Conducting Child Assessments. Technical Report.
ERIC Educational Resources Information Center
McLean, Mary
This report discusses assessment procedures for young children who are culturally and linguistically diverse and describes three practices that the authors feel should be added to the currently recommended DEC practices. In the first place, professionals should gather information prior to assessment to determine whether a child should be referred…
Standardized Evaluation for Multi-National Development Programs.
ERIC Educational Resources Information Center
Farrell, W. Timothy
This paper takes the position that standardized evaluation formats and procedures for multi-national development programs are not only desirable but possible in diverse settings. The key is the localization of standard systems, which involves not only the technical manipulation of items and scales, but also the contextual interpretation of…
SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS
GEBELLI, Jordi Pujol; de GORDEJUELA, Amador Garcia Ruiz; RAMOS, Almino Cardoso; NORA, Mario; PEREIRA, Ana Marta; CAMPOS, Josemberg Marins; RAMOS, Manoela Galvão; BASTOS, Eduardo Lemos de Souza; MARCHESINI, João Batista
2016-01-01
ABSTRACT Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. Aim: To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Methods: Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. Results: A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). Conclusions: SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. PMID:27683784
Rehman, Jamil; Sangalli, Mattia N; Guru, Khurshid; de Naeyer, Geert; Schatteman, Peter; Carpentier, Paul; Mottrie, Alexander
2011-02-01
Several recent preliminary reports have demonstrated that Robot-Assisted Cystectomy with total intracorporeal Ileal Conduit (RACIC) is a feasible option over the open technique. We report our stepwise surgical procedure of robotic total intracorporeal ileal conduit urinary diversion, technical consideration, development, refinements and initial experience. Only the ileal conduit urinary diversion is described with no emphasis on the cystectomy's steps. Between February 2008 and September 2009, nine patients underwent RACIC for muscle invasive transitional cell carcinoma (TCC). The entire procedure, including radical cystoprostatectomy, extended pelvic node dissection (ePLND), ileal conduit urinary diversion (Bricker) including isolation of the ileal loop (20 cm ileal segment) 15 cm away from the ileocecal junction, restoration of bowel continuity with stapled side-to-side ileo-ileal anastomosis, retroperitoneal transfer of the left ureter to the right side, and bilateral stented (8 F feeding tube) ileo-ureteral anastomoses in a Wallace faction were all performed exclusively intracorporeally using the da Vinci Si surgical robot and finally the conduit stoma was fashioned. The RACIC was technically successful in all nine patients (three females and six males. Mean age 74.1; 57 to 87) without open conversion. The mean operative time including extended pelvic lymphadenectomy and urinary diversion was 346.2 minutes (210 to 480). Mean operative time of diversion is 72 minutes (52-113) mean estimated blood loss 258 mL (200 to 500) and the median hospital stay were 14 days (10 to 27). In all three female patients, the specimen was extracted through the vagina. There were no intraoperative complications and only one major postoperative complication: one postoperative iatrogenous necrosis of the ileal conduit caused by uncareful retraction of the organ bag and thereby probably injuring the conduit pedicle, as the ileal conduit was well vascularised at the end of the operation, requiring an open revision (in male patient extracted through the suprapubic incision). A clear liquid diet was started on the third postoperative day. All patients returned to normal activity within 2 weeks (from date of surgery). Postoperative renal function was normal with mean postoperative creatine 0.99 mg/dL) and excretory urography revealed unobstructed upper tracts in all cases. Robot-assisted radical cystoprostatectomy with intracorporeal ileal conduit urinary diversion for the treatment of high risk or invasive bladder cancer with urinary diversion is technically feasible. The robotic system aids in performing a meticulous dissection and all operative steps of the open procedure are replicated precisely while adhering to the sound oncologic principles of traditional radical cystectomy. Robotics brings an unprecedented control of surgical instruments, shorten the learning curve, and allow open surgeons to apply more easily their technical skill in a minimal invasive fashion. Robotic cystectomy with total intracorporeal ileal conduit urinary diversion offers operative and perioperative benefits and functional outcome. In our hands results comparable to open experience with further reduced perioperative morbidity, early recovery, resumption of normal activities, excellent cosmesis and increased quality of life (QOL). In addition, minimal blood loss, fluid shifts, and electrolyte loss considerably reduce systemic and cardiovascular stress in these older groups of patients.
Annotated bibliography of structural equation modelling: technical work.
Austin, J T; Wolfle, L M
1991-05-01
Researchers must be familiar with a variety of source literature to facilitate the informed use of structural equation modelling. Knowledge can be acquired through the study of an expanding literature found in a diverse set of publishing forums. We propose that structural equation modelling publications can be roughly classified into two groups: (a) technical and (b) substantive applications. Technical materials focus on the procedures rather than substantive conclusions derived from applications. The focus of this article is the former category; included are foundational/major contributions, minor contributions, critical and evaluative reviews, integrations, simulations and computer applications, precursor and historical material, and pedagogical textbooks. After a brief introduction, we annotate 294 articles in the technical category dating back to Sewall Wright (1921).
Pron, Gaylene; Bennett, John; Common, Andrew; Sniderman, Kenneth; Asch, Murray; Bell, Stuart; Kozak, Roman; Vanderburgh, Leslie; Garvin, Greg; Simons, Martin; Tran, Cuong; Kachura, John
2003-05-01
To document the technical results and spectrum of practice of uterine artery embolization (UAE) for fibroids in the health care setting in Canada. The effects of interventional radiologist's (IR's) experience with UAE on procedure and fluoroscopy time were also investigated. The study involved a multicenter prospective single-arm clinical treatment trial and included the practices of 11 IRs at eight university-affiliated teaching and community hospitals. Vascular access with percutaneous femoral artery approach was followed by transcatheter delivery of polyvinyl alcohol (PVA) particles into uterine arteries with fluoroscopic guidance. Technical success, complications, procedural time, fluoroscopy time, and effects of operator experience were outcomes analyzed. Between November 1998 and November 2000, 570 embolization procedures were performed in 555 patients. UAE was bilaterally successful in 97% (95% CI: 95%-98%). Variant anatomy was the most common reason for failure to embolize bilaterally. The procedural complication rate was 5.3% (95% CI: 3.6%-7.4%). Of the 30 events, three involved major complications (one seizure and two allergic reactions) that resulted in additional care or extended hospital stay. Procedure time and fluoroscopy time averaged 61 minutes (95% CI; 58-63 minutes) and 18.9 minutes (95% CI; 18-19.8) and varied significantly among IRs (P <.001; P <.001). The average 27% reduction in procedure time (20 minutes; P <.001) and 24% reduction in fluoroscopy time (5.1 minutes; P <.001) with increasing UAE experience were significant. A high level of technical success with few complications was obtained with a variety of operators in diverse practice settings. Increased experience in UAE significantly reduced procedure and fluoroscopy time.
47 CFR 73.7003 - Point system selection procedures.
Code of Federal Regulations, 2010 CFR
2010-10-01
... stations. (3) State-wide network. Two points for an applicant that does not qualify for the credit for... the diversity credit and the state-wide network credit in any particular application. (4) Technical... following: (1) If the applicant is in a group for which a “B” cut-off notice issued prior to April 21, 2000...
Transforming Glycoscience: A Roadmap for the Future
Robert Moon
2012-01-01
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures approved by the National Research Councilâs Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making the published report as sound...
Barrett's esophagus: endoscopic treatments II
Greenwald, Bruce D.; Lightdale, Charles J.; Abrams, Julian A.; Horwhat, John D.; Chuttani, Ram; Komanduri, Srinadh; Upton, Melissa P.; Appelman, Henry D.; Shields, Helen M.; Shaheen, Nicholas J.; Sontag, Stephen J.
2013-01-01
The following on endoscopic treatments of Barrett's esophagus includes commentaries on animal experiments on cryotherapy; indications for cryotherapy, choice of dosimetry, number of sessions, and role in Barrett's esophagus and adenocarcinoma; recent technical developments of RFA technology and long-term effects; the comparative effects of diverse ablation procedures and the rate of recurrence following treatment; and the indications for treatment of dysplasia and the role of radiofrequency ablation. PMID:21950812
[Laparoscopic radical cystectomy with enteric urinary diversion. Alternative to open cystectomy?].
Lucan, M; Iacob, G; Lucan, V; Măgurean, O; Elec, F; Burghelea, C; Bărbos, A
2005-01-01
Radical cystectomy is the standard therapy for invasive bladder cancer, with best oncological results compared to any other therapeutic alternative. Even if laparoscopic radical cystectomy (LRC) is a well established surgical procedure, performing the urinary diversion completely intracorporeal, is still a challenge due to technical difficulties and associated complications. The aim of our study is to present the first series of LRC with ureterosigmoidostomy. Since May 2004 were performed 7 LRC (5 males and 2 females) (Gr. A). All cases were T2N0 clinical stage. These patients were compared with a retrospective group of 50 patients who underwent open procedure (Gr. B) in term of: operative time, blood loss, analgesic requirements, and hospital stay. LRC has a longer operative time but with statistically significant lower blood loss, less analgesia, and shorter hospital stay. The resection margins of the surgical specimens were tumor free at pathologic examination. Long-term follow-up is pending. On short-term, the results of laparoscopic radical cystectomy are encouraging. When significant experience in laparoscopic surgery is lacking, surgeons should exercise caution with completely intracorporeal urinary diversion.
Olson, Louise; Satherley, Hywel; Cleaveland, Paul; Zelhof, Bachar; Mokete, Max; Neilson, Donald; Srirangam, Shalom
2017-09-01
Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-center experience in performing retrograde ureteroscopy to treat or diagnose UUT abnormalities in patients with ileal conduit incontinent diversion. We performed a retrospective analysis of medical records for all patients with previous urinary diversion who underwent retrograde ureteroscopic procedures via the ileal loop in our institutions over a 9 year period (between June 2007 and August 2016). Fifty-four procedures were performed in 36 patients. Mean age was 61 (28-90) years. Average time from diversion to ureteroscopic procedure was 13.0 (0.08-53) years. Stone disease was the most common indication for intervention in 35.2% (19/54) of cases, with a stone-free rate of 78.9% (15/19). Other indications included surveillance of transitional-cell carcinoma in 22.2% (12/54), diagnostic flexible ureteroscopy (fURS) in 20.4% (11/54), stricture management in 11.1% (6/54), removal of encrusted stent/nephrostomy in 7.4% (4/54), urine leak after diversion in 1.9% (1/54), and miscellaneous in 1.9% (1/54). Successful retrograde access was possible in 74% (40/54) of cases. A long and tortuous ileal segment, too difficult to negotiate, was the most common cause of failure to access the UUT. In 13 out of 54 (24.1%) cases, retrograde fURS was combined with simultaneous percutaneous antegrade access. Six patients (11.1%) developed postprocedural pyrexia requiring additional antibiotic therapy, and one (1.9%) patient required embolization of the renal artery for ongoing bleeding. Median length of stay was 1 day (0-55), with 13 (24%) being performed as day-case procedures. Retrograde ureteroscopy in patients with ileal conduits can be technically challenging due to distorted anatomy. This procedure can be safely performed in experienced hands with standard endourological equipment. An antegrade approach can be carried out simultaneously, which may be required in a small number of patients.
Auer, Lucas; Mariadassou, Mahendra; O'Donohue, Michael; Klopp, Christophe; Hernandez-Raquet, Guillermina
2017-11-01
Next-generation sequencing technologies give access to large sets of data, which are extremely useful in the study of microbial diversity based on 16S rRNA gene. However, the production of such large data sets is not only marred by technical biases and sequencing noise but also increases computation time and disc space use. To improve the accuracy of OTU predictions and overcome both computations, storage and noise issues, recent studies and tools suggested removing all single reads and low abundant OTUs, considering them as noise. Although the effect of applying an OTU abundance threshold on α- and β-diversity has been well documented, the consequences of removing single reads have been poorly studied. Here, we test the effect of singleton read filtering (SRF) on microbial community composition using in silico simulated data sets as well as sequencing data from synthetic and real communities displaying different levels of diversity and abundance profiles. Scalability to large data sets is also assessed using a complete MiSeq run. We show that SRF drastically reduces the chimera content and computational time, enabling the analysis of a complete MiSeq run in just a few minutes. Moreover, SRF accurately determines the actual community diversity: the differences in α- and β-community diversity obtained with SRF and standard procedures are much smaller than the intrinsic variability of technical and biological replicates. © 2017 John Wiley & Sons Ltd.
Diverse knowledges and competing interests: an essay on socio-technical problem-solving.
di Norcia, Vincent
2002-01-01
Solving complex socio-technical problems, this paper claims, involves diverse knowledges (cognitive diversity), competing interests (social diversity), and pragmatism. To explain this view, this paper first explores two different cases: Canadian pulp and paper mill pollution and siting nuclear reactors in systematically sensitive areas of California. Solving such socio-technically complex problems involves cognitive diversity as well as social diversity and pragmatism. Cognitive diversity requires one to not only recognize relevant knowledges but also to assess their validity. Finally, it is suggested, integrating the resultant set of diverse relevant and valid knowledges determines the parameters of the solution space for the problem.
Gülay, Arda; Smets, Barth F
2015-09-01
Exploring the variation in microbial community diversity between locations (β diversity) is a central topic in microbial ecology. Currently, there is no consensus on how to set the significance threshold for β diversity. Here, we describe and quantify the technical components of β diversity, including those associated with the process of subsampling. These components exist for any proposed β diversity measurement procedure. Further, we introduce a strategy to set significance thresholds for β diversity of any group of microbial samples using rarefaction, invoking the notion of a meta-community. The proposed technique was applied to several in silico generated operational taxonomic unit (OTU) libraries and experimental 16S rRNA pyrosequencing libraries. The latter represented microbial communities from different biological rapid sand filters at a full-scale waterworks. We observe that β diversity, after subsampling, is inflated by intra-sample differences; this inflation is avoided in the proposed method. In addition, microbial community evenness (Gini > 0.08) strongly affects all β diversity estimations due to bias associated with rarefaction. Where published methods to test β significance often fail, the proposed meta-community-based estimator is more successful at rejecting insignificant β diversity values. Applying our approach, we reveal the heterogeneous microbial structure of biological rapid sand filters both within and across filters. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.
Teegala, Ramesh
2016-01-01
Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle - Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique.
ERIC Educational Resources Information Center
Pugh, Debra; Hamstra, Stanley J.; Wood, Timothy J.; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges
2015-01-01
Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal…
Pugh, Debra; Hamstra, Stanley J; Wood, Timothy J; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges
2015-03-01
Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.
Technical Standards for Nursing Education Programs in the 21st Century.
Ailey, Sarah H; Marks, Beth
The Institute of Medicine (2000, 2002) exposed serious safety problems in the health system and called for total qualitative system change. The Institute of Medicine (2011, 2015) also calls for improving the education of nurses to provide leadership for a redesigned health system. Intertwined with improving education is the need to recruit and retain diverse highly qualified students. Disability is part of diversity inclusion, but current technical standards (nonacademic requirements) for admission to many nursing programs are a barrier to the entry of persons with disabilities. Rehabilitation nurse leaders are in a unique position to improve disability diversity in nursing. The purpose of this paper is to discuss the importance of disability diversity in nursing. The history of existing technical standards used in many nursing programs is reviewed along with examples. On the basis of the concept that disability inclusion is a part of diversity inclusion, we propose a new model of technical standards for nursing education. Rehabilitation nurse leaders can lead in eliminating barriers to persons with disabilities entering nursing.
Code of Federal Regulations, 2010 CFR
2010-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.5 Procedures. All determinations to disseminate or withhold technical data subject to this part shall be consistent both with the policies set forth in § 250.4 of this part, and with the following procedures: (a) Requests for technical data shall be...
Groundwater technical procedures of the U.S. Geological Survey
Cunningham, William L.; Schalk, Charles W.
2011-01-01
A series of groundwater technical procedures documents (GWPDs) has been released by the U.S. Geological Survey, Water-Resources Discipline, for general use by the public. These technical procedures were written in response to the need for standardized technical procedures of many aspects of groundwater science, including site and measuring-point establishment, measurement of water levels, and measurement of well discharge. The techniques are described in the GWPDs in concise language and are accompanied by necessary figures and tables derived from cited manuals, reports, and other documents. Because a goal of this series of procedures is to remain current with the state of the science, and because procedures change over time, this report is released in an online format only. As new procedures are developed and released, they will be linked to this document.
Decelle, Johan; Romac, Sarah; Sasaki, Eriko; Not, Fabrice; Mahé, Frédéric
2014-01-01
Metabarcoding is a powerful tool for exploring microbial diversity in the environment, but its accurate interpretation is impeded by diverse technical (e.g. PCR and sequencing errors) and biological biases (e.g. intra-individual polymorphism) that remain poorly understood. To help interpret environmental metabarcoding datasets, we investigated the intracellular diversity of the V4 and V9 regions of the 18S rRNA gene from Acantharia and Nassellaria (radiolarians) using 454 pyrosequencing. Individual cells of radiolarians were isolated, and PCRs were performed with generalist primers to amplify the V4 and V9 regions. Different denoising procedures were employed to filter the pyrosequenced raw amplicons (Acacia, AmpliconNoise, Linkage method). For each of the six isolated cells, an average of 541 V4 and 562 V9 amplicons assigned to radiolarians were obtained, from which one numerically dominant sequence and several minor variants were found. At the 97% identity, a diversity metrics commonly used in environmental surveys, up to 5 distinct OTUs were detected in a single cell. However, most amplicons grouped within a single OTU whereas other OTUs contained very few amplicons. Different analytical methods provided evidence that most minor variants forming different OTUs correspond to PCR and sequencing artifacts. Duplicate PCR and sequencing from the same DNA extract of a single cell had only 9 to 16% of unique amplicons in common, and alignment visualization of V4 and V9 amplicons showed that most minor variants contained substitutions in highly-conserved regions. We conclude that intracellular variability of the 18S rRNA in radiolarians is very limited despite its multi-copy nature and the existence of multiple nuclei in these protists. Our study recommends some technical guidelines to conservatively discard artificial amplicons from metabarcoding datasets, and thus properly assess the diversity and richness of protists in the environment.
Ng, K H; Peh, W C G
2010-02-01
A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.
New Mexico Standards Based Assessment (NMSBA) Technical Report: 2006 Spring Administration
ERIC Educational Resources Information Center
Griph, Gerald W.
2006-01-01
The purpose of the NMSBA technical report is to provide users and other interested parties with a general overview of and technical characteristics of the 2006 NMSBA. The 2006 technical report contains the following information: (1) Test development; (2) Scoring procedures; (3) Calibration, scaling, and equating procedures; (4) Standard setting;…
Capurro, Daniel; Echeverry, Aisen; Figueroa, Rosa; Guiñez, Sergio; Taramasco, Carla; Galindo, César; Avendaño, Angélica; García, Alejandra; Härtel, Steffen
2017-01-01
Despite the continuous technical advancements around health information standards, a critical component to their widespread adoption involves political agreement between a diverse set of stakeholders. Countries that have addressed this issue have used diverse strategies. In this vision paper we present the path that Chile is taking to establish a national program to implement health information standards and achieve interoperability. The Chilean government established an inter-agency program to define the current interoperability situation, existing gaps, barriers, and facilitators for interoperable health information systems. As an answer to the identified issues, the government decided to fund a consortium of Chilean universities to create the National Center for Health Information Systems. This consortium should encourage the interaction between all health care stakeholders, both public and private, to advance the selection of national standards and define certification procedures for software and human resources in health information technologies.
Applicability of biotechnologically produced insect silks.
Herold, Heike M; Scheibel, Thomas
2017-09-26
Silks are structural proteins produced by arthropods. Besides the well-known cocoon silk, which is produced by larvae of the silk moth Bombyx mori to undergo metamorphosis inside their silken shelter (and which is also used for textile production by men since millennia), numerous further less known silk-producing animals exist. The ability to produce silk evolved multiple independent times during evolution, and the fact that silk was subject to convergent evolution gave rise to an abundant natural diversity of silk proteins. Silks are used in air, under water, or like honey bee silk in the hydrophobic, waxen environment of the bee hive. The good mechanical properties of insect silk fibres together with their non-toxic, biocompatible, and biodegradable nature renders these materials appealing for both technical and biomedical applications. Although nature provides a great diversity of material properties, the variation in quality inherent in materials from natural sources together with low availability (except from silkworm silk) impeded the development of applications of silks. To overcome these two drawbacks, in recent years, recombinant silks gained more and more interest, as the biotechnological production of silk proteins allows for a scalable production at constant quality. This review summarises recent developments in recombinant silk production as well as technical procedures to process recombinant silk proteins into fibres, films, and hydrogels.
Effective admissions practices to achieve greater student diversity in dental schools.
Price, Shelia S; Grant-Mills, Donna
2010-10-01
In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.
26 CFR 601.106 - Appeals functions.
Code of Federal Regulations, 2010 CFR
2010-04-01
... obtain Appeals consideration in (1) all office interview or correspondence examination cases or (2) a... technical advice on any technical or procedural question that develops during the processing and... on any technical or procedural question arising in connection with a case described in subdivision (i...
Kedia, Prashant; Gaidhane, Monica
2013-01-01
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is one of the least invasive and most effective modality in diagnosing pancreatic adenocarcinoma in solid pancreatic lesions, with a higher diagnostic accuracy than cystic tumors. EUS-FNA has been shown to detect tumors less than 3 mm, due to high spatial resolution allowing the detection of very small lesions and vascular invasion, particularly in the pancreatic head and neck, which may not be detected on transverse computed tomography. Furthermore, this minimally invasive procedure is often ideal in the endoscopic procurement of tissue in patients with unresectable tumors. While EUS-FNA has been increasingly used as a diagnostic tool, most studies have collectively looked at all primary pancreatic solid lesions, including lymphomas and pancreatic neuroendocrine neoplasms, whereas very few studies have examined the diagnostic utility of EUS-FNA of pancreatic ductal carcinoma only. As with any novel and advanced endoscopic procedure that may incorporate several practices and approaches, endoscopists have adopted diverse techniques to improve the tissue procurement practice and increase diagnostic accuracy. In this article, we present a review of literature to date and discuss currently practiced EUS-FNA technique, including indications, technical details, equipment, patient selection, and diagnostic accuracy. PMID:24143320
7 CFR 610.23 - State Technical Committee meetings.
Code of Federal Regulations, 2011 CFR
2011-01-01
... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...
7 CFR 610.23 - State Technical Committee meetings.
Code of Federal Regulations, 2013 CFR
2013-01-01
... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...
7 CFR 610.23 - State Technical Committee meetings.
Code of Federal Regulations, 2010 CFR
2010-01-01
... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...
7 CFR 610.23 - State Technical Committee meetings.
Code of Federal Regulations, 2014 CFR
2014-01-01
... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...
7 CFR 610.23 - State Technical Committee meetings.
Code of Federal Regulations, 2012 CFR
2012-01-01
... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...
Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A
2017-11-22
Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed <10 physiologically complex procedures (lower 99% confidence limit [CL], 51.3%). A total of 14.2% (lower 99% CL, 12.4%) of hospitals had >3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P < .0001). Teaching hospitals had greater diversity than did the rural and urban nonteaching hospitals (P < .0001). A total of 80.0% of the 170 large teaching hospitals commonly performed >30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the operational and financial consequences of performing a wide diversity of surgical procedures. Future research can evaluate the extent to which hospitals with very large diversity are indispensable in their catchment area.
48 CFR 227.7103-11 - Contractor procedures and records.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Rights in Technical Data 227.7103-11 Contractor procedures and records. (a) The clause at 252.227-7013, Rights in Technical Data—Noncommercial Items, requires a contractor, and its subcontractors or suppliers that will deliver technical data with other than unlimited rights, to establish and follow written...
Technical Operating Procedures for Resource Documentation Under the Oil Pollution Act of 1990
DOT National Transportation Integrated Search
1996-06-01
Technical Operating Procedures (TOPs) for Resource Documentation under the Oil Pollution Act of 1990 (P.L.101-380) have been developed to provide guidance to users operating as, or in support of, the Federal On-Scene Coordinator(FOSC). The procedures...
Mendiratta-Lala, Mishal; Williams, Todd R; Mendiratta, Vivek; Ahmed, Hafeez; Bonnett, John W
2015-04-01
The purpose of this study was to evaluate the effectiveness of a multifaceted simulation-based resident training for CT-guided fluoroscopic procedures by measuring procedural and technical skills, radiation dose, and procedure times before and after simulation training. A prospective analysis included 40 radiology residents and eight staff radiologists. Residents took an online pretest to assess baseline procedural knowledge. Second-through fourth-year residents' baseline technical skills with a procedural phantom were evaluated. First-through third-year residents then underwent formal didactic and simulation-based procedural and technical training with one of two interventional radiologists and followed the training with 1 month of supervised phantom-based practice. Thereafter, residents underwent final written and practical examinations. The practical examination included essential items from a 20-point checklist, including site and side marking, consent, time-out, and sterile technique along with a technical skills portion assessing pedal steps, radiation dose, needle redirects, and procedure time. The results indicated statistically significant improvement in procedural and technical skills after simulation training. For residents, the median number of pedal steps decreased by three (p=0.001), median dose decreased by 15.4 mGy (p<0.001), median procedure time decreased by 4.0 minutes (p<0.001), median number of needle redirects decreased by 1.0 (p=0.005), and median number of 20-point checklist items successfully completed increased by three (p<0.001). The results suggest that procedural skills can be acquired and improved by simulation-based training of residents, regardless of experience. CT simulation training decreases procedural time, decreases radiation dose, and improves resident efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.
ERIC Educational Resources Information Center
Alonzo, Julie; Tindal, Gerald; McCoy, Jan
2005-01-01
This technical report describes the development, pilot testing, and revision of a survey instrument designed to measure secondary school teachers' perceptions of their efficacy working with students from diverse backgrounds. A brief review of relevant literature frames the current study in the context of survey development that is technically…
The New Politics of Diversity: Lessons from a Federal Technical Assistance Grant
ERIC Educational Resources Information Center
Frankenberg, Erica; McDermott, Kathryn A.; DeBray, Elizabeth; Blankenship, Ann Elizabeth
2015-01-01
In 2009, the U.S. Department of Education distributed $2,500,000 via a competitive grant program, the Technical Assistance for Student Assignment Plans, to 11 school districts. The grants and their local effects provide an opportunity to examine the new politics of diversity in public education. Participants cited a wide range of conceptions of…
Pollutant Assessments Group procedures manual: Volume 2, Technical procedures
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-03-01
This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)
Pendergast, Laura L; von der Embse, Nathaniel; Kilgus, Stephen P; Eklund, Katie R
2017-02-01
Evidence-based interventions (EBIs) have become a central component of school psychology research and practice, but EBIs are dependent upon the availability and use of evidence-based assessments (EBAs) with diverse student populations. Multi-group confirmatory factor analysis (MG-CFA) is an analytical tool that can be used to examine the validity and measurement equivalence/invariance of scores across diverse groups. The objective of this article is to provide a conceptual and procedural overview of categorical MG-CFA, as well as an illustrated example based on data from the Social and Academic Behavior Risk Screener (SABRS) - a tool designed for use in school-based interventions. This article serves as a non-technical primer on the topic of MG-CFA with ordinal (rating scale) data and does so through the framework of examining equivalence of measures used for EBIs within multi-tiered models - an understudied topic. To go along with the illustrated example, we have provided supplementary files that include sample data, Mplus input code, and an annotated guide for understanding the input code (http://dx.doi.org/10.1016/j.jsp.2016.11.002). Data needed to reproduce analyses in this article are available as supplemental materials (online only) in the Appendix of this article. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
75 FR 16345 - Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-01
.... FDA-1999-N-3539] (formerly Docket No. 1999N-4783) Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment AGENCY: Food and Drug Administration, HHS. ACTION: Final rule... Subjects in 21 CFR Part 10 Administrative practice and procedure, News media. 0 Therefore, under the...
Proceedings of the Second NASA Aviation Safety Program Weather Accident Prevention Review
NASA Technical Reports Server (NTRS)
Martzaklis, K. Gus (Compiler)
2003-01-01
The Second NASA Aviation Safety Program (AvSP) Weather Accident Prevention (WxAP) Annual Project Review held June 5-7, 2001, in Cleveland, Ohio, presented the NASA technical plans and accomplishments to the aviation community. NASA-developed technologies presented included an Aviation Weather Information System with associated digital communications links, electronic atmospheric reporting technologies, forward-looking turbulence warning systems, and turbulence mitigation procedures. The meeting provided feedback and insight from the aviation community of diverse backgrounds and assisted NASA in steering its plans in the direction needed to meet the national safety goal of 80-percent reduction of aircraft accidents by 2007. The proceedings of the review are enclosed.
Zuhr, Otto; Rebele, Stephan F; Cheung, Stefani L; Hürzeler, Markus B
2018-06-01
Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession-type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone. Potential clinical scenarios include surgical thickening of thin buccal gingiva or peri-implant mucosa, alveolar ridge/socket preservation and implant second-stage surgery, as well as soft-tissue ridge augmentation or pontic site development. In this way, tunneling flap procedures developed from a technique, originally merely intended for surgical root coverage, into a capacious surgical conception in plastic periodontal and implant surgery. The purpose of this article is to provide a comprehensive overview on tunneling flap procedures, to introduce the successive development of the approach along with underlying ideas on surgical wound healing and to present contemporary clinical scenarios in step-by-step photograph-illustrated sequences, which aim to provide clinicians with guidance to help them integrate tunneling flap procedures into their daily clinical routine. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Diversity in the Work Force. The Highlight Zone: Research @ Work No. 4.
ERIC Educational Resources Information Center
Wentling, Rose Mary
A literature review was conducted to identify critical work force diversity issues in today's changing workplace and identify ways organizations and career and technical education (CTE) practitioners can increase work force diversity. A broad, all-inclusive definition of diversity was developed that focuses on how diversity affects individuals and…
NASA Technical Reports Server (NTRS)
Waggoner, J. T.; Phinney, D. E. (Principal Investigator)
1981-01-01
The crop estimation analysis procedures documentation of the AgRISTARS - Foreign Commodity Production Forecasting Project (FCPF) is presented. Specifically it includes the technical/management documentation of the remote sensing data analysis procedures prepared in accordance with the guidelines provided in the FCPF communication/documentation standards manual. Standard documentation sets are given arranged by procedural type and level then by crop types or other technically differentiating categories.
Determining procedures for simulation-based training in radiology: a nationwide needs assessment.
Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars
2018-06-01
New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.
Nucleotide diversity maps reveal variation in diversity among wheat genomes and chromosomes
USDA-ARS?s Scientific Manuscript database
Technical Abstract: 20-75 CHARACTER LINES A strategy for a genome-wide assessment of nucleotide diversity in a polyploid species must minimize the inclusion of homoeologous sequences into diversity estimates and reliably allocate individual haplotypes into respective genomes. In this study, nucle...
Adapting Project Management Practices to Research-Based Projects
NASA Technical Reports Server (NTRS)
Bahr, P.; Baker, T.; Corbin, B.; Keith, L.; Loerch, L.; Mullenax, C.; Myers, R.; Rhodes, B.; Skytland, N.
2007-01-01
From dealing with the inherent uncertainties in outcomes of scientific research to the lack of applicability of current NASA Procedural Requirements guidance documentation, research-based projects present challenges that require unique application of classical project management techniques. If additionally challenged by the creation of a new program transitioning from basic to applied research in a technical environment often unfamiliar with the cost and schedule constraints addressed by project management practices, such projects can find themselves struggling throughout their life cycles. Finally, supplying deliverables to a prime vehicle customer, also in the formative stage, adds further complexity to the development and management of research-based projects. The Biomedical Research and Countermeasures Projects Branch at NASA Johnson Space Center encompasses several diverse applied research-based or research-enabling projects within the newly-formed Human Research Program. This presentation will provide a brief overview of the organizational structure and environment in which these projects operate and how the projects coordinate to address and manage technical requirements. We will identify several of the challenges (cost, technical, schedule, and personnel) encountered by projects across the Branch, present case reports of actions taken and techniques implemented to deal with these challenges, and then close the session with an open forum discussion of remaining challenges and potential mitigations.
New research on women's low participation in science and technology
NASA Astrophysics Data System (ADS)
Stout, Jane
It is well known that women have historically been and continue to be grossly underrepresented in technical fields (i.e., the physical sciences, engineering, and computing). This presentation will address the following research questions: What dissuades women from entering into a technical career track, and what are women's experiences like within technical fields? At the same time, this presentation will acknowledge a shortcoming of decades of social science research and interventions designed to improve women's interest and persistence in technical fields: a narrow definition of ``women''. Given that the majority of women in colleges and universities (i.e., the typical sites of social science research) tend to be affluent and/or White, STEM education research that relies on convenience samples at colleges and universities paints a skewed picture of gender issues in technical fields. This presentation will showcase research findings that call into question conventional conceptions of gender disparities in technical fields. Specifically, the presentation will emphasize the importance of recognizing that women constitute more than their gender; women come from a diverse array of backgrounds, which no doubt play a role in the experience of being a woman in technical fields. By understanding the experiences of women from a broad array of demographics groups, the STEM education community can develop a corresponding set of strategies to recruit and retain women with diverse interests, experiences, and values (e.g., first generation versus second college students; women of different racial/ethnic backgrounds). The aim of this presentation is to promote social science research and interventions that acknowledge the nuanced experiences of diverse women in technical fields, in order to address the seemingly intractable problem of women's underrepresentation in technical fields. NSF DUE-1431112, NSF CNS-1246649.
ERIC Educational Resources Information Center
Jones, Natasha N.
2016-01-01
This article argues for the need for a social justice approach to technical communication research and pedagogy. Given previous calls by scholars in technical and professional communication (TPC) for an attention to diversity, inclusion, and equality, the author examines the place and purpose of social justice in TPC and provides useful approaches…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Iguchi, Toshihiro, E-mail: iguchi@ba2.so-net.ne.jp; Hiraki, Takao, E-mail: takaoh@tc4.so-net.ne.jp; Gobara, Hideo, E-mail: gobara@cc.okayama-u.ac.jp
PurposeThe aim of the study was to retrospectively evaluate simultaneous multiple hook wire placement outcomes before video-assisted thoracoscopic surgery (VATS).Materials and MethodsThirty-eight procedures were performed on 35 patients (13 men and 22 women; mean age, 59.9 years) with 80 lung lesions (mean diameter 7.9 mm) who underwent simultaneous multiple hook wire placements for preoperative localizations. The primary endpoints were technical success, complications, procedure duration, and VATS outcome; secondary endpoints included comparisons between technical success rates, complication rates, and procedure durations of the 238 single-placement procedures performed. Complications were also evaluated.ResultsIn 35 procedures including 74 lesions, multiple hook wire placements were technically successful;more » in the remaining three procedures, the second target placement was aborted because of massive pneumothorax after the first placement. Although complications occurred in 34 procedures, no grade 3 or above adverse event was observed. The mean procedure duration was 36.4 ± 11.8 min. Three hook wires dislodged during patient transport to the surgical suite. Seventy-four successfully marked lesions were resected. Six lesions without hook wires were successfully resected after detection by palpation with an additional mini-thoracotomy or using subtle pleural changes as a guide. The complication rates and procedure durations of multiple-placement procedures were significantly higher (P = 0.04) and longer (P < 0.001) than those in the single-placement group, respectively, while the technical success rate was not significantly different (P = 0.051).ConclusionsSimultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.« less
Wang, Ernest E; Quinones, Joshua; Fitch, Michael T; Dooley-Hash, Suzanne; Griswold-Theodorson, Sharon; Medzon, Ron; Korley, Frederick; Laack, Torrey; Robinett, Adam; Clay, Lamont
2008-11-01
Developing technical expertise in medical procedures is an integral component of emergency medicine (EM) practice and training. This article is the work of an expert panel composed of members from the Society for Academic Emergency Medicine (SAEM) Interest Group, the SAEM Technology in Medical Education Committee, and opinions derived from the May 2008 Academic Emergency Medicine Consensus Conference, "The Science of Simulation in Healthcare." The writing group reviewed the simulation literature on procedures germane to EM training, virtual reality training, and instructional learning theory as it pertains to skill acquisition and procedural skills decay. The authors discuss the role of simulation in teaching technical expertise, identify training conditions that lead to effective learning, and provide recommendations for future foci of research.
Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Masaoka, Yoshihisa; Tanaka, Takashi; Sato, Takuya; Gobara, Hideo; Toyooka, Shinichi; Kanazawa, Susumu
2018-05-01
To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429-43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631-0.996; p = 0.046). The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.
42 CFR 493.1449 - Standard; Technical supervisor qualifications.
Code of Federal Regulations, 2011 CFR
2011-10-01
... service in which the laboratory performs high complexity tests or procedures. The director of a laboratory... may perform anatomic and clinical laboratory procedures and tests in all specialties and... tests in the subspecialty of bacteriology, the individual functioning as the technical supervisor must...
Technical Operating Procedures for State Access Under the Oil Pollution Act of 1990
DOT National Transportation Integrated Search
1992-11-01
Technical Operating Procedures (TOPs) to be used by the National Pollution Funds : Center (NPFC) to provide guidance to Federal On-Scene Coordinators (FOSCs) and : Coast Guard Districts concerning a State Governor's request for access to the : Oil Sp...
7 CFR 1775.31 - Authorization.
Code of Federal Regulations, 2010 CFR
2010-01-01
... (CONTINUED) TECHNICAL ASSISTANCE GRANTS Technical Assistance and Training Grants § 1775.31 Authorization. This subpart sets forth additional policies and procedures for making Technical Assistance and Training...
Identifying Technical Content Training Needs of Georgia Agriculture Teachers
ERIC Educational Resources Information Center
Peake, Jason B.; Duncan, Dennis W.; Ricketts, John C.
2007-01-01
The continuing trend toward increasing diversity of curriculum offered within secondary agricultural education programs is driving a change in pre-service and in-service technical training for agriculture teachers. This study looks at agriculture teachers' perceived importance of, and competence in, traditional technical competencies such as…
Nayahangan, L J; Konge, L; Schroeder, T V; Paltved, C; Lindorff-Larsen, K G; Nielsen, B U; Eiberg, J P
2017-04-01
Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of "learning by doing." This change has established simulation as a cornerstone in providing trainees with the necessary skills and competences. However, the development of simulation based programs often evolves based on available resources and equipment, reflecting convenience rather than a systematic educational plan. The objective of the present study was to perform a national needs assessment to identify the technical procedures that should be integrated in a simulation based curriculum. A national needs assessment using a Delphi process was initiated by engaging 33 predefined key persons in vascular surgery. Round 1 was a brainstorming phase to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved elimination and ranking of procedures. The response rate for round 1 was 70%, with 36 procedures identified. Round 2 had a 76% response rate and resulted in a preliminary prioritised list after exploring the need for simulation based training. Round 3 had an 85% response rate; 17 procedures were eliminated, resulting in a final prioritised list of 19 technical procedures. A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-03
... FURTHER INFORMATION CONTACT: David Hunger (Technical Information), Office of Energy Policy and Innovation....hunger@ferc.gov . Caroline Daly (Technical Information), Office of Energy Policy and [[Page 54064... information about the technical conference or comment procedures, please contact: David Hunger (Technical...
A general method for bead-enhanced quantitation by flow cytometry
Montes, Martin; Jaensson, Elin A.; Orozco, Aaron F.; Lewis, Dorothy E.; Corry, David B.
2009-01-01
Flow cytometry provides accurate relative cellular quantitation (percent abundance) of cells from diverse samples, but technical limitations of most flow cytometers preclude accurate absolute quantitation. Several quantitation standards are now commercially available which, when added to samples, permit absolute quantitation of CD4+ T cells. However, these reagents are limited by their cost, technical complexity, requirement for additional software and/or limited applicability. Moreover, few studies have validated the use of such reagents in complex biological samples, especially for quantitation of non-T cells. Here we show that addition to samples of known quantities of polystyrene fluorescence standardization beads permits accurate quantitation of CD4+ T cells from complex cell samples. This procedure, here termed single bead-enhanced cytofluorimetry (SBEC), was equally capable of enumerating eosinophils as well as subcellular fragments of apoptotic cells, moieties with very different optical and fluorescent characteristics. Relative to other proprietary products, SBEC is simple, inexpensive and requires no special software, suggesting that the method is suitable for the routine quantitation of most cells and other particles by flow cytometry. PMID:17067632
Identifying content for simulation-based curricula in urology: a national needs assessment.
Nayahangan, Leizl Joy; Bølling Hansen, Rikke; Gilboe Lindorff-Larsen, Karen; Paltved, Charlotte; Nielsen, Bjørn Ulrik; Konge, Lars
2017-12-01
Simulation-based training is well recognized in the transforming field of urological surgery; however, integration into the curriculum is often unstructured. Development of simulation-based curricula should follow a stepwise approach starting with a needs assessment. This study aimed to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training. A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists. Round 1 identified technical procedures that newly qualified urologists should perform. Round 2 included a survey using an established needs assessment formula to explore: the frequency of procedures; the number of physicians who should be able to perform the procedure; the risk and/or discomfort to patients when a procedure is performed by an inexperienced physician; and the feasibility of simulation training. Round 3 involved elimination and reranking of procedures according to priority. The response rates for the three Delphi rounds were 70%, 55% and 67%, respectively. The 34 procedures identified in Round 1 were reduced to a final prioritized list of 18 technical procedures for simulation-based training. The five procedures that reached the highest prioritization were cystoscopy, transrectal ultrasound-guided biopsy of the prostate, placement of ureteral stent, insertion of urethral and suprapubic catheter, and transurethral resection of the bladder. The prioritized list of technical procedures in urology that were identified as highly suitable for simulation can be used as an aid in the planning and development of simulation-based training programs.
ERIC Educational Resources Information Center
Frasier, James E.; Stanton, William
This publication reports the development of the vocational-technical resource consortia in Ohio and identifies the operational procedures associated with successful programs. Five exemplary consortia were studied in some depth; however, data were obtained from all of the 23 consortia in the state. The research indicates that the consortium is an…
Taghizadeh, Farhan; Reiley, Carol; Mohr, Catherine; Paul, Malcolm
2014-03-01
We are evaluating the technical feasibility of robotic-assisted laparoscopic vertical-intermediate platysmaplasty in conjunction with an open rhytidectomy. In a cadaveric study, the da Vinci Surgical System was used to access certain angles in the lower neck that are difficult for traditional short incision, short flap procedures. Ergonomics, approach, and technical challenges were noted. To date, there are no published reports of robotic-assisted neck lifts, motivating us to assess its potential in this field of plastic surgery. Standard open technique short flap rhytidectomies with concurrent experimental robotic-assisted platysmaplasties (neck lifts) were performed on six cadavers with the da Vinci Si Surgical System(®) (Intuitive Surgical, Sunnyvale, CA, USA). The surgical procedures were performed on a diverse cadaver population from June 2011 to January 2012. The procedures included (1) submental incision and laser-assisted liposuction, (2) open rhytidectomy, and (3) robotic-assisted platysmaplasty using knot-free sutures. A variety of sutures and fat extraction techniques, coupled with 0° and 30° three-dimensional endoscopes, were utilized to optimize visualization of the platysma. An unaltered da Vinci Si Surgical System with currently available instruments was easily adaptable to neck lift surgery. Mid-neck platysma exposure was excellent, tissue handling was delicate and precise, and suturing was easily performed. Robotic-assisted surgery has the potential to improve outcomes in neck lifts by offering the ability to manipulate instruments with increased freedom of movement, scaled motion, tremor reduction, and stereoscopic three-dimensional visualization in the deep neck. Future clinical studies on live human patients can better assess subject and surgeon benefits arising from the use of the da Vinci system for neck lifts. Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
Single Anastomosis Duodeno-Ileal Switch (SADIS): A Systematic Review of Efficacy and Safety.
Shoar, Saeed; Poliakin, Lauren; Rubenstein, Rebecca; Saber, Alan A
2018-01-01
Owing to the possibility of weight regain after the long-term follow-up of gastric bypass patients and because of the high morbidity of biliopancreatic diversion with duodenal switch, single-anastomosis duodeno-ileal switch (SADIS) has emerged as a rescue procedure in bariatric surgery. The purpose of this review is to summarize the literature data on SADIS. University Hospital, NY. A comprehensive literature review was performed through October 2016 to identify English studies on SADIS performed in human subjects. Outcomes of interest were technical considerations, postoperative complications, weight loss outcome, comorbidity resolution rate, and nutritional deficiency after SADIS. A total of 12 studies including 581 SADIS patients (217 males and 364 females) were included. SADIS was a primary procedure in 508 patients (87.4%) and a conversion procedure in 73 patients (12.6%). The length of common limb was 300 cm in 54.2%, 250 cm in 23%, and 200 cm in 13.4% of patients. Anastomosis technique was a linear stapler in 26.7% and a hand sewn suture technique in 73.3% of patients. Diarrhea was the most common complication (1.2%). The average %EWL was 30% at 3 months, 55% at 6 months, 70% at 1 year, and 85% at 2 years. Co-morbidity resolution rate was 74.1% for type 2 diabetes mellitus, 96.3% for hypertension, 68.3% for dyslipidemia, 63.3% for obstructive sleep apnea, and 87.5% for GERD. Overall, vitamin A, selenium, and iron deficiency were the most common nutritional deficiencies with the possibility of the protein malnutrition in up to 34% of the patients when measured. As a modified bariatric procedure, SADIS has promising outcomes for weight loss and comorbidity resolution in morbidly obese patients. When measured, there was a high prevalence of macro-nutrient deficiencies following SADIS. There is a high technical variability, and long-term data are required before any meaningful conclusion can be made.
How family carers engage with technical health procedures in the home: a grounded theory study.
McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William
2015-07-06
To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. A qualitative study using grounded theory. New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a 'technical' solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers' emotional and behavioural responses to health technology during the training process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Insight into the da Vinci® Xi - technical notes for single-docking left-sided colorectal procedures.
Ngu, James Chi-Yong; Sim, Sarah; Yusof, Sulaiman; Ng, Chee-Yung; Wong, Andrew Siang-Yih
2017-12-01
The adoption of robot-assisted laparoscopic colorectal surgery has been hampered by issues with docking, operative duration, technical difficulties in multi-quadrant access, and cost. The da Vinci® Xi has been designed to overcome some of these limitations. We describe our experience with the system and offer technical insights to its application in left-sided colorectal procedures. Our initial series of left-sided robotic colorectal procedures was evaluated. Patient demographics and operative outcomes were recorded prospectively using a predefined database. Between March 2015 and April 2016, 54 cases of robot-assisted laparoscopic left-sided colorectal procedures were successfully completed with no cases of conversion. The majority were low anterior resections for colorectal malignancies. Using the da Vinci® Xi Surgical System, multi-quadrant surgery involving dissection from the splenic flexure to the pelvis was possible without redocking. The da Vinci® Xi simplifies the docking procedure and makes single-docking feasible for multi-quadrant left-sided colorectal procedures. Copyright © 2016 John Wiley & Sons, Ltd.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Contractor Facilities 242.7400 General. (a) Program managers may conclude that they need technical... manager may assign technical representatives under the procedures in 242.7401. (b) A technical representative is a representative of a DoD program, project, or system office performing non-CAS technical...
Code of Federal Regulations, 2013 CFR
2013-10-01
... Contractor Facilities 242.7400 General. (a) Program managers may conclude that they need technical... manager may assign technical representatives under the procedures in 242.7401. (b) A technical representative is a representative of a DoD program, project, or system office performing non-CAS technical...
Exposing Hidden Relations: Storytelling, Pedagogy, and the Study of Policy
ERIC Educational Resources Information Center
Moore, Kristen
2013-01-01
Within a Technical Communication classroom, policywork has been used to teach students the vital discursive and conceptual skills valued by technical fields. However, given the move of technical communicators into the public sphere, these skills can and should be expanded to include diverse practices and modes of thought. As such, this article…
Argenyi, Michael
2016-10-01
Applicants to medical schools who are deaf and hard of hearing (DHoH) or who have other disabilities face significant barriers to medical school admission. One commonly cited barrier to admission is medical schools' technical standards (TS) for admission, advancement, and graduation. Ethical values of diversity and equity support altering the technical standards to be more inclusive of people with disabilities. Incorporating these values into admissions, advancement, and graduation considerations for DHoH and other students with disabilities can contribute to the physician workforce being more representative of the diverse patients it serves and better able to care for them. © 2016 American Medical Association. All Rights Reserved.
48 CFR 2052.216-72 - Task order procedures.
Code of Federal Regulations, 2010 CFR
2010-10-01
...; (5) Technical skills required; and (6) Estimated level of effort. (b) Task order technical proposal. By the date specified in the TORFP, the contractor shall deliver to the contracting officer a written or verbal (as specified in the TORFP technical proposal submittal instructions) technical proposal...
15 CFR 911.8 - Technical requirements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...
15 CFR 911.8 - Technical requirements.
Code of Federal Regulations, 2013 CFR
2013-01-01
... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...
15 CFR 911.8 - Technical requirements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...
15 CFR 911.8 - Technical requirements.
Code of Federal Regulations, 2011 CFR
2011-01-01
... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...
15 CFR 911.8 - Technical requirements.
Code of Federal Regulations, 2010 CFR
2010-01-01
... PROCEDURES CONCERNING USE OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.8 Technical requirements. (a) All platform operators of the NOAA DCS must use a data collection platform radio set whose technical...
Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B
2017-12-01
To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (p<0.001), longer transparenchymal distance (p<0.001), and prone position (p=0.027). There was positive correlation between the need for chest tube placement and longer transparenchymal distance (p=0.007) and smaller lesion diameter (p=0.018). Lesions in the left lower lobe had the lowest rates of pneumothorax (p=0.008) and chest tube drainage (p=0.018). Patients whose pneumothoraces were diagnosed on the follow-up chest X-ray, but not on the immediate post-procedural CT scan had significantly higher requirement for chest tube drainage (p=0.039). CT-guided lung biopsy has a high rate of technical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Sommer, C M; Lemm, G; Hohenstein, E; Bellemann, N; Stampfl, U; Goezen, A S; Rassweiler, J; Kauczor, H U; Radeleff, B A; Pereira, P L
2013-06-01
This study was designed to evaluate the clinical efficacy of CT-guided bipolar and multipolar radiofrequency ablation (RF ablation) of renal cell carcinoma (RCC) and to analyze specific technical aspects between both technologies. We included 22 consecutive patients (3 women; age 74.2 ± 8.6 years) after 28 CT-guided bipolar or multipolar RF ablations of 28 RCCs (diameter 2.5 ± 0.8 cm). Procedures were performed with a commercially available RF system (Celon AG Olympus, Berlin, Germany). Technical aspects of RF ablation procedures (ablation mode [bipolar or multipolar], number of applicators and ablation cycles, overall ablation time and deployed energy, and technical success rate) were analyzed. Clinical results (local recurrence-free survival and local tumor control rate, renal function [glomerular filtration rate (GFR)]) and complication rates were evaluated. Bipolar RF ablation was performed in 12 procedures and multipolar RF ablation in 16 procedures (2 applicators in 14 procedures and 3 applicators in 2 procedures). One ablation cycle was performed in 15 procedures and two ablation cycles in 13 procedures. Overall ablation time and deployed energy were 35.0 ± 13.6 min and 43.7 ± 17.9 kJ. Technical success rate was 100 %. Major and minor complication rates were 4 and 14 %. At an imaging follow-up of 15.2 ± 8.8 months, local recurrence-free survival was 14.4 ± 8.8 months and local tumor control rate was 93 %. GFR did not deteriorate after RF ablation (50.8 ± 16.6 ml/min/1.73 m(2) before RF ablation vs. 47.2 ± 11.9 ml/min/1.73 m(2) after RF ablation; not significant). CT-guided bipolar and multipolar RF ablation of RCC has a high rate of clinical success and low complication rates. At short-term follow-up, clinical efficacy is high without deterioration of the renal function.
Cost Finding Principles and Procedures. Preliminary Field Review Edition. Technical Report 26.
ERIC Educational Resources Information Center
Ziemer, Gordon; And Others
This report is part of the Larger Cost Finding Principles Project designed to develop a uniform set of standards, definitions, and alternative procedures that will use accounting and statistical data to find the full cost of resources utilized in the process of producing institutional outputs. This technical report describes preliminary procedures…
DOT National Transportation Integrated Search
1996-06-01
Technical Operating Procedures (TOPS) for Providing Funding to Natural Resources : Trustees To Conduct An Initiation of Assessment of Natural Resource Damages : under the Oil Pollution Act of 1990 have been developed to provide guidance on : funding ...
Policies and Procedures Governing the Operation of Vocational-Technical Education in Nevada.
ERIC Educational Resources Information Center
Nevada State Dept. of Education, Carson City. Div. of Vocational-Technical and Adult Education.
This manual was prepared to assist local public schools in organizing and conducting a broadened program of vocational education of significant scope. Operating policies and procedures are provided in areas of: (1) Administration of Vocational-Technical Education, (2) Agricultural Education, (3) Vocational Business and Office Occupations, (4)…
Value Engineering. Technical Manual. School Facilities Development Procedures Manual.
ERIC Educational Resources Information Center
Washington Office of the State Superintendent of Public Instruction, Olympia.
Value Engineering (VE) is a cost-optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. This technical manual provides guidance in developing the scope and applicability of VE to school projects; in…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-18
... Market and Planning Efficiency Through Improved Software; Notice of Agenda and Procedures for Staff Technical Conference June 10, 2010. This notice establishes the agenda and procedures for the staff[email protected] . Kimberly D. Bose, Secretary. Agenda for AD10-12 Staff Technical Conference on Enhanced Power...
Managing Diversity within South African Technikons: A Strategic Management Approach.
ERIC Educational Resources Information Center
Norris, Brian
1996-01-01
Based on experiences with affirmative action and subsequent management of diversity at five research universities in the United States, a model for strategic management of diversity in South African technical institutes is outlined. The model has six components: organizational culture; organizational/environmental change; Total Quality Management…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Das, Raj, E-mail: rajdas@nhs.net, E-mail: raj.das@stgeorges.nhs.uk; Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Wang, Haofan, E-mail: wwhhff123@gmail.com
AimA clear understanding of operator experience is important in improving technical success whilst minimising patient risk undergoing endovascular procedures, and there is the need to ensure that trainees have the appropriate skills as primary operators. The aim of the study is to retrospectively analyse uterine artery embolisation (UAE) procedures performed by interventional radiology (IR) trainees at an IR training unit analysing fluoroscopy times and radiation dose as surrogate markers of technical skill.MethodsTen IR fellows were primary operator in 200 UAE procedures over a 5-year period. We compared fluoroscopy times, radiation dose and complications, after having them categorised according to threemore » groups: Group 1, initial five, Group 2, >5 procedures and Group 3, penultimate five UAE procedures. We documented factors that may affect screening time (number of vials employed and use of microcatheters).ResultsMean fluoroscopy time was 18.4 (±8.1), 17.3 (±9.0), 16.3 (±8.4) min in Groups 1, 2 and 3, respectively. There was no statistically significant difference between these groups (p > 0.05) with respect to fluoroscopy time or radiation dose. Analysis after correction for confounding factors showed no statistical significance (p > 0.05). All procedures were technically successful, and total complication rate was 4 %.ConclusionUAE was chosen as a highly standardised procedure followed by IR practitioners. Although there is a non-significant trend for shorter screening times with experience, technical success and safety were not compromised with appropriate Consultant supervision, which illustrates a safe construct for IR training. This is important and reassuring information for patients undergoing a procedure in a training unit.« less
Assessing technical performance at diverse ambulatory care sites.
Osterweis, M; Bryant, E
1978-01-01
The purpose of the large study reported here was to develop and test methods for assessing the quality of health care that would be broadly applicable to diverse ambulatory care organizations for periodic comparative review. Methodological features included the use of an age-sex stratified random sampling scheme, dependence on medical records as the source of data, a fixed study period year, use of Kessner's tracer methodology (including not only acute and chronic diseases but also screening and immunization rates as indicators), and a fixed tracer matrix at all test sites. This combination of methods proved more efficacious in estimating certain parameters for the total patient populations at each site (including utilization patterns, screening, and immunization rates) and the process of care for acute conditions than it did in examining the process of care for the selected chronic condition. It was found that the actual process of care at all three sites for the three acute conditions (streptococcal pharyngitis, urinary tract infection, and iron deficiency anemia) often differed from the expected process in terms of both diagnostic procedures and treatment. For hypertension, the chronic disease tracer, medical records were frequently a deficient data source from which to draw conclusions about the adequacy of treatment. Several aspects of the study methodology were found to be detrimental to between-site comparisons of the process of care for chronic disease management. The use of an age-sex stratified random sampling scheme resulted in the identification of too few cases of hypertension at some sites for analytic purposes, thereby necessitating supplementary sampling by diagnosis. The use of a fixed study period year resulted in an arbitrary starting point in the course of the disease. Furthermore, in light of the diverse sociodemographic characteristics of the patient populations, the use of a fixed matrix of tracer conditions for all test sites is questionable. The discussion centers on these and other problems encountered in attempting to compare technical performance within diverse ambulatory care organizations and provides some guidelines as to the utility of alternative methods for assessing the quality of health care.
Suprapubic cystostomy using optical urethrotome in female patients.
Sawant, Ajit Somaji; Patwardhan, Sujata K; Attar, Mohammad Ismail; Varma, Radheshyam; Bansal, Ujjwal
2009-08-01
In many female patients for lower urinary tract reconstructive procedures, a suprapubic cystostomy along with perurethral catheter is required for urinary diversion. We describe a new and simple method of intraoperative suprapubic catheter placement using optical urethrotome wherein distension of bladder is not required. A total of 26 patients underwent suprapubic catheter placement intraoperatively with the aid of Sachse' optical urethrotome and its outer sheath from January 2005 to May 2008. A 16F Foley catheter could be successfully placed suprapubically in all patients with this method. There were no complications like injury to intraabdominal viscera, retropubic hematoma, hematuria, or catheter dislodgement. We describe a new method of intraoperative suprapubic catheter placement in female patients that is minimally invasive, technically safe, simple, and effective, and does not require bladder distension.
Guevara, Carlos J; Rialon, Kristy L; Ramaswamy, Raja S; Kim, Seung K; Darcy, Michael D
2016-12-01
To describe technical details, success rate, and advantages of direct puncture of the thoracic duct (TD) under direct ultrasound (US) guidance at venous insertion in the left neck. All patients who underwent attempted thoracic duct embolization (TDE) via US-guided retrograde TD access in the left neck were retrospectively reviewed. Indications for lymphangiography were iatrogenic chyle leak, pulmonary lymphangiectasia, and plastic bronchitis. Ten patients with mean age 41.4 years (range, 21 d to 72 y) underwent US-guided TD access via the left neck. Technical details, procedural times, and clinical outcomes were evaluated. TD access time was defined as time from start of procedure to successful access of TD, and total procedural time was defined from start of procedure until TDE. All attempts at TD access via the neck were successful. Technical and clinical success of TDE was 60%. There were no complications. Mean TD access time was 17 minutes (range, 2-47 min), and mean total procedure time was 49 minutes (range, 25-69 min). Mean follow-up time was 5.4 months (range, 3-10 months). TDE via US-guided access in the left neck is technically feasible and safe with a potential decrease in procedure time and elimination of oil-based contrast material. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.
48 CFR 252.246-7001 - Warranty of data.
Code of Federal Regulations, 2011 CFR
2011-10-01
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data...
48 CFR 252.246-7001 - Warranty of data.
Code of Federal Regulations, 2014 CFR
2014-10-01
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data...
48 CFR 252.246-7001 - Warranty of data.
Code of Federal Regulations, 2013 CFR
2013-10-01
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data...
48 CFR 252.246-7001 - Warranty of data.
Code of Federal Regulations, 2010 CFR
2010-10-01
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data...
48 CFR 252.246-7001 - Warranty of data.
Code of Federal Regulations, 2012 CFR
2012-10-01
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data...
Dexter, Franklin; Ledolter, Johannes; Hindman, Bradley J
2016-01-01
In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications. The applications include strategic analyses (e.g., hospital marketing) and human resource analytics (e.g., comparisons among providers). Measures of diversity of procedures and activities (e.g., Herfindahl and Gini-Simpson index) are used for quantification of each facility (hospital) or anesthesia provider, one at a time. Diversity can be thought of as a summary measure. Thus, if the diversity of procedures for 48 hospitals is studied, the diversity (and its SE) is being calculated for each hospital. Likewise, the effective numbers of common procedures at each hospital can be calculated (e.g., by using the exponential of the Shannon index). Measures of similarity are pairwise assessments. Thus, if quantifying the similarity of procedures among cases with a break or handoff versus cases without a break or handoff, a similarity index represents a correlation coefficient. There are several different measures of similarity, and we compare their features and applicability for perioperative data. We rely extensively on sensitivity analyses to interpret observed values of the similarity index.
10 CFR 611.103 - Application evaluation.
Code of Federal Regulations, 2010 CFR
2010-01-01
...) Technical Program Factors such as economic development and diversity in technology, company, risk, and... DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE..., the following: (1) The technical merit of the proposed advanced technology vehicles or qualifying...
The Regional Structure of Technical Innovation
NASA Astrophysics Data System (ADS)
O'Neale, Dion
2014-03-01
There is strong evidence that the productivity per capita of cities and regions increases with population. One likely explanation for this phenomenon is that densely populated regions bring together otherwise unlikely combinations of individuals and organisations with diverse, specialised capabilities, leading to increased innovation and productivity. We have used the REGPAT patent database to construct a bipartite network of geographic regions and the patent classes for which those regions display a revealed comparative advantage. By analysing this network, we can infer relationships between different types of patent classes - and hence the structure of (patentable) technology. The network also provides a novel perspective for studying the combinations of technical capabilities in different geographic regions. We investigate measures such as the diversity and ubiquity of innovations within regions and find that diversity (resp. ubiquity) is positively (resp. negatively) correlated with population. We also find evidence of a nested structure for technical innovation. That is, specialised innovations tend to occur only when other more general innovations are already present.
Baker, B G; Bhalla, A; Doleman, B; Yarnold, E; Simons, S; Lund, J N; Williams, J P
2017-01-01
Simulation-based training (SBT) has become an increasingly important method by which doctors learn. Stress has an impact upon learning, performance, technical, and non-technical skills. However, there are currently no studies that compare stress in the clinical and simulated environment. We aimed to compare objective (heart rate variability, HRV) and subjective (state trait anxiety inventory, STAI) measures of stress theatre with a simulated environment. HRV recordings were obtained from eight anesthetic trainees performing an uncomplicated rapid sequence induction at pre-determined procedural steps using a wireless Polar RS800CX monitor © in an emergency theatre setting. This was repeated in the simulated environment. Participants completed an STAI before and after the procedure. Eight trainees completed the study. The theatre environment caused an increase in objective stress vs baseline (p = .004). There was no significant difference between average objective stress levels across all time points (p = .20) between environments. However, there was a significant interaction between the variables of objective stress and environment (p = .045). There was no significant difference in subjective stress (p = .27) between environments. Simulation was unable to accurately replicate the stress of the technical procedure. This is the first study that compares the stress during SBT with the theatre environment and has implications for the assessment of simulated environments for use in examinations, rating of technical and non-technical skills, and stress management training.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Training and technical assistance for unsuccessful... REQUIREMENTS Enforcement Procedures § 493.1838 Training and technical assistance for unsuccessful participation... may require the laboratory to undertake training of its personnel, or to obtain necessary technical...
Unresolved Technical Issues in Fair Interest Measurement.
ERIC Educational Resources Information Center
Cole, Nancy S.
The problem of sex differences in interest measurement involves many technical issues and procedures. The purpose of this paper is to provide a description of the technical problems involved in construction, scoring, and interpretation of interest measures as related to sex differences and to suggest guidelines within these technical issues which…
Consiglieri, Claudia F; Gornals, Joan B; Busquets, Juli; Peláez, Nuria; Secanella, Lluis; De-La-Hera, Meritxell; Sanzol, Resurrección; Fabregat, Joan; Castellote, José
2018-01-01
The need for fluoroscopy guidance in patients undergoing endoscopic ultrasound-guided transmural drainage (EUS-TMD) of peripancreatic fluid collections (PFCs) remains unclear. The aim of this study was to compare general outcomes of EUS-TMD of PFCs under fluoroscopy (F) vs fluoroless (FL). This is a comparative study with a retrospective analysis of a prospective and consecutive inclusion database at a tertiary centre, from 2009 to 2015. All patients were symptomatic pseudocyst (PSC) and walled-off pancreatic necrosis (WON). Two groups were assigned depending on availability of fluoroscopy. The groups were heterogeneous in terms of their demographic characteristics, PFCs and procedure. The main outcome measures included technical and clinical success, incidences, adverse events (AEs), and follow-up. Fifty EUS-TMD of PFCs from 86 EUS-guided drainages were included during the study period. Group F included 26 procedures, PSC 69.2%, WON 30.8%, metal stents 61.5% (46.1% lumen-apposing stent) and plastic stents 38.5%. Group FL included 24 procedures, PSC 37.5%, WON 62.5%, and metal stents 95.8% (lumen-apposing stents). Technical success was 100% in both groups, and clinical success was similar (F 88.5%, FL 87.5%). Technical incidences and intra-procedure AEs were only described in group F (7.6% and 11.5%, respectively) and none in group FL. Procedure time was less in group FL (8min, p=0.0341). Fluoroless in the EUS-TMD of PFCs does not involve more technical incidences or intra-procedure AEs. Technical and clinical success was similar in the two groups. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Guidelines for producing training films and videos.
Harper, P B
1991-01-01
Drawing from experience in producing a film on the surgical procedure of female sterilization, 4 guidelines to technical film production for training purposes are presented and discussed in this paper. In order of presentation in the text, the paper 1st encourages identifying and securing a technical expert, then clearly identifying steps of the technical procedure, involving trainees and trainers in the production process, and working with experienced producers, scriptwriters, and crew members. Returning to the 1st guideline, the technical advisor will have a central presence during all photography and editing, and ideally should not have any personal investment in the procedure being shown. Prior to script finalization and sorting, research is urged to ensure concrete procedural steps. Printed materials, slides, interviews of experienced clinicians, procedure observation, and test videotape shooting may be called upon and employed as parts of the research phase. Trainees should participate during preliminary research, script development, and pretesting of early film versions, their suggestions for change incorporated where appropriate in the final version. On the final point of securing experienced workers, country nationals sensitive to relevant cultural and background dynamics should be included in the team. The special concerns of airport security regulation and customs requirements knowledge are essential, as well as their attention to assuring adequate on-site electricity for camera equipment.
Virtual reality simulation for the optimization of endovascular procedures: current perspectives.
Rudarakanchana, Nung; Van Herzeele, Isabelle; Desender, Liesbeth; Cheshire, Nicholas J W
2015-01-01
Endovascular technologies are rapidly evolving, often requiring coordination and cooperation between clinicians and technicians from diverse specialties. These multidisciplinary interactions lead to challenges that are reflected in the high rate of errors occurring during endovascular procedures. Endovascular virtual reality (VR) simulation has evolved from simple benchtop devices to full physic simulators with advanced haptics and dynamic imaging and physiological controls. The latest developments in this field include the use of fully immersive simulated hybrid angiosuites to train whole endovascular teams in crisis resource management and novel technologies that enable practitioners to build VR simulations based on patient-specific anatomy. As our understanding of the skills, both technical and nontechnical, required for optimal endovascular performance improves, the requisite tools for objective assessment of these skills are being developed and will further enable the use of VR simulation in the training and assessment of endovascular interventionalists and their entire teams. Simulation training that allows deliberate practice without danger to patients may be key to bridging the gap between new endovascular technology and improved patient outcomes.
77 FR 48112 - Pipeline Safety: Administrative Procedures; Updates and Technical Corrections
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-13
...This Notice of Proposed Rulemaking updates the administrative civil penalty maximums for violation of the pipeline safety regulations to conform to current law, updates the informal hearing and adjudication process for pipeline enforcement matters to conform to current law, amends other administrative procedures used by PHMSA personnel, and makes other technical corrections and updates to certain administrative procedures. The proposed amendments do not impose any new operating, maintenance, or other substantive requirements on pipeline owners or operators.
Evaluation of the reproducibility of amplicon sequencing with Illumina MiSeq platform
Van Nostrand, Joy D.; Ning, Daliang; Sun, Bo; Xue, Kai; Liu, Feifei; Deng, Ye; Liang, Yuting; Zhou, Jizhong
2017-01-01
Illumina’s MiSeq has become the dominant platform for gene amplicon sequencing in microbial ecology studies; however, various technical concerns, such as reproducibility, still exist. To assess reproducibility, 16S rRNA gene amplicons from 18 soil samples of a reciprocal transplantation experiment were sequenced on an Illumina MiSeq. The V4 region of 16S rRNA gene from each sample was sequenced in triplicate with each replicate having a unique barcode. The average OTU overlap, without considering sequence abundance, at a rarefaction level of 10,323 sequences was 33.4±2.1% and 20.2±1.7% between two and among three technical replicates, respectively. When OTU sequence abundance was considered, the average sequence abundance weighted OTU overlap was 85.6±1.6% and 81.2±2.1% for two and three replicates, respectively. Removing singletons significantly increased the overlap for both (~1–3%, p<0.001). Increasing the sequencing depth to 160,000 reads by deep sequencing increased OTU overlap both when sequence abundance was considered (95%) and when not (44%). However, if singletons were not removed the overlap between two technical replicates (not considering sequence abundance) plateaus at 39% with 30,000 sequences. Diversity measures were not affected by the low overlap as α-diversities were similar among technical replicates while β-diversities (Bray-Curtis) were much smaller among technical replicates than among treatment replicates (e.g., 0.269 vs. 0.374). Higher diversity coverage, but lower OTU overlap, was observed when replicates were sequenced in separate runs. Detrended correspondence analysis indicated that while there was considerable variation among technical replicates, the reproducibility was sufficient for detecting treatment effects for the samples examined. These results suggest that although there is variation among technical replicates, amplicon sequencing on MiSeq is useful for analyzing microbial community structure if used appropriately and with caution. For example, including technical replicates, removing spurious sequences and unrepresentative OTUs, using a clustering method with a high stringency for OTU generation, estimating treatment effects at higher taxonomic levels, and adapting the unique molecular identifier (UMI) and other newly developed methods to lower PCR and sequencing error and to identify true low abundance rare species all can increase reproducibility. PMID:28453559
Evaluation of the reproducibility of amplicon sequencing with Illumina MiSeq platform
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wen, Chongqing; Wu, Liyou; Qin, Yujia
Illumina's MiSeq has become the dominant platform for gene amplicon sequencing in microbial ecology studies; however, various technical concerns, such as reproducibility, still exist. To assess reproducibility, 16S rRNA gene amplicons from 18 soil samples of a reciprocal transplantation experiment were sequenced on an Illumina MiSeq. The V4 region of 16S rRNA gene from each sample was sequenced in triplicate with each replicate having a unique barcode. The average OTU overlap, without considering sequence abundance, at a rarefaction level of 10,323 sequences was 33.4±2.1% and 20.2±1.7% between two and among three technical replicates, respectively. When OTU sequence abundance was considered,more » the average sequence abundance weighted OTU overlap was 85.6±1.6% and 81.2±2.1% for two and three replicates, respectively. Removing singletons significantly increased the overlap for both (~1-3%, p<0.001). Increasing the sequencing depth to 160,000 reads by deep sequencing increased OTU overlap both when sequence abundance was considered (95%) and when not (44%). However, if singletons were not removed the overlap between two technical replicates (not considering sequence abundance) plateaus at 39% with 30,000 sequences. Diversity measures were not affected by the low overlap as α-diversities were similar among technical replicates while β-diversities (Bray-Curtis) were much smaller among technical replicates than among treatment replicates (e.g., 0.269 vs. 0.374). Higher diversity coverage, but lower OTU overlap, was observed when replicates were sequenced in separate runs. Detrended correspondence analysis indicated that while there was considerable variation among technical replicates, the reproducibility was sufficient for detecting treatment effects for the samples examined. These results suggest that although there is variation among technical replicates, amplicon sequencing on MiSeq is useful for analyzing microbial community structure if used appropriately and with caution. For example, including technical replicates, removing spurious sequences and unrepresentative OTUs, using a clustering method with a high stringency for OTU generation, estimating treatment effects at higher taxonomic levels, and adapting the unique molecular identifier (UMI) and other newly developed methods to lower PCR and sequencing error and to identify true low abundance rare species all can increase reproducibility.« less
Evaluation of the reproducibility of amplicon sequencing with Illumina MiSeq platform
Wen, Chongqing; Wu, Liyou; Qin, Yujia; ...
2017-04-28
Illumina's MiSeq has become the dominant platform for gene amplicon sequencing in microbial ecology studies; however, various technical concerns, such as reproducibility, still exist. To assess reproducibility, 16S rRNA gene amplicons from 18 soil samples of a reciprocal transplantation experiment were sequenced on an Illumina MiSeq. The V4 region of 16S rRNA gene from each sample was sequenced in triplicate with each replicate having a unique barcode. The average OTU overlap, without considering sequence abundance, at a rarefaction level of 10,323 sequences was 33.4±2.1% and 20.2±1.7% between two and among three technical replicates, respectively. When OTU sequence abundance was considered,more » the average sequence abundance weighted OTU overlap was 85.6±1.6% and 81.2±2.1% for two and three replicates, respectively. Removing singletons significantly increased the overlap for both (~1-3%, p<0.001). Increasing the sequencing depth to 160,000 reads by deep sequencing increased OTU overlap both when sequence abundance was considered (95%) and when not (44%). However, if singletons were not removed the overlap between two technical replicates (not considering sequence abundance) plateaus at 39% with 30,000 sequences. Diversity measures were not affected by the low overlap as α-diversities were similar among technical replicates while β-diversities (Bray-Curtis) were much smaller among technical replicates than among treatment replicates (e.g., 0.269 vs. 0.374). Higher diversity coverage, but lower OTU overlap, was observed when replicates were sequenced in separate runs. Detrended correspondence analysis indicated that while there was considerable variation among technical replicates, the reproducibility was sufficient for detecting treatment effects for the samples examined. These results suggest that although there is variation among technical replicates, amplicon sequencing on MiSeq is useful for analyzing microbial community structure if used appropriately and with caution. For example, including technical replicates, removing spurious sequences and unrepresentative OTUs, using a clustering method with a high stringency for OTU generation, estimating treatment effects at higher taxonomic levels, and adapting the unique molecular identifier (UMI) and other newly developed methods to lower PCR and sequencing error and to identify true low abundance rare species all can increase reproducibility.« less
Evaluation of the reproducibility of amplicon sequencing with Illumina MiSeq platform.
Wen, Chongqing; Wu, Liyou; Qin, Yujia; Van Nostrand, Joy D; Ning, Daliang; Sun, Bo; Xue, Kai; Liu, Feifei; Deng, Ye; Liang, Yuting; Zhou, Jizhong
2017-01-01
Illumina's MiSeq has become the dominant platform for gene amplicon sequencing in microbial ecology studies; however, various technical concerns, such as reproducibility, still exist. To assess reproducibility, 16S rRNA gene amplicons from 18 soil samples of a reciprocal transplantation experiment were sequenced on an Illumina MiSeq. The V4 region of 16S rRNA gene from each sample was sequenced in triplicate with each replicate having a unique barcode. The average OTU overlap, without considering sequence abundance, at a rarefaction level of 10,323 sequences was 33.4±2.1% and 20.2±1.7% between two and among three technical replicates, respectively. When OTU sequence abundance was considered, the average sequence abundance weighted OTU overlap was 85.6±1.6% and 81.2±2.1% for two and three replicates, respectively. Removing singletons significantly increased the overlap for both (~1-3%, p<0.001). Increasing the sequencing depth to 160,000 reads by deep sequencing increased OTU overlap both when sequence abundance was considered (95%) and when not (44%). However, if singletons were not removed the overlap between two technical replicates (not considering sequence abundance) plateaus at 39% with 30,000 sequences. Diversity measures were not affected by the low overlap as α-diversities were similar among technical replicates while β-diversities (Bray-Curtis) were much smaller among technical replicates than among treatment replicates (e.g., 0.269 vs. 0.374). Higher diversity coverage, but lower OTU overlap, was observed when replicates were sequenced in separate runs. Detrended correspondence analysis indicated that while there was considerable variation among technical replicates, the reproducibility was sufficient for detecting treatment effects for the samples examined. These results suggest that although there is variation among technical replicates, amplicon sequencing on MiSeq is useful for analyzing microbial community structure if used appropriately and with caution. For example, including technical replicates, removing spurious sequences and unrepresentative OTUs, using a clustering method with a high stringency for OTU generation, estimating treatment effects at higher taxonomic levels, and adapting the unique molecular identifier (UMI) and other newly developed methods to lower PCR and sequencing error and to identify true low abundance rare species all can increase reproducibility.
ERIC Educational Resources Information Center
Baker, Scott K.; And Others
A curricular and instructional framework for increasing the vocabulary skills of diverse learners is described. Areas of convergence in research literature on vocabulary learning and diverse learners are noted, and two recommendations based on these areas of convergence are offered: interventions to address the vocabulary delays of diverse…
A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions
2017-01-01
The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897
ERIC Educational Resources Information Center
Ware, Mary C.; Stuck, Mary F.
2010-01-01
Designers and instructors of courses in career and technical education have realized the value of on-line delivery of instruction during the past several decades. Many students enrolled in career and technical education courses are what have been labeled "non-traditional" students. On-line learning is helpful to these students because it…
Principles and Procedures in Technical Assistance: An Approach to Educational Change
ERIC Educational Resources Information Center
Lillie, David L.; Black, Talbot
1976-01-01
The Technical Assistance Development System (TADS) has developed through the years a system for technical assistance and has identified some important principles that should be followed in the operation of organizational support systems. (Author/ER)
2012-01-01
Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were ‘technically oriented’, ‘improvising’ or ‘socially oriented’. Conclusion We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools. PMID:23256484
Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick
2012-12-20
The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were 'technically oriented', 'improvising' or 'socially oriented'. We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools.
van Delft, E A K; Schepers, T; Bonjer, H J; Kerkhoffs, G M M J; Goslings, J C; Schep, N W L
2018-04-01
Safety in the operating room is widely debated. Adverse events during surgery are potentially dangerous for the patient and staff. The incidence of adverse events during orthopedic trauma surgery is unknown. Therefore, we performed a study to quantify the incidence of these adverse events. Primary objective was to determine the incidence of adverse events related to technical equipment and logistics. The secondary objective was to evaluate the consequences of these adverse events. We completed a cross-sectional observational study to assess the incidence, consequences and preventability of adverse events related to technical equipment and logistics during orthopedic trauma surgery. During a 10 week period, all orthopedic trauma operations were evaluated by an observer. Six types of procedures were differentiated: osteosynthesis; arthroscopy; removal of hardware; joint replacement; bone grafting and other. Adverse events were divided in six categories: staff dependent factors; patient dependent factors; anaesthesia; imaging equipment; operation room equipment and instruments and implants. Adverse events were defined as any factor affecting the surgical procedure in a negative way. Hundred-fifty operative procedures were included. In 54% of the procedures, at least one adverse event occurred. In total, 147 adverse events occurred, with a range of 1-5 per procedure. Most adverse events occurred during joint replacement procedures. Thirty-seven percent of the incidents concerned defect, incorrect connected or absent instruments. In 36% of the procedures adverse events resulted in a prolonged operation time with a median prolongation of 10.0 min. In more than half of orthopedic trauma surgical procedures adverse events related to technical equipment and logistics occurred, most of them could easily be prevented. These adverse events could endanger the safety of the patient and staff and should therefore be reduced. 4.
Overgoor, Max L E; de Jong, Tom P V M; Kon, Moshe
2014-08-01
The "TOMAX" (TO MAX-imize sensation, sexuality, and quality of life) procedure restores genital sensation in men with low spinal lesions, improving sexual health, as shown previously. It connects the dorsal nerve of the penis to the intact ipsilateral ilioinguinal nerve, unilaterally or bilaterally. This study reports on the technical aspects based on 43 TOMAX nerve transfers. In 40 patients with no penile but intact groin sensation, 43 nerve transfers were performed. Data on patient selection, surgical history, anatomy of the ilioinguinal nerve and dorsal nerve of the penis, unilateral or bilateral surgery, surgical technique, complications, and patient information were collected prospectively. Regardless of origin, all patients with no penile but good groin sensation are eligible for the procedure, provided the ilioinguinal nerve is not damaged because of former inguinal surgery or absent because of anatomical variations. Selection of a unilateral or bilateral procedure depends on the presence or absence of reflex erections and bulbocavernosus reflex. Preliminary experience with the first three bilateral cases shows that it is technically feasible, with encouraging results. The surgical technique has evolved (described in detail, including video) to enhance outcome and reduce complications. Patients are better informed, resulting in realistic expectations. This article synthesizes the procedural and technical experience of 43 TOMAX nerve transfers. Anyone skilled in peripheral nerve surgery and microsurgery can adopt this concept and further develop it. The TOMAX procedure can then be used to restore erogenous penile sensation and improve the quality of sexual health in patients with absent penile but good groin sensation.
How family carers engage with technical health procedures in the home: a grounded theory study
McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William
2015-01-01
Objectives To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. Design A qualitative study using grounded theory. Participants New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Methods Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. Results The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a ‘technical’ solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. Conclusions The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers’ emotional and behavioural responses to health technology during the training process. PMID:26150143
Frey procedure combined with biliary diversion in chronic pancreatitis.
Merdrignac, Aude; Bergeat, Damien; Rayar, Michel; Harnoy, Yann; Turner, Kathleen; Courtin-Tanguy, Laetitia; Boudjema, Karim; Meunier, Bernard; Sulpice, Laurent
2016-11-01
The Frey procedure has become the standard operative treatment in chronic painful pancreatitis. Biliary diversion could be combined when associated with common bile duct obstruction. The aim of the present study was to evaluate the impact of the type of biliary diversion combined with the Frey procedure on late morbidity. The data from consecutive patients undergoing the Frey procedure and having a minimum follow-up of 2 years were extracted from a maintained prospective database. The mean endpoint was the rate of secondary biliary stricture after the Frey procedure combined with biliary diversion (bilioenteric anastomosis or common bile duct reinsertion in the resection cavity). Between 2006 and 2013, 55 consecutive patients underwent the Frey procedure. Twenty-nine patients had common bile duct obstruction (52.7%). The technique of biliary diversion resulted in bilioenteric anastomosis in 19 patients (65.5%) and common bile duct reinsertion in 10 patients (34.5%). Preoperative characteristics and early surgical outcomes were comparable. Pain control was similar. There was significantly more secondary biliary stricture after common bile duct reinsertion than after bilioenteric anastomosis (60% vs 11%, P = .008). Combined bilioenteric anastomosis during the Frey procedure is an efficient technique for treating common bile duct obstruction that complicates chronic painful pancreatitis. Bilioenteric anastomosis was associated with less secondary biliary stricture than common bile duct reinsertion in the pancreatic resection cavity. Copyright © 2016 Elsevier Inc. All rights reserved.
Procedures For Microbial-Ecology Laboratory
NASA Technical Reports Server (NTRS)
Huff, Timothy L.
1993-01-01
Microbial Ecology Laboratory Procedures Manual provides concise and well-defined instructions on routine technical procedures to be followed in microbiological laboratory to ensure safety, analytical control, and validity of results.
An adequate level of training for technically competent colonoscopic polypectomy.
Boo, Sun-Jin; Jung, Ji Hoon; Park, Jae Ho; Na, Soo-Young; Kim, Seon Ok; Park, Sang Hyoung; Yang, Dong-Hoon; Kim, Kyung-Jo; Ye, Byong Duk; Myung, Seung-Jae; Yang, Suk-Kyun; Kim, Jin-Ho; Byeon, Jeong-Sik
2015-07-01
The purpose of this study is to investigate the learning curve for colonoscopic polypectomy (CP) by trainee endoscopists. The amount of training required to achieve technical competence for CP is uncertain. The CP times and en bloc resection rates of three experienced colonoscopists were obtained from 240 procedures. These data were compared to those of three gastroenterology trainees who performed 750 CP procedures. A trainee procedure was deemed to be a success if en bloc resection was obtained and the CP time was within twice the median CP time of the experienced colonoscopists. Trainees were deemed to be technically competent when they achieved a CP success rate of greater than or equal to 80%. The median CP times and en bloc resection rates for the experienced colonoscopists and trainees were 79 s (range, 20-301 s) and 99.6% (239/240), and 118 s (range, 36-1051 s) and 95.6% (717/750), respectively. The trainee success rate of CP was 72% (540/750). The success rate of the procedure was associated with increased trainee experience (p = 0.003) and reached 80% after 250 procedures. The CP time significantly decreased (p < 0.001) and en bloc resection rate significantly increased (p = 0.011) as trainee experience accumulated. The level of experience was an independent predictor for successful CP. The achievement of technical competence with CP was associated with an accumulation of approximately 250 procedures. These findings suggest that dedicated education and training programs for CP are warranted.
9 CFR 351.6 - Official number.
Code of Federal Regulations, 2013 CFR
2013-01-01
... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant. ...
9 CFR 351.6 - Official number.
Code of Federal Regulations, 2012 CFR
2012-01-01
... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant. ...
9 CFR 351.6 - Official number.
Code of Federal Regulations, 2011 CFR
2011-01-01
... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant. ...
9 CFR 351.6 - Official number.
Code of Federal Regulations, 2010 CFR
2010-01-01
... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant. ...
9 CFR 351.6 - Official number.
Code of Federal Regulations, 2014 CFR
2014-01-01
... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant. ...
Code of Federal Regulations, 2013 CFR
2013-01-01
..., DEPARTMENT OF AGRICULTURE GUIDELINES FOR THE TRANSFER OF EXCESS COMPUTERS OR OTHER TECHNICAL EQUIPMENT..., in writing, an authorized official to approve transfers of excess computers or other technical...) Excess computers or other technical equipment must first be internally screened to ensure it is not...
Code of Federal Regulations, 2014 CFR
2014-01-01
..., DEPARTMENT OF AGRICULTURE GUIDELINES FOR THE TRANSFER OF EXCESS COMPUTERS OR OTHER TECHNICAL EQUIPMENT..., in writing, an authorized official to approve transfers of excess computers or other technical...) Excess computers or other technical equipment must first be internally screened to ensure it is not...
Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery.
Fecso, Andras B; Bhatti, Junaid A; Stotland, Peter K; Quereshy, Fayez A; Grantcharov, Teodor P
2018-03-23
The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated. A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-17
...) of the Internal Revenue Service to give advice on filing letter ruling, determination letter, and... Procedure 2011-4 (Letter Rulings), Revenue Procedure 2011-5 (Technical Advice), Revenue Procedure 2011-6... Advice), Revenue Procedure 2011-6 (Determination Letters), and Revenue Procedure 2011-8 (User Fees). OMB...
Mentoring for Diversity and Equity: Focusing on Students of Color and New Teachers of Color
ERIC Educational Resources Information Center
Achinstein, Betty
2012-01-01
The task of preparing and supporting new teachers for working with diverse youth has generated widespread interest in induction and mentoring programs (Wang & Odell, 2002). However, much of mentoring in practice falls short of equity- and diversity-focused work. It can be better characterized as "situational adjustment, technical advice, and…
32 CFR 250.6 - Responsibilities.
Code of Federal Regulations, 2012 CFR
2012-07-01
... WITHHOLDING OF UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.6 Responsibilities. (a) The Under... technical data that may be withheld from public disclosure under this Directive. (5) Establish procedures to... with this Directive. (2) Disseminate and withhold from public disclosure technical data subject to this...
32 CFR 250.6 - Responsibilities.
Code of Federal Regulations, 2014 CFR
2014-07-01
... WITHHOLDING OF UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.6 Responsibilities. (a) The Under... technical data that may be withheld from public disclosure under this Directive. (5) Establish procedures to... with this Directive. (2) Disseminate and withhold from public disclosure technical data subject to this...
32 CFR 250.6 - Responsibilities.
Code of Federal Regulations, 2010 CFR
2010-07-01
... WITHHOLDING OF UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.6 Responsibilities. (a) The Under... technical data that may be withheld from public disclosure under this Directive. (5) Establish procedures to... with this Directive. (2) Disseminate and withhold from public disclosure technical data subject to this...
32 CFR 250.6 - Responsibilities.
Code of Federal Regulations, 2013 CFR
2013-07-01
... WITHHOLDING OF UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.6 Responsibilities. (a) The Under... technical data that may be withheld from public disclosure under this Directive. (5) Establish procedures to... with this Directive. (2) Disseminate and withhold from public disclosure technical data subject to this...
32 CFR 250.6 - Responsibilities.
Code of Federal Regulations, 2011 CFR
2011-07-01
... WITHHOLDING OF UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.6 Responsibilities. (a) The Under... technical data that may be withheld from public disclosure under this Directive. (5) Establish procedures to... with this Directive. (2) Disseminate and withhold from public disclosure technical data subject to this...
48 CFR 742.1170-2 - Applicability.
Code of Federal Regulations, 2014 CFR
2014-10-01
... policies, procedures, and limitations of this section do not apply to technical reports, studies, papers... section applies to USAID non-personal, professional/technical services contracts exceeding the simplified... FAR 48 CFR subpart 42.11 are compatible with the types of technical assistance contracts usually...
48 CFR 742.1170-2 - Applicability.
Code of Federal Regulations, 2013 CFR
2013-10-01
... policies, procedures, and limitations of this section do not apply to technical reports, studies, papers... section applies to USAID non-personal, professional/technical services contracts exceeding the simplified... FAR 48 CFR subpart 42.11 are compatible with the types of technical assistance contracts usually...
48 CFR 742.1170-2 - Applicability.
Code of Federal Regulations, 2012 CFR
2012-10-01
... policies, procedures, and limitations of this section do not apply to technical reports, studies, papers... section applies to USAID non-personal, professional/technical services contracts exceeding the simplified... FAR 48 CFR subpart 42.11 are compatible with the types of technical assistance contracts usually...
TADS Needs Assessment Procedures Manual, Summer 1980.
ERIC Educational Resources Information Center
Black, Talbot; And Others
The TADS (Technical Assistance Development System) Needs Assessment Manual is designed to guide the comprehensive review of Handicapped Children's Early Education Program (HCEEP) demonstration projects in identifying technical assistance needs. An introduction reviews the TADS technical assistance model which includes program planning, needs…
Labbé, Mathilde; Young, Meredith; Nguyen, Lily H P
2017-10-08
To support the development of programs of assessment of technical skills in the operating room (OR), we systematically reviewed the literature to identify assessment tools specific to otolaryngology-head and neck surgery (OTL-HNS) core procedures and summarized their characteristics. We systematically searched Embase, MEDLINE, PubMed, and Cochrane to identify and report on assessment tools that can be used to assess residents' technical surgical skills in the operating room for OTL-HNS core procedures. Of the 736 unique titles retrieved, 16 articles met inclusion criteria, covering 11 different procedures (in otology, rhinology, laryngology, head and neck, and general otolaryngology). The tools were composed of a task-specific checklist and/or global rating scale and were developed in the OR, on human cadavers, or in a simulation setting. Our study reports on published tools for assessing technical skills for OTL-HNS residents during core procedures conducted in the OR. These assessment tools could facilitate the provision of timely feedback to trainees including specific goals for improvement. However, the paucity of publications suggests little agreement on how to best perform work-based direct-observation assessment for core surgical procedures in OTL-HNS. The sparsity of tools specific to OTL-HNS may become a barrier to a fluid transition to competency-based medical education. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Code of Federal Regulations, 2010 CFR
2010-07-01
... providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary... information or technical assistance? (a) The Secretary provides information or technical assistance to an IHE in writing, through site visits, or by other means. (b) The IHE shall inform the Secretary of any...
Code of Federal Regulations, 2011 CFR
2011-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.1 Purpose. This part establishes policy, prescribes procedures, and assigns responsibilities for the dissemination and withholding of technical data. ...
Code of Federal Regulations, 2012 CFR
2012-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.1 Purpose. This part establishes policy, prescribes procedures, and assigns responsibilities for the dissemination and withholding of technical data. ...
Code of Federal Regulations, 2013 CFR
2013-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.1 Purpose. This part establishes policy, prescribes procedures, and assigns responsibilities for the dissemination and withholding of technical data. ...
Code of Federal Regulations, 2014 CFR
2014-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.1 Purpose. This part establishes policy, prescribes procedures, and assigns responsibilities for the dissemination and withholding of technical data. ...
Code of Federal Regulations, 2010 CFR
2010-07-01
... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.1 Purpose. This part establishes policy, prescribes procedures, and assigns responsibilities for the dissemination and withholding of technical data. ...
Kraft, Marc
2008-09-03
Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority.
Kraft, Marc
2008-01-01
Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority. PMID:20204095
Design and development of reactive injectable and settable polymeric biomaterials.
Page, Jonathan M; Harmata, Andrew J; Guelcher, Scott A
2013-12-01
Injectable and settable biomaterials are a growing class of therapeutic technologies within the field of regenerative medicine. These materials offer advantages compared to prefabricated implants because of their ability to be utilized as part of noninvasive surgical procedures, fill complex defect shapes, cure in situ, and incorporate cells and other active biologics. However, there are significant technical barriers to clinical translation of injectable and settable biomaterials, such as achieving clinically relevant handling properties and benign reaction conditions. This review focuses on the engineering challenges associated with the design and development of injectable and chemically settable polymeric biomaterials. Additionally, specific examples of the diverse chemistries utilized to overcome these challenges are covered. The future translation of injectable and settable biomaterials is anticipated to improve patient outcomes for a number of clinical conditions. Copyright © 2013 Wiley Periodicals, Inc., a Wiley Company.
Laparoscopic repair of inguinal hernia in adults
Yang, Xue-Fei
2016-01-01
Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. The procedures include intraperitoneal onlay mesh (IPOM) repair, transabdominal preperitoneal (TAPP) repair and total extraperitoneal (TEP) repair. These procedures have totally different anatomic point of view, process and technical key points from open operations. The technical details of these operations are discussed in this article, also the strategies of treatment for some special conditions. PMID:27867954
ERIC Educational Resources Information Center
A. C., John; Manabete, S. S.
2015-01-01
This study sought to determine the procedural influence on internal and external assessment scores of undergraduate research projects in vocational and technical education programmes in the university under study. A survey research design was used for the conduct of this study. The population consisted of 130 lecturers and 1,847 students in the…
77 FR 3766 - Southwestern Gas Storage Technical Conference
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-25
... Storage Technical Conference Notice of Public Conference On December 13, 2011, the Secretary issued formal... related to natural gas storage development in the southwestern United States, to be held at the Radisson... to speak from numerous individuals representing diverse interests associated with storage development...
Advancing Sustainable Bioenergy: Evolving Stakeholder Interests and the Relevance of Research
NASA Astrophysics Data System (ADS)
Johnson, Timothy Lawrence; Bielicki, Jeffrey M.; Dodder, Rebecca S.; Hilliard, Michael R.; Ozge Kaplan, P.; Andrew Miller, C.
2013-02-01
The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different—and potentially conflicting—values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts to define and promote "sustainable" bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.
Advancing sustainable bioenergy: evolving stakeholder interests and the relevance of research.
Johnson, Timothy Lawrence; Bielicki, Jeffrey M; Dodder, Rebecca S; Hilliard, Michael R; Kaplan, P Ozge; Miller, C Andrew
2013-02-01
The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different-and potentially conflicting-values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts to define and promote "sustainable" bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.
29 CFR 95.44 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-07-01
..., record of past performance, financial and technical resources or accessibility to other necessary..., whenever practicable, of technical requirements in terms of functions to be performed or performance...
15 CFR 14.44 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-01-01
..., record of past performance, financial and technical resources or accessibility to other necessary... practicable, of technical requirements in terms of functions to be performed or performance required...
Pannell, J Scott; Santiago-Dieppa, David R; Wali, Arvin R; Hirshman, Brian R; Steinberg, Jeffrey A; Cheung, Vincent J; Oveisi, David; Hallstrom, Jon; Khalessi, Alexander A
2016-08-29
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded. Image quality was rated, and the absolute value of technically unsafe events was recorded. The trainees' device selection, macrovascular access, microvascular access, clinical management, and the overall performance of the trainee was rated during each procedure based on a traditional Likert scale score of 1=fail, 2=poor, 3=satisfactory, 4=good, and 5=excellent. These ordinal values correspond with published assessment scales on surgical technique. After performing five diagnostic angiograms and five embolectomies, all participants demonstrated marked decreases in procedure time, fluoroscopy doses, contrast doses, and adverse technical events; marked improvements in image quality, device selection, access scores, and overall technical performance were additionally observed (p < 0.05). Similarly, trainees demonstrated marked improvement in technical performance and clinical management after five coiling procedures (p < 0.05). However, trainees with less prior experience deploying coils continued to experience intra-procedural ruptures up to the eighth embolization procedure; this observation likely corresponded with less tactile procedural experience to an exertion of greater force than appropriate for coil placement. Trainees across all levels of training and prior experience demonstrated a significant performance improvement after completion of our simulator curriculum consisting of five diagnostic angiograms, five embolectomy cases, and 10 aneurysm coil embolizations.
48 CFR 227.7108 - Contractor data repositories.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Technical Data 227.7108 Contractor data repositories. (a) Contractor data repositories may be established... procedures for protecting technical data delivered to or stored at the repository from unauthorized release... disclosure of technical data from the repository to third parties consistent with the Government's rights in...
48 CFR 715.303-70 - Responsibilities of USAID evaluation committees.
Code of Federal Regulations, 2010 CFR
2010-10-01
... evaluation committees. A technical evaluation committee shall be established for each proposed procurement. In each case, the committee shall be composed of a chair representing the cognizant technical office... representatives from other concerned offices as appropriate. (b) Technical evaluation procedures. (1) The...
75 FR 12740 - Wyoming Interstate Company, Inc.; Notice of Technical Conference
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-17
... additional technical, engineering, and operational support for its proposed gas quality allocation procedures... should be prepared to support its position with adequate technical, engineering, and operational information. FERC conferences are accessible under section 508 of the Rehabilitation Act of 1973. For...
Providing Services to Virtual Patrons.
ERIC Educational Resources Information Center
Hulshof, Robert
1999-01-01
Discusses the types of services libraries need to support patrons who access the library via the Internet or e-mail. Highlights include issues in technical support; establishing policies and procedures; tools for technical support, including hardware and software; impacts of technical support on staff; and future possibilities. (LRW)
[Current status and changes of metabolic and bariatric surgery in China].
Liu, Jingang
2017-04-25
Through continuous development, metabolic and bariatric surgery (MBS) has become widely recognized in academic and medical circles. In China, the volume of MBS operations has increased year by year. Therapeutic goals of MBS have evolved from treating obesity to treating Type 2 diabetes mellitus, and further to treating a series of obesity-associated metabolic diseases (including conditions in the endocrine system, circulatory system, respiratory system, reproductive system, and etc). Surgical approach of MBS has also been evolving continuously. Currently the common surgical procedures include laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric banding (LAGB) and bilio-pancreatic diversion with duodenal switch (BPD-DS). All surgical procedures have pros and cons, and the choice of surgical procedures should be based on the conditions of patients, the surgeon's technical ability, and benefits and operative risks. With the development of MBS, the proportions of different surgical procedures also changed in China. In recent five years, the proportion of AGB has decreased continuously and LAGB is no longer a common procedure. The proportion of LSG has increased rapidly, rising from 9% in 2010 to 55% in 2015. The proportion of RYGB has increased from 57% to 64% between 2010 and 2013, and remained at 45% afterwards. Since 2010, most MBS operations are laparoscopic surgery. 3D Laparoscopic surgery, laparoendoscopic single-site surgery and da Vinci Robotic Surgery have also been introduced in MBS. This review discusses the status quo and changes of MBS in china, as well as the new technology in MBS, aiming to strengthen the information and comprehension of MBS in china.
Adrenal vein sampling: substantial need for technical improvement at regional referral centres.
Elliott, Panda; Holmes, Daniel T
2013-10-01
Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada. Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored. The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (p<0.01) to 82% for those employing ACTH (n=139). ACTH-stimulation significantly increased the median SI (left: 5.8 vs 36.7, p<0.01; right: 7.0 vs 51.2, p<0.01), and salvaged 36 procedures from yielding no information, 21 of which demonstrated lateralization of aldosterone production. In 64 cases showing lateralization both pre and post-stimulation, ACTH significantly decreased the median LI from 5.4 to 2.2, p<0.01, creating substantial risk for spurious loss of lateralization. The technical success of AVS is lower than reported elsewhere. Provided that effects on the LI are considered, the use of ACTH-stimulation during AVS assists in the identification of unilateral forms of PA. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Concept of Draft International Standard for a Unified Approach to Space Program Quality Assurance
NASA Astrophysics Data System (ADS)
Stryzhak, Y.; Vasilina, V.; Kurbatov, V.
2002-01-01
For want of the unified approach to guaranteed space project and product quality assurance, implementation of many international space programs has become a challenge. Globalization of aerospace industry and participation of various international ventures with diverse quality assurance requirements in big international space programs requires for urgent generation of unified international standards related to this field. To ensure successful fulfillment of space missions, aerospace companies should design and process reliable and safe products with properties complying or bettering User's (or Customer's) requirements. Quality of the products designed or processed by subcontractors (or other suppliers) should also be in compliance with the main user (customer)'s requirements. Implementation of this involved set of unified requirements will be made possible by creating and approving a system (series) of international standards under a generic title Space Product Quality Assurance based on a system consensus principle. Conceptual features of the baseline standard in this system (series) should comprise: - Procedures for ISO 9000, CEN and ECSS requirements adaptation and introduction into space product creation, design, manufacture, testing and operation; - Procedures for quality assurance at initial (design) phases of space programs, with a decision on the end product made based on the principle of independence; - Procedures to arrange incoming inspection of products delivered by subcontractors (including testing, audit of supplier's procedures, review of supplier's documentation), and space product certification; - Procedures to identify materials and primary products applied; - Procedures for quality system audit at the component part, primary product and materials supplier facilities; - Unified procedures to form a list of basic performances to be under configuration management; - Unified procedures to form a list of critical space product components, and unified procedures to define risks related to the specific component application and evaluate safety for the entire program implementation. In the eyes of the authors, those features together with a number of other conceptual proposals should constitute a unified standard-technical basis for implementing international space programs.
Eide, Torunn Bjerve; Straand, Jørund; Björkelund, Cecilia; Kosunen, Elise; Thorgeirsson, Ofeigur; Vedsted, Peter; Rosvold, Elin Olaug
2017-08-03
We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe. 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices. The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses. The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted intrauterine devices significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries. GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered.
Eide, Torunn Bjerve; Straand, Jørund; Björkelund, Cecilia; Kosunen, Elise; Thorgeirsson, Ofeigur; Vedsted, Peter; Rosvold, Elin Olaug
2017-06-01
We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC). A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices. The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses. The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted IUDs significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries. GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered.
Rigatelli, Gianluca; Rigateli, Gianluca; Cardaioli, Paolo; Braggion, Gabriele; Aggio, Silvio; Giordan, Massimo; Magro, Beatrice; Nascimben, Alberto; Favaro, Alberto; Roncon, Loris; Rincon, Loris
2007-02-01
We sought to prospectively assess the role of transesophageal (TEE) and intracardiac echocardiography (ICE) in detecting potential technical difficulties or failures in patients submitted to interatrial shunts percutaneous closure. We prospectively enrolled 46 consecutive patients (mean age 35+/-28, 8 years, 30 female) referred to our center for catheter-based closure of interatrial shunts. All patients were screened with TEE before the intervention. Patients who met the inclusion criteria underwent ICE study before the closure attempt (40 patients). TEE detected potential technical difficulties in 22.5% (9/40) patients, whereas ICE detected technical difficulties in 32.5% (13/40 patients). In patients with positive TEE/ICE the procedural success (92.4% versus 100% and, P = ns) and follow-up failure rate (7.7% versus 0%, P = ns) were similar to patients with negative TEE/ICE, whereas the fluoroscopy time (7 +/- 1.2 versus 5 +/- 0.7 minutes, P < 0.03), the procedural time (41 +/- 4.1 versus 30 +/- 8.2 minutes, P +/- 0.03), and technical difficulties rate (23.1% versus 0%, P = 0.013) were higher. Differences between ICE and TEE in the evaluation of rims, measurement of ASD or fossa ovalis, and detection of venous valve and embryonic septal membrane remnants impacted on technical challenges and on procedural and fluoroscopy times but did not influence the success rate and follow-up failure rate.
47 CFR 68.7 - Technical criteria for terminal equipment.
Code of Federal Regulations, 2010 CFR
2010-10-01
... (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.7 Technical criteria for... switched telephone network. (b) Technical criteria published by the Administrative Council for Terminal... network from harms caused by the connection of terminal equipment, subject to the appeal procedures in...
47 CFR 68.7 - Technical criteria for terminal equipment.
Code of Federal Regulations, 2011 CFR
2011-10-01
... (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK General § 68.7 Technical criteria for... switched telephone network. (b) Technical criteria published by the Administrative Council for Terminal... network from harms caused by the connection of terminal equipment, subject to the appeal procedures in...
Scaffolding Collaborative Technical Writing with Procedural Facilitation and Synchronous Discussion
ERIC Educational Resources Information Center
Yeh, Shiou-Wen; Lo, Jia-Jiunn; Huang, Jeng-Jia
2011-01-01
With the advent of computer technology, researchers and instructors are attempting to devise computer support for effective collaborative technical writing. In this study, a computer-supported environment for collaborative technical writing was developed. This system (Process-Writing Wizard) provides process-oriented scaffolds and a synchronous…
The 1996 NAEP Technical Report.
ERIC Educational Resources Information Center
Allen, Nancy L.; Carlson, James E.; Zelenak, Christine A.
This report documents the design, administration, and data analysis procedure of the National Assessment of Education Progress (NAEP) for 1996. It indicates the technical decisions that were made and the rationale behind them. Detailed substantive findings are not presented in this report. These chapters provide technical information about the…
The history of head transplantation: a review.
Lamba, Nayan; Holsgrove, Daniel; Broekman, Marike L
2016-12-01
Since the turn of the last century, the prospect of head transplantation has captured the imagination of scientists and the general public. Recently, head transplant has regained attention in popular media, as neurosurgeons have proposed performing this procedure in 2017. Given the potential impact of such a procedure, we were interested in learning the history of the technical hurdles that need to be overcome, and determine if it is even technically possible to perform such a procedure on humans today. We conducted a historical review of available literature on the technical challenges and developments of head transplantation. The many social, psychological, ethical, religious, cultural, and legal questions of head transplantation were beyond the scope of this review. Our historical review identified the following important technical considerations related to performing a head transplant: maintenance of blood flow to an isolated brain via vessel anastomosis; availability of immunosuppressive agents; spinal anastomosis and fusion following cord transfection; pain control in the recipient. Several animal studies have demonstrated success in maintaining recipient cerebral perfusion and achieving immunosuppression. However, there is currently sparse evidence in favor of successful spinal anastomosis and fusion after transection. While recent publications by an Italian group offer novel approaches to this challenge, research on this topic has been sparse and hinges on procedures performed in animal models in the 1970s. How transferrable these older methods are to the human nervous system is unclear and warrants further exploration. Our review identified several important considerations related to performing a viable head transplantation. Besides the technical challenges that remain, there are important ethical issues to consider, such as exploitation of vulnerable patients and informed consent. Thus, besides the remaining technical challenges, these ethical issues will also need to be addressed before moving these studies to the clinic.
45 CFR 2543.44 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...
36 CFR 1210.44 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-07-01
..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...
14 CFR 1260.144 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-01-01
..., record of past performance, financial and technical resources or accessibility to other necessary... technical requirements in terms of functions to be performed or performance required, including the range of...
21 CFR 1271.47 - What procedures must I establish and maintain?
Code of Federal Regulations, 2010 CFR
2010-04-01
... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Donor Eligibility § 1271.47 What procedures... technical manual prepared by another organization, provided that you have verified that the procedures are...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Paik, Nam Chull, E-mail: pncspine@gmail.com
2016-07-15
PurposeA technique for computed tomography fluoroscopy (CTF)-guided intraarticular (IA) sacroiliac joint (SIJ) injection was devised to limit procedural time and radiation dose.MethodsOur Institutional Review Board approved this retrospective analysis and waived the requirement for informed consent. Overall, 36 consecutive diagnostic or therapeutic IA SIJ injections (unilateral, 20; bilateral, 16) performed in 34 patients (female, 18; male, 16) with a mean age of 45.5 years (range 20–76 years) under CTF guidance were analyzed, assessing technical success (i.e., IA contrast spread), procedural time, and radiation dose.ResultsAll injections were successful from a technical perspective and were free of serious complications. Respective median proceduralmore » times and effective doses of SIJ injection were as follows: unilateral, 5.28 min (range 3.58–8.00 min) and 0.11 millisievert (mSv; range 0.07–0.24 mSv); and bilateral, 6.72 min (range 4.17–21.17 min) and 0.11 mSv (range 0.09–0.51 mSv).ConclusionsGiven the high rate of technical success achieved in limited time duration and with little radiation exposure, CTF-guided IA SIJ injection is a practical and low-risk procedure.« less
2011-08-25
Aeronautics Technical Seminar with Dennis Koehler, Vice President, Science Applications International Corporation (and former FAA executive) presenting 'Beyond the Technical: Procedural, Operational and Economic Factors 'POET' for NextGen Success
Fecso, A B; Kuzulugil, S S; Babaoglu, C; Bener, A B; Grantcharov, T P
2018-03-30
The operating theatre is a unique environment with complex team interactions, where technical and non-technical performance affect patient outcomes. The correlation between technical and non-technical performance, however, remains underinvestigated. The purpose of this study was to explore these interactions in the operating theatre. A prospective single-centre observational study was conducted at a tertiary academic medical centre. One surgeon and three fellows participated as main operators. All patients who underwent a laparoscopic Roux-en-Y gastric bypass and had the procedures captured using the Operating Room Black Box ® platform were included. Technical assessment was performed using the Objective Structured Assessment of Technical Skills and Generic Error Rating Tool instruments. For non-technical assessment, the Non-Technical Skills for Surgeons (NOTSS) and Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) tools were used. Spearman rank-order correlation and N-gram statistics were conducted. Fifty-six patients were included in the study and 90 procedural steps (gastrojejunostomy and jejunojejunostomy) were analysed. There was a moderate to strong correlation between technical adverse events (r s = 0·417-0·687), rectifications (r s = 0·380-0·768) and non-technical performance of the surgical and nursing teams (NOTSS and SPLINTS). N-gram statistics showed that after technical errors, events and prior rectifications, the staff surgeon and the scrub nurse exhibited the most positive non-technical behaviours, irrespective of operator (staff surgeon or fellow). This study demonstrated that technical and non-technical performances are related, on both an individual and a team level. Valuable data can be obtained around intraoperative errors, events and rectifications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.
19 CFR 115.30 - Technical requirements for containers by design type.
Code of Federal Regulations, 2011 CFR
2011-04-01
... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2011-04-01 2011-04-01 false Technical requirements for containers by design...
19 CFR 115.30 - Technical requirements for containers by design type.
Code of Federal Regulations, 2012 CFR
2012-04-01
... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2012-04-01 2012-04-01 false Technical requirements for containers by design...
19 CFR 115.30 - Technical requirements for containers by design type.
Code of Federal Regulations, 2014 CFR
2014-04-01
... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2014-04-01 2014-04-01 false Technical requirements for containers by design...
19 CFR 115.30 - Technical requirements for containers by design type.
Code of Federal Regulations, 2010 CFR
2010-04-01
... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2010-04-01 2010-04-01 false Technical requirements for containers by design...
19 CFR 115.30 - Technical requirements for containers by design type.
Code of Federal Regulations, 2013 CFR
2013-04-01
... SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers by Design Type § 115.30 Technical... 19 Customs Duties 1 2013-04-01 2013-04-01 false Technical requirements for containers by design...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-08
... calibration procedures under MIL-T-31000, General Specification for Technical Data Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or drawings and associated... Packages, Amendment 1, or MIL-T-47500, General Specification for Technical Data Packages, Supp 1, or...
Succession Planning for Management Staff at a Canadian Post Secondary Technical Institute.
ERIC Educational Resources Information Center
da Costa, Jose; Cembrowski, Barbara
2001-01-01
Analyzed interviews to explore how nine administrators, at three different career stages, perceived career-development and succession planning at a Canadian postsecondary technical institute. Managers attribute career success to possession of varied personal attributes, diverse work experiences, serendipity, and a fulfilling work environment. Job…
Workplace Skills in Practice. Case Studies of Technical Work.
ERIC Educational Resources Information Center
Stasz, Cathleen; And Others
A study was conducted to explore skills and work-related dispositions in technical work. It used a sociocultural approach to examine skills in seven target jobs in worksites representing diverse industries--health care, traffic management, transportation, and semiconductor manufacturing. It explored employers' strategies for obtaining the skills…
Organic Waste Diversion in Columbia, South Carolina, Feasibility Study
The study found that a variety of methods are technically and economically feasible for diverting food wastes and providing a positive return on investment for the source. Potential barriers and considerations for food waste diversion are identified in the study. Given the E...
Use of an Objective Structured Assessment of Technical Skill After a Sports Medicine Rotation.
Dwyer, Tim; Slade Shantz, Jesse; Kulasegaram, Kulamakan Mahan; Chahal, Jaskarndip; Wasserstein, David; Schachar, Rachel; Devitt, Brian; Theodoropoulos, John; Hodges, Brian; Ogilvie-Harris, Darrell
2016-12-01
The purpose of this study was to determine if the use of an Objective Structured Assessment of Technical skill (OSATS), using dry models, would be a valid method of assessing residents' ability to perform sports medicine procedures after training in a competency-based model. Over 18 months, 27 residents (19 junior [postgraduate year (PGY) 1-3] and 8 senior [PGY 4-5]) sat the OSATS after their rotation, in addition to 14 sports medicine staff and fellows. Each resident was provided a list of 10 procedures in which they were expected to show competence. At the end of the rotation, each resident undertook an OSATS composed of 6 stations sampled from the 10 procedures using dry models-faculty used the Arthroscopic Surgical Skill Evaluation Tool (ASSET), task-specific checklists, as well as an overall 5-point global rating scale (GRS) to score each resident. Each procedure was videotaped for blinded review. The overall reliability of the OSATS (0.9) and the inter-rater reliability (0.9) were both high. A significant difference by year in training was seen for the overall GRS, the total ASSET score, and the total checklist score, as well as for each technical procedure (P < .001). Further analysis revealed a significant difference in the total ASSET score between junior (mean 18.4, 95% confidence interval [CI] 16.8 to 19.9) and senior residents (24.2, 95% CI 22.7 to 25.6), senior residents and fellows (30.1, 95% CI 28.2 to 31.9), as well as between fellows and faculty (37, 95% CI 36.1 to 27.8) (P < .05). The results of this study show that an OSATS using dry models shows evidence of validity when used to assess performance of technical procedures after a sports medicine rotation. However, junior residents were not able to perform as well as senior residents, suggesting that overall surgical experience is as important as intensive teaching. As postgraduate medical training shifts to a competency-based model, methods of assessing performance of technical procedures become necessary. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Can Diversity in the Undergraduate Engineering Population BE Enhanced Through Curricular Change?
NASA Astrophysics Data System (ADS)
Busch-Vishniac, Ilene J.; Jarosz, Jeffrey P.
The lack of diversity in the engineering workforce is a persistent problem, with no signs of pending improvement. The situation continues despite a serious technical workforce shortage in the United States. Efforts to promote diversity in the student body in U.S. engineering schools, such as industrial partnerships, academic services, and the establishment of social networks, have produced modest gains. The authors intend to pursue a distinctly different approach to the problem of encouraging a diverse engineering student population, one that focuses on the curriculum. This study reviews curricular innovations attempted to date as a basis for rebuilding the undergraduate engineering curriculum from the ground up. The goal is to produce a curriculum that retains the salient technical material but enhances the link between fundamentals and applications, reduces critical path lengths in the course sequence, introduces team experiences into all courses, and creates an atmosphere of inclusion rather than exclusion. The new curriculum will require trial, assessment, and revision before it is ready for adoption.
Watanabe, Shigeru; Yamamoto, Akira; Torigoe, Teruyuki; Kanki, Akihiko; Tamada, Tsutomu; Ito, Katsuyoshi
2016-02-01
To assess the technical feasibility of transfemoral intra-arterial chemotherapy for head and neck cancer using a 3-French catheter system (3-Fr). Sixty-two patients with head and neck cancer who underwent transfemoral intra-arterial chemotherapy were included in this study. Thirty-three patients underwent treatment using a 3-Fr (group 3-Fr). Twenty-nine patients underwent treatment using a 4-French catheter system (group 4-Fr). The technical success rate, duration of the procedure with fluoroscopy, and rate of procedure-related complications were compared between group 3-Fr and group 4-Fr. In addition, in group 3-Fr, bleeding at the puncture site after 1.5 h of bed rest was evaluated. The technical success rate was 100% in both groups. The duration of the procedure with fluoroscopy didn't differ between group 3-Fr (mean 28.0 min) and group 4-Fr (mean 30.2 min) (p = 0.524). There was no procedure-related complication in either group. In group 3-Fr, no hemorrhagic complication was observed. A 3-French catheter system can be used to perform transfemoral intra-arterial chemotherapy for head and neck cancer and is technically feasible with approximately the same duration of the procedure with fluoroscopy. Furthermore, this method may shorten the bed rest time without hemorrhagic complication, and may reduce the risk of pulmonary embolism.
Suri, Rakesh M; Minha, Sa'ar; Alli, Oluseun; Waksman, Ron; Rihal, Charanjit S; Satler, Lowell P; Greason, Kevin L; Torguson, Rebecca; Pichard, Augusto D; Mack, Michael; Svensson, Lars G; Rajeswaran, Jeevanantham; Lowry, Ashley M; Ehrlinger, John; Mick, Stephanie L; Tuzcu, E Murat; Thourani, Vinod H; Makkar, Raj; Holmes, David; Leon, Martin B; Blackstone, Eugene H
2016-09-01
Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve). From April 2007 to February 2012, 1100 patients, average age 85.0 ± 6.4 years, underwent TA-TAVR in the PARTNER-I trial. Learning curves were defined by institution-specific patient sequence number using nonlinear mixed modeling. Mean procedure time decreased from 131 to 116 minutes within 30 cases (P = .06) and device success increased to 90% by case 45 (P = .0007). Within 30 days, 354 patients experienced a major adverse event (stroke in 29, death in 96), with possibly decreased complications over time (P ∼ .08). Although longer procedure time was associated with more adverse events (P < .0001), these events were associated with change in patient risk profile, not the technical performance learning curve (P = .8). The learning curve for TA-TAVR was 30 to 45 procedures performed, and technical efficiency was achieved without compromising patient safety. Although fewer patients are now undergoing TAVR via nontransfemoral access, understanding TA-TAVR learning curves and their relationship with outcomes is important as the field moves toward next-generation devices, such as those to replace the mitral valve, delivered via the left ventricular apex. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
The financial implications of endovascular aneurysm repair in the cost containment era.
Stone, David H; Horvath, Alexander J; Goodney, Philip P; Rzucidlo, Eva M; Nolan, Brian W; Walsh, Daniel B; Zwolak, Robert M; Powell, Richard J
2014-02-01
Endovascular aneurysm repair (EVAR) is associated with significant direct device costs. Such costs place EVAR at odds with efforts to constrain healthcare expenditures. This study examines the procedure-associated costs and operating margins associated with EVAR at a tertiary care academic medical center. All infrarenal EVARs performed from April 2011 to March 2012 were identified (n = 127). Among this cohort, 49 patients met standard commercial instruction for use guidelines, were treated using a single manufacturer device, and billed to Medicare diagnosis-related group (DRG) 238. Of these 49 patients, net technical operating margins (technical revenue minus technical cost) were calculated in conjunction with the hospital finance department. EVAR implant costs were determined for each procedure. DRG 238-associated costs and length of stay were benchmarked against other academic medical centers using University Health System Consortium 2012 data. Among the studied EVAR cohort (age 75, 82% male, mean length of stay, 1.7 days), mean technical costs totaled $31,672. Graft implants accounted for 52% of the allocated technical costs. Institutional overhead was 17% ($5495) of total technical costs. Net mean total technical EVAR-associated operating margins were -$4015 per procedure. Our institutional costs and length of stay, when benchmarked against comparable centers, remained in the lowest quartile nationally using University Health System Consortium costs for DRG 238. Stent graft price did not correlate with total EVAR market share. EVAR is currently associated with significant negative operating margins among Medicare beneficiaries. Currently, device costs account for over 50% of EVAR-associated technical costs and did not impact EVAR market share, reflecting an unawareness of cost differential among surgeons. These data indicate that EVAR must undergo dramatic care delivery redesign for this practice to remain sustainable. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Yamamoto, Katsumi; Michida, Tomoki; Nishida, Tsutomu; Hayashi, Shiro; Naito, Masafumi; Ito, Toshifumi
2015-01-01
Endoscopic submucosal dissection (ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. PMID:26468335
Transfer of knowledge in international cooperation: the Farmanguinhos - SMM case.
Silva, Samuel Araujo Gomes da; Duarte, Roberto Gonzalez; Castro, José Márcio de
2017-01-01
To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity.
Lessons Learned From 104 Years of Mobile Observatories
NASA Astrophysics Data System (ADS)
Miller, S. P.; Clark, P. D.; Neiswender, C.; Raymond, L.; Rioux, M.; Norton, C.; Detrick, R.; Helly, J.; Sutton, D.; Weatherford, J.
2007-12-01
As the oceanographic community ventures into a new era of integrated observatories, it may be helpful to look back on the era of "mobile observatories" to see what Cyberinfrastructure lessons might be learned. For example, SIO has been operating research vessels for 104 years, supporting a wide range of disciplines: marine geology and geophysics, physical oceanography, geochemistry, biology, seismology, ecology, fisheries, and acoustics. In the last 6 years progress has been made with diverse data types, formats and media, resulting in a fully-searchable online SIOExplorer Digital Library of more than 800 cruises (http://SIOExplorer.ucsd.edu). Public access to SIOExplorer is considerable, with 795,351 files (206 GB) downloaded last year. During the last 3 years the efforts have been extended to WHOI, with a "Multi-Institution Testbed for Scalable Digital Archiving" funded by the Library of Congress and NSF (IIS 0455998). The project has created a prototype digital library of data from both institutions, including cruises, Alvin submersible dives, and ROVs. In the process, the team encountered technical and cultural issues that will be facing the observatory community in the near future. Technological Lessons Learned: Shipboard data from multiple institutions are extraordinarily diverse, and provide a good training ground for observatories. Data are gathered from a wide range of authorities, laboratories, servers and media, with little documentation. Conflicting versions exist, generated by alternative processes. Domain- and institution-specific issues were addressed during initial staging. Data files were categorized and metadata harvested with automated procedures. With our second-generation approach to staging, we achieve higher levels of automation with greater use of controlled vocabularies. Database and XML- based procedures deal with the diversity of raw metadata values and map them to agreed-upon standard values, in collaboration with the Marine Metadata Interoperability (MMI) community. All objects are tagged with an expert level, thus serving an educational audience, as well as research users. After staging, publication into the digital library is completely automated. The technical challenges have been largely overcome, thanks to a scalable, federated digital library architecture from the San Diego Supercomputer Center, implemented at SIO, WHOI and other sites. The metadata design is flexible, supporting modular blocks of metadata tailored to the needs of instruments, samples, documents, derived products, cruises or dives, as appropriate. Controlled metadata vocabularies, with content and definitions negotiated by all parties, are critical. Metadata may be mapped to required external standards and formats, as needed. Cultural Lessons Learned: The cultural challenges have been more formidable than expected. They became most apparent during attempts to categorize and stage digital data objects across two institutions, each with their own naming conventions and practices, generally undocumented, and evolving across decades. Whether the questions concerned data ownership, collection techniques, data diversity or institutional practices, the solution involved a joint discussion with scientists, data managers, technicians and archivists, working together. Because metadata discussions go on endlessly, significant benefit comes from dictionaries with definitions of all community-authorized metadata values.
McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William
2016-09-01
To describe the learning process of family carers who manage technical health procedures (such as enteral tube feeding, intravenous therapy, dialysis or tracheostomy care) at home. Increasingly, complex procedures are being undertaken at home but little attention has been paid to the experiences of family carers who manage such procedures. Grounded theory, following Charmaz's constructivist approach. Interviews with 26 family carers who managed technical health procedures and 15 health professionals who taught carers such procedures. Data collection took place in New Zealand over 19 months during 2011-2013. Grounded theory procedures of iterative data collection, coding and analysis were followed, with the gradual development of theoretical ideas. The learning journey comprised three phases: (1) an initial, concentrated period of training; (2) novice carers taking responsibility for day-to-day care of procedures while continuing their learning; and (3) with time, experience and ongoing self-directed learning, the development of expertise. Teaching and support by health professionals (predominantly nurses) was focussed on the initial phase, but carers' learning continued throughout, developed through their own experience and using additional sources of information (notably the Internet and other carers). Further work is needed to determine the best educational process for carers, including where to locate training, who should teach them, optimal teaching methods and how structured or individualized teaching should be. Supporting carers well also benefits patient care. © 2016 John Wiley & Sons Ltd.
Syed, Mubin I; Karsan, Hetal; Ferral, Hector; Shaikh, Azim; Waheed, Uzma; Akhter, Talal; Gabbard, Alan; Morar, Kamal; Tyrrell, Robert
2012-02-27
To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group. A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010. Twenty-five patients were referred for TIPS. We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease. Of the 23 patients suitable for TIPS, the indications for TIPS placement was portal hypertension complicated by refractory ascites alone (n = 9), hepatic hydrothorax alone (n = 2), refractory ascites and hydrothorax (n = 1), gastrointestinal bleeding alone (n = 8), gastrointestinal bleeding and ascites (n = 3). Of these 23 attempted TIPS procedure patients, 21 patients had technically successful TIPS procedures. A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years (range 65-82 years). Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS. Sixteen of 21 patients who underwent successful TIPS (excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo. Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients. Bleeding was controlled following technically successful procedures in 10 out of 11 patients. We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.
2015-07-01
O R G STP 4-06 MODEL-BASED TECHNICAL DATA IN PROCUREMENT 3D PDF TECHNOLOGY DATA DEMONSTRATION PROJECT PHASE 1 SUMMARY REPORT DL309T2...LMI’s ISO- certified quality management procedures. J U L Y 2 0 1 5 STP 4-06 MODEL-BASED TECHNICAL DATA IN PROCUREMENT 3D PDF TECHNICAL DATA...Based Technical Data ..................................................................................... 5 3D PDF Demonstration Team
Information Exchange Procedures. Outcomes Study Procedures. Technical Report No. 66.
ERIC Educational Resources Information Center
Byers, Maureen
The Information Exchange Procedures (IEP) developed by the National Center for Higher Education Management Systems (NCHEMS) are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional characteristics. A fundamental purpose…
Moorthy, Krishna; Munz, Yaron; Adams, Sally; Pandey, Vikas; Darzi, Ara
2005-01-01
Background: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. Methods: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. Results: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. Conclusions: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills. PMID:16244534
Advancing sustainable bioenergy: Evolving stakeholder interests and the relevance of research
DOE Office of Scientific and Technical Information (OSTI.GOV)
Johnson, Timothy L; Bielicki, Dr Jeffrey M; Dodder, Rebecca
2013-01-01
The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different and potentially conflicting values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts tomore » define and promote sustainable bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.« less
Methylation analysis of polysaccharides: Technical advice.
Sims, Ian M; Carnachan, Susan M; Bell, Tracey J; Hinkley, Simon F R
2018-05-15
Glycosyl linkage (methylation) analysis is used widely for the structural determination of oligo- and poly-saccharides. The procedure involves derivatisation of the individual component sugars of a polysaccharide to partially methylated alditol acetates which are analysed and quantified by gas chromatography-mass spectrometry. The linkage positions for each component sugar can be determined by correctly identifying the partially methylated alditol acetates. Although the methods are well established, there are many technical aspects to this procedure and both careful attention to detail and considerable experience are required to achieve a successful methylation analysis and to correctly interpret the data generated. The aim of this article is to provide the technical details and critical procedural steps necessary for a successful methylation analysis and to assist researchers (a) with interpreting data correctly and (b) in providing the comprehensive data required for reviewers to fully assess the work. Copyright © 2018 Elsevier Ltd. All rights reserved.
Szuba, Marek
2006-01-01
This paper presents the most important elements of the localization procedure of high voltage overhead lines and substations and radiocommunication objects which are the source of electromagnetic fields. These fields are perceived as a major threat to human health. The point of departure to make a choice of investments is the special classification of technical installations described in one of the executive directive issued by virtue of the Environmental Protection Act. This special executive directive enumerates a lot of technical objects (installation), classified in the group of investments which have significant impact on the environment and some objects which could be classified in this group. For all this technical installations (e.g., overhead high voltage power lines) the provisions of the Environmental Protection Act impose an obligation to take particular steps to assure transparency of the environmental protection procedures, transborder procedures and the protection of areas included in the Natura 2000 network.
Let's get technical! Gaming and technology for weight control and health promotion in children.
Baranowski, Tom; Frankel, Leslie
2012-02-01
Most children, including lower socioeconomic status and ethnic minority children, play video games, use computers, and have cell phones, and growing numbers have smart phones and electronic tablets. They are comfortable with, even prefer, electronic media. Many expect to be entertained and have a low tolerance for didactic methods. Thus, health promotion with children needs to incorporate more interactive media. Interactive media for weight control and health promotion among children can be broadly classified into web-based educational/therapeutic programs, tailored motivational messaging systems, data monitoring and feedback systems, active video games, and diverse forms of interactive multimedia experiences involving games. This article describes the primary characteristics of these different technological methods; presents the strengths and weaknesses of each in meeting the needs of children of different ages; emphasizes that we are in the earliest stages of knowing how best to design these systems, including selecting the optimal requisite behavioral change theories; and identifies high-priority research issues. Gaming and technology offer many exciting, innovative opportunities for engaging children and promoting diet and physical activity changes that can contribute to obesity prevention and weight loss maintenance. Research needs to clarify optimal procedures for effectively promoting change with each change procedure.
Procedures for Determining Historical Full Costs. Technical Report 65. Second Edition.
ERIC Educational Resources Information Center
National Association of College and University Business Officers, Washington, DC.
The procedures form the costing component of the National Center for Higher Education Management Systems'"Information Exchange Procedures" (IEP). The IEP are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional…
What Consultation and Freelance Writing Can Do for You and for Your Students.
ERIC Educational Resources Information Center
Muller, John A.
This paper advises teachers of technical writing to "practice what they preach" by occasionally doing field work in technical communication. The possibilities for off-campus work include consultation, perhaps for an in-house manual of technical writing procedures and skills, editing assignments for businesses and public agencies, and freelance…
15 CFR 40.3 - Cooperation with bilateral technical assistance programs of the United States.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Cooperation with bilateral technical... to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE TRAINING OF FOREIGN PARTICIPANTS IN CENSUS PROCEDURES AND GENERAL STATISTICS § 40.3 Cooperation with bilateral technical assistance...
Design Study for Project on Standard Operating Procedures for Technical Library Services.
ERIC Educational Resources Information Center
Libbey, Miles A.; And Others
The overall objective of the Technical Information Support Activities (TISA) Project is the production of a "Post Commander's Handbook." The handbook will be instrumental in achieving greater utilization of available technical information resources to assist army scientists and engineers engaged in the support of army combat and other…
RTO Technical Publications: A Quarterly Listing
NASA Technical Reports Server (NTRS)
2005-01-01
A quarterly listing of RTO technical publications is presented. The topics include: Handbook on the Analysis of Smaller-Scale Contingency Operations in Long Term Defence Planning; 2) Radar Polarimetry and Interferometry; 3) Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures; and 4) RTO Technical Publications: A Quarterly Listing
76 FR 52955 - Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports
Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-24
... Panel's discussion is expected to be very technical in nature and will focus on the actuarial and... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...
76 FR 58514 - Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-21
... to be very technical in nature and will focus on the actuarial and economic assumptions and methods... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...
Cloning cattle: the methods in the madness.
Oback, Björn; Wells, David N
2007-01-01
Somatic cell nuclear transfer (SCNT) is much more widely and efficiently practiced in cattle than in any other species, making this arguably the most important mammal cloned to date. While the initial objective behind cattle cloning was commercially driven--in particular to multiply genetically superior animals with desired phenotypic traits and to produce genetically modified animals-researchers have now started to use bovine SCNT as a tool to address diverse questions in developmental and cell biology. In this paper, we review current cattle cloning methodologies and their potential technical or biological pitfalls at any step of the procedure. In doing so, we focus on one methodological parameter, namely donor cell selection. We emphasize the impact of epigenetic and genetic differences between embryonic, germ, and somatic donor cell types on cloning efficiency. Lastly, we discuss adult phenotypes and fitness of cloned cattle and their offspring and illustrate some of the more imminent commercial cattle cloning applications.
Cutignano, Adele; Nuzzo, Genoveffa; Ianora, Adrianna; Luongo, Elvira; Romano, Giovanna; Gallo, Carmela; Sansone, Clementina; Aprea, Susanna; Mancini, Francesca; D’Oro, Ugo; Fontana, Angelo
2015-01-01
The biological diversity of marine habitats is a unique source of chemical compounds with potential use as pharmaceuticals, cosmetics and dietary supplements. However, biological screening and chemical analysis of marine extracts pose specific technical constraints and require adequate sample preparation. Here we report an improved method on Solid Phase Extraction (SPE) to fractionate organic extracts containing high concentration of salt that hampers the recovery of secondary metabolites. The procedure uses a water suspension to load the extracts on a poly(styrene-divynylbenzene)-based support and a stepwise organic solvent elution to effectively desalt and fractionate the organic components. The novel protocol has been tested on MeOH-soluble material from three model organisms (Reniera sarai, Dendrilla membranosa and Amphidinium carterae) and was validated on a small panel of 47 marine samples, including sponges and protists, within discovery programs for identification of immuno-stimulatory and anti-infective natural products. PMID:26378547
Comparative Viral Metagenomics of Environmental Samples from Korea
Kim, Min-Soo; Whon, Tae Woong
2013-01-01
The introduction of metagenomics into the field of virology has facilitated the exploration of viral communities in various natural habitats. Understanding the viral ecology of a variety of sample types throughout the biosphere is important per se, but it also has potential applications in clinical and diagnostic virology. However, the procedures used by viral metagenomics may produce technical errors, such as amplification bias, while public viral databases are very limited, which may hamper the determination of the viral diversity in samples. This review considers the current state of viral metagenomics, based on examples from Korean viral metagenomic studies-i.e., rice paddy soil, fermented foods, human gut, seawater, and the near-surface atmosphere. Viral metagenomics has become widespread due to various methodological developments, and much attention has been focused on studies that consider the intrinsic role of viruses that interact with their hosts. PMID:24124407
Approval of Modified Seating Systems Initially Approved Under A Technical Standard Order
DOT National Transportation Integrated Search
1997-06-03
The Advisory Circular (AC) provides information, clarification, and procedural : guidance concerning the approval and installation of modified Technical Standard : Order (TSO) seating systems in U.S. type certificated aircraft.
Low-carbon yak cheese: transition to biogas in a Himalayan socio-technical niche
Campbell, Ben; Sallis, Paul
2013-01-01
This study looks at how potential for resilient low-carbon solutions can be understood and enhanced in the diverse environmental, economic and socio-political contexts in which actual scenarios of energy needs and diverse development pathways take shape. It discusses socio-technical transition approaches to assist implementation of a biogas digester system. This will replace fuelwood use in the high forests of Central Nepal, where yak cheese production provides livelihood income but is under threat from the Langtang National Park, which is concerned to protect biodiversity. Alternatives for digester design are discussed, and the consultative issues for deliberative processes among stakeholders’ varied agendas raised. PMID:24427516
PRODUCTION OF HEAVY WATER SAVANNAH RIVER AND DANA PLANTS. Technical Manual
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bebbington, W.P.; Thayer, V.R. eds.; Proctor, J.F. comp.
1959-07-01
A summary is presented of the basic technical iniormation that pertains to processes that are used at the Dana and Savannah River Plants for the production of heavy water. The manual is intended primarily for plant operating and technical personnel and was prepared to supplement and provide technical support for detailed operating procedures. Introductory sections contain some background information on the history, uses, available processes, and analytical procedures for heavy water. They also include a general comparison of the design and laserformance of the two plants and an analysis of their differences. The technology of the heavy water separation processesmore » used, namely hydrogen sulfide exchange, distillation of water, and electrolysis is discussed in detail. The manufacture and storage of hydrogen sulfide gas and the process water treatment facilities are also discussed. (auth)« less
Rhetorical Inventions and Cultural Diversity--A Historical Approach: Aristotle and Confucius.
ERIC Educational Resources Information Center
Wang, Haixia
While Aristotle treats the nature of rhetoric as philosophical, political/practical, and artistic/technical, Confucius views language use as philosophical and political/practical but not as artistic/technical, with the result that Confucius does not seem to offer as much as Aristotle does. In their essay "Refiguring Rhetoric as an Art:…
Vocational-Technical Education Today.
ERIC Educational Resources Information Center
American Vocational Association, Alexandria, VA.
Vocational-technical education (VTE) today encompasses a diverse array of programs to equip students with work and life skills. A widening skills gap in the nation's work force, coupled with the fact that only about 20% of the nation's current jobs require a four-year college degree, has made VTE more important than ever before. Research has…
Leff, H Stephen; Chow, Clifton; Wieman, Dow A; Ostrow, Laysha; Cortés, Dharma E; Harris, Treniece
2016-08-01
Measurement of patient satisfaction is now considered essential for providing patient centered care and is an important tool for addressing health care disparities. However, little is known about how ethnically and racially diverse (ERD) groups differ in how they perceive quality, and widely used instruments for measuring perceived quality give little attention to cultural elements of care. This study examined the relationship between the culturally determined beliefs and expectations of four ERD groups (African Americans, Latinos, Portuguese-speakers, and Haitians, total N = 160) and the technical quality of treatment for depression provided in four "culturally-specific" primary care clinics. Using data from the Experiences of Care and Health Outcomes survey, chart reviews and focus groups, the study addressed a set of questions related to the psychometric properties of perceived care measures and the technical quality of care. The groups differed in preferred cultural elements except all preferred inclusion of religion. They did not differ in overall perceived quality. Technical quality was higher for Portuguese and Haitians than for African Americans and Latinos. Implications of group differences for measuring quality are discussed.
The measurement of microcystins, cyanotoxins associated with cyanobacterial blooms which are increasingly prevalent in inland waters, is complicated by the diversity of congeners which have been observed in the environment. At present, more than 150 microcystin congeners have bee...
Identifying Francisella tularensis genes required for growth in host cells
USDA-ARS?s Scientific Manuscript database
Technical Abstract: Francisella tularensis is a highly virulent Gram negative intracellular pathogen capable of infecting a vast diversity of hosts, ranging from amoebae to humans. A hallmark of F. tularensis virulence is its ability to quickly grow to high densities within a diverse set of host cel...
ERIC Educational Resources Information Center
Farmer, Edgar I.
1997-01-01
Minorities and women are underrepresented in community college leadership as well as executive and administrative positions in corporations. Because these groups comprise 50% of the work force, it is essential that diversity in education and business leadership be cultivated. (SK)
ERIC Educational Resources Information Center
Bebermeyer, Jim; Edmond, Mary, Ed.
Reflecting a need to prepare students for working in diverse organizations, this document was developed to increase school officials' awareness of bias in instructional materials and help them select bias-free materials. A number of the examples illustrate situations dealing with diversity in the workplace. The guide is divided into three parts:…
Development of CMS monitoring procedures : technical summary.
DOT National Transportation Integrated Search
1998-04-01
This research study is concerned with the development of a set of procedures for monitoring congestion using GPS and GIS. These procedures are meant to be used more as a planning tool than for everyday traffic monitoring. Under this assumption, a ser...
Code of Federal Regulations, 2012 CFR
2012-10-01
... professional and technical components of any diagnostic test or procedure using x-rays, ultrasound...-ray, fluoroscopy, or ultrasound procedures that require the insertion of a needle, catheter, tube, or...
Code of Federal Regulations, 2013 CFR
2013-10-01
... professional and technical components of any diagnostic test or procedure using x-rays, ultrasound...-ray, fluoroscopy, or ultrasound procedures that require the insertion of a needle, catheter, tube, or...
Code of Federal Regulations, 2014 CFR
2014-10-01
... professional and technical components of any diagnostic test or procedure using x-rays, ultrasound...-ray, fluoroscopy, or ultrasound procedures that require the insertion of a needle, catheter, tube, or...
44 CFR 78.7 - Grant application procedures.
Code of Federal Regulations, 2011 CFR
2011-10-01
... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...
44 CFR 78.7 - Grant application procedures.
Code of Federal Regulations, 2013 CFR
2013-10-01
... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...
44 CFR 78.7 - Grant application procedures.
Code of Federal Regulations, 2010 CFR
2010-10-01
... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...
44 CFR 78.7 - Grant application procedures.
Code of Federal Regulations, 2012 CFR
2012-10-01
... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...
44 CFR 78.7 - Grant application procedures.
Code of Federal Regulations, 2014 CFR
2014-10-01
... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.7 Grant application procedures. States will apply for Technical Assistance and...
Choi, Yeon-Ju; Son, Wonsoo; Park, Ki-Su
2016-01-01
Objective This study used the intradural procedural time to assess the overall technical difficulty involved in surgically clipping an unruptured middle cerebral artery (MCA) aneurysm via a pterional or superciliary approach. The clinical and radiological variables affecting the intradural procedural time were investigated, and the intradural procedural time compared between a superciliary keyhole approach and a pterional approach. Methods During a 5.5-year period, patients with a single MCA aneurysm were enrolled in this retrospective study. The selection criteria for a superciliary keyhole approach included : 1) maximum diameter of the unruptured MCA aneurysm <15 mm, 2) neck diameter of the MCA aneurysm <10 mm, and 3) aneurysm location involving the sphenoidal or horizontal segment of MCA (M1) segment and MCA bifurcation, excluding aneurysms distal to the MCA genu. Meanwhile, the control comparison group included patients with the same selection criteria as for a superciliary approach, yet who preferred a pterional approach to avoid a postoperative facial wound or due to preoperative skin trouble in the supraorbital area. To determine the variables affecting the intradural procedural time, a multiple regression analysis was performed using such data as the patient age and gender, maximum aneurysm diameter, aneurysm neck diameter, and length of the pre-aneurysm M1 segment. In addition, the intradural procedural times were compared between the superciliary and pterional patient groups, along with the other variables. Results A total of 160 patients underwent a superciliary (n=124) or pterional (n=36) approach for an unruptured MCA aneurysm. In the multiple regression analysis, an increase in the diameter of the aneurysm neck (p<0.001) was identified as a statistically significant factor increasing the intradural procedural time. A Pearson correlation analysis also showed a positive correlation (r=0.340) between the neck diameter and the intradural procedural time. When comparing the superciliary and pterional groups, no statistically significant between-group difference was found in terms of the intradural procedural time reflecting the technical difficulty (mean±standard deviation : 29.8±13.0 min versus 27.7±9.6 min). Conclusion A superciliary keyhole approach can be a useful alternative to a pterional approach for an unruptured MCA aneurysm with a maximum diameter <15 mm and neck diameter <10 mm, representing no more of a technical challenge. For both surgical approaches, the technical difficulty increases along with the neck diameter of the MCA aneurysm. PMID:27847568
Planning a DSN support section technical library
NASA Technical Reports Server (NTRS)
Bailey, T.; Chatburn, C. C.
1980-01-01
The planning procedure being used to establish a technical library for the Deep Space Network support section is described. The inventory and survey methods employed are described and the preliminary results of these methods are discussed.
Ontogeny of a surgical technique: Robotic kidney transplantation with regional hypothermia.
Sood, Akshay; McCulloch, Peter; Dahm, Philipp; Ahlawat, Rajesh; Jeong, Wooju; Bhandari, Mahendra; Menon, Mani
2016-01-01
Innovation is a hallmark of surgical practice. It is generally accepted that a new procedure will undergo technical changes during its evolution; however, quantitative accounts of the process are limited. Multiple groups, including our own, have recently described a minimally-invasive approach to conventional kidney transplantation (KT) operation. Unique to our experience is a structured development of the technique within the confines of a safe surgical innovation framework - the IDEAL framework (idea, development, exploration, assessment, long-term monitoring; stages 0-4). We here provide a first-hand narrative of the progress of robotic KT operation from preclinical trial to clinical application. Overall, 54 patients underwent robotic KT with regional hypothermia successfully. Major technical changes including selection of optimal patient position (flank vs. lithotomy), robotic instrumentation, vascular occlusion method (bulldog vs. tourniquet) and suture material (prolene vs. GoreTex) occurred early during the procedure development (IDEAL stage 0, preclinical). Minor technical changes such as utilization of the aortic punch for arteriotomy (case 3), use of barbed suture during ureteroneocystostomy (case 6) and extraperitonealization of the graft kidney (case 6) that increased the efficiency and safety of the procedure continued throughout procedure development (IDEAL stages 1-2, clinical stages). We demonstrate that a surgical technique evolves continually; although, the majority of technical alterations occur early in the life-cycle of the procedure. Development of a new technique within the confines a structured surgical innovation framework allows for evidence based progression of the technique and may minimize the risk of harm to the patient. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.
Vertebral Artery Origin Stent Placement Using the Dual Lumen Qureshi-Jiao Guidecatheter
Qureshi, Adnan I.; Wang, Yabing; Afzal, Mohammad Rauf; Jiao, Liqun
2017-01-01
Objective We report the first experience with a new dual lumen guide catheter with lumen A with curved tip designed for delivery of stent and angioplasty catheters and lumen B with side exit for coaxial placement of stiff 0.014 inch wire. Methods We prospectively determined technical success, intended procedure (stent delivery at target lesion and a final residual stenosis <30%) completed without a need for a different catheter, and technical ease, intended procedure completed without ≥3 unsuccessful attempts in patients with symptomatic vertebral artery origin stenosis. Vertebral artery origin was classified as type A if originated from ascending segment and type B if originated from an arch or horizontal segment of subclavian artery. Results The mean age of the four treated patients was 66.2 years (range 64–68 years). The mean percentage of vertebral artery origin stenosis was 82.7% (range 60–92%). The origin of vertebral artery from subclavian artery was classified as type A and type B origins in two patients each. The dual lumen catheter was advanced over an exchange length of 0.035 inch glide wire in one patient and directly through transfemoral insertion in three patients. Technical success and technical ease was achieved in all four procedures. Post procedure residual stenosis was 6% (range 5–7%). The primary operator rated the performance of guide catheter as superior compared with another catheter used in such procedures. Conclusion The present study demonstrates the feasibility of performing stent placement for vertebral artery origin stenosis by using a dual lumen catheter with superior performance. PMID:29445438
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien; Department of Interventional Radiology, Nouvel Hôpital Civil
ObjectivesThe purpose of this study is to discuss technical aspects and rationales of magnetic resonance (MR)-guided cryoablation (CA) of Morton’s neuroma (MN); preliminary clinical experience is also retrospectively reviewed.MethodsProcedures were performed under local anaesthesia on an outpatient basis. Lesion size and location, procedural (technical success, procedural time, complications) and clinical outcomes (patient satisfaction according to a four-point scale, residual pain according to a 0–10 visual analogue scale and instances of “stump neuroma”) were assessed via chart review and cross-sectional telephone survey after the 20th case.ResultsTwenty patients (15 female, 5 male; mean age 50.3 years) were included; 24 MN (mean size 12.7 mm)more » were treated. Technical success was 100 %. Mean procedural time was 40.9 ± 10.4 min (range 35–60). One minor complication (superficial cellulitis) was reported (4.2 %). Follow-up (mean 19.7 months) was available for 18/24 MN. Patient satisfaction on a per-lesion basis was as follows: “completely satisfied” in 77.7 %, “satisfied with minor reservations” in 16.6 % and “satisfied with major reservations” in 5.7 % of cases. Mean pain score at last follow-up post-CA was 3.0. No instances of “stump neuroma” were reported.ConclusionsMR-guided CA of MN is a novel therapy which appears technically feasible. Clinical advantages of the procedure are high patient satisfaction, reduced risk of “stump neuroma” syndrome and good patient tolerance on an outpatient basis. Further, prospective studies are needed to confirm these encouraging results.« less
Patient-specific simulation in carotid artery stenting.
Willaert, Willem; Aggarwal, Rajesh; Bicknell, Colin; Hamady, Mo; Darzi, Ara; Vermassen, Frank; Cheshire, Nicholas
2010-12-01
Patient-specific virtual reality (VR) simulation is a technologic advancement that allows planning and practice of the carotid artery stenting (CAS) procedure before it is performed on the patient. The initial findings are reported, using this novel VR technique as a tool to optimize technical and nontechnical aspects of this complex endovascular procedure. In the angiography suite, the same interventional team performed the VR rehearsal and the actual CAS on the patient. All proceedings were recorded to allow for video analysis of team, technical, and nontechnical skills. Analysis of both procedures showed identical use of endovascular tools, similar access strategy, and a high degree of similarity between the angiography images. The total procedure time (24.04 vs 60.44 minutes), fluoroscopy time (11.19 vs 21.04 minutes), and cannulation of the common carotid artery (1.35 vs 9.34) took considerably longer in reality. An extensive questionnaire revealed that all team members found that the rehearsal increased the subjective sense of teamwork (4/5), communication (4/5), and patient safety (4/5). A VR procedure rehearsal is a practical and feasible preparatory tool for CAS and shows a high correlation with the real procedure. It has the potential to enhance the technical, nontechnical, and team performance. Further research is needed to evaluate if this technology can lead to improved outcomes for patients. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Embracing "Soft Skill" Diversity in the Workplace (Invited)
NASA Astrophysics Data System (ADS)
Thomas, T.
2010-12-01
Embracing "Soft Skill" Diversity in the Workplace Terri Thomas, Sr. Director Global Customer Support ShoreTel INRODUCTION Truly successful diversity programs go beyond gender, age, ethnicity, race, sexual orientation and spiritual practice. They include diversity of thought, style, leadership and communication styles, the so called “soft skills”. The increasing need for global workforces is stronger than ever and high performance teams have fully embraced, successfully harnessed and put into practice robust diversity programs than include a “soft skill” focus. Managing diversity presents significant organizational challenges, and is not an easy task, particularly in organizations that are heavily weighted with highly technical professionals such as engineers, accountants etc.. The focus of this presentation is on leveraging the “Soft Skills” diversity in technical work environments to create high performance and highly productive teams. WHY DIVERSITY and WHY NOW? Due to increasing changes in the U.S. population, in order to stay competitive, companies need to focus on diversity and look for ways to become inclusive organizations because diversity has the potential of yielding greater productivity and competitive advantages . Managing and valuing diversity is a key component of effective people management, which can improve workplace productivity (Black Enterprise, 2001). Changing demographics, from organizational restructuring, women in the workplace, equal opportunity legislation and other legal issues, are forcing organizations to become more aggressive in implementing robust diversity practices. However, YOU do not need to wait for your organization to introduce a formal “Diversity” program. There are steps you can take to introduce diversity into your own workgroups. There is no “one single answer” to solve this issue, however this discussion will provide thought provoking ideas, examples of success and failure and a starting point for you to implement “soft skill” diversity practices in your work environment. Most workplaces are made up of many aspects of diversity already so why not embrace it and use it to your competitive advantage.
10 CFR 26.137 - Quality assurance and quality control.
Code of Federal Regulations, 2013 CFR
2013-01-01
... validation of analytical procedures. Quality assurance procedures must be designed, implemented, and reviewed... resolving any technical, methodological, or administrative errors in the licensee testing facility's testing...
10 CFR 26.137 - Quality assurance and quality control.
Code of Federal Regulations, 2010 CFR
2010-01-01
... validation of analytical procedures. Quality assurance procedures must be designed, implemented, and reviewed... resolving any technical, methodological, or administrative errors in the licensee testing facility's testing...
10 CFR 26.137 - Quality assurance and quality control.
Code of Federal Regulations, 2011 CFR
2011-01-01
... validation of analytical procedures. Quality assurance procedures must be designed, implemented, and reviewed... resolving any technical, methodological, or administrative errors in the licensee testing facility's testing...
10 CFR 26.137 - Quality assurance and quality control.
Code of Federal Regulations, 2012 CFR
2012-01-01
... validation of analytical procedures. Quality assurance procedures must be designed, implemented, and reviewed... resolving any technical, methodological, or administrative errors in the licensee testing facility's testing...
10 CFR 26.137 - Quality assurance and quality control.
Code of Federal Regulations, 2014 CFR
2014-01-01
... validation of analytical procedures. Quality assurance procedures must be designed, implemented, and reviewed... resolving any technical, methodological, or administrative errors in the licensee testing facility's testing...
Syed, Mubin I; Karsan, Hetal; Ferral, Hector; Shaikh, Azim; Waheed, Uzma; Akhter, Talal; Gabbard, Alan; Morar, Kamal; Tyrrell, Robert
2012-01-01
AIM: To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group. METHODS: A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010. Twenty-five patients were referred for TIPS. We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease. Of the 23 patients suitable for TIPS, the indications for TIPS placement was portal hypertension complicated by refractory ascites alone (n = 9), hepatic hydrothorax alone (n = 2), refractory ascites and hydrothorax (n = 1), gastrointestinal bleeding alone (n = 8), gastrointestinal bleeding and ascites (n = 3). RESULTS: Of these 23 attempted TIPS procedure patients, 21 patients had technically successful TIPS procedures. A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years (range 65-82 years). Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS. Sixteen of 21 patients who underwent successful TIPS (excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo. Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients. Bleeding was controlled following technically successful procedures in 10 out of 11 patients. CONCLUSION: We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients. PMID:22400084
Application of Three Quasi-Experimental Designs.
ERIC Educational Resources Information Center
Cordray, David S.
Presented as part of a symposium on evaluation on juvenile diversion programs, this brief paper describes several specific research procedures which have been utilized to help decide which type of diversion approach is best for specific types of clients. Procedures discussed are the regression discontinuity design, the tie-breaker design, and the…
Development of an improved overlay procedure for Oregon : volume III, field manual.
DOT National Transportation Integrated Search
1987-12-01
This report is the third in a three-volume series dealing with the development of an improved overlay design procedure for Oregon. This report presents technical guidelines for using the proposed overlay design procedure. Four areas are described, in...
ERIC Educational Resources Information Center
Allen, Nancy L.; McClellan, Catherine A.; Stoeckel, Joan J.
2005-01-01
This report provides an update to the technical analysis procedures documenting the 1996 National Assessment of Educational Progress (NAEP) as presented in "The NAEP 1996 Technical Report" (Allen, Carlson, and Zelenak, 1999). It describes how the 1999 long-term trend data were incorporated into the trend analyses. Since no national main…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-02
...), Department of Transportation (DOT). ACTION: Notice of proposed rulemaking: Announcement of a public technical... this proposal. The first event, a public technical workshop, will be held on March 11, 2011, to discuss technical issues relevant to the test procedure described in the proposed rule. The second event, a public...
ERIC Educational Resources Information Center
Lamberth, Edwin E.
The purpose of this handbook is to present in a simple form the processes and procedures involved in preparing research and development projects in vocational-technical education in the State of Tennessee. It was prepared in conjunction with the Research Coordinating Unit (RCU) and the division of Vocational-Technical Education, State Department…
Siu, Joey; Maran, Nikki; Paterson-Brown, Simon
2016-06-01
The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
Field Branches Quality System and Technical Procedures: This document describes general and specific procedures, methods and considerations to be used and observed when collecting soil gas samples for field screening or laboratory analysis.
Zoppetti, Nicola; Bogi, Andrea; Pinto, Iole; Andreuccetti, Daniele
2015-02-01
In this paper, a procedure is described for the assessment of human exposure to magnetic fields with complex waveforms generated by arc-welding equipment. The work moves from the analysis of relevant guidelines and technical standards, underlining their strengths and their limits. Then, the procedure is described with particular attention to the techniques used to treat complex waveform fields. Finally, the procedure is applied to concrete cases encountered in the workplace. The discussion of the results highlights the critical points in the procedure, as well as those related to the evolution of the technical and exposure standards. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
[The LESS (Laparo-endoscopic Single-Site) procedure in urology. Technical and clinical aspects].
Neri, F; Cindolo, L; Gidaro, S; Schips, L
2010-01-01
Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundreds of procedures have been described with overall favorable intraoperative and postoperative outcomes. Our experience consists of more than 30 procedures successfully completed for adrenal, kidney disease and varicocele. To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.
Transfer of knowledge in international cooperation: the Farmanguinhos – SMM case
da Silva, Samuel Araujo Gomes; Duarte, Roberto Gonzalez; de Castro, José Márcio
2017-01-01
ABSTRACT OBJECTIVE To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. METHODS We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. RESULTS Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. CONCLUSIONS Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity. PMID:29166441
The Aristotle score: a complexity-adjusted method to evaluate surgical results.
Lacour-Gayet, F; Clarke, D; Jacobs, J; Comas, J; Daebritz, S; Daenen, W; Gaynor, W; Hamilton, L; Jacobs, M; Maruszsewski, B; Pozzi, M; Spray, T; Stellin, G; Tchervenkov, C; Mavroudis And, C
2004-06-01
Quality control is difficult to achieve in Congenital Heart Surgery (CHS) because of the diversity of the procedures. It is particularly needed, considering the potential adverse outcomes associated with complex cases. The aim of this project was to develop a new method based on the complexity of the procedures. The Aristotle project, involving a panel of expert surgeons, started in 1999 and included 50 pediatric surgeons from 23 countries, representing the EACTS, STS, ECHSA and CHSS. The complexity was based on the procedures as defined by the STS/EACTS International Nomenclature and was undertaken in two steps: the first step was establishing the Basic Score, which adjusts only the complexity of the procedures. It is based on three factors: the potential for mortality, the potential for morbidity and the anticipated technical difficulty. A questionnaire was completed by the 50 centers. The second step was the development of the Comprehensive Aristotle Score, which further adjusts the complexity according to the specific patient characteristics. It includes two categories of complexity factors, the procedure dependent and independent factors. After considering the relationship between complexity and performance, the Aristotle Committee is proposing that: Performance = Complexity x Outcome. The Aristotle score, allows precise scoring of the complexity for 145 CHS procedures. One interesting notion coming out of this study is that complexity is a constant value for a given patient regardless of the center where he is operated. The Aristotle complexity score was further applied to 26 centers reporting to the EACTS congenital database. A new display of centers is presented based on the comparison of hospital survival to complexity and to our proposed definition of performance. A complexity-adjusted method named the Aristotle Score, based on the complexity of the surgical procedures has been developed by an international group of experts. The Aristotle score, electronically available, was introduced in the EACTS and STS databases. A validation process evaluating its predictive value is being developed.
Eide, Torunn Bjerve; Straand, Jørund; Björkelund, Cecilia; Kosunen, Elise; Thorgeirsson, Ofeigur; Vedsted, Peter; Rosvold, Elin Olaug
2017-01-01
Objective We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. Design and setting We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC). Subjects A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices. Main outcome measures The GPs indicated which equipment they used in practice, which procedures that were carried out, and to what extent they were involved in treatment/follow-up of a selection of diagnoses. Results The Danish GPs performed minor surgical procedures significantly less frequent than GPs in all other countries, although they inserted IUDs significantly more often than GPs in Iceland, Sweden and Finland. Finnish GPs performed a majority of the medical procedures more frequently than GPs in the other countries. The GPs in Iceland reported involvement in a more narrow selection of conditions than the GPs in the other countries. The Finnish GPs had more advanced technical equipment than GPs in all other Nordic countries. Conclusions GPs in all Nordic countries are well equipped and offer a wide range of medical services, yet with a substantial variation between countries. There was no clear pattern of GPs in one country doing consistently more procedures, having consistently more equipment and treating a larger diversity of medical conditions than GPs in the other countries. However, structural factors seemed to affect the services offered. PMID:28613127
10 CFR 600.144 - Procurement procedures.
Code of Federal Regulations, 2010 CFR
2010-01-01
... integrity, record of past performance, financial and technical resources or accessibility to other necessary... DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative... practicable, of technical requirements in terms of functions to be performed or performance required...
Maringer, Marcus; Van't Veer, Pieter; Klepacz, Naomi; Verain, Muriel C D; Normann, Anne; Ekman, Suzanne; Timotijevic, Lada; Raats, Monique M; Geelen, Anouk
2018-06-09
The need for a better understanding of food consumption behaviour within its behavioural context has sparked the interest of nutrition researchers for user-documented food consumption data collected outside the research context using publicly available nutrition apps. The study aims to characterize the scientific, technical, legal and ethical features of this data in order to identify the opportunities and challenges associated with using this data for nutrition research. A search for apps collecting food consumption data was conducted in October 2016 against UK Google Play and iTunes storefronts. 176 apps were selected based on user ratings and English language support. Publicly available information from the app stores and app-related websites was investigated and relevant data extracted and summarized. Our focus was on characteristics related to scientific relevance, data management and legal and ethical governance of user-documented food consumption data. Food diaries are the most common form of data collection, allowing for multiple inputs including generic food items, packaged products, or images. Standards and procedures for compiling food databases used for estimating energy and nutrient intakes remain largely undisclosed. Food consumption data is interlinked with various types of contextual data related to behavioural motivation, physical activity, health, and fitness. While exchange of data between apps is common practise, the majority of apps lack technical documentation regarding data export. There is a similar lack of documentation regarding the implemented terms of use and privacy policies. While users are usually the owners of their data, vendors are granted irrevocable and royalty free licenses to commercially exploit the data. Due to its magnitude, diversity, and interconnectedness, user-documented food consumption data offers promising opportunities for a better understanding of habitual food consumption behaviour and its determinants. Non-standardized or non-documented food data compilation procedures, data exchange protocols and formats, terms of use and privacy statements, however, limit possibilities to integrate, process and share user-documented food consumption data. An ongoing research effort is required, to keep pace with the technical advancements of food consumption apps, their evolving data networks and the legal and ethical regulations related to protecting app users and their personal data.
ERIC Educational Resources Information Center
Mercer, John W.; Meunier, Greg R.
This document, which was developed by a task force whose members represent the instructional, student support service, administrative, and executive ranks of technical colleges with very diverse sizes, locations, and programs, lists 50 proposed indices of effectiveness regarding the program advisory committees (ACs) in Minnesota's technical…
Big Data Characterization of Learner Behaviour in a Highly Technical MOOC Engineering Course
ERIC Educational Resources Information Center
Douglas, Kerrie A.; Bermel, Peter; Alam, Md Monzurul; Madhavan, Krishna
2016-01-01
MOOCs attract a\tlarge\tnumber of learners with largely unknown diversity in terms of motivation,\tability, and goals. To understand more\tabout learners in highly technical engineering MOOCs,\tthis study investigates patterns of learners' (n = 337) behaviour and performance in the Nanophotonic Modelling MOOC, offered through nanoHUB-U. The authors…
ERIC Educational Resources Information Center
Williams, Sean D.
2010-01-01
This article argues that in spite of some attempts to expand the diversity of approaches in Technical Communication, the field remains rooted in an expedient, managerial, techno-rational discourse, where discourse is understood as the values that guide research, practice, and teaching. The article draws on approaches from Communication Studies,…
Performance Evaluation of Technical Institutions: An Application of Data Envelopment Analysis
ERIC Educational Resources Information Center
Debnath, Roma Mitra; Shankar, Ravi; Kumar, Surender
2008-01-01
Technical institutions (TIs) are playing an important role in making India a knowledge hub of this century. There is still great diversity in their relative performance, which is a matter of concern to the education planner. This article employs the method of data envelopment analysis (DEA) to compare the relative efficiency of TIs in India. The…
Electrical and optical evaluation aspects of public lighting systems
NASA Astrophysics Data System (ADS)
Tulbure, Adrian; Marc, Gheorghe; Kurt, Ünal
2016-12-01
This paper briefs a few issues regarding the technical validation of public lighting solutions. The novelty of the work is justified by the fact that it combines technical legislation in force [1], with practical analysis procedures [2]. Thus, in order to select the optimal solution, the paper describes a case study of measurement procedure which confirms the high electrical and optical characteristics [3] of the proposed solutions. At the end of the contribution, comparative design purposes for the two versions of modern street lighting are presented.
76 FR 64399 - Advisory Committee on Reactor Safeguards; Notice of Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-18
... Thursday, October 21, 2010 (74 FR 65038-65039). Thursday, November 3, 2011, Conference Room T2-B1, 11545... Evaluation of Diversity and Defense-In-Depth in Digital Computer-Based Instrumentation and Control Systems... staff regarding Branch Technical Position 7- 19, ``Guidance for the Evaluation of Diversity and Defense...
The Role of Majority Groups in Diversity Programs
ERIC Educational Resources Information Center
Rheingans, Penny; Brodsky, Anne; Scheibler, Jill; Spence, Anne
2011-01-01
The underrepresentation of women in technical fields is a widely acknowledged national problem, limiting both the raw size of the talent pool and the diversity of experiences and perspectives of those who will design solutions to key problems facing society. Empowering women to succeed in these fields is clearly one important component of any…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-24
... Digital Computer-Based Instrumentation and Control Systems.'' This BTP is to be cited as the acceptance criteria for Diversity and Defense-in-Depth in Digital Computer-Based Instrumentation and Control Systems... Evaluation of Diversity and Defense-in-Depth in Digital Computer-Based Instrumentation and Control Systems...
Deaf College Students' Attitudes toward Racial/Ethnic Diversity, Campus Climate, and Role Models
ERIC Educational Resources Information Center
Parasnis, Ila; Samar, Vincent J.; Fischer, Susan D.
2005-01-01
Deaf college Students attitudes toward a variety of issues related to racial/ethnic diversity were surveyed by contacting all racial/ethnic minority deaf students and a random sample of Caucasian deaf students attending the National Technical Institute for the Deaf (NTID), Rochester Institute of Technology; 38% completed the survey. Although…
10 CFR 455.62 - Contents of a technical assistance program.
Code of Federal Regulations, 2011 CFR
2011-01-01
... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...
10 CFR 455.62 - Contents of a technical assistance program.
Code of Federal Regulations, 2012 CFR
2012-01-01
... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...
10 CFR 455.62 - Contents of a technical assistance program.
Code of Federal Regulations, 2013 CFR
2013-01-01
... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...
10 CFR 455.62 - Contents of a technical assistance program.
Code of Federal Regulations, 2014 CFR
2014-01-01
... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...
10 CFR 455.62 - Contents of a technical assistance program.
Code of Federal Regulations, 2010 CFR
2010-01-01
... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...
Designing Flightdeck Procedures: Literature Resources
NASA Technical Reports Server (NTRS)
Feldman, Jolene; Barshi, Immanuel; Degani, Asaf; Loukopoulou, Loukia; Mauro, Robert
2017-01-01
This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.
Ko, Gi-Young; Kwon, Young Baek; Yoon, Hyun-Ki; Sung, Kyu-Bo
2018-01-01
Objective To investigate the technical and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GV) and to evaluate the role of intra-procedural cone-beam computed tomography (CBCT) performed during PARTO to confirm its technical success. Materials and Methods From January 2016 to December 2016, 17 patients with GV who had undergone PARTO were retrospectively evaluated. When the proximal part of the afferent vein was identified on a fluoroscopy, non-contrast CBCT images were obtained. In patients with incomplete embolization of GV, an additional injection of gelatin sponges was performed. Follow-up data from contrast-enhanced CT and upper intestinal endoscopy, as well as clinical and laboratory data were collected. Results Plug-assisted retrograde transvenous obliteration procedures were technically successful in all 17 patients. Complete embolization of GV was detected on CBCT images in 15 patients; whereas, incomplete embolization was detected in two. Complete embolization of GV was then achieved after an additional injection of gelatin sponges in these two patients as demonstrated on the 2nd CBCT image. The mean follow-up period after PARTO was 193 days (range, 73–383 days). A follow-up CT obtained 2–4 months after PARTO demonstrated marked shrinkage or complete obliteration of GV and portosystemic shunts in all 17 patients. There were no cases of variceal bleeding during the follow-up. Conclusion Plug-assisted retrograde transvenous obliteration is technically and clinically effective for the treatment of GV. In addition, intra-procedural CBCT can be an adjunct tool to fluoroscopy, because it can provide an immediate and accurate evaluation of the technical success of PARTO. PMID:29520179
Surgical resident technical skill self-evaluation: increased precision with training progression.
Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L
2017-10-01
Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.
Experiences of Women of Color University Chief Diversity Officers
ERIC Educational Resources Information Center
Nixon, Monica L.
2017-01-01
Contemporary models of operationalizing diversity on college campuses focus on the integration of diversity goals with the overall educational mission in ways that maximize the benefits of diversity for all. A growing number of institutions have created chief diversity officer (CDO) positions to procedurally and symbolically centralize diversity…
Weigl, Matthias; Stefan, Philipp; Abhari, Kamyar; Wucherer, Patrick; Fallavollita, Pascal; Lazarovici, Marc; Weidert, Simon; Euler, Ekkehard; Catchpole, Ken
2016-02-01
Surgical flow disruptions occur frequently and jeopardize perioperative care and surgical performance. So far, insights into subjective and cognitive implications of intra-operative disruptions for surgeons and inherent consequences for performance are inconsistent. This study aimed to investigate the effect of surgical flow disruption on surgeon's intra-operative workload and technical performance. In a full-scale OR simulation, 19 surgeons were randomly allocated to either of the two disruption scenarios (telephone call vs. patient discomfort). Using a mixed virtual reality simulator with a computerized, high-fidelity mannequin, all surgeons were trained in performing a vertebroplasty procedure and subsequently performed such a procedure under experimental conditions. Standardized measures on subjective workload and technical performance (trocar positioning deviation from expert-defined standard, number, and duration of X-ray acquisitions) were collected. Intra-operative workload during simulated disruption scenarios was significantly higher compared to training sessions (p < .01). Surgeons in the telephone call scenario experienced significantly more distraction compared to their colleagues in the patient discomfort scenario (p < .05). However, workload tended to be increased in surgeons who coped with distractions due to patient discomfort. Technical performance was not significantly different between both disruption scenarios. We found a significant association between surgeons' intra-operative workload and technical performance such that surgeons with increased mental workload tended to perform worse (β = .55, p = .04). Surgical flow disruptions affect surgeons' intra-operative workload. Increased mental workload was associated with inferior technical performance. Our simulation-based findings emphasize the need to establish smooth surgical flow which is characterized by a low level of process deviations and disruptions.
14 CFR 1240.109 - Hearing procedure.
Code of Federal Regulations, 2012 CFR
2012-01-01
... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...
14 CFR 1240.109 - Hearing procedure.
Code of Federal Regulations, 2010 CFR
2010-01-01
... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...
14 CFR 1240.109 - Hearing procedure.
Code of Federal Regulations, 2013 CFR
2013-01-01
... Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held... and arguments in support of the application. Evidence may be presented through means of such witnesses...
The French Space Operation Act: Technical Regulations
NASA Astrophysics Data System (ADS)
Trinchero, J. P.; Lazare, B.
2010-09-01
The French Space Operation Act(FSOA) stipulates that a prime objective of the National technical regulations is to protect people, property, public health and the environment. Compliance with these technical regulations is mandatory as of 10 December 2010 for space operations by French space operators and for space operations from French territory. The space safety requirements and regulations governing procedures are based on national and international best practices and experience. A critical design review of the space system and procedures shall be carried out by the applicant, in order to verify compliance with the Technical Regulations. An independent technical assessment of the operation is delegated to CNES. The principles applied when drafting technical regulations are as follows: requirements must as far as possible establish the rules according to the objective to be obtained, rather than how it is to be achieved; requirements must give preference to international standards recognised as being the state of the art; requirements must take previous experience into account. Technical regulations are divided into three sections covering common requirements for the launch, control and return of a space object. A dedicated section will cover specific rules to be applied at the Guiana Space Centre. The main topics addressed by the technical regulations are: operator safety management system; study of risks to people, property, public health and the Earth’s environment; impact study on the outer space environment: space debris generated by the operation; planetary protection.
Technical skills rotation for general surgery residents.
Gonzalez, Ray I; Martinez, Jose M; Iglesias, Alberto R; Lo Menzo, Emanuele; Hutson, Duane; Sleeman, Danny; Livingstone, Alan S; Madan, Atul K
2010-06-15
Technical skills are an important part of any general surgery residency curriculum. With the demands of limited work weeks, it is imperative that educators create novel methods of teaching technical skills to their residents. Our program utilizes a dedicated month to help accomplish this. This study hypothesized that general surgery residents would report a positive effect of a dedicated technical skills rotation. Residents who had undergone a 1 mo rotation in technical skills during their first year were asked to fill out a survey concerning their experience. During the 1-mo rotation, the residents had almost no clinical responsibilities. Teaching of technical skills was performed with various activities, including video content (VC), virtual reality simulators (VR), open foam procedures (OF), laparoscopic box trainers (BT), surgical equipment in-service (SE), and animate sessions (AS). Responses were given on a Likert scale (1-10) with higher numbers being more positive responses. There were seven residents in this study. The residents gave a very positive response to the overall rotation (9.4) and exposure to laparoscopic procedures (9.6). The other responses were enthusiastic as well: exposure to open procedures (8.9) and preparation for operative room (9.4). After their rotation, the residents were comfortable performing a laparoscopic cholecystectomy (9.2), a hand-sewn anastomosis (8.7), and a stapled anastomosis (9.4). The residents found theses activities helpful in increasing order: VC (7.8), VR (8.0), BT (9.0), ES (9.7), OF (9.8), and AS (9.8). A 1-mo dedicated technical skills rotations was perceived to be extremely positive by the residents. The residents felt very comfortable performing a laparoscopic cholecystectomy, a hand-sewn anastomosis, and a stapled anastomosis. With the 80-h work week, alternatives to learning technical skills in the operating room are essential. Further studies need to be performed to determine if this rotation aids in accomplishing this goal. Copyright 2010. Published by Elsevier Inc.
NASA Astrophysics Data System (ADS)
Hsu, L.
2017-12-01
In 2009, the U.S. Geological Survey determined that a focused effort on data integration was necessary to capture the full scientific potential of its topically and geographically diverse data assets. The Community for Data Integration was established to fill this role, and an emphasis emerged on grassroots learning and solving of shared data integration and management challenges. Now, eight years later, the CDI has grown to over 700 members and runs monthly presentations, working groups, special training events, and an annual USGS-wide grants program. With a diverse membership of scientists, technologists, data managers, program managers, and others, there are a wide range of motivations and interests competing to drive the direction of the community. Therefore, an important role of the community coordinators is to prioritize member interests while valuing and considering many different viewpoints. To do this, new tools and mechanisms are frequently introduced to circulate information and obtain community input and feedback. The coordinators then match community interests with opportunities to address USGS priorities. As a result, the community has facilitated the implementation of USGS-wide data policies and data management procedures, produced guidelines and lessons learned for technologies like mobile applications and use of semantic web technologies, and developed technical recommendations to enable integrated science capacity for USGS leadership.
Managing corporate capabilities:theory and industry approaches.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Slavin, Adam M.
2007-02-01
This study characterizes theoretical and industry approaches to organizational capabilities management and ascertains whether there is a distinct ''best practice'' in this regard. We consider both physical capabilities, such as technical disciplines and infrastructure, and non-physical capabilities such as corporate culture and organizational procedures. We examine Resource-Based Theory (RBT), which is the predominant organizational management theory focused on capabilities. RBT seeks to explain the effect of capabilities on competitiveness, and thus provide a basis for investment/divestment decisions. We then analyze industry approaches described to us in interviews with representatives from Goodyear, 3M, Intel, Ford, NASA, Lockheed Martin, and Boeing. Wemore » found diversity amongst the industry capability management approaches. Although all organizations manage capabilities and consider them to some degree in their strategies, no two approaches that we observed were identical. Furthermore, we observed that theory is not a strong driver in this regard. No organization used the term ''Resource-Based Theory'', nor did any organization mention any other guiding theory or practice from the organizational management literature when explaining their capabilities management approaches. As such, we concluded that there is no single best practice for capabilities management. Nevertheless, we believe that RBT and the diverse industry experiences described herein can provide useful insights to support development of capabilities management approaches.« less
Ultrasound-Guided Percutaneous Tenotomy of Biceps Tendon: Technical Feasibility on Cadavers.
Sconfienza, Luca Maria; Mauri, Giovanni; Messina, Carmelo; Aliprandi, Alberto; Secchi, Francesco; Sardanelli, Francesco; Randelli, Pietro Simone
2016-10-01
We tested the technical feasibility of ultrasound-guided percutaneous tenotomy of the long head of the biceps tendon (LHBT) in cadavers. Both shoulders of two fresh cadavers were scanned anteriorly to evaluate the extra-articular portion of the LHBT. Under ultrasound monitoring, a scalpel was advanced obliquely up to touch the superficial medial side of the LHBT, cutting it until the tendon was not visible anymore. Ultrasound evaluation was repeated after the procedure, and anatomic dissection was performed. The procedure was 100% feasible: four cuts were made to completely sever the tendon; the duration was less than 1 min. Skin incision measured 5 mm in two cases and 6 mm in two cases. Anatomic dissection confirmed complete tendon cut in all cases with proximal and distal tendon stumps very close to each other. Ultrasound-guided percutaneous LHBT tenotomy was 100% technically feasible in cadavers with a quick procedure and minimal cutaneous incision. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-02
... Justice (DOJ); clarify who is authorized to represent applicants and petitioners in cases before DHS... regulations; make technical and procedural changes; and conform terminology. This rule enhances the integrity... existing regulations; and eliminates references to procedural matters that are solely within the authority...
Designing, Developing, and Implementing Diversity Training: Guidelines for Practitioners.
ERIC Educational Resources Information Center
Kincaid, Tanna M.; Horner, Erin R.
1997-01-01
Discusses diversity in the workplace and offers guidelines for practitioners in designing, developing, and implementing diversity training. Highlights include linking the diversity initiative to the organization's mission, cultural climate assessments, reviewing policies and procedures, needs assessment, learner analysis, establishing objectives,…
14 CFR § 1240.109 - Hearing procedure.
Code of Federal Regulations, 2014 CFR
2014-01-01
... CONTRIBUTIONS Awards for Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral... present evidence and arguments in support of the application. Evidence may be presented through means of...
14 CFR 1240.109 - Hearing procedure.
Code of Federal Regulations, 2011 CFR
2011-01-01
... Scientific and Technical Contributions § 1240.109 Hearing procedure. (a) An Oral hearing held by the Board... arguments in support of the application. Evidence may be presented through means of such witnesses, exhibits...
Perronne, Rémi; Goldringer, Isabelle
2018-04-01
We present and highlight a partitioning procedure based on the Rao quadratic entropy index to assess temporal in situ inter-annual varietal and genetic changes of crop diversity. For decades, Western-European agroecosystems have undergone profound changes, among which a reduction of crop genetic diversity. These changes have been highlighted in numerous studies, but no unified partitioning procedure has been proposed to compute the inter-annual variability in both varietal and genetic diversity. To fill this gap, we tested, adjusted and applied a partitioning procedure based on the Rao quadratic entropy index that made possible to describe the different components of crop diversity as well as to account for the relative acreages of varieties. To emphasize the relevance of this procedure, we relied on a case study focusing on the temporal evolution of bread wheat diversity in France over the period 1981-2006 at both national and district scales. At the national scale, we highlighted a decrease of the weighted genetic replacement indicating that varieties sown in the most recent years were more genetically similar than older ones. At the district scale, we highlighted sudden changes in weighted genetic replacement in some agricultural regions that could be due to fast shifts of successive leading varieties over time. Other regions presented a relatively continuous increase of genetic similarity over time, potentially due to the coexistence of a larger number of co-leading varieties that got closer genetically. Based on the partitioning procedure, we argue that a tendency of in situ genetic homogenization could be compared to some of its potential causes, such as a decrease in the speed of replacement or an increase in between-variety genetic similarity over time.
Cryoablation of Osteoid Osteoma in the Pediatric and Adolescent Population.
Whitmore, Morgan J; Hawkins, C Matthew; Prologo, J David; Marshall, Kelley W; Fabregas, Jorge A; Yim, Douglas B; Monson, David; Oskouei, Shervin V; Fletcher, Nicholas D; Williams, Roger S
2016-02-01
To evaluate the technical feasibility and clinical efficacy of osteoid osteoma (OO) cryoablation in a large, pediatric/adolescent cohort. An electronic medical record and imaging archive review was performed to identify all cryoablations performed for OOs between 2011 and 2015 at a single tertiary care pediatric hospital. The subsequent analysis included 29 patients with suspected OOs treated by cryoablation (age range, 3-18 y; mean age, 11.3 y; 17 boys; 12 girls). Conventional CT guidance was used in 22 procedures; cone-beam CT guidance was used in 7 procedures. Follow-up data were obtained via a standardized telephone questionnaire (23/29 patients; 79.3%) and clinical notes (5/29 patients; 17.2%). One patient was lost to follow-up. Technical success was achieved in 100% of patients (29/29). Immediate clinical success (cessation of pain and nonsteroidal antiinflammatory drug [NSAID] use within 1 mo after the procedure) was achieved in 27/28 patients (96.4%). Short-term clinical success (cessation of pain and NSAID use for > 3 mo after the procedure) was achieved in 24/25 patients (96%). Long-term clinical success (cessation of pain and NSAID use for > 12 mo after the procedure) was achieved in 19/21 patients (90.5%). Median pain scale score before the procedure was 10 (range, 5-10); median pain scale score after the procedure was 0 (range, 0-8; P < .0001). There were 6 minor complications (21%) and no major complications. Image-guided cryoablation is a technically feasible, clinically efficacious therapeutic option for children and adolescents with symptomatic OO. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.
Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun
2015-02-01
Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test-retest repeatability data for illustrative purposes. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Huang, Erich P; Wang, Xiao-Feng; Choudhury, Kingshuk Roy; McShane, Lisa M; Gönen, Mithat; Ye, Jingjing; Buckler, Andrew J; Kinahan, Paul E; Reeves, Anthony P; Jackson, Edward F; Guimaraes, Alexander R; Zahlmann, Gudrun
2017-01-01
Medical imaging serves many roles in patient care and the drug approval process, including assessing treatment response and guiding treatment decisions. These roles often involve a quantitative imaging biomarker, an objectively measured characteristic of the underlying anatomic structure or biochemical process derived from medical images. Before a quantitative imaging biomarker is accepted for use in such roles, the imaging procedure to acquire it must undergo evaluation of its technical performance, which entails assessment of performance metrics such as repeatability and reproducibility of the quantitative imaging biomarker. Ideally, this evaluation will involve quantitative summaries of results from multiple studies to overcome limitations due to the typically small sample sizes of technical performance studies and/or to include a broader range of clinical settings and patient populations. This paper is a review of meta-analysis procedures for such an evaluation, including identification of suitable studies, statistical methodology to evaluate and summarize the performance metrics, and complete and transparent reporting of the results. This review addresses challenges typical of meta-analyses of technical performance, particularly small study sizes, which often causes violations of assumptions underlying standard meta-analysis techniques. Alternative approaches to address these difficulties are also presented; simulation studies indicate that they outperform standard techniques when some studies are small. The meta-analysis procedures presented are also applied to actual [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) test–retest repeatability data for illustrative purposes. PMID:24872353
Tsauo, Jiaywei; Luo, Xuefeng; Ye, Linchao; Li, Xiao
2015-06-01
This study was designed to report our results with a modified technique of three-dimensional (3D) path planning software assisted transjugular intrahepatic portosystemic shunt (TIPS). 3D path planning software was recently developed to facilitate TIPS creation by using two carbon dioxide portograms acquired at least 20° apart to generate a 3D path for overlay needle guidance. However, one shortcoming is that puncturing along the overlay would be technically impossible if the angle of the liver access set and the angle of the 3D path are not the same. To solve this problem, a prototype 3D path planning software was fitted with a utility to calculate the angle of the 3D path. Using this, we modified the angle of the liver access set accordingly during the procedure in ten patients. Failure for technical reasons occurred in three patients (unsuccessful wedged hepatic venography in two cases, software technical failure in one case). The procedure was successful in the remaining seven patients, and only one needle pass was required to obtain portal vein access in each case. The course of puncture was comparable to the 3D path in all patients. No procedure-related complication occurred following the procedures. Adjusting the angle of the liver access set to match the angle of the 3D path determined by the software appears to be a favorable modification to the technique of 3D path planning software assisted TIPS.
McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William
2017-12-01
With more care taking place in the home, family carers play an important role in supporting patients. Some family carers undertake technical health procedures generally managed by health professionals in hospital settings (e.g. managing a tracheostomy or enteral feeding). To explore how family carers learn to manage technical health procedures in order to help health professionals better understand and support this process. A grounded theory study using data from interviews with 26 New Zealand family carers who managed technical health procedures including nasogastric or gastrostomy feeding, stoma care, urinary catheterisation, tracheostomy management, intravenous therapy, diabetes management and complex wound dressings. Most (20 participants) were caring for their child and the remaining six for their spouse, parent or grandparent. Following grounded theory methods, each interview was coded soon after completion. Additional data were compared with existing material, and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was developed. Interviewing continued until no new ideas emerged and concepts were well defined. The core concept of 'wayfinding' indicates that the learning process for family carers is active, individualised and multi-influenced, developing over time as a response to lived experience. Health professional support was concentrated on the initial phase of carers' training, reducing and becoming more reactive as carers took responsibility for day-to-day management. Wayfinding involves self-navigation by carers, in contrast to patient navigator models which provide continuing professional assistance to patients receiving cancer or chronic care services. Wayfinding by carers raises questions about how carers should be best supported in their initial and ongoing learning as the management of these procedures changes over time. © 2017 Nordic College of Caring Science.
Ahn, Se Jin; Chung, Jin Wook; An, Sang Bu; Yin, Yong Hu; Jae, Hwan Jun; Park, Jae Hyung
2012-01-01
Objective To assess the technical success and complication rates of the radiologic placement of central venous ports via the internal jugular vein. Materials and Methods We retrospectively reviewed 1254 central venous ports implanted at our institution between August 2002 and October 2009. All procedures were guided by using ultrasound and fluoroscopy. Catheter maintenance days, technical success rates, peri-procedural, as well as early and late complication rates were evaluated based on the interventional radiologic reports and patient medical records. Results A total of 433386 catheter maintenance days (mean, 350 days; range 0-1165 days) were recorded. The technical success rate was 99.9% and a total of 61 complications occurred (5%), resulting in a post-procedural complication rate of 0.129 of 1000 catheter days. Among them, peri-procedural complications within 24 hours occurred in five patients (0.4%). There were 56 post-procedural complications including 24 (1.9%, 0.055 of 1000 catheter days) early and 32 (2.6%, 0.074 of 1000 catheter days) late complications including, infection (0.6%, 0.018 of 10000 catheter days), thrombotic malfunction (1.4%, 0.040 of 1000 catheter days), nonthrombotic malfunction (0.9%, 0.025 of 1000 catheter days), venous thrombosis (0.5%, 0.014 of 1000 catheter days), as well as wound problems (1.1%, 0.032 of 1000 catheter days). Thirty six CVPs (3%) were removed due to complications. Bloodstream infections and venous thrombosis were the two main adverse events prolonging hospitalization (mean 13 days and 5 days, respectively). Conclusion Radiologic placement of a central venous port via the internal jugular vein is safe and efficient as evidenced by its high technical success rate and a very low complication rate. PMID:22563269
Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O
2012-01-01
Objective The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. Methods We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. Results The mean MSD and DAP were respectively 389 mGy and 65 Gy cm−2 for CAs, and 916 mGy and 69 Gy cm−2 for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Conclusion Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions. PMID:22457404
de Lima, Erimara Dall'Agnol; Fleck, Caren Schlottefeld; Borges, Januário José Vieira; Condessa, Robledo Leal; Vieira, Sílvia Regina Rios
2013-01-01
Objective To evaluate the effectiveness of an educational intervention on healthcare professionals' adherence to the technical recommendations for tracheobronchial aspiration in intensive care unit patients. Methods A quasi-experimental study was performed to evaluate intensive care unit professionals' adherence to the tracheobronchial aspiration technical recommendations in intensive care unit patients both before and after a theoretical and practical educational intervention. Comparisons were performed using the chi-square test, and the significance level was set to p<0.05. Results A total of 124 procedures, pre- and post-intervention, were observed. Increased adherence was observed in the following actions: the use of personal protective equipment (p=0.01); precaution when opening the catheter package (p<0.001); the use of a sterile glove on the dominant hand to remove the catheter (p=0.003); the contact of the sterile glove with the catheter only (p<0.001); the execution of circular movements during the catheter removal (p<0.001); wrapping the catheter in the sterile glove at the end of the procedure (p=0.003); the use of distilled water, opened at the start of the procedure, to wash the connection latex (p=0.002); the disposal of the leftover distilled water at the end of the procedure (p<0.001); and the performance of the aspiration technique procedures (p<0.001). Conclusion There was a low adherence by health professionals to the preventive measures against hospital infection, indicating the need to implement educational strategies. The educational intervention used was shown to be effective in increasing adherence to the technical recommendations for tracheobronchial aspiration. PMID:23917976
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jalaeian, Hamed, E-mail: hjalaeia@umn.edu; Talaie, Reza; D’Souza, Donna
PurposeThis study was performed to compare the intrahepatic shunt function outcome and procedural complications of minilaparotomy-assisted transmesenteric (MAT)-transjugular intrahepatic portosystemic shunt (TIPS) placement with the conventional transjugular method.MethodsThis is a retrospective review of all patients who had a MAT or conventional TIPS procedure over a 6-year period at our institute. The primary patency rate, fluoroscopy time, technical success, major procedure-related complications, and mortality data were compared between two treatment groups.ResultsWe included 49 patients with MAT-TIPS, and 63 with conventional TIPS, with an average follow-up of 21.43 months. The primary patency rates at 6 and 12 months were 82.9 and 66.7 % in themore » conventional TIPS group, and 81.0 and 76.5 % in the MAT-TIPS group (p = 1.000, and 0.529), respectively. There was no significant difference in technical success rate, post-procedure portosystemic pressure gradient, fluoroscopy time, and peri-procedural mortality rate between treatment groups. Major procedural-related complications were seen more frequently among MAT-TIPS patients (p = 0.012). In the MAT-TIPS group, 5 (10.2 %) patients developed post-procedure minilaparotomy, wound-related complications, and 5 (10.2 %) developed bacterial peritonitis; whereas, none of patients with conventional TIPS had either of these complications (p = 0.014).ConclusionWhile both MAT-TIPS and conventional TIPS had similar shunt primary patency rate and technical success rate, the MAT approach was associated with a significantly higher rate of minilaparotomy-related wound complications or infectious complications. These complications maybe prevented by a change in post-procedure monitoring and therapy.« less
Collected Papers in Structural Mechanics Honoring Dr. James H. Starnes, Jr.
NASA Technical Reports Server (NTRS)
Knight, Norman F., Jr. (Compiler); Nemeth, Michael P. (Compiler); Malone, John B. (Compiler)
2006-01-01
This special publication contains a collection of structural mechanics papers honoring Dr. James H. Starnes, Jr. presented at the 46th AIAA/ASME/ASCE/AHS/ASC Structures, Structural Dynamics, and Materials Conference held in Austin, Texas, April 18-21, 2005. Contributors to this publication represent a small number of those influenced by Dr. Starnes' technical leadership, his technical prowess and diversity, and his technical breath and depth in engineering mechanics. These papers cover some of the research areas Dr. Starnes investigated, which included buckling, postbuckling, and collapse of structures; composite structural mechanics, residual strength and damage tolerance of metallic and composite structures; and aircraft structural design, certification and verification. He actively pursued technical understanding and clarity, championed technical excellence, and modeled humility and perseverance.
Dexter, Franklin; Epstein, Richard H; Lubarsky, David A
2018-05-01
Although having a large diversity of types of procedures has a substantial operational impact on the surgical suites of hospitals, the strategic importance is unknown. In the current study, we used longitudinal data for all hospitals and patient ages in the State of Florida to evaluate whether hospitals with greater diversity of types of physiologically complex major therapeutic procedures (PCMTP) also had greater rates of surgical growth. Observational cohort study. 1479 combinations of hospitals in the State of Florida and fiscal years, 2008-2015. The types of International Classification of Diseases, Ninth revision, Clinical Modification (ICD-9-CM) procedures studied were PCMT, defined as: a) major therapeutic procedure; b) >7 American Society of Anesthesiologists base units; and c) performed during a hospitalization with a Diagnosis Related Group with a mean length of stay ≥4.0days. The number of procedures of each type of PCMTP commonly performed at each hospital was calculated by taking 1/Herfindahl index (i.e., sum of the squares of the proportions of all procedures of each type of PCMTP). Over the 8 successive years studied, there was no change in the number of PCMTP being performed (Kendall's τ b =-0.014±0.017 [standard error], P=0.44; N=1479 hospital×years). Busier and larger hospitals commonly performed more types of PCMTP, respectively categorized based on performed PCMTP (τ=0.606±0.017, P<0.0001) or hospital beds (τ=0.524±0.017, P<0.0001). There was no association between greater diversity of types of PCMTP commonly performed and greater annual growth in numbers of PCMTP (τ=0.002±0.019, P=0.91; N=1295 hospital×years). Conclusions were the same with multiple sensitivity analyses. Post hoc, it was recognized that hospitals performing a greater diversity of PCMTP were more similar to the aggregate of other hospitals within the same health district (τ=0.550±0.017, P<0.0001). During a period with no overall growth in PCMTP, hospitals with greater diversities of types of PCMTP had growth that was, at most, minimally larger than that of the smaller hospitals, and vice-versa. Diversity is important operationally. From the perspective of delivering surgical care within a market, the unique contributions of each large teaching hospital performing many different types of PCMTP needs to be considered relative to the combined capabilities of other hospitals in its region. Copyright © 2018 Elsevier Inc. All rights reserved.
Training Manuals and Technical Publications.
ERIC Educational Resources Information Center
Army Test and Evaluation Command, Aberdeen Proving Ground, MD.
The objective of the Materiel Test Procedure is to describe methods for determining the need for adequacy of comprehensiveness, and clarity of training manuals and technical publications (or other pertinent types of literature) relating to the ammunition or ammunition components being tested. (Author)
TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES
This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. he document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic drai...
TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES
This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. The document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic dr...
ERIC Educational Resources Information Center
Mulcahy, Robert Sean
2010-01-01
Learners inevitably enter adult technical training classrooms--indeed, in all classrooms--with different levels of expertise on the subject matter. When the diversity of expertise is wide and the course makes use of small group problem solving, instructors have a choice about how to group learners: they may distribute learners with greater…
DOT National Transportation Integrated Search
2011-10-01
Criteria and procedures have been developed for assessing crashworthiness and occupant protection performance of alternatively designed trainsets to be used in Tier I (not exceeding 125 mph) passenger service. These criteria and procedures take advan...
Space Geodesy Project Information and Configuration Management Procedure
NASA Technical Reports Server (NTRS)
Merkowitz, Stephen M.
2016-01-01
This plan defines the Space Geodesy Project (SGP) policies, procedures, and requirements for Information and Configuration Management (CM). This procedure describes a process that is intended to ensure that all proposed and approved technical and programmatic baselines and changes to the SGP hardware, software, support systems, and equipment are documented.
40 CFR 53.43 - Test procedures.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedures. 53.43 Section 53.43... PM10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio (expressed... or filters to the mass concentration of particles of the same size approaching the sampler. (2) Test...
40 CFR 53.43 - Test procedures.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Test procedures. 53.43 Section 53.43... PM10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio (expressed... or filters to the mass concentration of particles of the same size approaching the sampler. (2) Test...
Using Three-Dimensional Interactive Graphics To Teach Equipment Procedures.
ERIC Educational Resources Information Center
Hamel, Cheryl J.; Ryan-Jones, David L.
1997-01-01
Focuses on how three-dimensional graphical and interactive features of computer-based instruction can enhance learning and support human cognition during technical training of equipment procedures. Presents guidelines for using three-dimensional interactive graphics to teach equipment procedures based on studies of the effects of graphics, motion,…
ERIC Educational Resources Information Center
Repp, Charles A.; Brach, Ronald C.
The manual provides a rationale, procedural guidelines, time-schedules, instruments, and supporting documentation for student services program evaluation at SUNY Agricultural and Technical College, Delhi. Six procedural guidelines include: (1) all programs and services should be evaluated at least once every four years, with provision for annual…
A Review of Personalised E-Learning: Towards Supporting Learner Diversity
ERIC Educational Resources Information Center
O'Donnell, Eileen; Lawless, Séamus; Sharp, Mary; Wade, Vincent P.
2015-01-01
The realisation of personalised e-learning to suit an individual learner's diverse learning needs is a concept which has been explored for decades, at great expense, but is still not achievable by non-technical authors. This research reviews the area of personalised e-learning and notes some of the technological challenges which developers may…
ERIC Educational Resources Information Center
Putman, Hannah; Hansen, Michael; Walsh, Kate; Quintero, Diana
2016-01-01
Public schools are suffering from a well-publicized diversity problem. Minority students make up nearly half of all public school students, yet minority teachers comprise just 18 percent of the teacher workforce. In an effort to address what Slate has described as "the one cause in education everyone supports," school districts across…
ERIC Educational Resources Information Center
Rehm, Marsha L.
2008-01-01
The purpose of this study was to identify CTE teachers' perceptions of selected rewards, difficulties, and useful teaching strategies in culturally diverse classes. The sample was comprised of 41 trade and industrial, business technology, and family and consumer sciences teachers who taught students from 30 cultural backgrounds. The data were…
ERIC Educational Resources Information Center
Frieze, Carol; Quesenberry, Jeria L.; Kemp, Elizabeth; Velazquez, Anthony
2012-01-01
Gender difference approaches to the participation of women in computing have not provided adequate explanations for women's declining interest in computer science (CS) and related technical fields. Indeed, the search for gender differences can work against diversity which we define as a cross-gender spectrum of characteristics, interests,…
ERIC Educational Resources Information Center
Flores, Jeff; Lopez, Eric J.; De Leon, Jozi
This manual presents New Mexico state guidelines for the assessment and evaluation of preschool children who are culturally and linguistically diverse, and focuses on the principles of parent participation and nondiscriminatory evaluation as defined in the Individuals with Disabilities Education Act and the New Mexico Administrative Codes. A…
Dulal, Bishnu; Mundy, Gary; Sawal, Rojee; Rana, Pooja Pandey; Cunningham, Kenda
2017-09-01
Suaahara, a large-scale integrated program, aimed to improve diets and nutritional status among women and children, in part by facilitating enhanced homestead food production (EHFP). This study examines associations between EHFP and maternal and child dietary diversity and variations by season and agroecological zone (AEZ): mountains and terai. We used data from household monitoring surveys (n = 2101 mothers; n = 994 children, 6-23 months), which included a 7-day dietary recall and maternal report on participation in 5 EHFP activities-received vegetable seeds, chicks, and technical support and participated in training and EHFP groups. We constructed binary variables for each activity and a scale (0-5) summing participation. For dietary diversity, we used the Women's Dietary Diversity Score using 10 food groups and 7 food groups for child diets. Multivariable linear regression analyses were used to assess associations between EHFP participation and dietary diversity by season and AEZ, controlling for potential confounders and clustering. In adjusted models, we found positive associations between dietary diversity and chicks, technical support, and EHFP beneficiary groups; the magnitude of the associations varied by season and AEZ. The degree of participation in 5 EHFP activities was positively associated with maternal dietary diversity in the terai (β = .24, P < .001) and mountains (β = .12, P = .01) and child dietary diversity in the terai (β = .35, P < .001) during the winter. No associations were found in the rainy season. Our findings highlight the potential for EHFP to address dietary diversity constraints among this population. Variation by subnational setting and seasonality suggest that policies and programs should be contextualized.
Naval Training Equipment Center Index of Technical Reports,
1982-09-01
741 RECOMMENDED PROCEDURES AND TRAINING NAVAL TRAINING AIDS. tAMPHIBIOUS OPERATIONS PROCEDURES AND RESEARCH PLANNING AD- 642 590 TRAINING DEVICES FOR...PROCEDURES AND RESEARCH PLANNING OBSERVATION AND FIRE CONTROL WITH FOR ANTI-AIR WARFARE TRAINING SPECIFIC REFERENCE TO THE TRAINING *AMPUTEES PROGRAM...619 AD- 707 757 NAVAL PERSONNEL *COMMUNICATION SATELLITES PROCEDURES AND RESEARCH PLANNING *COMBUSTION PRODUCTS Computer Managed Instruction by FOR
CAT-ASVAB Technical Bulletin Number 1
2006-03-01
CAT -ASVAB Technical Bulletin #1 Personnel Testing Division Defense Manpower Data Center March 2006 Report...2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE CAT -ASVAB Technical Bulletin #1 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...Hetter, R. D. "Psychometric Procedures for Administering CAT -ASVAB" (pp. 131-140) Chapter 4 Hetter, R. D., & Sympson J. B. "Item Exposure
Analysis of localizer and glide slope Flight Technical Error
DOT National Transportation Integrated Search
2008-12-09
A new wake turbulence procedure has been developed that permits two dependent arrival traffic streams during instrument meteorological conditions : to runways with centerline separations less than 2500 ft. For the proposed procedure, aircraft approac...
Accessible Electronic and Information Technology: Standards, Procedures, and Guidance
Defines electronic and information technology (EIT), and the technical and functional performance criteria for EIT to comply with Section 508 accessibility standards. Includes EPA procedures for EIT approval, 508 complaints, and undue burden justification.
Technical approaches for measurement of human errors
NASA Technical Reports Server (NTRS)
Clement, W. F.; Heffley, R. K.; Jewell, W. F.; Mcruer, D. T.
1980-01-01
Human error is a significant contributing factor in a very high proportion of civil transport, general aviation, and rotorcraft accidents. The technical details of a variety of proven approaches for the measurement of human errors in the context of the national airspace system are presented. Unobtrusive measurements suitable for cockpit operations and procedures in part of full mission simulation are emphasized. Procedure, system performance, and human operator centered measurements are discussed as they apply to the manual control, communication, supervisory, and monitoring tasks which are relevant to aviation operations.
Eckstein, Hans-Henning; Schmidli, Jürg; Schumacher, Hardy; Gürke, Lorenz; Klemm, Klaus; Duschek, Nikolaus; Meile, Toni; Assadian, Afshin
2013-05-01
Vascular surgical training currently has to cope with various challenges, including restrictions on work hours, significant reduction of open surgical training cases in many countries, an increasing diversity of open and endovascular procedures, and distinct expectations by trainees. Even more important, patients and the public no longer accept a "learning by doing" training philosophy that leaves the learning curve on the patient's side. The Vascular International (VI) Foundation and School aims to overcome these obstacles by training conventional vascular and endovascular techniques before they are applied on patients. To achieve largely realistic training conditions, lifelike pulsatile models with exchangeable synthetic arterial inlays were created to practice carotid endarterectomy and patch plasty, open abdominal aortic aneurysm surgery, and peripheral bypass surgery, as well as for endovascular procedures, including endovascular aneurysm repair, thoracic endovascular aortic repair, peripheral balloon dilatation, and stenting. All models are equipped with a small pressure pump inside to create pulsatile flow conditions with variable peak pressures of ~90 mm Hg. The VI course schedule consists of a series of 2-hour modules teaching different open or endovascular procedures step-by-step in a standardized fashion. Trainees practice in pairs with continuous supervision and intensive advice provided by highly experienced vascular surgical trainers (trainer-to-trainee ratio is 1:4). Several evaluations of these courses show that tutor-assisted training on lifelike models in an educational-centered and motivated environment is associated with a significant increase of general and specific vascular surgical technical competence within a short period of time. Future studies should evaluate whether these benefits positively influence the future learning curve of vascular surgical trainees and clarify to what extent sophisticated models are useful to assess the level of technical skills of vascular surgical residents at national or international board examinations. This article gives an overview of our experiences of >20 years of practical training of beginners and advanced vascular surgeons using lifelike pulsatile vascular surgical training models. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Esquinas-Alcázar, José
2005-12-01
Crop genetic diversity - which is crucial for feeding humanity, for the environment and for sustainable development - is being lost at an alarming rate. Given the enormous interdependence of countries and generations on this genetic diversity, this loss raises critical socio-economic, ethical and political questions. The recent ratification of a binding international treaty, and the development of powerful new technologies to conserve and use resources more effectively, have raised expectations that must now be fulfilled.
Taylor, Jay M; Perez-Toralla, Karla; Aispuro, Ruby; Morin, Stephen A
2018-02-01
The lamination of mechanically stiff structures to elastic materials is prevalent in biological systems and popular in many emerging synthetic systems, such as soft robotics, microfluidics, stretchable electronics, and pop-up assemblies. The disparate mechanical and chemical properties of these materials have made it challenging to develop universal synthetic procedures capable of reliably adhering to these classes of materials together. Herein, a simple and scalable procedure is described that is capable of covalently laminating a variety of commodity ("off-the-shelf") thermoplastic sheets to silicone rubber films. When combined with laser printing, the nonbonding sites can be "printed" onto the thermoplastic sheets, enabling the direct fabrication of microfluidic systems for actuation and liquid handling applications. The versatility of this approach in generating thin, multifunctional laminates is demonstrated through the fabrication of milliscale soft actuators and grippers with hinged articulation and microfluidic channels with built-in optical filtering and pressure-dependent geometries. This method of fabrication offers several advantages, including technical simplicity, process scalability, design versatility, and material diversity. The concepts and strategies presented herein are broadly applicable to the soft robotics, microfluidics, and advanced and additive manufacturing communities where hybrid rubber/plastic structures are prevalent. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Newman, Martin I.; Seeley, Neil; Hutchins, Jacob; Smith, Kevin L.; Mena, Gabriel; Selber, Jesse C.; Saint-Cyr, Michel H.; Gadsden, Jeffrey C.
2017-01-01
Enhanced recovery after surgery is a multidisciplinary perioperative clinical pathway that uses evidence-based interventions to improve the patient experience as well as increase satisfaction, reduce costs, mitigate the surgical stress response, accelerate functional recovery, and decrease perioperative complications. One of the most important elements of enhanced recovery pathways is multimodal pain management. Herein, aspects relating to multimodal analgesia following breast surgical procedures are discussed with the understanding that treatment decisions should be individualized and guided by sound clinical judgment. A review of liposomal bupivacaine, a prolonged-release formulation of bupivacaine, in the management of postoperative pain following breast surgical procedures is presented, and technical guidance regarding optimal administration of liposomal bupivacaine is provided. PMID:29062649
Privacy and security compliance in the E-healthcare marketplace.
Lutes, M
2000-03-01
Complying with security and privacy regulations proposed by HHS in response to the Health Insurance Portability and Accountability Act (HIPAA) will require healthcare managers to address both internal and external business interactions and initiatives. The proposed regulations mandate certain procedures regarding administration, physical safeguards, technical security for data integrity and confidentiality, and technical security against unauthorized access. In particular, the proposed regulations require organizations to contractually ensure that vendors adhere to the regulations. Healthcare organizations also must implement training procedures for staff members who have contact with protected health information and designate a privacy officer to guard against improper disclosure of such information. Documented policies for organizational decision making are vital to an organization's efforts to implement procedures for compliance with the regulations.
[Robotic surgery -- the modern surgical treatment of prostate cancer].
Szabó, Ferenc János; Alexander, de la Taille
2014-09-01
Minimally invasive laparoscopic surgery replaces many open surgery procedures in urology due to its advantages concerning post-operative morbidity. However, the technical challenges and need of learning have limited the application of this method to the work of highly qualified surgeons. The introduction of da Vinci surgical system has offered important technical advantages compared to the laparoscopic surgical procedure. Robot-assisted radical prostatectomy became a largely accepted procedure. It has paved the way for urologists to start other, more complex operations, decreasing this way the operative morbidity. The purpose of this article is to overview the history of robotic surgery, its current and future states in the treatment of the cancer. We present our robot-assisted radical prostatectomy and the results.
SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS.
Gebelli, Jordi Pujol; Gordejuela, Amador Garcia Ruiz de; Ramos, Almino Cardoso; Nora, Mario; Pereira, Ana Marta; Campos, Josemberg Marins; Ramos, Manoela Galvão; Bastos, Eduardo Lemos de Souza; Marchesini, João Batista
Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. Cerca de 500.000 cirurgias bariátricas são realizadas a cada ano em todo o mundo. As técnicas mais realizadas são o bypass gástrico em Y-de-Roux e a gastrectomia vertical. A derivação biliopancreática, com ou sem duodenal switch, é considerada técnica mais eficaz no tratamento cirúrgico do paciente obeso mórbido; entretanto, representa não mais do que 1,5% dos procedimentos na atualidade, pois sua complexidade técnica, morbimortalidade e graves efeitos adversos nutricionais impedem aceitação mais universal. Descrever os aspectos técnicos e os benefícios do SADI-S com ligadura da artéria gástrica direita como um modo simplificado do duodenal switch original. Foram incluídos todos os pacientes submetidos a este procedimento entre novembro 2014 e maio de 2016. Além da descrição da sistematização da técnica operatória, foram analisadas as complicações precoces associadas ao procedimento. Uma série de 67 pacientes foi operada no período analisado; 46 eram mulheres (68,7%) e a média de idade foi de 44 anos (33-56). O IMC médio foi de 53,5 kg/m2 (50-63,5). O tempo cirúrgico médio foi de 115 min (80-180) e a permanência hospitalar média foi de 2,5 dias (1-25). Complicações foram observadas em cinco pacientes (7,5%) e dois (2,9%) tiveram de ser reoperados. Duas pacientes evoluíram com fístula, uma no coto duodenal e outra na junção esofagogástrica. Não houve mortalidade. SADI-S com ligadura da artéria gástrica direita é procedimento seguro com poucas complicações precoces. A simplificação técnica em relação ao duodenal switch clássico pode permitir que este procedimento se torne mais popular. Todas as complicações observadas nesta série não estavam relacionadas com a ligadura da artéria gástrica direita.
Kawakubo, Kazumichi; Kawakami, Hiroshi; Toyokawa, Yoshihide; Otani, Koichi; Kuwatani, Masaki; Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Sakamoto, Naoya
2015-01-01
Endoscopic double self-expandable metallic stent (SEMS) placement by the partial stent-in-stent (PSIS) method has been reported to be useful for the management of unresectable hilar malignant biliary obstruction. However, it is technically challenging, and the optimal SEMS for the procedure remains unknown. The aim of this study was to identify the risk factors for technical failure of endoscopic double SEMS placement for unresectable malignant hilar biliary obstruction (MHBO). Between December 2009 and May 2013, 50 consecutive patients with MHBO underwent endoscopic double SEMS placement by the PSIS method. We retrospectively evaluated the rate of successful double SEMS placement and identified the risk factors for technical failure. The technical success rate for double SEMS placement was 82.0% (95% confidence interval [CI]: 69.2-90.2). On univariate analysis, the rate of technical failure was high in patients with metastatic disease and unilateral placement. Multivariate analysis revealed that metastatic disease was a significant risk factor for technical failure (odds ratio: 9.63, 95% CI: 1.11-105.5). The subgroup analysis after double guidewire insertion showed that the rate of technical success was higher in the laser-cut type SEMS with a large mesh and thick delivery system than in the braided type SEMS with a small mesh and thick delivery system. Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
A Schema Theory Account of Some Cognitive Processes in Complex Learning. Technical Report No. 81.
ERIC Educational Resources Information Center
Munro, Allen; Rigney, Joseph W.
Procedural semantics models have diminished the distinction between data structures and procedures in computer simulations of human intelligence. This development has theoretical consequences for models of cognition. One type of procedural semantics model, called schema theory, is presented, and a variety of cognitive processes are explained in…
47 CFR 15.611 - General technical requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 1 2010-10-01 2010-10-01 false General technical requirements. 15.611 Section 15.611 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Access... shut-off procedure, by the use of a non-volatile memory, or some other method, to immediately restore...
78 FR 3893 - Enbridge Energy, Limited Partnership; Notice of Technical Conference
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-17
... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. IS13-17-000] Enbridge Energy... Energy, Limited Partnership's proposed revision to its downstream Nomination Verification Procedure. \\1\\ Enbridge Energy, Limited Partnership, 141 FERC ] 61,246 (2012). Take notice that a technical conference...
A technical report on structural evaluation of the Meade County reinforced concrete bridge.
DOT National Transportation Integrated Search
2009-01-01
This is a technical report on the first phase of the evaluation of the Meade County reinforced concrete bridge. : The first three chapters introduce the main problem and provide a general review of the existing evaluation : methods and the procedures...
[A technical modification of the use of Dwyer's equipment].
Carlioz, H; Damsin, J P
1991-01-01
Dwyer's technique for correction and anterior fusion of the spine was improved by using lockers at the level of each screw. So, like with the Zielke's technic this procedure allowed a global progressive and controllable correction and a real derotation of the spine.
14 CFR 21.601 - Applicability.
Code of Federal Regulations, 2010 CFR
2010-01-01
... PROCEDURES FOR PRODUCTS AND PARTS Technical Standard Order Authorizations § 21.601 Applicability. (a) This... requirements for the issuance of a letter of Technical Standard Order design approval. (b) For the purpose of..., articles means materials, parts, processes, or appliances) used on civil aircraft. (2) A TSO authorization...
Forest health monitoring: 2004 national technical report
John W. Coulston; Mark J. Ambrose; Kurt H. Riitters; Barbara L. Conkling
2005-01-01
The Forest Health Monitoring (FHM) Programâs annual national technical report presents results of forest health analyses from a national perspective using data from a variety of sources. Results presented in the report pertain to the Santiago Declarationâs Criterion 1â Conservation of Biological Diversity and Criterion 3âMaintenance of Forest Ecosystem Health and...
Development of an accelerated creep testing procedure for geosynthetics : technical summary.
DOT National Transportation Integrated Search
1997-09-01
Temperature-creep relationships in geosynthetics vary for each type of geogrid and depend on many factors such as polymer structure, manufacture process, degree of crystallinity, and glass-transition temperature. The extrapolation procedures to predi...
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Procedures. 242.7401 Section 242.7401 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Technical Representation at...
Reproducibility and quantitation of amplicon sequencing-based detection
Zhou, Jizhong; Wu, Liyou; Deng, Ye; Zhi, Xiaoyang; Jiang, Yi-Huei; Tu, Qichao; Xie, Jianping; Van Nostrand, Joy D; He, Zhili; Yang, Yunfeng
2011-01-01
To determine the reproducibility and quantitation of the amplicon sequencing-based detection approach for analyzing microbial community structure, a total of 24 microbial communities from a long-term global change experimental site were examined. Genomic DNA obtained from each community was used to amplify 16S rRNA genes with two or three barcode tags as technical replicates in the presence of a small quantity (0.1% wt/wt) of genomic DNA from Shewanella oneidensis MR-1 as the control. The technical reproducibility of the amplicon sequencing-based detection approach is quite low, with an average operational taxonomic unit (OTU) overlap of 17.2%±2.3% between two technical replicates, and 8.2%±2.3% among three technical replicates, which is most likely due to problems associated with random sampling processes. Such variations in technical replicates could have substantial effects on estimating β-diversity but less on α-diversity. A high variation was also observed in the control across different samples (for example, 66.7-fold for the forward primer), suggesting that the amplicon sequencing-based detection approach could not be quantitative. In addition, various strategies were examined to improve the comparability of amplicon sequencing data, such as increasing biological replicates, and removing singleton sequences and less-representative OTUs across biological replicates. Finally, as expected, various statistical analyses with preprocessed experimental data revealed clear differences in the composition and structure of microbial communities between warming and non-warming, or between clipping and non-clipping. Taken together, these results suggest that amplicon sequencing-based detection is useful in analyzing microbial community structure even though it is not reproducible and quantitative. However, great caution should be taken in experimental design and data interpretation when the amplicon sequencing-based detection approach is used for quantitative analysis of the β-diversity of microbial communities. PMID:21346791
Melvin L. Warren; Brooks M. Burr; Stephen J. Walsh; Henry L. Bart; Robert C. Cashner; David A. Etnier; Byron J. Freeman; Bernard R. Kuhajda; Richard L. Mayden; Henry W. Robison; Stephen T. Ross; Wayne C. Starnes
2000-01-01
The Southeastern Fishes Council Technical Advisory Committee reviewed the diversity, distribution, and status of all native freshwater and diadromous fishes across 51 major drainage units of the Southern United States. The Southern United States supports more native fishes than any area of comparable size on the North American continent north of Mexico, but also has a...
ERIC Educational Resources Information Center
Çepni, Sevcan Bayraktar; Demirel, Elif Tokdemir
2016-01-01
This study aimed to find out the impact of "text mining and imitating" strategies on lexical richness, lexical diversity and general success of students in their compositions in second language writing. The participants were 98 students studying their first year in Karadeniz Technical University in English Language and Literature…
Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D
2016-05-09
The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Clark, Susan G.; Vernon, Marian E.
2015-08-01
The controversial elk reduction program (elk hunt) in Grand Teton National Park, WY, has been a source of conflict since it was legislated in 1950. The hunt is jointly managed by the National Park Service and the Wyoming Game and Fish Department. This forced organizational partnership and the conflicting mandates of these two agencies have led to persistent conflict that seems irresolvable under the current decision-making process. To better understand the decision-making process and participant perspectives, we reviewed management documents, technical literature, and newspaper articles, and interviewed 35 key participants in this case. We used these data to analyze and appraise the adequacy of the decision-making process for the park elk hunt and to ask whether it reflects the common interest. We found deficiencies in all functions of the decision-making process. Neither the decisions made nor the process itself include diverse perspectives, nor do they attend to valid and appropriate participant concerns. Agency officials focus their attention on technical rather than procedural concerns, which largely obfuscates the underlying tension in the joint inter-jurisdictional management arrangement and ultimately contributes to the hunt's annual implementation to the detriment of the common interest. We offer specific yet widely applicable recommendations to better approximate an inclusive and democratic decision-making process that serves the community's common interests.
[Patients' perception on attention received from Health Centres non-sanitary staff].
Ruiz Moral, R; Alba Dios, A; Jiménez García, C; González Neubauer, V; García Torres, M; Pérula de Torres, L A; Barrios Blasco, L
2011-01-01
To know patients' perceptions about relational aspects and technical procedures when they are attended by the administrative staff in Health Centres. To assess the utility of two ways for measuring satisfaction. Cross-sectional study carried out in people attending the administrative sections of Health Centres for diverse reasons. Just after the interaction with the administrative they were interviewed using two different questions for assessing their opinions and satisfaction with communicational and technical aspects related with their demands. Descriptive analysis. Significant differences among mean was explored by χ(2) test. Open-ended questions were grouped in categories in a process involving three researchers independently. Over than 90% (360) of the attendees declared to be satisfied or very satisfied with the service received from the staff personal. Nevertheless, among 18-36% gave suggestions for improving the service after their consultation. Independently the domain explored, people suggested the communicational, personal capability, quality and quantity of explanations and waiting time as the main aspects to be improved. Surveys with open-ended questions are more useful to assess the quality of the attention the citizens receive from no-sanitary staff in Health Centres. These type of questions are also more useful for detecting problems and planning new interventions. Relational and informative issues seem to be the most prioritary areas to improve in this section of Health Centres. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.
Detection of microRNAs in color space.
Marco, Antonio; Griffiths-Jones, Sam
2012-02-01
Deep sequencing provides inexpensive opportunities to characterize the transcriptional diversity of known genomes. The AB SOLiD technology generates millions of short sequencing reads in color-space; that is, the raw data is a sequence of colors, where each color represents 2 nt and each nucleotide is represented by two consecutive colors. This strategy is purported to have several advantages, including increased ability to distinguish sequencing errors from polymorphisms. Several programs have been developed to map short reads to genomes in color space. However, a number of previously unexplored technical issues arise when using SOLiD technology to characterize microRNAs. Here we explore these technical difficulties. First, since the sequenced reads are longer than the biological sequences, every read is expected to contain linker fragments. The color-calling error rate increases toward the 3(') end of the read such that recognizing the linker sequence for removal becomes problematic. Second, mapping in color space may lead to the loss of the first nucleotide of each read. We propose a sequential trimming and mapping approach to map small RNAs. Using our strategy, we reanalyze three published insect small RNA deep sequencing datasets and characterize 22 new microRNAs. A bash shell script to perform the sequential trimming and mapping procedure, called SeqTrimMap, is available at: http://www.mirbase.org/tools/seqtrimmap/ antonio.marco@manchester.ac.uk Supplementary data are available at Bioinformatics online.
Battery Test Manual For Electric Vehicles, Revision 3
DOE Office of Scientific and Technical Information (OSTI.GOV)
Christophersen, Jon P.
2015-06-01
This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Office. It is based on technical targets for commercial viability established for energy storage development projects aimed at meeting system level DOE goals for Electric Vehicles (EV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for EVs. However, it does share some methods described in the previously published battery test manual for plug-in hybrid electric vehicles. Due to the complexity of some of themore » procedures and supporting analysis, future revisions including some modifications and clarifications of these procedures are expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices. The DOE-United States Advanced Battery Consortium (USABC), Technical Advisory Committee (TAC) supported the development of the manual. Technical Team points of contact responsible for its development and revision are Chul Bae of Ford Motor Company and Jon P. Christophersen of the Idaho National Laboratory. The development of this manual was funded by the Unites States Department of Energy, Office of Energy Efficiency and Renewable Energy, Vehicle Technologies Office. Technical direction from DOE was provided by David Howell, Energy Storage R&D Manager and Hybrid Electric Systems Team Leader. Comments and questions regarding the manual should be directed to Jon P. Christophersen at the Idaho National Laboratory (jon.christophersen@inl.gov).« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tsauo, Jiaywei, E-mail: 80732059@qq.com; Luo, Xuefeng, E-mail: luobo-913@126.com; Ye, Linchao, E-mail: linchao.ye@siemens.com
2015-06-15
PurposeThis study was designed to report our results with a modified technique of three-dimensional (3D) path planning software assisted transjugular intrahepatic portosystemic shunt (TIPS).Methods3D path planning software was recently developed to facilitate TIPS creation by using two carbon dioxide portograms acquired at least 20° apart to generate a 3D path for overlay needle guidance. However, one shortcoming is that puncturing along the overlay would be technically impossible if the angle of the liver access set and the angle of the 3D path are not the same. To solve this problem, a prototype 3D path planning software was fitted with a utility to calculate themore » angle of the 3D path. Using this, we modified the angle of the liver access set accordingly during the procedure in ten patients.ResultsFailure for technical reasons occurred in three patients (unsuccessful wedged hepatic venography in two cases, software technical failure in one case). The procedure was successful in the remaining seven patients, and only one needle pass was required to obtain portal vein access in each case. The course of puncture was comparable to the 3D path in all patients. No procedure-related complication occurred following the procedures.ConclusionsAdjusting the angle of the liver access set to match the angle of the 3D path determined by the software appears to be a favorable modification to the technique of 3D path planning software assisted TIPS.« less
A tutorial platform suitable for surgical simulator training (SimMentor).
Røtnes, Jan Sigurd; Kaasa, Johannes; Westgaard, Geir; Eriksen, Eivind Myrold; Hvidsten, Per Oyvind; Strøm, Kyrre; Sørhus, Vidar; Halbwachs, Yvon; Haug, Einar; Grimnes, Morten; Fontenelle, Hugues; Ekeberg, Tom; Thomassen, Jan B; Elle, Ole Jakob; Fosse, Erik
2002-01-01
The introduction of simulators in surgical training entails the need to develop pedagogic platforms adapted to the potentials and limitations provided by the information technology. As a solution to the technical challenges in treating all possible interaction events and to obtain a suitable pedagogic approach, we have developed a pedagogic platform for surgical training, SimMentor. In SimMentor the procedure to be practiced is divided into a number of natural phases. The trainee will practice on one phase at a time, however he can select the sequence of phases arbitrarily. A phase is taught by letting the trainee alternate freely between 2 modes: 1: A 3-dimensional animated guidance designed for learning the objectives and challenges in a procedure. 2: An interactive training session through the instrument manipulator device designed for training motoric responses based on visual and tactile responses produced by the simulator. The two modes are interfaced with the same virtual reality platform, thus SimMentor allows a seamless transition between the modes. We have developed a prototype simulator for robotic assisted endoscopic CABG (Coronary Artery Bypass Grafting) procedure by first focusing on the anastomosis part of the operation. Tissue, suture and instrument models have been developed and integrated with a simulated model of a beating heart comprises the elements in the simulator engine that is used in construction a training platform for learning different methods for performing a coronary anastomosis procedure. The platform is designed for integrating the following features: 1) practical approach to handle interactivity events with flexible-objects 3D simulators, 2) methods for quantitative evaluations of performance, 3) didactic presentations, 4) effective ways of producing diversity of clinical and pathological training scenarios.
Sarı, Cenk; Baştuğ, Serdal; Kasapkara, Hacı Ahmet; Durmaz, Tahir; Keleş, Telat; Akçay, Murat; Aslan, Abdullah Nabi; Bayram, Nihal Akar; Bozkurt, Engin
2015-01-01
Introduction Transcatheter aortic valve implantation for severe symptomatic aortic stenosis in patients with a previous mitral valve prosthesis is technically challenging, and pre-procedural comprehensive assessment of these patients before transcatheter aortic valve implantation is vital for an uncomplicated and successful procedure. Aim We want to share our experience with transcatheter aortic valve implantation in patients with a preexisting functional mitral valve prosthesis and describe a series of important technical and pre-procedural details. Material and methods At our center, 135 patients with symptomatic severe aortic stenosis were treated with transcatheter aortic valve implantation. Six of them with a preexisting mitral valve prosthesis received an Edwards SAPIEN XT valve through the transfemoral route. Results Transcatheter aortic valve implantation was performed successfully in all 6 patients without any deformation of the cobalt-chromium/steel stents of the aortic valve bioprosthesis. Also no distortion or malfunction in the mitral valve prosthesis was observed after the procedure. There were no complications during the hospitalization period. Post-procedural echocardiography revealed no or mild aortic paravalvular regurgitation and normal valve function in all the patients. In addition, serial echocardiographic examination demonstrated that both the stability and function of the aortic and mitral prosthetic valves were normal without any deterioration in the gradients and the degree of the regurgitation at long-term follow-ups. Conclusions Our experience confirms that transcatheter aortic valve implantation is technically feasible in patients with previous mitral valve replacement but comprehensive evaluation of patients by multimodal imaging techniques such as transesophageal echocardiography and multislice computed tomography is mandatory for a successful and safe procedure. PMID:26677380
ONE-DIMENSIONAL HYDRODYNAMIC/SEDIMENT TRANSPORT MODEL FOR STREAM NETWORKS: TECHNICAL REPORT
This technical report describes a new sediment transport model and the supporting post-processor, and sampling procedures for sediments in streams. Specifically, the following items are described herein:
EFDC1D - This is a new one-dimensional hydrodynamic and sediment tr...
26 CFR 601.106 - Appeals functions.
Code of Federal Regulations, 2011 CFR
2011-04-01
... advice adverse to the taxpayer should be given and a conference has been requested, the taxpayer will be... after payment, but shall be made before the filing of a claim for refund. Technical advice procedures... Office technical advice is furnished concerning exemption or qualification, the decision of the National...
77 FR 20377 - Biomass Research and Development Technical Advisory Committee
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-04
... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee under Section 9008(d) of the Food... procedures, members of the public are welcome to observe the business of the Biomass Research and Development...
Fox Valley Technical Institute Economic Development Plan.
ERIC Educational Resources Information Center
Fox Valley Technical Inst., Appleton, WI.
Designed as an operating blueprint for Fox Valley Technical Institute's (FVTI's) economic development efforts, this guide incorporates the necessary operation procedures, descriptions, and resources for those involved in FVTI's effort to assist existing businesses to expand and to attract new businesses to the area. Introductory material describes…
Final Rule for Procedures for Testing Highway and Nonroad Engines and Omnibus Technical Amendments
This common set of test requirements is intended to streamline laboratory efforts for EPA and industry and to form the basis for internationally harmonized test procedures for nearly all categories of engines.
Relationship between Procedural Tactical Knowledge and Specific Motor Skills in Young Soccer Players
Aquino, Rodrigo; Marques, Renato Francisco R.; Petiot, Grégory Hallé; Gonçalves, Luiz Guilherme C.; Moraes, Camila; Santiago, Paulo Roberto P.; Puggina, Enrico Fuini
2016-01-01
The purpose of this study was to investigate the association between offensive tactical knowledge and the soccer-specific motor skills performance. Fifteen participants were submitted to two evaluation tests, one to assess their technical and tactical analysis. The motor skills performance was measured through four tests of technical soccer skills: ball control, shooting, passing and dribbling. The tactical performance was based on a tactical assessment system called FUT-SAT (Analyses of Procedural Tactical Knowledge in Soccer). Afterwards, technical and tactical evaluation scores were ranked with and without the use of the cluster method. A positive, weak correlation was perceived in both analyses (rho = 0.39, not significant p = 0.14 (with cluster analysis); and rho = 0.35; not significant p = 0.20 (without cluster analysis)). We can conclude that there was a weak association between the technical and the offensive tactical knowledge. This shows the need to reflect on the use of such tests to assess technical skills in team sports since they do not take into account the variability and unpredictability of game actions and disregard the inherent needs to assess such skill performance in the game. PMID:29910300
DOE Office of Scientific and Technical Information (OSTI.GOV)
Paik, Nam Chull, E-mail: pncspine@gmail.com
Background and PurposeIn CT fluoroscopy (CTF)-guided cervical transforaminal epidural steroid injection (TFESI), the majority of radiation dose is contributed by the planning CT scan rather than the CTF procedure itself. We replaced the planning helical CT with a spot CTF and accordingly changed the patient posture during scout and planning scans. The aim of this study was to test whether radiation dose reduction would be achieved by this protocol modification while still maintaining technical performance.MethodsOverall, 338 consecutive procedures before (control group: n = 163) and after (study group: n = 175) instituting the above-mentioned protocol modification were analyzed retrospectively, comparing patient characteristics (age, sex,more » neck diameter, and level injected) and technical performance [technical success rate, dose-length product (DLP), inadvertent contrast flow incidence, number of CTF acquisitions, and procedural time] between the two groups.ResultsAll injections were technically successful at every level from C3–C4 to C7–T1 without serious complications in both groups. The median DLP of the study group (7.92 mGy·cm) was significantly reduced compared to that of the control group (39.05 mGy·cm, P < 0.001). There were no significant differences between the two groups regarding the incidence of inadvertent contrast flow (20.6 vs. 17.2 %, P = 0.426), number of CTF acquisitions (median 5 vs. 4, P = 0.123), and the procedural time (median 6.62 vs. 6.90 min, P = 0.100).ConclusionsWhen conducting CTF-guided cervical TFESIs, a significant radiation dose reduction (median 79.7 % in DLP) can be achieved by modifying scout and planning steps, without compromising the technical performance.« less
Challenges and promises of integrating knowledge engineering and qualitative methods
NASA Astrophysics Data System (ADS)
Lundberg, C. Gustav; Holm, Gunilla
Our goal is to expose some of the close ties that exist between knowledge engineering (KE) and qualitative methodology (QM). Many key concepts of qualitative research, for example meaning, commonsense, understanding, and everyday life, overlap with central research concerns in artificial intelligence. These shared interests constitute a largely unexplored avenue for interdisciplinary cooperation. We compare and take some steps toward integrating two historically diverse methodologies by exploring the commonalities of KE and QM both from a substantive and a methodological/technical perspective. In the second part of this essay, we address knowledge acquisition problems and procedures. Knowledge acquisition within KE has been based primarily on cognitive psychology/science foundations, whereas knowledge acquisition within QM has a broader foundation in phenomenology, symbolic interactionism, and ethnomethodology. Our discussion and examples are interdisciplinary in nature. We do not suggest that there is a clash between the KE and QM frameworks, but rather that the lack of communication potentially may limit each framework's future development.
Moving into the paravisceral aorta using fenestrated and branched endografts.
Farber, Mark A; Vallabhaneni, Raghuveer
2012-12-01
When one compares the potential advantages of endovascular aortic repair with respect to traditional open repair, it would seem logical that extension into the paravisceral aorta would be easily justified, given the complexity of open aortic repair and its associated complications. Eight years have transpired between trial initiation and Food and Drug Administration approval of the first fenestrated device in the United States for the treatment of juxtarenal aneurysms. While there are only a few centers in the United States with substantial experience performing fenestrated and branched endovascular aortic repair, there is a diverse experience outside the United States that has been gained over the past decade. It is through the experience of these centers that the technical and procedural complexities of complex endovascular aortic repair has been solved and provide the foundation that has allowed aortic specialists to move endovascular therapy into the paravisceral aorta with fenestrated and branched endovascular aortic repairs. Copyright © 2012 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Lauritzen, Paul; Friedman, Stephen
This manual presents procedures for collecting data to project personnel needs in the field of special education, addressing in part the Comprehensive System of Personnel Development requirements of Public Law 94-142. Implementation of the procedures identifies: areas of education that show need for additional teachers as well as areas of surplus;…
40 CFR 53.23 - Test procedures.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Test procedures. 53.23 Section 53.23... Methods SO2, CO, O3, and NO2 § 53.23 Test procedures. (a) Range—(1) Technical definition. Nominal minimum... specified at the lower and upper range limits in concentration units, for example, 0-0.5 p/m. (2) Test...
40 CFR 53.23 - Test procedures.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Test procedures. 53.23 Section 53.23... Methods SO2, CO, O3, and NO2 § 53.23 Test procedures. (a) Range—(1) Technical definition. Nominal minimum... specified at the lower and upper range limits in concentration units, for example, 0-0.5 p/m. (2) Test...
Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.
Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J
2018-06-01
Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.
Automatically inserted technical details improve radiology report accuracy.
Abujudeh, Hani H; Govindan, Siddharth; Narin, Ozden; Johnson, Jamlik Omari; Thrall, James H; Rosenthal, Daniel I
2011-09-01
To assess the effect of automatically inserted technical details on the concordance of a radiology report header with the actual procedure performed. The study was IRB approved and informed consent was waived. We obtained radiology report audit data from the hospital's compliance office from the period of January 2005 through December 2009 spanning a total of 20 financial quarters. A "discordance percentage" was defined as the percentage of total studies in which a procedure code change was made during auditing. Using Chi-square analysis we compared discordance percentages between reports with manually inserted technical details (MITD) and automatically inserted technical details (AITD). The second quarter data of 2007 was not included in the analysis as the switch from MITD to AITD occurred during this quarter. The hospital's compliance office audited 9,110 studies from 2005-2009. Excluding the 564 studies in the second quarter of 2007, we analyzed a total of 8,546 studies, 3,948 with MITD and 4,598 with AITD. The discordance percentage in the MITD group was 3.95% (156/3,948, range per quarter, 1.5- 6.1%). The AITD discordance percentage was 1.37% (63/4,598, range per quarter, 0.0-2.6%). A Chi-square analysis determined a statistically significant difference between the 2 groups (P < 0.001). There was a statistically significant improvement in the concordance of a radiology report header with the performed procedure using automatically inserted technical details compared to manually inserted details. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Remote navigation systems in electrophysiology.
Schmidt, Boris; Chun, Kyoung Ryul Julian; Tilz, Roland R; Koektuerk, Buelent; Ouyang, Feifan; Kuck, Karl-Heinz
2008-11-01
Today, atrial fibrillation (AF) is the dominant indication for catheter ablation in big electrophysiologists (EP) centres. AF ablation strategies are complex and technically challenging. Therefore, it would be desirable that technical innovations pursue the goal to improve catheter stability to increase the procedural success and most importantly to increase safety by helping to avoid serious complications. The most promising technical innovation aiming at the aforementioned goals is remote catheter navigation and ablation. To date, two different systems, the NIOBE magnetic navigation system (MNS, Stereotaxis, USA) and the Sensei robotic navigation system (RNS, Hansen Medical, USA), are commercially available. The following review will introduce the basic principles of the systems, will give an insight into the merits and demerits of remote navigation, and will further focus on the initial clinical experience at our centre with focus on pulmonary vein isolation (PVI) procedures.
Kwon, Young Ho; Kwon, Se Hwan; Oh, Joo Hyeong; Jeong, Kyung Hwan; Lee, Tae Won
2014-06-01
To assess the efficacy of fluoroscopic guide wire manipulation in patients with malfunctioning peritoneal dialysis (PD) catheters that were initially placed by interventional radiologists under fluoroscopic guidance. From January 2002 to April 2012, 52 patients (mean age, 52.8 y ± 2.10s; range, 12-79 y) with malfunctioning PD catheters in whom fluoroscopic guide wire manipulation was performed were retrospectively reviewed. Technical success, clinical success, and complications were evaluated. Technical success was defined as fluoroscopically verified, successful catheter repositioning and adequate dialysate drainage after the procedure. Clinical success was defined as maintenance of PD catheter function for at least 30 days after the manipulation. During the study period, 72 manipulations (68 initial manipulations and 4 remanipulations) for malfunctioning PD catheters were done. The technical success rate was 74% (50 of 68) for initial manipulations and 75% (3 of 4) for remanipulations. The overall clinical success rate was 47% (32 of 68) for initial manipulations and 0% (0 of 4) for remanipulations. The primary causes of catheter malfunction were extraluminal obstruction by omental wrapping or adhesions in 43 of 68 cases (63.2%) and catheter malposition in 25 of 68 (36.8%) cases. There were no procedure-related major complications. Fluoroscopic guide wire manipulation in patients with malfunctioning PD catheters initially placed by interventional radiologists is a simple procedure, an effective way of prolonging PD catheter life, and a recommended procedure before invasive surgical procedures. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.
76 FR 80226 - Technical Amendments
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-23
... final rule, effective upon publication. Generally, the Administrative Procedure Act (APA) requires a.... Additionally, the APA requires that a final rule must have a delayed effective date of 30 days from the date of... delayed effective date requirement under the APA. 5 U.S.C. 553(d)(3). Again the technical change conforms...
78 FR 36083 - Small Business Size Standards; Educational Services; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-17
... industries and the Job Corps Centers exception under NAICS 611519, Other Technical and Trade Schools, within.... List of Subjects in 13 CFR Part 121 Administrative practice and procedure, Government procurement... * * * * * * * 611519 Other Technical and Trade Schools. $14.0 Except, Job Corps Centers \\16\\ \\16\\ 35.5...
Student Flow Model SFM-IA: System Documentation. Technical Report 41B. Preliminary Edition.
ERIC Educational Resources Information Center
Busby, John C.; Johnson, Richard S.
Technical specifications, operating procedures, and reference information for the National Center for Higher Education Management Systems' (NCHEMS) Student Flow Model (SFM) computer programs are presented. Included are narrative descriptions of the system and its modules, specific program documentation for each of the modules, system flowcharts,…
Computerising the Salesforce: The Introduction of Technical Change in a Non-Union Workforce.
ERIC Educational Resources Information Center
Newell, Helen; Lloyd, Caroline
1998-01-01
Results of interviews with 13 pharmaceutical sales representatives, five sales managers, and six human-resource managers and 47 survey responses showed that introduction of information technology was seen as purely technical; human-resources departments played no role; and informal communication procedures enabled management to ignore individual…
15 CFR Supplement No. 2 to Part 730 - Technical Advisory Committees
Code of Federal Regulations, 2010 CFR
2010-01-01
... utilization of production technology; licensing procedures that affect the level of export controls applicable... questions involving technical matters, worldwide availability and actual utilization of production and... of U.S. producers of such items; and (ii) The volume of annual production by such persons or firms of...
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Scope 1303.101 Section 1303.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PUBLIC INFORMATION AND REQUESTS § 1303.101 Scope This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding public access to...
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Scope 1303.101 Section 1303.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PUBLIC INFORMATION AND REQUESTS § 1303.101 Scope This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding public access to...
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Scope 1303.101 Section 1303.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PUBLIC INFORMATION AND REQUESTS § 1303.101 Scope This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding public access to...
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 4 2014-01-01 2014-01-01 false Scope 1303.101 Section 1303.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PUBLIC INFORMATION AND REQUESTS § 1303.101 Scope This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding public access to...
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Scope 1303.101 Section 1303.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PUBLIC INFORMATION AND REQUESTS § 1303.101 Scope This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding public access to...
ERIC Educational Resources Information Center
Congress of the U.S., Washington, DC. Office of Technology Assessment.
This technical memorandum discusses procedures for evaluating potential employment change associated with automation and outlines associated problems. It also describes the nature and modes of delivery of education, training, and retraining for persons holding or seeking employment in manufacturing industries. An introduction provides a brief…
46 CFR Appendix B to Subpart C of... - Substance Technical Guidelines, Benzene
Code of Federal Regulations, 2013 CFR
2013-10-01
... Subpart C of Part 197—Substance Technical Guidelines, Benzene I. Physical and Chemical Data (a) Substance...) Extinguishing media: Carbon dioxide, dry chemical, or foam. (5) Special fire fighting procedures: Do not use a... engineering). (b) Reactivity. (1) Conditions contributing to instability: Heat. (2) Incompatibility: Heat and...
Women in Technical Education. Annual Report 1990-91.
ERIC Educational Resources Information Center
Texas State Technical Coll., Waco.
First-year activities of Women in Technical Education, a project to develop a model for women in that field, were evaluated. A formative evaluation showed that intense development and implementation activity enabled achievement of first-year goals and objectives during the 1990-91 year. Procedures to accomplish objectives were effective.…
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-28
... information as part of the research needed to write a NIST Special Publication (SP) to help Computer Security.... The NIST SP will identify technical standards, methodologies, procedures, and processes that facilitate prompt and effective response. This RFI requests information regarding technical best practices...
48 CFR 31.205-43 - Trade, business, technical, and professional activity costs.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Trade, business, technical, and professional activity costs. 31.205-43 Section 31.205-43 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations...
48 CFR 31.205-43 - Trade, business, technical, and professional activity costs.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Trade, business, technical, and professional activity costs. 31.205-43 Section 31.205-43 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations...
48 CFR 31.205-43 - Trade, business, technical, and professional activity costs.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Trade, business, technical, and professional activity costs. 31.205-43 Section 31.205-43 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations...
48 CFR 31.205-43 - Trade, business, technical, and professional activity costs.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Trade, business, technical, and professional activity costs. 31.205-43 Section 31.205-43 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations...
Design Software Gives Rocketry a Boost in the Classroom
ERIC Educational Resources Information Center
Wilson, Spencer C.
2005-01-01
Building and launching model rockets makes a great activity for a technology education class. A model rocket curriculum provides a valuable tool for improving students' technical skills, including following technical instructions and procedures while learning about aerospace technology. This article describes a way of making model rocketry more…
Design Software Gives Rocketry a Boost in the Classroom
ERIC Educational Resources Information Center
Wilson, Spencer C.
2005-01-01
Building and launching model rockets makes a great activity for a technology education class. A model rocket curriculum provides a valuable tool for improving students' technical skills that includes, but is not limited to, following technical instructions and procedures while learning about aerospace technology. This article describes a way that…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-20
... technical data package, in cases where the Government may have funded only a small portion of the... subcontractor's asserted restrictions on technical data and computer software. DATES: Effective date: September... data and computer software. More specifically, the final rule affects these validation procedures in...
ERIC Educational Resources Information Center
Ulbricht, Kurt; Zimmermann, Peter
1981-01-01
Problems encountered in testing in aerospace engineering courses in an accelerated technical program of a German military university are outlined. Four common grading procedures are compared, and the optimum length of written tests is discussed. (MSE)
Current status and perspectives in split liver transplantation
Lauterio, Andrea; Di Sandro, Stefano; Concone, Giacomo; De Carlis, Riccardo; Giacomoni, Alessandro; De Carlis, Luciano
2015-01-01
Growing experience with the liver splitting technique and favorable results equivalent to those of whole liver transplant have led to wider application of split liver transplantation (SLT) for adult and pediatric recipients in the last decade. Conversely, SLT for two adult recipients remains a challenging surgical procedure and outcomes have yet to improve. Differences in organ shortages together with religious and ethical issues related to cadaveric organ donation have had an impact on the worldwide distribution of SLT. Despite technical refinements and a better understanding of the complex liver anatomy, SLT remains a technically and logistically demanding surgical procedure. This article reviews the surgical and clinical advances in this field of liver transplantation focusing on the role of SLT and the issues that may lead a further expansion of this complex surgical procedure. PMID:26494957
7 CFR 614.3 - Decisions subject to informal appeal procedures.
Code of Federal Regulations, 2011 CFR
2011-01-01
...) Soil and Water Conservation Program; (iv) Water Bank Program; (v) Watershed Protection and Flood... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS NRCS APPEAL PROCEDURES § 614.3... technical determinations made with respect to: (1) Conservation programs and regulatory requirements...
7 CFR 614.3 - Decisions subject to informal appeal procedures.
Code of Federal Regulations, 2012 CFR
2012-01-01
...) Soil and Water Conservation Program; (iv) Water Bank Program; (v) Watershed Protection and Flood... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS NRCS APPEAL PROCEDURES § 614.3... technical determinations made with respect to: (1) Conservation programs and regulatory requirements...
Evaluation of contract time estimation and contracting procedures : technical summary.
DOT National Transportation Integrated Search
1996-08-01
The objective of this research was 1) to provide the DOTD with a systematic approach to the determination of contract duration, and 2) to explore innovative contracting procedures that may prove beneficial in DOTD projects. The innovative contracting...
Code of Federal Regulations, 2010 CFR
2010-01-01
... after Repeated Home Laundering,” Technical Manual of the American Association of Textile Chemists and... containing the same identity while in production. (b) Application procedure. (1) Applicants seeking approval...
Code of Federal Regulations, 2010 CFR
2010-01-01
... after Repeated Home Laundering,” Technical Manual of the American Association of Textile Chemists and... containing the same identity while in production. (b) Application procedure. (1) Applicants seeking approval...
Qamar, Wajhul
2015-01-01
Bronchoalveolar lavage fluid (BALF) is an important tool in experimental toxicology and pharmacology. A number of researchers have utilized BAL in studies involving rodents. However, the detailed procedure of performing BAL in rodents has rarely been reported. In the present article, in situ BAL in rats has been described with technical points that ensure the quality and validity of BALF samples. BAL was performed in rats of Wistar strain. Flow cytometry and microscopy were utilized to analyze the BAL cells. The collected volume of BALF was 84.32 ± 2.7% of instilled volume. Alveolar macrophages were found to be prevalent in normal lungs when analyzed under microscope and by flow cytometry. The main problem that one may face is the accidental contamination of BALF samples with blood of the animal itself. Presence of blood in BALF certainly adds a significant number of cells and other biochemical variables. No blood contamination was detected in BALF. Here, a simple procedure for BAL and collection of alveolar cells (macrophages in the present study) is explained with an emphasis on technical steps and precautions, which ensures the quality of the BALF samples. Data exhibit that there is no blood contamination in the BALF and provide evidence that the technical points considered in the procedure here are successful in maintaining the quality and validity of BALF samples.
Are general surgeons able to accurately self-assess their level of technical skills?
Rizan, C; Ansell, J; Tilston, T W; Warren, N; Torkington, J
2015-11-01
Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether self-assessment is an accurate form of technical skills appraisal in general surgery. The PubMed, MEDLINE(®), Embase(™) and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence. Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation). Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.
A model to determine payments associated with radiology procedures.
Mabotuwana, Thusitha; Hall, Christopher S; Thomas, Shiby; Wald, Christoph
2017-12-01
Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards. The main challenge with current reporting systems is that the information is presented only at an aggregated level, and often not broken down further, for instance, by type of exam. As such, the primary objective of this research is to provide better visibility into payments associated with individual radiology procedures in order to better calibrate expense/capital structure of the imaging enterprise to the actual revenue or value-add to the organization it belongs to. We propose a methodology that can be used to determine technical payments at a procedure level. We use a proportion based model to allocate payments to individual radiology procedures based on total charges (which also includes non-radiology related charges). Using a production dataset containing 424,250 radiology exams we calculated the overall average technical charge for Radiology to be $873.08 per procedure and the corresponding average payment to be $326.43 (range: $48.27 for XR and $2750.11 for PET/CT) resulting in an average payment percentage of 37.39% across all exams. We describe how charges associated with a procedure can be used to approximate technical payments at a more granular level with a focus on Radiology. The methodology is generalizable to approximate payment for other services as well. Understanding payments associated with each procedure can be useful during strategic practice planning. Charge-to-total charge ratio can be used to approximate radiology payments at a procedure level. Copyright © 2017 Elsevier B.V. All rights reserved.
Intravascular US-Guided Portal Vein Access: Improved Procedural Metrics during TIPS Creation.
Gipson, Matthew G; Smith, Mitchell T; Durham, Janette D; Brown, Anthony; Johnson, Thor; Ray, Charles E; Gupta, Rajan K; Kondo, Kimi L; Rochon, Paul J; Ryu, Robert K
2016-08-01
To evaluate transjugular intrahepatic portosystemic shunt (TIPS) outcomes and procedure metrics with the use of three different image guidance techniques for portal vein (PV) access during TIPS creation. A retrospective review of consecutive patients who underwent TIPS procedures for a range of indications during a 28-month study period identified a population of 68 patients. This was stratified by PV access techniques: fluoroscopic guidance with or without portography (n = 26), PV marker wire guidance (n = 18), or intravascular ultrasound (US) guidance (n = 24). Procedural outcomes and procedural metrics, including radiation exposure, contrast agent volume used, procedure duration, and PV access time, were analyzed. No differences in demographic or procedural characteristics were found among the three groups. Technical success, technical success of the primary planned approach, hemodynamic success, portosystemic gradient, and procedure-related complications were not significantly different among groups. Fluoroscopy time (P = .003), air kerma (P = .01), contrast agent volume (P = .003), and total procedural time (P = .02) were reduced with intravascular US guidance compared with fluoroscopic guidance. Fluoroscopy time (P = .01) and contrast agent volume (P = .02) were reduced with intravascular US guidance compared with marker wire guidance. Intravascular US guidance of PV access during TIPS creation not only facilitates successful TIPS creation in patients with challenging anatomy, as suggested by previous investigations, but also reduces important procedure metrics including radiation exposure, contrast agent volume, and overall procedure duration compared with fluoroscopically guided TIPS creation. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.
76 FR 33999 - Spouse and Surviving Spouse; Technical Amendment
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-10
... procedure, Aged, Authority delegations, Blind, Buildings, Civil rights, Employment, Equal educational... Administrative practice and procedure, Armed forces, Civil rights, Claims, Colleges and universities, Conflict of...-ASSISTED PROGRAMS OF THE DEPARTMENT OF VETERANS AFFAIRS--EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT...
The goal of this document is to assist the regulated community to make proper utilization of the Toxicity Characteristic Leaching Procedure (TCLP) to demonstrate compliance with the Toxicity Characteristic (TC) and Land Ban Regulations.
7 CFR 614.3 - Decisions subject to informal appeal procedures.
Code of Federal Regulations, 2013 CFR
2013-01-01
... Innovation Grants, (E) Ground and Surface Water Conservation Program, (F) Klamath Basin Program, and (G... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS NRCS APPEAL PROCEDURES § 614.3... technical determinations made with respect to: (1) Conservation programs and regulatory requirements...
7 CFR 614.3 - Decisions subject to informal appeal procedures.
Code of Federal Regulations, 2014 CFR
2014-01-01
... Innovation Grants, (E) Ground and Surface Water Conservation Program, (F) Klamath Basin Program, and (G... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS NRCS APPEAL PROCEDURES § 614.3... technical determinations made with respect to: (1) Conservation programs and regulatory requirements...
Quality assurance software inspections at NASA Ames: Metrics for feedback and modification
NASA Technical Reports Server (NTRS)
Wenneson, G.
1985-01-01
Software inspections are a set of formal technical review procedures held at selected key points during software development in order to find defects in software documents--is described in terms of history, participants, tools, procedures, statistics, and database analysis.
Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J.A.; Dandorf, Stewart J.; Dunleavy, James; Viscusi, Rebecca; Amini, Richard
2016-01-01
Introduction Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). Conclusion The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills. PMID:27330672
Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard
2016-05-01
Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). The use of this novel cadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical students to improve and maintain their technical skills.
McCullough, Meghan; Campbell, Alex; Siu, Armando; Durnwald, Libby; Kumar, Shubha; Magee, William P; Swanson, Jordan
2018-03-01
The unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques. The program was designed and piloted among eight trainees at five international cleft lip and palate surgical mission sites in Latin America and Africa. A competency-based evaluation form, designed for the program, was utilized to grade general technical and procedure-specific competencies, and pre- and post-training scores were analyzed using a paired t test. Trainees demonstrated improvement in average procedure-specific competency scores for both lip repairs (60.4-71.0%, p < 0.01) and palate (50.6-66.0%, p < 0.01). General technical competency scores also improved (63.6-72.0%, p < 0.01). Among the procedural competencies assessed, surgical markings showed the greatest improvement (19.0 and 22.8% for lip and palate, respectively), followed by nasal floor/mucosal approximation (15.0%) and hard palate dissection (17.1%). Surgical delivery models in LMICs are varied, and trade-offs often exist between goals of case throughput, quality and training. Pilot program results show that procedure-specific and general technical competencies can be improved over a relatively short time and demonstrate the feasibility of incorporating such a training program into surgical outreach missions.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Christophersen, Jon P.
2014-09-01
This battery test procedure manual was prepared for the United States Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), Vehicle Technologies Office. It is based on technical targets for commercial viability established for energy storage development projects aimed at meeting system level DOE goals for Plug-in Hybrid Electric Vehicles (PHEV). The specific procedures defined in this manual support the performance and life characterization of advanced battery devices under development for PHEV’s. However, it does share some methods described in the previously published battery test manual for power-assist hybrid electric vehicles. Due to the complexity of somemore » of the procedures and supporting analysis, future revisions including some modifications and clarifications of these procedures are expected. As in previous battery and capacitor test manuals, this version of the manual defines testing methods for full-size battery systems, along with provisions for scaling these tests for modules, cells or other subscale level devices. The DOE-United States Advanced Battery Consortium (USABC), Technical Advisory Committee (TAC) supported the development of the manual. Technical Team points of contact responsible for its development and revision are Renata M. Arsenault of Ford Motor Company and Jon P. Christophersen of the Idaho National Laboratory. The development of this manual was funded by the Unites States Department of Energy, Office of Energy Efficiency and Renewable Energy, Vehicle Technologies Office. Technical direction from DOE was provided by David Howell, Energy Storage R&D Manager and Hybrid Electric Systems Team Leader. Comments and questions regarding the manual should be directed to Jon P. Christophersen at the Idaho National Laboratory (jon.christophersen@inl.gov).« less
Patel, Nishant; Chick, Jeffrey Forris Beecham; Gemmete, Joseph J; Castle, Jordan C; Dasika, Narasimham; Saad, Wael E; Srinivasa, Ravi N
2018-05-01
The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula. Cholecystostomy access, time between cholecystostomy and cholecystoscopy, endoscopic and fragmentation devices used, technical success, procedure time, fluoroscopy time, complications, length of hospital stay, time between cholecystoscopy and cholecystostomy removal, follow-up, and acute cholecystitis recurrence were recorded. Eleven (85%) patients underwent transhepatic cholecystostomy, and two (15%) patients underwent transperitoneal cholecystostomy. The mean time from cholecystostomy to cholecystoscopy was 151 days. Flexible endoscopy was used in eight (62%) patients, rigid endoscopy in three (23%), and both flexible and rigid in two (15%). Electrohydraulic lithotripsy was used in eight procedures, nitinol baskets in seven, ultrasonic lithotripsy in two, and percutaneous thrombectomy devices in one. Primary technical success was achieved in 11 (85%) patients, and secondary technical success was achieved in 13 (100%) patients. The mean procedure time was 164 minutes, and the mean number of procedures required to clear all gallstones was 1. One (8%) patient developed acute pancreatitis, and one (8%) patient died of gastrointestinal hemorrhage. The median hospital length of stay after cholecystoscopy was 1 day for postoperative monitoring. The mean time between cholecystoscopy and cholecystostomy removal was 39 days. One (8%) patient developed recurrent acute cholecystitis 1095 days after cholecystoscopy. Interventional radiology-operated cholecystoscopy may serve as an effective method for percutaneous gallstone removal in patients with multiple comorbidities precluding cholecystectomy.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com; Ierardi, Anna Maria; Radaelli, Alessandro
AimTo evaluate safety, feasibility, technical success, and clinical success of direct percutaneous sac injection (DPSI) for the treatment of type II endoleaks (T2EL) using anatomical landmarks on cone beam computed tomography (CBCT) and fusion imaging (FI).Materials and MethodsEight patients with T2EL were treated with DPSI using CBCT as imaging guidance. Anatomical landmarks on unenhanced CBCT were used for referencing T2EL location in the first five patients, while FI between unenhanced CBCT and pre-procedural computed tomography angiography (CTA) was used in the remaining three patients. Embolization was performed with thrombin, glue, and ethylene–vinyl alcohol copolymer. Technical and clinical success, iodinated contrastmore » utilization, procedural time, fluoroscopy time, and mean radiation dose were registered.ResultsDPSI was technically successful in all patients: the needle was correctly positioned at the first attempt in six patients, while in two of the first five patients the needle was repositioned once. Neither minor nor major complications were registered. Average procedural time was 45 min and the average administered iodinated contrast was 13 ml. Mean radiation dose of the procedure was 60.43 Gy cm{sup 2} and mean fluoroscopy time was 18 min. Clinical success was achieved in all patients (mean follow-up of 36 months): no sign of T2EL was reported in seven patients until last CT follow-up, while it persisted in one patient with stability of sac diameter.ConclusionsDPSI using unenhanced CBCT and FI is feasible and provides the interventional radiologist with an accurate and safe alternative to endovascular treatment with limited iodinated contrast utilization.« less
Technical skills assessment toolbox: a review using the unitary framework of validity.
Ghaderi, Iman; Manji, Farouq; Park, Yoon Soo; Juul, Dorthea; Ott, Michael; Harris, Ilene; Farrell, Timothy M
2015-02-01
The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools, using contemporary framework of validity. Competency-based training has become the predominant model in surgical education and assessment of performance is an essential component. Assessment methods must produce valid results to accurately determine the level of competency. A search was performed, using PubMed and Google Scholar, to identify tools that have been developed for assessment of the targeted technical skills. A total of 23 assessment tools for the 35 ACS/APDS skills modules were identified. Some tools, such as Operative Performance Rating System (OSATS) and Objective Structured Assessment of Technical Skill (OPRS), have been tested for more than 1 procedure. Therefore, 30 modules had at least 1 assessment tool, with some common surgical procedures being addressed by several tools. Five modules had none. Only 3 studies used Messick's framework to design their validity studies. The remaining studies used an outdated framework on the basis of "types of validity." When analyzed using the contemporary framework, few of these studies demonstrated validity for content, internal structure, and relationship to other variables. This study provides an assessment toolbox for common surgical skills/procedures. Our review shows that few authors have used the contemporary unitary concept of validity for development of their assessment tools. As we progress toward competency-based training, future studies should provide evidence for various sources of validity using the contemporary framework.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Holmes, D.R. Jr.; Wondrow, M.A.; Gray, J.E.
1990-01-01
The increased application of therapeutic interventional cardiology procedures is associated with increased radiation exposure to physicians, patients and technical personnel. New advances in imaging techniques have the potential for reducing radiation exposure. A progressive scanning video system with a standard vascular phantom has been shown to decrease entrance radiation exposure. The effect of this system on reducing actual radiation exposure to physicians and technicians was assessed from 1984 through 1987. During this time, progressive fluoroscopy was added sequentially to all four adult catheterization laboratories; no changes in shielding procedures were made. During this time, the case load per physician increasedmore » by 63% and the number of percutaneous transluminal coronary angioplasty procedures (a high radiation procedure) increased by 244%. Despite these increases in both case load and higher radiation procedures, the average radiation exposure per physician declined by 37%. During the same time, the radiation exposure for technicians decreased by 35%. Pulsed progressive fluoroscopy is effective for reducing radiation exposure to catheterization laboratory physicians and technical staff.« less
Characterization of technical surfaces by structure function analysis
NASA Astrophysics Data System (ADS)
Kalms, Michael; Kreis, Thomas; Bergmann, Ralf B.
2018-03-01
The structure function is a tool for characterizing technical surfaces that exhibits a number of advantages over Fourierbased analysis methods. So it is optimally suited for analyzing the height distributions of surfaces measured by full-field non-contacting methods. The structure function is thus a useful method to extract global or local criteria like e. g. periodicities, waviness, lay, or roughness to analyze and evaluate technical surfaces. After the definition of line- and area-structure function and offering effective procedures for their calculation this paper presents examples using simulated and measured data of technical surfaces including aircraft parts.
Lightning Protection Guidelines for Aerospace Vehicles
NASA Technical Reports Server (NTRS)
Goodloe, C. C.
1999-01-01
This technical memorandum provides lightning protection engineering guidelines and technical procedures used by the George C. Marshall Space Flight Center (MSFC) Electromagnetics and Aerospace Environments Branch for aerospace vehicles. The overviews illustrate the technical support available to project managers, chief engineers, and design engineers to ensure that aerospace vehicles managed by MSFC are adequately protected from direct and indirect effects of lightning. Generic descriptions of the lightning environment and vehicle protection technical processes are presented. More specific aerospace vehicle requirements for lightning protection design, performance, and interface characteristics are available upon request to the MSFC Electromagnetics and Aerospace Environments Branch, mail code EL23.
Task-Based EFL Language Teaching with Procedural Information Design in a Technical Writing Context
ERIC Educational Resources Information Center
Roy, Debopriyo
2017-01-01
Task-based language learning (TBLL) has heavily influenced syllabus design, classroom teaching, and learner assessment in a foreign or second language teaching context. In this English as foreign language (EFL) learning environment, the paper discussed an innovative language learning pedagogy based on design education and technical writing. In…
'Buildings in Use' Study. Technical Factors.
ERIC Educational Resources Information Center
Wisconsin Univ., Milwaukee. School of Architecture and Urban Planning.
The second report of the 'Buildings in Use' study documents the results of over 100 field tests conducted at four elementary schools, as well as discussion of these results and relevant technical specifications and details. The procedural framework used in the Field Tests Manual is followed and test results are rated numerically wherever possible.…
Mechanisation and Automation of Information Library Procedures in the USSR.
ERIC Educational Resources Information Center
Batenko, A. I.
Scientific and technical libraries represent a fundamental link in a complex information storage and retrieval system. The handling of a large volume of scientific and technical data and provision of information library services requires the utilization of computing facilities and automation equipment, and was started in the Soviet Union on a…
77 FR 1129 - Revisions to Test Methods and Testing Regulations
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-09
...This action proposes editorial and technical corrections necessary for source testing of emissions and operations. The revisions include the addition of alternative equipment and methods as well as corrections to technical and typographical errors. We also solicit public comment on potential changes to the current procedures for determining emission stratification.
Use of "t"-Test and ANOVA in Career-Technical Education Research
ERIC Educational Resources Information Center
Rojewski, Jay W.; Lee, In Heok; Gemici, Sinan
2012-01-01
Use of t-tests and analysis of variance (ANOVA) procedures in published research from three scholarly journals in career and technical education (CTE) during a recent 5-year period was examined. Information on post hoc analyses, reporting of effect size, alpha adjustments to account for multiple tests, power, and examination of assumptions…
10 CFR 1304.101 - Purpose and scope.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Purpose and scope. 1304.101 Section 1304.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.101 Purpose and scope. This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding...
10 CFR 1304.101 - Purpose and scope.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Purpose and scope. 1304.101 Section 1304.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.101 Purpose and scope. This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding...
10 CFR 1304.101 - Purpose and scope.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Purpose and scope. 1304.101 Section 1304.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.101 Purpose and scope. This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding...
10 CFR 1304.101 - Purpose and scope.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Purpose and scope. 1304.101 Section 1304.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.101 Purpose and scope. This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding...
10 CFR 1304.101 - Purpose and scope.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 4 2014-01-01 2014-01-01 false Purpose and scope. 1304.101 Section 1304.101 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.101 Purpose and scope. This part sets forth the policies and procedures of the U.S. Nuclear Waste Technical Review Board (Board) regarding...
ERIC Educational Resources Information Center
Burger, Laura J.; And Others
The goal of this project was to develop, validate, and utilize a process for vertically articulating curriculum between secondary and post secondary levels of vocational technical education throughout the state of Minnesota. Procedures involved the identification of two areas of staff responsibility: research and development, and service to local…
IDEA Technical Report No. 2. Description of Data Base, 1976-77.
ERIC Educational Resources Information Center
Cashin, William E.; Slawson, Hugh M.
The data and computational procedures used by the IDEA system at Kansas State University (during the 1976-77 academic year) to interpret ratings of teacher performance are described in this technical report. The computations for each of the seven parts (evaluation, course description, students' self ratings, methods, additional questions,…
IDEA Technical Report No. 3. Description of Data Base, 1977-78.
ERIC Educational Resources Information Center
Cashin, William E.; Slawson, Hugh M.
The data and computational procedures used by the IDEA System during the 1977-78 academic year at Kansas State University to interpret ratings of teacher performance are described in this technical report. The computations for each of the seven parts (evaluation, course description, students' self-ratings, methods, additional questions, diagnostic…
Organizing, Concerns and Control Numbers.
ERIC Educational Resources Information Center
Washington, Gene
A heuristic procedure can be used to teach organizational skills to students of technical writing. Designed to allow students on their own to explore ways that numbers can be used to give a definite shape to technical information, its central feature is a matrix composed of a series of control numbers (horizontal axis) and organizing concerns…
NASA Risk Management Handbook. Version 1.0
NASA Technical Reports Server (NTRS)
Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Maggio, Gaspare; Stamatelatos, Michael; Youngblood, Robert; Guarro, Sergio; Rutledge, Peter; Sherrard, James; Smith, Curtis;
2011-01-01
The purpose of this handbook is to provide guidance for implementing the Risk Management (RM) requirements of NASA Procedural Requirements (NPR) document NPR 8000.4A, Agency Risk Management Procedural Requirements [1], with a specific focus on programs and projects, and applying to each level of the NASA organizational hierarchy as requirements flow down. This handbook supports RM application within the NASA systems engineering process, and is a complement to the guidance contained in NASA/SP-2007-6105, NASA Systems Engineering Handbook [2]. Specifically, this handbook provides guidance that is applicable to the common technical processes of Technical Risk Management and Decision Analysis established by NPR 7123.1A, NASA Systems Engineering Process and Requirements [3]. These processes are part of the \\Systems Engineering Engine. (Figure 1) that is used to drive the development of the system and associated work products to satisfy stakeholder expectations in all mission execution domains, including safety, technical, cost, and schedule. Like NPR 7123.1A, NPR 8000.4A is a discipline-oriented NPR that intersects with product-oriented NPRs such as NPR 7120.5D, NASA Space Flight Program and Project Management Requirements [4]; NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Management Requirements [5]; and NPR 7120.8, NASA Research and Technology Program and Project Management Requirements [6]. In much the same way that the NASA Systems Engineering Handbook is intended to provide guidance on the implementation of NPR 7123.1A, this handbook is intended to provide guidance on the implementation of NPR 8000.4A. 1.2 Scope and Depth This handbook provides guidance for conducting RM in the context of NASA program and project life cycles, which produce derived requirements in accordance with existing systems engineering practices that flow down through the NASA organizational hierarchy. The guidance in this handbook is not meant to be prescriptive. Instead, it is meant to be general enough, and contain a sufficient diversity of examples, to enable the reader to adapt the methods as needed to the particular risk management issues that he or she faces. The handbook highlights major issues to consider when managing programs and projects in the presence of potentially significant uncertainty, so that the user is better able to recognize and avoid pitfalls that might otherwise be experienced.
Laparoscopic Ultrasound-Guided Radiofrequency Ablation of Uterine Fibroids
DOE Office of Scientific and Technical Information (OSTI.GOV)
Milic, Andrea; Asch, Murray R.; Hawrylyshyn, Peter A.
Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation. Symptom improvement, including a decrease in menstrual bleeding and pain, was achieved in 2 patients at 3 months. At 7 months, 1 of these 2 patients experienced symptom worsening which correlated with recurrent fibroid on MRI. Themore » third, initially technically successfully treated patient did not experience any symptom relief after the procedure and was ultimately diagnosed with adenomyosis. Our preliminary results suggest that RFA is a technically feasible treatment for symptomatic uterine fibroids in appropriately selected patients.« less
Atar, Eli; Ben Ari, Ziv; Bachar, Gil N; Amlinski, Yelena; Neyman, Chaim; Knizhnik, Michael; Litvin, Sergey; Schmilovitz-Weiss, Hemda; Shapiro, Riki; Bruckhaimer, Elchanan; Tur-Kaspa, Ran; Belenky, Alexander
2010-06-01
The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.
[Impact of 3 years of contract implementation on the quality of cataract surgery].
Begiristain, J; Elizalde, B; Ibarluzea, J; Mendicute, J; Sola, C
1999-01-01
To assess the adequacy to clinical practice of cataract procedures contracted in the Gipuzkoa Health Area (in public as well as concerted hospitals) from 1995. A second aim is to identify the achievements obtained three years after its implementation comparing the data with those of 1994, a year before. Before its implementation a multidisciplinar team established the number of surgical procedures to be contracted each year by age and sex, as well as the technical and quality conditions (out-patient surgery, loco-regional anaesthetic, facoemulsification, etc.). Data used for the assessment: Cataracts Registry of the Ophthalmologic Unit, Patient Management Categories and surgical waiting lists. During the period studied, 8,073 cataract operations were performed, 9% higher than expected. The distribution by age and sex was as estimated. Technical and quality standards were fulfilled, except for the surgical waiting list, in at least 75% of the procedures. The surgical technique mainly used was facoenmulsification, increasing from 15% in 1994 to 76.5% in 1997. The contracting of cataract surgery has allowed the assessment, reordering, and establishment of standards of care for all the professionals involved in the process. There were improvements in clinical practice during the period studied. This has given raise to the homogenisation of care in all the units following technical and quality standards, meaning better equity for the patients in need of the procedure.
Goltz, J P; Planert, M; Horn, M; Wiedner, M; Kleemann, M; Barkhausen, J; Stahlberg, E
2016-10-01
To evaluate the safety and technical and clinical success of endovascular below-the-knee (BTK) artery revascularization by a retrograde transpedal access. We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance. The procedure was finished in antegrade fashion by plain old balloon angioplasty (POBA). Comorbidities, vessel diameter and calcification at the access site were recorded. The analyzed outcomes were technical success, procedural complications, procedure time, crossing (guidewire beyond lesion and intra-luminal) and procedural (residual stenosis < 30 % after POBA) success, and limb salvage. Diabetes, coronary artery disease and hypertension were present in 15 patients (93.8 %), and both renal impairment and previous amputations in 7 (43.8 %). Pedal access vessel calcification was present in 5/16 patients (31.3 %). The mean diameter was 1.75 +/-0.24 mm. The procedure time was 92.4 +/-23 min. The success rate for achieving retrograde access was 100 %. Retrograde crossing was successful in 12/16 patients (75.0 %). Procedural success was observed in 10/16 patients (68.8 %). Minor complications occurred in 2/16 patients (12.5 %). The rate of limb salvage was 72.9 %, and the overall survival was 100 % at 12 months. Major amputations after revascularization occurred in 2/16 patients (12.5 %). If an antegrade transfemoral approach to BTK lesions fails, a retrograde transpedal approach may nevertheless facilitate treatment. This approach appears to be safe and offers high technical and acceptable clinical success rates. • Retrograde approaches via transpedal or transtibial vessels are safe and offer high technical success.• One problem after technically successful puncture might be the re-entry following subintimal retrograde lesion crossing.• After a failed attempt at antegrade revascularization of a BTK occlusion, a retrograde approach should be performed. Citation Format: • Goltz JP, Planert M, Horn M et al. Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach. Fortschr Röntgenstr 2016; 188: 940 - 948. © Georg Thieme Verlag KG Stuttgart · New York.
47 CFR 2.915 - Grant of application.
Code of Federal Regulations, 2012 CFR
2012-10-01
... RULES AND REGULATIONS Equipment Authorization Procedures Application Procedures for Equipment... officially notice, that: (1) The equipment is capable of complying with pertinent technical standards of the rule part(s) under which it is to be operated; and, (2) A grant of the application would serve the...
47 CFR 2.915 - Grant of application.
Code of Federal Regulations, 2010 CFR
2010-10-01
... RULES AND REGULATIONS Equipment Authorization Procedures Application Procedures for Equipment... officially notice, that: (1) The equipment is capable of complying with pertinent technical standards of the rule part(s) under which it is to be operated; and, (2) A grant of the application would serve the...
44 CFR 67.8 - Appeal procedure.
Code of Federal Regulations, 2010 CFR
2010-10-01
... technical or scientific data submitted by the community that tend to negate or contradict the information... FLOOD ELEVATION DETERMINATIONS § 67.8 Appeal procedure. (a) If a community appeals the proposed flood... to an independent scientific body or appropriate Federal agency for advice. (c) The final...
44 CFR 67.8 - Appeal procedure.
Code of Federal Regulations, 2011 CFR
2011-10-01
... technical or scientific data submitted by the community that tend to negate or contradict the information... FLOOD ELEVATION DETERMINATIONS § 67.8 Appeal procedure. (a) If a community appeals the proposed flood... to an independent scientific body or appropriate Federal agency for advice. (c) The final...
77 FR 53889 - Statement of Organization, Functions, and Delegations of Authority
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-04
..., methods, and statistical procedures for assessing and monitoring the health of communities and measuring... methods and the Community Guide, and coordinates division responses to requests for technical assistance...-federal partners in developing indicators, methods, and statistical procedures for measuring and reporting...
77 FR 71208 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-29
... Government Entities) of the Internal Revenue Service to give advice on filing letter ruling, determination... be registered and the purchaser must give the seller a resale certificate. Affected Public: Private... collection. Title: Revenue Procedure 2011-4 (Letter Rulings), Revenue Procedure 2011-5 (Technical Advice...
48 CFR 342.7101-2 - Procedures.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Procedures. 342.7101-2 Section 342.7101-2 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT... data received; (2) Request audit or cost advisory services, and technical support, as necessary, for...
DOT National Transportation Integrated Search
2016-10-01
Water permeability of concrete is one of the key factors concerning : many concrete deterioration problems. It is often evaluated indirectly by : measuring the volume of permeable voids through the KT-73 (2012) testing : procedures. These procedures ...
Kluge, Annette; Grauel, Britta; Burkolter, Dina
2013-03-01
Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.
(Dry) arthroscopic partial wrist arthrodesis: tips and tricks.
del Piñal, F; Tandioy-Delgado, F
2014-10-01
One of the options for performing a partial wrist arthrodesis is the arthroscopic technique. As a first advantage arthroscopy allows us to directly assess the state of the articular surface of the carpal bones and define the best surgical option during the salvage operation. Furthermore, it allows performance of the procedure with minimal ligament damage and minimal interference with the blood supply of the carpals. These will (presumably) entail less capsular scarring and more rapid healing. Lastly, there is cosmetic benefit by reducing the amount of external scarring. The procedure has a steep learning curve even for accomplished arthroscopists but can be performed in a competitive manner to the open procedure if the dry technique is used. The aim of this paper is to present the technical details, tricks and tips to make the procedure accessible to all hand specialists with an arthroscopic interest. As it is paramount that the surgeon is acquainted with the "dry" technique, some technical details about it will also be presented. © Georg Thieme Verlag KG Stuttgart · New York.
Bagla, Sandeep; Smirniotopoulos, John; Orlando, Julie C; Piechowiak, Rachel
2017-03-01
Prostatic artery embolization (PAE) is a safe and efficacious procedure for benign prostatic hyperplasia (BPH), though is technically challenging. We present our experience of technical and clinical outcomes of robotic and manual PAE in patients with BPH. IRB-approved retrospective study of 40 consecutive patients 49-81 years old with moderate or severe grade BPH from May 2014 to July 2015: 20 robotic-assisted PAE (group 1), 20 manual PAE (group 2). Robotic-assisted PAE was performed using the Magellan Robotic System. American Urological Association (AUA-SI) score, cost, technical and clinical success, radiation dose, fluoroscopy, and procedure time were reviewed. Statistical analysis was performed within and between each group using paired t test and one-way analysis of variance respectively, at 1 and 3 months. No significant baseline differences in age and AUA-SI between groups. Technical success was 100% (group 1) and 95% (group 2). One unsuccessful subject from group 2 returned for a successful embolization using robotic assistance. Fluoroscopy and procedural times were similar between groups, with a non-significant lower patient radiation dose in group 1 (30,632.8 mGy/cm 2 vs 35,890.9, p = 0.269). Disposable cost was significantly different between groups with the robotic-assisted PAE incurring a higher cost (group 1 $4530.2; group 2 $1588.5, p < 0.0001). Clinical improvement was significant in both arms at 3 months: group 1 mean change in AUA-SI of 8.3 (p = 0.006), group 2: 9.6 (p < 0.0001). No minor or major complications occurred. Robotic-assisted PAE offers technical success comparable to manual PAE, with similar clinical improvement with an increased cost.
Moynagh, Michael R; Schmit, Grant D; Thompson, Robert H; Boorjian, Stephen A; Woodrum, David A; Curry, Timothy B; Atwell, Thomas D
2015-06-01
To determine the technical success, safety, and preliminary clinical outcome of percutaneous cryoablation of large (> 7 cm) renal masses. Twelve patients underwent percutaneous cryoablation for treatment of renal tumors measuring greater than 7 cm (clinical stage II, T2aN0M0) between 2004 and 2013. Median patient age was 75 years (range, 46-84 y), median Charlson comorbidity index was 5 (range, 4-9), and median maximal tumor diameter was 8.4 cm (range, 7.2-9.7 cm). Seven of the 12 patients underwent superselective intraarterial tumor embolization before cryoablation. Technical success, procedural complications, renal function, and oncologic and survival outcomes were evaluated for each patient. All cryoablation procedures were technically successful in a single treatment session, with no mortalities at 30 days. Two patients (17%) experienced major complications related to postprocedural hemorrhage. Median change in estimated glomerular filtration rate within 7 days following cryoablation treatment was 11 mL/min (range, 7-14 mL/min). One patient with baseline stage IV chronic kidney disease and a major bleeding complication required temporary dialysis in the periprocedural period. In 11 patients (92%) who had follow-up beyond 3 months after the procedure (mean, 19 mo; range, 4-49 mo), recurrence-free survival and overall survival rates at 2 years were 100% and 91%, respectively. Percutaneous cryoablation of large (> 7 cm) renal masses was technically successful, with effective preliminary clinical outcomes. However, major complications are more common with cryoablation of stage T2 tumors than is typically encountered with treatment of smaller stage T1 tumors. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.
43 CFR 418.21 - Diversion of Truckee River water to Lahontan Reservoir, July through December.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Lahontan Reservoir, July through December. 418.21 Section 418.21 Public Lands: Interior Regulations... PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Operations and Management § 418.21 Diversion of Truckee River water to Lahontan Reservoir, July through December. Truckee River diversions through the...
43 CFR 418.21 - Diversion of Truckee River water to Lahontan Reservoir, July through December.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Lahontan Reservoir, July through December. 418.21 Section 418.21 Public Lands: Interior Regulations... PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Operations and Management § 418.21 Diversion of Truckee River water to Lahontan Reservoir, July through December. Truckee River diversions through the...
Human Geography Trains Diverse Perspectives on Global Development
ERIC Educational Resources Information Center
Ahamer, Gilbert
2012-01-01
Purpose: Education for equity in global development and cultural diversity calls for professional capacity building to perceive diverse perspectives on complex procedures of globalisation. The discipline of human geography is such a "provider of perspectives". The purpose of this paper is to propose a historic series of how theories of geography…
Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E
2015-06-01
Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.
Results of the first provisional technical secretariat interlaboratory comparison test
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stuff, J.R.; Hoffland, L.
1995-06-01
The principal task of this laboratory in the first Provisional Technical Secretariat (PTS) Interlaboratory Comparison Test was to verify and test the extraction and preparation procedures outlined in the Recommended Operating Procedures for Sampling and Analysis in the Verification of Chemical Disarmament in addition to our laboratory extraction methods and our laboratory analysis methods. Sample preparation began on 16 May 1994 and analysis was completed on 12 June 1994. The analytical methods used included NMR ({sup 1}H and {sup 31}P) GC/AED, GC/MS (EI and methane CI), GC/IRD, HPLC/IC, HPLC/TSP/MS, MS/MS(Electrospray), and CZE.
[Radical prostatectomy - pro robotic].
Gillitzer, R
2012-05-01
Anatomical radical prostatectomy was introduced in the early 1980s by Walsh and Donker. Elucidation of key anatomical structures led to a significant reduction in the morbidity of this procedure. The strive to achieve similar oncological and functional results to this gold standard open procedure but with further reduction of morbidity through a minimally invasive access led to the establishment of laparoscopic prostatectomy. However, this procedure is complex and difficult and is associated with a long learning curve. The technical advantages of robotically assisted surgery coupled with the intuitive handling of the device led to increased precision and shortening of the learning curve. These main advantages, together with a massive internet presence and aggressive marketing, have resulted in a rapid dissemination of robotic radical prostatectomy and an increasing patient demand. However, superiority of robotic radical prostatectomy in comparison to the other surgical therapeutic options has not yet been proven on a scientific basis. Currently robotic-assisted surgery is an established technique and future technical improvements will certainly further define its role in urological surgery. In the end this technical innovation will have to be balanced against the very high purchase and running costs, which remain the main limitation of this technology.
NASA Technical Reports Server (NTRS)
Jenkins, H. G.
1980-01-01
Photographs and brief descriptions summarize the diversity of the female work force at NASA. Jobs are classified as: (1) technical support positions; (2) clerical and nonprofessional administrative; (3) professional administrative; and (4) professional scientific and engineering.
Page, Michael M; Taranto, Mario; Ramsay, Duncan; van Schie, Greg; Glendenning, Paul; Gillett, Melissa J; Vasikaran, Samuel D
2018-01-01
Objective Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling studies. Adrenal vein sampling studies are technically demanding with a high failure rate in many centres. The use of intraprocedural cortisol measurement could improve the success rates of adrenal vein sampling but may be impracticable due to cost and effects on procedural duration. Design Retrospective review of the results of adrenal vein sampling procedures since commencement of point-of-care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the adrenal vein sampling Accuracy Kit. Success rate and complications of adrenal vein sampling procedures before and after use of the adrenal vein sampling Accuracy Kit. Routine use of the adrenal vein sampling Accuracy Kit device for intraprocedural measurement of cortisol commenced in 2016. Results Technical success rate of adrenal vein sampling increased from 63% of 99 procedures to 90% of 48 procedures ( P = 0.0007) after implementation of the adrenal vein sampling Accuracy Kit. Failure of right adrenal vein cannulation was the main reason for an unsuccessful study. Radiation dose decreased from 34.2 Gy.cm 2 (interquartile range, 15.8-85.9) to 15.7 Gy.cm 2 (6.9-47.3) ( P = 0.009). No complications were noted, and implementation costs were minimal. Conclusions Point-of-care cortisol measurement during adrenal vein sampling improved cannulation success rates and reduced radiation exposure. The use of the adrenal vein sampling Accuracy Kit is now standard practice at our centre.
Shuttle ku-band communications/radar technical concepts
NASA Technical Reports Server (NTRS)
Griffin, J. W.; Kelley, J. S.; Steiner, A. W.; Vang, H. A.; Zrubek, W. E.; Huth, G. K.
1985-01-01
Technical data on the Shuttle Orbiter K sub u-band communications/radar system are presented. The more challenging aspects of the system design and development are emphasized. The technical problems encountered and the advancements made in solving them are discussed. The radar functions are presented first. Requirements and design/implementation approaches are discussed. Advanced features are explained, including Doppler measurement, frequency diversity, multiple pulse repetition frequencies and pulse widths, and multiple modes. The communications functions that are presented include advances made because of the requirements for multiple communications modes. Spread spectrum, quadrature phase shift keying (QPSK), variable bit rates, and other advanced techniques are discussed. Performance results and conclusions reached are outlined.
Modular Engine Noise Component Prediction System (MCP) Technical Description and Assessment Document
NASA Technical Reports Server (NTRS)
Herkes, William H.; Reed, David H.
2005-01-01
This report describes an empirical prediction procedure for turbofan engine noise. The procedure generates predicted noise levels for several noise components, including inlet- and aft-radiated fan noise, and jet-mixing noise. This report discusses the noise source mechanisms, the development of the prediction procedures, and the assessment of the accuracy of these predictions. Finally, some recommendations for future work are presented.
FID Statutes, Rules of Procedures, Terms of Reference.
ERIC Educational Resources Information Center
International Federation for Documentation, The Hague (Netherlands).
Following a brief historical chronology of the International Federation for Documentation (FID), the organization's statutes are presented in the original French text and in English. The rules of procedures outline membership policy, conduct of technical bodies, FID conferences, publications, and regional commissions. Terms of reference are…
Idaho National Laboratory Annual Report FY 2013 LDRD Project Summaries
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dena Tomchak
The FY 2013 LDRD Annual Report is a compendium of the diverse research performed to develop and ensure the INL’s technical capabilities support the current and future DOE missions and national research priorities. LDRD is essential to INL—it provides a means for the Laboratory to maintain scientific and technical vitality while funding highly innovative, high-risk science and technology research and development (R&D) projects. The program enhances technical capabilities at the Laboratory, providing scientific and engineering staff with opportunities to explore proof-of-principle ideas, advanced studies of innovative concepts, and preliminary technical analyses. Established by Congress in 1991, the LDRD Program provesmore » its benefit each year through new programs, intellectual property, patents, copyrights, national and international awards, and publications.« less
1986-05-01
Information System (DGIS) is being developed to provide the DD crmjnj t with a modern tool to access diverse dtabaiees and extract information products...this community with a modern tool for accessing these databases and extracting information products from them. Since the Defense Technical Information...adjunct to DROLS xesults. The study , thereor. centerd around obtaining background information inside the unit on that unit’s users who request DROLS
NOTES: a review of the technical problems encountered and their solutions.
Mintz, Yoav; Horgan, Santiago; Cullen, John; Stuart, David; Falor, Eric; Talamini, Mark A
2008-08-01
Natural orifice translumenal endoscopic surgery (NOTES) is currently investigated and developed worldwide. In the past few years, multiple groups have confronted this challenge. Many technical problems are encountered in this technique due to the currently available tools for this approach. Some of the unique technical problems in NOTES include: blindly performed primary incisions; uncontrolled pneumoperitoneal pressure; no support for the endoscope in the abdominal cavity; inadequate vision; insufficient illumination; limited retraction and exposure; and the complexity of suturing and performing a safe anastomosis. In this paper, we review the problems encountered in NOTES and provide possible temporary solutions. Acute and survival studies were performed on 15 farm pigs. The hybrid technique approach (i.e., endoscopic surgery with the aid of laparoscopic vision) was performed in all cases. Procedures performed included liver biopsies, bilateral tubal ligation, oophprectomy, cholecystectomy, splenectomy and small bowel resection, and anastomosis. All attempted procedures were successfully performed. New methods and techniques were developed to overcome the technical problems. Closure of the gastrotomy was achieved by T-bar sutures and by stapler closure of the stomach incision. Small bowel anastomosis was achieved by the dual-lumen NOTES technique. The hybrid technique serves as a temporary approach to aid in developing the NOTES technique. A rectal or vaginal port of entry enables and facilitates gastrointestinal NOTES by using available laparoscopic instruments. The common operations performed today in the laparoscopic fashion could be probably performed in the NOTES approach. The safety of these procedures, however, is yet to be determined.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ohta, Kengo, E-mail: yesterday.is.yesterday@gmail.com; Shimohira, Masashi, E-mail: mshimohira@gmail.com; Sasaki, Shigeru, E-mail: ssasaki916@yahoo.co.jp
PurposeThe aim of this study is to analyze the technical and clinical success rates and safety of transarterial fiducial marker placement for image-guided proton therapy for malignant liver tumors.Methods and MaterialsFifty-five patients underwent this procedure as an interventional treatment. Five patients had 2 tumors, and 4 tumors required 2 markers each, so the total number of procedures was 64. The 60 tumors consisted of 46 hepatocellular carcinomas and 14 liver metastases. Five-mm-long straight microcoils of 0.018 inches in diameter were used as fiducial markers and placed in appropriate positions for each tumor. We assessed the technical and clinical success ratesmore » of transarterial fiducial marker placement, as well as the complications associated with it. Technical success was defined as the successful delivery and placement of the fiducial coil, and clinical success was defined as the completion of proton therapy.ResultsAll 64 fiducial coils were successfully installed, so the technical success rate was 100 % (64/64). Fifty-four patients underwent proton therapy without coil migration. In one patient, proton therapy was not performed because of obstructive jaundice due to bile duct invasion by hepatocellular carcinoma. Thus, the clinical success rate was 98 % (54/55). Slight bleeding was observed in one case, but it was stopped immediately and then observed. None of the patients developed hepatic infarctions due to fiducial marker migration.ConclusionTransarterial fiducial marker placement appears to be a useful and safe procedure for proton therapy for malignant liver tumors.« less
McCoul, Edward D; Singh, Ameet; Anand, Vijay K; Tabaee, Abtin
2012-04-01
The surgical management options for eustachian tube dysfunction have historically been limited. The goal of the current study was to evaluate the technical considerations, learning curve, and potential barriers for balloon dilation of the eustachian tube (BDET) as an alternative treatment modality. Prospective preclinical trial of BDET in a cadaver model. A novel balloon catheter device was used for eustachian tube dilation. Twenty-four BDET procedures were performed by three independent rhinologists with no prior experience with the procedure (eight procedures per surgeon). The duration and number of attempts of the individual steps and overall procedure were recorded. Endoscopic examination of the eustachian tube was performed after each procedure, and the surgeon was asked to rate the subjective difficulty on a five-point scale. Successful completion of the procedure occurred in each case. The overall mean duration of the procedure was 284 seconds, and a mean number of 1.15 attempts were necessary to perform the individual steps. The mean subjective procedure difficulty was noted as somewhat easy. Statistically shorter duration and subjectively easier procedure were noted in the second compared to the first half of the series, indicating a favorable learning curve. Linear fissuring within the eustachian tube lumen without submucosal disruption (nine procedures, 37%) and with submucosal disruption (five procedures, 21%) were noted. The significance of these physical findings is unclear. Preclinical testing of BDET is associated with favorable duration, learning curve, and overall ease of completion. Clinical trials are necessary to evaluate safety and efficacy. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
ERIC Educational Resources Information Center
BEAUMONT, JOHN A; AND OTHERS
DESIGNED TO ASSIST ADMINISTRATORS, SUPERVISORS, AND TEACHERS TO PLAN, DEVELOP, AND EVALUATE PROGRAMS, THIS CURRICULUM GUIDE OFFERS COURSE OUTLINES, PROCEDURES, LABORATORY LAYOUTS, TEXTS AND REFERENCES, LISTS OF LABORATORY EQUIPMENT AND ITS COST, AND A SELECTED LIST OF SCIENTIFIC AND TECHNICAL SOCIETIES. BASIC MATERIALS WERE PREPARED AT THE…
Meta-Analysis as a Choice to Improve Research in Career and Technical Education
ERIC Educational Resources Information Center
Gordon, Howard R. D.; McClain, Clifford R.; Kim, Yeonsoo; Maldonado, Cecilia
2010-01-01
A search of the ERIC and Academic Search Premier data bases, and a comprehensive review of literature suggest that meta-analysis is ignored by career and technical education (CTE) researchers, a situation that is regrettable but remediable. The purpose of this theoretical paper is to provide CTE researchers and consumers with procedures for…
ERIC Educational Resources Information Center
Whitehead, Everett
This practicum studies the future educational and/or occupational plans of 223 technical program students enrolled in Brevard Community College (BCC) during the Fall 1973 term in order to suggest adjustments in college procedures to facilitate student transition to continued college or to their chosen professions. The characteristics of technical…
Code of Federal Regulations, 2012 CFR
2012-04-01
... tribal organization to avoid declination of a proposal? 900.28 Section 900.28 Indians BUREAU OF INDIAN... CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Declination Procedures § 900.28 Is technical assistance available to an Indian tribe or tribal organization to avoid declination of a...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-01
... Market and Planning Efficiency Through Improved Software; Notice of Agenda and Procedures for Staff... planning models and software. The technical conference will be held from 8 a.m. to 5:30 p.m. (EDT) on June.... Agenda for AD10-12 Staff Technical Conference on Planning Models and Software Federal Energy Regulatory...
ERIC Educational Resources Information Center
Seppanen, Loretta
Each year, the Washington State Board for Community and Technical Colleges (SBCTC) compiles data on educational and job related outcomes for graduates of vocational preparation programs. The automated data matching procedure examines state unemployment insurance and benefits records, public post-secondary enrollments, U.S. Armed Forces…
50 CFR 91.13 - Technical requirements for design and submission of entry.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Technical requirements for design and submission of entry. 91.13 Section 91.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) MISCELLANEOUS PROVISIONS MIGRATORY BIRD HUNTING AND CONSERVATION STAMP CONTEST Procedures for Entering the...
50 CFR 91.13 - Technical requirements for design and submission of entry.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Technical requirements for design and submission of entry. 91.13 Section 91.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) MISCELLANEOUS PROVISIONS MIGRATORY BIRD HUNTING AND CONSERVATION STAMP CONTEST Procedures for Entering the...
ERIC Educational Resources Information Center
Kishi, Akemi
To aid in the construction of effective task analysis inventories, this technical report discusses: (1) an optimum questionnaire length that adequately covers Marine tasks without unduly fatiguing respondents; (2) procedures for the phrasing of task statements to avoid ambiguities and be understandable to as broad a range of Marines as is…
ERIC Educational Resources Information Center
Bakar, Ab Rahim; Mohamed, Shamsiah; Hamzah, Ramlah
2013-01-01
This study was performed to identify the employability skills of technical students from the Industrial Training Institutes (ITI) and Indigenous People's Trust Council (MARA) Skills Training Institutes (IKM) in Malaysia. The study sample consisted of 850 final year trainees of IKM and ITI. The sample was chosen by a random sampling procedure from…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-22
... discussion is expected to be very technical in nature and will focus on the actuarial and economic... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-07
... be very technical in nature and will focus on the actuarial and economic assumptions and methods by... discussion is expected to focus on highly technical aspects of estimation involving economics and actuarial science. Panelists are not restricted, however, in the topics that they choose to discuss. Procedure and...
ERIC Educational Resources Information Center
Hepburn, Larry; Shin, Masako
This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on clerical occupations. This program is designed to run 36 weeks and cover 10 instructional areas: beginning typing, typing I, typing II, duplicating, receptionist activities, general office procedures, operation of electronic calculator,…
Third Progress and Information Report of the Vocational-Technical Education Consortium of States.
ERIC Educational Resources Information Center
Lee, Connie W.; And Others
This description of major activities and accomplishments of the Vocational-Technical Education Consortium of the States (V-TECS) since the second progress report of May, 1975, is designed to provide the reader with a basic understanding of the processes and procedures used by the consortium in achieving its major goal: The production of catalogs…
An Exploration of Alternative Scoring Methods Using Curriculum-Based Measurement in Early Writing
ERIC Educational Resources Information Center
Allen, Abigail A.; Poch, Apryl L.; Lembke, Erica S.
2018-01-01
This manuscript describes two empirical studies of alternative scoring procedures used with curriculum-based measurement in writing (CBM-W). Study 1 explored the technical adequacy of a trait-based rubric in first grade. Study 2 explored the technical adequacy of a trait-based rubric, production-dependent, and production-independent scores in…
ERIC Educational Resources Information Center
Siebold, Guy L.
Research was conducted to assess the applicability of the Instructional Systems Development (ISD) job analysis procedures to nine technical aviation maintenance military occupational specialties (MOS). Job analysis questionnaires were developed for each of the nine aviation maintenance MOS's. Research teams administered the questionnaires to…
ERIC Educational Resources Information Center
Ohio State Univ., Columbus. National Center for Research in Vocational Education.
This instructional package on material testing and quality control of soils has been adapted from military curriculum materials for use in technical and vocational education programs. This short course presents basic information on soils as well as exploration, field identification, and laboratory procedures that will enable students completing…
EPA Technical Support Centers (TSC): FY14 Lessons ...
EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this information to users in both direct applications (i.e., site-specific technical support) and general applications (i.e., technical transfer activities such as technical guidance documents, conferences, or workshops) . The TSCs are charged with providing solutions by: 1) linking EPA research to Agency decision-makers; 2) applying best practices to real world field applications; and 3) channeling feedback from field application to research communities. The TSP goal is to provide Regional Remedial Project Managers (RPMs), Corrective Action Staff, and On-Scene Coordinators (OSCs) with a diverse set of readily-accessible resources for technical assistance. This research summary provides six case studies – two from each of the three TSCs (Ground Water Technical Support Center, Engineering Technical Support Center, and Site Characterization Technical Support Center) – to exemplify and summarize the variety of TSC approaches that contribute to fulfilling the TSP mission. EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this informati
National Institute of Neurological Disorders and Stroke
... All News Technical Assistance Webinar for the BRAIN Initiative Diversity K99/R00 Tuesday, June 12, 2018 | Online ... View All Events Director's Corner The NIH HEAL Initiative and Pain Research Thursday, June 21, 2018 At ...
41 CFR 109-50.205 - Procedure.
Code of Federal Regulations, 2010 CFR
2010-07-01
... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...
41 CFR 109-50.205 - Procedure.
Code of Federal Regulations, 2014 CFR
2014-01-01
... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...
41 CFR 109-50.205 - Procedure.
Code of Federal Regulations, 2013 CFR
2013-07-01
... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...
41 CFR 109-50.205 - Procedure.
Code of Federal Regulations, 2012 CFR
2012-01-01
... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...
41 CFR 109-50.205 - Procedure.
Code of Federal Regulations, 2011 CFR
2011-01-01
... DISPOSAL AUTHORITIES 50.2-Math and Science Equipment Gift Program § 109-50.205 Procedure. (a) The DOE... math and science projects where the equipment would further enhance the progress of the project. (e... will be used to improve math and science curricula or in the conduct of technical and scientific...
47 CFR 22.150 - Standard pre-filing technical coordination procedure.
Code of Federal Regulations, 2010 CFR
2010-10-01
... this procedure for specific channels and types of stations are contained in the subparts governing the..., emission type and polarization. (4) Transmitting antenna pattern and maximum gain. (5) Transmitting antenna..., even if no channel usage conflicts are anticipated. If any notified party fails to respond within 30...
Aortic root repair for thoracic aorta false aneurysm following Bentall procedure.
Kumar, Sanjay; Jones, Steve; Sivananthan, U M; McGoldrick, J P
2008-08-01
The Bentall procedure for aortic root replacement in Marfan's syndrome is safe and durable. We describe successful repair of periprosthetic valvular leak, 12 years following Bentall repair with composite graft. The aim of this report is to analyse and evaluate technical factors leading to this unusual occurrence.
Microbial ecology laboratory procedures manual NASA/MSFC
NASA Technical Reports Server (NTRS)
Huff, Timothy L.
1990-01-01
An essential part of the efficient operation of any microbiology laboratory involved in sample analysis is a standard procedures manual. The purpose of this manual is to provide concise and well defined instructions on routine technical procedures involving sample analysis and methods for monitoring and maintaining quality control within the laboratory. Of equal importance is the safe operation of the laboratory. This manual outlines detailed procedures to be followed in the microbial ecology laboratory to assure safety, analytical control, and validity of results.
ERIC Educational Resources Information Center
Williams, Brandi Danielle
2012-01-01
Most investigations of faculty diversity have focused on higher education institutions in general. Despite the debates and many years of affirmative action policies and procedures. the increase in female. racial and ethnic minority faculty remains minimal. The United States student population is becoming more diverse, whereas. faculty…
Professional technical standards in colleges and schools of pharmacy.
Berry, Tricia M; Chichester, Clinton O; Lundquist, Lisa M; Sanoski, Cynthia A; Woodward, Donald A; Worley, Marcia M; Early, Johnnie L
2011-04-11
To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE). The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information. Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures. More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study.
Professional Technical Standards in Colleges and Schools of Pharmacy
Berry, Tricia M.; Chichester, Clinton O.; Sanoski, Cynthia A.; Woodward, Donald A.; Worley, Marcia M.; Early, Johnnie L.
2011-01-01
Objective To determine the prevalence, characteristics, and use of professional technical standards among colleges and schools of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE). Methods The Web site of every college and school of pharmacy accredited by ACPE was searched to identify information regarding the availability, content, and use of technical standards and to obtain demographic information. Results Information was obtained from all of the 114 colleges and schools of pharmacy and 67 (59%) had technical standards in place. Common themes for technical standards were: observation; communication; motor; intellectual, conceptual, integrative and quantitative abilities; and behavioral and social attributes. Of those colleges and schools with technical standards, 61 (91%) had standards that addressed all 5 of these themes and 34 (51%) specified that the technical standards were used in their admission, progression, and graduation procedures. Conclusion More than half of the colleges and schools of pharmacy examined in this study have technical standards; however, 41% have yet to develop and implement them. Colleges and schools of pharmacy looking for guidance in technical standards development could use the technical standards themes identified in this study. PMID:21655404
Kodama, Y; Furumatsu, T; Fujii, M; Tanaka, T; Miyazawa, S; Ozaki, T
2016-11-01
A medial meniscus posterior root tear (MMPRT) may increase the tibiofemoral contact pressure by decreasing the tibiofemoral contact area. Meniscal dysfunction induced by posterior root injury may lead to the development of osteoarthritic knees. Repair of a MMPRT can restore medial meniscus (MM) function and prevent knee osteoarthritis progression. Several surgical procedures have been reported for treating a MMPRT. However, these procedures are associated with several technical difficulties. Here, we describe a technique to stabilize a torn MM posterior root using the FasT-Fix ® all-inside meniscal suture device and a new aiming device. The uncut free-end of the FasT-Fix ® suture can be used as a thread for transtibial pullout repair. Our procedure might help overcome the technical difficulties in arthroscopic treatment of a MMPRT. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Randomization Procedures Applied to Analysis of Ballistic Data
1991-06-01
test,;;15. NUMBER OF PAGES data analysis; computationally intensive statistics ; randomization tests; permutation tests; 16 nonparametric statistics ...be 0.13. 8 Any reasonable statistical procedure would fail to support the notion of improvement of dynamic over standard indexing based on this data ...AD-A238 389 TECHNICAL REPORT BRL-TR-3245 iBRL RANDOMIZATION PROCEDURES APPLIED TO ANALYSIS OF BALLISTIC DATA MALCOLM S. TAYLOR BARRY A. BODT - JUNE
CT-Guided Percutaneous Biopsy of Intrathoracic Lesions
Lal, Hira; Nath, Alok; Borah, Samudra
2012-01-01
Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications. PMID:22438689
Army Blast Claims Evaluation Procedures
1994-03-01
ARMY RESEARCH LABORATORY ARL-MR-131 Army Blast Claims Evaluation Procedures William P. Wright APPROVED FOR PUBUC RELEASE; DISTRIBtmON IS...NUMBERS Anny Blast Claims Evaluation Procedures 4G061-304-U2 6. AUTHOR(S) William P. Wrisht 1. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8...of the technical review process which bas been instituted to develop an opinion as to Army responsibility. 14. SUBJECT TERMS blast effects. muzzle
Ewers, R; Schicho, K; Undt, G; Wanschitz, F; Truppe, M; Seemann, R; Wagner, A
2005-01-01
Computer-aided surgical navigation technology is commonly used in craniomaxillofacial surgery. It offers substantial improvement regarding esthetic and functional aspects in a range of surgical procedures. Based on augmented reality principles, where the real operative site is merged with computer generated graphic information, computer-aided navigation systems were employed, among other procedures, in dental implantology, arthroscopy of the temporomandibular joint, osteotomies, distraction osteogenesis, image guided biopsies and removals of foreign bodies. The decision to perform a procedure with or without computer-aided intraoperative navigation depends on the expected benefit to the procedure as well as on the technical expenditure necessary to achieve that goal. This paper comprises the experience gained in 12 years of research, development and routine clinical application. One hundred and fifty-eight operations with successful application of surgical navigation technology--divided into five groups--are evaluated regarding the criteria "medical benefit" and "technical expenditure" necessary to perform these procedures. Our results indicate that the medical benefit is likely to outweight the expenditure of technology with few exceptions (calvaria transplant, resection of the temporal bone, reconstruction of the orbital floor). Especially in dental implantology, specialized software reduces time and additional costs necessary to plan and perform procedures with computer-aided surgical navigation.
Minimally invasive repair of pectus excavatum
Calder, Bennett W.; Lesher, Aaron
2016-01-01
Pectus excavatum, an acquired or congenital depression of the anterior chest wall, is the most commonly occurring chest wall deformity. Patients with pectus excavatum experience psychosocial and physiologic consequences such as impaired social development and pulmonary and/or cardiac dysfunction as a result of the deformity. Traditionally, repair of the defect was performed with a major open operation, the most common being based on modifications of the Ravitch procedure. In the late 1990’s, the operative approach was challenged with a new minimally invasive technique described by Dr. Donald Nuss. This approach utilizes thoracoscopic visualization with small incisions and placement of a temporary metal bar positioned behind the sternum for support it while the costal cartilages remodel. Since introduction, the minimally invasive repair of pectus excavatum (MIRPE) has become accepted in many centers as the procedure of choice for repair of pectus excavatum. In experienced hands, the procedure has excellent outcomes, shorter procedural length, and outstanding cosmetic results. However, proper patient selection and attention to technical details are essential to achieve optimal outcomes and prevent significant complications. In the following, we describe our perspective on pectus excavatum deformities, operative planning, and technical details of the MIRPE procedure. PMID:29078501
Pesticide use and biodiversity conservation in the Amazonian agricultural frontier.
Schiesari, Luis; Waichman, Andrea; Brock, Theo; Adams, Cristina; Grillitsch, Britta
2013-06-05
Agricultural frontiers are dynamic environments characterized by the conversion of native habitats to agriculture. Because they are currently concentrated in diverse tropical habitats, agricultural frontiers are areas where the largest number of species is exposed to hazardous land management practices, including pesticide use. Focusing on the Amazonian frontier, we show that producers have varying access to resources, knowledge, control and reward mechanisms to improve land management practices. With poor education and no technical support, pesticide use by smallholders sharply deviated from agronomical recommendations, tending to overutilization of hazardous compounds. By contrast, with higher levels of technical expertise and resources, and aiming at more restrictive markets, large-scale producers adhered more closely to technical recommendations and even voluntarily replaced more hazardous compounds. However, the ecological footprint increased significantly over time because of increased dosage or because formulations that are less toxic to humans may be more toxic to other biodiversity. Frontier regions appear to be unique in terms of the conflicts between production and conservation, and the necessary pesticide risk management and risk reduction can only be achieved through responsibility-sharing by diverse stakeholders, including governmental and intergovernmental organizations, NGOs, financial institutions, pesticide and agricultural industries, producers, academia and consumers.