including unpredictable list length, SIMPLE fit the data well. Because SIMPLE posits a single memory system, these results constitute yet another demonstration that performance on tasks originally thought to tap different memory systems can be explained without invoking multiple memory systems.

  19. The cognitive architecture for chaining of two mental operations.

    PubMed

    Sackur, Jérôme; Dehaene, Stanislas

    2009-05-01

    A simple view, which dates back to Turing, proposes that complex cognitive operations are composed of serially arranged elementary operations, each passing intermediate results to the next. However, whether and how such serial processing is achieved with a brain composed of massively parallel processors, remains an open question. Here, we study the cognitive architecture for chained operations with an elementary arithmetic algorithm: we required participants to add (or subtract) two to a digit, and then compare the result with five. In four experiments, we probed the internal implementation of this task with chronometric analysis, the cued-response method, the priming method, and a subliminal forced-choice procedure. We found evidence for an approximately sequential processing, with an important qualification: the second operation in the algorithm appears to start before completion of the first operation. Furthermore, initially the second operation takes as input the stimulus number rather than the output of the first operation. Thus, operations that should be processed serially are in fact executed partially in parallel. Furthermore, although each elementary operation can proceed subliminally, their chaining does not occur in the absence of conscious perception. Overall, the results suggest that chaining is slow, effortful, imperfect (resulting partly in parallel rather than serial execution) and dependent on conscious control.

  20. [Aseptic non-touch technique in the operating room: keep it simple].

    PubMed

    Pans, Solange J A; Molmans, Eva; Marczinski, Susanne C; Bijker, Jilles B; Snijdelaar, Dik G

    2015-01-01

    The Dutch national patient safety platform developed a protocol for the preparation of intravenous medication; the Aseptic Non-Touch Technique (ANTT). Use of ANTT on nursing wards has shown to reduce contamination of intravenous medication. Therefore it is dictated by the Dutch Healthcare Inspectorate that this technique has to be used at all departments in the hospital, including the operating theatre. However, because of the use of air treatment and operating theatre uniforms, the operating theatre cannot be compared with a nursing ward. In this study, the bacterial contamination of syringes prepared in the operating theatre by anesthesia nurses was determined. Simulation study 45 anesthesia nurses prepared 1000 syringes of 10 ml bacterial culture medium, using their routine method of drawing up iv medication from vials. Turbidity in a syringe after culturing for 14 days at 30° C was used as evidence for bacterial contamination. Using questionnaires, nurses were interviewed in what degree their working method equals ANTT-protocol. We calculated how much extra time must be invested when using the strict ANTT-protocol in the operating theatre. Six syringes (0,6%) were contaminated. Normal dermal bacteria were identified in all syringes. The nurses who prepared the contaminated syringes worked similar manner as their colleagues. It takes an additional 54 minutes per day per operating theatre to work strictly using the ANTT technique. Contamination rates of aseptic preparations in the OR are very low, and are as low as ANTT preparations in a GMP-certified hospital pharmacy. Therefore it is legitimate to develop a modified ANTT-protocol for use in the operating theatre.

  1. Harmonic and Anharmonic Behaviour of a Simple Oscillator

    ERIC Educational Resources Information Center

    O'Shea, Michael J.

    2009-01-01

    We consider a simple oscillator that exhibits harmonic and anharmonic regimes and analyse its behaviour over the complete range of possible amplitudes. The oscillator consists of a mass "m" fixed at the midpoint of a horizontal rope. For zero initial rope tension and small amplitude the period of oscillation, tau, varies as tau is approximately…

  2. Direct memory access transfer completion notification

    DOEpatents

    Archer, Charles J. , Blocksome; Michael A. , Parker; Jeffrey, J [Rochester, MN

    2011-02-15

    Methods, systems, and products are disclosed for DMA transfer completion notification that include: inserting, by an origin DMA on an origin node in an origin injection FIFO, a data descriptor for an application message; inserting, by the origin DMA, a reflection descriptor in the origin injection FIFO, the reflection descriptor specifying a remote get operation for injecting a completion notification descriptor in a reflection injection FIFO on a reflection node; transferring, by the origin DMA to a target node, the message in dependence upon the data descriptor; in response to completing the message transfer, transferring, by the origin DMA to the reflection node, the completion notification descriptor in dependence upon the reflection descriptor; receiving, by the origin DMA from the reflection node, a completion packet; and notifying, by the origin DMA in response to receiving the completion packet, the origin node's processing core that the message transfer is complete.

  3. Amplitude Frequency Response Measurement: A Simple Technique

    ERIC Educational Resources Information Center

    Satish, L.; Vora, S. C.

    2010-01-01

    A simple method is described to combine a modern function generator and a digital oscilloscope to configure a setup that can directly measure the amplitude frequency response of a system. This is achieved by synchronously triggering both instruments, with the function generator operated in the "Linear-Sweep" frequency mode, while the oscilloscope…

  4. Completeness relations for Maass Laplacians and heat kernels on the super Poincaré upper half-plane

    NASA Astrophysics Data System (ADS)

    Oshima, Kazuto

    1990-12-01

    Simple completeness relations are proposed for Maass Laplacians. With the help of these completeness relations, correct heat kernels of (super) Maass Laplacians are derived on the (super) Poincaré upper half-plane.

  5. Holmium laser enucleation versus laparoscopic simple prostatectomy for large adenomas.

    PubMed

    Juaneda, R; Thanigasalam, R; Rizk, J; Perrot, E; Theveniaud, P E; Baumert, H

    2016-01-01

    The aim of this study is to compare Holmium laser enucleation of the prostate with another minimally invasive technique, the laparoscopic simple prostatectomy. We compared outcomes of a series of 40 patients who underwent laparoscopic simple prostatectomy (n=20) with laser enucleation of the prostate (n=20) for large adenomas (>100 grams) at our institution. Study variables included operative time and catheterization time, hospital stay, pre- and post-operative International Prostate Symptom Score and maximum urinary flow rate, complications and economic evaluation. Statistical analyses were performed using the Student t test and Fisher test. There were no significant differences in patient age, preoperative prostatic size, operating time or specimen weight between the 2 groups. Duration of catheterization (P=.0008) and hospital stay (P<.0001) were significantly less in the laser group. Both groups showed a statistically significant improvement in functional variables at 3 months post operatively. The cost utility analysis for Holmium per case was 2589 euros versus 4706 per laparoscopic case. In the laser arm, 4 patients (20%) experienced complications according to the modified Clavien classification system versus 5 (25%) in the laparoscopic group (P>.99). Holmium enucleation of the prostate has similar short term functional results and complication rates compared to laparoscopic simple prostatectomy performed in large glands with the advantage of less catheterization time, lower economic costs and a reduced hospital stay. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. A complete history of everything

    NASA Astrophysics Data System (ADS)

    Lanclos, Kyle; Deich, William T. S.

    2012-09-01

    This paper discusses Lick Observatory's local solution for retaining a complete history of everything. Leveraging our existing deployment of a publish/subscribe communications model that is used to broadcast the state of all systems at Lick Observatory, a monitoring daemon runs on a dedicated server that subscribes to and records all published messages. Our success with this system is a testament to the power of simple, straightforward approaches to complex problems. The solution itself is written in Python, and the initial version required about a week of development time; the data are stored in PostgreSQL database tables using a distinctly simple schema. Over time, we addressed scaling issues as the data set grew, which involved reworking the PostgreSQL database schema on the back-end. We also duplicate the data in flat files to enable recovery or migration of the data from one server to another. This paper will cover both the initial design as well as the solutions to the subsequent deployment issues, the trade-offs that motivated those choices, and the integration of this history database with existing client applications.

  7. Home tele-rehabilitation for rheumatic patients: impact and satisfaction of care analysis.

    PubMed

    Pani, D; Piga, M; Barabino, G; Crabolu, M; Uras, S; Mathieu, A; Raffo, L

    2017-02-01

    Introduction In this paper, we evaluated patients' perspectives on the use of a system for home tele-rehabilitation, designed for subjects with low computer literacy suffering hand impairment due to rheumatic diseases. Methods After a clinical trial assessing device effectiveness, the Psychosocial Impact of Assistive Devices Scale (PIADS), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) and Individually Prioritised Problem Assessment (IPPA) questionnaires were administered to evaluate the system's impact on each patient's life, and the results were correlated with clinical indices. Patients were asked to continue self-administered rehabilitation with common objects. One year later, a semi-structured telephone interview gathered data on their experience. Results The system received a positive QUEST score (4.5 ± 0.3) and a modest PIADS score (0.84 ± 0.8) due to the small impact on adaptability and self-esteem. The IPPA (3.7 ± 3.4) revealed improvement in the ability to perform tasks considered important, which was significantly correlated ( r = 0.60; p < 0.02) with the clinical Health Assessment Questionnaire (HAQ) index improvement. The interviews revealed a positive engagement effect, enhanced by the need to develop skills to be able to use the device (technological challenge) and by the perception of more attention by the medical staff. This may explain the significant dropout rate (80%) from the post-trial rehabilitation of the patients who used the device. Discussion The system was largely accepted by the patients. The results suggest that the need for information on their rehabilitation progress and the technological challenge deserves further study to make patients more autonomous in cases of continuous rehabilitation.

  8. Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: a retrospective case study in Southeast China

    PubMed Central

    Guo, Wan-liang; Zhan, Yang; Fang, Fang; Deng, Yan-bing; Zhao, Jun-gang

    2018-01-01

    Objective The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). Design A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. Setting This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China. Participants Sixty-five paediatric patients with CCM were included in this study. We derived all available information on patient demographics, clinical characteristics, preoperative complications and surgical methods from the charts of all these patients. Interventions Univariate and multivariate logistic regression analyses were used to evaluate factors significantly affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM. Results Twenty-three of the 65 case surgeries were performed using laparoscopic technique, and 42 surgeries were performed by conventional open surgery. The median operating time was 215 min (range 120–430 min). The morphological subtype of CCM and the presence of cholecystitis or cholangitis were the only factors found to affect the operating time (p<0.05). Logistic regression analysis confirmed cholangitis as an independent risk factor. Conclusions The morphological subtype of CMM and the presence of cholecystitis or cholangitis are factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM, whereas cholangitis is an independent risk factor. PMID:29804066

  9. An Operationally Simple Method for Separating the Rare-Earth Elements Neodymium and Dysprosium.

    PubMed

    Bogart, Justin A; Lippincott, Connor A; Carroll, Patrick J; Schelter, Eric J

    2015-07-06

    Rare-earth metals are critical components of electronic materials and permanent magnets. Recycling of consumer materials is a promising new source of rare earths. To incentivize recycling there is a clear need for simple methods for targeted separations of mixtures of rare-earth metal salts. Metal complexes of a tripodal nitroxide ligand [{(2-(t) BuNO)C6 H4 CH2 }3 N](3-) (TriNOx(3-) ), feature a size-sensitive aperture formed of its three η(2) -(N,O) ligand arms. Exposure of metal cations in the aperture induces a self-associative equilibrium comprising [M(TriNOx)thf]/ [M(TriNOx)]2 (M=rare-earth metal). Differences in the equilibrium constants (Keq ) for early and late metals enables simple Nd/Dy separations through leaching with a separation ratio SNd/Dy =359. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Direct memory access transfer completion notification

    DOEpatents

    Archer, Charles J [Rochester, MN; Blocksome, Michael A [Rochester, MN; Parker, Jeffrey J [Rochester, MN

    2011-02-15

    DMA transfer completion notification includes: inserting, by an origin DMA engine on an origin node in an injection first-in-first-out (`FIFO`) buffer, a data descriptor for an application message to be transferred to a target node on behalf of an application on the origin node; inserting, by the origin DMA engine, a completion notification descriptor in the injection FIFO buffer after the data descriptor for the message, the completion notification descriptor specifying a packet header for a completion notification packet; transferring, by the origin DMA engine to the target node, the message in dependence upon the data descriptor; sending, by the origin DMA engine, the completion notification packet to a local reception FIFO buffer using a local memory FIFO transfer operation; and notifying, by the origin DMA engine, the application that transfer of the message is complete in response to receiving the completion notification packet in the local reception FIFO buffer.

  11. A Simple Proof of an Interesting Fibonacci Generalization. Classroom Notes

    ERIC Educational Resources Information Center

    Falcon, Sergio

    2004-01-01

    It is reasonably well known that the ratios of consecutive terms of a Fibonacci series converge to the golden ratio. This note presents a simple, complete proof of an interesting generalization of this result to a whole family of 'precious metal ratios'.

  12. Development of a Standardized Cranial Phantom for Training and Optimization of Functional Stereotactic Operations.

    PubMed

    Krüger, Marie T; Coenen, Volker A; Egger, Karl; Shah, Mukesch; Reinacher, Peter C

    2018-06-13

    In recent years, simulations based on phantom models have become increasingly popular in the medical field. In the field of functional and stereotactic neurosurgery, a cranial phantom would be useful to train operative techniques, such as stereo-electroencephalography (SEEG), to establish new methods as well as to develop and modify radiological techniques. In this study, we describe the construction of a cranial phantom and show examples for it in stereotactic and functional neurosurgery and its applicability with different radiological modalities. We prepared a plaster skull filled with agar. A complete operation for deep brain stimulation (DBS) was simulated using directional leads. Moreover, a complete SEEG operation including planning, implantation of the electrodes, and intraoperative and postoperative imaging was simulated. An optimally customized cranial phantom is filled with 10% agar. At 7°C, it can be stored for approximately 4 months. A DBS and an SEEG procedure could be realistically simulated. Lead artifacts can be studied in CT, X-ray, rotational fluoroscopy, and MRI. This cranial phantom is a simple and effective model to simulate functional and stereotactic neurosurgical operations. This might be useful for teaching and training of neurosurgeons, establishing operations in a new center and for optimization of radiological examinations. © 2018 S. Karger AG, Basel.

  13. Relation of squeezed states between damped harmonic and simple harmonic oscillators

    NASA Technical Reports Server (NTRS)

    Um, Chung-In; Yeon, Kyu-Hwang; George, Thomas F.; Pandey, Lakshmi N.

    1993-01-01

    The minimum uncertainty and other relations are evaluated in the framework of the coherent states of the damped harmonic oscillator. It is shown that the coherent states of the damped harmonic oscillator are the squeezed coherent states of the simple harmonic oscillator. The unitary operator is also constructed, and this connects coherent states with damped harmonic and simple harmonic oscillators.

  14. Convection with a simple chemically reactive passive scalar

    NASA Astrophysics Data System (ADS)

    Herring, J. R.; Wyngaard, J. C.

    Convection between horizontal stress-free perfectly conducting plates is examined in the turbulent regime for air. Results are presented for an additional scalar undergoing simple linear decay. We discuss qualitative aspects of the flow in terms of spectral and three-dimensional contour maps of the velocity and scalar fields. The horizontal mean profiles of scalar gradients and fluxes agree rather well with simple mixing-length concepts. Further, the mean profiles for a range of the destruction-rate parameter are shown to be nearly completely characterized by the boundary fluxes. Finally, we shall use the present numerical data as a basis for exploring a generalization of eddy-diffusion concepts so as to properly incorporate non-local effects.

  15. Direct memory access transfer completion notification

    DOEpatents

    Archer, Charles J.; Blocksome, Michael A.; Parker, Jeffrey J.

    2010-08-17

    Methods, apparatus, and products are disclosed for DMA transfer completion notification that include: inserting, by an origin DMA engine on an origin compute node in an injection FIFO buffer, a data descriptor for an application message to be transferred to a target compute node on behalf of an application on the origin compute node; inserting, by the origin DMA engine, a completion notification descriptor in the injection FIFO buffer after the data descriptor for the message, the completion notification descriptor specifying an address of a completion notification field in application storage for the application; transferring, by the origin DMA engine to the target compute node, the message in dependence upon the data descriptor; and notifying, by the origin DMA engine, the application that the transfer of the message is complete, including performing a local direct put operation to store predesignated notification data at the address of the completion notification field.

  16. Simple Spectral Lines Data Model Version 1.0

    NASA Astrophysics Data System (ADS)

    Osuna, Pedro; Salgado, Jesus; Guainazzi, Matteo; Dubernet, Marie-Lise; Roueff, Evelyne; Osuna, Pedro; Salgado, Jesus

    2010-12-01

    This document presents a Data Model to describe Spectral Line Transitions in the context of the Simple Line Access Protocol defined by the IVOA (c.f. Ref[13] IVOA Simple Line Access protocol) The main objective of the model is to integrate with and support the Simple Line Access Protocol, with which it forms a compact unit. This integration allows seamless access to Spectral Line Transitions available worldwide in the VO context. This model does not provide a complete description of Atomic and Molecular Physics, which scope is outside of this document. In the astrophysical sense, a line is considered as the result of a transition between two energy levels. Under the basis of this assumption, a whole set of objects and attributes have been derived to define properly the necessary information to describe lines appearing in astrophysical contexts. The document has been written taking into account available information from many different Line data providers (see acknowledgments section).

  17. Simple versus complex degenerative mitral valve disease.

    PubMed

    Javadikasgari, Hoda; Mihaljevic, Tomislav; Suri, Rakesh M; Svensson, Lars G; Navia, Jose L; Wang, Robert Z; Tappuni, Bassman; Lowry, Ashley M; McCurry, Kenneth R; Blackstone, Eugene H; Desai, Milind Y; Mick, Stephanie L; Gillinov, A Marc

    2018-07-01

    At a center where surgeons favor mitral valve (MV) repair for all subsets of leaflet prolapse, we compared results of patients undergoing repair for simple versus complex degenerative MV disease. From January 1985 to January 2016, 6153 patients underwent primary isolated MV repair for degenerative disease, 3101 patients underwent primary isolated MV repair for simple disease (posterior prolapse), and 3052 patients underwent primary isolated MV repair for complex disease (anterior or bileaflet prolapse), based on preoperative echocardiographic images. Logistic regression analysis was used to generate propensity scores for risk-adjusted comparisons (n = 2065 matched pairs). Durability was assessed by longitudinal recurrence of mitral regurgitation and reoperation. Compared with patients with simple disease, those undergoing repair of complex pathology were more likely to be younger and female (both P values < .0001) but with similar symptoms (P = .3). The most common repair technique was ring/band annuloplasty (3055/99% simple vs 3000/98% complex; P = .5), followed by leaflet resection (2802/90% simple vs 2249/74% complex; P < .0001). Among propensity-matched patients, recurrence of severe mitral regurgitation 10 years after repair was 6.2% for simple pathology versus 11% for complex pathology (P = .007), reoperation at 18 years was 6.3% for simple pathology versus 11% for complex pathology, and 20-year survival was 62% for simple pathology versus 61% for complex pathology (P = .6). Early surgical intervention has become more common in patients with degenerative MV disease, regardless of valve prolapse complexity or symptom status. Valve repair was associated with similarly low operative risk and time-related survival but less durability in complex disease. Lifelong annual echocardiographic surveillance after MV repair is recommended, particularly in patients with complex disease. Copyright © 2018 The American Association for Thoracic Surgery

  18. Knowledge acquisition for a simple expert controller

    NASA Technical Reports Server (NTRS)

    Bieker, B.

    1987-01-01

    A method is presented for process control which has the properties of being incremental, cyclic and top-down. It is described on the basis of the development of an expert controller for a simple, but nonlinear control route. A quality comparison between expert controller and process operator shows the ability of the method for knowledge acquisition.

  19. 14. Implementation, execution, and completion of projects.

    PubMed

    2014-05-01

    Once an intervention has been selected for implementation, it becomes a project. Implementation of a project is a complex process and requires completion of a host of tasks. The implementation process has been deconstructed into its components so that it can be analysed and evaluated. A prerequisite for implementation is an operational plan. The tasks that require completion include: (1) reassessing current status and verifying the needs; (2) activating the operational plan; (3) setting-up and operating an administrative structure; (4) identifying, acquiring, and organising resources (including human resources); (5) assigning roles and responsibilities; (6) educating and training personnel (including mission-specific); (7) briefing staff; (8) preparing/readying resources for transport; (9) assuring project self-sufficiency; (10) arranging for personal necessities; (11) ensuring the safety of personnel and the security of equipment and supplies; (12) insuring personnel; (13) coordinating with other projects/actors; (14) coordinating with other BSF systems (role of the coordination and control centre); (15) communicating with community leaders; (16) initiating the use of standardised progress reports; (17) deploying personnel, equipment, and supplies; (18) initiating the intervention(s); (19) executing the intervention(s); (20) reporting start of interventions; (21) completing the project; and (22) completing and submitting a formal report. This deconstruction is essential in order to study the process and identify critical points of success and failure. It also is recognised that many interventions consist of many components (subfunctions), each of which may be considered a production process.

  20. Simple Apparatus for Measuring the Critical Properties of Gases

    ERIC Educational Resources Information Center

    Donaldson, G. B.

    1973-01-01

    Describes the construction and operational procedures of a simple setup which enables undergraduate students to conduct experiments on critical phenomena in gases. Indicates that the experimental features are proved comparable to those of the Reamer and Sage apparatus. (CC)

  1. Performance of a web-based, realtime, tele-ultrasound consultation system over high-speed commercial telecommunication lines.

    PubMed

    Yoo, Sun K; Kim, D K; Jung, S M; Kim, E-K; Lim, J S; Kim, J H

    2004-01-01

    A Web-based, realtime, tele-ultrasound consultation system was designed. The system employed ActiveX control, MPEG-4 coding of full-resolution ultrasound video (640 x 480 pixels at 30 frames/s) and H.320 videoconferencing. It could be used via a Web browser. The system was evaluated over three types of commercial line: a cable connection, ADSL and VDSL. Three radiologists assessed the quality of compressed and uncompressed ultrasound video-sequences from 16 cases (10 abnormal livers, four abnormal kidneys and two abnormal gallbladders). The radiologists' scores showed that, at a given frame rate, increasing the bit rate was associated with increasing quality; however, at a certain threshold bit rate the quality did not increase significantly. The peak signal to noise ratio (PSNR) was also measured between the compressed and uncompressed images. In most cases, the PSNR increased as the bit rate increased, and increased as the number of dropped frames increased. There was a threshold bit rate, at a given frame rate, at which the PSNR did not improve significantly. Taking into account both sets of threshold values, a bit rate of more than 0.6 Mbit/s, at 30 frames/s, is suggested as the threshold for the maintenance of diagnostic image quality.

  2. Improving Course Completions in Distance Education: An Institutional Case Study

    ERIC Educational Resources Information Center

    Thistoll, Tony; Yates, Anne

    2016-01-01

    This article reports two studies undertaken at The Open Polytechnic of New Zealand, a vocational distance education (DE) provider, where course completion rates have risen to match those of face-to-face technical institutions. A simple model of student engagement is presented, which reflects the triality between the student, institution, and…

  3. The bilinear-biquadratic model on the complete graph

    NASA Astrophysics Data System (ADS)

    Jakab, Dávid; Szirmai, Gergely; Zimborás, Zoltán

    2018-03-01

    We study the spin-1 bilinear-biquadratic model on the complete graph of N sites, i.e. when each spin is interacting with every other spin with the same strength. Because of its complete permutation invariance, this Hamiltonian can be rewritten as the linear combination of the quadratic Casimir operators of \

  4. Tensor completion for estimating missing values in visual data.

    PubMed

    Liu, Ji; Musialski, Przemyslaw; Wonka, Peter; Ye, Jieping

    2013-01-01

    In this paper, we propose an algorithm to estimate missing values in tensors of visual data. The values can be missing due to problems in the acquisition process or because the user manually identified unwanted outliers. Our algorithm works even with a small amount of samples and it can propagate structure to fill larger missing regions. Our methodology is built on recent studies about matrix completion using the matrix trace norm. The contribution of our paper is to extend the matrix case to the tensor case by proposing the first definition of the trace norm for tensors and then by building a working algorithm. First, we propose a definition for the tensor trace norm that generalizes the established definition of the matrix trace norm. Second, similarly to matrix completion, the tensor completion is formulated as a convex optimization problem. Unfortunately, the straightforward problem extension is significantly harder to solve than the matrix case because of the dependency among multiple constraints. To tackle this problem, we developed three algorithms: simple low rank tensor completion (SiLRTC), fast low rank tensor completion (FaLRTC), and high accuracy low rank tensor completion (HaLRTC). The SiLRTC algorithm is simple to implement and employs a relaxation technique to separate the dependent relationships and uses the block coordinate descent (BCD) method to achieve a globally optimal solution; the FaLRTC algorithm utilizes a smoothing scheme to transform the original nonsmooth problem into a smooth one and can be used to solve a general tensor trace norm minimization problem; the HaLRTC algorithm applies the alternating direction method of multipliers (ADMMs) to our problem. Our experiments show potential applications of our algorithms and the quantitative evaluation indicates that our methods are more accurate and robust than heuristic approaches. The efficiency comparison indicates that FaLTRC and HaLRTC are more efficient than SiLRTC and between FaLRTC an

  5. Effects of a tele-prehabilitation program or an in-person prehabilitation program in surgical candidates awaiting total hip or knee arthroplasty: Protocol of a pilot single blind randomized controlled trial.

    PubMed

    Doiron-Cadrin, Patrick; Kairy, Dahlia; Vendittoli, Pascal-André; Lowry, Véronique; Poitras, Stéphane; Desmeules, François

    2016-12-15

    The accessibility for total joint arthroplasty often comes up against long wait lists, and may lead to deleterious effects for the awaiting patients. This pilot single blind randomized controlled trial aims to evaluate the impact of a telerehabilitation prehabilitation program before a hip or knee arthroplasty compared to in-person prehabilitation or to usual wait for surgery. Thirty-six patients on a wait list for a total hip or knee arthroplasty will be recruited and randomly assigned to one of three groups. The in-person prehabilitation group (n = 12) will receive a 12-week rehabilitation program (2 sessions/week) including education, exercises of the lower limb and cardiovascular training. Patients in the tele-prehabilitation group (n = 12) will receive the same intervention using a telecommunication software. The control group (n = 12) will be provided with the hospital's usual documentation before surgery. The Lower Extremity Functional Scale (LEFS) will be the primary outcome measure taken at baseline and at 12 weeks. Secondary measures will include self-reported function and quality of life as well as performance tests. A mixed-model, 2-way repeated-measure ANOVA will be used to analyse the effects of the rehabilitation programs. This pilot study is the first to evaluate the feasibility and the impact of a telerehabilitation prehabilitation program for patients awaiting a total joint arthroplasty. The results of this pilot-RCT will set the foundations for further research in the fields of rehabilitation and tele-medicine for patients suffering from lower limb osteoarthritis. ClinicalTrials.gov: NCT02636751.

  6. Tele-Presence: Bringing the Operator Back in the Loop

    DTIC Science & Technology

    2006-06-01

    1998). Improved Camera - Monitor system for driving YPR-765 under armour (Report TM-98-A024). Soesterberg, The Netherlands: TNO Human Factors Research...Institute. [25] Van Erp, J.B.F., Padmos, P. (1997). Improving outside view when driving YPR-765 under armour (TM-97-A026). Soesterberg, The

  7. A simple web-based risk calculator (www.anastomoticleak.com) is superior to the surgeon's estimate of anastomotic leak after colon cancer resection.

    PubMed

    Sammour, T; Lewis, M; Thomas, M L; Lawrence, M J; Hunter, A; Moore, J W

    2017-01-01

    Anastomotic leak can be a devastating complication, and early prediction is difficult. The aim of this study is to prospectively validate a simple anastomotic leak risk calculator and compare its predictive value with the estimate of the primary operating surgeon. Consecutive patients undergoing elective or emergency colon cancer surgery with a primary anastomosis over a 1-year period were prospectively included. A recently published anastomotic leak risk nomogram was converted to an online calculator ( www.anastomoticleak.com ). The calculator-derived risk of anastomotic leak and the risk estimated by the primary operating surgeon were recorded at the completion of surgery. The primary outcome was anastomotic leak within 90 days as defined by previously published criteria. Area under receiver operating characteristic curve analysis (AUROC) was performed for both risk estimates. A total of 105 patients were screened for inclusion during the study period, of whom 83 met the inclusion criteria. The overall anastomotic leak rate was 9.6%. The anastomotic leak calculator was highly predictive of anastomotic leak (AUROC 0.84, P = 0.002), whereas the surgeon estimate was not predictive (AUROC 0.40, P = 0.243). A simple anastomotic leak risk calculator is significantly better at predicting anastomotic leak than the estimate of the primary surgeon. Further external validation on a larger data set is required.

  8. Experimental scheme for qubit and qutrit symmetric informationally complete positive operator-valued measurements using multiport devices

    NASA Astrophysics Data System (ADS)

    Tabia, Gelo Noel M.

    2012-12-01

    It is crucial for various quantum information processing tasks that the state of a quantum system can be determined reliably and efficiently from general quantum measurements. One important class of measurements for this purpose is symmetric informationally complete positive operator-valued measurements (SIC-POVMs). SIC-POVMs have the advantage of providing an unbiased estimator for the quantum state with the minimal number of outcomes needed for full tomography. By virtue of Naimark's dilation theorem, any POVM can always be realized with a suitable coupling between the system and an auxiliary system and by performing a projective measurement on the joint system. In practice, finding the appropriate coupling is rather nontrivial. Here we propose an experimental design for directly implementing SIC-POVMs using multiport devices and path-encoded qubits and qutrits, the utility of which has recently been demonstrated by several experimental groups around the world. Furthermore, we describe how these multiports can be attained in practice with an integrated photonic system composed of nested linear optical elements.

  9. Crustal structure in the southern part of Central Java based on analysis of tele-seismic receiver function using a neighbourhood algorithm

    NASA Astrophysics Data System (ADS)

    Ariyanto, P.; Syuhada; Rosid, S.; Anggono, T.; Januarti, Y.

    2018-03-01

    In this study, we applied receiver functions analysis to determine the crustal thickness, the ratio of Vp/Vs and the S wave velocity in the southern part of the Central Java. We selected tele-seismic data with magnitude more than 6 (M>6) and epicenter distance 30°-90° recorded from 3 broadband stations: UGM, YOGI, and WOJI station, as part of Indonesia-Geophone Network (IA-GE). Inversions were performed using nonlinear Neighborhood Algorithm (NA). We observed Ps phase conversion on the receiver functions corresponding to Moho depth at around 36-39 km. We also observed strong negative phase arrivals at around 10-12 s which might be associated with Indo-Australian subducting slab underneath the stations. The inversion results show the presence of low velocity zone with high Vp/Vs ratio (>1.78) in the middle crust around the study area which could be related to the Merapi-Lawu Anomaly (MLA).

  10. Six-Month Outcomes of a Randomized, Motivational Tele-intervention for Change in the Codependent Behavior of Family Members of Drug Users.

    PubMed

    Bortolon, Cassandra Borges; Moreira, Taís de Campos; Signor, Luciana; Guahyba, Bárbara Léa; Figueiró, Luciana Rizzieri; Ferigolo, Maristela; Barros, Helena Maria Tannhauser

    2017-01-28

    Families of substance abusers may develop maladaptive strategies, such as codependency, to address drug-related problems. It is important for families to receive specialist treatment in order to contribute to the recovery process. The Tele-intervention Model and Monitoring of Families of Drug Users (TMMFDU), based on motivational interviewing and stages of change, aims to encourage the family to change the codependents' behaviors. A randomized clinical trial was carried out to verify the change in codependent behavior after intervention with 6 months of follow-up. Three hundred and twenty-five families with high or low codependency scores were randomized into the intervention group (n = 163) or the usual treatment (UT) (n = 162). After 6 months of follow-up, the family members of the TMMFDU group were twice as likely to modify their codependency behavior when compared to the UT group (OR 2.08 CI 95% 1.18-3.65). TMMFDU proved to be effective in changing codependent behaviors among compliant family members of drug users.

  11. Self-dual gravity is completely integrable

    NASA Astrophysics Data System (ADS)

    Nutku, Y.; Sheftel, M. B.; Kalayci, J.; Yazıcı, D.

    2008-10-01

    We discover a multi-Hamiltonian structure of a complex Monge-Ampère equation (CMA) set in a real first-order 2-component form. Therefore, by Magri's theorem this is a completely integrable system in four real dimensions. We start with Lagrangian and Hamiltonian densities and obtain a symplectic form and the Hamiltonian operator that determines the Dirac bracket. We have calculated all point symmetries of the 2-component CMA system and Hamiltonians of the symmetry flows. We have found two new real recursion operators for symmetries which commute with the operator of a symmetry condition on solutions of the CMA system. These operators form two Lax pairs for the 2-component system. The recursion operators, applied to the first Hamiltonian operator, generate infinitely many real Hamiltonian structures. We show how to construct an infinite hierarchy of higher commuting flows together with the corresponding infinite chain of their Hamiltonians.

  12. 30 CFR 250.1620 - Well-completion and well-workover requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Well-completion and well-workover requirements... Well-completion and well-workover requirements. (a) Lessees shall conduct well-completion and well-workover operations in sulphur wells, bleedwells, and brine wells in accordance with §§ 250.1620 through...

  13. Completion techniques for horizontal wells in the Pearsall Austin Chalk

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

    Pope, C.D.; Handren, P.J.

    1992-05-01

    Oryx Energy Co. used three basic completion techniques and various combinations of them to complete 20 horizontal wells in the Pearsall Austin Chalk. The completion method selected is based on a general set of guidelines. In this paper additionally, equipment selection and various types of workover operations are reviewed.

  14. A simple strategy to reduce stereotype threat for orthopedic residents

    PubMed Central

    Gomez, Everlyne; Wright, James G.

    2014-01-01

    Background Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. Methods The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Results Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Conclusion Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR. PMID:24666454

  15. A simple strategy to reduce stereotype threat for orthopedic residents.

    PubMed

    Gomez, Everlyne; Wright, James G

    2014-04-01

    Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR.

  16. Arizona TeleMedicine Network: Segment Specifications--Tuba City via Mt. Elden, Phoenix; Keams Canyon, Second Mesa, Low Mountain; Phoenix, San Carlos, Bylas; Keams Canyon via Ganado Mesa, Ft. Defiance; Tuba City via Black Mesa, Ft. Defiance; and Budgetary Cost Information--Pinal Peak via San Xavier, Tucson.

    ERIC Educational Resources Information Center

    Atlantic Research Corp., Alexandria, VA.

    The communication links of five different segments of the Arizona TeleMedicine Network (a telecommunication system designed to provide health services for American Indians in rurally isolated areas) and budgetary cost information for Pinal Peak via San Xavier and Tucson are described in this document. The five communication links are identified…

  17. EQClinic: a platform for learning communication skills in clinical consultations

    PubMed Central

    Liu, Chunfeng; Scott, Karen M.; Lim, Renee L.; Taylor, Silas; Calvo, Rafael A.

    2016-01-01

    Background Doctors’ verbal and non-verbal communication skills have an impact on patients’ health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient–doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion It is not easy to improve non-verbal communication skills in a

  18. EQClinic: a platform for learning communication skills in clinical consultations.

    PubMed

    Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

    2016-01-01

    Background Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. Methods We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Results Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. Discussion It is not easy to improve non-verbal communication skills in a short

  19. EQClinic: a platform for learning communication skills in clinical consultations.

    PubMed

    Liu, Chunfeng; Scott, Karen M; Lim, Renee L; Taylor, Silas; Calvo, Rafael A

    2016-01-01

    Doctors' verbal and non-verbal communication skills have an impact on patients' health outcomes, so it is important for medical students to develop these skills. Traditional, non-verbal communication skills training can involve a tutor manually annotating a student's non-verbal behaviour during patient-doctor consultations, but this is very time-consuming. Tele-conference systems have been used in verbal communication skills training. We describe EQClinic, a system that enables verbal and non-verbal communication skills training during tele-consultations with simulated patients (SPs), with evaluation exercises promoting reflection. Students and SPs can have tele-consultations through the tele-consultation component. In this component, SPs can provide feedback to students through a thumbs-up/ thumbs-down tool and a comments box. EQClinic automatically analyses communication features in the recorded consultations, such as facial expressions, and provides graphical representations. Our 2015 pilot study investigated whether EQClinic helped students be aware of their non-verbal behaviour and improve their communication skills, and evaluated the usability of the platform. Students received automated feedback, and SP and tutor evaluations, and then completed self-assessment and reflection questionnaires. Eight medical students and three SPs conducted 13 tele-consultations using EQClinic. More students paid attention to their non-verbal communication and students who were engaged in two consultations felt more confident in their second consultation. Students rated the system positively, felt comfortable using it (5.9/7), and reported that the structure (5.4/7) and information (5.8/7) were clear. This pilot provides evidence that EQClinic helps, and positively influences, medical students practise their communication skills with SPs using a tele-conference platform. It is not easy to improve non-verbal communication skills in a short time period. Further evaluation of

  20. Learning in tele-autonomous systems using Soar

    NASA Technical Reports Server (NTRS)

    Laird, John E.; Yager, Eric S.; Tuck, Christopher M.; Hucka, Michael

    1989-01-01

    Robo-Soar is a high-level robot arm control system implemented in Soar. Robo-Soar learns to perform simple block manipulation tasks using advice from a human. Following learning, the system is able to perform similar tasks without external guidance. It can also learn to correct its knowledge, using its own problem solving in addition to outside guidance. Robo-Soar corrects its knowledge by accepting advice about relevance of features in its domain, using a unique integration of analytic and empirical learning techniques.

  1. Double gloves: a randomized trial to evaluate a simple strategy to reduce contamination in the operating room.

    PubMed

    Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Carling, Philip; Arheart, Kristopher L; Munoz-Price, L Silvia

    2015-04-01

    Oral flora, blood-borne pathogens, and bacterial contamination pose a direct risk of infection to patients and health care workers. We conducted a study in a simulated operating room using a newly validated technology to determine whether the use of 2 sets of gloves, with the outer set removed immediately after endotracheal intubation, may reduce this risk. Forty-one anesthesiology residents (PGY 2-4) were enrolled in a study consisting of individual or group simulation sessions. On entry to the simulated operating room, the residents were asked to perform an anesthetic induction and tracheal intubation timed to approximately 6 minutes; they were unaware of the study design. Of the 22 simulation sessions, 11 were conducted with the intubating resident wearing single gloves, and 11 with the intubating resident using double gloves with the outer pair removed after verified intubation. Before the start of the scenario, we coated the lips and inside of the mouth of the mannequin with a fluorescent marking gel as a surrogate pathogen. After the simulation, an observer examined 40 different sites using a handheld ultraviolet light in the operating room to determine the transfer of surrogate pathogens to the patient and the patient's environment. Residents who wore double gloves were instructed by a confederate nurse to remove the outer set immediately after completion of the intubation. Forty sites of potential intraoperative pathogen spread were identified and assigned a score. The difference in the rate of contamination between anesthesiology residents who wore single gloves versus those with double gloves was clinically and statistically significant. The number of sites that were contaminated in the operating room when the intubating resident wore single gloves was 20.3 ± 1.4 (mean ± SE); the number of contaminated sites when residents wore double gloves was 5.0 ± 0.7 (P < 0.001). The results of this study suggest that when an anesthesiologist wears 2 sets of

  2. Tele-transmission of stereoscopic images of the optic nerve head in glaucoma via Internet.

    PubMed

    Bergua, Antonio; Mardin, Christian Y; Horn, Folkert K

    2009-06-01

    The objective was to describe an inexpensive system to visualize stereoscopic photographs of the optic nerve head on computer displays and to transmit such images via the Internet for collaborative research or remote clinical diagnosis in glaucoma. Stereoscopic images of glaucoma patients were digitized and stored in a file format (joint photographic stereoimage [jps]) containing all three-dimensional information for both eyes on an Internet Web site (www.trizax.com). The size of jps files was between 0.4 to 1.4 MB (corresponding to a diagonal stereo image size between 900 and 1400 pixels) suitable for Internet protocols. A conventional personal computer system equipped with wireless stereoscopic LCD shutter glasses and a CRT-monitor with high refresh rate (120 Hz) can be used to obtain flicker-free stereo visualization of true-color images with high resolution. Modern thin-film transistor-LCD displays in combination with inexpensive red-cyan goggles achieve stereoscopic visualization with the same resolution but reduced color quality and contrast. The primary aim of our study was met to transmit stereoscopic images via the Internet. Additionally, we found that with both stereoscopic visualization techniques, cup depth, neuroretinal rim shape, and slope of the inner wall of the optic nerve head, can be qualitatively better perceived and interpreted than with monoscopic images. This study demonstrates high-quality and low-cost Internet transmission of stereoscopic images of the optic nerve head from glaucoma patients. The technique allows exchange of stereoscopic images and can be applied to tele-diagnostic and glaucoma research.

  3. [Treatment of simple snoring by radiofrequency velar coblation].

    PubMed

    Pessey, J-J; Rose, X; Michenet, F; Calmels, M-N; Lagleyre, S

    2005-02-01

    Short- and long-term evaluation of the efficacy and safety of radiofrequency velar coblation for simple snoring. From February 2000 to May 2004, 175 patients underwent a single radiofrequency session for velar coblation. All patients suffered from snoring without sleep apnea. They presented modifications of the velo-pharyngeal region but did not have tonsillar or basilingual hypertrophy. Outcome was assessed in terms of pain, changes in snoring, secondary effects and complications at three months and one, two, and three years. Secondary uvulectomy was performed in 28 patients. At three months, snoring had decreased in 82% of patients with complete resolution in 12%. Outcome remained unchanged in 70% of patients at one, two, and three years. After uvulectomy, snoring declined in 96% of patients with complete resolution in 48%. Post-treatment pain lasted less than five days in 68% of patients. Mean duration was three days. Fifteen patients developed pharyngeal paresthesia which regressed at one year. Two patients had a nasal voice and three developed necrosis of the uvula. Velar coblation is a simple treatment for snoring which can be performed in a single session. The best results are achieved in patients whose body mass index is below 25 and after secondary uvulectomy.

  4. Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India.

    PubMed

    Acharya, Rajesh V; Rai, Jasuma J

    2016-01-01

    Telemedicine incorporates electronic information and medical technology. It connects healthcare through vast distances which would benefit both patients and doctors. The aim of this questionnaire study was to evaluate the effects of telemedicine on patients and medical specialists. A cross-sectional study was conducted among 122 participants (71 patients and 51 doctors) on satisfaction in quality of service, cost-effectiveness, and problems encountered in healthcare provided by the telemedicine in Apollo Tele Health Services, Hyderabad, Telangana, India. The data for each group were calculated and compared. About 80% patients and all the doctors reported their satisfaction on the quality of treatment given through telemedicine. Approximately, 90% of the participants found telemedicine cost-effective and 61% of the doctors found an increase in patient's inflow apart for their regular practice. Problems encountered in telemedicine were 47% in technical issues and 39% in time scheduling by doctors and 31% of patients were uncomfortable to face the camera, and 24% had technical issues. The results of the present study showed that telemedicine in healthcare could prove to be useful to patients in distant regions and to rural doctors in India. In the near future, telemedicine can be considered as an alternate to face to face patient care.

  5. Step-by-step training in basic laparoscopic skills using two-way web conferencing software for remote coaching: A multicenter randomized controlled study.

    PubMed

    Mizota, Tomoko; Kurashima, Yo; Poudel, Saseem; Watanabe, Yusuke; Shichinohe, Toshiaki; Hirano, Satoshi

    2018-07-01

    Despite its advantages, few trainees outside of North America have access to simulation training. We hypothesized that a stepwise training method using tele-mentoring system would be an efficient technique for training in basic laparoscopic skills. Residents were randomized into two groups and trained to proficiency in intracorporeal suturing. The stepwise group (SG) practiced the task step-by-step, while the other group practiced comprehensively (CG). Each participant received weekly coaching via two-way web conferencing software. The duration of the coaching sessions and self-practice time were compared between the two groups. Twenty residents from 15 institutions participated, and all achieved proficiency. Coaching sessions using tele-mentoring system were completed without difficulties. The SG required significantly shorter coaching time per session than the CG (p = .002). There was no significant difference in self-practice time. The stepwise training method with the tele-mentoring system appears to make efficient use of surgical trainees' and trainers' time. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Completable scheduling: An integrated approach to planning and scheduling

    NASA Technical Reports Server (NTRS)

    Gervasio, Melinda T.; Dejong, Gerald F.

    1992-01-01

    The planning problem has traditionally been treated separately from the scheduling problem. However, as more realistic domains are tackled, it becomes evident that the problem of deciding on an ordered set of tasks to achieve a set of goals cannot be treated independently of the problem of actually allocating resources to the tasks. Doing so would result in losing the robustness and flexibility needed to deal with imperfectly modeled domains. Completable scheduling is an approach which integrates the two problems by allowing an a priori planning module to defer particular planning decisions, and consequently the associated scheduling decisions, until execution time. This allows a completable scheduling system to maximize plan flexibility by allowing runtime information to be taken into consideration when making planning and scheduling decision. Furthermore, through the criteria of achievability placed on deferred decision, a completable scheduling system is able to retain much of the goal-directedness and guarantees of achievement afforded by a priori planning. The completable scheduling approach is further enhanced by the use of contingent explanation-based learning, which enables a completable scheduling system to learn general completable plans from example and improve its performance through experience. Initial experimental results show that completable scheduling outperforms classical scheduling as well as pure reactive scheduling in a simple scheduling domain.

  7. A Complete Set for the Maass Laplacians on the Pseudosphere

    NASA Astrophysics Data System (ADS)

    Oshima, K.

    1989-02-01

    We obtain a completeness relation from eigenfunctions of the Maass laplacians in terms of the pseudospherical polar coordinates. We derive addition theorems of ``generalized'' associated Legendre functions. With the help of the addition theorems, we get a simple path integral picture for a charged particle on the Poincaré upper half plane with a constant magnetic field.

  8. 10 CFR 54.13 - Completeness and accuracy of information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Completeness and accuracy of information. 54.13 Section 54.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REQUIREMENTS FOR RENEWAL OF OPERATING LICENSES FOR NUCLEAR POWER PLANTS General Provisions § 54.13 Completeness and accuracy of information. (a...

  9. 10 CFR 54.13 - Completeness and accuracy of information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Completeness and accuracy of information. 54.13 Section 54.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REQUIREMENTS FOR RENEWAL OF OPERATING LICENSES FOR NUCLEAR POWER PLANTS General Provisions § 54.13 Completeness and accuracy of information. (a...

  10. 10 CFR 54.13 - Completeness and accuracy of information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Completeness and accuracy of information. 54.13 Section 54.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REQUIREMENTS FOR RENEWAL OF OPERATING LICENSES FOR NUCLEAR POWER PLANTS General Provisions § 54.13 Completeness and accuracy of information. (a...

  11. 10 CFR 54.13 - Completeness and accuracy of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Completeness and accuracy of information. 54.13 Section 54.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REQUIREMENTS FOR RENEWAL OF OPERATING LICENSES FOR NUCLEAR POWER PLANTS General Provisions § 54.13 Completeness and accuracy of information. (a...

  12. 10 CFR 54.13 - Completeness and accuracy of information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Completeness and accuracy of information. 54.13 Section 54.13 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REQUIREMENTS FOR RENEWAL OF OPERATING LICENSES FOR NUCLEAR POWER PLANTS General Provisions § 54.13 Completeness and accuracy of information. (a...

  13. ViSimpl: Multi-View Visual Analysis of Brain Simulation Data

    PubMed Central

    Galindo, Sergio E.; Toharia, Pablo; Robles, Oscar D.; Pastor, Luis

    2016-01-01

    After decades of independent morphological and functional brain research, a key point in neuroscience nowadays is to understand the combined relationships between the structure of the brain and its components and their dynamics on multiple scales, ranging from circuits of neurons at micro or mesoscale to brain regions at macroscale. With such a goal in mind, there is a vast amount of research focusing on modeling and simulating activity within neuronal structures, and these simulations generate large and complex datasets which have to be analyzed in order to gain the desired insight. In such context, this paper presents ViSimpl, which integrates a set of visualization and interaction tools that provide a semantic view of brain data with the aim of improving its analysis procedures. ViSimpl provides 3D particle-based rendering that allows visualizing simulation data with their associated spatial and temporal information, enhancing the knowledge extraction process. It also provides abstract representations of the time-varying magnitudes supporting different data aggregation and disaggregation operations and giving also focus and context clues. In addition, ViSimpl tools provide synchronized playback control of the simulation being analyzed. Finally, ViSimpl allows performing selection and filtering operations relying on an application called NeuroScheme. All these views are loosely coupled and can be used independently, but they can also work together as linked views, both in centralized and distributed computing environments, enhancing the data exploration and analysis procedures. PMID:27774062

  14. ViSimpl: Multi-View Visual Analysis of Brain Simulation Data.

    PubMed

    Galindo, Sergio E; Toharia, Pablo; Robles, Oscar D; Pastor, Luis

    2016-01-01

    After decades of independent morphological and functional brain research, a key point in neuroscience nowadays is to understand the combined relationships between the structure of the brain and its components and their dynamics on multiple scales, ranging from circuits of neurons at micro or mesoscale to brain regions at macroscale. With such a goal in mind, there is a vast amount of research focusing on modeling and simulating activity within neuronal structures, and these simulations generate large and complex datasets which have to be analyzed in order to gain the desired insight. In such context, this paper presents ViSimpl, which integrates a set of visualization and interaction tools that provide a semantic view of brain data with the aim of improving its analysis procedures. ViSimpl provides 3D particle-based rendering that allows visualizing simulation data with their associated spatial and temporal information, enhancing the knowledge extraction process. It also provides abstract representations of the time-varying magnitudes supporting different data aggregation and disaggregation operations and giving also focus and context clues. In addition, ViSimpl tools provide synchronized playback control of the simulation being analyzed. Finally, ViSimpl allows performing selection and filtering operations relying on an application called NeuroScheme. All these views are loosely coupled and can be used independently, but they can also work together as linked views, both in centralized and distributed computing environments, enhancing the data exploration and analysis procedures.

  15. Operational Risk Defined Through a Complex Operating Environment

    DTIC Science & Technology

    2015-02-26

    including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed , and completing and reviewing...This argument defines operational risk as any environmental, institutional, or social impediment to the principles of joint operations that disrupt...Restraint, Perseverance, and Legitimacy. This argument defines operational risk as any environmental, institutional, or social impediment to the

  16. IOTA simple rules in differentiating between benign and malignant ovarian tumors.

    PubMed

    Tantipalakorn, Charuwan; Wanapirak, Chanane; Khunamornpong, Surapan; Sukpan, Kornkanok; Tongsong, Theera

    2014-01-01

    To evaluate the diagnostic performance of IOTA simple rules in differentiating between benign and malignant ovarian tumors. A study of diagnostic performance was conducted on women scheduled for elective surgery due to ovarian masses between March 2007 and March 2012. All patients underwent ultrasound examination for IOTA simple rules within 24 hours of surgery. All examinations were performed by the authors, who had no any clinical information of the patients, to differentiate between benign and malignant adnexal masses using IOTA simple rules. Gold standard diagnosis was based on pathological or operative findings. A total of 398 adnexal masses, in 376 women, were available for analysis. Of them, the IOTA simple rules could be applied in 319 (80.1%) including 212 (66.5%) benign tumors and 107 (33.6%) malignant tumors. The simple rules yielded inconclusive results in 79 (19.9%) masses. In the 319 masses for which the IOTA simple rules could be applied, sensitivity was 82.9% and specificity 95.3%. The IOTA simple rules have high diagnostic performance in differentiating between benign and malignant adnexal masses. Nevertheless, inconclusive results are relatively common.

  17. Horizontal Running Mattress Suture Modified with Intermittent Simple Loops

    PubMed Central

    Chacon, Anna H; Shiman, Michael I; Strozier, Narissa; Zaiac, Martin N

    2013-01-01

    Using the combination of a horizontal running mattress suture with intermittent loops achieves both good eversion with the horizontal running mattress plus the ease of removal of the simple loops. This combination technique also avoids the characteristic railroad track marks that result from prolonged non-absorbable suture retention. The unique feature of our technique is the incorporation of one simple running suture after every two runs of the horizontal running mattress suture. To demonstrate its utility, we used the suturing technique on several patients and analyzed the cosmetic outcome with post-operative photographs in comparison to other suturing techniques. In summary, the combination of running horizontal mattress suture with simple intermittent loops demonstrates functional and cosmetic benefits that can be readily taught, comprehended, and employed, leading to desirable aesthetic results and wound edge eversion. PMID:23723610

  18. Conditions for Mission Completion in Low Intensity Conflict: Operation Enduring Freedom-Philippines

    DTIC Science & Technology

    2017-06-01

    ENDURING FREEDOM–PHILIPPINES 5. FUNDING NUMBERS 6. AUTHOR(S) James T. McCabe 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate...School Monterey, CA 93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) N/A 10...extremist organizations . 14. SUBJECT TERMS Operation Enduring Freedom—Philippines (OEF-P), Joint Special Operations Task Force— Philippines

  19. 10 CFR 55.9 - Completeness and accuracy of information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Completeness and accuracy of information. 55.9 Section 55.9 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES General Provisions § 55.9 Completeness and accuracy of information. Information provided to the Commission by an applicant for a license...

  20. 10 CFR 55.9 - Completeness and accuracy of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Completeness and accuracy of information. 55.9 Section 55.9 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES General Provisions § 55.9 Completeness and accuracy of information. Information provided to the Commission by an applicant for a license...

  1. Operational Dynamic Configuration Analysis

    NASA Technical Reports Server (NTRS)

    Lai, Chok Fung; Zelinski, Shannon

    2010-01-01

    Sectors may combine or split within areas of specialization in response to changing traffic patterns. This method of managing capacity and controller workload could be made more flexible by dynamically modifying sector boundaries. Much work has been done on methods for dynamically creating new sector boundaries [1-5]. Many assessments of dynamic configuration methods assume the current day baseline configuration remains fixed [6-7]. A challenging question is how to select a dynamic configuration baseline to assess potential benefits of proposed dynamic configuration concepts. Bloem used operational sector reconfigurations as a baseline [8]. The main difficulty is that operational reconfiguration data is noisy. Reconfigurations often occur frequently to accommodate staff training or breaks, or to complete a more complicated reconfiguration through a rapid sequence of simpler reconfigurations. Gupta quantified a few aspects of airspace boundary changes from this data [9]. Most of these metrics are unique to sector combining operations and not applicable to more flexible dynamic configuration concepts. To better understand what sort of reconfigurations are acceptable or beneficial, more configuration change metrics should be developed and their distribution in current practice should be computed. This paper proposes a method to select a simple sequence of configurations among operational configurations to serve as a dynamic configuration baseline for future dynamic configuration concept assessments. New configuration change metrics are applied to the operational data to establish current day thresholds for these metrics. These thresholds are then corroborated, refined, or dismissed based on airspace practitioner feedback. The dynamic configuration baseline selection method uses a k-means clustering algorithm to select the sequence of configurations and trigger times from a given day of operational sector combination data. The clustering algorithm selects a simplified

  2. Molecular implementation of simple logic programs.

    PubMed

    Ran, Tom; Kaplan, Shai; Shapiro, Ehud

    2009-10-01

    Autonomous programmable computing devices made of biomolecules could interact with a biological environment and be used in future biological and medical applications. Biomolecular implementations of finite automata and logic gates have already been developed. Here, we report an autonomous programmable molecular system based on the manipulation of DNA strands that is capable of performing simple logical deductions. Using molecular representations of facts such as Man(Socrates) and rules such as Mortal(X) <-- Man(X) (Every Man is Mortal), the system can answer molecular queries such as Mortal(Socrates)? (Is Socrates Mortal?) and Mortal(X)? (Who is Mortal?). This biomolecular computing system compares favourably with previous approaches in terms of expressive power, performance and precision. A compiler translates facts, rules and queries into their molecular representations and subsequently operates a robotic system that assembles the logical deductions and delivers the result. This prototype is the first simple programming language with a molecular-scale implementation.

  3. 40 CFR 62.15105 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... supervisors, and control room operators who have obtained full certification from the American Society of... supervisors, and control room operators who have obtained provisional certification from the American Society...

  4. 40 CFR 62.15105 - Who must complete the operator training course? By when?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... supervisors, and control room operators who have obtained full certification from the American Society of... supervisors, and control room operators who have obtained provisional certification from the American Society...

  5. The Pacific Asynchronous TeleHealth (PATH) system: review of 1,000 pediatric teleconsultations.

    PubMed

    Mahnke, Christopher Becket; Jordan, Christopher P; Bergvall, Ethan; Person, Donald A; Pinsker, Jordan E

    2011-01-01

    The aim of this study was to evaluate the impact on pediatric care of the Pacific Asynchronous TeleHealth (PATH) system, a provider-to-provider teleconsultation platform utilized by military medical facilities throughout the Pacific Region. This review focuses on access to care, quality of care, and cost savings for the Department of Defense as a result of ongoing development of the PATH system from 2006 to 2009. This is a retrospective review of 1,000 consecutive teleconsultations occurring from January 2006 to March 2009. Three pediatric subspecialists reviewed the characteristics of each teleconsultation and the ultimate outcome. The PATH system processed > 300 pediatric teleconsultations in 2009 from 20 hospitals and clinics throughout the Pacific Region. The number of teleconsultations has grown significantly since 2006. Median teleconsultation response time was 14.5 h with 97% of teleconsultations answered within 1 week. The majority (75%) of teleconsultations came from areas without host nation pediatric subspecialty resources. Most teleconsultations (72%) involved diagnostic questions, whereas 21% were primarily for treatment issues. Teleconsultations originated predominantly from outpatient clinics (90%), with question resolution in 60% of cases without a face-to-face subspecialty evaluation. Fifteen percent of teleconsultations resulted in patient transfer to our center for definitive diagnosis and treatment. The diagnostic and/or treatment plan was modified in 74% of teleconsultations. PATH precluded patient transfer in 12%-43% of teleconsultations (annual savings: $208,283-$746,348 per year) and generated an average of 1.7 relative value units per teleconsultation. PATH provided patient access to pediatric subspecialty expertise via provider-to-provider asynchronous teleconsultation. Internet-based pediatric subspecialty teleconsultation provides fast, convenient, cost-effective, quality pediatric care to populations of patients who might otherwise

  6. The complete Brans–Dicke theories

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

    Kofinas, Georgios, E-mail: gkofinas@aegean.gr

    Given that the simple wave equation of Brans–Dicke theory for the scalar field is preserved, we have investigated, through exhaustively analyzing the Bianchi identities, the consistent theories which violate the exact energy conservation equation. It is found that only three theories exist which are unambiguously determined from consistency, without imposing arbitrary functions by hand. Each of these theories possesses a specific interaction term which controls the energy exchange between the scalar field and ordinary matter. The theories contain new parameters (integration constants from the integration procedure) and when these are switched-off, Brans–Dicke theory emerges. As usually, the vacuum theories canmore » be defined from the complete Brans–Dicke theories when the matter energy–momentum tensor vanishes.« less

  7. Addressing Early Retention in Antenatal Care Among HIV-Positive Women Through a Simple Intervention in Kinshasa, DRC: The Elombe "Champion" Standard Operating Procedure.

    PubMed

    Gill, Michelle M; Ditekemena, John; Loando, Aimé; Mbonze, Nana; Bakualufu, Jo; Machekano, Rhoderick; Nyombe, Cady; Temmerman, Marleen; Fwamba, Franck

    2018-03-01

    This cluster-randomized study aimed to assess the Elombe ("Champion") standard operating procedure (SOP), implemented by providers and Mentor Mothers, on HIV-positive pregnant women's retention between first and second antenatal visits. Sixteen facilities in Kinshasa were randomly assigned to intervention (SOP) or comparison (no SOP). Effect of the SOP was estimated using relative risk. Women in comparison facilities were more likely to miss second visits (RR 2.5, 95% CI 1.05-5.98) than women in intervention facilities (30.0%, n = 27 vs. 12.0%, n = 9, p < 0.002). Findings demonstrate that a simple intervention can reduce critical early loss to care in PMTCT programs providing universal, lifelong treatment.

  8. Advanced Space Surface Systems Operations

    NASA Technical Reports Server (NTRS)

    Huffaker, Zachary Lynn; Mueller, Robert P.

    2014-01-01

    The importance of advanced surface systems is becoming increasingly relevant in the modern age of space technology. Specifically, projects pursued by the Granular Mechanics and Regolith Operations (GMRO) Lab are unparalleled in the field of planetary resourcefulness. This internship opportunity involved projects that support properly utilizing natural resources from other celestial bodies. Beginning with the tele-robotic workstation, mechanical upgrades were necessary to consider for specific portions of the workstation consoles and successfully designed in concept. This would provide more means for innovation and creativity concerning advanced robotic operations. Project RASSOR is a regolith excavator robot whose primary objective is to mine, store, and dump regolith efficiently on other planetary surfaces. Mechanical adjustments were made to improve this robot's functionality, although there were some minor system changes left to perform before the opportunity ended. On the topic of excavator robots, the notes taken by the GMRO staff during the 2013 and 2014 Robotic Mining Competitions were effectively organized and analyzed for logistical purposes. Lessons learned from these annual competitions at Kennedy Space Center are greatly influential to the GMRO engineers and roboticists. Another project that GMRO staff support is Project Morpheus. Support for this project included successfully producing mathematical models of the eroded landing pad surface for the vertical testbed vehicle to predict a timeline for pad reparation. And finally, the last project this opportunity made contribution to was Project Neo, a project exterior to GMRO Lab projects, which focuses on rocket propulsion systems. Additions were successfully installed to the support structure of an original vertical testbed rocket engine, thus making progress towards futuristic test firings in which data will be analyzed by students affiliated with Rocket University. Each project will be explained in

  9. The Complete Reconfiguration of Dendritic Gold

    NASA Astrophysics Data System (ADS)

    Paneru, Govind; Flanders, Bret

    2014-03-01

    Reconfigurability-by-design is an important strategy in modern materials science, as materials with this capability could potentially be used to confer hydrophobic, lipophobic, or anti-corrosive character to substrates in a regenerative manner. The present work extends the directed electrochemical nanowire assembly (DENA) methodology, which is a technique that employs alternating voltages to grow single crystalline metallic nanowires and nano-dendrites from simple salt solutions, to enable the complete dissolution of macroscopic arrays of metallic dendrites following their growth. Our main finding is that structural reconfiguration of dendritic gold is induced by changes in the MHz-level frequencies of voltages that are applied to the dendrites. Cyclic voltammetry and micro-Raman spectroscopy have been used to show that dendritic gold grows and dissolves by the same chemical mechanisms as bulk gold. Hence, the redox chemistry that occurs at the crystal-solution interface is no different than the established electrochemistry of gold. What differs in this process and allows for reconfiguration to occur is the diffusive behavior of the gold chloride molecules in the solution adjacent to the interface. We will present a simple model that captures the physics of this behavior.

  10. High power laser workover and completion tools and systems

    DOEpatents

    Zediker, Mark S; Rinzler, Charles C; Faircloth, Brian O; Koblick, Yeshaya; Moxley, Joel F

    2014-10-28

    Workover and completion systems, devices and methods for utilizing 10 kW or more laser energy transmitted deep into the earth with the suppression of associated nonlinear phenomena. Systems and devices for the laser workover and completion of a borehole in the earth. These systems and devices can deliver high power laser energy down a deep borehole, while maintaining the high power to perform laser workover and completion operations in such boreholes deep within the earth.

  11. 30 CFR 250.1622 - Approvals and reporting of well-completion and well-workover operations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... results of any well tests, shall be submitted to the District Manager. (2) Within 30 days after completing... District Manager and shall include the results of any well tests and a new schematic of the well if any... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Approvals and reporting of well-completion and...

  12. Simple Kidney Cysts

    MedlinePlus

    ... Solitary Kidney Your Kidneys & How They Work Simple Kidney Cysts What are simple kidney cysts? Simple kidney cysts are abnormal, fluid-filled ... that form in the kidneys. What are the kidneys and what do they do? The kidneys are ...

  13. Simple and powerful visual stimulus generator.

    PubMed

    Kremlácek, J; Kuba, M; Kubová, Z; Vít, F

    1999-02-01

    We describe a cheap, simple, portable and efficient approach to visual stimulation for neurophysiology which does not need any special hardware equipment. The method based on an animation technique uses the FLI autodesk animator format. This form of the animation is replayed by a special program ('player') providing synchronisation pulses toward recording system via parallel port. The 'player is running on an IBM compatible personal computer under MS-DOS operation system and stimulus is displayed on a VGA computer monitor. Various stimuli created with this technique for visual evoked potentials (VEPs) are presented.

  14. CTEPP STANDARD OPERATING PROCEDURE FOR PROCESSING COMPLETED DATA FORMS (SOP-4.10)

    EPA Science Inventory

    This SOP describes the methods for processing completed data forms. Key components of the SOP include (1) field editing, (2) data form Chain-of-Custody, (3) data processing verification, (4) coding, (5) data entry, (6) programming checks, (7) preparation of data dictionaries, cod...

  15. Tele-health-care in the elderly living in nursing home: the first Sicilian multimodal approach.

    PubMed

    De Luca, Rosaria; Bramanti, Alessia; De Cola, Maria Cristina; Trifiletti, Antonino; Tomasello, Provvidenza; Torrisi, Michele; Reitano, Simone; Leo, Antonino; Bramanti, Placido; Calabrò, Rocco Salvatore

    2016-08-01

    The continued aging of the population is affecting the health of the industrialized countries, with an increasing burden for the healthcare system. Thus, during the last decade, we assisted to relevant progress in the medical treatment and rehabilitation techniques and devices, including the development of telemedicine for geriatric care. To demonstrate the effectiveness of a novel tele-health-care model allowing a better management of elderly living in nursing homes. Fifty-nine elderly patients (19 males and 40 females; mean age 79.1 (±9.2), were randomly divided into two groups: the experimental group that performed a proper telemonitoring with a multimodal approach (including monitoring of the vital signs and neurological/psychological counseling), and the control group, which underwent standard in-home nursing care. Neurobehavioral symptoms and quality of life were assessed in both the groups at baseline, and after the telecare protocol's end. The experimental group had a statistically significant reduction in Geriatric Depression Scale (p < 0.01) and Brief Psychiatric Rating Scale (p < 0.05) scores, and an improvement in their quality of life. Moreover, mean blood pressure and heart rate were lower in the experimental than in the control group (p < 0.05), and admission to health care services was higher in the control than in the experimental group (p < 0.05). Telemedicine can be considered as an important tool in improving health and quality of life in the elderly living in nursing homes, and potentially reducing healthcare service access, hospitalization, and costs.

  16. A complete active space valence bond method with nonorthogonal orbitals

    NASA Astrophysics Data System (ADS)

    Hirao, Kimihiko; Nakano, Haruyuki; Nakayama, Kenichi

    1997-12-01

    A complete active space self-consistent field (SCF) wave function is transformed into a valence bond type representation built from nonorthogonal orbitals, each strongly localized on a single atom. Nonorthogonal complete active space SCF orbitals are constructed by Ruedenberg's projected localization procedure so that they have maximal overlaps with the corresponding minimum basis set of atomic orbitals of the free-atoms. The valence bond structures which are composed of such nonorthogonal quasiatomic orbitals constitute the wave function closest to the concept of the oldest and most simple valence bond method. The method is applied to benzene, butadiene, hydrogen, and methane molecules and compared to the previously proposed complete active space valence bond approach with orthogonal orbitals. The results demonstrate the validity of the method as a powerful tool for describing the electronic structure of various molecules.

  17. Design and development of a tele-healthcare information system based on web services and HL7 standards.

    PubMed

    Huang, Ean-Wen; Hung, Rui-Suan; Chiou, Shwu-Fen; Liu, Fei-Ying; Liou, Der-Ming

    2011-01-01

    Information and communication technologies progress rapidly and many novel applications have been developed in many domains of human life. In recent years, the demand for healthcare services has been growing because of the increase in the elderly population. Consequently, a number of healthcare institutions have focused on creating technologies to reduce extraneous work and improve the quality of service. In this study, an information platform for tele- healthcare services was implemented. The architecture of the platform included a web-based application server and client system. The client system was able to retrieve the blood pressure and glucose levels of a patient stored in measurement instruments through Bluetooth wireless transmission. The web application server assisted the staffs and clients in analyzing the health conditions of patients. In addition, the server provided face-to-face communications and instructions through remote video devices. The platform deployed a service-oriented architecture, which consisted of HL7 standard messages and web service components. The platform could transfer health records into HL7 standard clinical document architecture for data exchange with other organizations. The prototyping system was pretested and evaluated in a homecare department of hospital and a community management center for chronic disease monitoring. Based on the results of this study, this system is expected to improve the quality of healthcare services.

  18. Complete liquefaction methods and apparatus

    DOEpatents

    Turner, Terry D.; Wilding, Bruce M.

    2013-10-15

    A method and apparatus are described to provide complete gas utilization in the liquefaction operation from a source of gas without return of natural gas to the source thereof from the process and apparatus. The mass flow rate of gas input into the system and apparatus may be substantially equal to the mass flow rate of liquefied product output from the system, such as for storage or use.

  19. Application of Robotics in Decommissioning and Decontamination - 12536

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

    Banford, Anthony; Kuo, Jeffrey A.; Bowen, R.A.

    Decommissioning and dismantling of nuclear facilities is a significant challenge worldwide and one which is growing in size as more plants reach the end of their operational lives. The strategy chosen for individual projects varies from the hands-on approach with significant manual intervention using traditional demolition equipment at one extreme to bespoke highly engineered robotic solutions at the other. The degree of manual intervention is limited by the hazards and risks involved, and in some plants are unacceptable. Robotic remote engineering is often viewed as more expensive and less reliable than manual approaches, with significant lead times and capital expenditure.more » However, advances in robotics and automation in other industries offer potential benefits for future decommissioning activities, with the high probability of reducing worker exposure and other safety risks as well as reducing the schedule and costs required to complete these activities. Some nuclear decommissioning tasks and facility environments are so hazardous that they can only be accomplished by exclusive use of robotic and remote intervention. Less hazardous tasks can be accomplished by manual intervention and the use of PPE. However, PPE greatly decreases worker productivity and still exposes the worker to both risk and dose making remote operation preferable to achieve ALARP. Before remote operations can be widely accepted and deployed, there are some economic and technological challenges that must be addressed. These challenges will require long term investment commitments in order for technology to be: - Specifically developed for nuclear applications; - At a sufficient TRL for practical deployment; - Readily available as a COTS. Tremendous opportunities exist to reduce cost and schedule and improve safety in D and D activities through the use of robotic and/or tele-operated systems. - Increasing the level of remote intervention reduces the risk and dose to an operator. Better

  20. Fast Fuzzy Arithmetic Operations

    NASA Technical Reports Server (NTRS)

    Hampton, Michael; Kosheleva, Olga

    1997-01-01

    In engineering applications of fuzzy logic, the main goal is not to simulate the way the experts really think, but to come up with a good engineering solution that would (ideally) be better than the expert's control, In such applications, it makes perfect sense to restrict ourselves to simplified approximate expressions for membership functions. If we need to perform arithmetic operations with the resulting fuzzy numbers, then we can use simple and fast algorithms that are known for operations with simple membership functions. In other applications, especially the ones that are related to humanities, simulating experts is one of the main goals. In such applications, we must use membership functions that capture every nuance of the expert's opinion; these functions are therefore complicated, and fuzzy arithmetic operations with the corresponding fuzzy numbers become a computational problem. In this paper, we design a new algorithm for performing such operations. This algorithm is applicable in the case when negative logarithms - log(u(x)) of membership functions u(x) are convex, and reduces computation time from O(n(exp 2))to O(n log(n)) (where n is the number of points x at which we know the membership functions u(x)).

  1. Figuring the Acceleration of the Simple Pendulum

    NASA Astrophysics Data System (ADS)

    Lieberherr, Martin

    2011-12-01

    The centripetal acceleration has been known since Huygens' (1659) and Newton's (1684) time.1,2 The physics to calculate the acceleration of a simple pendulum has been around for more than 300 years, and a fairly complete treatise has been given by C. Schwarz in this journal.3 But sentences like "the acceleration is always directed towards the equilibrium position" beside the picture of a swing on a circular arc can still be found in textbooks, as e.g. in Ref. 4. Vectors have been invented by Grassmann (1844)5 and are conveniently used to describe the acceleration in curved orbits, but acceleration is more often treated as a scalar with or without sign, as the words acceleration/deceleration suggest. The component tangential to the orbit is enough to deduce the period of the simple pendulum, but it is not enough to discuss the forces on the pendulum, as has been pointed out by Santos-Benito and A. Gras-Marti.6 A suitable way to address this problem is a nice figure with a catch for classroom discussions or homework. When I plotted the acceleration vectors of the simple pendulum in their proper positions, pictures as in Fig. 1 appeared on the screen. The endpoints of the acceleration vectors, if properly scaled, seemed to lie on a curve with a familiar shape: a cardioid. Is this true or just an illusion?

  2. Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment.

    PubMed

    Ren, Wenbiao; Xue, Bichen; Qu, Jiandong; Liu, Longfei; Li, Chao; Zu, Xiongbing

    2018-04-30

    To evaluate the preoperative imaging manifestation and therapeutic effect of laparoscopic simple enucleation (SE) for localized chromophobe renal cell carcinoma (chRCC). Clinical data of 36 patients who underwent laparoscopic SE of localized chRCC at our institute were retrospectively analyzed. All patients underwent preoperative renal protocol CT (unenhanced, arterial, venous, and delayed images). CT scan characteristics were evaluated. After intraoperative occlusion of the renal artery, the tumor was free bluntly along the pseudocapsule and enucleated totally. The patients were followed up regularly after the operation. Mean tumor diameter was 3.9±1.0 cm, 80% of tumors were homogeneous and all the tumors had complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and degree of enhancement of the tumors were significantly lower than normal renal cortex. Mean operation time was 104.3±18.2 min. Mean warm ischemia time (WIT) was 21.3±3.5 min. Mean blood loss was 78.6±25.4 mL. No positive surgical margin was identified. Mean postoperative hospital stay was 5.3±1.5 d. Hematuria occurred in 3 patients and all disappeared within 3 days. After a mean follow-up of 32.1±20.6 months, no patient had local recurrence or metastatic progression. Localized chRCCs have a great propensity for homogeneity and complete pseudocapsule. The attenuation values were slightly lower than normal renal cortex and small degree of enhancement. Laparoscopic SE is a safe and effective treatment for localized chRCC. The oncological results were satisfactory. Copyright® by the International Brazilian Journal of Urology.

  3. Simple projects guidebook : federal-aid procedure for simple projects

    DOT National Transportation Integrated Search

    2002-06-01

    Experience has shown that a simple project generally 1) does not have any right-of-way involvement and 2) has a Programmatic Categorical Exclusion or Categorical Exclusion environmental determination. Page 7 outlines the definition of simple projects...

  4. Cut and join operator ring in tensor models

    NASA Astrophysics Data System (ADS)

    Itoyama, H.; Mironov, A.; Morozov, A.

    2018-07-01

    Recent advancement of rainbow tensor models based on their superintegrability (manifesting itself as the existence of an explicit expression for a generic Gaussian correlator) has allowed us to bypass the long-standing problem seen as the lack of eigenvalue/determinant representation needed to establish the KP/Toda integrability. As the mandatory next step, we discuss in this paper how to provide an adequate designation to each of the connected gauge-invariant operators that form a double coset, which is required to cleverly formulate a tree-algebra generalization of the Virasoro constraints. This problem goes beyond the enumeration problem per se tied to the permutation group, forcing us to introduce a few gauge fixing procedures to the coset. We point out that the permutation-based labeling, which has proven to be relevant for the Gaussian averages is, via interesting complexity, related to the one based on the keystone trees, whose algebra will provide the tensor counterpart of the Virasoro algebra for matrix models. Moreover, our simple analysis reveals the existence of nontrivial kernels and co-kernels for the cut operation and for the join operation respectively that prevent a straightforward construction of the non-perturbative RG-complete partition function and the identification of truly independent time variables. We demonstrate these problems by the simplest non-trivial Aristotelian RGB model with one complex rank-3 tensor, studying its ring of gauge-invariant operators, generated by the keystone triple with the help of four operations: addition, multiplication, cut and join.

  5. Miniature Intermittent Contact Switch

    NASA Technical Reports Server (NTRS)

    Sword, Antony

    1972-01-01

    This tech brief concerns work to provide a shock-resistant switch capable of being actuated by forces of varying magnitude and direction, primarily for use as a sensor on remote control (tele-operator) and prosthetic devices.

  6. Interprovincial has completed the 540-mile Norman Wells line

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

    Rowland, L.O.

    Interprovinial Pipe Line Ltd., has completed and is now operating the 540-mi., 12-in. crude trunkline from Norman Wells, Northwest Territories, to Zama, Alberta. This is the largest and the only significant pipe line to be built north of the provincial boundaries. Construction was completed a month ahead of schedule and was comfortably under budget, through two winter seasons.

  7. Evaluation of maternal and neonatal hospital care: quality index of completeness

    PubMed Central

    da Silva, Ana Lúcia Andrade; Mendes, Antonio da Cruz Gouveia; Miranda, Gabriella Morais Duarte; de Sá, Domicio Aurélio; de Souza, Wayner Vieira; Lyra, Tereza Maciel

    2014-01-01

    OBJECTIVE Develop an index to evaluate the maternal and neonatal hospital care of the Brazilian Unified Health System. METHODS This descriptive cross-sectional study of national scope was based on the structure-process-outcome framework proposed by Donabedian and on comprehensive health care. Data from the Hospital Information System and the National Registry of Health Establishments were used. The maternal and neonatal network of Brazilian Unified Health System consisted of 3,400 hospitals that performed at least 12 deliveries in 2009 or whose number of deliveries represented 10.0% or more of the total admissions in 2009. Relevance and reliability were defined as criteria for the selection of variables. Simple and composite indicators and the index of completeness were constructed and evaluated, and the distribution of maternal and neonatal hospital care was assessed in different regions of the country. RESULTS A total of 40 variables were selected, from which 27 single indicators, five composite indicators, and the index of completeness of care were built. Composite indicators were constructed by grouping simple indicators and included the following variables: hospital size, level of complexity, delivery care practice, recommended hospital practice, and epidemiological practice. The index of completeness of care grouped the five variables and classified them in ascending order, thereby yielding five levels of completeness of maternal and neonatal hospital care: very low, low, intermediate, high, and very high. The hospital network was predominantly of small size and low complexity, with inadequate child delivery care and poor development of recommended and epidemiological practices. The index showed that more than 80.0% hospitals had a low index of completeness of care and that most qualified heath care services were concentrated in the more developed regions of the country. CONCLUSIONS The index of completeness proved to be of great value for monitoring the

  8. Can we estimate the cellular phone RF peak output power with a simple experiment?

    NASA Astrophysics Data System (ADS)

    Fioreze, Maycon; dos Santos Junior, Sauli; Goncalves Hönnicke, Marcelo

    2016-07-01

    Cellular phones are becoming increasingly useful tools for students. Since cell phones operate in the microwave bandwidth, they can be used to motivate students to demonstrate and better understand the properties of electromagnetic waves. However, since these waves operate at higher frequencies (L-band, from 800 MHz to 2 GHz) it is not simple to detect them. Usually, expensive real-time high frequency oscilloscopes are required. Indirect measurements are also possible through heat-based and diode-detector-based radio-frequency (RF) power sensors. Another didactic and intuitive way is to explore a simple and inexpensive detection system, based on the interference effect caused in the electronic circuit of TV and PC soundspeakers, and to try to investigate different properties of the cell phones’ RF electromagnetic waves, such as its power and modulated frequency. This manuscript proposes a trial to quantify these measurements, based on a simple Friis equation model and the time constant of the circuit used in the detection system, in order to show it didactically to the students and even allow them also to explore such a simple detection system at home.

  9. Telemedicine Enables Broader Access to Movement Disorders Curricula for Medical Students.

    PubMed

    Cubo, Esther; Doumbe, Jacques; López, Emiliano; Lopez, Guadalupe A; Gatto, Emilia; Persi, Gabriel; Guttman, Mark

    2017-01-01

    The impact of tele-education for movement disorders on medical students is unknown. The present study had three objectives. First, to create a tele-education program for medical students in regions with limited access to movement disorders curricula. Second, to analyze the feasibility, satisfaction, and improvement of medical knowledge. Third, to assess the main reasons of medical students for attending this course. In 2016, a program was piloted in a low-middle income (Cameroon) and a middle-high income (Argentina) country. Medical students were offered a free movement disorder tele-education program (four medical schools in Argentina, and 1 medical school in Cameroon). Six real-time videoconferences covering hyperkinetic and hypokinetic movement disorders were included. Evaluations included attendance, pre- and post-medical knowledge, and satisfaction questionnaires. The study included 151 undergraduate medical students (79.4% from Argentina, 20.6% from Cameroon). Feasibility was acceptable with 100% and 85.7% of the videoconferences completed in Argentina and Cameroon, respectively. Attendance was higher in Argentina compared to Cameroon (75% vs. 33.1%). According to student reports, the topics and innovative educational environment were the main reasons for attendance. Both groups ranked satisfaction as moderate to high, and medical knowledge improved similarly in both countries. Tele-education can improve movement disorders knowledge in medical schools in high-middle and low-middle income countries lacking access to other educational opportunities.

  10. Warehousing Operations.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    Developed as part of the Marine Corps Institute (MCI) correspondence training program, this course on warehousing operations is designed to provide instruction in the procedures used in warehousing operations. Introductory materials include specific information for MCI students and a study guide (guidelines to complete the course). The 22-hour…

  11. A simple technique for correction of relapsed overjet.

    PubMed

    Kakkirala, Neelima; Saxena, Ruchi

    2014-01-01

    Class III malocclusions are usually growth related discrepancies, which often become more severe when growth is completed Orthognathic surgery can be a part of the treatment plan, although a good number of cases can be treated non-surgically by camouflage treatment. The purpose of this report is to review the relapse tendency in patients treated non-surgically. A simple technique is described to combat one such post-treatment relapse condition in an adult patient who had undergone orthodontic treatment by extraction of a single lower incisor.

  12. Pre-service Elementary School Teachers' Ability to Account for the Operation of Simple Physical Systems Using the Energy Conservation Law

    NASA Astrophysics Data System (ADS)

    Papadouris, Nicos; Hadjigeorgiou, Angela; Constantinou, Constantinos P.

    2014-12-01

    Energy is recognized as a core idea in science and, hence, a significant learning objective of science education. The effective promotion of this learning objective posits that teachers themselves possess sound conceptual understanding. This is needed for enabling them to organize effective learning environments for their students. In this study, we report on the results of an empirical investigation of teachers' understanding of energy. In particular, the focus is placed on pre-service teachers' ability to employ energy as a framework for analyzing the operation of physical systems. We have collected data from 198 pre-service teachers through three open-ended tasks that involved the application of the energy conservation principle to simple physical systems. The results corroborate the claim made in the literature that teachers typically do not possess functional, coherent understanding of this principle. Most importantly, the data serve to identify and document specific difficulties that hamper attempts to use energy for the analysis of the operation of physical systems. The difficulties we were able to document lend support to the idea that it is important to introduce the idea of energy degradation alongside the conservation of energy principle. The findings of this study have implications for the design of preparation programs for teachers, about energy. The findings also provide insights into the limitations of conventional teaching of energy, to which the participants had been exposed as students, in fostering coherent understanding of energy conservation.

  13. Determining collective barrier operation skew in a parallel computer

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

    Faraj, Daniel A.

    2015-11-24

    Determining collective barrier operation skew in a parallel computer that includes a number of compute nodes organized into an operational group includes: for each of the nodes until each node has been selected as a delayed node: selecting one of the nodes as a delayed node; entering, by each node other than the delayed node, a collective barrier operation; entering, after a delay by the delayed node, the collective barrier operation; receiving an exit signal from a root of the collective barrier operation; and measuring, for the delayed node, a barrier completion time. The barrier operation skew is calculated by:more » identifying, from the compute nodes' barrier completion times, a maximum barrier completion time and a minimum barrier completion time and calculating the barrier operation skew as the difference of the maximum and the minimum barrier completion time.« less

  14. Determining collective barrier operation skew in a parallel computer

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

    Faraj, Daniel A.

    Determining collective barrier operation skew in a parallel computer that includes a number of compute nodes organized into an operational group includes: for each of the nodes until each node has been selected as a delayed node: selecting one of the nodes as a delayed node; entering, by each node other than the delayed node, a collective barrier operation; entering, after a delay by the delayed node, the collective barrier operation; receiving an exit signal from a root of the collective barrier operation; and measuring, for the delayed node, a barrier completion time. The barrier operation skew is calculated by:more » identifying, from the compute nodes' barrier completion times, a maximum barrier completion time and a minimum barrier completion time and calculating the barrier operation skew as the difference of the maximum and the minimum barrier completion time.« less

  15. Urban Scaling in Europe

    DTIC Science & Technology

    2016-03-16

    European city has experienced periods of profound crisis alternating with booming development and has seen enormous demographic, economic, political...simplest model of network effects, proposed for a simple all-to-all tele- communications network, a city is characterized by more limited increases in...Urban characteristics attributable to density-driven tie formation. Nat. Commun . 4, 1961. (doi:10.1038/ncomms2961) 29. Sim A, Yaliraki SN, Barahona M

  16. Experiences with the JPL telerobot testbed: Issues and insights

    NASA Technical Reports Server (NTRS)

    Stone, Henry W.; Balaram, Bob; Beahan, John

    1989-01-01

    The Jet Propulsion Laboratory's (JPL) Telerobot Testbed is an integrated robotic testbed used to develop, implement, and evaluate the performance of advanced concepts in autonomous, tele-autonomous, and tele-operated control of robotic manipulators. Using the Telerobot Testbed, researchers demonstrated several of the capabilities and technological advances in the control and integration of robotic systems which have been under development at JPL for several years. In particular, the Telerobot Testbed was recently employed to perform a near completely automated, end-to-end, satellite grapple and repair sequence. The task of integrating existing as well as new concepts in robot control into the Telerobot Testbed has been a very difficult and timely one. Now that researchers have completed the first major milestone (i.e., the end-to-end demonstration) it is important to reflect back upon experiences and to collect the knowledge that has been gained so that improvements can be made to the existing system. It is also believed that the experiences are of value to the others in the robotics community. Therefore, the primary objective here will be to use the Telerobot Testbed as a case study to identify real problems and technological gaps which exist in the areas of robotics and in particular systems integration. Such problems have surely hindered the development of what could be reasonably called an intelligent robot. In addition to identifying such problems, researchers briefly discuss what approaches have been taken to resolve them or, in several cases, to circumvent them until better approaches can be developed.

  17. 43 CFR 3252.14 - How must I complete a temperature gradient well?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false How must I complete a temperature gradient... LEASING Conducting Exploration Operations § 3252.14 How must I complete a temperature gradient well? Complete temperature gradient wells to allow for proper abandonment, and to prevent interzonal migration of...

  18. 43 CFR 3252.14 - How must I complete a temperature gradient well?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false How must I complete a temperature gradient... LEASING Conducting Exploration Operations § 3252.14 How must I complete a temperature gradient well? Complete temperature gradient wells to allow for proper abandonment, and to prevent interzonal migration of...

  19. 43 CFR 3252.14 - How must I complete a temperature gradient well?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false How must I complete a temperature gradient... LEASING Conducting Exploration Operations § 3252.14 How must I complete a temperature gradient well? Complete temperature gradient wells to allow for proper abandonment, and to prevent interzonal migration of...

  20. 43 CFR 3252.14 - How must I complete a temperature gradient well?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false How must I complete a temperature gradient... LEASING Conducting Exploration Operations § 3252.14 How must I complete a temperature gradient well? Complete temperature gradient wells to allow for proper abandonment, and to prevent interzonal migration of...