Is the Abramson technique effective in pectus carinatum repair?

PubMed

Katrancioglu, Ozgur; Akkas, Yucel; Karadayi, Sule; Sahin, Ekber; Kaptanoğlu, Melih

2018-01-01

The minimally invasive pectus carinatum (PC) surgery described by Abramson has been performed in many centers. We have been using this technique since 2011. This article describes our experience with PC correction. Between 2011 and 2016, 32 patients at our institution underwent minimally invasive repair of a PC deformity. All patients presented with cosmetic complaints. The deformity involved the lower sternum (all had chondrogladiolar type PC), and three patients had asymmetrical deformities. All operations followed the principles defined by Abramson. Satisfactory esthetic results were achieved in our patients. The hospital stay averaged 5.3 days (range 4-7 days). The most common early complication was pneumothorax, and the most common late complication was wire suture breakage. The Abramson technique is an effective, minimally invasive procedure for PC with shorter operating and hospitalization times and low morbidity rates. Copyright © 2016. Published by Elsevier Taiwan.

Intranets: virtual procedure manuals for the pathology lab.

PubMed

Ruby, S G; Krempel, G

1998-08-01

A novel system exists for replacing standard written operation manuals using a computerized PC-based peer-to-peer network. The system design is based on commonly available hardware and software and utilizes existing equipment to minimize implementation expense. The system is relatively easy to implement and maintain, involves minimal training, and should quickly become a financial asset. In addition, such a system can improve access to laboratory procedure manuals so that resources can be better used on a daily basis.

5 CFR 295.101 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

....101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS TESTIMONY BY OPM... you submit a demand or request to an employee of the U.S. Office of Personnel Management (OPM) to... efficiency in its programs and operations; (2) Minimize the possibility of involving OPM in controversial...

Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept document was developed as a first step in developing the Component-Level Electronic-Assembly Repair (CLEAR) System Architecture (NASA/TM-2011-216956). The CLEAR operational concept defines how the system will be used by the Constellation Program and what needs it meets. The document creates scenarios for major elements of the CLEAR architecture. These scenarios are generic enough to apply to near-Earth, Moon, and Mars missions. The CLEAR operational concept involves basic assumptions about the overall program architecture and interactions with the CLEAR system architecture. The assumptions include spacecraft and operational constraints for near-Earth orbit, Moon, and Mars missions. This document addresses an incremental development strategy where capabilities evolve over time, but it is structured to prevent obsolescence. The approach minimizes flight hardware by exploiting Internet-like telecommunications that enables CLEAR capabilities to remain on Earth and to be uplinked as needed. To minimize crew time and operational cost, CLEAR exploits offline development and validation to support online teleoperations. Operational concept scenarios are developed for diagnostics, repair, and functional test operations. Many of the supporting functions defined in these operational scenarios are further defined as technologies in NASA/TM-2011-216956.

Building Phrase Structure from Items and Contexts

ERIC Educational Resources Information Center

McKinney-Bock, Katherine S.

2013-01-01

This dissertation aims to revisit foundational issues in syntactic theory regarding cyclicity and displacement. I take narrow syntax to operate over domains ("phases") more local than in current Minimalism. To do this, I define a notion of "phase overlap" which involves the sharing of grammatical features across two independent…

Computer program determines chemical composition of physical system at equilibrium

NASA Technical Reports Server (NTRS)

Kwong, S. S.

1966-01-01

FORTRAN 4 digital computer program calculates equilibrium composition of complex, multiphase chemical systems. This is a free energy minimization method with solution of the problem reduced to mathematical operations, without concern for the chemistry involved. Also certain thermodynamic properties are determined as byproducts of the main calculations.

An Alternative Method to Gauss-Jordan Elimination: Minimizing Fraction Arithmetic

ERIC Educational Resources Information Center

Smith, Luke; Powell, Joan

2011-01-01

When solving systems of equations by using matrices, many teachers present a Gauss-Jordan elimination approach to row reducing matrices that can involve painfully tedious operations with fractions (which I will call the traditional method). In this essay, I present an alternative method to row reduce matrices that does not introduce additional…

Fracturing alliance allows economical production of massive diatomite oil reserves: A case study

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

Klins, M.A.; Stewart, D.W.; Pferdehirt, D.J.

1996-01-01

As North American oilfield operations mature, there is a perceptible loosening of the autocratic ties between oil companies and contractors. They are being replaced by alliances or partnerships designed to minimize cost while improving profitability of the companies involved. This paper evaluates a mature alliance, its implementation, structure, and results.

Models of Organization and Governance at the Community College.

ERIC Educational Resources Information Center

Silverman, Michael

In order to provide the best management model for the effective and efficient operation of community colleges, it is useful to look briefly at management theories. The three principle theories in use in corporate management are: (1) theory X, involving an autocratic supervisor allowing for minimal group influence; (2) theory Y, in which…

Teaching Statistics from the Operating Table: Minimally Invasive and Maximally Educational

ERIC Educational Resources Information Center

Nowacki, Amy S.

2015-01-01

Statistics courses that focus on data analysis in isolation, discounting the scientific inquiry process, may not motivate students to learn the subject. By involving students in other steps of the inquiry process, such as generating hypotheses and data, students may become more interested and vested in the analysis step. Additionally, such an…

Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract

PubMed Central

Mori, Hirohito; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Masaki, Tsutomu

2015-01-01

Natural-orifice transluminal endoscopic surgery (NOTES) using flexible endoscopy has attracted attention as a minimally invasive surgical method that does not cause an operative wound on the body surface. However, minimizing the number of devices involved in endoscopic, compared to laparoscopic, surgeries has remained a challenge, causing endoscopic surgeries to gradually be phased out of use. If a flexible endoscopic full-thickness suturing device and a counter-traction device were developed to expand the surgical field for gastrointestinal-tract collapse, then endoscopic full-thickness resection using NOTES, which is seen as an extension of endoscopic submucosal dissection for full-thickness excision of tumors involving the gastrointestinal-tract wall, might become an extremely minimally invasive surgical method that could be used to resect only full-thickness lesions approached by the shortest distance via the mouth. It is expected that gastroenterological endoscopists will use this surgery if device development is advanced. This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs. Development of a new surgical method using a multipurpose flexible endoscope is therefore considered a socially urgent issue. PMID:26343069

Quantum theory of the generalised uncertainty principle

NASA Astrophysics Data System (ADS)

Bruneton, Jean-Philippe; Larena, Julien

2017-04-01

We extend significantly previous works on the Hilbert space representations of the generalized uncertainty principle (GUP) in 3 + 1 dimensions of the form [X_i,P_j] = i F_{ij} where F_{ij} = f({{P}}^2) δ _{ij} + g({{P}}^2) P_i P_j for any functions f. However, we restrict our study to the case of commuting X's. We focus in particular on the symmetries of the theory, and the minimal length that emerge in some cases. We first show that, at the algebraic level, there exists an unambiguous mapping between the GUP with a deformed quantum algebra and a quadratic Hamiltonian into a standard, Heisenberg algebra of operators and an aquadratic Hamiltonian, provided the boost sector of the symmetries is modified accordingly. The theory can also be mapped to a completely standard Quantum Mechanics with standard symmetries, but with momentum dependent position operators. Next, we investigate the Hilbert space representations of these algebraically equivalent models, and focus specifically on whether they exhibit a minimal length. We carry the functional analysis of the various operators involved, and show that the appearance of a minimal length critically depends on the relationship between the generators of translations and the physical momenta. In particular, because this relationship is preserved by the algebraic mapping presented in this paper, when a minimal length is present in the standard GUP, it is also present in the corresponding Aquadratic Hamiltonian formulation, despite the perfectly standard algebra of this model. In general, a minimal length requires bounded generators of translations, i.e. a specific kind of quantization of space, and this depends on the precise shape of the function f defined previously. This result provides an elegant and unambiguous classification of which universal quantum gravity corrections lead to the emergence of a minimal length.

The meteorological monitoring system for the Kennedy Space Center/Cape Canaveral Air Station

NASA Technical Reports Server (NTRS)

Dianic, Allan V.

1994-01-01

The Kennedy Space Center (KSC) and Cape Canaveral Air Station (CCAS) are involved in many weather-sensitive operations. Manned and unmanned vehicle launches, which occur several times each year, are obvious example of operations whose success and safety are dependent upon favorable meteorological conditions. Other operations involving NASA, Air Force, and contractor personnel, including daily operations to maintain facilities, refurbish launch structures, prepare vehicles for launch, and handle hazardous materials, are less publicized but are no less weather-sensitive. The Meteorological Monitoring System (MMS) is a computer network which acquires, processes, disseminates, and monitors near real-time and forecast meteorological information to assist operational personnel and weather forecasters with the task of minimizing the risk to personnel, materials, and the surrounding population. CLIPS has been integrated into the MMS to provide quality control analysis and data monitoring. This paper describes aspects of the MMS relevant to CLIPS including requirements, actual implementation details, and results of performance testing.

Virtual Ultrasound Guidance for Inexperienced Operators

NASA Technical Reports Server (NTRS)

Caine, Timothy; Martin, Davis

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit, in which the time delay inherent with communication will make remote guidance impractical.

Effective four-fermion operators in top physics: A roadmap

NASA Astrophysics Data System (ADS)

Aguilar-Saavedra, J. A.

2011-02-01

We write down a minimal basis for dimension-six gauge-invariant four-fermion operators, with some operator replacements with respect to previous ones which make it simpler for calculations. Using this basis we classify all four-fermion operator contributions involving one or two top quarks. Taking into account the different fermion chiralities, possible colour contractions and independent flavour combinations, a total number of 572 gauge-invariant operators are involved. We apply this to calculate all three-body top decay widths t→dud, t→dei+ν, t→uuu, t→uej+ei-, t→uνν (with i,j,k generation indices) mediated by dimension-six four-fermion operators, including the interference with the Standard Model amplitudes when present. All single top production cross sections in pp, pp¯ and ee collisions are calculated as well, namely ud→dt, dd→ut, ud→dt, uu→ut, uu→ut, ee→ut and the charge conjugate processes. We also compute all top pair production cross sections, uu→tt¯, dd→tt¯, uu→tt and ee→tt¯. Our results are completely general, without assuming any particular relation among effective operator coefficients.

76 FR 12763 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses Involving No...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... CFR 51.22(b), no environmental impact statement or environmental assessment need be prepared for these... than the upper limit of ``minimal'' as defined pursuant to 10 CFR 50.59(c)(2)(iii) and NEI [Nuclear Energy Institute] 96-07 Revision 1 [``Guidelines for 10 CFR 50.59 Implementation,'' November 2000...

Considerations for Architecture Level Trade Studies for Environmental Sensors

NASA Technical Reports Server (NTRS)

Peterson, Craig

2010-01-01

Comparisons of key characteristics of environmental sensors such as technology readiness levels, mass, power, volume, and detection capabilities are essential for initial trade studies to determine likely candidates for further development and evaluation. However, these trade studies only provide part of the information necessary to make selection decisions. Ultimately, the sensors must be judged based on the overall system architectures and operational scenarios for which they are intended. This means that additional characteristics, such as architectural needs for redundancy, operational lifetime, ability to maintain calibration, and repair and replacement strategies, among others, must also be considered. Given that these characteristics can be extremely time-consuming and costly to obtain, careful planning is essential to minimize the effort involved. In this paper, an approach is explored for determining an effective yet comprehensive set of architecture level trades which is minimally impacted by the inevitable changes in operational (mission) scenarios. The approach will also identify and integrate the various facilities and opportunities required to obtain the desired architecture level trade information.

Description of a 20 kilohertz power distribution system

NASA Technical Reports Server (NTRS)

Hansen, I. G.

1986-01-01

A single phase, 440 VRMS, 20 kHz power distribution system with a regulated sinusoidal wave form is discussed. A single phase power system minimizes the wiring, sensing, and control complexities required in a multi-sourced redundantly distributed power system. The single phase addresses only the distribution links multiphase lower frequency inputs and outputs accommodation techniques are described. While the 440 V operating potential was initially selected for aircraft operating below 50,000 ft, this potential also appears suitable for space power systems. This voltage choice recognizes a reasonable upper limit for semiconductor ratings, yet will direct synthesis of 220 V, 3 power. A 20 kHz operating frequency was selected to be above the range of audibility, minimize the weight of reactive components, yet allow the construction of single power stages of 25 to 30 kW. The regulated sinusoidal distribution system has several advantages. With a regulated voltage, most ac/dc conversions involve rather simple transformer rectifier applications. A sinusoidal distribution system, when used in conjunction with zero crossing switching, represents a minimal source of EMI. The present state of 20 kHz power technology includes computer controls of voltage and/or frequency, low inductance cable, current limiting circuit protection, bi-directional power flow, and motor/generator operating using standard induction machines. A status update and description of each of these items and their significance is presented.

Description of a 20 Kilohertz power distribution system

NASA Technical Reports Server (NTRS)

Hansen, I. G.

1986-01-01

A single phase, 440 VRMS, 20 kHz power distribution system with a regulated sinusoidal wave form is discussed. A single phase power system minimizes the wiring, sensing, and control complexities required in a multi-sourced redundantly distributed power system. The single phase addresses only the distribution link; mulitphase lower frequency inputs and outputs accommodation techniques are described. While the 440 V operating potential was initially selected for aircraft operating below 50,000 ft, this potential also appears suitable for space power systems. This voltage choice recognizes a reasonable upper limit for semiconductor ratings, yet will direct synthesis of 220 V, 3 power. A 20 kHz operating frequency was selected to be above the range of audibility, minimize the weight of reactive components, yet allow the construction of single power stages of 25 to 30 kW. The regulated sinusoidal distribution system has several advantages. With a regulated voltage, most ac/dc conversions involve rather simple transformer rectifier applications. A sinusoidal distribution system, when used in conjunction with zero crossing switching, represents a minimal source of EMI. The present state of 20 kHz power technology includes computer controls of voltage and/or frequency, low inductance cable, current limiting circuit protection, bi-directional power flow, and motor/generator operating using standard induction machines. A status update and description of each of these items and their significance is presented.

Hessian-based norm regularization for image restoration with biomedical applications.

PubMed

Lefkimmiatis, Stamatios; Bourquard, Aurélien; Unser, Michael

2012-03-01

We present nonquadratic Hessian-based regularization methods that can be effectively used for image restoration problems in a variational framework. Motivated by the great success of the total-variation (TV) functional, we extend it to also include second-order differential operators. Specifically, we derive second-order regularizers that involve matrix norms of the Hessian operator. The definition of these functionals is based on an alternative interpretation of TV that relies on mixed norms of directional derivatives. We show that the resulting regularizers retain some of the most favorable properties of TV, i.e., convexity, homogeneity, rotation, and translation invariance, while dealing effectively with the staircase effect. We further develop an efficient minimization scheme for the corresponding objective functions. The proposed algorithm is of the iteratively reweighted least-square type and results from a majorization-minimization approach. It relies on a problem-specific preconditioned conjugate gradient method, which makes the overall minimization scheme very attractive since it can be applied effectively to large images in a reasonable computational time. We validate the overall proposed regularization framework through deblurring experiments under additive Gaussian noise on standard and biomedical images.

Theoretical Bounds of Direct Binary Search Halftoning.

PubMed

Liao, Jan-Ray

2015-11-01

Direct binary search (DBS) produces the images of the best quality among half-toning algorithms. The reason is that it minimizes the total squared perceived error instead of using heuristic approaches. The search for the optimal solution involves two operations: (1) toggle and (2) swap. Both operations try to find the binary states for each pixel to minimize the total squared perceived error. This error energy minimization leads to a conjecture that the absolute value of the filtered error after DBS converges is bounded by half of the peak value of the autocorrelation filter. However, a proof of the bound's existence has not yet been found. In this paper, we present a proof that shows the bound existed as conjectured under the condition that at least one swap occurs after toggle converges. The theoretical analysis also indicates that a swap with a pixel further away from the center of the autocorrelation filter results in a tighter bound. Therefore, we propose a new DBS algorithm which considers toggle and swap separately, and the swap operations are considered in the order from the edge to the center of the filter. Experimental results show that the new algorithm is more efficient than the previous algorithm and can produce half-toned images of the same quality as the previous algorithm.

Game Theoretic Approaches to Protect Cyberspace

DTIC Science & Technology

2010-04-20

security problems. 3.1 Definitions Game A description of the strategic interaction between opposing, or co-operating, interests where the con ...that involves probabilistic transitions through several states of the system. The game pro - gresses as a sequence of states. The game begins with a...eventually leads to a discretized model. The reaction functions uniquely minimize the strictly con - vex cost functions. After discretization, this

Greenstick fracture of the mandible: a case report.

PubMed

Kalia, V; Singh, A P

2008-03-01

This case report is an insight in to pediatric traumatology whereby bilateral greenstick fracture of condyle is used as a means to discuss the incidence and anatomic considerations for the management of the same, highlighting the fact that dental surgeons require a unique understanding of the anatomy, growth considerations, healing pattern and operative management involving minimal manipulation while managing pediatric facial fractures.

[Peri-areolar approach in pronounced gynecomastia with focus-plasty and liposuction].

PubMed

Bauer, T; Gruber, S; Todoroff, B

2001-04-01

The treatment of gigantic gynecomastia has usually been accompanied by ugly scars. Because of our experiences in 38 patients with gynecomastia grade III, we suggest a surgical technique that not only involves a simple mastectomy and liposuction, but also a mere periareoler incision and, if necessary, repeated focusplasty and liposuction. Excessive skin can be repaired with a so-called focusplasty. In young patients this can successfully be achieved in one operation. Because skin has a minimized ability to retract in older patients, repeat operative sessions are necessary.

Nuclear resonance fluorescence imaging in non-intrusive cargo inspection

NASA Astrophysics Data System (ADS)

Bertozzi, William; Ledoux, Robert J.

2005-12-01

Nuclear resonance fluorescence is able to non-intrusively interrogate a region space and measure the isotopic content of the material in that space for any element with atomic number greater than that of helium. The technique involves exposing material to a continuous energy distribution of photons and detecting the scattered photons that have a discrete energy distribution unique to an isotope. The interrogating photons, which range from 2 to 8 MeV, are the most penetrating probes and can "see" through many inches of steel. Determination of the chemical components of the material occupying a region of space greatly enhances the identification of threats such as explosives, fissile materials, toxic materials and weapons of mass destruction. Systems can be designed to involve minimal operator intervention, to minimize dose to the sample, and to provide high throughput at commercial seaports, airports and other entry points.

Optimal trajectories for aeroassisted orbital transfer

NASA Technical Reports Server (NTRS)

Miele, A.; Venkataraman, P.

1983-01-01

Consideration is given to classical and minimax problems involved in aeroassisted transfer from high earth orbit (HEO) to low earth orbit (LEO). The transfer is restricted to coplanar operation, with trajectory control effected by means of lift modulation. The performance of the maneuver is indexed to the energy expenditure or, alternatively, the time integral of the heating rate. Firist-order optimality conditions are defined for the classical approach, as are a sequential gradient-restoration algorithm and a combined gradient-restoration algorithm. Minimization techniques are presented for the aeroassisted transfer energy consumption and time-delay integral of the heating rate, as well as minimization of the pressure. It is shown that the eigenvalues of the Jacobian matrix of the differential system is both stiff and unstable, implying that the sequential gradient restoration algorithm in its present version is unsuitable. A new method, involving a multipoint approach to the two-poing boundary value problem, is recommended.

Equilibrium of fluid membranes endowed with orientational order

NASA Astrophysics Data System (ADS)

Kumar Alageshan, Jaya; Chakrabarti, Buddhapriya; Hatwalne, Yashodhan

2017-04-01

Minimization of the low-temperature elastic free-energy functional of orientationlly ordered membranes involves independent variation of the membrane-shape, while keeping the orientational order on it (its texture) fixed. We propose an operational, coordinate-independent method for implementing such a variation. Using the Nelson-Peliti formulation of elasticity that emphasizes the interplay between geometry, topology, and thermal fluctuations of orientationally ordered membranes, we minimize the elastic free energy to obtain equations governing their equilibrium shape, together with associated free boundary conditions. Our results are essential for understanding and predicting equilibrium shapes as well as textures of membranes and vesicles; particularly under conditions in which shape deformations are large.

Linking axionlike dark matter to neutrino masses

NASA Astrophysics Data System (ADS)

Carvajal, C. D. R.; Sánchez-Vega, B. L.; Zapata, O.

2017-12-01

We present a framework linking axionlike particles (ALPs) to neutrino masses through the minimal inverse seesaw (ISS) mechanism in order to explain the dark matter (DM) puzzle. Specifically, we explore three minimal ISS cases where mass scales are generated through gravity-induced operators involving a scalar field hosting ALPs. In all of these cases, we find gravity-stable models that provide the observed DM relic density and, simultaneously, are consistent with the phenomenology of neutrinos and ALPs. Remarkably, in one of the ISS cases, the DM can be made of ALPs and sterile neutrinos. Furthermore, other considered ISS cases have ALPs with parameters that are within the reach of proposed ALP experiments.

Post-coma persons emerged from a minimally conscious state and showing multiple disabilities learn to manage a radio-listening activity.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Colonna, Fabio; Buonocunto, Francesca; Sacco, Valentina; Megna, Marisa; Oliva, Doretta

2012-01-01

This study assessed microswitch-based technology to enable three post-coma adults, who had emerged from a minimally conscious state but presented motor and communication disabilities, to operate a radio device. The material involved a modified radio device, a microprocessor-based electronic control unit, a personal microswitch, and an amplified MP3 player. The study was carried out according to a non-concurrent multiple baseline design across participants. During the intervention, all three participants learned to operate the radio device, changing stations and tuning on some of them longer amounts of time than on others (i.e., suggesting preferences among the topics covered by those stations). They also ended a number of sessions before the maximum length of time allowed for them had elapsed. The practical (rehabilitation) implications of the findings were discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Environmental assessment for the Plating Shop Replacement, Y-12 Plant, Oak Ridge, Tennessee

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

Not Available

1992-03-01

The existing of Y-12 Plant Plating Shop provides vital support functions for the US Department of Energy (DOE) Defense Programs operations. In addition to weapon component plating, the facility performs other plating services to support existing operations for the Y-12 Plant, other DOE facilities, and other federal agencies. In addition, the facility would also provide essential deplating services for weapons reclamation and teardown. The existing Y-12 Plant Plating Shop is presently located in a structure which is rapidly deteriorating and obsolete. The existing building structure was originally designed to house a steam plant, not chemical plating operations. As such, vaporsmore » from plating operations have deteriorated the structure to a point where a new facility is needed for continued safe operations. The potential environmental impacts of the proposed action was anticipated to be minimal and would affect no environmentally sensitive areas. Some short-term construction- and demolition-related effects would occur in an already highly industrialized setting. These include temporarily disturbing 72,000 square feet of land for the new plating shop and related site preparation activities, constructing a permanent building on part of the area, and using 80 construction personnel over a period of 18 months for site preparation and construction. Demolition effects vary depending on the environmentally suitable option selected, but they could involve as much as 262 cubic yards of concrete rubble and approximately 1600 cubic yards of soil disposed as waste. Either 1600 cubic yards of fresh soil or 1850 yards of clay and fresh soil could be required. Soil erosion would be minimal. Approximately 20 construction personnel would be involved for 12 months in demolition activities.« less

Cost reduction in space operations - Structuring a planetary program to minimize the annual funding requirement as opposed to minimizing the program runout cost

NASA Technical Reports Server (NTRS)

Herman, D. H.; Niehoff, J. C.; Spadoni, D. J.

1980-01-01

An approach is proposed for the structuring of a planetary mission set wherein the peak annual funding is minimized to meet the annual budget restraint. One aspect of the approach is to have a transportation capability that can launch a mission in any planetary opportunity; such capability can be provided by solar electric propulsion. Another cost reduction technique is to structure a mission test in a time sequenced fashion that could utilize essentially the same spacecraft for the implementation of several missions. A third technique would be to fulfill a scientific objective in several sequential missions rather than attempt to accomplish all of the objectives with one mission. The application of the approach is illustrated by an example involving the Solar Orbiter Dual Probe mission.

Preparation of supported electrocatalyst comprising multiwalled carbon nanotubes

DOEpatents

Wu, Gang; Zelenay, Piotr

2013-08-27

A process for preparing a durable non-precious metal oxygen reduction electrocatalyst involves heat treatment of a ball-milled mixture of polyaniline and multiwalled carbon nanotubes in the presence of a Fe species. The catalyst is more durable than catalysts that use carbon black supports. Performance degradation was minimal or absent after 500 hours of operation at constant cell voltage of 0.40 V.

Deformable three-dimensional model architecture for interactive augmented reality in minimally invasive surgery.

PubMed

Vemuri, Anant S; Wu, Jungle Chi-Hsiang; Liu, Kai-Che; Wu, Hurng-Sheng

2012-12-01

Surgical procedures have undergone considerable advancement during the last few decades. More recently, the availability of some imaging methods intraoperatively has added a new dimension to minimally invasive techniques. Augmented reality in surgery has been a topic of intense interest and research. Augmented reality involves usage of computer vision algorithms on video from endoscopic cameras or cameras mounted in the operating room to provide the surgeon additional information that he or she otherwise would have to recognize intuitively. One of the techniques combines a virtual preoperative model of the patient with the endoscope camera using natural or artificial landmarks to provide an augmented reality view in the operating room. The authors' approach is to provide this with the least number of changes to the operating room. Software architecture is presented to provide interactive adjustment in the registration of a three-dimensional (3D) model and endoscope video. Augmented reality including adrenalectomy, ureteropelvic junction obstruction, and retrocaval ureter and pancreas was used to perform 12 surgeries. The general feedback from the surgeons has been very positive not only in terms of deciding the positions for inserting points but also in knowing the least change in anatomy. The approach involves providing a deformable 3D model architecture and its application to the operating room. A 3D model with a deformable structure is needed to show the shape change of soft tissue during the surgery. The software architecture to provide interactive adjustment in registration of the 3D model and endoscope video with adjustability of every 3D model is presented.

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

PubMed

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

2007-06-01

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

Optics measurement and correction during beam acceleration in the Relativistic Heavy Ion Collider

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

Liu, C.; Marusic, A.; Minty, M.

2014-09-09

To minimize operational complexities, setup of collisions in high energy circular colliders typically involves acceleration with near constant β-functions followed by application of strong focusing quadrupoles at the interaction points (IPs) for the final beta-squeeze. At the Relativistic Heavy Ion Collider (RHIC) beam acceleration and optics squeeze are performed simultaneously. In the past, beam optics correction at RHIC has taken place at injection and at final energy with some interpolation of corrections into the acceleration cycle. Recent measurements of the beam optics during acceleration and squeeze have evidenced significant beta-beats which if corrected could minimize undesirable emittance dilutions and maximizemore » the spin polarization of polarized proton beams by avoidance of higher-order multipole fields sampled by particles within the bunch. In this report the methodology now operational at RHIC for beam optics corrections during acceleration with simultaneous beta-squeeze will be presented together with measurements which conclusively demonstrate the superior beam control. As a valuable by-product, the corrections have minimized the beta-beat at the profile monitors so reducing the dominant error in and providing more precise measurements of the evolution of the beam emittances during acceleration.« less

Laparoendoscopic single site (LESS) cholecystectomy.

PubMed

Hodgett, Steven E; Hernandez, Jonathan M; Morton, Connor A; Ross, Sharona B; Albrink, Michael; Rosemurgy, Alexander S

2009-02-01

The journey from conventional "open" operations to truly "minimally invasive" operations naturally includes progression from operations involving multiple trocars and multiple incisions to operations involving access through the umbilicus alone. Laparoscopic operations through the umbilicus alone, laparoendoscopic single site surgery (LESS), offer improved cosmesis and hopes for less pain and improved recovery. This study was undertaken to evaluate our initial experience with LESS cholecystectomy and to compare our initial experience to concurrent outcomes with more conventional multiport, multi-incision laparoscopic cholecystectomy. All patients referred for cholecystectomy over a 6-month period were offered LESS. Outcomes, including blood loss, operative time, complications, and length of stay were recorded. Outcomes with our first LESS cholecystectomies were compared to an uncontrolled group of concurrent patients undergoing multiport, multi-incision laparoscopic cholecystectomy at the same hospital by the same surgeon. Twenty-nine patients of median age 50 years undergoing LESS cholecystectomy from November 2007 until May 2008 were compared to 29* patients, median age 48 years, undergoing standard multiport, multiple-incision laparoscopic cholecystectomy over the same time period. Median operative time for patients undergoing LESS cholecystectomy was 72 min and was not different from that of patients undergoing multiport, multi-incision laparoscopic cholecystectomy (p = 0.81). Median length of hospital stay was 1.0 day for patients undergoing LESS cholecystectomy and was not different from patients undergoing standard laparoscopic cholecystectomy (p = 0.46). Operative estimated blood loss was less than 100 cc for all patients. No patients undergoing attempted LESS cholecystectomy had conversions to "open" operations; two patients had an additional trocar(s) placed distant from the umbilicus to aid in exposure. Three patients undergoing LESS cholecystectomy had complications: two were troubled by pain control and another had urinary retention. LESS cholecystectomy is a safe and effective alternative to standard laparoscopic cholecystectomy. It can be undertaken without the expense of added operative time and provides patients with minimal, if any, apparent scarring. We believe LESS cholecystectomy will be driven by consumer demand, and therefore, laparoscopic surgeons will need to become proficient with LESS procedures.

Aircraft Optimization for Minimum Environmental Impact

NASA Technical Reports Server (NTRS)

Antoine, Nicolas; Kroo, Ilan M.

2001-01-01

The objective of this research is to investigate the tradeoff between operating cost and environmental acceptability of commercial aircraft. This involves optimizing the aircraft design and mission to minimize operating cost while constraining exterior noise and emissions. Growth in air traffic and airport neighboring communities has resulted in increased pressure to severely penalize airlines that do not meet strict local noise and emissions requirements. As a result, environmental concerns have become potent driving forces in commercial aviation. Traditionally, aircraft have been first designed to meet performance and cost goals, and adjusted to satisfy the environmental requirements at given airports. The focus of the present study is to determine the feasibility of including noise and emissions constraints in the early design of the aircraft and mission. This paper introduces the design tool and results from a case study involving a 250-passenger airliner.

Time Management in the Operating Room: An Analysis of the Dedicated Minimally Invasive Surgery Suite

PubMed Central

Hsiao, Kenneth C.; Machaidze, Zurab

2004-01-01

Background: Dedicated minimally invasive surgery suites are available that contain specialized equipment to facilitate endoscopic surgery. Laparoscopy performed in a general operating room is hampered by the multitude of additional equipment that must be transported into the room. The objective of this study was to compare the preparation times between procedures performed in traditional operating rooms versus dedicated minimally invasive surgery suites to see whether operating room efficiency is improved in the specialized room. Methods: The records of 50 patients who underwent laparoscopic procedures between September 2000 and April 2002 were retrospectively reviewed. Twenty-three patients underwent surgery in a general operating room and 18 patients in an minimally invasive surgery suite. Nine patients were excluded because of cystoscopic procedures undergone prior to laparoscopy. Various time points were recorded from which various time intervals were derived, such as preanesthesia time, anesthesia induction time, and total preparation time. A 2-tailed, unpaired Student t test was used for statistical analysis. Results: The mean preanesthesia time was significantly faster in the minimally invasive surgery suite (12.2 minutes) compared with that in the traditional operating room (17.8 minutes) (P=0.013). Mean anesthesia induction time in the minimally invasive surgery suite (47.5 minutes) was similar to time in the traditional operating room (45.7 minutes) (P=0.734). The average total preparation time for the minimally invasive surgery suite (59.6 minutes) was not significantly faster than that in the general operating room (63.5 minutes) (P=0.481). Conclusion: The amount of time that elapses between the patient entering the room and anesthesia induction is statically shorter in a dedicated minimally invasive surgery suite. Laparoscopic surgery is performed more efficiently in a dedicated minimally invasive surgery suite versus a traditional operating room. PMID:15554269

Laparoscopic Pelvic Exenteration for Locally Advanced Rectal Cancer, Technique and Short-Term Outcomes.

PubMed

Pokharkar, Ashish; Kammar, Praveen; D'souza, Ashwin; Bhamre, Rahul; Sugoor, Pavan; Saklani, Avanish

2018-05-09

Since last two decades minimally invasive techniques have revolutionized surgical field. In 2003 Pomel first described laparoscopic pelvic exenteration, since then very few reports have described minimally invasive approaches for total pelvic exenteration. We report the 10 cases of locally advanced rectal adenocarcinoma which were operated between the periods from March 1, 2017 to November 11, 2017 at the Tata Memorial Hospital, Mumbai. All male patients had lower rectal cancer with prostate involvement on magnetic resonance imaging (MRI). One female patient had uterine and fornix involvement. All perioperative and intraoperative parameters were collected retrospectively from prospectively maintained electronic data. Nine male patients with diagnosis of nonmetastatic locally advanced lower rectal adenocarcinoma were selected. All patients were operated with minimally invasive approach. All patients underwent abdominoperineal resection with permanent sigmoid stoma. Ileal conduit was constructed with Bricker's procedure through small infraumbilical incision (4-5 cm). Lateral pelvic lymph node dissection was done only when postchemoradiotherapy MRI showed enlarged pelvic nodes. All 10 patients received neoadjuvant chemo radiotherapy, whereas 8 patients received additional neoadjuvant chemotherapy. Mean body mass index was 21.73 (range 19.5-26.3). Mean blood loss was 1000 mL (range 300-2000 mL). Mean duration of surgery was 9.13 hours (range 7-13 hours). One patient developed paralytic ileus, which was managed conservatively. One patient developed intestinal obstruction due to herniation of small intestine behind the left ureter and ileal conduit. The same patient developed acute pylonephritis, which was managed with antibiotics. Mean postoperative stay was 14.6 days (range 9-25 days). On postoperative histopathology, all margins were free of tumor in all cases. Minimally invasive approaches can be used safely for total pelvic exenteration in locally advanced lower rectal adenocarcinoma. All patients had fast recovery with less blood loss. In all patients R0 resection was achieved with adequate margins. Long-term oncological outcomes are still uncertain and will require further follow-up.

Laboratory safety handbook

USGS Publications Warehouse

Skinner, E.L.; Watterson, C.A.; Chemerys, J.C.

1983-01-01

Safety, defined as 'freedom from danger, risk, or injury,' is difficult to achieve in a laboratory environment. Inherent dangers, associated with water analysis and research laboratories where hazardous samples, materials, and equipment are used, must be minimized to protect workers, buildings, and equipment. Managers, supervisors, analysts, and laboratory support personnel each have specific responsibilities to reduce hazards by maintaining a safe work environment. General rules of conduct and safety practices that involve personal protection, laboratory practices, chemical handling, compressed gases handling, use of equipment, and overall security must be practiced by everyone at all levels. Routine and extensive inspections of all laboratories must be made regularly by qualified people. Personnel should be trained thoroughly and repetitively. Special hazards that may involve exposure to carcinogens, cryogenics, or radiation must be given special attention, and specific rules and operational procedures must be established to deal with them. Safety data, reference materials, and texts must be kept available if prudent safety is to be practiced and accidents prevented or minimized.

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

PubMed

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

2013-07-01

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

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

Chianese, Marco; Merle, Alexander, E-mail: chianese@na.infn.it, E-mail: amerle@mpp.mpg.de

The high energy events observed at the IceCube Neutrino Observatory have triggered many investigations interpreting the highly energetic neutrinos detected as decay products of heavy unstable Dark Matter particles. However, while very detailed treatments of the IceCube phenomenology exist, only a few references focus on the (non-trivial) Dark Matter production part—and all of those rely on relatively complicated new models which are not always testable directly. We instead investigate two of the most minimal scenarios possible, where the operator responsible for the IceCube events is directly involved in Dark Matter production. We show that the simplest (four-dimensional) operator is notmore » powerful enough to accommodate all constraints. A more non-minimal setting (at mass dimension six), however, can do both fitting all the data and also allowing for a comparatively small parameter space only, parts of which can be in reach of future observations. We conclude that minimalistic approaches can be enough to explain all data required, while complicated new physics seems not to be required by IceCube.« less

Acquisition Dominance: Why The Make - Buy Decision And Decentralization Are Essential For DoDs Information Technology Acquisitions And Operations

DTIC Science & Technology

2013-04-01

of contractors which may impact mission and security. Organic DOD subject matter experts can assure their IT-dependent missions. Utilizing in...involved typically conduct a ritualistic liability-focused finger-pointing that detracts from solving the mission- impacting problem. Resolving these...that if things go wrong, sufficient risk management actions have been taken to minimize the impact of failure. The military bears the consequences

Automated Water-Purification System

NASA Technical Reports Server (NTRS)

Ahlstrom, Harlow G.; Hames, Peter S.; Menninger, Fredrick J.

1988-01-01

Reverse-osmosis system operates and maintains itself with minimal human attention, using programmable controller. In purifier, membranes surround hollow cores through which clean product water flows out of reverse-osmosis unit. No chemical reactions or phase changes involved. Reject water, in which dissolved solids concentrated, emerges from outer membrane material on same side water entered. Flow controls maintain ratio of 50 percent product water and 50 percent reject water. Membranes expected to last from 3 to 15 years.

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

PubMed

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

2012-01-01

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

Detachable clamps for minimal access surgery.

PubMed

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

1995-01-01

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

Endoscopic Transsphenoidal Cisternostomy for Nonneoplastic Sellar Cysts

PubMed Central

Su, Yukai; Ishii, Yudo; Lin, Chien-Min; Tahara, Shigeyuki; Teramoto, Akira; Morita, Akio

2015-01-01

Background and Importance. Sellar arachnoid cysts and Rathke's cleft cysts are benign lesions that produce similar symptoms, including optochiasmatic compression, pituitary dysfunction, and headache. Studies have reported the use of various surgical treatment methods for treating these symptoms, preventing recurrence, and minimizing operative complications. However, the postoperative cerebrospinal fluid (CSF) fistula and recurrence rate remain significant. Clinical Presentation. In this paper, we present 8 consecutive cases involving arachnoid cysts and Rathke's cleft cysts, which were managed by using drainage and cisternostomy, the intentional fenestration of the cyst into the subarachnoid space, and then meticulously closing sellar floor using dural sutures. The postoperative images, CSF fistula rate, and the recurrence rate were favorable. Conclusion. We report this technique and discuss the benefit of this minimally invasive approach. PMID:25685785

The unacknowledged incidence of laparoscopic stapler malfunction.

PubMed

Kwazneski, Douglas; Six, Cheryl; Stahlfeld, Kurt

2013-01-01

Laparoscopic instruments are being used with increasing frequency. Our surgeons recently experienced several independent adverse events involving the laparoscopic linear stapler. Although the Food and Drug Administration maintains a Manufacturer and User Facility Device Experience (MAUDE) database to track such voluntary reports, many events are not reported and the true incidence of adverse events is unknown. We attempted to determine how frequently minimally invasive surgeons have experienced technical problems with a laparoscopic stapler. Following IRB approval, we electronically distributed an anonymous 10-question survey to the 124 minimally invasive program directors listed in the Fellowship Council database. The questions focused on personal or peer experience with laparoscopic stapler malfunction, frequency and type of malfunction, device manufacturer, whether the operation was altered, and root cause analysis of the event. Forty-four of the 124 program directors (35%) completed the survey. The majority reported personal or peer experience (86%) with a linear stapler not releasing (66%) or not firing (73%) after application, with 27% of the respondents noting that this occurred three or more times. The malfunction was not related to type of load, straight (23%) or reticulating (32%) model, or manufacturer (Ethicon 30%, Covidien 36%). One quarter of the respondents noted that the malfunction caused them to significantly alter their operative procedure, and 30% reported that they received no helpful feedback from the manufacturer despite contacting it. Most minimally invasive surgeons have experienced laparoscopic linear stapler malfunction and 25% have had to significantly alter the planned operative procedure due to the malfunction.

28 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... kinds of research involving no more than minimal risk, and for minor changes in approved research. 46... SUBJECTS § 46.110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and...

16 CFR 1028.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-01-01

... kinds of research involving no more than minimal risk, and for minor changes in approved research. 1028... HUMAN SUBJECTS § 1028.110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established...

22 CFR 225.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-04-01

... of research involving no more than minimal risk, and for minor changes in approved research. 225.110....110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and published as a...

14 CFR 1230.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-01-01

... kinds of research involving no more than minimal risk, and for minor changes in approved research. 1230... HUMAN SUBJECTS § 1230.110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established...

22 CFR 225.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-04-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... of research involving no more than minimal risk, and for minor changes in approved research. 225.110....110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and...

40 CFR 26.1110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... kinds of research involving no more than minimal risk, and for minor changes in approved research. 26.1110 Section 26.1110 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF... kinds of research involving no more than minimal risk, and for minor changes in approved research. (a...

Parotitis and Sialendoscopy of the Parotid Gland.

PubMed

Hernandez, Stephen; Busso, Carlos; Walvekar, Rohan R

2016-04-01

Nonneoplastic disorders of the salivary glands involve inflammatory processes. These disorders have been managed conservatively with antibiotics, warm compresses, massage, sialogogues, and adequate hydration. Up to 40% of patients may have an inadequate response or persistent symptoms. When conservative techniques fail, the next step is operative intervention. Sialendoscopy offers a minimally invasive option for the diagnosis and management of chronic inflammatory disorders of the salivary glands and offers the option of gland and function preservation. In this article, we review some of the more common nonneoplastic disorders of the parotid gland, indications for diagnostic and interventional sialendoscopy, and operative techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

Retroperitoneal laparoscopic nephrectomy: the effect of the learning curve, and concentrating expertise, on operating times.

PubMed

Skinner, Adrian; Maoate, Kiki; Beasley, Spencer

2010-05-01

Laparoscopic nephrectomy is an accepted alternative to open nephrectomy. We analyzed our first 80 procedures of laparoscopic nephrectomy to evaluate the effect of experience and configuration of service on operative times. A retrospective review of 80 consecutive children who underwent retroperitoneal laparoscopic nephrectomy or heminephrectomy during an 11-year period from 1997 at Christchurch Hospital (Christchurch, New Zealand) was conducted. Operative times, in relation to the experience of the surgeon for this procedure, were analyzed. Four surgeons, assisted by an annually rotating trainee registrar, performed the procedure in 26 girls and 54 boys (range, 8 months to 15 years). Operating times ranged from 38 to 225 minutes (mean, 104). The average operative time fell from 105 to 90 minutes. One surgeon performed 40% of the procedures and assisted with a further 55%. The operative times for all surgeons showed a tendency to reduce, but this was not marked. Most procedures were performed by two surgeons working together, although one surgeon was involved in the majority of cases. The lead surgeon is often assisted by a fellow consultant colleague. Operative times were influenced by experience, but not markedly so. The shorter operative times and minimal "learning curve," compared with other reported series, may, in part, be due to the involvement of two surgeons experienced in laparoscopy for the majority of cases.

Minimally invasive surgery using intraoperative electron-beam radiotherapy for the treatment of soft tissue sarcoma of the extremities with tendon involvement.

PubMed

Matsumine, Akihiko; Tsujii, Masaya; Nakamura, Tomoki; Asanuma, Kunihiro; Matsubara, Takao; Kakimoto, Takuya; Yada, Yuki; Takada, Akinori; Ii, Noriko; Nomoto, Yoshihito; Sudo, Akihiro

2016-08-12

When a soft tissue sarcoma (STS) is located at the distal part of an extremity and involves the tendon, a wide excision usually causes severe functional disability. We therefore developed a minimally invasive surgical technique using intraoperative electron-beam radiotherapy (IOERT) to reduce the incidence of post-operative functional disability in patients with peri-/intra-tendinous STS. We assessed the clinical outcomes of the novel minimally invasive surgery. The study population included five patients who received treatment for distal extremity STSs. After elevating the tumor mass, including the tendon and nerve from the tumor bed with a wide margin, a lead board was inserted beneath the tumor mass to shield the normal tissue. IOERT (25-50 Gy) was then applied, and the tumor excised with care taken to maintain the continuity of the tendon. In a desmoid patient, local recurrence was observed outside the irradiated field. No cases of neuropathy or bone necrosis were observed. The mean limb function score was excellent in all patients. None of the high-grade sarcoma patients had local recurrence or distant metastasis. Although the current study is only a pilot study with a small number of patients, it shows that this minimally invasive procedure has the potential to become a standard treatment option for selected patients. H17-250 (registered 2 November 2005) and H25-250 (modified from H17-250, registered 5 December 2013).

[Flat rate reimbursement system for minimally invasive management of unstable vertebral fractures. An analysis of costs and benefits].

PubMed

Hartwig, E; Schultheiss, M; Bischoff, M

2002-08-01

Some 30% of unstable vertebral fractures of the thoracic and lumbar spine involve a destruction of the ventral column and thus of the supporting structures of the spine. This requires extensive surgical reconstruction procedures, which are carried out using minimally invasive techniques. The disadvantages of the minimally invasive methods are the high cost, the technical equipment and the expenditure of time required in the initial phase for the performance of the surgical procedure. With the structural reform of the health care system in the year 2000, the private-sector regulatory bodies were called upon to introduce a flat-rate compensation system for hospital services according to section 17b of the Hospital Law (KHG). The previous financing system which involved per-diem operating cost rates has thus been abolished. Calculations of individual entities are now required. Considering the case values to date, a contribution margin deficit of EUR 4628.45 has been calculated for our patients with fractures of the thoracic and lumbar spine without neurological defunctionalization symptoms. An economically efficient medical care is thus no longer possible. Consequently, an adjustment of the German relative weights must urgently be demanded in order to guarantee a high-quality medical care of patients.

Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach.

PubMed

Park, Bumsoo; Choo, Seol Ho; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

2014-12-01

Traditionally, urologists recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy. The aim of our study was to evaluate whether the interval from prostate biopsy to radical prostatectomy affects immediate operative outcomes, with a focus on differences in surgical approach. The study population of 1,848 radical prostatectomy patients was divided into two groups according to the surgical approach: open or minimally invasive. Open group included perineal and retropubic approach, and minimally invasive group included laparoscopic and robotic approach. The cut-off of the biopsy-to-surgery interval was 4 weeks. Positive surgical margin status, operative time and estimated blood loss were evaluated as endpoint parameters. In the open group, there were significant differences in operative time and estimated blood loss between the <4-week and ≥4-week interval subgroups, but there was no difference in positive margin rate. In the minimally invasive group, there were no differences in the three outcome parameters between the two subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was not a significant factor affecting immediate operative outcomes in both open and minimally invasive groups, with the exception of the interval ≥4 weeks as a significant factor decreasing operative time in the minimally invasive group. In conclusion, performing open or minimally invasive radical prostatectomy within 4 weeks of prostate biopsy is feasible for both approaches, and is even beneficial for minimally invasive radical prostatectomy to reduce operative time.

Efficient modeling of vector hysteresis using a novel Hopfield neural network implementation of Stoner–Wohlfarth-like operators

PubMed Central

Adly, Amr A.; Abd-El-Hafiz, Salwa K.

2012-01-01

Incorporation of hysteresis models in electromagnetic analysis approaches is indispensable to accurate field computation in complex magnetic media. Throughout those computations, vector nature and computational efficiency of such models become especially crucial when sophisticated geometries requiring massive sub-region discretization are involved. Recently, an efficient vector Preisach-type hysteresis model constructed from only two scalar models having orthogonally coupled elementary operators has been proposed. This paper presents a novel Hopfield neural network approach for the implementation of Stoner–Wohlfarth-like operators that could lead to a significant enhancement in the computational efficiency of the aforementioned model. Advantages of this approach stem from the non-rectangular nature of these operators that substantially minimizes the number of operators needed to achieve an accurate vector hysteresis model. Details of the proposed approach, its identification and experimental testing are presented in the paper. PMID:25685446

Trends and perioperative outcomes for laparoscopic and robotic nephrectomy using the National Surgical Quality Improvement Program (NSQIP) database.

PubMed

Liu, Jen-Jane; Leppert, John T; Maxwell, Bryan G; Panousis, Periklis; Chung, Benjamin I

2014-05-01

We sought to examine the trends in perioperative outcomes of kidney cancer surgery stratified by type (radical nephrectomy [RN] vs. partial nephrectomy [PN]) and approach (open vs. minimally invasive). We queried the National Surgical Quality Improvement Program database to identify kidney cancer operations performed from 2005 to 2011. We examined 30-day perioperative outcomes including operative time, transfusion rate, length of stay, major morbidity (cardiovascular, pulmonary, renal, and infectious), and mortality. A total of 2,902 PN and 5,459 RN cases were identified. The use of PN increased over time, accounting for 39% of all nephrectomies in 2011. Minimally invasive approaches also increased over time for both RN and PN. Open surgery was associated with increased length of stay, receipt of transfusion, major complications, and perioperative mortality. Resident involvement and open approach were independent predictors of major complications for both PN and RN. Additionally, the presence of a medical comorbidity was also a risk factor for complications after RN. The overall complication rates decreased for all approaches over the study period. Minimally invasive approaches to kidney cancer renal surgery have increased with favorable outcomes. The safety of open and minimally invasive PN improved significantly over the study period. Although pathologic features cannot be determined from this data set, these data show that complications from renal surgical procedures are decreasing in an era of increasing use. © 2013 Published by Elsevier Inc.

7 CFR 1c.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-01-01

... an expedited review procedure shall adopt a method for keeping all members advised of research... research involving no more than minimal risk, and for minor changes in approved research. 1c.110 Section 1c... review procedures for certain kinds of research involving no more than minimal risk, and for minor...

15 CFR 27.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-01-01

... certain kinds of research involving no more than minimal risk, and for minor changes in approved research... HUMAN SUBJECTS § 27.110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and...

45 CFR 690.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-10-01

... research involving no more than minimal risk, and for minor changes in approved research. 690.110 Section... PROTECTION OF HUMAN SUBJECTS § 690.110 Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has...

21 CFR 56.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-04-01

... uses an expedited review procedure shall adopt a method for keeping all members advised of research... research involving no more than minimal risk, and for minor changes in approved research. 56.110 Section 56... of research involving no more than minimal risk, and for minor changes in approved research. (a) The...

34 CFR 97.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... research involving no more than minimal risk, and for minor changes in approved research. 97.110 Section 97... Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects) § 97.110 Expedited review procedures for certain kinds of research involving no more than minimal risk...

32 CFR 219.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... adopt a method for keeping all members advised of research proposals which have been approved under the... research involving no more than minimal risk, and for minor changes in approved research. 219.110 Section... kinds of research involving no more than minimal risk, and for minor changes in approved research. (a...

49 CFR 11.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-10-01

... an expedited review procedure shall adopt a method for keeping all members advised of research... research involving no more than minimal risk, and for minor changes in approved research. 11.110 Section 11... Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor...

21 CFR 56.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-04-01

... research involving no more than minimal risk, and for minor changes in approved research. 56.110 Section 56... of research involving no more than minimal risk, and for minor changes in approved research. (a) The... categories of research that may be reviewed by the IRB through an expedited review procedure. The list will...

49 CFR 11.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-10-01

... research involving no more than minimal risk, and for minor changes in approved research. 11.110 Section 11... Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and published as a Notice in the...

28 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-07-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... kinds of research involving no more than minimal risk, and for minor changes in approved research. 46... SUBJECTS § 46.110 Expedited review procedures for certain kinds of research involving no more than minimal...

32 CFR 219.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-07-01

... adopt a method for keeping all members advised of research proposals which have been approved under the... research involving no more than minimal risk, and for minor changes in approved research. 219.110 Section... kinds of research involving no more than minimal risk, and for minor changes in approved research. (a...

CD-ROM preparation: An overview and guide

NASA Technical Reports Server (NTRS)

Daniel, Ralph E.; Jeschke, Mark W.; Schroer, James A.

1995-01-01

A primer on the options and procedures involved in producing CD-ROM products in a small to medium sized business operation is presented in language that persons with a minimal technical background can easily understand. The capabilities, limitations, and standards of CD-ROM technology are surveyed. Emphasis is placed on CD-ROM production, especially upon design, data conversion to an electronic medium, data file preparation, the use of vendors, and the steps for in-house production of CD-ROM products.

7 CFR 1c.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-01-01

... research involving no more than minimal risk, and for minor changes in approved research. 1c.110 Section 1c... review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and published as a Notice in the...

Knowledge engineering for PACES, the particle accelerator control expert system

NASA Astrophysics Data System (ADS)

Lind, P. C.; Poehlman, W. F. S.; Stark, J. W.; Cousins, T.

1992-04-01

The KN-3000 used at Defense Research Establishment Ottawa is a Van de Graaff particle accelerator employed primarily to produce monoenergetic neutrons for calibrating radiation detectors. To provide training and assistance for new operators, it was decided to develop an expert system for accelerator operation. Knowledge engineering aspects of the expert system are reviewed. Two important issues are involved: the need to encapsulate expert knowledge into the system in a form that facilitates automatic accelerator operation and to partition the system so that time-consuming inferencing is minimized in favor of faster, more algorithmic control. It is seen that accelerator control will require fast, narrowminded decision making for rapid fine tuning, but slower and broader reasoning for machine startup, shutdown, fault diagnosis, and correction. It is also important to render the knowledge base in a form conducive to operator training. A promising form of the expert system involves a hybrid system in which high level reasoning is performed on the host machine that interacts with the user, while an embedded controller employs neural networks for fast but limited adjustment of accelerator performance. This partitioning of duty facilitates a hierarchical chain of command yielding an effective mixture of speed and reasoning ability.

Improving operating theatre efficiency: an intervention to significantly reduce changeover time.

PubMed

Soliman, Bishoy A B; Stanton, Raymond; Sowter, Steven; Rozen, Warren Matthew; Shahbaz, Shekib

2013-07-01

Operating theatre inefficiency and changeover delays are not only a significant source of wasted resources, but also a familiar source of frustration to patients and health-care providers. This study aimed to prove that the surgical registrar through active involvement in patient changeover can significantly improve operating room efficiency and minimize delays. A two-phase prospective cohort study was undertaken, conducted over the course of 4 weeks at a single institution. The only inclusion criteria comprised patients to undertake endoscopic urological day surgery cases and require general anaesthesia. There were no exclusions. In the first phase (observational, with no intervention), changeover times between cases were documented. The second phase followed a structured intervention, involving the surgical registrar being actively involved in the patient's operative journey. Outcome measures were qualitative measures of operative efficiency. Statistical analysis was undertaken. There were 42 patients included in this study, with 21 patients in each of its arms. A 48% (P-value < 0.01) reduction in overall case changeover times was demonstrated with the utilization of a structured intervention from 27.7 min (95% confidence interval (CI) 22.8-32.7%) to 15.7 min (95% CI 13.2-18.2%). The intervention results were statistically significant (P-value < 0.05) for all markers of efficiency except for the waiting time in the anaesthetic holding bay (P-value 0.13). The surgical registrar can improve operating room efficiency by using a structured intervention, ultimately reducing patient changeover times. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Two-loop renormalization of quantum gravity simplified

NASA Astrophysics Data System (ADS)

Bern, Zvi; Chi, Huan-Hang; Dixon, Lance; Edison, Alex

2017-02-01

The coefficient of the dimensionally regularized two-loop R3 divergence of (nonsupersymmetric) gravity theories has recently been shown to change when nondynamical three-forms are added to the theory, or when a pseudoscalar is replaced by the antisymmetric two-form field to which it is dual. This phenomenon involves evanescent operators, whose matrix elements vanish in four dimensions, including the Gauss-Bonnet operator which is also connected to the trace anomaly. On the other hand, these effects appear to have no physical consequences for renormalized scattering processes. In particular, the dependence of the two-loop four-graviton scattering amplitude on the renormalization scale is simple. We explain this result for any minimally-coupled massless gravity theory with renormalizable matter interactions by using unitarity cuts in four dimensions and never invoking evanescent operators.

Tool for a configurable integrated circuit that uses determination of dynamic power consumption

NASA Technical Reports Server (NTRS)

Davoodi, Azadeh (Inventor); French, Matthew C. (Inventor); Agarwal, Deepak (Inventor); Wang, Li (Inventor)

2011-01-01

A configurable logic tool that allows minimization of dynamic power within an FPGA design without changing user-entered specifications. The minimization of power may use minimized clock nets as a first order operation, and a second order operation that minimizes other factors, such as area of placement, area of clocks and/or slack.

Potential use of advanced process control for safety purposes during attack of a process plant.

PubMed

Whiteley, James R

2006-03-17

Many refineries and commodity chemical plants employ advanced process control (APC) systems to improve throughputs and yields. These APC systems utilize empirical process models for control purposes and enable operation closer to constraints than can be achieved with traditional PID regulatory feedback control. Substantial economic benefits are typically realized from the addition of APC systems. This paper considers leveraging the control capabilities of existing APC systems to minimize the potential impact of a terrorist attack on a process plant (e.g., petroleum refinery). Two potential uses of APC are described. The first is a conventional application of APC and involves automatically moving the process to a reduced operating rate when an attack first begins. The second is a non-conventional application and involves reconfiguring the APC system to optimize safety rather than economics. The underlying intent in both cases is to reduce the demands on the operator to allow focus on situation assessment and optimal response planning. An overview of APC is provided along with a brief description of the modifications required for the proposed new applications of the technology.

Tiltrotor Acoustic Flight Test: Terminal Area Operations

NASA Technical Reports Server (NTRS)

SantaMaria, O. L.; Wellman, J. B.; Conner, D. A.; Rutledge, C. K.

1991-01-01

This paper provides a comprehensive description of an acoustic flight test of the XV- 15 Tiltrotor Aircraft with Advanced Technology Blades (ATB) conducted in August and September 1991 at Crows Landing, California. The purpose of this cooperative research effort of the NASA Langley and Ames Research Centers was to obtain a preliminary, high quality database of far-field acoustics for terminal area operations of the XV-15 at a takeoff gross weight of approximately 14,000 lbs for various glide slopes, airspeeds, rotor tip speeds, and nacelle tilt angles. The test also was used to assess the suitability of the Crows Landing complex for full scale far-field acoustic testing. This was the first acoustic flight test of the XV-15 aircraft equipped with ATB involving approach and level flyover operations. The test involved coordination of numerous personnel, facilities and equipment. Considerable effort was made to minimize potential extraneous noise sources unique to the region during the test. Acoustic data from the level flyovers were analyzed, then compared with data from a previous test of the XV-15 equipped with Standard Metal Blades

Remote Operation of the Fermilab/NICADD Photoinjector

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

Nikolai Barov et al.

2002-03-21

The recognition that a new major HEP facility must receive international support and that its execution would benefit from worldwide interaction from design through operation has given rise to the term Global Accelerator Network (GAN). A welcome consequence has been a more permissive attitude toward remote operation of existing facilities.For roughly thirty years, the computer has been the principal operator interface to the beam,and, through the development of the Internet, the operator can be literally anywhere. In this note, the authors describe their approach to enabling a sufficient degree of operation of the photoinjector from afar in order to carrymore » out investigations in beam physics. The goal was to do so on a time scale of a few months and at minimal cost. At this writing, remote shifts are routinely scheduled involving DESY and LBL, limited in frequency only by the requests of the collaborators and by the need for time to interpret the data.« less

Model-based minimization algorithm of a supercritical helium loop consumption subject to operational constraints

NASA Astrophysics Data System (ADS)

Bonne, F.; Bonnay, P.; Girard, A.; Hoa, C.; Lacroix, B.; Le Coz, Q.; Nicollet, S.; Poncet, J.-M.; Zani, L.

2017-12-01

Supercritical helium loops at 4.2 K are the baseline cooling strategy of tokamaks superconducting magnets (JT-60SA, ITER, DEMO, etc.). This loops work with cryogenic circulators that force a supercritical helium flow through the superconducting magnets in order that the temperature stay below the working range all along their length. This paper shows that a supercritical helium loop associated with a saturated liquid helium bath can satisfy temperature constraints in different ways (playing on bath temperature and on the supercritical flow), but that only one is optimal from an energy point of view (every Watt consumed at 4.2 K consumes at least 220 W of electrical power). To find the optimal operational conditions, an algorithm capable of minimizing an objective function (energy consumption at 5 bar, 5 K) subject to constraints has been written. This algorithm works with a supercritical loop model realized with the Simcryogenics [2] library. This article describes the model used and the results of constrained optimization. It will be possible to see that the changes in operating point on the temperature of the magnet (e.g. in case of a change in the plasma configuration) involves large changes on the cryodistribution optimal operating point. Recommendations will be made to ensure that the energetic consumption is kept as low as possible despite the changing operating point. This work is partially supported by EUROfusion Consortium through the Euratom Research and Training Program 20142018 under Grant 633053.

Open three-stage transthoracic oesophagectomy versus minimally invasive thoraco-laparoscopic oesophagectomy for oesophageal cancer: protocol for a multicentre prospective, open and parallel, randomised controlled trial.

PubMed

Mu, Juwei; Gao, Shugeng; Mao, Yousheng; Xue, Qi; Yuan, Zuyang; Li, Ning; Su, Kai; Yang, Kun; Lv, Fang; Qiu, Bin; Liu, Deruo; Chen, Keneng; Li, Hui; Yan, Tiansheng; Han, Yongtao; Du, Ming; Xu, Rongyu; Wen, Zhaoke; Wang, Wenxiang; Shi, Mingxin; Xu, Quan; Xu, Shun; He, Jie

2015-11-17

Oesophageal cancer is the eighth most common cause of cancer worldwide. In 2009 in China, the incidence and death rate of oesophageal cancer was 22.14 per 100 000 person-years and 16.77 per 100 000 person-years, respectively, the highest in the world. Minimally invasive oesophagectomy (MIO) was introduced into clinical practice with the aim of reducing the morbidity rate. The mechanisms of MIO may lie in minimising the reaction to surgical injury and inflammation. There are some randomised trials regarding minimally invasive versus open oesophagectomy, with 100-850 subjects enrolled. To date, no large randomised controlled trial comparing minimally invasive versus open oesophagectomy has been reported in China, where squamous cell carcinoma predominated over adenocarcinoma of the oesophagus. This is a 3 year multicentre, prospective, randomised, open and parallel controlled trial, which aims to compare the effectiveness of minimally invasive thoraco-laparoscopic oesophagectomy to open three-stage transthoracic oesophagectomy for resectable oesophageal cancer. Group A patients receive MIO which involves thoracoscopic oesophagectomy and laparoscopic gastric mobilisation with cervical anastomosis. Group B patients receive the open three-stage transthoracic oesophagectomy which involves a right thoracotomy and laparotomy with cervical anastomosis. Primary endpoints include respiratory complications within 30 days after operation. The secondary endpoints include other postoperative complications, influences on pulmonary function, intraoperative data including blood loss, operative time, the number and location of lymph nodes dissected, and mortality in hospital, the length of hospital stay, total expenses in hospital, mortality within 30 days, survival rate after 2 years, postoperative pain, and health-related quality of life (HRQoL). Three hundred and twenty-four patients in each group will be needed and a total of 648 patients will finally be enrolled into the study. The study protocol has been approved by the Institutional Ethics Committees of all participating institutions. The findings of this trial will be disseminated to patients and through peer-reviewed publications and international presentations. NCT02355249. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

3D nonrigid registration via optimal mass transport on the GPU.

PubMed

Ur Rehman, Tauseef; Haber, Eldad; Pryor, Gallagher; Melonakos, John; Tannenbaum, Allen

2009-12-01

In this paper, we present a new computationally efficient numerical scheme for the minimizing flow approach for optimal mass transport (OMT) with applications to non-rigid 3D image registration. The approach utilizes all of the gray-scale data in both images, and the optimal mapping from image A to image B is the inverse of the optimal mapping from B to A. Further, no landmarks need to be specified, and the minimizer of the distance functional involved is unique. Our implementation also employs multigrid, and parallel methodologies on a consumer graphics processing unit (GPU) for fast computation. Although computing the optimal map has been shown to be computationally expensive in the past, we show that our approach is orders of magnitude faster then previous work and is capable of finding transport maps with optimality measures (mean curl) previously unattainable by other works (which directly influences the accuracy of registration). We give results where the algorithm was used to compute non-rigid registrations of 3D synthetic data as well as intra-patient pre-operative and post-operative 3D brain MRI datasets.

Replacement of tritiated water from irradiated fuel storage bay

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

Castillo, I.; Boniface, H.; Suppiah, S.

2015-03-15

Recently, AECL developed a novel method to reduce tritium emissions (to groundwater) and personnel doses at the NRU (National Research Universal) reactor irradiated fuel storage bay (also known as rod or spent fuel bay) through a water swap process. The light water in the fuel bay had built up tritium that had been transferred from the heavy water moderator through normal fuel transfers. The major advantage of the thermal stratification method was that a very effective tritium reduction could be achieved by swapping a minimal volume of bay water and warm tritiated water would be skimmed off the bay surface.more » A demonstration of the method was done that involved Computational Fluid Dynamics (CFD) modeling of the swap process and a test program that showed excellent agreement with model prediction for the effective removal of almost all the tritium with a minimal water volume. Building on the successful demonstration, AECL fabricated, installed, commissioned and operated a full-scale system to perform a water swap. This full-scale water swap operation achieved a tritium removal efficiency of about 96%.« less

Costs and benefits of different methods of esophagectomy for esophageal cancer.

PubMed

Yanasoot, Alongkorn; Yolsuriyanwong, Kamtorn; Ruangsin, Sakchai; Laohawiriyakamol, Supparerk; Sunpaweravong, Somkiat

2017-01-01

Background A minimally invasive approach to esophagectomy is being used increasingly, but concerns remain regarding the feasibility, safety, cost, and outcomes. We performed an analysis of the costs and benefits of minimally invasive, hybrid, and open esophagectomy approaches for esophageal cancer surgery. Methods The data of 83 consecutive patients who underwent a McKeown's esophagectomy at Prince of Songkla University Hospital between January 2008 and December 2014 were analyzed. Open esophagectomy was performed in 54 patients, minimally invasive esophagectomy in 13, and hybrid esophagectomy in 16. There were no differences in patient characteristics among the 3 groups Minimally invasive esophagectomy was undertaken via a thoracoscopic-laparoscopic approach, hybrid esophagectomy via a thoracoscopic-laparotomy approach, and open esophagectomy by a thoracotomy-laparotomy approach. Results Minimally invasive esophagectomy required a longer operative time than hybrid or open esophagectomy ( p = 0.02), but these patients reported less postoperative pain ( p = 0.01). There were no significant differences in blood loss, intensive care unit stay, hospital stay, or postoperative complications among the 3 groups. Minimally invasive esophagectomy incurred higher operative and surgical material costs than hybrid or open esophagectomy ( p = 0.01), but there were no significant differences in inpatient care and total hospital costs. Conclusion Minimally invasive esophagectomy resulted in the least postoperative pain but the greatest operative cost and longest operative time. Open esophagectomy was associated with the lowest operative cost and shortest operative time but the most postoperative pain. Hybrid esophagectomy had a shorter learning curve while sharing the advantages of minimally invasive esophagectomy.

Robotics in surgery: is a robot necessary? For what?

PubMed

Ross, Sharona B; Downs, Darrell; Saeed, Sabrina M; Dolce, John K; Rosemurgy, Alexander S

2017-02-01

Every operation can be categorized along a spectrum from "most invasive" to "least invasive", based on the approach(es) through which it is commonly undertaken. Operations that are considered "most invasive" are characterized by "open" approaches with a relatively high degree of morbidity, while operations that are considered "least invasive" are undertaken with minimally invasive techniques and are associated with relatively improved patient outcomes, including faster recovery times and fewer complications. Because of the potential for reduced morbidity, movement along the spectrum towards minimally invasive surgery (MIS) is associated with a host of salutary benefits and, as well, lower costs of patient care. Accordingly, the goal of all stakeholders in surgery should be to attain universal application of the most minimally invasive approaches. Yet the difficulty of performing minimally invasive operations has largely limited its widespread application in surgery, particularly in the context of complex operations (i.e., those requiring complex extirpation and/or reconstruction). Robotic surgery, however, may facilitate application of minimally invasive techniques requisite for particular operations. Enhancements in visualization and dexterity offered by robotic surgical systems allow busy surgeons to quickly gain proficiency in demanding techniques (e.g., pancreaticojejunostomy), within a short learning curve. That is not to say, however, that all operations undertaken with minimally invasive techniques require robotic technology. Herein, we attempt to define how surgeon skill, operative difficulty, patient outcomes, and cost factors determine when robotic technology should be reasonably applied to patient care in surgery.

Operations and maintenance philosophy

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

DUNCAN, G.P.

1999-10-28

This Operations and Maintenance (O&M) Philosophy document is intended to establish a future O&M vision, with an increased focus on minimizing worker exposure, ensuring uninterrupted retrieval operations, and minimizing operation life-cycle cost. It is intended that this document would incorporate O&M lessons learned into on-going and future project upgrades.

The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients.

PubMed

Terluin, Berend; Eekhout, Iris; Terwee, Caroline B

2017-03-01

Patients have their individual minimal important changes (iMICs) as their personal benchmarks to determine whether a perceived health-related quality of life (HRQOL) change constitutes a (minimally) important change for them. We denote the mean iMIC in a group of patients as the "genuine MIC" (gMIC). The aims of this paper are (1) to examine the relationship between the gMIC and the anchor-based minimal important change (MIC), determined by receiver operating characteristic analysis or by predictive modeling; (2) to examine the impact of the proportion of improved patients on these MICs; and (3) to explore the possibility to adjust the MIC for the influence of the proportion of improved patients. Multiple simulations of patient samples involved in anchor-based MIC studies with different characteristics of HRQOL (change) scores and distributions of iMICs. In addition, a real data set is analyzed for illustration. The receiver operating characteristic-based and predictive modeling MICs equal the gMIC when the proportion of improved patients equals 0.5. The MIC is estimated higher than the gMIC when the proportion improved is greater than 0.5, and the MIC is estimated lower than the gMIC when the proportion improved is less than 0.5. Using an equation including the predictive modeling MIC, the log-odds of improvement, the standard deviation of the HRQOL change score, and the correlation between the HRQOL change score and the anchor results in an adjusted MIC reflecting the gMIC irrespective of the proportion of improved patients. Adjusting the predictive modeling MIC for the proportion of improved patients assures that the adjusted MIC reflects the gMIC. We assumed normal distributions and global perceived change scores that were independent on the follow-up score. Additionally, floor and ceiling effects were not taken into account. Copyright © 2017 Elsevier Inc. All rights reserved.

Two-loop renormalization of quantum gravity simplified

DOE PAGES

Bern, Zvi; Chi, Huan -Hang; Dixon, Lance; ...

2017-02-22

The coefficient of the dimensionally regularized two-loop R 3 divergence of (nonsupersymmetric) gravity theories has recently been shown to change when nondynamical three-forms are added to the theory, or when a pseudoscalar is replaced by the antisymmetric two-form field to which it is dual. This phenomenon involves evanescent operators, whose matrix elements vanish in four dimensions, including the Gauss-Bonnet operator which is also connected to the trace anomaly. On the other hand, these effects appear to have no physical consequences for renormalized scattering processes. In particular, the dependence of the two-loop four-graviton scattering amplitude on the renormalization scale is simple.more » As a result, we explain this result for any minimally-coupled massless gravity theory with renormalizable matter interactions by using unitarity cuts in four dimensions and never invoking evanescent operators.« less

Advanced Modular Power Approach to Affordable, Supportable Space Systems

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Kimnach, Greg L.; Fincannon, James; Mckissock,, Barbara I.; Loyselle, Patricia L.; Wong, Edmond

2013-01-01

Recent studies of missions to the Moon, Mars and Near Earth Asteroids (NEA) indicate that these missions often involve several distinct separately launched vehicles that must ultimately be integrated together in-flight and operate as one unit. Therefore, it is important to see these vehicles as elements of a larger segmented spacecraft rather than separate spacecraft flying in formation. The evolution of large multi-vehicle exploration architecture creates the need (and opportunity) to establish a global power architecture that is common across all vehicles. The Advanced Exploration Systems (AES) Modular Power System (AMPS) project managed by NASA Glenn Research Center (GRC) is aimed at establishing the modular power system architecture that will enable power systems to be built from a common set of modular building blocks. The project is developing, demonstrating and evaluating key modular power technologies that are expected to minimize non-recurring development costs, reduce recurring integration costs, as well as, mission operational and support costs. Further, modular power is expected to enhance mission flexibility, vehicle reliability, scalability and overall mission supportability. The AMPS project not only supports multi-vehicle architectures but should enable multi-mission capability as well. The AMPS technology development involves near term demonstrations involving developmental prototype vehicles and field demonstrations. These operational demonstrations not only serve as a means of evaluating modular technology but also provide feedback to developers that assure that they progress toward truly flexible and operationally supportable modular power architecture.

Automated packing systems: review of industrial implementations

NASA Astrophysics Data System (ADS)

Whelan, Paul F.; Batchelor, Bruce G.

1993-08-01

A rich theoretical background to the problems that occur in the automation of material handling can be found in operations research, production engineering, systems engineering and automation, more specifically machine vision, literature. This work has contributed towards the design of intelligent handling systems. This paper will review the application of these automated material handling and packing techniques to industrial problems. The discussion will also highlight the systems integration issues involved in these applications. An outline of one such industrial application, the automated placement of shape templates on to leather hides, is also discussed. The purpose of this system is to arrange shape templates on a leather hide in an efficient manner, so as to minimize the leather waste, before they are automatically cut from the hide. These pieces are used in the furniture and car manufacturing industries for the upholstery of high quality leather chairs and car seats. Currently this type of operation is semi-automated. The paper will outline the problems involved in the full automation of such a procedure.

Digital control of highly augmented combat rotorcraft

NASA Technical Reports Server (NTRS)

Tischler, Mark B.

1987-01-01

Proposed concepts for the next generation of combat helicopters are to be embodied in a complex, highly maneuverable, multiroled vehicle with avionics systems. Single pilot and nap-of-the-Earth operations require handling qualities which minimize the involvement of the pilot in basic stabilization tasks. To meet these requirements will demand a full authority, high-gain, multimode, multiply-redundant, digital flight-control system. The gap between these requirements and current low-authority, low-bandwidth operational rotorcraft flight-control technology is considerable. This research aims at smoothing the transition between current technology and advanced concept requirements. The state of the art of high-bandwidth digital flight-control systems are reviewed; areas of specific concern for flight-control systems of modern combat are exposed; and the important concepts are illustrated in design and analysis of high-gain, digital systems with a detailed case study involving a current rotorcraft system. Approximate and exact methods are explained and illustrated for treating the important concerns which are unique to digital systems.

Continued research on selected parameters to minimize community annoyance from airplane noise

NASA Technical Reports Server (NTRS)

Frair, L.

1981-01-01

Results from continued research on selected parameters to minimize community annoyance from airport noise are reported. First, a review of the initial work on this problem is presented. Then the research focus is expanded by considering multiobjective optimization approaches for this problem. A multiobjective optimization algorithm review from the open literature is presented. This is followed by the multiobjective mathematical formulation for the problem of interest. A discussion of the appropriate solution algorithm for the multiobjective formulation is conducted. Alternate formulations and associated solution algorithms are discussed and evaluated for this airport noise problem. Selected solution algorithms that have been implemented are then used to produce computational results for example airports. These computations involved finding the optimal operating scenario for a moderate size airport and a series of sensitivity analyses for a smaller example airport.

Efficient Variational Quantum Simulator Incorporating Active Error Minimization

NASA Astrophysics Data System (ADS)

Li, Ying; Benjamin, Simon C.

2017-04-01

One of the key applications for quantum computers will be the simulation of other quantum systems that arise in chemistry, materials science, etc., in order to accelerate the process of discovery. It is important to ask the following question: Can this simulation be achieved using near-future quantum processors, of modest size and under imperfect control, or must it await the more distant era of large-scale fault-tolerant quantum computing? Here, we propose a variational method involving closely integrated classical and quantum coprocessors. We presume that all operations in the quantum coprocessor are prone to error. The impact of such errors is minimized by boosting them artificially and then extrapolating to the zero-error case. In comparison to a more conventional optimized Trotterization technique, we find that our protocol is efficient and appears to be fundamentally more robust against error accumulation.

21 CFR 50.51 - Clinical investigations not involving greater than minimal risk.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Clinical investigations not involving greater than... HUMAN SERVICES GENERAL PROTECTION OF HUMAN SUBJECTS Additional Safeguards for Children in Clinical Investigations § 50.51 Clinical investigations not involving greater than minimal risk. Any clinical...

Benefit from the minimally invasive sinus technique.

PubMed

Salama, N; Oakley, R J; Skilbeck, C J; Choudhury, N; Jacob, A

2009-02-01

Sinus drainage is impeded by the transition spaces that the anterior paranasal sinuses drain into, not the ostia themselves. Addressing the transition spaces and leaving the ostia intact, using the minimally invasive sinus technique, should reverse chronic rhinosinusitis. To assess patient benefit following use of the minimally invasive sinus technique for chronic rhinosinusitis. One hundred and forty-three consecutive patients underwent the minimally invasive sinus technique for chronic rhinosinusitis. Symptoms (i.e. blocked nose, poor sense of smell, rhinorrhoea, post-nasal drip, facial pain and sneezing) were recorded using a visual analogue scale, pre-operatively and at six and 12 weeks post-operatively. Patients were also surveyed using the Glasgow benefit inventory, one and three years post-operatively. We found a significant reduction in all nasal symptom scores at six and 12 weeks post-operatively, and increased total quality of life scores at one and three years post-operatively (25.2 and 14.8, respectively). The patient benefits of treatment with the minimally invasive sinus technique compare with the published patient benefits for functional endoscopic sinus surgery.

A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study.

PubMed

Şahin, Nur; Genc, Mine; Turan, Gülüzar Arzu; Kasap, Esin; Güçlü, Serkan

2018-03-13

The modified Misgav-Ladach method (MML) is a minimally invasive cesarean section procedure compared with the classic Pfannenstiel-Kerr (PK) method. The aim of the study was to compare the MML method and the PK method in terms of intraoperative and short-term postoperative outcomes. This prospective, randomized controlled trial involved 252 pregnant women scheduled for primary emergency or elective cesarean section between October, 2014 and July, 2015. The primary outcome measures were the duration of surgery, extraction time, Apgar score, blood loss, wound complications, and number of sutures used. Secondary outcome measures were the wound infection, time of bowel restitution, visual analogue scale (VAS) scores at 6 h and 24 h after the operation, limitations in movement, and analgesic requirements. At 6 weeks after surgery, the patients were evaluated regarding late complications. There was a significant reduction in total operating and extraction time in the MML group (p < 0.001). Limitations in movement were lower at 24 h after the MML operation, and less analgesic was required in the MML group. There was no difference between the 2 groups in terms of febrile morbidity or the duration of hospitalization. At 6 weeks after the operation, no complaints and no additional complications from the surgery were noted. The MML method is a minimally invasive cesarean section. In the future, as surgeons' experience increases, MML will likely be chosen more often than the classic PK method.

Method for Ground-to-Satellite Laser Calibration System

NASA Technical Reports Server (NTRS)

Lukashin, Constantine (Inventor); Wielicki, Bruce A. (Inventor)

2015-01-01

The present invention comprises an approach for calibrating the sensitivity to polarization, optics degradation, spectral and stray light response functions of instruments on orbit. The concept is based on using an accurate ground-based laser system, Ground-to-Space Laser Calibration (GSLC), transmitting laser light to instrument on orbit during nighttime substantially clear-sky conditions. To minimize atmospheric contribution to the calibration uncertainty the calibration cycles should be performed in short time intervals, and all required measurements are designed to be relative. The calibration cycles involve ground operations with laser beam polarization and wavelength changes.

A unified development of several techniques for the representation of random vectors and data sets

NASA Technical Reports Server (NTRS)

Bundick, W. T.

1973-01-01

Linear vector space theory is used to develop a general representation of a set of data vectors or random vectors by linear combinations of orthonormal vectors such that the mean squared error of the representation is minimized. The orthonormal vectors are shown to be the eigenvectors of an operator. The general representation is applied to several specific problems involving the use of the Karhunen-Loeve expansion, principal component analysis, and empirical orthogonal functions; and the common properties of these representations are developed.

Method for Ground-to-Space Laser Calibration System

NASA Technical Reports Server (NTRS)

Lukashin, Constantine (Inventor); Wielicki, Bruce A. (Inventor)

2014-01-01

The present invention comprises an approach for calibrating the sensitivity to polarization, optics degradation, spectral and stray light response functions of instruments on orbit. The concept is based on using an accurate ground-based laser system, Ground-to-Space Laser Calibration (GSLC), transmitting laser light to instrument on orbit during nighttime substantially clear-sky conditions. To minimize atmospheric contribution to the calibration uncertainty the calibration cycles should be performed in short time intervals, and all required measurements are designed to be relative. The calibration cycles involve ground operations with laser beam polarization and wavelength changes.

CMPF: class-switching minimized pathfinding in metabolic networks.

PubMed

Lim, Kevin; Wong, Limsoon

2012-01-01

The metabolic network is an aggregation of enzyme catalyzed reactions that converts one compound to another. Paths in a metabolic network are a sequence of enzymes that describe how a chemical compound of interest can be produced in a biological system. As the number of such paths is quite large, many methods have been developed to score paths so that the k-shortest paths represent the set of paths that are biologically meaningful or efficient. However, these approaches do not consider whether the sequence of enzymes can be manufactured in the same pathway/species/localization. As a result, a predicted sequence might consist of groups of enzymes that operate in distinct pathway/species/localization and may not truly reflect the events occurring within cell. We propose a path weighting method CMPF (Class-switching Minimized Pathfinder) to search for routes in a metabolic network which minimizes pathway switching. In biological terms, a pathway is a series of chemical reactions which define a specific function (e.g. glycolysis). We conjecture that routes that cross many pathways are inefficient since different pathways define different metabolic functions. In addition, native routes are also well characterized within pathways, suggesting that reasonable paths should not involve too many pathway switches. Our method can be generalized when reactions participate in a class set (e.g., pathways, species or cellular localization) so that the paths predicted have minimal class crossings. We show that our method generates k-paths that involve the least number of class switching. In addition, we also show that native paths are recoverable and alternative paths deviates less from native paths compared to other methods. This suggests that paths ranked by our method could be a way to predict paths that are likely to occur in biological systems.

Model Based Autonomy for Robust Mars Operations

NASA Technical Reports Server (NTRS)

Kurien, James A.; Nayak, P. Pandurang; Williams, Brian C.; Lau, Sonie (Technical Monitor)

1998-01-01

Space missions have historically relied upon a large ground staff, numbering in the hundreds for complex missions, to maintain routine operations. When an anomaly occurs, this small army of engineers attempts to identify and work around the problem. A piloted Mars mission, with its multiyear duration, cost pressures, half-hour communication delays and two-week blackouts cannot be closely controlled by a battalion of engineers on Earth. Flight crew involvement in routine system operations must also be minimized to maximize science return. It also may be unrealistic to require the crew have the expertise in each mission subsystem needed to diagnose a system failure and effect a timely repair, as engineers did for Apollo 13. Enter model-based autonomy, which allows complex systems to autonomously maintain operation despite failures or anomalous conditions, contributing to safe, robust, and minimally supervised operation of spacecraft, life support, In Situ Resource Utilization (ISRU) and power systems. Autonomous reasoning is central to the approach. A reasoning algorithm uses a logical or mathematical model of a system to infer how to operate the system, diagnose failures and generate appropriate behavior to repair or reconfigure the system in response. The 'plug and play' nature of the models enables low cost development of autonomy for multiple platforms. Declarative, reusable models capture relevant aspects of the behavior of simple devices (e.g. valves or thrusters). Reasoning algorithms combine device models to create a model of the system-wide interactions and behavior of a complex, unique artifact such as a spacecraft. Rather than requiring engineers to all possible interactions and failures at design time or perform analysis during the mission, the reasoning engine generates the appropriate response to the current situation, taking into account its system-wide knowledge, the current state, and even sensor failures or unexpected behavior.

A combined approach of simulation and analytic hierarchy process in assessing production facility layouts

NASA Astrophysics Data System (ADS)

Ramli, Razamin; Cheng, Kok-Min

2014-07-01

One of the important areas of concern in order to obtain a competitive level of productivity in a manufacturing system is the layout design and material transportation system (conveyor system). However, changes in customers' requirements have triggered the need to design other alternatives of the manufacturing layout for existing production floor. Hence, this paper discusses effective alternatives of the process layout specifically, the conveyor system layout. Subsequently, two alternative designs for the conveyor system were proposed with the aims to increase the production output and minimize space allocation. The first proposed layout design includes the installation of conveyor oven in the particular manufacturing room based on priority, and the second one is the one without the conveyor oven in the layout. Simulation technique was employed to design the new facility layout. Eventually, simulation experiments were conducted to understand the performance of each conveyor layout design based on operational characteristics, which include predicting the output of layouts. Utilizing the Analytic Hierarchy Process (AHP), the newly and improved layout designs were assessed before the final selection was done. As a comparison, the existing conveyor system layout was included in the assessment process. Relevant criteria involved in this layout design problem were identified as (i) usage of space of each design, (ii) operator's utilization rates, (iii) return of investment (ROI) of the layout, and (iv) output of the layout. In the final stage of AHP analysis, the overall priority of each alternative layout was obtained and thus, a selection for final use by the management was made based on the highest priority value. This efficient planning and designing of facility layout in a particular manufacturing setting is able to minimize material handling cost, minimize overall production time, minimize investment in equipment, and optimize utilization of space.

Influence of hospital-level practice patterns on variation in the application of minimally invasive surgery in United States pediatric patients.

PubMed

Train, Arianne T; Harmon, Carroll M; Rothstein, David H

2017-10-01

Although disparities in access to minimally invasive surgery are thought to exist in pediatric surgical patients in the United States, hospital-level practice patterns have not been evaluated as a possible contributing factor. Retrospective cohort study using the Kids' Inpatient Database, 2012. Odds ratios of undergoing a minimally invasive compared to open operation were calculated for six typical pediatric surgical operations after adjustment for multiple patient demographic and hospital-level variables. Further adjustment to the regression model was made by incorporating hospital practice patterns, defined as operation-specific minimally invasive frequency and volume. Age was the most significant patient demographic factor affecting application of minimally invasive surgery for all procedures. For several procedures, adjusting for individual hospital practice patterns removed race- and income-based disparities seen in performance of minimally invasive operations. Disparities related to insurance status were not affected by the same adjustment. Variation in the application of minimally invasive surgery in pediatric surgical patients is primarily influenced by patient age and the type of procedure performed. Perceived disparities in access related to some socioeconomic factors are decreased but not eliminated by accounting for individual hospital practice patterns, suggesting that complex underlying factors influence application of advanced surgical techniques. II. Copyright © 2017 Elsevier Inc. All rights reserved.

Minimally invasive thyroid nodulectomy reduces post-operative hypothyroidism when compared with thyroid lobectomy.

PubMed

Sarkis, Leba M; Norlen, Olov; Sywak, Mark; Delbridge, Leigh

2017-05-01

It has been a long-standing surgical tenet that the minimum surgical procedure for a single thyroid nodule is lobectomy. Such an approach, however, has been associated with a significant incidence of post-operative hypothyroidism with patients becoming medication dependent for life. Thermal sealing devices have enabled local nodule excision to be undertaken safely with preservation of more residual thyroid mass. The aim of this study was to determine if this approach was associated with a reduction in post-operative hypothyroidism. This is a retrospective cohort study comprising 351 patients treated between January 2010 and December 2012. Patients were assessed at 6-8-week review. Subclinical hypothyroidism was defined as a thyroid-stimulating hormone (TSH) >4.5 mIU/L, with clinical hypothyroidism defined as both an elevated TSH and presence of clinical symptoms requiring thyroxine replacement. One hundred and ninety patients underwent open thyroid lobectomy, 86 a minimally invasive thyroid lobectomy and 75 a minimally invasive nodulectomy. There was no difference in post-operative hypothyroidism after lobectomy whether by the open (22.1%) or minimally invasive (22.1%) technique. However, after minimally invasive nodulectomy, post-operative hypothyroidism was less than one quarter (5.3%) of that following lobectomy overall (22.1%, P < 0.01). There were no differences in post-operative complications between any of the groups. Minimally invasive local nodule excision can be performed safely, with the potential for significantly reducing the rate of post-operative hypothyroidism. As such, the procedure should be considered for appropriately selected patients. © 2014 Royal Australasian College of Surgeons.

Optimization of ground-water withdrawal at the old O-Field area, Aberdeen Proving Ground, Maryland

USGS Publications Warehouse

Banks, William S.L.; Dillow, Jonathan J.A.

2001-01-01

The U.S. Army disposed of chemical agents, laboratory materials, and unexploded ordnance at the Old O-Field landfill at Aberdeen Proving Ground, Maryland, beginning prior to World War II and continuing until at least the 1950?s. Soil, ground water, surface water, and wetland sediments in the Old O-Field area were contaminated by the disposal of these materials. The site is in the Atlantic Coastal Plain, and is characterized by a complex series of Pleistocene and Holocene sediments formed in various fluvial, estuarine, and marine-marginal hydrogeologic environments. A previously constructed transient finite-difference ground-water-flow model was used to simulate ground-water flow and the effects of a pump-and-treat remediation system designed to prevent contaminated ground water from flowing into Watson Creek (a tidal estuary and a tributary to the Gunpowder River). The remediation system consists of 14 extraction wells located between the Old O-Field landfill and Watson Creek.Linear programming techniques were applied to the results of the flow-model simulations to identify optimal pumping strategies for the remediation system. The optimal management objective is to minimize total withdrawal from the water-table aquifer, while adhering to the following constraints: (1) ground-water flow from the landfill should be prevented from reaching Watson Creek, (2) no extraction pump should be operated at a rate that exceeds its capacity, and (3) no extraction pump should be operated at a rate below its minimum capacity, the minimum rate at which an Old O-Field pump can function. Water withdrawal is minimized by varying the rate and frequency of pumping at each of the 14 extraction wells over time. This minimizes the costs of both pumping and water treatment, thus providing the least-cost remediation alternative while simultaneously meeting all operating constraints.The optimal strategy identified using this objective and constraint set involved operating 13 of the 14 extraction wells at rates ranging from 0.4 to 4.9 gallons per minute.

[Application of diffusion tensor imaging fractography in minimally invasive surgery of brain tumors].

PubMed

Yang, Lei; Zhang, Mao-zhi; Zhang, Wei; Zhao, Yuan-li; Zhao, Ji-zong

2006-05-23

To investigate the effects and prospect of application of diffusion tensor imaging (DTI) fractography in minimally invasive surgery of brain tumors. DTI fractography was performed in 52 patients with malignant brain tumors. Based on the DTI fractography results, 34 of the 52 patients underwent operation under neuro-navigation, and 18 of the 52 patients underwent operation routine minimally invasive craniotomy and tumor resection without neuro-navigation. The rate of total tumor resection was 86.5% (45/52). The mortality was 1.9% (1/52). The disability rate was 11.5% (6/52). No case needed the second operation. DTI fractography has raised the minimally invasive neurosurgery to the level of protecting the nuclei and nerve tracts and guiding intra-operative management of infiltration of deep-seated tumors, especially when combined with neuro-navigation and interventional MRI.

Implementation of collisions on GPU architecture in the Vorpal code

NASA Astrophysics Data System (ADS)

Leddy, Jarrod; Averkin, Sergey; Cowan, Ben; Sides, Scott; Werner, Greg; Cary, John

2017-10-01

The Vorpal code contains a variety of collision operators allowing for the simulation of plasmas containing multiple charge species interacting with neutrals, background gas, and EM fields. These existing algorithms have been improved and reimplemented to take advantage of the massive parallelization allowed by GPU architecture. The use of GPUs is most effective when algorithms are single-instruction multiple-data, so particle collisions are an ideal candidate for this parallelization technique due to their nature as a series of independent processes with the same underlying operation. This refactoring required data memory reorganization and careful consideration of device/host data allocation to minimize memory access and data communication per operation. Successful implementation has resulted in an order of magnitude increase in simulation speed for a test-case involving multiple binary collisions using the null collision method. Work supported by DARPA under contract W31P4Q-16-C-0009.

Wind Turbine Contingency Control Through Generator De-Rating

NASA Technical Reports Server (NTRS)

Frost, Susan; Goebel, Kai; Balas, Mark

2013-01-01

Maximizing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. In that context, systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage to the turbine. Advanced contingency control is one way to enable autonomous decision-making by providing the mechanism to enable safe and efficient turbine operation. The work reported herein explores the integration of condition monitoring of wind turbines with contingency control to balance the trade-offs between maintaining system health and energy capture. The contingency control involves de-rating the generator operating point to achieve reduced loads on the wind turbine. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.

Safety policy and requirements for payloads using the Space Transportation System (STS)

NASA Technical Reports Server (NTRS)

1982-01-01

The Space Transportation Operations (STO) safety policy is to minimize STO involvement in the payload and its GSE (ground support equipment) design process while maintaining the assurance of a safe operation. Requirements for assuring payload mission success are the responsibility of the payload organization and are beyond the scope of this document. The intent is to provide the overall safety policies and requirements while allowing for negotiation between the payload organization and the STO operator in the method of implementation of payload safety. This revision provides for a relaxation in the monitoring requirements for inhibits, allows the payload organization to pursue design options and reflects, additionally, some new requirements. As of the issue date of this NHB, payloads which have completed the formal safety assessment reviews of their preliminary design on the basis of the May 1979 issue will be reassessed for compliance with the above changes.

A simulator study for the development and evaluation of operating procedures on a supersonic cruise research transport to minimize airport-community noise

NASA Technical Reports Server (NTRS)

Grantham, W. D.; Smith, P. M.; Deal, P. L.

1980-01-01

Piloted-simulator studies were conducted to determine takeoff and landing operating procedures for a supersonic cruise research transport concept that result in predicted noise levels which meet current Federal Aviation Administration (FAA) certification standards. With the use of standard FAA noise certification test procedures, the subject simulated aircraft did not meet the FAA traded-noise-level standards during takeoff and landing. However, with the use of advanced procedures, this aircraft meets the traded-noise-level standards for flight crews with average skills. The advanced takeoff procedures developed involved violating some of the current Federal Aviation Regulations (FAR), but it was not necessary to violate any FAR noise-test conditions during landing approach. Noise contours were also determined for some of the simulated takeoffs and landings in order to indicate the noise-reduction advantages of using operational procedures other than standard.

Managing human fallibility in critical aerospace situations

NASA Astrophysics Data System (ADS)

Tew, Larry

2014-11-01

Human fallibility is pervasive in the aerospace industry with over 50% of errors attributed to human error. Consider the benefits to any organization if those errors were significantly reduced. Aerospace manufacturing involves high value, high profile systems with significant complexity and often repetitive build, assembly, and test operations. In spite of extensive analysis, planning, training, and detailed procedures, human factors can cause unexpected errors. Handling such errors involves extensive cause and corrective action analysis and invariably schedule slips and cost growth. We will discuss success stories, including those associated with electro-optical systems, where very significant reductions in human fallibility errors were achieved after receiving adapted and specialized training. In the eyes of company and customer leadership, the steps used to achieve these results lead to in a major culture change in both the workforce and the supporting management organization. This approach has proven effective in other industries like medicine, firefighting, law enforcement, and aviation. The roadmap to success and the steps to minimize human error are known. They can be used by any organization willing to accept human fallibility and take a proactive approach to incorporate the steps needed to manage and minimize error.

Angular momentum and Zeeman effect in the presence of a minimal length based on the Kempf-Mann-Mangano algebra

NASA Astrophysics Data System (ADS)

Khosropour, B.

2016-07-01

In this work, we consider a D-dimensional ( β, β^' -two-parameters deformed Heisenberg algebra, which was introduced by Kempf et al. The angular-momentum operator in the presence of a minimal length scale based on the Kempf-Mann-Mangano algebra is obtained in the special case of β^' = 2β up to the first order over the deformation parameter β . It is shown that each of the components of the modified angular-momentum operator, commutes with the modified operator {L}2 . We find the magnetostatic field in the presence of a minimal length. The Zeeman effect in the deformed space is studied and also Lande's formula for the energy shift in the presence of a minimal length is obtained. We estimate an upper bound on the isotropic minimal length.

A multi-objective approach to solid waste management.

PubMed

Galante, Giacomo; Aiello, Giuseppe; Enea, Mario; Panascia, Enrico

2010-01-01

The issue addressed in this paper consists in the localization and dimensioning of transfer stations, which constitute a necessary intermediate level in the logistic chain of the solid waste stream, from municipalities to the incinerator. Contextually, the determination of the number and type of vehicles involved is carried out in an integrated optimization approach. The model considers both initial investment and operative costs related to transportation and transfer stations. Two conflicting objectives are evaluated, the minimization of total cost and the minimization of environmental impact, measured by pollution. The design of the integrated waste management system is hence approached in a multi-objective optimization framework. To determine the best means of compromise, goal programming, weighted sum and fuzzy multi-objective techniques have been employed. The proposed analysis highlights how different attitudes of the decision maker towards the logic and structure of the problem result in the employment of different methodologies and the obtaining of different results. The novel aspect of the paper lies in the proposal of an effective decision support system for operative waste management, rather than a further contribution to the transportation problem. The model was applied to the waste management of optimal territorial ambit (OTA) of Palermo (Italy). 2010 Elsevier Ltd. All rights reserved.

Orbital management and design considerations for NiCd satellite power systems

NASA Technical Reports Server (NTRS)

Tausch, Benjamin J., II

1994-01-01

Several recently manufactured 50 and 60 ampere hour aerospace NiCd battery cell lots, produced by Gates Aerospace Batteries, are prone to premature on orbit performance degradation. The failure mechanism is cadmium migration, and the consequent development of soft shorts. A Martin Marietta Astronautics satellite program instituted an orbital management strategy for a set of these batteries that reduced the rate of degradation and brought the system to stable operation. This strategy involves: (1) minimizing the accumulated battery overcharge; (2) regular discharge exercises; and (3) periodic battery reconditioning. Because of changes in the NiCd cell manufacturing process, the actual performance of subsequent lots of NiCd cells is open to question. Future NiCd based power system designs should therefore allow for fine control of charge parameters, and an on orbit battery reconditioning capability. To minimize risk, it is much better to perform a full life test to qualify the cells before launch, rather than in parallel with orbital operations. If there are any changes in the manufacturing process of cells, it is extremely important to maintain very strong cognizance of secondary subcontractors, recognizing that the cell and battery manufacturing discipline is easily atrophied.

A multi-objective approach to solid waste management

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

Galante, Giacomo, E-mail: galante@dtpm.unipa.i; Aiello, Giuseppe; Enea, Mario

2010-08-15

The issue addressed in this paper consists in the localization and dimensioning of transfer stations, which constitute a necessary intermediate level in the logistic chain of the solid waste stream, from municipalities to the incinerator. Contextually, the determination of the number and type of vehicles involved is carried out in an integrated optimization approach. The model considers both initial investment and operative costs related to transportation and transfer stations. Two conflicting objectives are evaluated, the minimization of total cost and the minimization of environmental impact, measured by pollution. The design of the integrated waste management system is hence approached inmore » a multi-objective optimization framework. To determine the best means of compromise, goal programming, weighted sum and fuzzy multi-objective techniques have been employed. The proposed analysis highlights how different attitudes of the decision maker towards the logic and structure of the problem result in the employment of different methodologies and the obtaining of different results. The novel aspect of the paper lies in the proposal of an effective decision support system for operative waste management, rather than a further contribution to the transportation problem. The model was applied to the waste management of optimal territorial ambit (OTA) of Palermo (Italy).« less

16 CFR 1028.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-01-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... kinds of research involving no more than minimal risk, and for minor changes in approved research. 1028... HUMAN SUBJECTS § 1028.110 Expedited review procedures for certain kinds of research involving no more...

14 CFR 1230.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-01-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... kinds of research involving no more than minimal risk, and for minor changes in approved research. 1230... HUMAN SUBJECTS § 1230.110 Expedited review procedures for certain kinds of research involving no more...

45 CFR 690.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-10-01

... research involving no more than minimal risk, and for minor changes in approved research. 690.110 Section 690.110 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION PROTECTION OF HUMAN SUBJECTS § 690.110 Expedited review procedures for certain kinds of research involving no...

Cryogenics Testbed Laboratory Flange Baseline Configuration

NASA Technical Reports Server (NTRS)

Acuna, Marie Lei Ysabel D.

2013-01-01

As an intern at Kennedy Space Center (KSC), I was involved in research for the Fluids and Propulsion Division of the NASA Engineering (NE) Directorate. I was immersed in the Integrated Ground Operations Demonstration Units (IGODU) project for the majority of my time at KSC, primarily with the Ground Operations Demonstration Unit Liquid Oxygen (GODU L02) branch of IGODU. This project was established to develop advancements in cryogenic systems as a part of KSC's Advanced Exploration Systems (AES) program. The vision of AES is to develop new approaches for human exploration, and operations in and beyond low Earth orbit. Advanced cryogenic systems are crucial to minimize the consumable losses of cryogenic propellants, develop higher performance launch vehicles, and decrease operations cost for future launch programs. During my internship, I conducted a flange torque tracking study that established a baseline configuration for the flanges in the Simulated Propellant Loading System (SPLS) at the KSC Cryogenics Test Laboratory (CTL) - the testing environment for GODU L02.

Introduction to System Health Engineering and Management in Aerospace

NASA Technical Reports Server (NTRS)

Johnson, Stephen B.

2005-01-01

This paper provides a technical overview of Integrated System Health Engineering and Management (ISHEM). We define ISHEM as "the paper provides a techniques, and technologies used to design, analyze, build, verify, and operate a system to prevent faults and/or minimize their effects." This includes design and manufacturing techniques as well operational and managerial methods. ISHEM is not a "purely technical issue" as it also involves and must account for organizational, communicative, and cognitive f&ms of humans as social beings and as individuals. Thus the paper will discuss in more detail why all of these elements, h m the technical to the cognitive and social, are necessary to build dependable human-machine systems. The paper outlines a functional homework and architecture for ISHEM operations, describes the processes needed to implement ISHEM in the system life-cycle, and provides a theoretical framework to understand the relationship between the different aspects of the discipline. It then derives from these and the social and cognitive bases a set of design and operational principles for ISHEM.

Universal Darwinism As a Process of Bayesian Inference.

PubMed

Campbell, John O

2016-01-01

Many of the mathematical frameworks describing natural selection are equivalent to Bayes' Theorem, also known as Bayesian updating. By definition, a process of Bayesian Inference is one which involves a Bayesian update, so we may conclude that these frameworks describe natural selection as a process of Bayesian inference. Thus, natural selection serves as a counter example to a widely-held interpretation that restricts Bayesian Inference to human mental processes (including the endeavors of statisticians). As Bayesian inference can always be cast in terms of (variational) free energy minimization, natural selection can be viewed as comprising two components: a generative model of an "experiment" in the external world environment, and the results of that "experiment" or the "surprise" entailed by predicted and actual outcomes of the "experiment." Minimization of free energy implies that the implicit measure of "surprise" experienced serves to update the generative model in a Bayesian manner. This description closely accords with the mechanisms of generalized Darwinian process proposed both by Dawkins, in terms of replicators and vehicles, and Campbell, in terms of inferential systems. Bayesian inference is an algorithm for the accumulation of evidence-based knowledge. This algorithm is now seen to operate over a wide range of evolutionary processes, including natural selection, the evolution of mental models and cultural evolutionary processes, notably including science itself. The variational principle of free energy minimization may thus serve as a unifying mathematical framework for universal Darwinism, the study of evolutionary processes operating throughout nature.

Universal Darwinism As a Process of Bayesian Inference

PubMed Central

Campbell, John O.

2016-01-01

Many of the mathematical frameworks describing natural selection are equivalent to Bayes' Theorem, also known as Bayesian updating. By definition, a process of Bayesian Inference is one which involves a Bayesian update, so we may conclude that these frameworks describe natural selection as a process of Bayesian inference. Thus, natural selection serves as a counter example to a widely-held interpretation that restricts Bayesian Inference to human mental processes (including the endeavors of statisticians). As Bayesian inference can always be cast in terms of (variational) free energy minimization, natural selection can be viewed as comprising two components: a generative model of an “experiment” in the external world environment, and the results of that “experiment” or the “surprise” entailed by predicted and actual outcomes of the “experiment.” Minimization of free energy implies that the implicit measure of “surprise” experienced serves to update the generative model in a Bayesian manner. This description closely accords with the mechanisms of generalized Darwinian process proposed both by Dawkins, in terms of replicators and vehicles, and Campbell, in terms of inferential systems. Bayesian inference is an algorithm for the accumulation of evidence-based knowledge. This algorithm is now seen to operate over a wide range of evolutionary processes, including natural selection, the evolution of mental models and cultural evolutionary processes, notably including science itself. The variational principle of free energy minimization may thus serve as a unifying mathematical framework for universal Darwinism, the study of evolutionary processes operating throughout nature. PMID:27375438

MST's Programmable Power Supplies: Bt Update, Bp Prototype

NASA Astrophysics Data System (ADS)

Holly, D. J.; Chapman, B. E.; McCollam, K. J.; Morin, J. C.; Thomas, M. A.

2013-10-01

MST's toroidal field programmable power supply (Bt PPS) has now been in operation for several years and has provided important new capabilities. One of the primary goals for the Bt PPS is the partial optimization of inductive current profile control, involving control of the poloidal electric field. The Bt PPS has achieved fluctuation reduction over MST's entire range of Ip. At the largest Ip, the Bt PPS achieves fluctuation reduction with a smaller poloidal electric field than the previous passive system, implying that substantially longer periods of current profile control may be possible. The Bt PPS has also been used to produce Ohmic tokamak plasmas in MST. With an applied toroidal field of 0.135 T, and q(a) > 2, the estimated energy confinement time is roughly consistent with neo-Alcator scaling. Driving q(a) < 2 with larger Ip, the confinement time degrades, but the discharge duration does not terminate prematurely. To fully optimize current profile control and to test MST operational limits, a PPS is also needed for the Bp circuit. Currently in prototype stage, the Bp PPS will feature a number of innovations to increase its flexibility and performance. Isolated charging, control, and monitor systems will eliminate charging relays, reduce coupling between modules, and minimize capacitor heating. Seven-level pulse width modulation will reduce output ripple and switching losses. Solid state shorting bars will eliminate shorting relays and minimize wiring. A balanced switching algorithm will minimize capacitive noise generation. Work supported by U. S. D. o. E.

Robotics-based synthesis of human motion.

PubMed

Khatib, O; Demircan, E; De Sapio, V; Sentis, L; Besier, T; Delp, S

2009-01-01

The synthesis of human motion is a complex procedure that involves accurate reconstruction of movement sequences, modeling of musculoskeletal kinematics, dynamics and actuation, and characterization of reliable performance criteria. Many of these processes have much in common with the problems found in robotics research. Task-based methods used in robotics may be leveraged to provide novel musculoskeletal modeling methods and physiologically accurate performance predictions. In this paper, we present (i) a new method for the real-time reconstruction of human motion trajectories using direct marker tracking, (ii) a task-driven muscular effort minimization criterion and (iii) new human performance metrics for dynamic characterization of athletic skills. Dynamic motion reconstruction is achieved through the control of a simulated human model to follow the captured marker trajectories in real-time. The operational space control and real-time simulation provide human dynamics at any configuration of the performance. A new criteria of muscular effort minimization has been introduced to analyze human static postures. Extensive motion capture experiments were conducted to validate the new minimization criterion. Finally, new human performance metrics were introduced to study in details an athletic skill. These metrics include the effort expenditure and the feasible set of operational space accelerations during the performance of the skill. The dynamic characterization takes into account skeletal kinematics as well as muscle routing kinematics and force generating capacities. The developments draw upon an advanced musculoskeletal modeling platform and a task-oriented framework for the effective integration of biomechanics and robotics methods.

Using benchmarking to minimize common DOE waste streams: Volume 5. Office paper waste

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

Levin, V.

Finding innovative ways to reduce waste streams generated at US Department of Energy (DOE) sites by 50% by the year 2000 is a challenge for DOE`s waste minimization efforts. A team composed of members from several DOE facilities used the quality tool known as benchmarking to improve waste minimization efforts. First the team examined office waste generation and handling processes at their sites. Then team members developed telephone and written questionnaires to help identify potential ``best-in-class`` industry partners willing to share information about their best waste minimization techniques and technologies. The team identified two benchmarking partners, NIKE, Inc., in Beaverton,more » Oregon, and Microsoft, Inc., in Redmond, Washington. Both companies have proactive, employee-driven environmental issues programs. Both companies report strong employee involvement, management commitment, and readily available markets for recyclable materials such as white paper and nonwhite assorted paper. The availability of markets, the initiative and cooperation of employees, and management support are the main enablers for their programs. At both companies, recycling and waste reduction programs often cut across traditional corporate divisions such as procurement, janitorial services, environmental compliance, grounds maintenance, cafeteria operations, surplus sales, and shipping and receiving. These companies exhibited good cooperation between these functions to design and implement recycling and waste reduction programs.« less

Laparoscopic supracervical hysterectomy with transcervical morcellation: our experience.

PubMed

Graziano, Angela; Lo Monte, Giuseppe; Hanni, Herbert; Brugger, Johann Georg; Engl, Bruno; Marci, Roberto

2015-02-01

To present our experience with laparoscopic supracervical hysterectomy with transcervical morcellation (LSH-TM). A retrospective observational study (Canadian Task Force Classification III). Gynecologic Department at Brunico Hospital, Brunico, Italy. Three hundred sixty-five patients affected by gynecologic benign diseases who underwent LSH-TM. A minimally invasive surgical technique for supracervical hysterectomy that involves extraction of the morcellated uterus through the cervical canal. We performed LSH-TM successfully in 365 patients; the mean (standard deviation) operating time was 72.24 (23.21) minutes. We registered no intraoperative complications. The main postoperative complications resulted in 2 cases of second-look laparoscopy because of internal bleeding, 5 cases of asymptomatic hematoma around the cervical stump, and 7 cases of pelvic pain. Our experience shows that LSH-TM is a safe and easy to perform technique and that it ensures minimal blood loss. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Pre-operative patient teaching in an acute care ward in Hong Kong: a case study.

PubMed

Lee, David S; Chien, W T

2002-10-01

Many nurses have acknowledged that adequate pre-operative teaching can alleviate patients' anxiety, increase patient participation in their own care, and minimize post-operative complications. However, the organization and degree to which pre-operative patient teachingfeatured in nurses' practice varies in different acute care settings. A case study design was used to explore the practice of pre-operative teaching in a surgical ward of an acute general hospital in Hong Kong. Seventeen registered nurses working on the ward were interviewed and observed in order to explore how they conduct a pre-operative teaching program and the difficulties encountered by them in carrying out pre-operative teaching on this acute care setting. Thefindings of this study indicate that pre-operative teaching workshops are organized and conducted by nursesfrom the operating theatre, in the day surgery center. Ward nurses were not actively involved in this pre-operative teaching. The results of this study present some similarities to a study with the similar design in Australia. There are also issues unique to the Hong Kong context. This case study was to review Hong Kong nurses' current practices of pre-operative teaching and to understand the cultural, conceptual and managementfactors influencing the practice in pre-operative teaching.

An evidence-based review of enhanced recovery interventions in knee replacement surgery

PubMed Central

Alazzawi, S; Nizam, I; Haddad, FS

2013-01-01

Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements. PMID:24025284

An evidence-based review of enhanced recovery interventions in knee replacement surgery.

PubMed

Ibrahim, M S; Alazzawi, S; Nizam, I; Haddad, F S

2013-09-01

Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient's postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. A thorough literature search of the electronic healthcare databases (MEDLINE(®), Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

Self-Averaging Property of Minimal Investment Risk of Mean-Variance Model.

PubMed

Shinzato, Takashi

2015-01-01

In portfolio optimization problems, the minimum expected investment risk is not always smaller than the expected minimal investment risk. That is, using a well-known approach from operations research, it is possible to derive a strategy that minimizes the expected investment risk, but this strategy does not always result in the best rate of return on assets. Prior to making investment decisions, it is important to an investor to know the potential minimal investment risk (or the expected minimal investment risk) and to determine the strategy that will maximize the return on assets. We use the self-averaging property to analyze the potential minimal investment risk and the concentrated investment level for the strategy that gives the best rate of return. We compare the results from our method with the results obtained by the operations research approach and with those obtained by a numerical simulation using the optimal portfolio. The results of our method and the numerical simulation are in agreement, but they differ from that of the operations research approach.

Use of new minimum intervention dentistry technologies in caries management.

PubMed

Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

2013-06-01

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the disease, or keep the oral environment in a state of balance between pathological and preventive factors. Early detection and diagnosis and prediction of lesion activity are of great interest and may change traditional operative procedures substantially. Fluorescence tools with high levels of magnification and observational capacity should guide clinicians towards a more preventive and minimally invasive treatment strategy. © 2013 Australian Dental Association.

Ultra Low Temperature Ultra Low Power Instrument Packages for Planetary Surfaces

NASA Technical Reports Server (NTRS)

Clark, P. E.; Millar, P. S.; Beaman, B.; Yeh, P. S.; Cooper, L.; Feng, S.; Young, E.

2010-01-01

Achievement of solar system exploration roadmap goals will involve robotic or human deployment and longterm operation of surface science packages remote from human presence, thus requiring autonomous, self-powered operation. The major challenge such packages face will be operating during long periods of darkness in extreme cold potentially without the Pu238 based power and thermal systems available to Apollo era packages (ALSEP). Development of such science payloads will thus require considerable optimization of instrument and subsystem design, packaging and integration for a variety of planetary surface environments in order to support solar system exploration fully. Our work supports this process through the incorporation of low temperature operational components and design strategies which radically minimize power, mass, and cost while maximizing the performance under extreme surface conditions that are in many cases more demanding than those routinely experienced by spacecraft in deep space. Chief instruments/instrument package candidates include those which could provide long-term monitoring of the surface and subsurface environments for fundamental science and human crew safety. The initial attempt to design a 10 instrument environmental monitoring package with a solar/battery based power system led to a package with a unacceptably large mass (500 kg) of which over half was battery mass. In phase 1, a factor of 5 reduction in mass was achieved, first through the introduction of high performance electronics capable of operating at far lower temperature and then through the use of innovative thermal balance strategies involving the use of multi-layer thin materials and gravity-assisted heat pipes. In phase 2, reported here, involves strategies such as universal incorporation of ULT/ULP digital and analog electronics, and distributed or non-conventionally packaged power systems. These strategies will be required to meet the far more challenging thermal requirements of operating through a normal 28 day diurnal cycle. The limited temperature range of efficient battery operation remains the largest obstacle.

Principles of a clean operating room environment.

PubMed

Howard, James L; Hanssen, Arlen D

2007-10-01

Optimizing the operating room environment is necessary to minimize the prevalence of arthroplasty infection. Reduction of bacterial contamination in the operating room should be a primary focus of all members of the operating room team. However, in recent years, there has been a decline in the emphasis of the basic principles of antisepsis in many operating rooms. The purpose of this review is to highlight important considerations for optimizing the operating room environment. These principles should be actively promoted by orthopedic surgeons in their operating rooms as part of a comprehensive approach to minimizing arthroplasty infection.

Minimal sufficient positive-operator valued measure on a separable Hilbert space

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

Kuramochi, Yui, E-mail: kuramochi.yui.22c@st.kyoto-u.ac.jp

We introduce a concept of a minimal sufficient positive-operator valued measure (POVM), which is the least redundant POVM among the POVMs that have the equivalent information about the measured quantum system. Assuming the system Hilbert space to be separable, we show that for a given POVM, a sufficient statistic called a Lehmann-Scheffé-Bahadur statistic induces a minimal sufficient POVM. We also show that every POVM has an equivalent minimal sufficient POVM and that such a minimal sufficient POVM is unique up to relabeling neglecting null sets. We apply these results to discrete POVMs and information conservation conditions proposed by the author.

15 CFR 27.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-01-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... certain kinds of research involving no more than minimal risk, and for minor changes in approved research... HUMAN SUBJECTS § 27.110 Expedited review procedures for certain kinds of research involving no more than...

Preliminary Thermal Characterization of a Fully-Passive Wireless Backscattering Neuro-Recording Microsystem

NASA Technical Reports Server (NTRS)

Schwerdt, H. N.; Xu, W.; Shekhar, S.; Chae, J.; Miranda, F. A.

2011-01-01

We present analytical and experimental thermal characteristics of a battery-less, fully-passive wireless backscattering microsystem for recording of neuropotentials. A major challenge for cortically implantable microsystems involves minimizing the heat dissipated by on-chip circuitry, which can lead to permanent brain damage. Therefore, knowledge of temperature changes induced by implantable microsystems while in operation is of utmost importance. In this work, a discrete diode appended to the neuro-recording microsystem has been used to indirectly monitor the aforesaid temperature changes. Using this technique, the maximum temperature rise measured for the microsystem while in operation was 0.15 +/- 0.1 C, which is significantly less than current safety guidelines. Specific absorption ratio (SAR) due to the microsystem was also computed to further demonstrate fully-passive functionality of the neuro-recording microsystem.

An emulator for minimizing finite element analysis implementation resources

NASA Technical Reports Server (NTRS)

Melosh, R. J.; Utku, S.; Salama, M.; Islam, M.

1982-01-01

A finite element analysis emulator providing a basis for efficiently establishing an optimum computer implementation strategy when many calculations are involved is described. The SCOPE emulator determines computer resources required as a function of the structural model, structural load-deflection equation characteristics, the storage allocation plan, and computer hardware capabilities. Thereby, it provides data for trading analysis implementation options to arrive at a best strategy. The models contained in SCOPE lead to micro-operation computer counts of each finite element operation as well as overall computer resource cost estimates. Application of SCOPE to the Memphis-Arkansas bridge analysis provides measures of the accuracy of resource assessments. Data indicate that predictions are within 17.3 percent for calculation times and within 3.2 percent for peripheral storage resources for the ELAS code.

Modeling of electrical and mesoscopic circuits at quantum nanoscale from heat momentum operator

NASA Astrophysics Data System (ADS)

El-Nabulsi, Rami Ahmad

2018-04-01

We develop a new method to study electrical circuits at quantum nanoscale by introducing a heat momentum operator which reproduces quantum effects similar to those obtained in Suykens's nonlocal-in-time kinetic energy approach for the case of reversible motion. The series expansion of the heat momentum operator is similar to the momentum operator obtained in the framework of minimal length phenomenologies characterized by the deformation of Heisenberg algebra. The quantization of both LC and mesoscopic circuits revealed a number of motivating features like the emergence of a generalized uncertainty relation and a minimal charge similar to those obtained in the framework of minimal length theories. Additional features were obtained and discussed accordingly.

Real-Time Control of Lean Blowout in a Turbine Engine for Minimizing No(x) Emissions

NASA Technical Reports Server (NTRS)

Zinn, Ben

2004-01-01

This report describes research on the development and demonstration of a controlled combustor operates with minimal NO, emissions, thus meeting one of NASA s UEET program goals. NO(x) emissions have been successfully minimized by operating a premixed, lean burning combustor (modeling a lean prevaporized, premixed LPP combustor) safely near its lean blowout (LBO) limit over a range of operating conditions. This was accomplished by integrating the combustor with an LBO precursor sensor and closed-loop, rule-based control system that allowed the combustor to operate far closer to the point of LBO than an uncontrolled combustor would be allowed to in a current engine. Since leaner operation generally leads to lower NO, emissions, engine NO, was reduced without loss of safety.

Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases.

PubMed

Sukkarieh, Hamdi G; Hitchon, Patrick W; Awe, Olatilewa; Noeller, Jennifer

2015-10-01

The authors sought to determine patient-related outcomes after minimally invasive surgical (MIS) lumbar intraspinal synovial cyst excision via a tubular working channel and a contralateral facet-sparing approach. All the patients with a symptomatic lumbar intraspinal synovial cyst who underwent surgery at the University of Iowa Hospitals and Clinics with an MIS excision via a contralateral approach were treated between July 2010 and August 2014. There was a total of 13 cases. Each patient was evaluated with preoperative neurological examinations, lumbar spine radiography, MRI, and visual analog scale (VAS) scores. The patients were evaluated postoperatively with neurological examinations and VAS and Macnab scores. The primary outcomes were improvement in VAS and Macnab scores. Secondary outcomes were average blood loss, hospital stay duration, and operative times. There were 5 males and 8 females. The mean age was 66 years, and the mean body mass index was 28.5 kg/m(2). Sixty-nine percent (9 of 13) of the cysts were at L4-5. Most patients had low-back pain and radicular pain, and one-third of them had Grade 1 spondylolisthesis. The mean (± SD) follow-up duration was 20.8 ± 16.9 months. The mean Macnab score was 3.4 ± 1.0, and the VAS score decreased from 7.8 preoperatively to 2.9 postoperatively. The mean operative time was 123 ± 30 minutes, with a mean estimated blood loss of 44 ± 29 ml. Hospital stay averaged 1.5 ± 0.7 days. There were no complications noted in this series. The MIS excision of lumbar intraspinal synovial cysts via a contralateral approach offers excellent exposure to the cyst and spares the facet joint at the involved level, thus minimizing risk of instability, blood loss, operative time, and hospital stay. Prospective randomized trials with longer follow-up times and larger cohorts are needed to conclusively determine the superiority of the contralateral MIS approach over others, including open or ipsilateral minimally invasive surgery.

Firework-related injury in the Top End: a 16-year review.

PubMed

Read, David J; Bradbury, Richard; Yeboah, Edward

2017-12-01

On July 1st on 'Territory Day', the public in the Northern Territory are permitted to purchase and operate consumer fireworks without a licence. Serious permanent injuries from fireworks are well described, leading to their banning in many other jurisdictions. This study describes those seriously injured by fireworks in the Top End of the Northern Territory, with the aim of identifying opportunities for prevention and harm minimization. This is a retrospective audit of all admitted patients with an injury from fireworks at the Royal Darwin Hospital between 2000 and 2015. The variables collected included demographic data and the circumstances around injury (operator versus bystander, alcohol involvement and day of device operation). The consequences such as injuries, operating theatre visits, length of stay and outpatient visits are described. Fifty-five patients (including 17 children) suffered 67 injuries over the study period, resulting in 68 operating theatre visits, 322 hospital days and 380 outpatient appointments. Burns, hand and eye injuries predominate. Females (P = 0.000) and children (P = 0.029) were more likely to be injured as bystanders. Injuries on a day other than Territory Day were more likely to have alcohol involvement (P = 0.01), and occur in the operator (P = 0.017). Consumer firework usage results in a small number of life altering injuries annually. Previous prevention campaigns focusing on device user safety should be expanded to include the safety of bystanders and children and reduce firework usage outside of the Territory Day. © 2017 Royal Australasian College of Surgeons.

Gravitational forces and moments on spacecraft

NASA Technical Reports Server (NTRS)

Kane, T. R.; Likins, P. W.

1975-01-01

The solution of problems of attitude dynamics of spacecraft and the influence of gravitational forces and moments is examined. Arguments are presented based on Newton's law of gravitation, and employing the methods of Newtonian (vectorial) mechanics, with minimal recourse to the classical concepts of potential theory. The necessary ideas were developed and relationships were established to permit the representation of gravitational forces and moments exerted on bodies in space by other bodies, both in terms involving the mass distribution properties of the bodies, and in terms of vector operations on those scalar functions classically described as gravitational potential functions.

Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

NASA Technical Reports Server (NTRS)

Taddeo, Terrance

2012-01-01

Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

Self-Averaging Property of Minimal Investment Risk of Mean-Variance Model

PubMed Central

Shinzato, Takashi

2015-01-01

In portfolio optimization problems, the minimum expected investment risk is not always smaller than the expected minimal investment risk. That is, using a well-known approach from operations research, it is possible to derive a strategy that minimizes the expected investment risk, but this strategy does not always result in the best rate of return on assets. Prior to making investment decisions, it is important to an investor to know the potential minimal investment risk (or the expected minimal investment risk) and to determine the strategy that will maximize the return on assets. We use the self-averaging property to analyze the potential minimal investment risk and the concentrated investment level for the strategy that gives the best rate of return. We compare the results from our method with the results obtained by the operations research approach and with those obtained by a numerical simulation using the optimal portfolio. The results of our method and the numerical simulation are in agreement, but they differ from that of the operations research approach. PMID:26225761

E&P forum land transport safety management guidelines

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

Barber, S.; Carouso, M.; Covil, M.

1996-11-01

Against a general background of falling lost time injuries the member of serious incidents and fatalities in the upstream E&P industry involving motor vehicles employed in land transport remains stubbornly high. In consequence the E&P Forum has prepared guidelines to provide the E&P industry with clear guidance and a shared aim in minimizing vehicle incidents and their costs. Logistics and land transport are multifunctional activities involving personnel throughout the E&P industry. All those involved in land transport share a joint commitment to amazing land transport risks in their operation and to preventing incidents and fatalities as stated in their HSEmore » policies. Historically management`s focus has been on those activities which have a higher perceived risk. This attention has resulted in significant reductions in the number of accidents in these areas. The management of land transport safety requires the same approach and the same proactive emphasis as the management of other HSE risks within the business activity. Companies should have in place a management system for land transport operations based on a full and careful appraisal of the risks, followed by a clear management strategy to minimis and control those risks to a level as low as reasonably practicable.« less

The cost of conversion in robotic and laparoscopic colorectal surgery.

PubMed

Cleary, Robert K; Mullard, Andrew J; Ferraro, Jane; Regenbogen, Scott E

2018-03-01

Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015. We evaluated colorectal resections initiated with open and minimally invasive approaches, and compared reported risk-adjusted and price-standardized 30-day episode payments and their components. We identified 1061 open, 1604 laparoscopic, and 275 robotic colorectal resections. Adjusted episode payments were significantly higher for open operations than for minimally invasive procedures completed without conversion ($19,489 vs. $15,518, p < 0.001). The conversion rate was significantly higher with laparoscopic than robotic operations (15.1 vs. 7.6%, p < 0.001). Adjusted episode payments for minimally invasive operations converted to open were significantly higher than for those completed by minimally invasive approaches ($18,098 vs. $15,518, p < 0.001). Payments for operations completed robotically were greater than those completed laparoscopically ($16,949 vs. $15,250, p < 0.001), but the difference was substantially decreased when conversion to open cases was included ($16,939 vs. $15,699, p = 0.041). Episode payments for open colorectal surgery exceed both laparoscopic and robotic minimally invasive options. Conversion to open surgery significantly increases the payments associated with minimally invasive colorectal surgery. Because conversion rates in robotic colorectal operations are half of those in laparoscopy, the excess expenditures attributable to robotics are attenuated by consideration of the cost of conversions.

Primary benign brachial plexus tumors: an experience of 115 operated cases.

PubMed

Desai, Ketan I

2012-01-01

Primary benign brachial plexus tumors are rare. They pose a great challenge to the neurosurgeon, because the majority of patients present with minimal or no neurological deficits. Radical to complete excision of the tumor with preservation of neurological function of the involved nerve is an ideal surgical treatment option with benign primary brachial plexus tumor surgery. We present a review article of our 10-year experience with primary benign brachial plexus tumors surgically treated at King Edward Memorial Hospital and P.D. Hinduja National Hospital from 2000 to 2009. The clinical presentations, radiological features, surgical strategies, and the eventual outcome following surgery are analyzed, discussed, and compared with available series in the world literature. Various difficulties and problems faced in the management of primary benign brachial plexus tumors are analyzed. Irrespective of the tumor size, the indications for surgical intervention are also discussed. The goal of our study was to optimize the treatment of patients with benign brachial plexus tumors with minimal neurological deficits. It is of paramount importance that brachial plexus tumors be managed by a peripheral nerve surgeon with expertise and experience in this field to minimize the neurological insult following surgery.

40 CFR 63.11085 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Distribution Bulk Terminals, Bulk Plants, and Pipeline Facilities Emission Limitations and Management Practices... control practices for minimizing emissions. Determination of whether such operation and maintenance... operation and maintenance records, and inspection of the source. (b) You must keep applicable records and...

40 CFR 63.11085 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Distribution Bulk Terminals, Bulk Plants, and Pipeline Facilities Emission Limitations and Management Practices... control practices for minimizing emissions. Determination of whether such operation and maintenance... operation and maintenance records, and inspection of the source. (b) You must keep applicable records and...

40 CFR 63.11085 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Distribution Bulk Terminals, Bulk Plants, and Pipeline Facilities Emission Limitations and Management Practices... control practices for minimizing emissions. Determination of whether such operation and maintenance... operation and maintenance records, and inspection of the source. (b) You must keep applicable records and...

A technical case report on use of tubular retractors for anterior cervical spine surgery.

PubMed

Kulkarni, Arvind G; Patel, Ankit; Ankith, N V

2017-12-19

The authors put-forth this technical report to establish the feasibility of performing an anterior cervical corpectomy and fusion (ACCF) and a two-level anterior cervical discectomy and fusion (ACDF) using a minimally invasive approach with tubular retractors. First case: cervical spondylotic myelopathy secondary to a large postero-inferiorly migrated disc treated with corpectomy and reconstruction with a mesh cage and locking plate. Second case: cervical disc herniation with radiculopathy treated with a two-level ACDF. Both cases were operated with minimally invasive approach with tubular retractor using a single incision. Technical aspects and clinical outcomes have been reported. No intra or post-operative complications were encountered. Intra-operative blood loss was negligible. The patients had a cosmetic scar on healing. Standard procedure of placement of tubular retractors is sufficient for adequate surgical exposure with minimal invasiveness. Minimally invasive approach to anterior cervical spine with tubular retractors is feasible. This is the first report on use of minimally invasive approach for ACCF and two-level ACDF.

Periodic Application of Stochastic Cost Optimization Methodology to Achieve Remediation Objectives with Minimized Life Cycle Cost

NASA Astrophysics Data System (ADS)

Kim, U.; Parker, J.

2016-12-01

Many dense non-aqueous phase liquid (DNAPL) contaminated sites in the U.S. are reported as "remediation in progress" (RIP). However, the cost to complete (CTC) remediation at these sites is highly uncertain and in many cases, the current remediation plan may need to be modified or replaced to achieve remediation objectives. This study evaluates the effectiveness of iterative stochastic cost optimization that incorporates new field data for periodic parameter recalibration to incrementally reduce prediction uncertainty and implement remediation design modifications as needed to minimize the life cycle cost (i.e., CTC). This systematic approach, using the Stochastic Cost Optimization Toolkit (SCOToolkit), enables early identification and correction of problems to stay on track for completion while minimizing the expected (i.e., probability-weighted average) CTC. This study considers a hypothetical site involving multiple DNAPL sources in an unconfined aquifer using thermal treatment for source reduction and electron donor injection for dissolved plume control. The initial design is based on stochastic optimization using model parameters and their joint uncertainty based on calibration to site characterization data. The model is periodically recalibrated using new monitoring data and performance data for the operating remediation systems. Projected future performance using the current remediation plan is assessed and reoptimization of operational variables for the current system or consideration of alternative designs are considered depending on the assessment results. We compare remediation duration and cost for the stepwise re-optimization approach with single stage optimization as well as with a non-optimized design based on typical engineering practice.

Critical management practices influencing on-site waste minimization in construction projects.

PubMed

Ajayi, Saheed O; Oyedele, Lukumon O; Bilal, Muhammad; Akinade, Olugbenga O; Alaka, Hafiz A; Owolabi, Hakeem A

2017-01-01

As a result of increasing recognition of effective site management as the strategic approach for achieving the required performance in construction projects, this study seeks to identify the key site management practices that are requisite for construction waste minimization. A mixed methods approach, involving field study and survey research were used as means of data collection. After confirmation of construct validity and reliability of scale, data analysis was carried out through a combination of Kruskal-Wallis test, descriptive statistics and exploratory factor analysis. The study suggests that site management functions could significantly reduce waste generation through strict adherence to project drawings, and by ensuring fewer or no design changes during construction process. Provision of waste skips for specific materials and maximisation of on-site reuse of materials are also found to be among the key factors for engendering waste minimization. The result of factor analysis suggests four factors underlying on-site waste management practices with 96.093% of total variance. These measures include contractual provisions for waste minimization, waste segregation, maximisation of materials reuse and effective logistic management. Strategies through which each of the underlying measures could be achieved are further discussed in the paper. Findings of this study would assist construction site managers and other site operatives in reducing waste generated by construction activities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cavernous hemangioma--uncommon presentation in zygomatic bone.

PubMed

Dhupar, Vikas; Yadav, Sunil; Dhupar, Anita; Akkara, Francis

2012-03-01

Hemangiomas are benign vascular neoplasms characterized by an abnormal proliferation of blood vessels. They may occur in any vascularized tissue including skin, subcutaneous tissue, muscle, and bone. Intraosseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare and occurs most commonly in the maxilla, mandible, and nasal bones. In literature, only 20 cases of zygomatic involvement have been reported. We report a case of an intraosseous hemangioma of the zygoma with the history and physical findings of slowly growing, bony, hard tumor causing facial and ocular deformity. The typical clinicopathologic and radiologic findings helped to set up the correct diagnosis. Early recognition and excision are recommended to preserve facial contour. Operative blood loss is minimal, and there is no need for preoperative angiography.

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

PubMed

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

2016-02-01

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

Building a model for day case hiatal surgery - Lessons learnt over a 10 year period in a high volume unit: A case series.

PubMed

Mistry, Pritesh; Zaman, Shafquat; Shapey, Iestyn; Daskalakis, Markos; Nijjar, Rajwinder; Richardson, Martin; Super, Paul; Singhal, Rishi

2018-06-01

Laparoscopic anti-reflux surgery has become the standard treatment for symptomatic gastro-oesophageal reflux disease refractory to medical therapy. Successful anti-reflux surgery involves safe, minimally invasive surgery, resulting in symptom resolution with minimal side effects. This study aims to assess the feasibility and safety of day case anti-reflux surgery focussing on peri- and post-operative outcomes as a measure of success. Data was collected from the hospital database from 2003 to 2012. Data collection included demographics, surgeon, mode of admission, length of stay and complications. Electronic records were independently scrutinised for all patients with a length of stay of more than two nights. 723 patients underwent laparoscopic fundoplication ± small hiatus hernia repair (<5 cm) with a day case rate of 67.1%. The 30 day readmission rate in these patients was 2.9% (21/723 patients). Nine patients had a failure of their initial laparoscopic fundoplication (defined as recurrence of symptoms). Three patients required a re-operation within 12 months of their initial procedure (re-operation rate = 0.41% (3/723 patients)). Laparoscopic hiatal surgery can be performed safely as a day case in high volume specialist centres with good outcomes. Raising the national standard for day case fundoplication promotes good practice and should be the model for future commissioning. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Piezo-Operated Shutter Mechanism Moves 1.5 cm

NASA Technical Reports Server (NTRS)

Glaser, Robert; Bamford, Robert

2005-01-01

The figure shows parts of a shutter mechanism designed to satisfy a number of requirements specific to its original intended application as a component of an atomic clock to be flown in outer space. The mechanism may also be suitable for use in laboratory and industrial vacuum systems on Earth for which there are similar requirements. The requirements include the following: a) To alternately close, then open, a 1.5-cm-diameter optical aperture twice per second, with a stroke time of no more than 15 ms, during a total operational lifetime of at least a year; b) To attenuate light by a factor of at least 1012 when in the closed position; c) To generate little or no magnetic field; d) To be capable of withstanding bakeout at a temperature of 200 C to minimize outgassing during subsequent operation in an ultrahigh vacuum; and e) To fit within a diameter of 12 in. (=305 mm) a size limit dictated by the size of an associated magnetic shield. The light-attenuation requirement is satisfied by use of overlapping shutter blades. The closure of the aperture involves, among other things, insertion of a single shutter blade between a pair of shutter blades. The requirement to minimize the magnetic field is satisfied by use of piezoelectric actuators. Because piezoelectric actuators cannot withstand bakeout, they must be mounted outside the vacuum chamber, and, hence, motion must be transmitted from the actuators to the shutter levers via a vacuum-chamber-wall diaphragm.

Typical Toddlers' Participation in “Just-in-Time” Programming of Vocabulary for Visual Scene Display Augmentative and Alternative Communication Apps on Mobile Technology: A Descriptive Study

PubMed Central

Drager, Kathryn; Light, Janice; Caron, Jessica Gosnell

2017-01-01

Purpose Augmentative and alternative communication (AAC) promotes communicative participation and language development for young children with complex communication needs. However, the motor, linguistic, and cognitive demands of many AAC technologies restrict young children's operational use of and influence over these technologies. The purpose of the current study is to better understand young children's participation in programming vocabulary “just in time” on an AAC application with minimized demands. Method A descriptive study was implemented to highlight the participation of 10 typically developing toddlers (M age: 16 months, range: 10–22 months) in just-in-time vocabulary programming in an AAC app with visual scene displays. Results All 10 toddlers participated in some capacity in adding new visual scene displays and vocabulary to the app just in time. Differences in participation across steps were observed, suggesting variation in the developmental demands of controls involved in vocabulary programming. Conclusions Results from the current study provide clinical insights toward involving young children in AAC programming just in time and steps that may allow for more independent participation or require more scaffolding. Technology designed to minimize motor, cognitive, and linguistic demands may allow children to participate in programming devices at a younger age. PMID:28586825

Typical Toddlers' Participation in "Just-in-Time" Programming of Vocabulary for Visual Scene Display Augmentative and Alternative Communication Apps on Mobile Technology: A Descriptive Study.

PubMed

Holyfield, Christine; Drager, Kathryn; Light, Janice; Caron, Jessica Gosnell

2017-08-15

Augmentative and alternative communication (AAC) promotes communicative participation and language development for young children with complex communication needs. However, the motor, linguistic, and cognitive demands of many AAC technologies restrict young children's operational use of and influence over these technologies. The purpose of the current study is to better understand young children's participation in programming vocabulary "just in time" on an AAC application with minimized demands. A descriptive study was implemented to highlight the participation of 10 typically developing toddlers (M age: 16 months, range: 10-22 months) in just-in-time vocabulary programming in an AAC app with visual scene displays. All 10 toddlers participated in some capacity in adding new visual scene displays and vocabulary to the app just in time. Differences in participation across steps were observed, suggesting variation in the developmental demands of controls involved in vocabulary programming. Results from the current study provide clinical insights toward involving young children in AAC programming just in time and steps that may allow for more independent participation or require more scaffolding. Technology designed to minimize motor, cognitive, and linguistic demands may allow children to participate in programming devices at a younger age.

Interaction in planning vocalizations and grasping.

PubMed

Tiainen, Mikko; Tiippana, Kaisa; Vainio, Martti; Komeilipoor, Naeem; Vainio, Lari

2017-08-01

Previous studies have shown a congruency effect between manual grasping and syllable articulation. For instance, a power grip is associated with syllables whose articulation involves the tongue body and/or large mouth aperture ([kɑ]) whereas a precision grip is associated with articulations that involve the tongue tip and/or small mouth aperture ([ti]). Previously, this effect has been observed in manual reaction times. The primary aim of the current study was to investigate whether this congruency effect also takes place in vocal responses and to investigate involvement of action selection processes in the effect. The congruency effect was found in vocal and manual responses regardless of whether or not the syllable or grip was known a priori, suggesting that the effect operates with minimal or absent action selection processes. In addition, the effect was observed in vocal responses even when the grip was only prepared but not performed, suggesting that merely planning a grip response primes the corresponding articulatory response. These results support the view that articulation and grasping are processed in a partially overlapping network.

Preliminary analysis of the benefits derived to US Air Force spacecraft from on-orbit refueling

NASA Astrophysics Data System (ADS)

Smith, Scott

1993-02-01

This analysis was undertaken during FY-91 as a preliminary step to identify potential benefits from refueling Air Force satellites on orbit. Both economic and operational benefits were included. Operational benefits were related in economic terms to allow evaluation. All economic comparisons were made using FY-91 costs. An additional purpose of the effort was to identify the preferred mission parameters, for an on-orbit refueling system. A companion study was being concurrently conducted by SSD/XRP and NASA/JPL to develop a hardware concept for an on-orbit refueling system. The mass estimates for refueling missions obtained from the companion study were used in conducting the economic analyses of this benefits study. For this study, on-orbit refueling was based on the concept developed in the companion JPL study. The concept involves launching an S/C carrying fuel that would be transferred to another 'target' S/C which is already in orbit. The two S/C would then rendezvous, dock, and transfer fuel. Another fluid, such as a cryogenic, might be included if needed by the target S/C. The hardware concept for refueling was intended to minimize costs. The re-fueler S/C was designated to be expendable and would contain only the minimal capabilities. It would be launched into the orbit plane and altitude of the target S/C(s). The re-fueler S/C would rendezvous and dock with the target S/C and the fluid transfer would occur. When the refueling mission was completed, the re-fueler S/C would be ejected from the orbit. In order to optimize launch costs, some missions involved launching two re-fueler S/C on the LV. In this case the second re-fueler S/C would be placed in a storage orbit until needed.

Preliminary analysis of the benefits derived to US Air Force spacecraft from on-orbit refueling

NASA Technical Reports Server (NTRS)

Smith, Scott

1993-01-01

This analysis was undertaken during FY-91 as a preliminary step to identify potential benefits from refueling Air Force satellites on orbit. Both economic and operational benefits were included. Operational benefits were related in economic terms to allow evaluation. All economic comparisons were made using FY-91 costs. An additional purpose of the effort was to identify the preferred mission parameters, for an on-orbit refueling system. A companion study was being concurrently conducted by SSD/XRP and NASA/JPL to develop a hardware concept for an on-orbit refueling system. The mass estimates for refueling missions obtained from the companion study were used in conducting the economic analyses of this benefits study. For this study, on-orbit refueling was based on the concept developed in the companion JPL study. The concept involves launching an S/C carrying fuel that would be transferred to another 'target' S/C which is already in orbit. The two S/C would then rendezvous, dock, and transfer fuel. Another fluid, such as a cryogenic, might be included if needed by the target S/C. The hardware concept for refueling was intended to minimize costs. The re-fueler S/C was designated to be expendable and would contain only the minimal capabilities. It would be launched into the orbit plane and altitude of the target S/C(s). The re-fueler S/C would rendezvous and dock with the target S/C and the fluid transfer would occur. When the refueling mission was completed, the re-fueler S/C would be ejected from the orbit. In order to optimize launch costs, some missions involved launching two re-fueler S/C on the LV. In this case the second re-fueler S/C would be placed in a storage orbit until needed.

40 CFR 26.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... kinds of research involving no more than minimal risk, and for minor changes in approved research. 26.110 Section 26.110 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF... risk, and for minor changes in approved research. (a) The Secretary, HHS, has established, and...

40 CFR 63.543 - What are my standards for process vents?

Code of Federal Regulations, 2014 CFR

2014-07-01

... develop and follow standard operating procedures designed to minimize emissions of total hydrocarbon for... manufacturer's recommended procedures, if available, and the standard operating procedures designed to minimize... 40 Protection of Environment 10 2014-07-01 2014-07-01 false What are my standards for process...

77 FR 29749 - 74th Meeting: RTCA Special Committee 147, Minimal Operations Performance Standards for Traffic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-18

... 147, Minimal Operations Performance Standards for Traffic Alert and Collision Avoidance Systems... Traffic Alert and Collision Avoidance Systems Airborne Equipment. SUMMARY: The FAA is issuing this notice... Performance Standards for Traffic Alert and Collision Avoidance Systems Airborne Equipment. DATES: The meeting...

Fuel use control in the fishing industry. Final report

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

Billington, G.

1985-08-01

The project undertook fuel flow monitoring of a random sample of fishing vessels in the New Zealand fishing industry. The object of the project was to determine the value of fuel flow measurement on a range of vessels of differing size and fishing method, and to investigate the effect on fuel consumption of hull fouling and propeller repitching where this appeared to be required. Eight vessels in the port of Tauranga were included in the trials. Three of these are company-owned and operated and the remainder are owner-operated. One purse seiner, two longliners and five trawlers (pair and single) weremore » involved. Fuel flow measurements were carried out, with before-and-after tests on one vessel to determine the value of removing hull fouling. In two cases propeller repitching was undertaken. The tests demonstrated that five of the eight vessels could, through minor operational changes, make significant fuel conservation gains with minimal loss of performance.« less

Disease control operations

USGS Publications Warehouse

Friend, M.; Franson, J.C.

1999-01-01

Individual disease outbreaks have killed many thousands of animals on numerous occasions. Tens of thousands of migratory birds have died in single die-offs with as many as 1,000 birds succumbing in 1 day. The ability to successfully combat such explosive situations is highly dependent on the readiness of field personnel to deal with them. Because many disease agents can spread through wildlife populations very quickly, advance preparation is essential for preventing infected animals from spreading disease to additional species and locations. Carefully thought-out disease contingency plans should be developed as practical working documents for field personnel and updated as necessary. Well-designed plans can prove invaluable in minimizing wildlife losses and the costs associated with disease control activities.Although requirements for disease control operations vary and must be tailored to each situation, all disease contingency planning involves general concepts and basic biological information. This chapter, which is intended to be a practical guide, identifies the major activities and needs of disease control operations, and relates them to disease contingency planning.

The use of ECDIS equipment to achieve an optimum value for energy efficiency operation index

NASA Astrophysics Data System (ADS)

Acomi, N.; Acomi, O. C.; Stanca, C.

2015-11-01

To reduce air pollution produced by ships, the International Maritime Organization has developed a set of technical, operational and management measures. The subject of our research addresses the operational measures for minimizing CO2 air emissions and the way how the emission value could be influenced by external factors regardless of ship-owners’ will. This study aims to analyse the air emissions for a loaded voyage leg performed by an oil tanker. The formula that allows us to calculate the predicted Energy Efficiency Operational Index involves the estimation of distance and fuel consumption, while the quantity of cargo is known. The electronic chart display and information system, ECDIS Simulation Software, will be used for adjusting the passage plan in real time, given the predicted severe environmental conditions. The distance will be determined using ECDIS, while the prediction of the fuel consumption will consider the sea trial and the vessel experience records. That way it will be possible to compare the estimated EEOI value in the case of great circle navigation in adverse weather condition with the estimated EEOI value for weather navigation.

[Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

PubMed

Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

2015-08-01

To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (P<0.05). The occurrences of lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation in group A significantly decreased compared with group B (P<0.05). The operation time, integrity of extraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (P<0.05). High-speed handpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

Robot-assisted radical prostatectomy: a case series of the first 100 patients -constitutional introduction and implementation on the basis of comprehensive department of minimal invasive surgery center-

PubMed Central

2013-01-01

Background Although a very small number of Japanese hospitals had been performing robotic surgery before 2011, the number now using it is increasing rapidly due to the application of health insurance to robotic surgery for prostate cancer (PCa) since April, 2012. We report our initial experience of treating 100 patients by robot-assisted radical prostatectomy (RARP) with a focus on constitutional introduction and implementation based on minimal invasive surgery center (MISC) and patient outcomes. Methods The MISC involved all of the hospital sections related to robotic surgery including four surgery departments, anesthesiology, operating room nurses, medical engineers. The data were prospectively collected from the first 100 consecutive patients who underwent RARP under supervision of MISC for localized PCa from October 2010 to December 2012. Results During the period of our initial 100 cases of RARP, the gynecology, respiratory and digestive surgery departments performed initial cases of 20, 33 and 23 robotic surgeries under control of MISC. Peri-operative complications in RARP appeared to be minimal with no cases of intra-operative open conversion. The positive surgical margin rate was 19% for the entire series. At the median follow-up time of 11.9 months, 91% of patients had undetectable PSA levels, and 76% of patients were not using pads. Sequential urinary functional data indicated a significant beneficial effect on lower urinary tract symptoms beyond cancer control over a period of several months. Although the pre-operative potent patient number was small, the transitions of constant potency recovery at precise time points were shown according to different nerve sparing procedures. Conclusions This is the first report of an initial 100 RARP cases that were implemented using the constitutional framework of an academic institution. The MISC is providing immeasurable benefits from the aspects of patient safety and education for the robotic surgical team. RARP is a safe and efficient method for achieving PCa control together with functional preservation, even during the initial trial for this procedure. PMID:24171923

Robot-assisted radical prostatectomy: a case series of the first 100 patients--constitutional introduction and implementation on the basis of comprehensive department of minimal invasive surgery center.

PubMed

Sejima, Takehiro; Masago, Toshihiko; Morizane, Shuichi; Hikita, Katsuya; Kobayashi, Naoto; Yao, Akihisa; Muraoka, Kuniyasu; Honda, Masashi; Kitano, Hiroya; Takenaka, Atsushi

2013-10-30

Although a very small number of Japanese hospitals had been performing robotic surgery before 2011, the number now using it is increasing rapidly due to the application of health insurance to robotic surgery for prostate cancer (PCa) since April, 2012. We report our initial experience of treating 100 patients by robot-assisted radical prostatectomy (RARP) with a focus on constitutional introduction and implementation based on minimal invasive surgery center (MISC) and patient outcomes. The MISC involved all of the hospital sections related to robotic surgery including four surgery departments, anesthesiology, operating room nurses, medical engineers. The data were prospectively collected from the first 100 consecutive patients who underwent RARP under supervision of MISC for localized PCa from October 2010 to December 2012. During the period of our initial 100 cases of RARP, the gynecology, respiratory and digestive surgery departments performed initial cases of 20, 33 and 23 robotic surgeries under control of MISC. Peri-operative complications in RARP appeared to be minimal with no cases of intra-operative open conversion. The positive surgical margin rate was 19% for the entire series. At the median follow-up time of 11.9 months, 91% of patients had undetectable PSA levels, and 76% of patients were not using pads. Sequential urinary functional data indicated a significant beneficial effect on lower urinary tract symptoms beyond cancer control over a period of several months. Although the pre-operative potent patient number was small, the transitions of constant potency recovery at precise time points were shown according to different nerve sparing procedures. This is the first report of an initial 100 RARP cases that were implemented using the constitutional framework of an academic institution. The MISC is providing immeasurable benefits from the aspects of patient safety and education for the robotic surgical team. RARP is a safe and efficient method for achieving PCa control together with functional preservation, even during the initial trial for this procedure.

Forced evolution in silico by artificial transposons and their genetic operators: The ant navigation problem.

PubMed

Zamdborg, Leonid; Holloway, David M; Merelo, Juan J; Levchenko, Vladimir F; Spirov, Alexander V

2015-06-10

Modern evolutionary computation utilizes heuristic optimizations based upon concepts borrowed from the Darwinian theory of natural selection. Their demonstrated efficacy has reawakened an interest in other aspects of contemporary biology as an inspiration for new algorithms. However, amongst the many excellent candidates for study, contemporary models of biological macroevolution attract special attention. We believe that a vital direction in this field must be algorithms that model the activity of "genomic parasites", such as transposons, in biological evolution. Many evolutionary biologists posit that it is the co-evolution of populations with their genomic parasites that permits the high efficiency of evolutionary searches found in the living world. This publication is our first step in the direction of developing a minimal assortment of algorithms that simulate the role of genomic parasites. Specifically, we started in the domain of genetic algorithms (GA) and selected the Artificial Ant Problem as a test case. This navigation problem is widely known as a classical benchmark test and possesses a large body of literature. We add new objects to the standard toolkit of GA - artificial transposons and a collection of operators that operate on them. We define these artificial transposons as a fragment of an ant's code with properties that cause it to stand apart from the rest. The minimal set of operators for transposons is a transposon mutation operator, and a transposon reproduction operator that causes a transposon to multiply within the population of hosts. An analysis of the population dynamics of transposons within the course of ant evolution showed that transposons are involved in the processes of propagation and selection of blocks of ant navigation programs. During this time, the speed of evolutionary search increases significantly. We concluded that artificial transposons, analogous to real transposons, are truly capable of acting as intelligent mutators that adapt in response to an evolutionary problem in the course of co-evolution with their hosts.

Forced evolution in silico by artificial transposons and their genetic operators: The ant navigation problem

PubMed Central

Zamdborg, Leonid; Holloway, David M.; Merelo, Juan J.; Levchenko, Vladimir F.; Spirov, Alexander V.

2015-01-01

Modern evolutionary computation utilizes heuristic optimizations based upon concepts borrowed from the Darwinian theory of natural selection. Their demonstrated efficacy has reawakened an interest in other aspects of contemporary biology as an inspiration for new algorithms. However, amongst the many excellent candidates for study, contemporary models of biological macroevolution attract special attention. We believe that a vital direction in this field must be algorithms that model the activity of “genomic parasites”, such as transposons, in biological evolution. Many evolutionary biologists posit that it is the co-evolution of populations with their genomic parasites that permits the high efficiency of evolutionary searches found in the living world. This publication is our first step in the direction of developing a minimal assortment of algorithms that simulate the role of genomic parasites. Specifically, we started in the domain of genetic algorithms (GA) and selected the Artificial Ant Problem as a test case. This navigation problem is widely known as a classical benchmark test and possesses a large body of literature. We add new objects to the standard toolkit of GA - artificial transposons and a collection of operators that operate on them. We define these artificial transposons as a fragment of an ant's code with properties that cause it to stand apart from the rest. The minimal set of operators for transposons is a transposon mutation operator, and a transposon reproduction operator that causes a transposon to multiply within the population of hosts. An analysis of the population dynamics of transposons within the course of ant evolution showed that transposons are involved in the processes of propagation and selection of blocks of ant navigation programs. During this time, the speed of evolutionary search increases significantly. We concluded that artificial transposons, analogous to real transposons, are truly capable of acting as intelligent mutators that adapt in response to an evolutionary problem in the course of co-evolution with their hosts. PMID:25767296

Surgery scheduling optimization considering real life constraints and comprehensive operation cost of operating room.

PubMed

Xiang, Wei; Li, Chong

2015-01-01

Operating Room (OR) is the core sector in hospital expenditure, the operation management of which involves a complete three-stage surgery flow, multiple resources, prioritization of the various surgeries, and several real-life OR constraints. As such reasonable surgery scheduling is crucial to OR management. To optimize OR management and reduce operation cost, a short-term surgery scheduling problem is proposed and defined based on the survey of the OR operation in a typical hospital in China. The comprehensive operation cost is clearly defined considering both under-utilization and overutilization. A nested Ant Colony Optimization (nested-ACO) incorporated with several real-life OR constraints is proposed to solve such a combinatorial optimization problem. The 10-day manual surgery schedules from a hospital in China are compared with the optimized schedules solved by the nested-ACO. Comparison results show the advantage using the nested-ACO in several measurements: OR-related time, nurse-related time, variation in resources' working time, and the end time. The nested-ACO considering real-life operation constraints such as the difference between first and following case, surgeries priority, and fixed nurses in pre/post-operative stage is proposed to solve the surgery scheduling optimization problem. The results clearly show the benefit of using the nested-ACO in enhancing the OR management efficiency and minimizing the comprehensive overall operation cost.

Minimum Equipment Lists, Flight Rules and ... Past, Present and Future of Safety Pre-Determined Decisions for Operations

NASA Astrophysics Data System (ADS)

Herd, A.; Wolff, M.

2012-01-01

Extended mission operations, such as human spaceflight to Mars provide an opportunity for take current human exploration beyond Low Earth Orbit, such as the operations undertaken on the International Space Station (ISS). This opportunity also presents a challenge in terms of extending what we currently understand as "remote operations" performed on ISS, offering learning beyond that gained from the successful moon- lander expeditions. As such there is a need to assess how the existing operations concept of ground support teams directing (and supporting) on-orbit ISS operations can be applied in the extended mission concept. The current mission support concept involves three interacting operations products - a short term plan, crew procedures and flight rules. Flight rules (for ISS operations) currently provide overall planning, engineering and operations constraints (including those derived from a safety perspective) in the form of a rule book. This paper will focus specifically on flight rules, and describe the current use of them, and assess the future role of flight rules to support exploration, including the deployment of decision support tools (DSTs) to ensure flight rule compliancy for missions with minimal ground support. Taking consideration of the historical development of pre-planned decisions, and their manifestation within the operations environment, combined with the extended remoteness of human exploration missions, we will propose a future development of this product and a platform on which it could be presented.

Minimally invasive resection of large dumbbell tumors of the lumbar spine: Advantages and pitfalls.

PubMed

Zairi, Fahed; Troux, Camille; Sunna, Tarek; Karnoub, Mélodie-Anne; Boubez, Ghassan; Shedid, Daniel

2018-05-01

The surgical management of dumbbell tumors of the lumbar spine remains controversial, because of their large volume and complex location, involving both the spinal canal and the retro peritoneum. While sporadically reported, our study aims to confirm the value of minimally invasive posterior access for the complete resection of large lumbar dumbbell tumors. In this prospective study, we included all consecutive patients who underwent the resection of a voluminous dumbbell tumor at the lumbar spine through a minimally invasive approach, between March 2015 and August 2017. There were 4 men and 4 women, with a mean age at diagnosis of 40.6 years (range 29-58 years). The resection was performed through a trans muscular tubular retractor by the same surgical team. Operative parameters and initial postoperative course were systematically reported. Clinical and radiological monitoring was scheduled at 3 months, 1 year and 2 years. The mean operative time was 144 min (range 58-300 minutes) and the mean estimated blood loss was 250 ml (range 100-500 ml). Gross total resection was achieved in all patients. No major complication was reported. The mean length of hospital stay was 3.1 days (range 2 to 6 days). Histological analysis confirmed the diagnosis of grade 1 schwannoma in all patients. The mean follow up period was 14.9 months (range 6 to 26 months), and 5 patients completed at least 1-year follow-up. At 6 months the Macnab was excellent in 6 patients, good in one patient and fair in one patient because of residual neuropathic pain requiring the maintenance of a long-term treatment. No tumor recurrence was noted to date. Lumbar dumbbell tumors can be safely and completely resected using a single-stage minimally invasive procedure, in a trained team. Copyright © 2018 Elsevier B.V. All rights reserved.

Enzymatically modified isoquercitrin supplementation intensifies plantaris muscle fiber hypertrophy in functionally overloaded mice.

PubMed

Kohara, Akiko; Machida, Masanao; Setoguchi, Yuko; Ito, Ryouichi; Sugitani, Masanori; Maruki-Uchida, Hiroko; Inagaki, Hiroyuki; Ito, Tatsuhiko; Omi, Naomi; Takemasa, Tohru

2017-01-01

Enzymatically modified isoquercitrin (EMIQ) is produced from rutin using enzymatic hydrolysis followed by treatment with glycosyltransferase in the presence of dextrin to add glucose residues. EMIQ is absorbed in the same way as quercetin, a powerful antioxidant reported to prevent disused muscle atrophy by targeting mitochondria and to have ergogenic effects. The present study investigated the effect of EMIQ on skeletal muscle hypertrophy induced by functional overload. In Study 1, 6-week-old ICR male mice were divided into 4 groups: sham-operated control, sham-operated EMIQ, overload-operated control, and overload-operated EMIQ groups. In Study 2, mice were divided into 3 groups: overload-operated whey control, overload-operated whey/EMIQ (low dose), and overload-operated whey/EMIQ (high dose) groups. The functional overload of the plantaris muscle was induced by ablation of the synergist (gastrocnemius and soleus) muscles. EMIQ and whey protein were administered with food. Three weeks after the operation, the cross-sectional area and minimal fiber diameter of the plantaris muscle fibers were measured. In Study 1, functional overload increased the cross-sectional area and minimal fiber diameter of the plantaris muscle. EMIQ supplementation significantly increased the cross-sectional area and minimal fiber diameter of the plantaris muscle in both the sham-operated and overload-operated groups. In Study 2, EMIQ supplementation combined with whey protein administration significantly increased the cross-sectional area and minimal fiber diameter of the plantaris muscle. EMIQ, even when administered as an addition to whey protein supplementation, significantly intensified the fiber hypertrophy of the plantaris muscle in functionally overloaded mice. EMIQ supplementation also induced fiber hypertrophy of the plantaris in sham-operated mice.

Vehicle routing problem with time windows using natural inspired algorithms

NASA Astrophysics Data System (ADS)

Pratiwi, A. B.; Pratama, A.; Sa’diyah, I.; Suprajitno, H.

2018-03-01

Process of distribution of goods needs a strategy to make the total cost spent for operational activities minimized. But there are several constrains have to be satisfied which are the capacity of the vehicles and the service time of the customers. This Vehicle Routing Problem with Time Windows (VRPTW) gives complex constrains problem. This paper proposes natural inspired algorithms for dealing with constrains of VRPTW which involves Bat Algorithm and Cat Swarm Optimization. Bat Algorithm is being hybrid with Simulated Annealing, the worst solution of Bat Algorithm is replaced by the solution from Simulated Annealing. Algorithm which is based on behavior of cats, Cat Swarm Optimization, is improved using Crow Search Algorithm to make simplier and faster convergence. From the computational result, these algorithms give good performances in finding the minimized total distance. Higher number of population causes better computational performance. The improved Cat Swarm Optimization with Crow Search gives better performance than the hybridization of Bat Algorithm and Simulated Annealing in dealing with big data.

Short communication: The water footprint of dairy products: case study involving skim milk powder.

PubMed

Ridoutt, B G; Williams, S R O; Baud, S; Fraval, S; Marks, N

2010-11-01

In the context of global water scarcity and food security concerns, water footprints are emerging as an important sustainability indicator in the agriculture and food sectors. Using a recently developed life cycle assessment-based methodology that takes into account local water stress where operations occur, the normalized water footprints of milk products from South Gippsland, one of Australia's major dairy regions, were 14.4 L/kg of total milk solids in whole milk (at farm gate) and 15.8 L/kg of total milk solids in skim milk powder (delivered to export destination). These results demonstrate that dairy products can be produced with minimal potential to contribute to freshwater scarcity. However, not all dairy production systems are alike and the variability in water footprints between systems and products should be explored to obtain strategic insights that will enable the dairy sector to minimize its burden on freshwater systems from consumptive water use. Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Laparoscopic nephroureterectomy: making management of upper-tract transitional-cell carcinoma entirely minimally invasive.

PubMed

Keeley, F X; Tolley, D A

1998-04-01

Endoscopic treatment of upper-tract transitional-cell carcinoma (TCC) is well established. Nevertheless, many patients still required major ablative surgery. We have applied our experience with laparoscopic nephrectomy to the performance of laparoscopic nephroureterectomy in order to make the management of upper-tract TCC entirely minimally invasive. Since 1993, we have performed 22 laparoscopic nephroureterectomies for upper-tract TCC. Initially, we excluded patients with tumors below the pelvic brim, but we now offer a trial of laparoscopy to all patients. We describe the evolution of our technique, which involves resecting the ureteral orifice prior to laparoscopic dissection of the kidney and ureter. We have had to convert three cases to open surgery, one each for bleeding, failure to progress, and unappreciated tumor extent. Operative times averaged 156 minutes, which compares well with contemporary times for open nephroureterectomy. Complication rates, transfusion requirements, and length of stay, although higher than those of laparoscopic nephrectomy, were all reduced in comparison with open nephroureterectomy.

Initial brazilian experience in the treatment of localized prostate cancer using a new generation cryotechnology: feasibility study.

PubMed

Kim, Fernando J; Cerqueira, Michael A; Almeida, Jose C; Pompeo, Alexandre; Sehrt, David; Calheiros, Jose M; Martins, Fernando A; Molina, Wilson R

2012-01-01

The objective of our study is to present the first Brazilian cryoablation experience in the treatment of low and intermediate risk localized prostate cancer using 3rd generation cryoablation and real-time biplanar transrectal ultrasonography. Ten Brazilian patients underwent primary cryoablation for localized prostate cancer between October 2010 and June 2011. All patients consented for whole gland primary cryotherapy. The procedures were performed by 3rd generation cryoablation with the Cryocare System ® (Endocare, Irvine, California). Preoperative data collection included patient demographics along with prostate gland size, Gleason score, serum prostate specific antigen, and erectile function status. Operative and post--operative assessment involved estimated blood loss, operative time, complications, serum PSA level, erectile function status, urinary incontinence, biochemical disease free survival (BDFS), and follow-up time. All patients in the study successfully underwent whole gland cryoablation. The mean of: age, prostate size, PSA level, and Gleason score, was 66.2 years old; 40.7 g; 7.8 ng/mL; and 6 respectively. All patients were classified as low or moderate D' Amico risk (5 low and 5 moderate). Erectile dysfunction was present in 50% of patients. The estimated blood loss was minimal, operative time was 46.1 minutes. All patients that developed erectile dysfunction post-treatment responded to oral or intracavernosal medications with early penile rehabilitation. All patients maintained urinary continence by the end of a 10 months evaluation period and none had biochemical relapse within the mean follow-up of 13 months (7-15 months). Our initial experience shows that cryoablation is a minimally invasive option for the treatment of localized prostate cancer. Short term data seems to be promising but longer follow-up is necessary to verify oncological and functional results.

Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX - RAdiation Dose study (RAD-MATRIX).

PubMed

Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

2014-06-01

Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes. Copyright © 2014 Elsevier Inc. All rights reserved.

The Liquid Nitrogen System for Chamber A: A Change from Original Forced Flow Design to a Natural Flow (Thermo Siphon) System

NASA Technical Reports Server (NTRS)

Homan, Jonathan; Montz, Michael; Sidi-Yekhlef, Ahmed; Ganni, Venkatarao (Rao); Knudsen, Peter; Garcia, Sam; Linza, Robert; Meagher, Daniel; Lauterbauch, John

2008-01-01

NASA Johnson Space Center (JSC) in Houston is currently supplementing its 20K helium refrigeration system to meet the new requirements for testing the James Web Space Telescope in the environmental control Chamber-A (65 dia x 120 high) in Building 32. The new system is required to meet the various operating modes which include a high 20K heat load, a required temperature stability at the load, rapid (but controlled) cool down and warm up and bake out of the chamber. This paper will present the proposed modifications to the existing helium system(s) to incorporate the new requirements and the integration of the new helium refrigerator with the existing two 3.5KW 20K helium refrigerators. In addition, the floating pressure process control philosophy to achieve high efficiency over the operating range (40% to 100% of the refrigeration system capacity), and the required temperature stability of +/- 0.25 K at the load will be discussed. The refrigeration systems ability to naturally seek the operating conditions under various loads and thus minimizing operator involvement and the over all improvements to the system operability and the reliability will be explained.

Coordinating plug-in electric vehicle charging with electric grid: Valley filling and target load following

NASA Astrophysics Data System (ADS)

Zhang, Li; Jabbari, Faryar; Brown, Tim; Samuelsen, Scott

2014-12-01

Plug-in electric vehicles (PEVs) shift energy consumption from petroleum to electricity for the personal transportation sector. This work proposes a decentralized charging protocol for PEVs with grid operators updating the cost signal. Each PEV calculates its own optimal charging profile only once based on the cost signal, after it is plugged in, and sends the result back to the grid operators. Grid operators only need to aggregate charging profiles and update the load and cost. The existing PEV characteristics, national household travel survey (NHTS), California Independent System Operator (CAISO) demand, and estimates for future renewable generation in California are used to simulate PEV operation, PEV charging profiles, grid demand, and grid net load (demand minus renewable). Results show the proposed protocol has good performance for overnight net load valley filling if the costs to be minimized are proportional to the net load. Annual results are shown in terms of overnight load variation and comparisons are made with grid level valley filling results. Further, a target load can be approached in the same manner by using the gap between current load and the target load as the cost. The communication effort involved is quite modest.

Safety illusion and error trap in a collectively-operated machine accident.

PubMed

de Almeida, Ildeberto Muniz; Nobre, Hildeberto; do Amaral Dias, Maria Dionísia; Vilela, Rodolfo Andrade Gouveia

2012-01-01

Workplace accidents involving machines are relevant for their magnitude and their impacts on worker health. Despite consolidated critical statements, explanation centered on errors of operators remains predominant with industry professionals, hampering preventive measures and the improvement of production-system reliability. Several initiatives were adopted by enforcement agencies in partnership with universities to stimulate production and diffusion of analysis methodologies with a systemic approach. Starting from one accident case that occurred with a worker who operated a brake-clutch type mechanical press, the article explores cognitive aspects and the existence of traps in the operation of this machine. It deals with a large-sized press that, despite being endowed with a light curtain in areas of access to the pressing zone, did not meet legal requirements. The safety devices gave rise to an illusion of safety, permitting activation of the machine when a worker was still found within the operational zone. Preventive interventions must stimulate the tailoring of systems to the characteristics of workers, minimizing the creation of traps and encouraging safety policies and practices that replace judgments of behaviors that participate in accidents by analyses of reasons that lead workers to act in that manner.

45 CFR 690.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 690.110 Section 690.110 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION...

45 CFR 690.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 690.110 Section 690.110 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION...

45 CFR 690.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 690.110 Section 690.110 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION...

38 CFR 16.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 16.110 Section 16.110 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS PROTECTION OF HUMAN SUBJECTS § 16.110 Expedited review procedures for certain kinds of research...

40 CFR 26.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-07-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... kinds of research involving no more than minimal risk, and for minor changes in approved research. 26... HUMAN SUBJECTS Basic EPA Policy for Protection of Subjects in Human Research Conducted or Supported by...

38 CFR 16.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-07-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 16.110 Section 16.110 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...

34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

Code of Federal Regulations, 2010 CFR

2010-07-01

... subject's disorder or condition. 97.406 Section 97.406 Education Office of the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Additional ED Protections for Children Who Are Subjects in Research... 34 Education 1 2010-07-01 2010-07-01 false Research involving greater than minimal risk and no...

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

PubMed

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

2015-01-01

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

Randomization in clinical trials: stratification or minimization? The HERMES free simulation software.

PubMed

Fron Chabouis, Hélène; Chabouis, Francis; Gillaizeau, Florence; Durieux, Pierre; Chatellier, Gilles; Ruse, N Dorin; Attal, Jean-Pierre

2014-01-01

Operative clinical trials are often small and open-label. Randomization is therefore very important. Stratification and minimization are two randomization options in such trials. The first aim of this study was to compare stratification and minimization in terms of predictability and balance in order to help investigators choose the most appropriate allocation method. Our second aim was to evaluate the influence of various parameters on the performance of these techniques. The created software generated patients according to chosen trial parameters (e.g., number of important prognostic factors, number of operators or centers, etc.) and computed predictability and balance indicators for several stratification and minimization methods over a given number of simulations. Block size and proportion of random allocations could be chosen. A reference trial was chosen (50 patients, 1 prognostic factor, and 2 operators) and eight other trials derived from this reference trial were modeled. Predictability and balance indicators were calculated from 10,000 simulations per trial. Minimization performed better with complex trials (e.g., smaller sample size, increasing number of prognostic factors, and operators); stratification imbalance increased when the number of strata increased. An inverse correlation between imbalance and predictability was observed. A compromise between predictability and imbalance still has to be found by the investigator but our software (HERMES) gives concrete reasons for choosing between stratification and minimization; it can be downloaded free of charge. This software will help investigators choose the appropriate randomization method in future two-arm trials.

Minimally invasive surgery. Future developments.

PubMed

Wickham, J E

1994-01-15

The rapid development of minimally invasive surgery means that there will be fundamental changes in interventional treatment. Technological advances will allow new minimally invasive procedures to be developed. Application of robotics will allow some procedures to be done automatically, and coupling of slave robotic instruments with virtual reality images will allow surgeons to perform operations by remote control. Miniature motors and instruments designed by microengineering could be introduced into body cavities to perform operations that are currently impossible. New materials will allow changes in instrument construction, such as use of memory metals to make heat activated scissors or forceps. With the reduced trauma associated with minimally invasive surgery, fewer operations will require long hospital stays. Traditional surgical wards will become largely redundant, and hospitals will need to cope with increased through-put of patients. Operating theatres will have to be equipped with complex high technology equipment, and hospital staff will need to be trained to manage it. Conventional nursing care will be carried out more in the community. Many traditional specialties will be merged, and surgical training will need fundamental revision to ensure that surgeons are competent to carry out the new procedures.

Ideas That Work! The Midnight Audit

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

Parker, Steven A.

The midnight audit provides valuable insight toward identifying opportunities to reduce energy consumption—insight that can be easily overlooked during the normal (daytime) energy auditing process. The purpose of the midnight audit is to observe after-hour operation with the mindset of seeking ways to further minimize energy consumption during the unoccupied mode and minimize energy waste by reducing unnecessary operation. The midnight audit should be used to verify that equipment is off when it is supposed to be, or operating in set-back mode when applicable. Even a facility that operates 2 shifts per day, 5 days per week experiences fewer annualmore » hours in occupied mode than it does during unoccupied mode. Minimizing energy loads during unoccupied hours can save significant energy, which is why the midnight audit is an Idea That Works.« less

Advances in Laparoscopic Colorectal Surgery.

PubMed

Parker, James Michael; Feldmann, Timothy F; Cologne, Kyle G

2017-06-01

Laparoscopic colorectal surgery has now become widely adopted for the treatment of colorectal neoplasia, with steady increases in utilization over the past 15 years. Common minimally invasive techniques include multiport laparoscopy, single-incision laparoscopy, and hand-assisted laparoscopy, with the choice of technique depending on several patient and surgeon factors. Laparoscopic colorectal surgery involves a robust learning curve, and fellowship training often lays the foundation for a high-volume laparoscopic practice. This article provides a summary of the various techniques for laparoscopic colorectal surgery, including operative steps, the approach to difficult patients, and the learning curve for proficiency. Copyright © 2017 Elsevier Inc. All rights reserved.

A laser technique for characterizing the geometry of plant canopies

NASA Technical Reports Server (NTRS)

Vanderbilt, V. C.; Silva, L. F.; Bauer, M. E.

1977-01-01

The interception of solar power by the canopy is investigated as a function of solar zenith angle (time), component of the canopy, and depth into the canopy. The projected foliage area, cumulative leaf area, and view factors within the canopy are examined as a function of the same parameters. Two systems are proposed that are capable of describing the geometrical aspects of a vegetative canopy and of operation in an automatic mode. Either system would provide sufficient data to yield a numerical map of the foliage area in the canopy. Both systems would involve the collection of large data sets in a short time period using minimal manpower.

Issues and Design Drivers for Deep Space Habitats

NASA Technical Reports Server (NTRS)

Rucker, Michelle A.; Anderson, Molly

2012-01-01

A cross-disciplinary team of scientists and engineers applied expertise gained in Lunar Lander development to the conceptual design of a long-duration, deep space habitat for Near Earth Asteroid (NEA) missions. The design reference mission involved two launches to assemble 5-modules for a 380-day round trip mission carrying 4 crew members. The conceptual design process yielded a number of interesting debates, some of which could be significant design drivers in a detailed Deep Space Habitat (DSH) design. These issues included: Design to minimize crew radiation exposure, launch loads, communications challenges, docking system and hatch commonality, pointing and visibility, consumables, and design for contingency operations.

Definition of air quality measurements for monitoring space shuttle launches

NASA Technical Reports Server (NTRS)

Thorpe, R. D.

1978-01-01

A description of a recommended air quality monitoring network to characterize the impact on ambient air quality in the Kennedy Space Center (KSC) (area) of space shuttle launch operations is given. Analysis of ground cloud processes and prevalent meteorological conditions indicates that transient HCl depositions can be a cause for concern. The system designed to monitor HCl employs an extensive network of inexpensive detectors combined with a central analysis device. An acid rain network is also recommended. A quantitative measure of projected minimal long-term impact involves the limited monitoring of NOx and particulates. All recommended monitoring is confined ti KSC property.

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

PubMed

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

2018-05-08

Embryonal tumors arise typically in infants and young children and are often massive at presentation. Operative resection is a cornerstone in the multimodal treatment of embryonal tumors but potentially disrupts therapeutic timelines. When used appropriately, minimally invasive surgery can minimize treatment delays. The oncologic integrity and safety attainable with minimally invasive resection of embryonal tumors, however, remains controversial. Query of the Vanderbilt Cancer Registry identified all children treated for intracavitary, embryonal tumors during a 15-year period. Tumors were assessed radiographically to measure volume (mL) and image-defined risk factors (neuroblastic tumors only) at time of diagnosis, and at preresection and postresection. Patient and tumor characteristics, perioperative details, and oncologic outcomes were compared between minimally invasive surgery and open resection of tumors of comparable size. A total of 202 patients were treated for 206 intracavitary embryonal tumors, of which 178 were resected either open (n = 152, 85%) or with minimally invasive surgery (n = 26, 15%). The 5-year, relapse-free, and overall survival were not significantly different after minimally invasive surgery or open resection of tumors having a volume less than 100 mL, corresponding to the largest resected with minimally invasive surgery (P = .249 and P = .124, respectively). No difference in margin status or lymph node sampling between the 2 operative approaches was detected (p = .333 and p = .070, respectively). Advantages associated with minimally invasive surgery were decreased blood loss (P < .001), decreased operating time (P = .002), and shorter hospital stay (P < .001). Characteristically, minimally invasive surgery was used for smaller volume and earlier stage neuroblastic tumors without image-defined risk factors. When selected appropriately, minimally invasive resection of pediatric embryonal tumors, particularly neuroblastic tumors, provides acceptable oncologic integrity. Large tumor volume, small patient size, and image-defined risk factors may limit the broader applicability of minimally invasive surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

Steady state method to determine unsaturated hydraulic conductivity at the ambient water potential

DOEpatents

HUbbell, Joel M.

2014-08-19

The present invention relates to a new laboratory apparatus for measuring the unsaturated hydraulic conductivity at a single water potential. One or more embodiments of the invented apparatus can be used over a wide range of water potential values within the tensiometric range, requires minimal laboratory preparation, and operates unattended for extended periods with minimal supervision. The present invention relates to a new laboratory apparatus for measuring the unsaturated hydraulic conductivity at a single water potential. One or more embodiments of the invented apparatus can be used over a wide range of water potential values within the tensiometric range, requires minimal laboratory preparation, and operates unattended for extended periods with minimal supervision.

DMN Operational Synchrony Relates to Self-Consciousness: Evidence from Patients in Vegetative and Minimally Conscious States.

PubMed

Fingelkurts, Andrew A; Fingelkurts, Alexander A; Bagnato, Sergio; Boccagni, Cristina; Galardi, Giuseppe

2012-01-01

The default mode network (DMN) has been consistently activated across a wide variety of self-related tasks, leading to a proposal of the DMN's role in self-related processing. Indeed, there is limited fMRI evidence that the functional connectivity within the DMN may underlie a phenomenon referred to as self-awareness. At the same time, none of the known studies have explicitly investigated neuronal functional interactions among brain areas that comprise the DMN as a function of self-consciousness loss. To fill this gap, EEG operational synchrony analysis [1, 2] was performed in patients with severe brain injuries in vegetative and minimally conscious states to study the strength of DMN operational synchrony as a function of self-consciousness expression. We demonstrated that the strength of DMN EEG operational synchrony was smallest or even absent in patients in vegetative state, intermediate in patients in minimally conscious state and highest in healthy fully self-conscious subjects. At the same time the process of ecoupling of operations performed by neuronal assemblies that comprise the DMN was highest in patients in vegetative state, intermediate in patients in minimally conscious state and minimal in healthy fully self-conscious subjects. The DMN's frontal EEG operational module had the strongest decrease in operational synchrony strength as a function of selfconsciousness loss, when compared with the DMN's posterior modules. Based on these results it is suggested that the strength of DMN functional connectivity could mediate the strength of self-consciousness expression. The observed alterations similarly occurred across EEG alpha, beta1 and beta2 frequency oscillations. Presented results suggest that the EEG operational synchrony within DMN may provide an objective and accurate measure for the assessment of signs of self-(un)consciousness in these challenging patient populations. This method therefore, may complement the current diagnostic procedures for patients with severe brain injuries and, hence, the planning of a rational rehabilitation intervention.

DMN Operational Synchrony Relates to Self-Consciousness: Evidence from Patients in Vegetative and Minimally Conscious States

PubMed Central

Fingelkurts, Andrew A; Fingelkurts, Alexander A; Bagnato, Sergio; Boccagni, Cristina; Galardi, Giuseppe

2012-01-01

The default mode network (DMN) has been consistently activated across a wide variety of self-related tasks, leading to a proposal of the DMN’s role in self-related processing. Indeed, there is limited fMRI evidence that the functional connectivity within the DMN may underlie a phenomenon referred to as self-awareness. At the same time, none of the known studies have explicitly investigated neuronal functional interactions among brain areas that comprise the DMN as a function of self-consciousness loss. To fill this gap, EEG operational synchrony analysis [1, 2] was performed in patients with severe brain injuries in vegetative and minimally conscious states to study the strength of DMN operational synchrony as a function of self-consciousness expression. We demonstrated that the strength of DMN EEG operational synchrony was smallest or even absent in patients in vegetative state, intermediate in patients in minimally conscious state and highest in healthy fully self-conscious subjects. At the same time the process of ecoupling of operations performed by neuronal assemblies that comprise the DMN was highest in patients in vegetative state, intermediate in patients in minimally conscious state and minimal in healthy fully self-conscious subjects. The DMN’s frontal EEG operational module had the strongest decrease in operational synchrony strength as a function of selfconsciousness loss, when compared with the DMN’s posterior modules. Based on these results it is suggested that the strength of DMN functional connectivity could mediate the strength of self-consciousness expression. The observed alterations similarly occurred across EEG alpha, beta1 and beta2 frequency oscillations. Presented results suggest that the EEG operational synchrony within DMN may provide an objective and accurate measure for the assessment of signs of self-(un)consciousness in these challenging patient populations. This method therefore, may complement the current diagnostic procedures for patients with severe brain injuries and, hence, the planning of a rational rehabilitation intervention. PMID:22905075

Methods of Collecting and Analyzing Rearward Visibility Data for Agricultural Machinery: Hazard and/or Object Detectability.

PubMed

Ehlers, Shawn G; Field, William E; Ess, Daniel R

2017-01-26

Recent interest in rearward visibility for private, construction, and commercial vehicles and documentation of rearward runovers involving bystanders outside the field of vision of the vehicle operator led to an investigation into the need for enhanced methods of rearward visibility for large, off-highway, agricultural equipment. A review of the literature found limited relevant research and minimal data on incidents involving rearward runovers of bystanders and co-workers. This article reviews the findings regarding the methods identified and tested to collect and analyze rearward visibility data, from the operator's perspective, for large self-propelled agricultural equipment, including the four-wheel drive tractors, combines, agricultural sprayers, and skid-steer loaders that are increasingly found on agricultural production sites. The methods identified, largely drawn from research conducted on private and commercial vehicles, were tested to determine their application in identifying rearward blind spots. These methods are described, and the findings from field-testing of specific machines are provided. Recommendations include establishing an appropriate engineering standard regarding rearward visibility of agricultural equipment with limited rearward vision and the use of rearward alarm systems for warning bystanders of rearward movement. Copyright© by the American Society of Agricultural Engineers.

A Compact VLSI System for Bio-Inspired Visual Motion Estimation.

PubMed

Shi, Cong; Luo, Gang

2018-04-01

This paper proposes a bio-inspired visual motion estimation algorithm based on motion energy, along with its compact very-large-scale integration (VLSI) architecture using low-cost embedded systems. The algorithm mimics motion perception functions of retina, V1, and MT neurons in a primate visual system. It involves operations of ternary edge extraction, spatiotemporal filtering, motion energy extraction, and velocity integration. Moreover, we propose the concept of confidence map to indicate the reliability of estimation results on each probing location. Our algorithm involves only additions and multiplications during runtime, which is suitable for low-cost hardware implementation. The proposed VLSI architecture employs multiple (frame, pixel, and operation) levels of pipeline and massively parallel processing arrays to boost the system performance. The array unit circuits are optimized to minimize hardware resource consumption. We have prototyped the proposed architecture on a low-cost field-programmable gate array platform (Zynq 7020) running at 53-MHz clock frequency. It achieved 30-frame/s real-time performance for velocity estimation on 160 × 120 probing locations. A comprehensive evaluation experiment showed that the estimated velocity by our prototype has relatively small errors (average endpoint error < 0.5 pixel and angular error < 10°) for most motion cases.

Modelling of microalgal growth and lipid production in Dunaliella tertiolecta using nitrogen-phosphorus-potassium fertilizer medium in sintered disk chromatographic glass bubble column.

PubMed

Kumar, Anup; Guria, Chandan; Chitres, G; Chakraborty, Arunangshu; Pathak, A K

2016-10-01

A comprehensive mathematical model involving NPK-10:26:26 fertilizer, NaCl, NaHCO3, light and temperature operating variables for Dunaliella tertiolecta cultivation is formulated to predict microalgae-biomass and lipid productivity. Proposed model includes Monod/Andrews kinetics for the absorption of essential nutrients into algae-biomass and Droop model involving internal nutrient cell quota for microalgae growth, assuming algae-biomass is composed of sugar, functional-pool and neutral-lipid. Biokinetic model parameters are determined by minimizing the residual-sum-of-square-errors between experimental and computed microalgae-biomass and lipid productivity using genetic algorithm. Developed model is validated with the experiments of Dunaliella tertiolecta cultivation using air-agitated sintered-disk chromatographic glass-bubble column and the effects of operating variables on microalgae-biomass and lipid productivity is investigated. Finally, parametric sensitivity analysis is carried out to know the sensitivity of model parameters on the obtained results in the input parameter space. Proposed model may be helpful in scale-up studies and implementation of model-based control strategy in large-scale algal cultivation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Novel low-risk commercial sex practices in the parks of Vietnam.

PubMed

Walters, I

2003-06-01

This is a paper about a novel form of commercial sex practice recorded in Vietnam, and its implications for HIV/AIDS prevention strategies. Female commercial sex workers occupy urban parks in the evenings, offering on-site masturbation services to clients at cheap prices even by local standards. All sex acts are performed in public by workers who sit on benches, path edges or stools,often behind bicycles or open umbrellas in the quest for some semblance of privacy. Clients are local men, with only an occasional foreigner involved Many sex workers were involved, some having 15 to 20 or more clients a night. Sex workers and clients in Vietnam, a s elsewhere, operate at high risk of HIV/AIDS infection. As a service which minimizes risks, this form of commercial sex practice should perhaps be given serious consideration by policy makers and authorities for formal deployment in the fight against AIDS.

Challenges and benefits of conducting environmental justice research in a school setting.

PubMed

Guidry, Virginia T; Lowman, Amy; Hall, Devon; Baron, Dothula; Wing, Steve

2014-01-01

Environmental justice (EJ) research requires attention to consequences for research participants beyond those typically considered by institutional review boards. The imbalance of power between impacted communities and those who create and regulate pollution creates challenges for participation, yet research can also benefit those involved. Our community-academic partnership designed the Rural Air Pollutants and Children's Health (RAPCH) study to provide positive impacts while measuring health effects at three low-resource public middle schools near concentrated animal feeding operations (CAFOs) in North Carolina. We evaluated perceived benefits and challenges of study involvement by interviewing school staff and community liaisons who facilitated data collection. Reported benefits included enhancement of students' academic environment and increased community environmental awareness; challenges were associated mainly with some participants' immaturity. Leadership from a strong community-based organization was crucial to recruitment, yet our approach entailed minimal focus on EJ, which may have limited opportunities for community education or organizing for environmental health.

Chronic fibrosing pulmonary aspergillosis: a cause of 'destroyed lung' syndrome.

PubMed

Kosmidis, Chris; Newton, Pippa; Muldoon, Eavan G; Denning, David W

2017-04-01

Chronic pulmonary aspergillosis (CPA) has substantial impact on quality of life. A subset of patients develops significant pulmonary fibrosis, identified either on biopsy or radiologically. The term chronic fibrosing pulmonary aspergillosis (CFPA) has been suggested. We describe 11 patients with CFPA referred to our centre. Mean age was 58.5 years and five were male. In nine, fibrosis was already evident on presentation, while in two it developed 3 and 6 years later. The predominant radiological feature was extensive or complete involvement of the entire lung, with minimal contralateral involvement. All patients received prolonged antifungal treatment. Two patients had surgical treatment; both developed post-operative complications. The contralateral lung remained free of significant disease in all but three patients. CFPA is a rare complication of CPA that is usually evident on presentation, but may develop after years in patients not on antifungals. Fibrosis resembles the 'destroyed lung' syndrome described after treated tuberculosis.

[MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM].

PubMed

Xu, Bing; Liu, Wenying

2015-04-01

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

An active constraint environment for minimally invasive heart surgery: early experience of a cutting operation.

PubMed

Borelli, Joao; Bello, Fernando; Rodriguez Y Bena, Ferdinando; Davies, Brian

2004-01-01

Master/slave telemanipulator systems can be applied in minimally invasive heart surgery. However, due to the beating heart and difficulties of finding inner points inside the heart, a surgical task operation such as cutting can be very difficult. In order to avoid surgical error, the "active constraint" concept can be applied. This paper shows an example of an "active constraint" environment used for minimally invasive heart surgery. Experiments have been carried out for a 2-DOF master and the preliminary results validate the present approach.

Can we always ignore ship-generated food waste?

PubMed

Polglaze, John

2003-01-01

Considerable quantities of food waste can be generated at a rapid rate in ships, particularly those with large numbers of people onboard. By virtue of the amounts involved and its nature, food waste is potentially the most difficult to manage component of a ship's garbage stream, however, in most sea areas it may be dealt with by the simple expedient of direct discharge to sea. As a consequence, only minimal attention is paid to food waste management by many ship and port operators and advisory bodies, and there is a paucity of information in the available literature. The determination that management of ships' food waste is inconsequential is, however, incorrect in many circumstances. Disposal to sea is not always possible due to restrictions imposed by MARPOL 73/78 and other marine pollution control instruments. Effective management of food waste can be critical for ships that operate in areas where disposal is restricted or totally prohibited.

Interactive display of molecular models using a microcomputer system

NASA Technical Reports Server (NTRS)

Egan, J. T.; Macelroy, R. D.

1980-01-01

A simple, microcomputer-based, interactive graphics display system has been developed for the presentation of perspective views of wire frame molecular models. The display system is based on a TERAK 8510a graphics computer system with a display unit consisting of microprocessor, television display and keyboard subsystems. The operating system includes a screen editor, file manager, PASCAL and BASIC compilers and command options for linking and executing programs. The graphics program, written in USCD PASCAL, involves the centering of the coordinate system, the transformation of centered model coordinates into homogeneous coordinates, the construction of a viewing transformation matrix to operate on the coordinates, clipping invisible points, perspective transformation and scaling to screen coordinates; commands available include ZOOM, ROTATE, RESET, and CHANGEVIEW. Data file structure was chosen to minimize the amount of disk storage space. Despite the inherent slowness of the system, its low cost and flexibility suggests general applicability.

Transforming a conventional theatre into a gynaecological endoscopy unit.

PubMed

Anastasakis, E; Protopapas, A; Daskalakis, G; Papadakis, M; Milingos, S; Antsaklis, A

2007-01-01

Most minimally invasive procedures are now performed in operating rooms that were originally designed for traditional open surgery. We designed an endoscopic theatre based on our experience with special features specific for gynaecological endoscopy. We designed a detailed plan with an architect's aid of a gynaecological unit (based on a Greek presidential decree published in 1991). The space utilized was that of a conventional theatre. With the architectural plan we anticipated every area needed in a gynaecological endoscopic theatre. A twin theatre was considered appropriate in order for the surgical team to operate alternatively in one theatre while the other is being cleaned and prepared for use. The design of a unit dedicated to gynaecologic laparoscopy is a multidisciplinary task where the endoscopic surgeon undertakes an active and prominent role. It is a project with great benefits and rewards for all parties involved. We present our design for evaluation.

Fatal hemorrhage following sacroiliac joint fusion surgery: A case report.

PubMed

Palmiere, Cristian; Augsburger, Marc; Del Mar Lesta, Maria; Grabherr, Silke; Borens, Olivier

2017-05-01

Threaded pins and wires are commonly used in orthopedic practice and their migration intra- or post-operatively may be responsible for potentially serious complications. Vascular and visceral injury from intra-pelvic pin or guide-wire migration during or following hip surgery has been reported frequently in the literature and may result in progression through soft tissues with subsequent perforation of organs and vessels. In this report, we describe an autopsy case involving a 40-year old man suffering from chronic low back pain due to sacroiliac joint disruption. The patient underwent minimally invasive sacroiliac joint arthrodesis. Some intra-operative bleeding was noticed when a drill was retrieved, though the patient died postoperatively. Postmortem investigations allowed the source of bleeding to be identified (a perforation of a branch of the right internal iliac artery) and a potentially toxic tramadol concentration in peripheral blood to be measured. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prolonged Exposure for Guilt and Shame in a Veteran of Operation Iraqi Freedom

PubMed Central

Paul, Lisa A.; Gros, Daniel F.; Strachan, Martha; Worsham, Glenna; Foa, Edna B.; Acierno, Ron

2014-01-01

Morally injurious events appear capable of producing posttraumatic stress disorder (PTSD), even though they may not involve actual or perceived life-threat or a response of fear, horror, or helplessness. Researchers have questioned whether exposure therapies can address these events. The current report presents evidence of the effectiveness of this treatment approach for addressing posttraumatic symptoms related to a morally injurious event through an illustrative case of an Operation Iraqi Freedom veteran with PTSD characterized by symptoms of guilt and shame. The veteran was successfully treated with nine sessions of prolonged exposure therapy, reporting minimal PTSD symptoms one week post-treatment and at a six-month follow-up assessment. Implications for the treatment of veterans with significant guilt and shame using exposure-based therapies, and with respect to the recent changes to the diagnostic criteria for PTSD, are discussed. PMID:25505798

Optimal design method to minimize users' thinking mapping load in human-machine interactions.

PubMed

Huang, Yanqun; Li, Xu; Zhang, Jie

2015-01-01

The discrepancy between human cognition and machine requirements/behaviors usually results in serious mental thinking mapping loads or even disasters in product operating. It is important to help people avoid human-machine interaction confusions and difficulties in today's mental work mastered society. Improving the usability of a product and minimizing user's thinking mapping and interpreting load in human-machine interactions. An optimal human-machine interface design method is introduced, which is based on the purpose of minimizing the mental load in thinking mapping process between users' intentions and affordance of product interface states. By analyzing the users' thinking mapping problem, an operating action model is constructed. According to human natural instincts and acquired knowledge, an expected ideal design with minimized thinking loads is uniquely determined at first. Then, creative alternatives, in terms of the way human obtains operational information, are provided as digital interface states datasets. In the last, using the cluster analysis method, an optimum solution is picked out from alternatives, by calculating the distances between two datasets. Considering multiple factors to minimize users' thinking mapping loads, a solution nearest to the ideal value is found in the human-car interaction design case. The clustering results show its effectiveness in finding an optimum solution to the mental load minimizing problems in human-machine interaction design.

45 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 46.110 Section 46.110 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION PROTECTION OF HUMAN...

45 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 46.110 Section 46.110 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN...

45 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 46.110 Section 46.110 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN...

45 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 46.110 Section 46.110 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN...

45 CFR 46.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-10-01

... review procedure shall adopt a method for keeping all members advised of research proposals which have... research involving no more than minimal risk, and for minor changes in approved research. 46.110 Section 46... SUBJECTS Basic HHS Policy for Protection of Human Research Subjects § 46.110 Expedited review procedures...

10 CFR 745.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-01-01

... adopt a method for keeping all members advised of research proposals which have been approved under the... 10 Energy 4 2011-01-01 2011-01-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 745.110 Section 745.110...

34 CFR 97.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2011 CFR

2011-07-01

... of research proposals which have been approved under the procedure. (d) The department or agency head... research involving no more than minimal risk, and for minor changes in approved research. 97.110 Section 97... Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects...

10 CFR 745.110 - Expedited review procedures for certain kinds of research involving no more than minimal risk...

Code of Federal Regulations, 2010 CFR

2010-01-01

... adopt a method for keeping all members advised of research proposals which have been approved under the... 10 Energy 4 2010-01-01 2010-01-01 false Expedited review procedures for certain kinds of research involving no more than minimal risk, and for minor changes in approved research. 745.110 Section 745.110...

Underground Architecture and Layout for the Belgian High-Level and Long-Lived Intermediate-Level Radioactive Waste Disposal Facility- 12116

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

Van Cotthem, Alain; Van Humbeeck, Hughes; Biurrun, Enrique

The underground architecture and layout of the proposed Belgian high-level (HLW) and long-lived, intermediate-level radioactive wastes (ILW-LL) disposal system (repository) is mainly based on lessons learned during the development and 30-year-long operation of an underground research laboratory (URL) ('HADES') located adjacent to the city of Mol at a depth of 225 m in a 100-m-thick, Tertiary clay formation; the Boom clay. The following main operational and safety challenges are addressed in the proposed architecture and layout: 1. Following excavation, the underground openings needed to be promptly supported to minimize the extent of the excavation damaged zone (EDZ). 2. The sizemore » and unsupported stand-up time at tunnel crossings/intersections also needed to be minimized to minimize the extent of the related EDZ. 3. Steel components had to be minimized to limit the related long-term (post-closure) corrosion and hydrogen production. 4. The shafts and all equipment had to go down through a 180-m-thick aquifer and handle up to 65-Ton payloads. 5. The shaft seals had to be placed in the underlying clay layer. The currently proposed layout minimizes the excavated volume based on strict long-term-safety criteria and optimizes operational safety. Operational safety is further enhanced by a remote-controlled waste-package-handling system transporting the waste packages from their respective surface location down to their respective disposal location with no intermediate operation. The related on-site preparation and thenceforth use of cement-based, waste package- transportation containers are integral operational-safety components. In addition to strengthening the waste packages and providing radiation protection, these containers also provide long-term corrosion protection of the internal 'primary' steel packages. (authors)« less

Minimally invasive evacuation of intraventricular hemorrhage with the Apollo vibration/suction device.

PubMed

Tan, Lee A; Lopes, Demetrius K; Munoz, Lorenzo F; Shah, Yojan; Bhabad, Sudeep; Jhaveri, Miral; Moftakhar, Roham

2016-05-01

Intraventricular hemorrhages (IVH) can occur as a consequence of spontaneous intracerebral hemorrhage, aneurysm rupture, arteriovenous malformation hemorrhage, trauma, or coagulopathy. IVH is a known risk factor for poor clinical outcome with up to 80% mortality. The current standard treatment strategy for IVH consists of the placement of an external ventricular drain. We report our early experience with using the Apollo suction/vibration aspiration system (Penumbra, Alameda, CA, USA) for minimally invasive evacuation of IVH with a review of the pertinent literature. Medical records of patients with IVH who were admitted to Rush University Medical Center, USA, from July to November 2014 were queried from the electronic database. Patients with Graeb Scores (GS) >6 were selected for minimally invasive IVH evacuation with the Apollo aspiration system. Patient demographics, pre- and post-operative GS, pre- and post-operative modified Graeb Score (mGS), as well procedure related complications were analyzed and recorded. A total of eight patients (five men) were identified during the study period. The average age was 55.5years. The mean GS was 9.6 pre-operatively and decreased to 4.9 post-operatively (p=0.0002). The mean mGS was 22.9 pre-operatively and decreased to 11.4 post-operatively (p=0.0001). Most of the IVH reduction occurred in the frontal horn and atrium of the lateral ventricle, as well the third ventricle. One (1/8) procedure-related complication occurred consisted of a tract hemorrhage. The Apollo system can be used for minimally invasive IVH evacuation to achieve significant blood clot volume reduction with minimal procedure-related complication. Copyright © 2016. Published by Elsevier Ltd.

Robust model-based 3d/3D fusion using sparse matching for minimally invasive surgery.

PubMed

Neumann, Dominik; Grbic, Sasa; John, Matthias; Navab, Nassir; Hornegger, Joachim; Ionasec, Razvan

2013-01-01

Classical surgery is being disrupted by minimally invasive and transcatheter procedures. As there is no direct view or access to the affected anatomy, advanced imaging techniques such as 3D C-arm CT and C-arm fluoroscopy are routinely used for intra-operative guidance. However, intra-operative modalities have limited image quality of the soft tissue and a reliable assessment of the cardiac anatomy can only be made by injecting contrast agent, which is harmful to the patient and requires complex acquisition protocols. We propose a novel sparse matching approach for fusing high quality pre-operative CT and non-contrasted, non-gated intra-operative C-arm CT by utilizing robust machine learning and numerical optimization techniques. Thus, high-quality patient-specific models can be extracted from the pre-operative CT and mapped to the intra-operative imaging environment to guide minimally invasive procedures. Extensive quantitative experiments demonstrate that our model-based fusion approach has an average execution time of 2.9 s, while the accuracy lies within expert user confidence intervals.

Reversing the Landauer's erasure: Single-electron Maxwell's demon operating at the limit of thermodynamic efficiency

NASA Astrophysics Data System (ADS)

Averin, Dmitri V.; Pekola, Jukka P.

2017-03-01

According to Landauer's principle, erasure of information is the only part of a computation process that unavoidably involves energy dissipation. If done reversibly, such an erasure generates the minimal heat of $k_BT\\ln 2$ per erased bit of information. The goal of this work is to discuss the actual reversal of the optimal erasure which can serve as the basis for the Maxwell's demon operating with ultimate thermodynamic efficiency as dictated by the second law of thermodynamics. The demon extracts $k_BT\\ln 2$ of heat from an equilibrium reservoir at temperature $T$ per one bit of information obtained about the measured system used by the demon. We have analyzed this Maxwell's demon in the situation when it uses a general quantum system with a discrete spectrum of energy levels as its working body. In the case of the effectively two-level system, which has been realized experimentally based on tunneling of individual electron in a single-electron box [J.V. Koski et al., PNAS 111, 13786 (2014)], we also studied and minimized corrections to the ideal reversible operation of the demon. These corrections include, in particular, the non-adiabatic terms which are described by a version of the classical fluctuation-dissipation theorem. The overall reversibility of the Maxwell's demon requires, beside the reversibility of the intrinsic working body dynamics, the reversibility of the measurement and feedback processes. The single-electron demon can, in principle, be made fully reversible by developing a thermodynamically reversible single-electron charge detector for measurements of the individual charge states of the single-electron box.

Energy Efficiency in Small Server Rooms: Field Surveys and Findings

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

Cheung, Iris; Greenberg, Steve; Mahdavi, Roozbeh

Fifty-seven percent of US servers are housed in server closets, server rooms, and localized data centers, in what are commonly referred to as small server rooms, which comprise 99percent of all server spaces in the US. While many mid-tier and enterprise-class data centers are owned by large corporations that consider energy efficiency a goal to minimize business operating costs, small server rooms typically are not similarly motivated. They are characterized by decentralized ownership and management and come in many configurations, which creates a unique set of efficiency challenges. To develop energy efficiency strategies for these spaces, we surveyed 30 smallmore » server rooms across eight institutions, and selected four of them for detailed assessments. The four rooms had Power Usage Effectiveness (PUE) values ranging from 1.5 to 2.1. Energy saving opportunities ranged from no- to low-cost measures such as raising cooling set points and better airflow management, to more involved but cost-effective measures including server consolidation and virtualization, and dedicated cooling with economizers. We found that inefficiencies mainly resulted from organizational rather than technical issues. Because of the inherent space and resource limitations, the most effective measure is to operate servers through energy-efficient cloud-based services or well-managed larger data centers, rather than server rooms. Backup power requirement, and IT and cooling efficiency should be evaluated to minimize energy waste in the server space. Utility programs are instrumental in raising awareness and spreading technical knowledge on server operation, and the implementation of energy efficiency measures in small server rooms.« less

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

PubMed

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

2014-03-01

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

WASTE MINIMIZATION AUDIT REPORT: CASE STUDIES OF MINIMIZATION OF CYANIDE WASTE FROM ELECTROPLATING OPERATIONS

EPA Science Inventory

To promote waste minimization activities in accordance with the national policy objectives established under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and Recovery Act of 1976 (RCRA), the Hazardous Waste Engineering Research Laboratory (HWERL) of ...

Evaluation of Dual Pressurized Rover Operations During Simulated Planetary Surface Exploration

NASA Technical Reports Server (NTRS)

Abercromby, Andrew F. J.; Gernhardt, Michael L.

2010-01-01

Introduction: A pair of small pressurized rovers (Space Exploration Vehicles, or SEVs) is at the center of the Global Point-of-Departure architecture for future human planetary exploration. Simultaneous operation of multiple crewed surface assets should maximize productive crew time, minimize overhead, and preserve contingency return paths. Methods: A 14-day mission simulation was conducted in the Arizona desert as part of NASA?s 2010 Desert Research and Technology Studies (DRATS). The simulation involved two SEV concept vehicles performing geological exploration under varied operational modes affecting both the extent to which the SEVs must maintain real-time communications with mission control ("Continuous" vs. "Twice-a-Day") and their proximity to each other ("Lead-and-Follow" vs. "Divide-and-Conquer"). As part of a minimalist lunar architecture, no communications relay satellites were assumed. Two-person crews consisting of an astronaut and a field geologist operated each SEV, day and night, throughout the entire 14-day mission, only leaving via the suit ports to perform simulated extravehicular activities. Standard metrics enabled quantification of the habitability and usability of all aspects of the SEV concept vehicles throughout the mission, as well as comparison of the extent to which the operating modes affected crew productivity and performance. Practically significant differences in the relevant metrics were prospectively defined for the testing of all hypotheses. Results and Discussion: Data showed a significant 14% increase in available science time (AST) during Lead-and-Follow mode compared with Divide-and-Conquer, primarily because of the minimal overhead required to maintain communications during Lead-and-Follow. In Lead-and-Follow mode, there was a non-significant 2% increase in AST during Twice-a-Day vs. Continuous communications. Situational awareness of the other vehicle?s location, activities, and contingency return constraints were enhanced during Lead-and-Follow and Twice-a-Day communications modes due to line-of-sight and direct SEV-to-SEV communication. Preliminary analysis of Scientific Data Quality and Observation Quality metrics showed no significant differences between modes.

Minimization In Digital Design As A Meta-Planning Problem

NASA Astrophysics Data System (ADS)

Ho, William P. C.; Wu, Jung-Gen

1987-05-01

In our model-based expert system for automatic digital system design, we formalize the design process into three sub-processes - compiling high-level behavioral specifications into primitive behavioral operations, grouping primitive operations into behavioral functions, and grouping functions into modules. Consideration of design minimization explicitly controls decision-making in the last two subprocesses. Design minimization, a key task in the automatic design of digital systems, is complicated by the high degree of interaction among the time sequence and content of design decisions. In this paper, we present an AI approach which directly addresses these interactions and their consequences by modeling the minimization prob-lem as a planning problem, and the management of design decision-making as a meta-planning problem.

Surgical treatment of atrial fibrillation.

PubMed

Pagé, Pierre; Skanes, Allan C

2005-09-01

Surgery aims to eliminate atrial fibrillation (AF) through direct modification of the arrhythmogenic substratum. The Maze procedure, developed two decades ago, has proven to be clearly effective in restoring sinus rhythm in AF patients with or without associated organic cardiac disorders. Indications for surgery may be tailored to the clinical situation involved. In patients with continuous AF associated with structural heart disease (eg, valvular, congenital or coronary artery disease), the performance of a concomitant AF ablation procedure proven to add minimal morbidity to the operation may be highly beneficial to patient outcome. It is likely, although not entirely proven, that the restoration and maintenance of sinus rhythm after mitral valve surgery promotes survival by preventing tachycardia-induced cardiomyopathy and stroke. Novel strategies for AF surgery involve the use of alternate energy sources to create the lines of block in the atria and the simplification of the lesion pattern compared with the earlier Cox-Maze procedure. Published clinical data support the contention that left atrial ablation techniques performed concomitantly with valvular and/or coronary artery bypass surgery are likely to result in a 70% to 90% cure rate of AF in patients with preoperatively documented AF. Despite the lack of evidence for long-term outcome benefit, intraoperative pulmonary vein ablation, feasible with minimal morbidity, clearly appears to be an improvement over simply ignoring AF in patients undergoing cardiac surgery. Left atrial appendectomy appears warranted in patients with chronic persistent AF.

Minimally invasive surgery. Future developments.

PubMed Central

Wickham, J. E.

1994-01-01

The rapid development of minimally invasive surgery means that there will be fundamental changes in interventional treatment. Technological advances will allow new minimally invasive procedures to be developed. Application of robotics will allow some procedures to be done automatically, and coupling of slave robotic instruments with virtual reality images will allow surgeons to perform operations by remote control. Miniature motors and instruments designed by microengineering could be introduced into body cavities to perform operations that are currently impossible. New materials will allow changes in instrument construction, such as use of memory metals to make heat activated scissors or forceps. With the reduced trauma associated with minimally invasive surgery, fewer operations will require long hospital stays. Traditional surgical wards will become largely redundant, and hospitals will need to cope with increased through-put of patients. Operating theatres will have to be equipped with complex high technology equipment, and hospital staff will need to be trained to manage it. Conventional nursing care will be carried out more in the community. Many traditional specialties will be merged, and surgical training will need fundamental revision to ensure that surgeons are competent to carry out the new procedures. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 PMID:8312776

Adoption of waste minimization technology to benefit electroplaters

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

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

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

Boosted ARTMAP: modifications to fuzzy ARTMAP motivated by boosting theory.

PubMed

Verzi, Stephen J; Heileman, Gregory L; Georgiopoulos, Michael

2006-05-01

In this paper, several modifications to the Fuzzy ARTMAP neural network architecture are proposed for conducting classification in complex, possibly noisy, environments. The goal of these modifications is to improve upon the generalization performance of Fuzzy ART-based neural networks, such as Fuzzy ARTMAP, in these situations. One of the major difficulties of employing Fuzzy ARTMAP on such learning problems involves over-fitting of the training data. Structural risk minimization is a machine-learning framework that addresses the issue of over-fitting by providing a backbone for analysis as well as an impetus for the design of better learning algorithms. The theory of structural risk minimization reveals a trade-off between training error and classifier complexity in reducing generalization error, which will be exploited in the learning algorithms proposed in this paper. Boosted ART extends Fuzzy ART by allowing the spatial extent of each cluster formed to be adjusted independently. Boosted ARTMAP generalizes upon Fuzzy ARTMAP by allowing non-zero training error in an effort to reduce the hypothesis complexity and hence improve overall generalization performance. Although Boosted ARTMAP is strictly speaking not a boosting algorithm, the changes it encompasses were motivated by the goals that one strives to achieve when employing boosting. Boosted ARTMAP is an on-line learner, it does not require excessive parameter tuning to operate, and it reduces precisely to Fuzzy ARTMAP for particular parameter values. Another architecture described in this paper is Structural Boosted ARTMAP, which uses both Boosted ART and Boosted ARTMAP to perform structural risk minimization learning. Structural Boosted ARTMAP will allow comparison of the capabilities of off-line versus on-line learning as well as empirical risk minimization versus structural risk minimization using Fuzzy ARTMAP-based neural network architectures. Both empirical and theoretical results are presented to enhance the understanding of these architectures.

Operations mission planner beyond the baseline

NASA Technical Reports Server (NTRS)

Biefeld, Eric; Cooper, Lynne

1991-01-01

The scheduling of Space Station Freedom must satisfy four major requirements. It must ensure efficient housekeeping operations, maximize the collection of science, respond to changes in tasking and available resources, and accommodate the above changes in a manner that minimizes disruption of the ongoing operations of the station. While meeting these requirements the scheduler must cope with the complexity, scope, and flexibility of SSF operations. This requires the scheduler to deal with an astronomical number of possible schedules. The Operations Mission Planner (OMP) is centered around minimally disruptive replanning and the use of heuristics limit search in scheduling. OMP has already shown several artificial intelligence based scheduling techniques such as Interleaved Iterative Refinement and Bottleneck Identification using Process Chronologies.

Application of multiobjective optimization to scheduling capacity expansion of urban water resource systems

NASA Astrophysics Data System (ADS)

Mortazavi-Naeini, Mohammad; Kuczera, George; Cui, Lijie

2014-06-01

Significant population increase in urban areas is likely to result in a deterioration of drought security and level of service provided by urban water resource systems. One way to cope with this is to optimally schedule the expansion of system resources. However, the high capital costs and environmental impacts associated with expanding or building major water infrastructure warrant the investigation of scheduling system operational options such as reservoir operating rules, demand reduction policies, and drought contingency plans, as a way of delaying or avoiding the expansion of water supply infrastructure. Traditionally, minimizing cost has been considered the primary objective in scheduling capacity expansion problems. In this paper, we consider some of the drawbacks of this approach. It is shown that there is no guarantee that the social burden of coping with drought emergencies is shared equitably across planning stages. In addition, it is shown that previous approaches do not adequately exploit the benefits of joint optimization of operational and infrastructure options and do not adequately address the need for the high level of drought security expected for urban systems. To address these shortcomings, a new multiobjective optimization approach to scheduling capacity expansion in an urban water resource system is presented and illustrated in a case study involving the bulk water supply system for Canberra. The results show that the multiobjective approach can address the temporal equity issue of sharing the burden of drought emergencies and that joint optimization of operational and infrastructure options can provide solutions superior to those just involving infrastructure options.

Arithmetic functions in torus and tree networks

DOEpatents

Bhanot, Gyan; Blumrich, Matthias A.; Chen, Dong; Gara, Alan G.; Giampapa, Mark E.; Heidelberger, Philip; Steinmacher-Burow, Burkhard D.; Vranas, Pavlos M.

2007-12-25

Methods and systems for performing arithmetic functions. In accordance with a first aspect of the invention, methods and apparatus are provided, working in conjunction of software algorithms and hardware implementation of class network routing, to achieve a very significant reduction in the time required for global arithmetic operation on the torus. Therefore, it leads to greater scalability of applications running on large parallel machines. The invention involves three steps in improving the efficiency and accuracy of global operations: (1) Ensuring, when necessary, that all the nodes do the global operation on the data in the same order and so obtain a unique answer, independent of roundoff error; (2) Using the topology of the torus to minimize the number of hops and the bidirectional capabilities of the network to reduce the number of time steps in the data transfer operation to an absolute minimum; and (3) Using class function routing to reduce latency in the data transfer. With the method of this invention, every single element is injected into the network only once and it will be stored and forwarded without any further software overhead. In accordance with a second aspect of the invention, methods and systems are provided to efficiently implement global arithmetic operations on a network that supports the global combining operations. The latency of doing such global operations are greatly reduced by using these methods.

WASTE MINIMIZATION AUDIT REPORT: CASE STUDIES OF MINIMIZATION OF SOLVENT WASTE FROM PARTS CLEANING AND FROM ELECTRONIC CAPACITOR MANUFACTURING OPERATIONS

EPA Science Inventory

To promote waste minimization activities in accordance with the national policy objectives established under the 1984 Hazardous and Solid Waste Amendments to the Resource Conservation and Recovery Act of 1976 (RCRA), the Hazardous Waste Engineering Research Laboratory (HWERL) of ...

A Cis-Lunar Propellant Infrastructure for Flexible Path Exploration and Space Commerce

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.

2012-01-01

This paper describes a space infrastructure concept that exploits lunar water for propellant production and delivers it to users in cis-lunar space. The goal is to provide responsive economical space transportation to destinations beyond low Earth orbit (LEO) and enable in-space commerce. This is a game changing concept that could fundamentally affect future space operations, provide greater access to space beyond LEO, and broaden participation in space exploration. The challenge is to minimize infrastructure development cost while achieving a low operational cost. This study discusses the evolutionary development of the infrastructure from a very modest robotic operation to one that is capable of supporting human operations. The cis-lunar infrastructure involves a mix of technologies including cryogenic propellant production, reusable lunar landers, propellant tankers, orbital transfer vehicles, aerobraking technologies, and electric propulsion. This cislunar propellant infrastructure replaces Earth-launched propellants for missions beyond LEO. It enables users to reach destinations with smaller launchers or effectively multiplies the user s existing payload capacity. Users can exploit the expanded capacity to launch logistics material that can then be traded with the infrastructure for propellants. This mutually beneficial trade between the cis-lunar infrastructure and propellant users forms the basis of in-space commerce.

Hand-held computer operating system program for collection of resident experience data.

PubMed

Malan, T K; Haffner, W H; Armstrong, A Y; Satin, A J

2000-11-01

To describe a system for recording resident experience involving hand-held computers with the Palm Operating System (3 Com, Inc., Santa Clara, CA). Hand-held personal computers (PCs) are popular, easy to use, inexpensive, portable, and can share data among other operating systems. Residents in our program carry individual hand-held database computers to record Residency Review Committee (RRC) reportable patient encounters. Each resident's data is transferred to a single central relational database compatible with Microsoft Access (Microsoft Corporation, Redmond, WA). Patient data entry and subsequent transfer to a central database is accomplished with commercially available software that requires minimal computer expertise to implement and maintain. The central database can then be used for statistical analysis or to create required RRC resident experience reports. As a result, the data collection and transfer process takes less time for residents and program director alike, than paper-based or central computer-based systems. The system of collecting resident encounter data using hand-held computers with the Palm Operating System is easy to use, relatively inexpensive, accurate, and secure. The user-friendly system provides prompt, complete, and accurate data, enhancing the education of residents while facilitating the job of the program director.

ATLAST ULE mirror segment performance analytical predictions based on thermally induced distortions

NASA Astrophysics Data System (ADS)

Eisenhower, Michael J.; Cohen, Lester M.; Feinberg, Lee D.; Matthews, Gary W.; Nissen, Joel A.; Park, Sang C.; Peabody, Hume L.

2015-09-01

The Advanced Technology Large-Aperture Space Telescope (ATLAST) is a concept for a 9.2 m aperture space-borne observatory operating across the UV/Optical/NIR spectra. The primary mirror for ATLAST is a segmented architecture with pico-meter class wavefront stability. Due to its extraordinarily low coefficient of thermal expansion, a leading candidate for the primary mirror substrate is Corning's ULE® titania-silicate glass. The ATLAST ULE® mirror substrates will be maintained at `room temperature' during on orbit flight operations minimizing the need for compensation of mirror deformation between the manufacturing temperature and the operational temperatures. This approach requires active thermal management to maintain operational temperature while on orbit. Furthermore, the active thermal control must be sufficiently stable to prevent time-varying thermally induced distortions in the mirror substrates. This paper describes a conceptual thermal management system for the ATLAST 9.2 m segmented mirror architecture that maintains the wavefront stability to less than 10 pico-meters/10 minutes RMS. Thermal and finite element models, analytical techniques, accuracies involved in solving the mirror figure errors, and early findings from the thermal and thermal-distortion analyses are presented.

Unsettled teamwork: communication and learning in the operating theatres of an urban hospital.

PubMed

Bezemer, Jeff; Korkiakangas, Terhi; Weldon, Sharon-Marie; Kress, Gunther; Kneebone, Roger

2016-02-01

To explore the unsettling effects of increased mobility of nurses, surgeons and other healthcare professionals on communication and learning in the operating theatre. Increasingly, healthcare professionals step in and out of newly formed transient teams and work with colleagues they have not met before, unsettling previously relatively stable team work based on shared, local knowledge accumulated over significant periods of close collaboration. An ethnographic case study was conducted of the operating theatre department of a major teaching hospital in London. Video recordings were made of 20 operations, involving different teams. The recordings were systematically reviewed and coded. Instances where difficulties arose in the communication between scrub nurse and surgeons were identified and subjected to detailed, interactional analysis. Instrument requests frequently prompted clarification from the scrub nurse (e.g. 'Sorry, what did you want?'). Such requests were either followed by a relatively elaborate clarification, designed to maximize learning opportunities, or a by a relatively minimal clarification, designed to achieve the immediate task at hand. Significant variation exists in the degree of support given to scrub nurses requesting clarification. Some surgeons experience such requests as disruptions, while others treat them as opportunities to build shared knowledge. © 2015 John Wiley & Sons Ltd.

Minimizing Cache Misses Using Minimum-Surface Bodies

NASA Technical Reports Server (NTRS)

Frumkin, Michael; VanderWijngaart, Rob; Biegel, Bryan (Technical Monitor)

2002-01-01

A number of known techniques for improving cache performance in scientific computations involve the reordering of the iteration space. Some of these reorderings can be considered as coverings of the iteration space with the sets having good surface-to-volume ratio. Use of such sets reduces the number of cache misses in computations of local operators having the iteration space as a domain. First, we derive lower bounds which any algorithm must suffer while computing a local operator on a grid. Then we explore coverings of iteration spaces represented by structured and unstructured grids which allow us to approach these lower bounds. For structured grids we introduce a covering by successive minima tiles of the interference lattice of the grid. We show that the covering has low surface-to-volume ratio and present a computer experiment showing actual reduction of the cache misses achieved by using these tiles. For planar unstructured grids we show existence of a covering which reduces the number of cache misses to the level of structured grids. On the other hand, we present a triangulation of a 3-dimensional cube such that any local operator on the corresponding grid has significantly larger number of cache misses than a similar operator on a structured grid.

Braiding by Majorana tracking and long-range CNOT gates with color codes

NASA Astrophysics Data System (ADS)

Litinski, Daniel; von Oppen, Felix

2017-11-01

Color-code quantum computation seamlessly combines Majorana-based hardware with topological error correction. Specifically, as Clifford gates are transversal in two-dimensional color codes, they enable the use of the Majoranas' non-Abelian statistics for gate operations at the code level. Here, we discuss the implementation of color codes in arrays of Majorana nanowires that avoid branched networks such as T junctions, thereby simplifying their realization. We show that, in such implementations, non-Abelian statistics can be exploited without ever performing physical braiding operations. Physical braiding operations are replaced by Majorana tracking, an entirely software-based protocol which appropriately updates the Majoranas involved in the color-code stabilizer measurements. This approach minimizes the required hardware operations for single-qubit Clifford gates. For Clifford completeness, we combine color codes with surface codes, and use color-to-surface-code lattice surgery for long-range multitarget CNOT gates which have a time overhead that grows only logarithmically with the physical distance separating control and target qubits. With the addition of magic state distillation, our architecture describes a fault-tolerant universal quantum computer in systems such as networks of tetrons, hexons, or Majorana box qubits, but can also be applied to nontopological qubit platforms.

Modeling the Impact of Motivation, Personality, and Emotion on Social Behavior

NASA Astrophysics Data System (ADS)

Miller, Lynn C.; Read, Stephen J.; Zachary, Wayne; Rosoff, Andrew

Models seeking to predict human social behavior must contend with multiple sources of individual and group variability that underlie social behavior. One set of interrelated factors that strongly contribute to that variability - motivations, personality, and emotions - has been only minimally incorporated in previous computational models of social behavior. The Personality, Affect, Culture (PAC) framework is a theory-based computational model that addresses this gap. PAC is used to simulate social agents whose social behavior varies according to their personalities and emotions, which, in turn, vary according to their motivations and underlying motive control parameters. Examples involving disease spread and counter-insurgency operations show how PAC can be used to study behavioral variability in different social contexts.

Highly stable multi-wavelength erbium-doped fiber linear laser based on modal interference

NASA Astrophysics Data System (ADS)

Herrera-Piad, L. A.; Jauregui-Vazquez, D.; Lopez-Dieguez, Y.; Estudillo-Ayala, J. M.; Hernandez-Garcia, J. C.; Sierra-Hernandez, J. M.; Bianchetti, M.; Rojas-Laguna, R.

2018-03-01

We report a linear fiber laser cavity based on an all-fiber Fabry-Perot interferometer and bi-tapered optical fiber for multi-wavelength emission generation. Curvature and strain are used to operate the laser system and the number of lines as well, the emission regions are stronger related to the physical effect applied, due to the phase alteration between the multiple fiber optic modes involved. The original laser emissions present zero wavelength variations, minimal power fluctuations and small spacing mode (1 nm). Additionally, a nonlinear fiber was employed trying to improve the performance of the multiple lasing lines. This system offers a low implementation cost, compactness and good laser parameters.

A perverse quality incentive in surgery: implications of reimbursing surgeons less for doing laparoscopic surgery.

PubMed

Fader, Amanda N; Xu, Tim; Dunkin, Brian J; Makary, Martin A

2016-11-01

Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States. We explore the incentive of the current surgeon reimbursement fee schedule and its potential implications. A surgeon's preference to perform minimally invasive compared with open surgery remains highly variable in the U.S., even after adjustment for patient comorbidities and surgical complexity. Nationwide administrative claims data across several surgical disciplines demonstrates that minimally invasive surgery utilization in place of open surgery is associated with reduced adverse events and cost savings. Reducing surgical complications by increasing adoption of minimally invasive operations has significant cost implications for health care. However, current U.S. payment structures may perversely incentivize open surgery and financially reward physicians who do not necessarily embrace newer or best minimally invasive surgery practices. Utilization of minimally invasive surgery varies considerably in the U.S., representing one of the greatest disparities in health care. Existing physician payment models must translate the growing body of research in surgical care into physician-level rewards for quality, including choice of operation. Promoting safe surgery should be an important component of a strong, value-based healthcare system. Resolving the potentially perverse incentives in paying for surgical approaches may help address disparities in surgical care, reduce the prevalent problem of variation, and help contain health care costs.

GPS: Public Utility or Software Platform

DTIC Science & Technology

2016-09-01

major occurrences that could interrupt GPS’s operation for an extended period of time . Despite these safeguards, the U.S. government has...in the event of a GPS interruption .178 2. GPS Infrastructure is designed to Prevent and Minimize Disruption Like a public utility, GPS is designed ...production and distribution while at the same time minimizing the likelihood of signal interruptions . Each of GPS’s operational satellites are

Children with Multiple Disabilities and Minimal Motor Behavior Using Chin Movements to Operate Microswitches to Obtain Environmental Stimulation

ERIC Educational Resources Information Center

Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Tota, Alessia; Antonucci, Massimo; Oliva, Doretta

2006-01-01

In these two studies, two children with multiple disabilities and minimal motor behavior were assessed to see if they could use chin movements to operate microswitches to obtain environmental stimulation. In Study I, we applied an adapted version of a recently introduced electronic microswitch [Lancioni, G. E., O'Reilly, M. F., Singh, N. N.,…

Combined Simulated Annealing and Genetic Algorithm Approach to Bus Network Design

NASA Astrophysics Data System (ADS)

Liu, Li; Olszewski, Piotr; Goh, Pong-Chai

A new method - combined simulated annealing (SA) and genetic algorithm (GA) approach is proposed to solve the problem of bus route design and frequency setting for a given road network with fixed bus stop locations and fixed travel demand. The method involves two steps: a set of candidate routes is generated first and then the best subset of these routes is selected by the combined SA and GA procedure. SA is the main process to search for a better solution to minimize the total system cost, comprising user and operator costs. GA is used as a sub-process to generate new solutions. Bus demand assignment on two alternative paths is performed at the solution evaluation stage. The method was implemented on four theoretical grid networks of different size and a benchmark network. Several GA operators (crossover and mutation) were utilized and tested for their effectiveness. The results show that the proposed method can efficiently converge to the optimal solution on a small network but computation time increases significantly with network size. The method can also be used for other transport operation management problems.

Design of experiments applications in bioprocessing: concepts and approach.

PubMed

Kumar, Vijesh; Bhalla, Akriti; Rathore, Anurag S

2014-01-01

Most biotechnology unit operations are complex in nature with numerous process variables, feed material attributes, and raw material attributes that can have significant impact on the performance of the process. Design of experiments (DOE)-based approach offers a solution to this conundrum and allows for an efficient estimation of the main effects and the interactions with minimal number of experiments. Numerous publications illustrate application of DOE towards development of different bioprocessing unit operations. However, a systematic approach for evaluation of the different DOE designs and for choosing the optimal design for a given application has not been published yet. Through this work we have compared the I-optimal and D-optimal designs to the commonly used central composite and Box-Behnken designs for bioprocess applications. A systematic methodology is proposed for construction of the model and for precise prediction of the responses for the three case studies involving some of the commonly used unit operations in downstream processing. Use of Akaike information criterion for model selection has been examined and found to be suitable for the applications under consideration. © 2013 American Institute of Chemical Engineers.

Space Technology 5: Changing the Mission Design without Changing the Hardware

NASA Technical Reports Server (NTRS)

Carlisle, Candace C.; Webb, Evan H.; Slavin, James A.

2005-01-01

The Space Technology 5 (ST-5) Project is part of NASA's New Millennium Program. The validation objectives are to demonstrate the research-quality science capability of the ST-5 spacecraft; to operate the three spacecraft as a constellation; and to design, develop, test and flight-validate three capable micro-satellites with new technologies. A three-month flight demonstration phase is planned, beginning in March 2006. This year, the mission was re-planned for a Pegasus XL dedicated launch into an elliptical polar orbit (instead of the Originally-planned Geosynchronous Transfer Orbit.) The re-plan allows the mission to achieve the same high-level technology validation objectives with a different launch vehicle. The new mission design involves a revised science validation strategy, a new orbit and different communication strategy, while minimizing changes to the ST-5 spacecraft itself. The constellation operations concepts have also been refined. While the system engineers, orbit analysts, and operations teams were re-planning the mission, the implementation team continued to make progress on the flight hardware. Most components have been delivered, and the first spacecraft is well into integration and test.

Quantitative risk assessment integrated with process simulator for a new technology of methanol production plant using recycled CO₂.

PubMed

Di Domenico, Julia; Vaz, Carlos André; de Souza, Maurício Bezerra

2014-06-15

The use of process simulators can contribute with quantitative risk assessment (QRA) by minimizing expert time and large volume of data, being mandatory in the case of a future plant. This work illustrates the advantages of this association by integrating UNISIM DESIGN simulation and QRA to investigate the acceptability of a new technology of a Methanol Production Plant in a region. The simulated process was based on the hydrogenation of chemically sequestered carbon dioxide, demanding stringent operational conditions (high pressures and temperatures) and involving the production of hazardous materials. The estimation of the consequences was performed using the PHAST software, version 6.51. QRA results were expressed in terms of individual and social risks. Compared to existing tolerance levels, the risks were considered tolerable in nominal conditions of operation of the plant. The use of the simulator in association with the QRA also allowed testing the risk in new operating conditions in order to delimit safe regions for the plant. Copyright © 2014 Elsevier B.V. All rights reserved.

New minimally access hydrocelectomy.

PubMed

Saber, Aly

2011-02-01

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

An autonomous payload controller for the Space Shuttle

NASA Technical Reports Server (NTRS)

Hudgins, J. I.

1979-01-01

The Autonomous Payload Control (APC) system discussed in the present paper was designed on the basis of such criteria as minimal cost of implementation, minimal space required in the flight-deck area, simple operation with verification of the results, minimal additional weight, minimal impact on Orbiter design, and minimal impact on Orbiter payload integration. In its present configuration, the APC provides a means for the Orbiter crew to control as many as 31 autononous payloads. The avionics and human engineering aspects of the system are discussed.

Operational Performance Risk Assessment in Support of A Supervisory Control System

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

Denning, Richard S.; Muhlheim, Michael David; Cetiner, Sacit M.

Supervisory control system (SCS) is developed for multi-unit advanced small modular reactors to minimize human interventions in both normal and abnormal operations. In SCS, control action decisions made based on probabilistic risk assessment approach via Event Trees/Fault Trees. Although traditional PRA tools are implemented, their scope is extended to normal operations and application is reversed; success of non-safety related system instead failure of safety systems this extended PRA approach called as operational performance risk assessment (OPRA). OPRA helps to identify success paths, combination of control actions for transients and to quantify these success paths to provide possible actions without activatingmore » plant protection system. In this paper, a case study of the OPRA in supervisory control system is demonstrated within the context of the ALMR PRISM design, specifically power conversion system. The scenario investigated involved a condition that the feed water control valve is observed to be drifting to the closed position. Alternative plant configurations were identified via OPRA that would allow the plant to continue to operate at full or reduced power. Dynamic analyses were performed with a thermal-hydraulic model of the ALMR PRISM system using Modelica to evaluate remained safety margins. Successful recovery paths for the selected scenario are identified and quantified via SCS.« less

Early and late outcomes of 1000 minimally invasive aortic valve operations.

PubMed

Tabata, Minoru; Umakanthan, Ramanan; Cohn, Lawrence H; Bolman, Ralph Morton; Shekar, Prem S; Chen, Frederick Y; Couper, Gregory S; Aranki, Sary F

2008-04-01

Minimal access cardiac valve surgery is increasingly utilized. We report our 11-year experience with minimally invasive aortic valve surgery. From 07/96 to 12/06, 1005 patients underwent minimally invasive aortic valve surgery. Early and late outcomes were analyzed. Median patient age was 68 years (range: 24-95), 179 patients (18%) were 80 years or older, 130 patients (13%) had reoperative aortic valve surgery, 86 (8.4%) had aortic root replacement, 62 (6.1%) had concomitant ascending aortic replacement, and 26 (2.6%) had percutaneous coronary intervention on the day of surgery (hybrid procedure). Operative mortality was 1.9% (19/1005). The incidences of deep sternal wound infection, pneumonia and reoperation for bleeding were 0.5% (5/1005), 1.3% (13/1005) and 2.4% (25/1005), respectively. Median length of stay was 6 days and 733 patients (72%) were discharged home. Actuarial survival was 91% at 5 years and 88% at 10 years. In the subgroup of the elderly (> or =80 years), operative mortality was 1.7% (3/179), median length of stay was 8 days and 66 patients (37%) were discharged home. Actuarial survival at 5 years was 84%. There was a significant decreasing trend in cardiopulmonary bypass time, the incidence of bleeding, and operative mortality over time. Minimal access approaches in aortic valve surgery are safe and feasible with excellent outcomes. Aortic root replacement, ascending aortic replacement, and reoperative surgery can be performed with these approaches. These procedures are particularly well-tolerated in the elderly.

Centrifugal compressor controller for minimizing power consumption while avoiding surge

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

Haley, P.F.; Junk, B.S.; Renaud, M.A.

1987-08-18

For use with a variable capacity centrifugal compressor driven by an electric motor, a controller is described for adjusting the capacity of the compressor to satisfy a demand, minimize electric power consumption and avoid a surge condition. The controller consists of: a. means for sensing an operating parameter that is indicative of the capacity of the compressor; b. means for setting a selected setpoint that represents a desired value of the operating parameter; c. surge sensing means for detecting an impending surge by sensing fluctuation in the electric current supplied to the compressor motor, wherein an impending surge is detectedmore » whenever fluctuations in excess of a predetermined amplitude occur in excess of a predetermined frequency; and d. control means, responsive to the operating parameter sensing means, the setpoint setting means, and the surge sensing means, for controlling the compressor, such that its capacity is minimally above a level that would cause a surge condition yet is sufficient to maintain the operating parameter at the setpoint.« less

Design of a magnetic-tunnel-junction-oriented nonvolatile lookup table circuit with write-operation-minimized data shifting

NASA Astrophysics Data System (ADS)

Suzuki, Daisuke; Hanyu, Takahiro

2018-04-01

A magnetic-tunnel-junction (MTJ)-oriented nonvolatile lookup table (LUT) circuit, in which a low-power data-shift function is performed by minimizing the number of write operations in MTJ devices is proposed. The permutation of the configuration memory cell for read/write access is performed as opposed to conventional direct data shifting to minimize the number of write operations, which results in significant write energy savings in the data-shift function. Moreover, the hardware cost of the proposed LUT circuit is small since the selector is shared between read access and write access. In fact, the power consumption in the data-shift function and the transistor count are reduced by 82 and 52%, respectively, compared with those in a conventional static random-access memory-based implementation using a 90 nm CMOS technology.

A Guide to Safe Field Operations

DTIC Science & Technology

1996-01-01

be dangerous depending on the type of insect and your reaction to their sting or bite. Stinging insects, which include honey bees , killer bees ...and operational policies of the WRD to ensure that (1) their activities avoid or minimize personal injury to the employee, coworkers, or anyone in...assignments with minimal chance of personal injury or infringement on the rights of others. However, once you have received training and have been

High-performance reactionless scan mechanism

NASA Technical Reports Server (NTRS)

Williams, Ellen I.; Summers, Richard T.; Ostaszewski, Miroslaw A.

1995-01-01

A high-performance reactionless scan mirror mechanism was developed for space applications to provide thermal images of the Earth. The design incorporates a unique mechanical means of providing reactionless operation that also minimizes weight, mechanical resonance operation to minimize power, combined use of a single optical encoder to sense coarse and fine angular position, and a new kinematic mount of the mirror. A flex pivot hardware failure and current project status are discussed.

40 CFR Table 2c to Subpart Zzzz of... - Requirements for Existing Compression Ignition Stationary RICE Located at a Major Source of HAP...

Code of Federal Regulations, 2013 CFR

2013-07-01

... stationary CI RICE 1 a. Change oil and filter every 500 hours of operation or annually, whichever comes first.2 b. Inspect air cleaner every 1,000 hours of operation or annually, whichever comes first, and... comes first, and replace as necessary.3 Minimize the engine's time spent at idle and minimize the engine...

40 CFR Table 2c to Subpart Zzzz of... - Requirements for Existing Compression Ignition Stationary RICE Located at a Major Source of HAP...

Code of Federal Regulations, 2014 CFR

2014-07-01

... stationary CI RICE 1 a. Change oil and filter every 500 hours of operation or annually, whichever comes first.2 b. Inspect air cleaner every 1,000 hours of operation or annually, whichever comes first, and... comes first, and replace as necessary.3 Minimize the engine's time spent at idle and minimize the engine...

Vertical-plane pendulum absorbers for minimizing helicopter vibratory loads

NASA Technical Reports Server (NTRS)

Amer, K. B.; Neff, J. R.

1974-01-01

The use of pendulum dynamic absorbers mounted on the blade root and operating in the vertical plane to minimize helicopter vibratory loads was discussed. A qualitative description was given of the concept of the dynamic absorbers and some results of analytical studies showing the degree of reduction in vibratory loads attainable are presented. Operational experience of vertical plane dynamic absorbers on the OH-6A helicopter is also discussed.

Wildlife interactions at Solar One. Final report

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

McCrary, M.D.; McKernan, R.L.; Flanagan, P.A.

1984-01-01

The purpose of this final report is to provide the results of the study period from December 1982 through May 1983 and to report on the overall impact of the facility on wildlife. During 102 days of study 107 bird species and over 22,000 individuals were counted in the vicinity of Solar One. This high bird use of the Solar One study area in comparison to the sparse population of most of the Mojave desert is a result of the close proximity of Solar One to extensive (53 ha) ponds and active agricultural fields. Almost all cases of incineration atmore » Solar One involved aerial insects. In most cases the identity of the actual species involved could not be determined, but most incinerations probably involved dragonflies, wasps, bees, and butterflies. Unlike insects, the incineration of birds in the standby points is a rare occurrence. During the 14 month period from April 1982 through May 1983, only 6 bird incinerations were known to have occurred at Solar One. Avian collisions with plant structures, especially heliostat mirrors were more frequent than incinerations. Considering all known avian fatalities regardless of cause of death in the 14 month period from April 1982 through May 1983, 60 birds may have died as a direct result of Solar One operation. This low mortality in relation to the high bird use of the study area indicates that the impact of Solar One on birds after initial construction is minimal. The results of this study suggest that, to insure the minimal impact of this technology on birds, future solar central receiver power plants in the Mojave desert should not be sited in close proximity to open water or other areas of high bird use.« less

Operation and force analysis of the guide wire in a minimally invasive vascular interventional surgery robot system

NASA Astrophysics Data System (ADS)

Yang, Xue; Wang, Hongbo; Sun, Li; Yu, Hongnian

2015-03-01

To develop a robot system for minimally invasive surgery is significant, however the existing minimally invasive surgery robots are not applicable in practical operations, due to their limited functioning and weaker perception. A novel wire feeder is proposed for minimally invasive vascular interventional surgery. It is used for assisting surgeons in delivering a guide wire, balloon and stenting into a specific lesion location. By contrasting those existing wire feeders, the motion methods for delivering and rotating the guide wire in blood vessel are described, and their mechanical realization is presented. A new resistant force detecting method is given in details. The change of the resistance force can help the operator feel the block or embolism existing in front of the guide wire. The driving torque for rotating the guide wire is developed at different positions. Using the CT reconstruction image and extracted vessel paths, the path equation of the blood vessel is obtained. Combining the shapes of the guide wire outside the blood vessel, the whole bending equation of the guide wire is obtained. That is a risk criterion in the delivering process. This process can make operations safer and man-machine interaction more reliable. A novel surgery robot for feeding guide wire is designed, and a risk criterion for the system is given.

The effects of type of knowledge upon human problem solving in a process control task

NASA Technical Reports Server (NTRS)

Morris, N. M.; Rouse, W. B.

1985-01-01

The question of what the operator of a dynamic system needs to know was investigated in an experiment using PLANT, a simulation of a generic dynamic production process. Knowledge of PLANT was manipulated via different types of instruction, so that four different groups were created: (1) minimal instructions only; (2) minimal instructions and guidelines for operation (procedures); (3) minimal instructions and dynamic relationships (principles); and (4) minimal instructions, and procedures, and principles. Subjects controlled PLANT in a variety of situations which required maintaining production while also diagnosing familiar and unfamiliar failures. Despite the fact that these manipulations resulted in differences in subjects' Knowledge, as assessed via a written test at the end of the experiment, instructions had no effect upon achievement of the primary goal of production, or upon subjects' ability to diagnose unfamiliar failures. However, those groups receiving procedures controlled the system in a more stable manner. Possible reasons for the failure to find an effect of principles are presented, and the implications of these results for operator training and aiding are discussed.

Designing visual displays and system models for safe reactor operations based on the user`s perspective of the system

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

Brown-VanHoozer, S.A.

Most designers are not schooled in the area of human-interaction psychology and therefore tend to rely on the traditional ergonomic aspects of human factors when designing complex human-interactive workstations related to reactor operations. They do not take into account the differences in user information processing behavior and how these behaviors may affect individual and team performance when accessing visual displays or utilizing system models in process and control room areas. Unfortunately, by ignoring the importance of the integration of the user interface at the information process level, the result can be sub-optimization and inherently error- and failure-prone systems. Therefore, tomore » minimize or eliminate failures in human-interactive systems, it is essential that the designers understand how each user`s processing characteristics affects how the user gathers information, and how the user communicates the information to the designer and other users. A different type of approach in achieving this understanding is Neuro Linguistic Programming (NLP). The material presented in this paper is based on two studies involving the design of visual displays, NLP, and the user`s perspective model of a reactor system. The studies involve the methodology known as NLP, and its use in expanding design choices from the user`s ``model of the world,`` in the areas of virtual reality, workstation design, team structure, decision and learning style patterns, safety operations, pattern recognition, and much, much more.« less

Psychological Effects of Stimulant Drugs in Children with Minimal Brain Dysfunction

ERIC Educational Resources Information Center

Conners, C. Keith

1972-01-01

Two technical studies involving the drugs dextroamphetamine, methylphenidate, and magnesium pemoline were reported in regard to the psychological characteristics and effects of stimulant drugs in children with minimal brain injuries. (CB)

Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse.

PubMed

Takazawa, Naoko; Fujisaki, Akiko; Yoshimura, Yasukuni; Tsujimura, Akira; Horie, Shigeo

2018-03-01

This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q) stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS) and prolapse quality of life questionnaire (P-QOL) and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Prolapse recurred in 10 of 91 patients (11.0%), and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2%) and pelvic pain in one (1.1%) of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP.

Short-term outcomes of the transvaginal minimal mesh procedure for pelvic organ prolapse

PubMed Central

Takazawa, Naoko; Fujisaki, Akiko; Yoshimura, Yasukuni; Tsujimura, Akira

2018-01-01

Purpose This study aimed to evaluate the clinical outcomes and complications of transvaginal minimal mesh repair without using commercially available kits for treatment of pelvic organ prolapse (POP). Materials and Methods This retrospective cohort study involved 91 women who underwent surgical management of POP with originally designed small mesh between July 2014 and August 2015. This mesh is 56% smaller than the mesh widely used in Japan, and it has only two arms delivered into each right and left sacrospinous ligament. The main study outcome was the anatomic cure rate defined as recurrence of POP quantification (POP-Q) stage II or more. We also assessed changes in the overactive bladder symptom score (OABSS) and prolapse quality of life questionnaire (P-QOL) and evaluated adverse events. Finally, we compared patient backgrounds between the patients with and without recurrence. Results Prolapse recurred in 10 of 91 patients (11.0%), and all patients with recurrence were diagnosed as POP-Q stage II. As adverse events, only mesh erosion occurred in two (2.2%) and pelvic pain in one (1.1%) of the 91 patients. The OABSS and P-QOL were significantly improved by the operation. When we compared patient backgrounds between the patients with and without recurrence, body mass index was the only factor influencing affecting recurrence. Conclusions Transvaginal minimal mesh repair resulted in successful outcomes with low mesh-related complications and anatomic recurrence at one year. Furthermore, significant improvement in QOL was offered by this procedure. Our minimal mesh technique should be considered as one treatment option for the management of POP. PMID:29520390

[Clinical application of accurate placement of lumbar pedicle screws using three-dimensional printing navigational templates under Quadrant system].

PubMed

Chen, Xuanhuang; Yu, Zhengxi; Wu, Changfu; Li, Xing; Chen, Xu; Zhang, Guodong; Zheng, Zugao; Lin, Haibin

2017-02-01

To explore the feasibility and the effectiveness of the accurate placement of lumbar pedicle screws using three-dimensional (3D) printing navigational templates in Quadrant minimally invasive system. The L 1-5 spines of 12 adult cadavers were scanned using CT. The 3D models of the lumbar spines were established. The screw trajectory was designed to pass through the central axis of the pedicle by using Mimics software. The navigational template was designed and 3D-printed according to the bony surface where the soft tissues could be removed. The placed screws were scanned using CT to create the 3D model again after operation. The 3D models of the designed trajectory and the placed screws were registered to evaluate the placed screws coincidence rate. Between November 2014 and November 2015, 31 patients with lumbar instability accepted surgery assisted with 3D-printing navigation module under Quadrant minimally invasive system. There were 14 males and 17 females, aged from 42 to 60 years, with an average of 45.2 years. The disease duration was 6-13 months (mean, 8.8 months). Single segment was involved in 15 cases, two segments in 13 cases, and three segments in 3 cases. Preoperative visual analogue scale (VAS) was 7.59±1.04; Oswestry disability index (ODI) was 76.21±5.82; and the Japanese Orthopaedic Association (JOA) score was 9.21±1.64. A total of 120 screws were placed in 12 cadavers specimens. The coincidence rate of placed screw was 100%. A total of 162 screws were implanted in 31 patients. The operation time was 65-147 minutes (mean, 102.23 minutes); the intraoperative blood loss was 50-116 mL (mean, 78.20 mL); and the intraoperative radiation exposure time was 8-54 seconds (mean, 42 seconds). At 3-7 days after operation, CT showed that the coincidence rate of the placed screws was 98.15% (159/162). At 4 weeks after operation, VAS, ODI, and JOA score were 2.24±0.80, 29.17±2.50, and 23.43±1.14 respectively, showing significant differences when compared with preoperative ones ( t =14.842, P =0.006; t =36.927, P =0.002; t =-36.031, P =0.001). Thirty-one patients were followed up 8-24 months (mean, 18.7 months). All incision healed by first intention, and no complication occurred. During the follow-up, X-ray film and CT showed that pedicle screw was accurately placed without loosening or breakage, and with good fusion of intervertebral bone graft. 3D-printing navigational templates in Quadrant minimally invasive system can help lumbar surgery gain minimal invasion, less radiation, and accurate placement.

Technology-based intervention programs to promote stimulation control and communication in post-coma persons with different levels of disability

PubMed Central

Lancioni, Giulio E.; Bosco, Andrea; Olivetti Belardinelli, Marta; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Oliva, Doretta

2013-01-01

Post-coma persons in a minimally conscious state and with extensive motor impairment or emerging/emerged from such a state, but affected by lack of speech and motor impairment, tend to be passive and isolated. A way to help them develop functional responding to control environmental events and communication involves the use of intervention programs relying on assistive technology. This paper provides an overview of technology-based intervention programs for enabling the participants to (a) access brief periods of stimulation through one or two microswitches, (b) pursue stimulation and social contact through the combination of a microswitch and a sensor connected to a speech generating device (SGD) or through two SGD-related sensors, (c) control stimulation options through computer or radio systems and a microswitch, (d) communicate through modified messaging or telephone systems operated via microswitch, and (e) control combinations of leisure and communication options through computer systems operated via microswitch. Twenty-six studies, involving a total of 52 participants, were included in this paper. The intervention programs were carried out using single-subject methodology, and their outcomes were generally considered positive from the standpoint of the participants and their context. Practical implications of the programs are discussed. PMID:24574992

The Influence of Hospital Volume on Circumferential Resection Margin Involvement: Results of the Dutch Surgical Colorectal Audit.

PubMed

Gietelink, Lieke; Henneman, Daniel; van Leersum, Nicoline J; de Noo, Mirre; Manusama, Eric; Tanis, Pieter J; Tollenaar, Rob A E M; Wouters, Michel W J M

2016-04-01

This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio=1.54; 95% CI: 1.12-2.11). To evaluate the association between hospital volume and CRM (circumferential resection margin) involvement in rectal cancer surgery. To guarantee the quality of surgical treatment of rectal cancer, the Association of Surgeons of the Netherlands has stated a minimal annual volume standard of 20 procedures per hospital. The influence of hospital volume has been examined for different outcome variables in rectal cancer surgery. Its influence on the pathological outcome (CRM) however remains unclear. As long-term outcomes are best predicted by the CRM status, this parameter is of essential importance in the debate on the justification of minimal volume standards in rectal cancer surgery. Data from the Dutch Surgical Colorectal Audit (2011-2012) were used. Hospital volume was divided into 3 groups, and baseline characteristics were described. The influence of hospital volume on CRM involvement was analyzed, in a multivariate model, between low- and high-volume hospitals, according to the minimal volume standards. This study included 5161 patients. CRM was recorded in 86% of patients. CRM involvement was 11% in low-volume group versus 7.7% and 7.9% in the medium- and high-volume group (P≤0.001). After adjustment for relevant confounders, the influence of hospital volume on CRM involvement was still significant odds ratio (OR) = 1.54; 95% CI: 1.12-2.11). The outcomes of this pooled analysis support minimal volume standards in rectal cancer surgery. Low hospital volume was independently associated with a higher risk of CRM involvement (OR = 1.54; 95% CI: 1.12-2.11).

Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method.

PubMed

Milenković, Sasa; Mitković, Milorad; Micić, Ivan; Mladenović, Desimir; Najman, Stevo; Trajanović, Miroslav; Manić, Miodrag; Mitković, Milan

2013-09-01

Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint.

Rapid fabrication of microneedles using magnetorheological drawing lithography.

PubMed

Chen, Zhipeng; Ren, Lei; Li, Jiyu; Yao, Lebin; Chen, Yan; Liu, Bin; Jiang, Lelun

2018-01-01

Microneedles are micron-sized needles that are widely applied in biomedical fields owing to their painless, minimally invasive, and convenient operation. However, most microneedle fabrication approaches are costly, time consuming, involve multiple steps, and require expensive equipment. In this study, we present a novel magnetorheological drawing lithography (MRDL) method to efficiently fabricate microneedle, bio-inspired microneedle, and molding-free microneedle array. With the assistance of an external magnetic field, the 3D structure of a microneedle can be directly drawn from a droplet of curable magnetorheological fluid. The formation process of a microneedle consists of two key stages, elasto-capillary self-thinning and magneto-capillary self-shrinking, which greatly affect the microneedle height and tip radius. Penetration and fracture tests demonstrated that the microneedle had sufficient strength and toughness for skin penetration. Microneedle arrays and a bio-inspired microneedle were also fabricated, which further demonstrated the versatility and flexibility of the MRDL method. Microneedles have been widely applied in biomedical fields owing to their painless, minimally invasive, and convenient operation. However, most microneedle fabrication approaches are costly, time consuming, involve multiple steps, and require expensive equipment. Furthermore, most researchers have focused on the biomedical applications of microneedles but have given little attention to the optimization of the fabrication process. This research presents a novel magnetorheological drawing lithography (MRDL) method to fabricate microneedle, bio-inspired microneedle, and molding-free microneedle array. In this proposed technique, a droplet of curable magnetorheological fluid (CMRF) is drawn directly from almost any substrate to produce a 3D microneedle under an external magnetic field. This method not only inherits the advantages of thermal drawing approach without the need for a mask and light irradiation but also eliminates the requirement for drawing temperature adjustment. The MRDL method is extremely simple and can even produce the complex and multiscale structure of bio-inspired microneedle. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Aerospace Fuels From Nonpetroleum Raw Materials

NASA Technical Reports Server (NTRS)

Palaszewski, Bryan A.; Hepp, Aloysius F.; Kulis, Michael J.; Jaworske, Donald A.

2013-01-01

Recycling human metabolic and plastic wastes minimizes cost and increases efficiency by reducing the need to transport consumables and return trash, respectively, from orbit to support a space station crew. If the much larger costs of transporting consumables to the Moon and beyond are taken into account, developing waste recycling technologies becomes imperative and possibly mission enabling. Reduction of terrestrial waste streams while producing energy and/or valuable raw materials is an opportunity being realized by a new generation of visionary entrepreneurs; several relevant technologies are briefly compared, contrasted and assessed for space applications. A two-step approach to nonpetroleum raw materials utilization is presented; the first step involves production of supply or producer gas. This is akin to synthesis gas containing carbon oxides, hydrogen, and simple hydrocarbons. The second step involves production of fuel via the Sabatier process, a methanation reaction, or another gas-to-liquid technology, typically Fischer-Tropsch processing. Optimization to enhance the fraction of product stream relevant to transportation fuels via catalytic (process) development at NASA Glenn Research Center is described. Energy utilization is a concern for production of fuels whether for operation on the lunar or Martian surface, or beyond. The term green relates to not only mitigating excess carbon release but also to the efficiency of energy usage. For space, energy usage can be an essential concern. Another issue of great concern is minimizing impurities in the product stream(s), especially those that are potential health risks and/or could degrade operations through catalyst poisoning or equipment damage; technologies being developed to remove heteroatom impurities are discussed. Alternative technologies to utilize waste fluids, such as a propulsion option called the resistojet, are discussed. The resistojet is an electric propulsion technology with a powered thruster to vaporize and heat a propellant to high temperature, hot gases are subsequently passed through a converging-diverging nozzle expanding gases to supersonic velocities. A resistojet can accommodate many different fluids, including various reaction chamber (by-)products.

Aerospace Fuels from Nonpetroleum Raw Materials

NASA Technical Reports Server (NTRS)

Palaszewski, B. A.; Hepp, A. F.; Kulis, M. J.; Jaworske, D. A.

2013-01-01

Recycling human metabolic and plastic wastes minimizes cost and increases efficiency by reducing the need to transport consumables and return trash, respectively, from orbit to support a space station crew. If the much larger costs of transporting consumables to the Moon and beyond are taken into account, developing waste recycling technologies becomes imperative and possibly mission enabling. Reduction of terrestrial waste streams while producing energy and/or valuable raw materials is an opportunity being realized by a new generation of visionary entrepreneurs; several relevant technologies are briefly compared, contrasted and assessed for space applications. A two-step approach to nonpetroleum raw materials utilization is presented; the first step involves production of supply or producer gas. This is akin to synthesis gas containing carbon oxides, hydrogen, and simple hydrocarbons. The second step involves production of fuel via the Sabatier process, a methanation reaction, or another gas-to-liquid technology, typically Fischer- Tropsch processing. Optimization to enhance the fraction of product stream relevant to transportation fuels via catalytic (process) development at NASA GRC is described. Energy utilization is a concern for production of fuels whether for operation on the lunar or Martian surface, or beyond. The term "green" relates to not only mitigating excess carbon release but also to the efficiency of energy usage. For space, energy usage can be an essential concern. Other issues of great concern include minimizing impurities in the product stream(s), especially those that are potential health risks and/or could de-grade operations through catalyst poisoning or equipment damage; technologies being developed to remove heteroatom impurities are discussed. Alternative technologies to utilize waste fluids, such as a propulsion option called the resistojet, are discussed. The resistojet is an electric propulsion technology with a powered thruster to vaporize and heat a propellant to high temperature, hot gases are subsequently passed through a converging-diverging nozzle expanding gases to supersonic velocities. A resistojet can accommodate many different fluids, including various reaction chamber (by-)products.

Normal accidents: human error and medical equipment design.

PubMed

Dain, Steven

2002-01-01

High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in promoting a culture of safety in their organizations.

Alcohol use trajectories after high school graduation among emerging adults with type 1 diabetes.

PubMed

Hanna, Kathleen M; Stupiansky, Nathan W; Weaver, Michael T; Slaven, James E; Stump, Timothy E

2014-08-01

To explore alcohol involvement trajectories and associated factors during the year post-high school (HS) graduation among emerging adults with type 1 diabetes. Youth (N = 181) self-reported alcohol use at baseline and every 3 months for 1 year post-HS graduation. Data were also collected on parent-youth conflict, diabetes self-efficacy, major life events, living and educational situations, diabetes management, marijuana use, cigarette smoking, and glycemic control. Trajectories of alcohol use were modeled using latent class growth analysis. Associations between trajectory class and specific salient variables were examined using analysis of variance, chi square, or generalized linear mixed model, as appropriate. Identified alcohol involvement trajectory classes were labeled as (1) consistent involvement group (n = 25, 13.8%) with stable, high use relative to other groups over the 12 months; (2) growing involvement group (n = 55, 30.4%) with increasing use throughout the 12 months; and (3) minimal involvement group (n = 101, 55.8%) with essentially no involvement until the ninth month. Those with minimal involvement had the best diabetes management and better diabetes self-efficacy than those with consistent involvement. In comparison with those minimally involved, those with growing involvement were more likely to live independently of parents; those consistently involved had more major life events; and both the growing and consistent involvement groups were more likely to have tried marijuana and cigarettes. This sample of emerging adults with type 1 diabetes has three unique patterns of alcohol use during the first year after HS. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Novel Catalysts and Processing Technologies for Production of Aerospace Fuels from Non-Petroleum Raw Materials

NASA Technical Reports Server (NTRS)

Hepp, Aloysius F.; Kulis, Michael J.; Psarras, Peter C.; Ball, David W.; Timko, Michael T.; Wong, Hsi-Wu; Peck, Jay; Chianelli, Russell R.

2014-01-01

Transportation fuels production (including aerospace propellants) from non-traditional sources (gases, waste materials, and biomass) has been an active area of research and development for decades. Reducing terrestrial waste streams simultaneous with energy conversion, plentiful biomass, new low-cost methane sources, and/or extra-terrestrial resource harvesting and utilization present significant technological and business opportunities being realized by a new generation of visionary entrepreneurs. We examine several new approaches to catalyst fabrication and new processing technologies to enable utilization of these nontraditional raw materials. Two basic processing architectures are considered: a single-stage pyrolysis approach that seeks to basically re-cycle hydrocarbons with minimal net chemistry or a two-step paradigm that involves production of supply or synthesis gas (mainly carbon oxides and H2) followed by production of fuel(s) via Sabatier or methanation reactions and/or Fischer-Tröpsch synthesis. Optimizing the fraction of product stream relevant to targeted aerospace (and other transportation) fuels via modeling, catalyst fabrication and novel reactor design are described. Energy utilization is a concern for production of fuels for either terrestrial or space operations; renewable sources based on solar energy and/or energy efficient processes may be mission enabling. Another important issue is minimizing impurities in the product stream(s), especially those potentially posing risks to personnel or operations through (catalyst) poisoning or (equipment) damage. Technologies being developed to remove (and/or recycle) heteroatom impurities are briefly discussed as well as the development of chemically robust catalysts whose activities are not diminished during operation. The potential impacts on future missions by such new approaches as well as balance of system issues are addressed.

Novel Catalysts and Processing Technologies for Production of Aerospace Fuels from Non-Petroleum Raw Materials

NASA Technical Reports Server (NTRS)

Hepp, A. F.; Kulis, M. J.; Psarras, P. C.; Ball, D. W.; Timko, M. T.; Wong, H.-W.; Peck, J.; Chianelli, R. R.

2014-01-01

Transportation fuels production (including aerospace propellants) from non-traditional sources (gases, waste materials, and biomass) has been an active area of research and development for decades. Reducing terrestrial waste streams simultaneous with energy conversion, plentiful biomass, new low-cost methane sources, and/or extra-terrestrial resource harvesting and utilization present significant technological and business opportunities being realized by a new generation of visionary entrepreneurs. We examine several new approaches to catalyst fabrication and new processing technologies to enable utilization of these non-traditional raw materials. Two basic processing architectures are considered: a single-stage pyrolysis approach that seeks to basically re-cycle hydrocarbons with minimal net chemistry or a two-step paradigm that involves production of supply or synthesis gas (mainly carbon oxides and hydrogen) followed by production of fuel(s) via Sabatier or methanation reactions and/or Fischer-Tropsch synthesis. Optimizing the fraction of product stream relevant to targeted aerospace (and other transportation) fuels via modeling, catalyst fabrication and novel reactor design are described. Energy utilization is a concern for production of fuels for either terrestrial or space operations; renewable sources based on solar energy and/or energy efficient processes may be mission enabling. Another important issue is minimizing impurities in the product stream(s), especially those potentially posing risks to personnel or operations through (catalyst) poisoning or (equipment) damage. Technologies being developed to remove (and/or recycle) heteroatom impurities are briefly discussed as well as the development of chemically robust catalysts whose activity are not diminished during operation. The potential impacts on future missions by such new approaches as well as balance of system issues are addressed.

Short- and long-term outcomes after enucleation of pancreatic tumors: An evidence-based assessment.

PubMed

Zhou, Yanming; Zhao, Min; Wu, Lupeng; Ye, Feng; Si, Xiaoying

Enucleation of pancreatic tumors is rarely performed. The aim of this study was to evaluate the published evidence for its short- and long-term outcomes. PubMed (MEDLINE) and EMBASE databases were searched from 1990 to March 2016. Studies including at least ten patients who underwent enucleation of pancreatic lesions were included. Data on the outcomes were synthesized and meta-analyzed where appropriate. Twenty-seven studies involving 1316 patients were included in the systematic review. The postoperative mortality was 0.3%, and the postoperative morbidity was 50.3%, mainly represented by pancreatic fistula (38.1%). Endocrine insufficiency, exocrine insufficiency and tumor recurrence was observed in 2.4%, 1.1% and 2.3% of the patients respectively. Compared with typical resection, the operation time, blood loss, length of hospital stay, and the incidence of endocrine and exocrine insufficiency were all significantly reduced after enucleation. The occurrence of pancreatic fistula was significantly higher in enucleation group, but overall morbidity, the reoperation rate and mortality were comparable between the two groups. There was no significant difference in disease recurrence between the two groups. Compared with central pancreatectomy, enucleation had a shorter operation time, lower blood loss, less morbidity, and better pancreatic function. Compared with open enucleation, minimally invasive enucleation had a shorter operation time and a shorter length of hospital stay. Enucleation is an appropriate surgical procedure in selected patients with benign or low-malignant lesions of the pancreas. The benefits of minimally invasive approach need to be validated in further investigations with larger groups of patients. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Human Behavior and Performance Support for ISS Operations and Astronaut Selections: NASA Operational Psychology for Six-Crew Operations

NASA Technical Reports Server (NTRS)

VanderArk, Steve; Sipes, Walter; Holland, Albert; Cockrell, Gabrielle

2010-01-01

The Behavioral Health and Performance group at NASA Johnson Space Center provides psychological support services and behavioral health monitoring for ISS astronauts and their families. The ISS began as an austere outpost with minimal comforts of home and minimal communication capabilities with family, friends, and colleagues outside of the Mission Control Center. Since 1998, the work of international partners involved in the Space Flight Human Behavior and Performance Working Group has prepared high-level requirements for behavioral monitoring and support. The "buffet" of services from which crewmembers can choose has increased substantially. Through the process of development, implementation, reviewing effectiveness and modifying as needed, the NASA and Wyle team have proven successful in managing the psychological health and well being of the crews and families with which they work. Increasing the crew size from three to six brought additional challenges. For the first time, all partners had to collaborate at the planning and implementation level, and the U.S. served as mentor to extrapolate their experiences to the others. Parity in available resources, upmass, and stowage had to be worked out. Steady progress was made in improving off-hours living and making provisions for new technologies within a system that has difficulty moving quickly on certifications. In some respect, the BHP support team fell victim to its previous successes. With increasing numbers of crewmembers in training, requests to engage our services spiraled upward. With finite people and funds, a cap had to placed on many services to ensure that parity could be maintained. The evolution of NASA BHP services as the ISS progressed from three- to six-crew composition will be reviewed, and future challenges that may be encountered as the ISS matures in its assembly-complete state will be discussed.

Minimally invasive strabismus surgery versus paralimbal approach: A randomized, parallel design study is minimally invasive strabismus surgery worth the effort?

PubMed Central

Sharma, Richa; Amitava, Abadan K; Bani, Sadat AO

2014-01-01

Introduction: Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS) approach with a standard paralimbal strabismus surgery (SPSS) approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS), and drop intolerance (DI) on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS). Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon's signed rank test. Results: On the first post-operative day, only FBS (P =0.01) and TIS (P =0.04) showed significant difference favoring MISS. At 2-3 weeks, redness (P =0.04), congestion (P =0.04), FBS (P =0.02), and TIS (P =0.04) were significantly less in MISS eye. At 6 weeks, only redness (P =0.04) and TIS (P =0.05) were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period. PMID:24088635

Control Synthesis for a Class of Hybrid Systems Subject to Configuration-Based Safety Constraints

NASA Technical Reports Server (NTRS)

Heymann, Michael; Lin, Feng; Meyer, George

1997-01-01

We examine a class of hybrid systems which we call Composite Hybrid Machines (CHM's) that consists of the concurrent (and partially synchronized) operation of Elementary Hybrid Machines (EHM's). Legal behavior, specified by a set of illegal configurations that the CHM may not enter, is to be achieved by the concurrent operation of the CHM with a suitably designed legal controller. In the present paper we focus on the problem of synthesizing a legal controller, whenever such a controller exists. More specifically, we address the problem of synthesizing the minimally restrictive legal controller. A controller is minimally restrictive if, when composed to operate concurrently with another legal controller, it will never interfere with the operation of the other controller and, therefore, can be composed to operate concurrently with any other controller that may be designed to achieve liveness specifications or optimality requirements without the need to reinvestigate or reverify legality of the composite controller. We confine our attention to a special class of CHM's where system dynamics is rate-limited and legal guards are conjunctions or disjunctions of atomic formulas in the dynamic variables (of the type x less than or equal to x(sub 0), or x greater than or equal to x(sub 0)). We present an algorithm for synthesis of the minimally restrictive legal controller. We demonstrate our approach by synthesizing a minimally restrictive controller for a steam boiler (the verification of which recently received a great deal of attention).

Internalization of fresh produce by foodborne pathogens.

PubMed

Erickson, Marilyn C

2012-01-01

Recent studies addressing the internalization of fresh produce by foodborne pathogens arose in response to the growing number of recent and high profile outbreaks involving fresh produce. Because chemical sanitizing agents used during harvest and minimal processing are unlikely to reach enteric pathogens residing within plant tissue, it is imperative that paths for pathogen entry be recognized and minimized. Using both microscopy and microbial enumeration tools, enteric pathogens have been shown to enter plant tissues through both natural apertures (stomata, lateral junctions of roots, flowers) and damaged (wounds, cut surfaces) tissue. In studies revealing preharvest internalization via plant roots or leaf stomata, experimental conditions have primarily involved exposure of plants to high pathogen concentrations (≥ 6 log g⁻¹ soil or 6 log ml⁻¹ water), but those pathogens internalized appear to have short-term persistence. Postharvest internalization of pathogens via cut surfaces may be minimized by maintaining effective levels of sanitizing agents in waters during harvesting and minimal processing.

Jerk Minimization Method for Vibration Control in Buildings

NASA Technical Reports Server (NTRS)

Abatan, Ayo O.; Yao, Leummim

1997-01-01

In many vibration minimization control problems for high rise buildings subject to strong earthquake loads, the emphasis has been on a combination of minimizing the displacement, the velocity and the acceleration of the motion of the building. In most cases, the accelerations that are involved are not necessarily large but the change in them (jerk) are abrupt. These changes in magnitude or direction are responsible for most building damage and also create discomfort like motion sickness for inhabitants of these structures because of the element of surprise. We propose a method of minimizing also the jerk which is the sudden change in acceleration or the derivative of the acceleration using classical linear quadratic optimal controls. This was done through the introduction of a quadratic performance index involving the cost due to the jerk; a special change of variable; and using the jerk as a control variable. The values of the optimal control are obtained using the Riccati equation.

Muscle gap approach under a minimally invasive channel technique for treating long segmental lumbar spinal stenosis

PubMed Central

Bin, Yang; De cheng, Wang; wei, Wang Zong; Hui, Li

2017-01-01

Abstract This study aimed to compare the efficacy of muscle gap approach under a minimally invasive channel surgical technique with the traditional median approach. In the Orthopedics Department of Traditional Chinese and Western Medicine Hospital, Tongzhou District, Beijing, 68 cases of lumbar spinal canal stenosis underwent surgery using the muscle gap approach under a minimally invasive channel technique and a median approach between September 2013 and February 2016. Both approaches adopted lumbar spinal canal decompression, intervertebral disk removal, cage implantation, and pedicle screw fixation. The operation time, bleeding volume, postoperative drainage volume, and preoperative and postoperative visual analog scale (VAS) score and Japanese Orthopedics Association score (JOA) were compared between the 2 groups. All patients were followed up for more than 1 year. No significant difference between the 2 groups was found with respect to age, gender, surgical segments. No diversity was noted in the operation time, intraoperative bleeding volume, preoperative and 1 month after the operation VAS score, preoperative and 1 month after the operation JOA score, and 6 months after the operation JOA score between 2 groups (P > .05). The amount of postoperative wound drainage (260.90 ± 160 mL vs 447.80 ± 183.60 mL, P < .001) and the VAS score 6 months after the operation (1.71 ± 0.64 vs 2.19 ± 0.87, P = .01) were significantly lower in the muscle gap approach group than in the median approach group (P < .05). In the muscle gap approach under a minimally invasive channel group, the average drainage volume was reduced by 187 mL, and the average VAS score 6 months after the operation was reduced by an average of 0.48. The muscle gap approach under a minimally invasive channel technique is a feasible method to treat long segmental lumbar spinal canal stenosis. It retains the integrity of the posterior spine complex to the greatest extent, so as to reduce the adjacent spinal segmental degeneration and soft tissue trauma. Satisfactory short-term and long-term clinical results were obtained. PMID:28796075

34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

Code of Federal Regulations, 2013 CFR

2013-07-01

... conducts or funds research in which the IRB finds that more than minimal risk to children is presented by..., only if the IRB finds that— (a) The risk represents a minor increase over minimal risk; (b) The... or condition that is of vital importance for the understanding or amelioration of the subjects...

34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

Code of Federal Regulations, 2012 CFR

2012-07-01

... conducts or funds research in which the IRB finds that more than minimal risk to children is presented by..., only if the IRB finds that— (a) The risk represents a minor increase over minimal risk; (b) The... or condition that is of vital importance for the understanding or amelioration of the subjects...

34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

Code of Federal Regulations, 2014 CFR

2014-07-01

... conducts or funds research in which the IRB finds that more than minimal risk to children is presented by..., only if the IRB finds that— (a) The risk represents a minor increase over minimal risk; (b) The... or condition that is of vital importance for the understanding or amelioration of the subjects...

34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

Code of Federal Regulations, 2011 CFR

2011-07-01

... conducts or funds research in which the IRB finds that more than minimal risk to children is presented by..., only if the IRB finds that— (a) The risk represents a minor increase over minimal risk; (b) The... or condition that is of vital importance for the understanding or amelioration of the subjects...

Minimally invasive functional approach for cholesteatoma surgery.

PubMed

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

2014-10-01

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

Operator performance and localized muscle fatigue in a simulated space vehicle control task

NASA Technical Reports Server (NTRS)

Lewis, J. L., Jr.

1979-01-01

Fourier transforms in a special purpose computer were utilized to obtain power spectral density functions from electromyograms of the biceps brachii, triceps brachii, brachioradialis, flexor carpi ulnaris, brachialis, and pronator teres in eight subjects performing isometric tracking tasks in two directions utilizing a prototype spacecraft rotational hand controller. Analysis of these spectra in general purpose computers aided in defining muscles involved in performing the task, and yielded a derived measure potentially useful in predicting task termination. The triceps was the only muscle to show significant differences in all possible tests for simple effects in both tasks and, overall, was the most consistently involved of the six muscles. The total power monitored for triceps, biceps, and brachialis dropped to minimal levels across all subjects earlier than for other muscles. However, smaller variances existed for the biceps, brachioradialis, brachialis, and flexor carpi ulnaris muscles and could provide longer predictive times due to smaller standard deviations for a greater population range.

CHALLENGES AND BENEFITS OF CONDUCTING ENVIRONMENTAL JUSTICE RESEARCH IN A SCHOOL SETTING

PubMed Central

GUIDRY, VIRGINIA T.; LOWMAN, AMY; HALL, DEVON; BARON, DOTHULA; WING, STEVE

2015-01-01

Environmental justice (EJ) research requires attention to consequences for research participants beyond those typically considered by institutional review boards. The imbalance of power between impacted communities and those who create and regulate pollution creates challenges for participation, yet research can also benefit those involved. Our community-academic partnership designed the Rural Air Pollutants and Children's Health (RAPCH) study to provide positive impacts while measuring health effects at three low-resource public middle schools near concentrated animal feeding operations (CAFOs) in North Carolina. We evaluated perceived benefits and challenges of study involvement by interviewing school staff and community liaisons who facilitated data collection. Reported benefits included enhancement of students’ academic environment and increased community environmental awareness; challenges were associated mainly with some participants’ immaturity. Leadership from a strong community-based organization was crucial to recruitment, yet our approach entailed minimal focus on EJ, which may have limited opportunities for community education or organizing for environmental health. PMID:25085828

Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; van Veelen, M A; Pierie, J P E N

2008-11-01

With the expanding implementation of minimally invasive surgery, the operating team is confronted with challenges in the field of ergonomics. Visual feedback is derived from a monitor placed outside the operating field. This crossover trial was conducted to evaluate and compare neck posture in relation to monitor position in a dedicated minimally invasive surgery (MIS) suite and a conventional operating room. Assessment of the neck was conducted for 16 surgeons, assisting surgeons, and scrub nurses performing a laparoscopic cholecystectomy in both types of operating room. Flexion and rotation of the cervical spine were measured intraoperatively using a video analysis system. A two-question visual analog scale (VAS) questionnaire was used to evaluate posture in relation to the monitor position. Neck rotation was significantly reduced in the MIS suite for the surgeon (p = 0.018) and the assisting surgeon (p < 0.001). Neck flexion was significantly improved in the MIS suite for the surgeon (p < 0.001) and the scrub nurse (p = 0.018). On the questionnaire, the operating room team scored their posture significantly higher in the MIS suite and also indicated fewer musculoskeletal complaints. The ergonomic quality of the neck posture is significantly improved in the MIS suite for the entire operating room team.

Minimally invasive neurosurgery within a 0.5 tesla intraoperative magnetic resonance scanner using an off-line neuro-navigation system.

PubMed

Mursch, K; Gotthardt, T; Kröger, R; Bublat, M; Behnke-Mursch, J

2005-08-01

We evaluated an advanced concept for patient-based navigation during minimally invasive neurosurgical procedures. An infrared-based, off-line neuro-navigation system (LOCALITE, Bonn, Germany) was applied during operations within a 0.5 T intraoperative MRI scanner (iMRI) (Signa SF, GE Medical Systems, Milwaukee, WI, USA) in addition to the conventional real-time system. The three-dimensional (3D) data set was acquired intraoperatively and up-dated when brain-shift was suspected. Twenty-three patients with subcortical lesions were operated upon with the aim to minimise the operative trauma. Small craniotomies (median diameter 30 mm, mean diameter 27 mm) could be placed exactly. In all cases, the primary goal of the operation (total resection or biopsy) was achieved in a straightforward procedure without permanent morbidity. The navigation system could be easily used without technical problems. In contrast to the real-time navigation mode of the MR system, the higher quality as well as the real-time display of the MR images reconstructed from the 3D reference data provided sufficient visual-manual coordination. The system combines the advantages of conventional neuro-navigation with the ability to adapt intraoperatively to the continuously changing anatomy. Thus, small and/or deep lesions can be operated upon in straightforward minimally invasive operations.

NAVAIR Hexavalent Chromium Minimization Status

DTIC Science & Technology

2010-11-01

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

Assembling Precise Truss Structures With Minimal Stresses

NASA Technical Reports Server (NTRS)

Sword, Lee F.

1996-01-01

Improved method of assembling precise truss structures involves use of simple devices. Tapered pins that fit in tapered holes indicate deviations from prescribed lengths. Method both helps to ensure precision of finished structures and minimizes residual stresses within structures.

Radiation exposure from fluoroscopy during orthopedic surgical procedures

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

Riley, S.A.

1989-11-01

The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of thismore » study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.« less

Scar Management of the Burned Hand

PubMed Central

Sorkin, Michael; Cholok, David; Levi, Benjamin

2017-01-01

Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars. PMID:28363297

Acoustic Characterization of Compact Jet Engine Simulator Units

NASA Technical Reports Server (NTRS)

Doty, Michael J.; Haskin, Henry H.

2013-01-01

Two dual-stream, heated jet, Compact Jet Engine Simulator (CJES) units are designed for wind tunnel acoustic experiments involving a Hybrid Wing Body (HWB) vehicle. The newly fabricated CJES units are characterized with a series of acoustic and flowfield investigations to ensure successful operation with minimal rig noise. To limit simulator size, consistent with a 5.8% HWB model, the CJES units adapt Ultra Compact Combustor (UCC) technology developed at the Air Force Research Laboratory. Stable and controllable operation of the combustor is demonstrated using passive swirl air injection and backpressuring of the combustion chamber. Combustion instability tones are eliminated using nonuniform flow conditioners in conjunction with upstream screens. Through proper flow conditioning, rig noise is reduced by more than 20 dB over a broad spectral range, but it is not completely eliminated at high frequencies. The low-noise chevron nozzle concept designed for the HWB test shows expected acoustic benefits when installed on the CJES unit, and consistency between CJES units is shown to be within 0.5 dB OASPL.

System engineering analysis of derelict collision prevention options

NASA Astrophysics Data System (ADS)

McKnight, Darren S.; Di Pentino, Frank; Kaczmarek, Adam; Dingman, Patrick

2013-08-01

Sensitivities to the future growth of orbital debris and the resulting hazard to operational satellites due to collisional breakups of large derelict objects are being studied extensively. However, little work has been done to quantify the technical and operational tradeoffs between options for minimizing future derelict fragmentations that act as the primary source for future debris hazard growth. The two general categories of debris mitigation examined for prevention of collisions involving large derelict objects (rocket bodies and payloads) are active debris removal (ADR) and just-in-time collision avoidance (JCA). Timing, cost, and effectiveness are compared for ADR and JCA solutions highlighting the required enhancements in uncooperative element set accuracy, rapid ballistic launch, despin/grappling systems, removal technologies, and remote impulsive devices. The primary metrics are (1) the number of derelict objects moved/removed per the number of catastrophic collisions prevented and (2) cost per collision event prevented. A response strategy that contains five different activities, including selective JCA and ADR, is proposed as the best approach going forward.

Open reduction internal fixation of the unstable mallet fracture.

PubMed

Phadnis, Joideep; Yousaf, Sohail; Little, Nicholas; Chidambaram, Ramiah; Mok, Daniel

2010-09-01

Unstable mallet fractures of the digit pose a challenge when treated surgically. We present the results of a technique, not earlier described, for the fixation of these uncommon injuries. The technique involves anatomical reduction and stable fixation of the distal articular fragment combined with stabilization of the distal interphalangeal joint with buried Kirschner wires allowing early mobilization of the digit. Twenty patients with an average follow-up of 12.7 months (10 mo to 21 mo) are presented. Results were good/excellent (Crawford's criteria) in 16 patients, fair in 3, and poor in 1 with those operated upon within 2 weeks postinjury achieving the best results. There were no incidences of fixation failure, loss of reduction, or posttraumatic osteoarthritis. One patient had a minor infection, but there were no cases of nail deformity or wound breakdown. There was high patient satisfaction and all patients returned to work after treatment. We conclude that this is a reliable technique with minimal complications and is comparable with other published operative and nonoperative treatment modalities.

Is the Australian hospital system adequately prepared for terrorism?

PubMed

Rosenfeld, Jeffrey V; Fitzgerald, Mark; Kossmann, Thomas; Pearce, Andrew; Joseph, Anthony; Joseph, Andrew; Tan, Gim; Gardner, Michele; Shapira, Shmuel

Australian hospitals need to be prepared to deal with mass casualties from terrorist strikes, including bomb blasts and chemical, biological and radiation injury. Injuries from bomb explosions are more severe than those commonly seen in Australian hospitals. In disasters involving mass casualties in urban areas, many of the injured make their own way to hospital, often arriving before the more seriously injured casualties. Major hospitals in Australia should plan for large numbers of undifferentiated and potentially contaminated casualties arriving with minimal warning. It is critical that experienced and trained senior medical officers perform the triage of casualties in emergency departments, with frequent reassessment to detect missed injuries (especially pulmonary blast injury). Hospitals require well developed standard operating procedures for mass casualty events, reinforced by regular drills. Preparing for a major event includes training staff in major incident management, setting up an operational/control unit, nominating key personnel, ensuring there is an efficient intra-hospital communication system, and enhancing links with other emergency services and hospitals.

Integration of ecological-biological thresholds in conservation decision making.

PubMed

Mavrommati, Georgia; Bithas, Kostas; Borsuk, Mark E; Howarth, Richard B

2016-12-01

In the Anthropocene, coupled human and natural systems dominate and only a few natural systems remain relatively unaffected by human influence. On the one hand, conservation criteria based on areas of minimal human impact are not relevant to much of the biosphere. On the other hand, conservation criteria based on economic factors are problematic with respect to their ability to arrive at operational indicators of well-being that can be applied in practice over multiple generations. Coupled human and natural systems are subject to economic development which, under current management structures, tends to affect natural systems and cross planetary boundaries. Hence, designing and applying conservation criteria applicable in real-world systems where human and natural systems need to interact and sustainably coexist is essential. By recognizing the criticality of satisfying basic needs as well as the great uncertainty over the needs and preferences of future generations, we sought to incorporate conservation criteria based on minimal human impact into economic evaluation. These criteria require the conservation of environmental conditions such that the opportunity for intergenerational welfare optimization is maintained. Toward this end, we propose the integration of ecological-biological thresholds into decision making and use as an example the planetary-boundaries approach. Both conservation scientists and economists must be involved in defining operational ecological-biological thresholds that can be incorporated into economic thinking and reflect the objectives of conservation, sustainability, and intergenerational welfare optimization. © 2016 Society for Conservation Biology.

Comparison of outcomes between operative vaginal deliveries and spontaneous vaginal deliveries in southeast Nigeria.

PubMed

Lawani, Lucky O; Anozie, Okechukwu B; Ezeonu, Paul O; Iyoke, Chukwuemeka A

2014-06-01

To evaluate the incidence of, indications for, and outcome of operative vaginal deliveries compared with spontaneous vaginal deliveries in southeast Nigeria. A retrospective cohort study was conducted involving cases of operative vaginal delivery performed at Ebonyi State University Teaching Hospital over a 10-year period. Data on the procedures were abstracted from the operation notes of the medical records of parturients. An incidence of 4.7% (n = 461) was recorded. The most common indications for vacuum and forceps delivery were prolonged second stage of labor (44.9%) and poor maternal effort (27.8%). The only indication for destructive operation was intrauterine fetal death (3.7%). The risk ratio (RR) for hemorrhage/vulvar hematoma was 1.14 (95% confidence interval [CI], 0.53-2.48) for vacuum-assisted delivery and 5.49 (95% CI, 0.82-36.64) for forceps delivery. The RR for genital laceration was 1.21 (95% CI, 0.44-3.30) for vacuum-assisted delivery and 9.41 (95% CI, 1.33-66.65) for forceps delivery. The risk of fetal scalp bruises and caput succedaneum was higher for operative vaginal delivery than for spontaneous vaginal delivery, with no significant difference in maternal morbidity. The perinatal mortality rate was 0.9 per 1000 live births. Operative vaginal delivery by experienced healthcare providers is associated with good obstetric outcomes with minimal risk. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The impact of preventable disruption on the operative time for minimally invasive surgery.

PubMed

Al-Hakim, Latif

2011-10-01

Current ergonomic studies show that disruption exposes surgical teams to stress and musculoskeletal disorders. This study considers minimally invasive surgery as a sociotechnical process subjected to a variety of disruption events other than those recognized by ergonomic science. The research takes into consideration the impact of preventable disruption on operating time rather than on the physical and emotional status of the surgical team. Events inside operating rooms that disturbed operative time were recorded for 17 minimally invasive surgeries. The disruption events were classified into four main areas: prerequisite requirements, work design, communication during surgery, and other. Each area was further classified according to sources of disruption. Altogether, 11 sources of disruption were identified: patient record, protocol and policy, surgical requirements and surgeon preferences, operating table and patient positioning, arrangement of instruments, lighting, monitor, clothing, surgical teamwork, coordination, and other. Disruption prolonged operative time by more than 32%. Teamwork forms the main source of disruption followed by operating table and patient positioning and arrangement of instruments. These three sources represented approximately 20% of operative time. Failure to follow principles of work design had a significant negative impact, lengthening operative time by approximately 15%. Although lighting and monitors had a relatively small impact on operative time, these factors could create inconvenience and stress within the surgical teams. In addition, the effect of failure to follow surgical protocols and policies or having incomplete patient records may have a limited effect on operative time but could have serious consequences. This report demonstrates that preventable disruption caused an increase in operative time and forced surgeons and patients to endure unnecessary delay of more than 32%. Such additional time could be used to deal with the pressure of emergency cases and to reduce waiting lists for elective surgery.

Documentation: Records and Reports.

PubMed

Akers, Michael J

2017-01-01

This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Environment, health and safety issues for sources used in MOVPE growth of compound semiconductors

NASA Astrophysics Data System (ADS)

Shenai-Khatkhate, Deodatta V.; Goyette, Randall J.; DiCarlo, Ronald L., Jr.; Dripps, Gregory

2004-12-01

As metalorganic vapor-phase epitaxy (MOVPE) is becoming well-established production technology, there are equally growing concerns associated with its bearing on personnel and community safety, environmental impact and maximum quantities of hazardous materials permissible in the device fabrication operations. Safety as well as responsible environmental care has always been of paramount importance in the MOVPE-based crystal growth of compound semiconductors. In this paper, we present the findings from workplace exposure monitoring studies on conventional MOVPE sources such as trimethylgallium, triethylgallium, trimethylantimony and diethylzinc. Also reviewed are the environmental, health and safety hazard aspects for metalorganic sources of routine elements, and the means to minimize the risks (i.e., engineering controls) involved while using these MOVPE sources.

Constrained Multiobjective Biogeography Optimization Algorithm

PubMed Central

Mo, Hongwei; Xu, Zhidan; Xu, Lifang; Wu, Zhou; Ma, Haiping

2014-01-01

Multiobjective optimization involves minimizing or maximizing multiple objective functions subject to a set of constraints. In this study, a novel constrained multiobjective biogeography optimization algorithm (CMBOA) is proposed. It is the first biogeography optimization algorithm for constrained multiobjective optimization. In CMBOA, a disturbance migration operator is designed to generate diverse feasible individuals in order to promote the diversity of individuals on Pareto front. Infeasible individuals nearby feasible region are evolved to feasibility by recombining with their nearest nondominated feasible individuals. The convergence of CMBOA is proved by using probability theory. The performance of CMBOA is evaluated on a set of 6 benchmark problems and experimental results show that the CMBOA performs better than or similar to the classical NSGA-II and IS-MOEA. PMID:25006591

Tissue preservation with mass spectroscopic analysis: Implications for cancer diagnostics.

PubMed

Hall, O Morgan; Peer, Cody J; Figg, William D

2018-05-17

Surgical intervention is a common treatment modality for localized cancer. Post-operative analysis involves evaluation of surgical margins to assess whether all malignant tissue has been resected because positive surgical margins lead to a greater likelihood of recurrence. Secondary treatments are utilized to minimize the negative effects of positive surgical margins. Recently, in Science Translational Medicine, Zhang et al describe a new mass spectroscopic technique that could potentially decrease the likelihood of positive surgical margins. Their nondestructive in vivo tissue sampling leads to a highly accurate and rapid cancer diagnosis with great precision between healthy and malignant tissue. This new tool has the potential to improve surgical margins and accelerate cancer diagnostics by analyzing biomolecular signatures of various tissues and diseases.

Transhepatic metallic stenting for hepaticojejunostomy stricture following laparoscopic cholecystectomy biliary injury: A case of successful 20 years follow-up.

PubMed

Donatelli, Gianfranco; Mutter, Didier; Dhumane, Parag; Callari, Cosimo; Marescaux, Jacques

2012-07-01

Laparoscopic cholecystectomy is still associated with a considerable rate of biliary injuries and related strictures. Advances in interventional endoscopy and percutaneous techniques have made stenting a preferred treatment modality for the management of these strictures. We report successful 20 years of follow-up of a case of trans-hepatic metallic stenting (2 Gianturco(®) prostheses, 5 cm long, 2 cm in diameter) done for stenosed hepatico-jejunostomy anastomosis after laparoscopic CBD injury. Percutaneous transhepatic stenting and long-term placement of metallic stents need to be re-evaluated as a minimally invasive definitive treatment option for benign biliary strictures in patients with altered anatomy such as hepatico-jejunostomy or in whom re-operation involves high risk.

Improvement of Efficiency of Transportation in Harbor Physical Distribution Considering Inland Carriage

NASA Astrophysics Data System (ADS)

Hino, Hisato; Hoshino, Satoshi; Fujisawa, Tomoharu; Maruyama, Shigehisa; Ota, Jun

Currently, container ships move cargo with minimal participation from external trucks. However, there is slack time between the departure of container ships and the completion of cargo handling by container ships without the participation of external trucks; therefore, external trucks can be used to move cargo without delaying the departure time. In this paper, we propose a solution involving the control algorithms of transfer cranes (TCs) because the efficiency of yard operations depends largely on the productivity of TCs. TCs work according to heuristic rules using the forecasted arrival times of internal and external trucks. Simulation results show that the proposed method can reduce the waiting time of external trucks and meet the departure time of container ships.

Anaesthetic considerations for pectus repair surgery

PubMed Central

Patvardhan, Chinmay

2016-01-01

Repair of pectus is one of the most common congenital abnormality for which patient presents for thoracic surgery. In recent years, innovative minimally invasive techniques involving video assisted thoracoscopy for pectus repair have become the norm. Similarly, anaesthetic techniques have evolved to include principles of enhanced recovery, multimodal analgesia and innovative ultrasound guided neuraxial and nerve blocks. Adequate anaesthetic set up and monitoring including the use of real time intraoperative monitoring with transesophageal echocardiography (TOE) has enabled the anaesthetist to enhance patient safety by providing instantaneous imaging of cardiac compression and complications during surgery. In this review article we aim to provide non-systematic review and institutional experience of our anaesthetic strategy to provide effective peri-operative care in this patient group. PMID:29078504

Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives

PubMed Central

Neumann, Philipp-Alexander; Rijcken, Emile

2016-01-01

Patients with inflammatory bowel disease (IBD) comprise a population of patients that have a high likelihood of both surgical treatment at a young age and repetitive operative interventions. Therefore surgical procedures need to aim at minimizing operative trauma with best postoperative recovery. Minimally invasive techniques have been one of the major advancements in surgery in the last decades and are nowadays almost routinely performed in colorectal resections irrespective of underlying disease. However due to special disease related characteristics such as bowel stenosis, interenteric fistula, abscesses, malnutrition, repetitive surgeries, or immunosuppressive medications, patients with IBD represent a special cohort with specific needs for surgery. This review summarizes current evidence of minimally invasive surgery for patients with Crohn’s disease or ulcerative colitis and gives an outlook on the future perspective of technical advances in this highly moving field with its latest developments in single port surgery, robotics and trans-anal techniques. PMID:27158537

WASTE MINIMIZATION AUDIT REPORT: CASE STUDIES OF MINIMIZATION OF SOLVENT WASTES AND ELECTROPLATING WASTES AT A DOD (DEPARTMENT OF DEFENSE) INSTALLATION

EPA Science Inventory

The report results of a waste minimization audit carried out in 1987 at a tank reconditioning facility operated by the DOD. The audit team developed recommendations for reducing the generation FOO6 wastewater treatment sludge, and FOO2, and FOO4 solvent wastes. In addition to det...

Use of Traffic Intent Information by Autonomous Aircraft in Constrained Operations

NASA Technical Reports Server (NTRS)

Wing, David J.; Barmore, Bryan E.; Krishnamurthy, Karthik

2002-01-01

This paper presents findings of a research study designed to provide insight into the issue of intent information exchange in constrained en-route air-traffic operations and its effect on pilot decision-making and flight performance. The piloted simulation was conducted in the Air Traffic Operations Laboratory at the NASA Langley Research Center. Two operational modes for autonomous flight management were compared under conditions of low and high operational complexity (traffic and airspace hazard density). The tactical mode was characterized primarily by the use of traffic state data for conflict detection and resolution and a manual approach to meeting operational constraints. The strategic mode involved the combined use of traffic state and intent information, provided the pilot an additional level of alerting, and allowed an automated approach to meeting operational constraints. Operational constraints applied in the experiment included separation assurance, schedule adherence, airspace hazard avoidance, flight efficiency, and passenger comfort. The strategic operational mode was found to be effective in reducing unnecessary maneuvering in conflict situations where the intruder's intended maneuvers would resolve the conflict. Conditions of high operational complexity and vertical maneuvering resulted in increased proliferation of conflicts, but both operational modes exhibited characteristics of stability based on observed conflict proliferation rates of less than 30 percent. Scenario case studies illustrated the need for maneuver flight restrictions to prevent the creation of new conflicts through maneuvering and the need for an improved user interface design that appropriately focuses the pilot's attention on conflict prevention information. Pilot real-time assessment of maximum workload indicated minimal sensitivity to operational complexity, providing further evidence that pilot workload is not the limiting factor for feasibility of an en-route distributed traffic management system, even under highly constrained conditions.

Causes Underlying Minimal Parent Involvement in the Education of Their Children.

ERIC Educational Resources Information Center

Dwyer, David J.; Hecht, Jeffrey B.

In this document, recent literature on schools' attempts to involve parents in the education of their children and on the rationale for parent involvement is evaluated. Research reviewed concerns parent involvement programs designed to improve student academic performance, increase student attendance, decrease behaviors that leave students at…

Minimizing both dropped formulas and concepts in knowledge fusion

NASA Astrophysics Data System (ADS)

Grégoire, Éric

2006-04-01

In this paper, a new family of approaches to fuse inconsistent knowledge sources is introduced in a standard logical setting. They combine two preference criteria to arbitrate between conflicting information: the minimization of falsified formulas and the minimization of the number of the different atoms that are involved in those formulas. Although these criteria exhibit a syntactical flavor, the approaches are semantically-defined.

Fastener Capture Plate Technology to Contain On-Orbit Debris

NASA Technical Reports Server (NTRS)

Eisenhower, Kevin

2010-01-01

The Fastener Capture Plate technology was developed to solve the problem of capturing loose hardware and small fasteners, items that were not originally intended to be disengaged in microgravity, thus preventing them from becoming space debris. This technology was incorporated into astronaut tools designed and successfully used on NASA s Hubble Space Telescope Servicing Mission #4. The technology s ultimate benefit is that it allows a very time-efficient method for disengaging fasteners and removing hardware while minimizing the chances of losing parts or generating debris. The technology aims to simplify the manual labor required of the operator. It does so by optimizing visibility and access to the work site and minimizing the operator's need to be concerned with debris while performing the operations. It has a range of unique features that were developed to minimize task time, as well as maximize the ease and confidence of the astronaut operator. This paper describes the technology and the astronaut tools developed specifically for a complicated on-orbit repair, and it includes photographs of the hardware being used in outer space.

[Comparison of minimally invasive extraction and traditional method in the extraction of impacted mandibular third molar].

PubMed

Xu, Fang; Zhang, Hui-Xia

2016-10-01

To compare minimally invasive extraction and traditional method in the extraction of impacted mandibular third molar. One hundred and sixty patients with impacted mandibular third molar were equally divided into two groups. Patients in the experimental group were treated with minimally invasive extraction, using implant machine and luxator, while patients in the control group were treated with traditional methods including use of orthodox chisel. The operation time, intraoperative and postoperative complications including deformation of extraction sockets, dry socket, limitation of mouth opening, pain and swelling, and fear were observed and compared between the two groups. The data were analyzed with SPSS18.0 software package. The operation time was (17.32±1.01) min in the experimental group, significantly shorter than the control group which was (33.46±1.12）min (P<0.05); significant difference was found in the incidence of root fracture, medium or severe tooth sockets deformation and incidence of psychological fear during operation between the control group and experimental group(P<0.05); the degree of mouth opening after surgery, the incidence of moderate or severe pain after surgery was significantly lower in the experimental than in the control group(P<0.05). Minimally invasive extraction of mandibular impacted wisdom tooth is better than traditional method, with shorter operation time and less intraoperative and postoperative complications, which should be widely applied in clinic.

Minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum.

PubMed

Lee, Seock Yeol; Song, In Hag; Lee, Seung Jin

2014-01-01

This report presents early results of surgical experience of minimal invasive extrathoracic presternal compression using a metal bar for correction of the pectus carinatum. From February 2008 to February 2012, 15 patients with combined pectus carinatum and pectus excavatum underwent minimal invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum and Nuss operation for pectus excavatum. After 2 years, bar removal was done in all patients. In this paper, we focused on pectus carinatum repair. The effects and complications of the minimally invasive extrathoracic presternal compression using a metal bar for correction of pectus carinatum were reviewed. The median age was 15.7 years. The mean operation time for pectus carinatum with pectus excavatum was 122 min. The median length of hospitalization was 6 days. The Haller pectus index of pectus carinatum was 2.93 ± 0.36 pre-operatively and this was increased to 3.33 ± 0.61 post-operatively. There were no special complications. The degree of satisfaction of pectus carinatum correction was 3.75 ± 0.46 (range 1-4). Our results were favorable in spite of the small number of cases and short follow-up, and our modified technique of pectus carinatum was easy and simple. However, long-term follow-up is needed to accurately evaluate the effects of this surgery in many cases.

Minimally invasive mitral valve surgery is associated with equivalent cost and shorter hospital stay when compared with traditional sternotomy.

PubMed

Atluri, Pavan; Stetson, Robert L; Hung, George; Gaffey, Ann C; Szeto, Wilson Y; Acker, Michael A; Hargrove, W Clark

2016-02-01

Mitral valve surgery is increasingly performed through minimally invasive approaches. There are limited data regarding the cost of minimally invasive mitral valve surgery. Moreover, there are no data on the specific costs associated with mitral valve surgery. We undertook this study to compare the costs (total and subcomponent) of minimally invasive mitral valve surgery relative to traditional sternotomy. All isolated mitral valve repairs performed in our health system from March 2012 through September 2013 were analyzed. To ensure like sets of patients, only those patients who underwent isolated mitral valve repairs with preoperative Society of Thoracic Surgeons scores of less than 4 were included in this study. A total of 159 patients were identified (sternotomy, 68; mini, 91). Total incurred direct cost was obtained from hospital financial records. Analysis demonstrated no difference in total cost (operative and postoperative) of mitral valve repair between mini and sternotomy ($25,515 ± $7598 vs $26,049 ± $11,737; P = .74). Operative costs were higher for the mini cohort, whereas postoperative costs were significantly lower. Postoperative intensive care unit and total hospital stays were both significantly shorter for the mini cohort. There were no differences in postoperative complications or survival between groups. Minimally invasive mitral valve surgery can be performed with overall equivalent cost and shorter hospital stay relative to traditional sternotomy. There is greater operative cost associated with minimally invasive mitral valve surgery that is offset by shorter intensive care unit and hospital stays. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

From medical images to minimally invasive intervention: Computer assistance for robotic surgery.

PubMed

Lee, Su-Lin; Lerotic, Mirna; Vitiello, Valentina; Giannarou, Stamatia; Kwok, Ka-Wai; Visentini-Scarzanella, Marco; Yang, Guang-Zhong

2010-01-01

Minimally invasive surgery has been established as an important way forward in surgery for reducing patient trauma and hospitalization with improved prognosis. The introduction of robotic assistance enhances the manual dexterity and accuracy of instrument manipulation. Further development of the field in using pre- and intra-operative imaging guidance requires the integration of the general anatomy of the patient with clear pathologic indications and geometrical information for preoperative planning and intra-operative manipulation. It also requires effective visualization and the recreation of haptic and tactile sensing with dynamic active constraints to improve consistency and safety of the surgical procedures. This paper describes key technical considerations of tissue deformation tracking, 3D reconstruction, subject-specific modeling, image guidance and augmented reality for robotic assisted minimally invasive surgery. It highlights the importance of adapting preoperative surgical planning according to intra-operative data and illustrates how dynamic information such as tissue deformation can be incorporated into the surgical navigation framework. Some of the recent trends are discussed in terms of instrument design and the usage of dynamic active constraints and human-robot perceptual docking for robotic assisted minimally invasive surgery. Copyright 2009 Elsevier Ltd. All rights reserved.

Soft learning vector quantization and clustering algorithms based on ordered weighted aggregation operators.

PubMed

Karayiannis, N B

2000-01-01

This paper presents the development and investigates the properties of ordered weighted learning vector quantization (LVQ) and clustering algorithms. These algorithms are developed by using gradient descent to minimize reformulation functions based on aggregation operators. An axiomatic approach provides conditions for selecting aggregation operators that lead to admissible reformulation functions. Minimization of admissible reformulation functions based on ordered weighted aggregation operators produces a family of soft LVQ and clustering algorithms, which includes fuzzy LVQ and clustering algorithms as special cases. The proposed LVQ and clustering algorithms are used to perform segmentation of magnetic resonance (MR) images of the brain. The diagnostic value of the segmented MR images provides the basis for evaluating a variety of ordered weighted LVQ and clustering algorithms.

Savannah River bus project

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

Summers, W.A.

1998-08-01

The H2Fuel Bus is the world`s first hybrid hydrogen electric transit bus. It was developed through a public/private partnership involving several leading technology and industrial organizations in the Southeast, with primary funding and program management provided by the Department of Energy. The primary goals of the project are to gain valuable information on the technical readiness and economic viability of hydrogen buses and to enhance the public awareness and acceptance of emerging hydrogen technologies. The bus has been operated by the transit agency in Augusta, Georgia since April, 1997. It employs a hybrid IC engine/battery/electric drive system, with onboard hydrogenmore » fuel storage based on the use of metal hydrides. Initial operating results have demonstrated an overall energy efficiency (miles per Btu) of twice that of a similar diesel-fueled bus and an operating range twice that of an all-battery powered electric bus. Tailpipe emissions are negligible, with NOx less than 0.2 ppm. Permitting, liability and insurance issues were addressed on the basis of extensive risk assessment and safety analyses, with the inherent safety characteristic of metal hydride storage playing a major role in minimizing these concerns. Future plans for the bus include continued transit operation and use as a national testbed, with potential modifications to demonstrate other hydrogen technologies, including fuel cells.« less

A Distributed Trajectory-Oriented Approach to Managing Traffic Complexity

NASA Technical Reports Server (NTRS)

Idris, Husni; Wing, David J.; Vivona, Robert; Garcia-Chico, Jose-Luis

2007-01-01

In order to handle the expected increase in air traffic volume, the next generation air transportation system is moving towards a distributed control architecture, in which ground-based service providers such as controllers and traffic managers and air-based users such as pilots share responsibility for aircraft trajectory generation and management. While its architecture becomes more distributed, the goal of the Air Traffic Management (ATM) system remains to achieve objectives such as maintaining safety and efficiency. It is, therefore, critical to design appropriate control elements to ensure that aircraft and groundbased actions result in achieving these objectives without unduly restricting user-preferred trajectories. This paper presents a trajectory-oriented approach containing two such elements. One is a trajectory flexibility preservation function, by which aircraft plan their trajectories to preserve flexibility to accommodate unforeseen events. And the other is a trajectory constraint minimization function by which ground-based agents, in collaboration with air-based agents, impose just-enough restrictions on trajectories to achieve ATM objectives, such as separation assurance and flow management. The underlying hypothesis is that preserving trajectory flexibility of each individual aircraft naturally achieves the aggregate objective of avoiding excessive traffic complexity, and that trajectory flexibility is increased by minimizing constraints without jeopardizing the intended ATM objectives. The paper presents conceptually how the two functions operate in a distributed control architecture that includes self separation. The paper illustrates the concept through hypothetical scenarios involving conflict resolution and flow management. It presents a functional analysis of the interaction and information flow between the functions. It also presents an analytical framework for defining metrics and developing methods to preserve trajectory flexibility and minimize its constraints. In this framework flexibility is defined in terms of robustness and adaptability to disturbances and the impact of constraints is illustrated through analysis of a trajectory solution space with limited degrees of freedom and in simple constraint situations involving meeting multiple times of arrival and resolving a conflict.

Psychological commitment as a mediator of the relationship between involvement and loyalty

Treesearch

Joohyun Lee; Alan Graefe

2002-01-01

This study tested the ill-understood issues of involvement and loyalty relations. Even though many studies have indicated that loyalty is a function of involvement, only minimal agreement has been reached on the extent to which the constructs of involvement would predict repeat participation. A structural model is developed that relates members' involvement and...

The Hand-Assisted Laparoscopic Approach to Resection of Pancreatic Mucinous Cystic Neoplasms: An Underused Technique?

PubMed

Postlewait, Lauren M; Ethun, Cecilia G; McInnis, Mia R; Merchant, Nipun; Parikh, Alexander; Idrees, Kamran; Isom, Chelsea A; Hawkins, William; Fields, Ryan C; Strand, Matthew; Weber, Sharon M; Cho, Clifford S; Salem, Ahmed; Martin, Robert C G; Scoggins, Charles; Bentrem, David; Kim, Hong J; Carr, Jacquelyn; Ahmad, Syed; Abbott, Daniel; Wilson, Gregory C; Kooby, David A; Maithel, Shishir K

2018-01-01

Pancreatic mucinous cystic neoplasms (MCNs) are rare tumors typically of the distal pancreas that harbor malignant potential. Although resection is recommended, data are limited on optimal operative approaches to distal pancreatectomy for MCN. MCN resections (2000-2014; eight institutions) were included. Outcomes of minimally invasive and open MCN resections were compared. A total of 289 patients underwent distal pancreatectomy for MCN: 136(47%) minimally invasive and 153(53%) open. Minimally invasive procedures were associated with smaller MCN size (3.9 vs 6.8 cm; P = 0.001), lower operative blood loss (192 vs 392 mL; P = 0.001), and shorter hospital stay(5 vs 7 days; P = 0.001) compared with open. Despite higher American Society of Anesthesiologists class, hand-assisted (n = 46) had similar advantages as laparoscopic/robotic (n = 76). When comparing hand-assisted to open, although MCN size was slightly smaller (4.1 vs 6.8 cm; P = 0.001), specimen length, operative time, and nodal yield were identical. Similar to laparoscopic/robotic, hand-assisted had lower operative blood loss (161 vs 392 mL; P = 0.001) and shorter hospital stay (5 vs 7 days; P = 0.03) compared with open, without increased complications. Hand-assisted laparoscopic technique is a useful approach for MCN resection because specimen length, lymph node yield, operative time, and complication profiles are similar to open procedures, but it still offers the advantages of a minimally invasive approach. Hand-assisted laparoscopy should be considered as an alternative to open technique or as a successive step before converting from total laparoscopic to open distal pancreatectomy for MCN.

Portable diagnostic devices for identifying obstructive sleep apnea among commercial motor vehicle drivers: considerations and unanswered questions.

PubMed

Zhang, Chunbai; Berger, Mark; Malhotra, Atul; Kales, Stefanos N

2012-11-01

Obstructive sleep apnea (OSA), a syndrome defined by breathing abnormalities during sleep, can lead to fatigue and excessive daytime sleepiness (EDS) with an increased risk of motor vehicle crashes. Identifying commercial motor vehicle operators with unrecognized OSA is a major public health priority. Portable monitors (PMs) are being actively marketed to trucking firms as potentially lower-cost and more accessible alternatives to the reference standard of in-laboratory polysomnography (PSG) in the diagnosis of OSA among commercial motor vehicle operators. Several factors regarding PMs remain uncertain in this unique patient population: their sensitivity and specificity; the cost-benefit ratio of the PMs versus PSG; potential barriers from human factors; and evolving technologic advancement. Human factors that alter test accuracy are a major concern among commercial drivers motivated to gain/maintain employment. Current available data using PMs as a diagnostic tool among CMV operators indicate relatively high data loss and high loss to follow-up. Loss to follow-up has also been an issue using PSG in commercial motor vehicle operators. Furthermore, PM testing and PM results interpretation protocols may have no sleep specialist oversight, and sometimes minimal physician oversight and involvement. Additional studies comparing unattended and unmonitored PMs directly against full in-laboratory PSG are needed to provide evidence for their efficacy among commercial motor vehicle operators.

Validated analytical methodology for the simultaneous determination of a wide range of pesticides in human blood using GC-MS/MS and LC-ESI/MS/MS and its application in two poisoning cases.

PubMed

Luzardo, Octavio P; Almeida-González, Maira; Ruiz-Suárez, Norberto; Zumbado, Manuel; Henríquez-Hernández, Luis A; Meilán, María José; Camacho, María; Boada, Luis D

2015-09-01

Pesticides are frequently responsible for human poisoning and often the information on the involved substance is lacking. The great variety of pesticides that could be responsible for intoxication makes necessary the development of powerful and versatile analytical methodologies, which allows the identification of the unknown toxic substance. Here we developed a methodology for simultaneous identification and quantification in human blood of 109 highly toxic pesticides. The application of this analytical scheme would help in minimizing the cost of this type of chemical identification, maximizing the chances of identifying the pesticide involved. In the methodology that we present here, we use a liquid-liquid extraction, followed by one single purification step, and quantitation of analytes by a combination of liquid and gas chromatography, both coupled to triple quadrupole mass spectrometry, which is operated in the mode of multiple reaction monitoring. The methodology has been fully validated, and its applicability has been demonstrated in two recent cases involving one self-poisoning fatality and one non-fatal homicidal attempt. Copyright © 2015 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

Comparison between open plating versus minimally invasive plate osteosynthesis for acute displaced clavicular shaft fractures.

PubMed

Sohn, Hoon-Sang; Kim, Won Ju; Shon, Min Soo

2015-08-01

Current literatures describe good clinical outcomes of acute displaced fracture of clavicle treated with minimally invasive plate osteosynthesis (MIPO). But, there are little comparative data of the outcomes between open plating and MIPO techniques. We compared the outcomes of open plating and MIPO for treatment of acute displaced clavicular shaft fractures. The author performed a retrospective review on a consecutive series of patients with clavicular shaft fracture who underwent open plating or MIPO. Fourteen patients were treated with open plating with interfragmentary screw fixation, and 19 were treated with the MIPO technique without exposing a fracture site itself. A superior plating method was applied to both groups. Patient demographics, clinical outcomes using Constant score and University of California Los Angeles (UCLA) shoulder score, operation time, union rate, complications, and radiographic evaluation were evaluated. There were no statistically significant differences in the demographic data, including patient's variables (age, gender, involved side, smoking, alcohol, and diabetic status) and fracture characteristics (trauma mechanism, distribution of fracture type, presence of polytrauma, and time from trauma to surgery) between the two groups. Mean operation time was 87.5 min in open plating and 77.2 min in MIPO (p=0.129). The mean time to union was 15.7 weeks in patients who underwent open plating and 16.8 weeks in patients who underwent MIPO (p=0.427). Although there was no significant difference, nonunion developed 1 case in MIPO while none was in open plating. Four patients in open plating had skin numbness (none in MIPO, p=0.024). There was no significant difference in the Constant score and UCLA score of the two surgical methods. This study showed that both open plating with interfragmentary screw fixation (Open plating) and minimally invasive plate osteosynthesis (MIPO) are equally effective and safe treatment methods for acute displaced clavicle shaft fracture. Copyright © 2015 Elsevier Ltd. All rights reserved.

Use of optimization to predict the effect of selected parameters on commuter aircraft performance

NASA Technical Reports Server (NTRS)

Wells, V. L.; Shevell, R. S.

1982-01-01

The relationships between field length and cruise speed and aircraft direct operating cost were determined. A gradient optimizing computer program was developed to minimize direct operating cost (DOC) as a function of airplane geometry. In this way, the best airplane operating under one set of constraints can be compared with the best operating under another. A constant 30-passenger fuselage and rubberized engines based on the General Electric CT-7 were used as a baseline. All aircraft had to have a 600 nautical mile maximum range and were designed to FAR part 25 structural integrity and climb gradient regulations. Direct operating cost was minimized for a typical design mission of 150 nautical miles. For purposes of C sub L sub max calculation, all aircraft had double-slotted flaps but with no Fowler action.

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

PubMed

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

2018-01-01

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

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

PubMed

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

2016-07-01

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

Minimally Invasive Surgery (MIS) in Children and Adolescents with Pheochromocytomas and Retroperitoneal Paragangliomas: Experiences in 42 Patients.

PubMed

Walz, Martin K; Iova, Laura D; Deimel, Judith; Neumann, Hartmut P H; Bausch, Birke; Zschiedrich, Stefan; Groeben, Harald; Alesina, Pier F

2018-04-01

Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access. In the setting of a prospective study (1/2001-12/2016), 42 consecutive children and adolescents (33 m, 9 f) were operated on. Thirty-seven patients (88%) suffered from inherited diseases. Twenty-six patients had PH, 11 presented retroperitoneal PGL, and five patients suffered from both. Altogether, 70 tumours (mean size 2.7 cm) were removed (45 PH, 25 PGL). All operations were performed by a minimally invasive access (retroperitoneoscopic, laparoscopic, extraperitoneal). Partial adrenalectomy was the preferred procedure for PH (31 out of 39 patients). Twenty patients received α-receptor blockade preoperatively. One patient died after induction of anaesthesia due to cardiac arrest. All other complications were minor. Conversion to open surgery was necessary in two cases with PGL. Median operating time for unilateral PH was 55 min, in bilateral cases 125, 143 min in PGs, and 180 min in combined cases. Median blood loss was 20 ml (range 0-1000). Blood transfusion was necessary in two cases. Intraoperative, systolic peak pressure was 170 ± 39 mmHg with α-receptor blockade and 191 ± 33 mmHg without α-receptor blockade (p = 0.41). The median post-operative hospital stay was 3 days. After a mean follow-up of 8.5 years, two patients presented ipsilateral recurrence (after partial adrenalectomy). All patients with bilateral PH (n = 13) are steroid independent post-operatively. PH and PGL in children and adolescents should preferably be removed by minimally invasive surgery. Partial adrenalectomy provides long-term steroid independence in bilateral PH and a low rate of (ipsilateral) recurrence. α-Receptor blockade may not be necessary in these patients.

Mission Operations of the Mars Exploration Rovers

NASA Technical Reports Server (NTRS)

Bass, Deborah; Lauback, Sharon; Mishkin, Andrew; Limonadi, Daniel

2007-01-01

A document describes a system of processes involved in planning, commanding, and monitoring operations of the rovers Spirit and Opportunity of the Mars Exploration Rover mission. The system is designed to minimize command turnaround time, given that inherent uncertainties in terrain conditions and in successful completion of planned landed spacecraft motions preclude planning of some spacecraft activities until the results of prior activities are known by the ground-based operations team. The processes are partitioned into those (designated as tactical) that must be tied to the Martian clock and those (designated strategic) that can, without loss, be completed in a more leisurely fashion. The tactical processes include assessment of downlinked data, refinement and validation of activity plans, sequencing of commands, and integration and validation of sequences. Strategic processes include communications planning and generation of long-term activity plans. The primary benefit of this partition is to enable the tactical portion of the team to focus solely on tasks that contribute directly to meeting the deadlines for commanding the rover s each sol (1 sol = 1 Martian day) - achieving a turnaround time of 18 hours or less, while facilitating strategic team interactions with other organizations that do not work on a Mars time schedule.

Impact of Electrostatics on Processing and Product Performance of Pharmaceutical Solids.

PubMed

Desai, Parind Mahendrakumar; Tan, Bernice Mei Jin; Liew, Celine Valeria; Chan, Lai Wah; Heng, Paul Wan Sia

2015-01-01

Manufacturing of pharmaceutical solids involves different unit operations and processing steps such as powder blending, fluidization, sieving, powder coating, pneumatic conveying and spray drying. During these operations, particles come in contact with other particles, different metallic, glass or polymer surfaces and can become electrically charged. Electrostatic charging often gives a negative connotation as it creates sticking, jamming, segregation or other issues during tablet manufacturing, capsule filling, film packaging and other pharmaceutical operations. A thorough and fundamental appreciation of the current knowledge of mechanisms and the potential outcomes is essential in order to minimize potential risks resulting from this phenomenon. The intent of this review is to discuss the electrostatic properties of pharmaceutical powders, equipment surfaces and devices affecting pharmaceutical processing and product performance. Furthermore, the underlying mechanisms responsible for the electrostatic charging are described and factors affecting electrostatic charging have been reviewed in detail. Feasibility of different methods used in the laboratory and pharmaceutical industry to measure charge propensity and decay has been summarized. Different computational and experimental methods studied have proven that the particle charging is a very complex phenomenon and control of particle charging is extremely important to achieve reliable manufacturing and reproducible product performance.

Cybersonics: Tapping into Technology

NASA Technical Reports Server (NTRS)

2001-01-01

With the assistance of Small Business Innovation Research (SBIR) funding from NASA's Jet Propulsion Laboratory, Cybersonics, Inc., developed an ultrasonic drill with applications ranging from the medical industry to space exploration. The drill, which has the ability to take a core sample of the hardest granite or perform the most delicate diagnostic medical procedure, is a lightweight, ultrasonic device made to fit in the palm of the hand. Piezoelectric actuators, which have only two moving parts and no gears or motors, drive the components of the device, enabling it to operate in a wide range of temperatures. The most remarkable aspect of the drill is its ability to penetrate even the hardest rock with minimal force application. The ultrasonic device requires 20 to 30 times less force than standard rotating drills, allowing it to be safely guided by hand during operation. Also, the drill is operable at a level as low as three watts of power, where conventional drills require more than three times this level. Potential future applications for the ultrasonic drill include rock and soil sampling, medical procedures that involve core sampling or probing, landmine detection, building and construction, and space exploration. Cybersonics, Inc. developed an ultrasonic drill with applications ranging from the medical industry to space exploration.

Enhancing dissolved oxygen control using an on-line hybrid fuzzy-neural soft-sensing model-based control system in an anaerobic/anoxic/oxic process.

PubMed

Huang, Mingzhi; Wan, Jinquan; Hu, Kang; Ma, Yongwen; Wang, Yan

2013-12-01

An on-line hybrid fuzzy-neural soft-sensing model-based control system was developed to optimize dissolved oxygen concentration in a bench-scale anaerobic/anoxic/oxic (A(2)/O) process. In order to improve the performance of the control system, a self-adapted fuzzy c-means clustering algorithm and adaptive network-based fuzzy inference system (ANFIS) models were employed. The proposed control system permits the on-line implementation of every operating strategy of the experimental system. A set of experiments involving variable hydraulic retention time (HRT), influent pH (pH), dissolved oxygen in the aerobic reactor (DO), and mixed-liquid return ratio (r) was carried out. Using the proposed system, the amount of COD in the effluent stabilized at the set-point and below. The improvement was achieved with optimum dissolved oxygen concentration because the performance of the treatment process was optimized using operating rules implemented in real time. The system allows various expert operational approaches to be deployed with the goal of minimizing organic substances in the outlet while using the minimum amount of energy.

Disease control operations

USGS Publications Warehouse

Friend, Milton; Franson, J. Christian

1987-01-01

Individual disease outbreaks have killed many thousands of animals on numerous occasions. Tens of thousands of migratory birds have died in single die-offs with as many as 1,000 birds succumbing in 1 day. In mammals, individual disease outbreaks have killed hundreds to thousands of animals with, for example, hemorrhagic disease in white-tailed deer, distemper in raccoon, Errington's disease in muskrat, and sylvatic plague in wild rodents. The ability to successfully combat such explosive situations is highly dependent n the readiness of field personnel to deal with them. Because many disease agents can spread though wildlife populations very fast, advance preparation is essential in preventing infected animals from spreading disease to additional species and locations. Carefully though-out disease contingency plans should be developed as practical working documents for field personnel and updated as necessary. Such well-designed plans can prove invaluable in minimizing wildlife losses and costs associated with disease control activities. Although requirements for disease control operations vary and must be tailored to each situation, all disease contingency planning involved general concepts and basic biological information. This chapter, intended as a practical guide, identifies the major activities and needs of disease control operations, and relates them to disease contingency planning.

Design and Development of a Segmented Magnet Homopolar Torque Converter

DTIC Science & Technology

1975-02-01

seals . They will be designed for low leakage and wear at operating speeds from zero to 500 rpm in either direction. 1-7 — . E.M. 4648 SECTION 2...to flow in a manner that would minimize the pressure drop across the seals , thus minimizing leakage flow. As an example, the liquid metal might be...included seal wear, leakage and operating temperature leaicage. 6-2 J E.M. 4648 order to obtain bench mark performance data on standard seal

Overview and fundamentals of urologic robot-integrated systems.

PubMed

Allaf, Mohamad; Patriciu, Alexandru; Mazilu, Dumitru; Kavoussi, Louis; Stoianovici, Dan

2004-11-01

Advances in technology have revolutionized urology. Minimally invasive tools now form the core of the urologist's armamentarium. Laparoscopic surgery has become the favored approach for treating many complicated urologic ailments. Surgical robots represent the next evolutionary step in the fruitful man-machine partnership. The introduction of robotic technology in urology changes how urologists learn, teach, plan, and operate. As technology evolves, robots not only will improve performance in minimally invasive procedures, but also enhance other procedures or enable new kinds of operations.

Spacelab cost reduction alternatives study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1976-01-01

Alternative approaches to payload operations planning and control and flight crew training are defined for spacelab payloads with the goal of: lowering FY77 and FY 78 costs for new starts; lowering costs to achieve Spacelab operational capability; and minimizing the cost per Spacelab flight. These alternatives attempt to minimize duplication of hardware, software, and personnel, and the investment in supporting facility and equipment. Of particular importance is the possible reduction of equipment, software, and manpower resources such as comtational systems, trainers, and simulators.

Robust telerobotics - an integrated system for waste handling, characterization and sorting

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

Couture, S.A.; Hurd, R.L.; Wilhelmsen, K.C.

The Mixed Waste Management Facility (MWMF) at the Lawrence Livermore National Laboratory was designed to serve as a national testbed to demonstrate integrated technologies for the treatment of low-level organic mixed waste at a pilot-plant scale. Pilot-scale demonstration serves to bridge the gap between mature, bench-scale proven technologies and full-scale treatment facilities by providing the infrastructure needed to evaluate technologies in an integrated, front-end to back-end facility. Consistent with the intent to focus on technologies that are ready for pilot scale deployment, the front-end handling and feed preparation of incoming waste material has been designed to demonstrate the application ofmore » emerging robotic and remotely operated handling systems. The selection of telerobotics for remote handling in MWMF was made based on a number of factors - personnel protection, waste generation, maturity, cost, flexibility and extendibility. Telerobotics, or shared control of a manipulator by an operator and a computer, provides the flexibility needed to vary the amount of automation or operator intervention according to task complexity. As part of the telerobotics design effort, the technical risk of deploying the technology was reduced through focused developments and demonstrations. The work involved integrating key tools (1) to make a robust telerobotic system that operates at speeds and reliability levels acceptable to waste handling operators and, (2) to demonstrate an efficient operator interface that minimizes the amount of special training and skills needed by the operator. This paper describes the design and operation of the prototype telerobotic waste handling and sorting system that was developed for MWMF.« less

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

PubMed

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

2014-06-01

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

Minimizing transient influence in WHPA delineation: An optimization approach for optimal pumping rate schemes

NASA Astrophysics Data System (ADS)

Rodriguez-Pretelin, A.; Nowak, W.

2017-12-01

For most groundwater protection management programs, Wellhead Protection Areas (WHPAs) have served as primarily protection measure. In their delineation, the influence of time-varying groundwater flow conditions is often underestimated because steady-state assumptions are commonly made. However, it has been demonstrated that temporary variations lead to significant changes in the required size and shape of WHPAs. Apart from natural transient groundwater drivers (e.g., changes in the regional angle of flow direction and seasonal natural groundwater recharge), anthropogenic causes such as transient pumping rates are of the most influential factors that require larger WHPAs. We hypothesize that WHPA programs that integrate adaptive and optimized pumping-injection management schemes can counter transient effects and thus reduce the additional areal demand in well protection under transient conditions. The main goal of this study is to present a novel management framework that optimizes pumping schemes dynamically, in order to minimize the impact triggered by transient conditions in WHPA delineation. For optimizing pumping schemes, we consider three objectives: 1) to minimize the risk of pumping water from outside a given WHPA, 2) to maximize the groundwater supply and 3) to minimize the involved operating costs. We solve transient groundwater flow through an available transient groundwater and Lagrangian particle tracking model. The optimization problem is formulated as a dynamic programming problem. Two different optimization approaches are explored: I) the first approach aims for single-objective optimization under objective (1) only. The second approach performs multiobjective optimization under all three objectives where compromise pumping rates are selected from the current Pareto front. Finally, we look for WHPA outlines that are as small as possible, yet allow the optimization problem to find the most suitable solutions.

Treatment preferences and involvement in treatment decision making of patients with endometrial cancer and clinicians.

PubMed

Kunneman, M; Pieterse, A H; Stiggelbout, A M; Nout, R A; Kamps, M; Lutgens, L C H W; Paulissen, J; Mattheussens, O J A; Kruitwagen, R F P M; Creutzberg, C L

2014-08-12

Vaginal brachytherapy (VBT) in high-intermediate-risk endometrial cancer (EC) provides a significant reduction in the risk of local cancer recurrence, but without survival benefit and with increased mucosal atrophy. Five-year local control is estimated to be similar for VBT and a watchful waiting policy (WWP), in which patients receive VBT combined with external radiation in case of a recurrence. Our aim was to assess treatment preferences of EC patients and clinicians regarding VBT and WWP, and to evaluate their preferred and perceived involvement in treatment decision making. Interviews were held with 95 treated EC patients. The treatment trade-off method was used to assess the minimally desired benefit from VBT in local control. Patients' preferred and perceived involvement in decision making were assessed using a questionnaire. Seventy-seven clinicians completed a questionnaire assessing their minimally desired benefit and preferred involvement in decision making. Minimally desired benefit of VBT was significantly lower for patients than for clinicians (median=0 vs 8%, P<0.001), for irradiated than for non-irradiated patients (median=0 vs 6.5%, P<0.001), and for radiation oncologists than for gynaecologists (median=4 vs 13%, P<0.001). Substantial variation existed within the groups of patients and clinicians. Participants preferred the patient and clinician to share in the decision about VBT. However, irradiated patients indicated low perceived involvement in actual treatment decision making. We found variations between and within patients and clinicians in minimally desired benefit from VBT. However, the recurrence risk at which patients preferred VBT was low. Our results showed that patients consider active participation in decision making essential.

Treatment preferences and involvement in treatment decision making of patients with endometrial cancer and clinicians

PubMed Central

Kunneman, M; Pieterse, A H; Stiggelbout, A M; Nout, R A; Kamps, M; Lutgens, L C H W; Paulissen, J; Mattheussens, O J A; Kruitwagen, R F P M; Creutzberg, C L

2014-01-01

Background: Vaginal brachytherapy (VBT) in high–intermediate-risk endometrial cancer (EC) provides a significant reduction in the risk of local cancer recurrence, but without survival benefit and with increased mucosal atrophy. Five-year local control is estimated to be similar for VBT and a watchful waiting policy (WWP), in which patients receive VBT combined with external radiation in case of a recurrence. Our aim was to assess treatment preferences of EC patients and clinicians regarding VBT and WWP, and to evaluate their preferred and perceived involvement in treatment decision making. Methods: Interviews were held with 95 treated EC patients. The treatment trade-off method was used to assess the minimally desired benefit from VBT in local control. Patients' preferred and perceived involvement in decision making were assessed using a questionnaire. Seventy-seven clinicians completed a questionnaire assessing their minimally desired benefit and preferred involvement in decision making. Results: Minimally desired benefit of VBT was significantly lower for patients than for clinicians (median=0 vs 8%, P<0.001), for irradiated than for non-irradiated patients (median=0 vs 6.5%, P<0.001), and for radiation oncologists than for gynaecologists (median=4 vs 13%, P<0.001). Substantial variation existed within the groups of patients and clinicians. Participants preferred the patient and clinician to share in the decision about VBT. However, irradiated patients indicated low perceived involvement in actual treatment decision making. Conclusions: We found variations between and within patients and clinicians in minimally desired benefit from VBT. However, the recurrence risk at which patients preferred VBT was low. Our results showed that patients consider active participation in decision making essential. PMID:24921911

76 FR 19911 - Drawbridge Operation Regulation; Calcasieu River, Westlake, LA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... maintenance and updates to the bridge's operating system. This deviation allows the bridge to remain closed to...'s operating system while minimizing the exposure of personnel to hazards associated with performing... deviation from the operating schedule for the swing span bridge across the Calcasieu River, mile 36.4, at...

Epidermolysis bullosa acquisita: clinical manifestations, microscopic findings, and surgical periodontal therapy. A case report.

PubMed

Hakki, S S; Celenligil-Nazliel, H; Karaduman, A; Usubütün, A; Ertoy, D; Ayhan, A; Ruacan, S

2001-04-01

Epidermolysis bullosa acquisita (EBA) is an uncommon, acquired, chronic subepidermal bullous disease. This report describes a case of EBA with gingival involvement. A 43-year-old woman with EBA was referred to our clinic for periodontal therapy because of gingival tenderness and bleeding. She has been on cyclosporin A therapy for the last 2 years. Clinical findings were analyzed. Anterior gingivectomy operations were performed in 2 stages. The samples obtained during the surgery were examined using histopathologic, immunohistologic, and electronmicroscopic methods. Long-term effects of the surgical periodontal treatment on gingiva were evaluated both clinically and microscopically. The dentition displayed minimal enamel hypoplasia. Decayed, missing, and filled surfaces score was found to be elevated. Periodontal examination showed generalized diffuse gingival inflammation and gingival enlargement localized mainly to the anterior region. Nikolsky's sign was positive. However, wound healing was uneventful after the operations. Microscopic findings were similar to those obtained from the skin. Twenty-one months after the operations, Nikolsky's sign was negative and no remarkable gingival inflammation was noted. Microscopic examination revealed that the blisters were fewer in number and smaller in size. These results indicate that gingival tissues may also be involved in EBA. Uneventful wound healing after periodontal surgery in this case suggests that periodontal surgery can be performed in patients with EBA. Moreover, both our clinical and histopathologic findings imply that gingivectomy proves useful in maintaining gingival integrity in these patients. Our data may also suggest that the patients with EBA are highly likely to develop dental caries.

Cygnus Performance in Subcritical Experiments

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

G. Corrow, M. Hansen, D. Henderson, S. Lutz, C. Mitton, et al.

2008-02-01

The Cygnus Dual Beam Radiographic Facility consists of two identical radiographic sources with the following specifications: 4-rad dose at 1 m, 1-mm spot size, 50-ns pulse length, 2.25-MeV endpoint energy. The facility is located in an underground tunnel complex at the Nevada Test Site. Here SubCritical Experiments (SCEs) are performed to study the dynamic properties of plutonium. The Cygnus sources were developed as a primary diagnostic for these tests. Since SCEs are single-shot, high-value events - reliability and reproducibility are key issues. Enhanced reliability involves minimization of failure modes through design, inspection, and testing. Many unique hardware and operational featuresmore » were incorporated into Cygnus to insure reliability. Enhanced reproducibility involves normalization of shot-to-shot output also through design, inspection, and testing. The first SCE to utilize Cygnus, Armando, was executed on May 25, 2004. A year later, April - May 2005, calibrations using a plutonium step wedge were performed. The results from this series were used for more precise interpretation of the Armando data. In the period February - May 2007 Cygnus was fielded on Thermos, which is a series of small-sample plutonium shots using a one-dimensional geometry. Pulsed power research generally dictates frequent change in hardware configuration. Conversely, SCE applications have typically required constant machine settings. Therefore, while operating during the past four years we have accumulated a large database for evaluation of machine performance under highly consistent operating conditions. Through analysis of this database Cygnus reliability and reproducibility on Armando, Step Wedge, and Thermos is presented.« less

33 CFR 151.2035 - What are the required ballast water management practices for my vessel?

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulations. (4) Discharge only the minimal amount of ballast water essential for vessel operations while in... operating beyond the Exclusive Economic Zone, you (the master, operator, or person-in-charge of a vessel...

47 CFR 90.403 - General operating requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... communications in progress and such other measures as may be necessary to minimize the potential for causing... 90.403 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Operating Requirements § 90.403 General operating requirements...

Cost-Effective Telemetry and Command Ground Systems Automation Strategy for the Soil Moisture Active Passive (SMAP) Mission

NASA Technical Reports Server (NTRS)

Choi, Josh; Sanders, Antonio

2012-01-01

Soil Moisture Active Passive (SMAP) is an Earth-orbiting, remote-sensing NASA mission slated for launch in 2014. The ground data system (GDS) being developed for SMAP is composed of many heterogeneous subsystems, ranging from those that support planning and sequencing to those used for real-time operations, and even further to those that enable science data exchange. A full end-to-end automation of the GDS may result in cost savings during mission operations, but it would require a significant upfront investment to develop such a comprehensive automation. As demonstrated by the Jason-1 and Wide-field Infrared Survey Explorer (WISE) missions, a measure of "lights-out" automation for routine, orbital pass, ground operations can still reduce mission costs through smaller staffing of operators and limiting their working hours. The challenge, then, for the SMAP GDS engineering team, is to formulate an automated operations strategy--and corresponding system architecture -- to minimize operator intervention during routine operations, while balancing the development costs associated with the scope and complexity of automation. This paper discusses the automated operations approach being developed for the SMAP GDS. The focus is on automating the activities involved in routine passes, which limits the scope to real-time operations. A key subsystem of the SMAP GDS -- NASA's AMMOS Mission Data Processing and Control System (AMPCS) -- provides a set of capabilities that enable such automation. Also discussed are the lights-out pass automations of the Jason-1 and WISE missions and how they informed the automation strategy for SMAP. The paper aims to provide insights into what is necessary in automating the GDS operations for Earth satellite missions.

Cost-Effective Telemetry and Command Ground Systems Automation Strategy for the Soil Moisture Active Passive (SMAP) Mission

NASA Technical Reports Server (NTRS)

Choi, Joshua S.; Sanders, Antonio L.

2012-01-01

Soil Moisture Active Passive (SMAP) is an Earth-orbiting, remote-sensing NASA mission slated for launch in 2014.[double dagger] The ground data system (GDS) being developed for SMAP is composed of many heterogeneous subsystems, ranging from those that support planning and sequencing to those used for real-time operations, and even further to those that enable science data exchange. A full end-to-end automation of the GDS may result in cost savings during mission operations, but it would require a significant upfront investment to develop such comprehensive automation. As demonstrated by the Jason-1 and Wide-field Infrared Survey Explorer (WISE) missions, a measure of "lights-out" automation for routine, orbital pass ground operations can still reduce mission cost through smaller staffing of operators and limited work hours. The challenge, then, for the SMAP GDS engineering team is to formulate an automated operations strategy--and corresponding system architecture--to minimize operator intervention during operations, while balancing the development cost associated with the scope and complexity of automation. This paper discusses the automated operations approach being developed for the SMAP GDS. The focus is on automating the activities involved in routine passes, which limits the scope to real-time operations. A key subsystem of the SMAP GDS--NASA's AMMOS Mission Data Processing and Control System (AMPCS)--provides a set of capabilities that enable such automation. Also discussed are the lights-out pass automations of the Jason-1 and WISE missions and how they informed the automation strategy for SMAP. The paper aims to provide insights into what is necessary in automating the GDS operations for Earth satellite missions.

Learning curve of single port laparoscopic cholecystectomy determined using the non-linear ordinary least squares method based on a non-linear regression model: An analysis of 150 consecutive patients.

PubMed

Han, Hyung Joon; Choi, Sae Byeol; Park, Man Sik; Lee, Jin Suk; Kim, Wan Bae; Song, Tae Jin; Choi, Sang Yong

2011-07-01

Single port laparoscopic surgery has come to the forefront of minimally invasive surgery. For those familiar with conventional techniques, however, this type of operation demands a different type of eye/hand coordination and involves unfamiliar working instruments. Herein, the authors describe the learning curve and the clinical outcomes of single port laparoscopic cholecystectomy for 150 consecutive patients with benign gallbladder disease. All patients underwent single port laparoscopic cholecystectomy using a homemade glove port by one of five operators with different levels of experiences of laparoscopic surgery. The learning curve for each operator was fitted using the non-linear ordinary least squares method based on a non-linear regression model. Mean operating time was 77.6 ± 28.5 min. Fourteen patients (6.0%) were converted to conventional laparoscopic cholecystectomy. Complications occurred in 15 patients (10.0%), as follows: bile duct injury (n = 2), surgical site infection (n = 8), seroma (n = 2), and wound pain (n = 3). One operator achieved a learning curve plateau at 61.4 min per procedure after 8.5 cases and his time improved by 95.3 min as compared with initial operation time. Younger surgeons showed significant decreases in mean operation time and achieved stable mean operation times. In particular, younger surgeons showed significant decreases in operation times after 20 cases. Experienced laparoscopic surgeons can safely perform single port laparoscopic cholecystectomy using conventional or angled laparoscopic instruments. The present study shows that an operator can overcome the single port laparoscopic cholecystectomy learning curve in about eight cases.

78 FR 34655 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-10

... also be made to better define minimally successful performance for assignments involving displacement..., third block Part 351, subpart G, section 351.701--Assignment Involving Displacement, replace paragraph...

Reconnaissance and Autonomy for Small Robots (RASR) team: MAGIC 2010 challenge

NASA Astrophysics Data System (ADS)

Lacaze, Alberto; Murphy, Karl; Del Giorno, Mark; Corley, Katrina

2012-06-01

The Reconnaissance and Autonomy for Small Robots (RASR) team developed a system for the coordination of groups of unmanned ground vehicles (UGVs) that can execute a variety of military relevant missions in dynamic urban environments. Historically, UGV operations have been primarily performed via tele-operation, requiring at least one dedicated operator per robot, and requiring substantial real-time bandwidth to accomplish those missions. Our team goal was to develop a system that can provide long-term value to the war-fighter, utilizing MAGIC-2010 as a stepping stone. To that end, we self-imposed a set of constraints that would force us to develop technology that could readily be used by the military in the near term: • Use a relevant (deployed) platform • Use low-cost, reliable sensors • Develop an expandable and modular control system with innovative software algorithms to minimize the computing footprint required • Minimize required communications bandwidth and handle communication losses • Minimize additional power requirements to maximize battery life and mission duration

Completion of potential conflicts of interest through optimization of Rukoh reservoir operation in Pidie District, Aceh Province, Indonesia

NASA Astrophysics Data System (ADS)

Azmeri, Hadihardaja, Iwan K.; Shaskia, Nina; Admaja, Kamal Surya

2017-11-01

Rukoh Reservoir's construction was planned to be built in Krueng Rukoh Watershed with supplet ion from Krueng Tiro River. Rukoh Reservoir operating system as a multipurpose reservoir raised potential conflict of interest between raw water and irrigation water. In this study, the operating system of Rukoh Reservoirs was designed to supply raw water in Titeu Sub-District and replenish water shortage in Baro Irrigation Area which is not able to be served by the Keumala Weir. Reservoir operating system should be planned optimally so that utilization of water in accordance with service area demands. Reservoir operation method was analyzed by using optimization technique with nonlinear programming. Optimization of reservoir operation is intended to minimize potential conflicts of interest in the operation. Suppletion discharge from Krueng Tiro River amounted to 46.62%, which was calculated based on ratio of Baro and Tiro irrigation area. However, during dry seasons, water demands could not be fully met, so there was a shortage of water. By considering the rules to minimize potential conflicts of interest between raw water and irrigation water, it would require suppletion from Krueng Tiro amounted to 52.30%. The increment of suppletion volume could minimize conflicts of interest. It produced l00% reservoir reliability for raw water and irrigation demands. Rukoh reservoir could serve raw water demands of Titeu Sub-District and irrigation demands of Baro irrigation area which is covering an area of 6,047 hectars. Reservoir operation guidelines can specify reservoir water release to balance the demands and the target storage.

[Percutaneous treatment of unstable spine fractures - OP video and results from over 300 cases].

PubMed

Prokop, A; Chmielnicki, M

2014-02-01

Minimally invasive surgery for vertebral fractures results in less approach-related morbidity, decreased postoperative pain, and rapid mobilisation of patients. Such procedures can be performed even in elderly patients. However, along with the many advantages, minimally invasive procedures are technically demanding, require sophisticated tools, and there is a learning curve for surgeons. Intraoperative visualisation is often possible only radiologically, and implants are generally much more expensive. Using the data from over 300 unstable vertebral fracture cases treated over the past 3.5 years, we have developed a differentiated treatment concept, depending on the age of the patient and the fracture characteristics. Unstable fractures with involvement of the posterior edge are stabilised from posterior, percutaneously with a fixator. In patients under 60 years, monoaxial screws with inserted rods (top loading) are used, with which distraction and restoration of lordosis are also possible. Patients over 60 years are treated percutaneously with a polyaxial sextant system with rods inserted to avoid avulsion of the pedicle screws from the vertebral body. To avoid cutting through the vertebra, the fenestrated screws can be augmented with cement. The operation technique is demonstrated by a video. Georg Thieme Verlag KG Stuttgart · New York.

Germanium photodetectors fabricated on 300 mm silicon wafers for near-infrared focal plane arrays

NASA Astrophysics Data System (ADS)

Zeller, John W.; Rouse, Caitlin; Efstathiadis, Harry; Dhar, Nibir K.; Wijewarnasuriya, Priyalal; Sood, Ashok K.

2017-09-01

SiGe p-i-n photodetectors have been fabricated on 300 mm (12") diameter silicon (Si) wafers utilizing high throughput, large-area complementary metal-oxide semiconductor (CMOS) technologies. These Ge photodetectors are designed to operate in room temperature environments without cooling, and thus have potential size and cost advantages over conventional cooled infrared detectors. The two-step fabrication process for the p-i-n photodetector devices, designed to minimize the formation of defects and threading dislocations, involves low temperature epitaxial growth of a thin p+ (boron) Ge seed/buffer layer, followed by higher temperature deposition of a thicker Ge intrinsic layer. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) demonstrated uniform layer compositions with well defined layer interfaces and reduced dislocation density. Time-of-flight secondary ion mass spectroscopy (TOF-SIMS) was likewise employed to analyze the doping levels of the p+ and n+ layers. Current-voltage (I-V) measurements demonstrated that these SiGe photodetectors, when exposed to incident visible-NIR radiation, exhibited dark currents down below 1 μA and significant enhancement in photocurrent at -1 V. The zero-bias photocurrent was also relatively high, showing a minimal drop compared to that at -1 V bias.

PRA (Probabilistic Risk Assessment) Applications Program for inspection at Oconee Unit 3

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

Gore, B.F.; Vo, T.V.; Harris, M.S.

1987-10-01

The extensive Oconee-3 PRA performed by EPRI has been analyzed to identify plant systems and components important to minimizing public risk, and to identify the primary failure modes of these components. This information has been tabulated, and correlated with inspection modules from the NRC Inspection and Enforcement Manual. The report presents a series of tables, organized by system and prioritized by public risk (in person-rem per year), which identify components associated with 98% of the inspectable risk due to plant operation. External events (earthquakes, tornadoes, fires and floods) are not addressed because inspections cannot directly minimize the risks from thesemore » events; however, flooding caused by the breach of internal systems is addressed. The systems addressed, in descending order of risk importance, are: Reactor Building Spray, R B Cooling, Condenser Circulating Water, Safety Relief Valves, Low Pressure Injection, Standby Shutdown Facility-High Pressure Injection, Low-Pressure Service Water, and Emergency Feedwater. This ranking is based on the Fussel-Vesely measure of risk importance, i.e., the fraction of the total risk which involves failures of the system of interest. 8 refs., 25 tabs.« less

Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest

PubMed Central

Mahmood, Zahid; Al Benna, Sammy; Nkere, Udim; Murday, Andrew

2006-01-01

Objectives The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions. Design We conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. Results Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B. With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However there were significantly more infections in Group A compared with Group B. Conclusion Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique. PMID:16759395

Minimizing variability of cascade impaction measurements in inhalers and nebulizers.

PubMed

Bonam, Matthew; Christopher, David; Cipolla, David; Donovan, Brent; Goodwin, David; Holmes, Susan; Lyapustina, Svetlana; Mitchell, Jolyon; Nichols, Steve; Pettersson, Gunilla; Quale, Chris; Rao, Nagaraja; Singh, Dilraj; Tougas, Terrence; Van Oort, Mike; Walther, Bernd; Wyka, Bruce

2008-01-01

The purpose of this article is to catalogue in a systematic way the available information about factors that may influence the outcome and variability of cascade impactor (CI) measurements of pharmaceutical aerosols for inhalation, such as those obtained from metered dose inhalers (MDIs), dry powder inhalers (DPIs) or products for nebulization; and to suggest ways to minimize the influence of such factors. To accomplish this task, the authors constructed a cause-and-effect Ishikawa diagram for a CI measurement and considered the influence of each root cause based on industry experience and thorough literature review. The results illustrate the intricate network of underlying causes of CI variability, with the potential for several multi-way statistical interactions. It was also found that significantly more quantitative information exists about impactor-related causes than about operator-derived influences, the contribution of drug assay methodology and product-related causes, suggesting a need for further research in those areas. The understanding and awareness of all these factors should aid in the development of optimized CI methods and appropriate quality control measures for aerodynamic particle size distribution (APSD) of pharmaceutical aerosols, in line with the current regulatory initiatives involving quality-by-design (QbD).

On the role of constant-stress surfaces in the problem of minimizing elastic stress concentration

NASA Technical Reports Server (NTRS)

Wheeler, L.

1976-01-01

Cases involving antiplane shear deformation, axisymmetric torsion, and plane strain theory, with surfaces of constant stress magnitude optimal in terms of minimizing stress, are investigated. Results for the plane theory refer to exterior doubly connected domains. Stresses generated by torsion of an elastic solid lying within a radially convex region of revolution with plane ends, body force absent, and lateral surface traction-free, are examined. The unknown portion of the boundary of such domains may involve a hole, fillet, or notch.

Parenteral glutamine supplement has synergic effects in minimally invasive surgery of subtotal gastrectomy patients.

PubMed

Chen, Chien-Chia; Chang, Tung-Cheng; Wang, Ming-Yang; Wu, Ming-Hsun; Lin, Ming-Tsan

2012-09-01

Exogenous glutamine supplement is known to improve morbidity and mortality of critically-ill patients. This study was conducted to elucidate the role of glutamine in minimally invasive surgery. We retrospectively reviewed subtotal gastrectomy patients in National Taiwan University Hospital from Dec 2005 to Dec 2008. The patients were divided into three groups. Group 1 underwent subtotal gastrectomy by laparotomy without glutamine supplement, group 2 underwent subtotal gastrectomy by laparotomy with glutamine supplement and group 3 underwent gasless laparoscopy-assisted subtotal gastrectomy with parenteral glutamine supplement. There were 155 patients in total; 85 patients in group 1, 17 in group 2 and 53 in group 3. The mean flatus days after operation are 3.6, 3.1 and 2.8 for groups 1, 2 and 3, respectively (p=0.001). Oral intake after operation was commenced after 6.7, 5.0 and 4.7 days (p=0.006). The body temperature had borderline differences between groups 3 and 1. There were significant differences in postoperative systemic responses including heart rates (p<0.001) and tenderness (p=0.011) 5 days after operation for group 3 vs. group 1. Minimally invasive surgery was a negative factor for postoperative body temperature change. Glutamine was a significant factor for postoperative heart rate change and reduction of tenderness. Glutamine supplement may have synergic effects of rapid recovery in minimal invasive surgery for subtotal gastrectomy patients by minimizing the postoperative systemic response and accelerating recovery.

Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.

PubMed

Kaye, Ian David; Passias, Peter

2018-03-01

Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.

Minimal investment risk of a portfolio optimization problem with budget and investment concentration constraints

NASA Astrophysics Data System (ADS)

Shinzato, Takashi

2017-02-01

In the present paper, the minimal investment risk for a portfolio optimization problem with imposed budget and investment concentration constraints is considered using replica analysis. Since the minimal investment risk is influenced by the investment concentration constraint (as well as the budget constraint), it is intuitive that the minimal investment risk for the problem with an investment concentration constraint can be larger than that without the constraint (that is, with only the budget constraint). Moreover, a numerical experiment shows the effectiveness of our proposed analysis. In contrast, the standard operations research approach failed to identify accurately the minimal investment risk of the portfolio optimization problem.

Guidelines To Validate Control of Cross-Contamination during Washing of Fresh-Cut Leafy Vegetables.

PubMed

Gombas, D; Luo, Y; Brennan, J; Shergill, G; Petran, R; Walsh, R; Hau, H; Khurana, K; Zomorodi, B; Rosen, J; Varley, R; Deng, K

2017-02-01

The U.S. Food and Drug Administration requires food processors to implement and validate processes that will result in significantly minimizing or preventing the occurrence of hazards that are reasonably foreseeable in food production. During production of fresh-cut leafy vegetables, microbial contamination that may be present on the product can spread throughout the production batch when the product is washed, thus increasing the risk of illnesses. The use of antimicrobials in the wash water is a critical step in preventing such water-mediated cross-contamination; however, many factors can affect antimicrobial efficacy in the production of fresh-cut leafy vegetables, and the procedures for validating this key preventive control have not been articulated. Producers may consider three options for validating antimicrobial washing as a preventive control for cross-contamination. Option 1 involves the use of a surrogate for the microbial hazard and the demonstration that cross-contamination is prevented by the antimicrobial wash. Option 2 involves the use of antimicrobial sensors and the demonstration that a critical antimicrobial level is maintained during worst-case operating conditions. Option 3 validates the placement of the sensors in the processing equipment with the demonstration that a critical antimicrobial level is maintained at all locations, regardless of operating conditions. These validation options developed for fresh-cut leafy vegetables may serve as examples for validating processes that prevent cross-contamination during washing of other fresh produce commodities.

Decision support system for the operating room rescheduling problem.

PubMed

van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

2012-12-01

Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

Robust Multivariable Optimization and Performance Simulation for ASIC Design

NASA Technical Reports Server (NTRS)

DuMonthier, Jeffrey; Suarez, George

2013-01-01

Application-specific-integrated-circuit (ASIC) design for space applications involves multiple challenges of maximizing performance, minimizing power, and ensuring reliable operation in extreme environments. This is a complex multidimensional optimization problem, which must be solved early in the development cycle of a system due to the time required for testing and qualification severely limiting opportunities to modify and iterate. Manual design techniques, which generally involve simulation at one or a small number of corners with a very limited set of simultaneously variable parameters in order to make the problem tractable, are inefficient and not guaranteed to achieve the best possible results within the performance envelope defined by the process and environmental requirements. What is required is a means to automate design parameter variation, allow the designer to specify operational constraints and performance goals, and to analyze the results in a way that facilitates identifying the tradeoffs defining the performance envelope over the full set of process and environmental corner cases. The system developed by the Mixed Signal ASIC Group (MSAG) at the Goddard Space Flight Center is implemented as a framework of software modules, templates, and function libraries. It integrates CAD tools and a mathematical computing environment, and can be customized for new circuit designs with only a modest amount of effort as most common tasks are already encapsulated. Customization is required for simulation test benches to determine performance metrics and for cost function computation.

Minimally Invasive Tubular Resection of Lumbar Synovial Cysts: Report of 40 Consecutive Cases.

PubMed

Birch, Barry D; Aoun, Rami James N; Elbert, Gregg A; Patel, Naresh P; Krishna, Chandan; Lyons, Mark K

2016-10-01

Lumbar synovial cysts are a relatively common clinical finding. Surgical treatment of symptomatic synovial cysts includes computed tomography-guided aspiration, open resection and minimally invasive tubular resection. We report our series of 40 consecutive minimally invasive microscopic tubular lumbar synovial cyst resections. Following Institutional Review Board approval, a retrospective analysis of 40 cases of minimally invasive microscopic tubular retractor synovial cyst resections at a single institution by a single surgeon (B.D.B.) was conducted. Gross total resection was performed in all cases. Patient characteristics, surgical operating time, complications, and outcomes were analyzed. Lumbar radiculopathy was the presenting symptoms in all but 1 patient, who presented with neurogenic claudication. The mean duration of symptoms was 6.5 months (range, 1-25 months), mean operating time was 58 minutes (range, 25-110 minutes), and mean blood loss was 20 mL (range, 5-50 mL). Seven patients required overnight observation. The median length of stay in the remaining 33 patients was 4 hours. There were 2 cerebrospinal fluid leaks repaired directly without sequelae. The mean follow-up duration was 80.7 months. Outcomes were good or excellent in 37 of the 40 patients, fair in 1 patient, and poor in 2 patients. Minimally invasive microscopic tubular retractor resection of lumbar synovial cysts can be done safely and with comparable outcomes and complication rates as open procedures with potentially reduced operative time, length of stay, and healthcare costs. Patient selection for microscopic tubular synovial cyst resection is based in part on the anatomy of the spine and synovial cyst and is critical when recommending minimally invasive vs. open resection to patients. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-05-01

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

Low-rank matrix decomposition and spatio-temporal sparse recovery for STAP radar

DOE PAGES

Sen, Satyabrata

2015-08-04

We develop space-time adaptive processing (STAP) methods by leveraging the advantages of sparse signal processing techniques in order to detect a slowly-moving target. We observe that the inherent sparse characteristics of a STAP problem can be formulated as the low-rankness of clutter covariance matrix when compared to the total adaptive degrees-of-freedom, and also as the sparse interference spectrum on the spatio-temporal domain. By exploiting these sparse properties, we propose two approaches for estimating the interference covariance matrix. In the first approach, we consider a constrained matrix rank minimization problem (RMP) to decompose the sample covariance matrix into a low-rank positivemore » semidefinite and a diagonal matrix. The solution of RMP is obtained by applying the trace minimization technique and the singular value decomposition with matrix shrinkage operator. Our second approach deals with the atomic norm minimization problem to recover the clutter response-vector that has a sparse support on the spatio-temporal plane. We use convex relaxation based standard sparse-recovery techniques to find the solutions. With extensive numerical examples, we demonstrate the performances of proposed STAP approaches with respect to both the ideal and practical scenarios, involving Doppler-ambiguous clutter ridges, spatial and temporal decorrelation effects. As a result, the low-rank matrix decomposition based solution requires secondary measurements as many as twice the clutter rank to attain a near-ideal STAP performance; whereas the spatio-temporal sparsity based approach needs a considerably small number of secondary data.« less

DEVELOPING TOOLS FOR EVALUATING RISK MANAGEMENT OF ENDOCRINE DISRUPTING CHEMICALS

EPA Science Inventory

The goal of endocrine disrupting chemical (EDC) risk management (RM) is to minimize the release of EDCs into the environment or to minimize the exposure of humans or wildlife to EDCs already present in the environment. RM research projects may involve: substituting more innocuous...

Electromyographic study of hip muscles involved in total hip arthroplasty: Surprising results using the direct anterior minimally invasive approach.

PubMed

Bernard, Jules; Razanabola, Fredson; Beldame, Julien; Van Driessche, Stéphane; Brunel, Helena; Poirier, Thomas; Matsoukis, Jean; Billuart, Fabien

2018-05-16

The functional and clinical benefit of minimally invasive total hip arthroplasty (THA) is well-known, but the literature reports impaired gait and posture parameters as compared to the general population, especially following use of the anterior minimally invasive approach, which has more severe impact on posture than the posterior approach. The reasons for this impairment, however, remain unexplained. We therefore conducted a surface electromyography (sEMG) study of the hip muscles liable to be affected by arthroplasty surgery: gluteus maximus (GMax), gluteus medius (GMed), tensor fasciae latae (TFL), and sartorius (S). The study addressed the following questions: (1) Is bipodal and unipodal GMed activity greater following anterior THA than in asymptomatic subjects? (2) Is a single manual test sufficient to assess maximal voluntary contraction (MVC) in hip abductors (GMax, GMed, TFL) and flexors (TFL, S)? Bipodal and unipodal GMed activity is greater following anterior THA than in asymptomatic subjects. Eleven patients with anterior THA and 11 asymptomatic subjects, matched for age, gender and body-mass index, were included. Subjects underwent 3 postural tests: bipodal, eyes closed (BEC), unipodal on the operated side (UOP), and unipodal on the non-operated side (UnOP), with unipodal results averaged between both sides in the asymptomatic subjects. Data were recorded from 4-channel EMG and a force plate. EMG test activity was normalized as a ratio of MVC activity. Postural parameters (mean center of pressure displacement speed) were poorer and sEMG activity higher in anterior THA than asymptomatic subjects (p<0.005). On the BEC test, GMax and GMed activity was higher on both operated and non-operated sides than in asymptomatic controls (respectively, 0.15±0.12 and 0.12±0.6 versus 0.07±0.06 for GMax, and 0.13±0.08 and 0.13±0.08 versus 0.08±0.05 for GMed; p<0.05). On unipodal tests, both UOP and UnOP GMed activities were higher than in controls (respectively, 0.51±0.3 and 0.48±0.27 versus 0.28±0.13; p<0.04); GMax and TFL activities were higher than in controls only on the UOP tests (respectively, 0.49±0.43 versus 0.24±0.18, and 0.23±0.17 versus 0.12±0.16; p<0.05). sEMG activity in the hip abductors, which are the main stabilizing muscles for the pelvis, is increased following anterior THA, in parallel with impaired postural parameters. This finding may be due to intraoperative TFL and S neuromuscular spindle lesion. The present preliminary study is to be followed up by a comparison of all 3 common minimally invasive approaches (anterior, anterolateral and posterior) using the same study protocol. III, prospective case-control study. Copyright © 2018. Published by Elsevier Masson SAS.

Minimally Invasive Mitral Valve Procedures: The Current State

PubMed Central

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

2013-01-01

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

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

PubMed

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

2004-11-01

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

Evaluation of decision making and negotiation processes under uncertainties regarding the water management of Peiros-Parapeiros Dam, in Achaia Region (Greece).

NASA Astrophysics Data System (ADS)

Podimata, Marianthi V.; Yannopoulos, Panayotis C.

2015-04-01

Water managers, decision-makers, water practitioners and others involved in Integrated Water Resources Management often encounter the problem of finding a joint agreement among stakeholders concerning the management of a common water body. Handling conflict situations/disputes over water issues and finding an acceptable joint solution remain a thorny issue in water negotiation processes, since finding a formula for wise, fair and sustainable management of a water resource is a complex process that includes environmental, economic, technical, socio-political criteria and their uncertainties. Decision Support Systems and Adaptive Management are increasingly used in that direction. To assist decision makers in handling water disputes and execute negotiations, a conceptual tool is required. The Graph Model for Conflict Resolution is a Decision Support flexible tool for negotiation support regarding water conflicts. It includes efficient algorithms for estimating strategic moves of water stakeholders, even though there is a lack of detail concerning their real motives and prospects. It calculates the stability of their states and encourages what-if analyses. This paper presents a case study of water decision makers' evaluations concerning the management of up-coming technical infrastructure Peiros-Parapeiros Dam, in Achaia Region (Greece). The continuous consultations between institutions and representatives revealed that the formation of a joint agreement between stakeholders is not easy, due to arising conflicts and contradictions regarding the jurisdiction and legal status of the dam operator and the cost undertaking of the dam operation. This paper analyzes the positions of the parties involved in the consultation process and examines possible conflict resolution states, using GMCR II. This methodology tries to minimize uncertainty to a certain extent concerning the possible moves/decisions of involved parties regarding the operation and management of the dam by developing and simulating potential strategic interactions and multilateral negotiations and finding confidence-building cooperation schemes (cooperative arrangements) over water use and management.

[Application of water jet ERBEJET 2 in salivary glands surgery].

PubMed

Gasiński, Mateusz; Modrzejewski, Maciej; Cenda, Paweł; Nazim-Zygadło, Elzbieta; Kozok, Andrzej; Dobosz, Paweł

2009-09-01

Anatomical location of salivary glands requires from surgeon high precision during the operation in this site. Waterjet is one of the modern tools which allows to perform "minimal invasive" operating procedure. This tool helps to separate pathological structures from healthy tissue with a stream of high pressure saline pumped to the operating area via special designed applicators. Stream of fluid is generated by double piston pummp under 1 to 80 bar pressure that can be regulated. This allows to precise remove tumors, spare nerves and vessels in glandular tissue and minimize use of electrocoagulation. Waterjet is a modern tool that can help to improve the safety of patients and comfort of surgeon's work.

INTELLIGENT DECISION SUPPORT FOR WASTE MINIMIZATION IN ELECTROPLATING PLANTS. (R824732)

EPA Science Inventory

Abstract

Wastewater, spent solvent, spent process solutions, and sludge are the major waste streams generated in large volumes daily in electroplating plants. These waste streams can be significantly minimized through process modification and operational improvement. I...

49 CFR 571.118 - Standard No. 118; Power-operated window, partition, and roof panel systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-operated window, partition, and roof panel systems. S1. Purpose and scope. This standard specifies requirements for power operated window, partition, and roof panel systems to minimize the likelihood of death... Figure 2. Power operated roof panel systems mean moveable panels in the vehicle roof which close by...

49 CFR 571.118 - Standard No. 118; Power-operated window, partition, and roof panel systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-operated window, partition, and roof panel systems. S1. Purpose and scope. This standard specifies requirements for power operated window, partition, and roof panel systems to minimize the likelihood of death... Figure 2. Power operated roof panel systems mean moveable panels in the vehicle roof which close by...

49 CFR 571.118 - Standard No. 118; Power-operated window, partition, and roof panel systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-operated window, partition, and roof panel systems. S1. Purpose and scope. This standard specifies requirements for power operated window, partition, and roof panel systems to minimize the likelihood of death... Figure 2. Power operated roof panel systems mean moveable panels in the vehicle roof which close by...

49 CFR 571.118 - Standard No. 118; Power-operated window, partition, and roof panel systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-operated window, partition, and roof panel systems. S1. Purpose and scope. This standard specifies requirements for power operated window, partition, and roof panel systems to minimize the likelihood of death... Figure 2. Power operated roof panel systems mean moveable panels in the vehicle roof which close by...

49 CFR 571.118 - Standard No. 118; Power-operated window, partition, and roof panel systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-operated window, partition, and roof panel systems. S1. Purpose and scope. This standard specifies requirements for power operated window, partition, and roof panel systems to minimize the likelihood of death... Figure 2. Power operated roof panel systems mean moveable panels in the vehicle roof which close by...

Joint Sandia/NIOSH exercise on aerosol contamination using the BROOM tool.

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

Ramsey, James L., Jr.; .); Melton, Brad

In February of 2005, a joint exercise involving Sandia National Laboratories (SNL) and the National Institute for Occupational Safety and Health (NIOSH) was conducted in Albuquerque, NM. The SNL participants included the team developing the Building Restoration Operations and Optimization Model (BROOM), a software product developed to expedite sampling and data management activities applicable to facility restoration following a biological contamination event. Integrated data-collection, data-management, and visualization software improve the efficiency of cleanup, minimize facility downtime, and provide a transparent basis for reopening. The exercise was held at an SNL facility, the Coronado Club, a now-closed social club for Sandiamore » employees located on Kirtland Air Force Base. Both NIOSH and SNL had specific objectives for the exercise, and all objectives were met.« less

Eigenvalue assignment by minimal state-feedback gain in LTI multivariable systems

NASA Astrophysics Data System (ADS)

Ataei, Mohammad; Enshaee, Ali

2011-12-01

In this article, an improved method for eigenvalue assignment via state feedback in the linear time-invariant multivariable systems is proposed. This method is based on elementary similarity operations, and involves mainly utilisation of vector companion forms, and thus is very simple and easy to implement on a digital computer. In addition to the controllable systems, the proposed method can be applied for the stabilisable ones and also systems with linearly dependent inputs. Moreover, two types of state-feedback gain matrices can be achieved by this method: (1) the numerical one, which is unique, and (2) the parametric one, in which its parameters are determined in order to achieve a gain matrix with minimum Frobenius norm. The numerical examples are presented to demonstrate the advantages of the proposed method.

Transhepatic metallic stenting for hepaticojejunostomy stricture following laparoscopic cholecystectomy biliary injury: A case of successful 20 years follow-up

PubMed Central

Donatelli, Gianfranco; Mutter, Didier; Dhumane, Parag; Callari, Cosimo; Marescaux, Jacques

2012-01-01

Laparoscopic cholecystectomy is still associated with a considerable rate of biliary injuries and related strictures. Advances in interventional endoscopy and percutaneous techniques have made stenting a preferred treatment modality for the management of these strictures. We report successful 20 years of follow-up of a case of trans-hepatic metallic stenting (2 Gianturco® prostheses, 5 cm long, 2 cm in diameter) done for stenosed hepatico-jejunostomy anastomosis after laparoscopic CBD injury. Percutaneous transhepatic stenting and long-term placement of metallic stents need to be re-evaluated as a minimally invasive definitive treatment option for benign biliary strictures in patients with altered anatomy such as hepatico-jejunostomy or in whom re-operation involves high risk. PMID:22837599

Free Energy Minimization by Simulated Annealing with Applications to Lithospheric Slabs and Mantle Plumes

NASA Astrophysics Data System (ADS)

Bina, C. R.

An optimization algorithm based upon the method of simulated annealing is of utility in calculating equilibrium phase assemblages as functions of pressure, temperature, and chemical composi tion. Operating by analogy to the statistical mechanics of the chemical system, it is applicable both to problems of strict chemical equilibrium and to problems involving metastability. The method reproduces known phase diagrams and illustrates the expected thermal deflection of phase transitions in thermal models of subducting lithospheric slabs and buoyant mantle plumes. It reveals temperature-induced changes in phase transition sharpness and the stability of Fe-rich γ phase within an α+γ field in cold slab thermal models, and it suggests that transitions such as the possible breakdown of silicate perovskite to mixed oxides can amplify velocity anomalies.

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

PubMed Central

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

2009-01-01

A Prospective randomised controlled study was done to determine statistical difference between the standard microsurgical discotomy (MC) and a minimally invasive microscopic procedure for disc prolapse surgery by comparing operation duration and clinical outcome. Additionally, the transferability of the results was determined by a bicentric design. The microscopic assisted percutaneous nucleotomy (MAPN) has been advocated as a minimally invasive tubular technique. Proponents have claimed that minimally invasive procedures reduce postoperative pain and accelerate the recovery. In addition, there exist only a limited number of well-designed comparison studies comparing standard microdiscotomy to a tubular minimally invasive technique that support this claim. Furthermore, there are no well-designed studies looking at the transferability of those results and possible learning curve phenomena. We studied 100 patients, who were planned for disc prolapse surgery at two centres [50 patients at the developing centre (index) and 50 patients at the less experienced (transfer) centre]. The randomisation was done separately for each centre, employing a block-randomisation procedure with respect to age and preoperative Oswestry score. Operation duration was chosen as a primary outcome parameter as there was a distinguished shortening observed in a preliminary study at the index centre enabling a sound case number estimation. The following data were compared between the two groups and the centres with a 12-month follow-up: surgical times (operation duration and approach duration), the clinical results, leg and back pain by visual analogue scale, the Oswestry disability index, length of hospital stay, return to work time, and complications. The operation duration was statistically identical for MC (57.8 ± 20.2 min) at the index centre and for MAPN (50.3 ± 18.3 min) and MC (54.7 ± 18.1 min) at the transfer centre. The operation duration was only significantly shorter for the MAPN technique at the index centre with 33.3 min (SD 12.1 min). There was a huge clinical improvement for all patients regardless of centre or method revealed by a repeated measures ANOVA for all follow-up visits Separate post hoc ANOVAs for each centre revealed that there was a significant time–method (MAPN vs. MC) interaction at the index centre (F = 3.75, P = 0.006), whereas this crucial interaction was not present at the transfer centre (F = 0.5, P = 0.7). These results suggest a slightly faster clinical recovery for the MAPN patients only at the index centre. This was due to a greater reduction in VAS score for back pain at discharge, 8-week and 6-month follow up (P < 0.002). The Oswestry-disability scores reached a significant improvement compared to the initial values extending over the complete follow-up at both centres for both methods without revealing any differences for the two methods in either centre. There was no difference regarding complications. The results demonstrate that a shorter operation duration and concomitant quicker recovery is comprehensible at an experienced minimally invasively operating centre. These advantages could not be found at the transfer centre within 25 minimally invasive procedures. In conclusion both procedures show equal mid term clinical results and the same complication rate even if the suggested advantages for the minimally invasive procedure could not be confirmed for the transfer centre within the framework of this study. PMID:19360440

40 CFR 26.405 - Observational research involving greater than minimal risk but presenting the prospect of direct...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Observational research involving... Section 26.405 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Observational Research: Additional Protections for Children Involved as Subjects in Observational...

Consequences of "Minimal" Group Affiliations in Children

ERIC Educational Resources Information Center

Dunham, Yarrow; Baron, Andrew Scott; Carey, Susan

2011-01-01

Three experiments (total N = 140) tested the hypothesis that 5-year-old children's membership in randomly assigned "minimal" groups would be sufficient to induce intergroup bias. Children were randomly assigned to groups and engaged in tasks involving judgments of unfamiliar in-group or out-group children. Despite an absence of information…

Introduction [Chapter 1

Treesearch

R. C. Musselman; D. G Fox; A. W. Schoettle; C. M. Regan

1994-01-01

Wilderness ecosystems in the United States are federally mandated and set aside by the Wilderness Act. They are managed to minimize human impact using methods that leave these systems, to the extent possible, in their natural state uninfluenced by manipulation or disruption by humans. Management often involves controlling or minimizing visual impact by enforcing strict...

A Pilot Study of a Novel Automated Somatosensory Evoked Potential (SSEP) Monitoring Device for Detection and Prevention of Intraoperative Peripheral Nerve Injury in Total Shoulder Arthroplasty Surgery.

PubMed

Chui, Jason; Murkin, John M; Drosdowech, Darren

2018-05-21

Peripheral nerve injury is a potentially devastating complication after total shoulder arthroplasty (TSA) surgery. This pilot study aimed to assess the feasibility of using an automated somatosensory evoked potential (SSEP) device to provide a timely alert/intervention to minimize intraoperative nerve insults during TSA surgery. A prospective, single-arm, observational study was conducted in a single university hospital. The attending anesthesiologist monitored the study participants using the EPAD automated SSEP device and an intervention was made if there was an alert during TSA surgery. The median, radial, and ulnar nerve SSEP on the operative arm, as well as the median nerve SSEP of the nonoperative arm were monitored for each patient. All patients were evaluated for postoperative neurological deficits 6 weeks postoperatively. In total, 21 patients were consented and were successfully monitored. In total, 4 (19%) patients developed intraoperative abnormal SSEP signal changes in the operative arm, in which 3 were reversible and 1 was irreversible till the end of surgery. Median and radial nerves were mostly involved (3/4 patients). The mean cumulative duration of nerve insult (abnormal SSEP) was 21.7±26.2 minutes. Univariate analysis did not identify predictor of intraoperative nerve insults. No patients demonstrated postoperative peripheral neuropathy at 6 weeks. A high incidence (19%) of intraoperative nerve insult was observed in this study demonstrating the feasibility of using an automated SSEP device to provide a timely alert and enable an intervention in order to minimize peripheral nerve injury during TSA. Further randomized studies are warranted.

Cardiothoracic Applications of 3D Printing

PubMed Central

Giannopoulos, Andreas A.; Steigner, Michael L.; George, Elizabeth; Barile, Maria; Hunsaker, Andetta R.; Rybicki, Frank J.; Mitsouras, Dimitris

2016-01-01

Summary Medical 3D printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as CT, MRI, echocardiography and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides. Cardiovascular 3D printed models can improve diagnosis and allow for advanced pre-operative planning. The majority of applications reported involve congenital heart diseases, valvular and great vessels pathologies. Printed models are suitable for planning both surgical and minimally invasive procedures. Added value has been reported toward improving outcomes, minimizing peri-operative risk, and developing new procedures such as transcatheter mitral valve replacements. Similarly, thoracic surgeons are using 3D printing to assess invasion of vital structures by tumors and to assist in diagnosis and treatment of upper and lower airway diseases. Anatomic models enable surgeons to assimilate information more quickly than image review, choose the optimal surgical approach, and achieve surgery in a shorter time. Patient-specific 3D-printed implants are beginning to appear and may have significant impact on cosmetic and life-saving procedures in the future. In summary, cardiothoracic 3D printing is rapidly evolving and may be a potential game-changer for surgeons. The imager who is equipped with the tools to apply this new imaging science to cardiothoracic care is thus ideally positioned to innovate in this new emerging imaging modality. PMID:27149367

Gas purification in the dense phase at the CATS terminal

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

Openshaw, P.J.; Carnell, P.J.H.; Rhodes, E.F.

The purification and transportation of natural gas at very high pressures can help to minimize the capital cost of pipelines and processing equipment. However, complex mixtures of hydrocarbons undergo unusual phase changes, such as retrograde condensation, as the temperature and pressure are altered. The Central Area Transmission System (CATS) is a joint venture of Amoci, BG, Amerada Hess, Phillips, Agip and Fina operated by Amoco on behalf of the owners. The design of the CATS terminal has provided an interesting processing challenge. The terminal receives a total of 1.6 Bscf/d of rich gas from a number of offshore fields. Allmore » are relatively sweet but the small amounts of H{sub 2}S and Hg are removed. Fixed bed technology was selected as the most economic purification process, while minimizing hydrocarbon loss and operator involvement. Conventionally, the raw gas would be split into the different hydrocarbon fractions and each would be processed separately. This would require the installation of a large number of reactors. A more elegant solution is to treat the gas on arrival at the terminal in the dense phase. This option raised questions around whether a fixed bed would be prone to fouling, could the pressure drop be kept low enough to avoid phase separation and would inadvertent wetting by condensation cause problems. Details are given of the test work carried out to prove the viability of using fixed bed technology for dense phase gas processing, the eventual design adopted and the performance over the first year of service.« less

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

PubMed

Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

2015-04-01

Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. Although the main treatment is radical nephroureterectomy (NU), oncologic outcomes are not comparable to lower tract urothelial cancers. Identifying prognostic factors can help guide management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2013-08-01

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

Future of Minimally Invasive Colorectal Surgery

PubMed Central

Whealon, Matthew; Vinci, Alessio; Pigazzi, Alessio

2016-01-01

Minimally invasive surgery is slowly taking over as the preferred operative approach for colorectal diseases. However, many of the procedures remain technically difficult. This article will give an overview of the state of minimally invasive surgery and the many advances that have been made over the last two decades. Specifically, we discuss the introduction of the robotic platform and some of its benefits and limitations. We also describe some newer techniques related to robotics. PMID:27582647

[Effects of robot-assisted minimally invasive transforaminal lumbar interbody fusion and traditional open surgery in the treatment of lumbar spondylolisthesis].

PubMed

Cui, G Y; Tian, W; He, D; Xing, Y G; Liu, B; Yuan, Q; Wang, Y Q; Sun, Y Q

2017-07-01

Objective: To compare the clinical effects of robot-assisted minimally invasive transforaminal lumbar interbody fusion (TLIF) and traditional open TLIF in the treatment of lumbar spondylolisthesis. Methods: A total of 41 patients with lumbar spondylolisthesis accepted surgical treatment in Department of Spinal Surgery of Beijing Jishuitan Hospital From July 2015 to April 2016 were retrospectively analyzed. There were 16 cases accepted robot-assisted minimally invasive TLIF and 25 accepted traditional open TLIF. The operation time, X-ray radiation exposure time, perioperative bleeding, drainage volume, time of hospitalization, time for pain relief, time for ambulatory recovery, visual analogue scale (VAS), Oswestry disability index (ODI) and complications were compared. T test and χ(2) were used to analyze data. Results: There were no significant difference in gender, age, numbers, degrees, pre-operative VAS and ODI in spondylolisthesis (all P >0.05). Compared with traditional open TLIF group, the robot-assisted minimally invasive TLIF group had less perioperative bleeding ((187.5±18.4) ml vs . (332.1±23.5) ml), less drainage volume ((103.1±15.6) ml vs . (261.3±19.8) ml), shorter hospitalization ((7.8±1.9) days vs . (10.0±1.6) days), shorter time for pain relief ((2.8±1.0) days vs . (5.2±1.1) days), shorter time for ambulatory recovery ((1.7±0.9) days vs . (2.9±1.3) days) and less VAS of the third day postoperatively (2.2±0.9 vs . 4.2±2.4) ( t =2.762-16.738, all P <0.05), but need more operation time ((151.3±12.3) minutes vs . (102.2±7.1) minutes) and more X-ray radiation exposure ((26.1±3.3) seconds vs . (5.5±2.1) seconds) ( t =6.125, 15.168, both P <0.01). In both groups ODI was significantly lower in final follow-up than that of the pre-operation ( t =12.215, 14.036, P <0.01). Intervertebral disc height of the final follow-up in both groups were significantly larger than that of the preoperation (robot-assisted minimally invasive TLIF group: (11.8 ± 2.8) mm vs . (7.5 ± 1.9) mm, traditional open TLIF group: (12.7 ± 2.5) mm vs . (7.9±2.0) mm), and so was the lumbar lordosis angle (robot-assisted minimally invasive TLIF group: (48.7±9.2)° vs . (39.6±7.9)°, traditional open TLIF group: (50.1±10.8)° vs . (41.4±8.8)°), the lordosis angle of the slippage segment (robot-assisted minimally invasive TLIF group: (18.7±5.6)° vs . (10.9±3.8)°, traditional open TLIF group: (17.6±6.1)° vs .(8.7±3.2)°) ( t =4.128-16.738, all P <0.01). Slippage rate of the final follow-up in both groups were significantly smaller than those of the pre-operation (robot-assisted minimally invasive TLIF group: (5.3±2.3) % vs . (27.8±7.2) %, traditional open TLIF group: (6.6±2.8) % vs . (29.1±9.5) %) ( t =11.410, 18.504, both P <0.01). There was no difference of the upper data between two groups ( t =0.106-1.227, P >0.05). The results of the post-operative CT showed that the pedicle screws in the robot-assisted minimally invasive TLIF group were more precisely placed than traditional open TLIF group (χ(2)=4.247, P =0.039). The mean follow-up time was 8 months (ranging from 3 to 12 months). There were no significant difference in outcomes between the two groups (χ(2)=0.366, P =0.545). Conclusions: In the treatment of lumbar spondylolisthesis, Robot-assisted minimally invasive TLIF can lead to less perioperative bleeding, less post-operative pain, and quicker recovery than traditional open TLIF surgery, but it needs more operation time and radiation exposure.

Operation of a wet near-field scanning optical microscope in stable zones by minimizing the resonance change of tuning forks.

PubMed

Park, Kyoung-Duck; Park, Doo Jae; Lee, Seung Gol; Choi, Geunchang; Kim, Dai-Sik; Byeon, Clare Chisu; Choi, Soo Bong; Jeong, Mun Seok

2014-02-21

A resonant shift and a decrease of resonance quality of a tuning fork attached to a conventional fiber optic probe in the vicinity of liquid is monitored systematically while varying the protrusion length and immersion depth of the probe. Stable zones where the resonance modification as a function of immersion depth is minimized are observed. A wet near-field scanning optical microscope (wet-NSOM) is operated for a sample within water by using such a stable zone.

Operational responses to climate change impacts

DOT National Transportation Integrated Search

2008-01-01

Systems Operations and Management activities of transportation agencies-both state and localhave the objective of making the most effective use of the existing roadway capacity by : improving efficiency (throughput, speed, safety), minimizing the ser...

Universal behavior of generalized causal set d’Alembertians in curved spacetime

NASA Astrophysics Data System (ADS)

Belenchia, Alessio

2016-07-01

Causal set non-local wave operators allow both for the definition of an action for causal set theory and the study of deviations from local physics that may have interesting phenomenological consequences. It was previously shown that, in all dimensions, the (unique) minimal discrete operators give averaged continuum non-local operators that reduce to \\square -R/2 in the local limit. Recently, dropping the constraint of minimality, it was shown that there exist an infinite number of discrete operators satisfying basic physical requirements and with the right local limit in flat spacetime. In this work, we consider this entire class of generalized causal set d’Alembertins in curved spacetimes and extend to them the result about the universality of the -R/2 factor. Finally, we comment on the relation of this result to the Einstein equivalence principle.

40 CFR 125.94 - How will requirements reflecting best technology available for minimizing adverse environmental...

Code of Federal Regulations, 2010 CFR

2010-07-01

... construction, operational, maintenance, monitoring, and adaptive management requirements of a Technology... the Director that your existing design and construction technologies, operational measures, and/or..., operational measures, and/or restoration measures that will, in combination with any existing design and...

Re-appraisal and consideration of minimally invasive surgery in colorectal cancer

PubMed Central

Abu Gazala, Mahmoud

2017-01-01

Throughout history, surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma. During the last three decades, there have been tremendous advances in the field of minimally invasive colorectal surgery, with an explosion of different technologies and approaches offered to treat well-known diseases. Laparoscopic surgery has been shown to be equal or superior to open surgery. The boundaries of laparoscopy have been pushed further, in the form of single-incision laparoscopy, natural-orifice transluminal endoscopic surgery and robotics. This paper critically reviews the pathway of development of minimally invasive surgery, and appraises the different minimally invasive colorectal surgical approaches available to date. PMID:28567286

Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS)

PubMed Central

Anastasiadis, Kyriakos; Murkin, John; Antonitsis, Polychronis; Bauer, Adrian; Ranucci, Marco; Gygax, Erich; Schaarschmidt, Jan; Fromes, Yves; Philipp, Alois; Eberle, Balthasar; Punjabi, Prakash; Argiriadou, Helena; Kadner, Alexander; Jenni, Hansjoerg; Albrecht, Guenter; van Boven, Wim; Liebold, Andreas; de Somer, Fillip; Hausmann, Harald; Deliopoulos, Apostolos; El-Essawi, Aschraf; Mazzei, Valerio; Biancari, Fausto; Fernandez, Adam; Weerwind, Patrick; Puehler, Thomas; Serrick, Cyril; Waanders, Frans; Gunaydin, Serdar; Ohri, Sunil; Gummert, Jan; Angelini, Gianni; Falk, Volkmar; Carrel, Thierry

2016-01-01

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists. PMID:26819269

Operationally efficient propulsion system study (OEPSS) data book. Volume 6; Space Transfer Propulsion Operational Efficiency Study Task of OEPSS

NASA Technical Reports Server (NTRS)

Harmon, Timothy J.

1992-01-01

This document is the final report for the Space Transfer Propulsion Operational Efficiency Study Task of the Operationally Efficient Propulsion System Study (OEPSS) conducted by the Rocketdyne Division of Rockwell International. This Study task studied, evaluated and identified design concepts and technologies which minimized launch and in-space operations and optimized in-space vehicle propulsion system operability.

49 CFR 238.447 - Train operator's controls and power car cab layout.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Train operator's controls and power car cab layout... Specific Requirements for Tier II Passenger Equipment § 238.447 Train operator's controls and power car cab layout. (a) Train operator controls in the power car cab shall be arranged so as to minimize the chance...

49 CFR 238.447 - Train operator's controls and power car cab layout.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Train operator's controls and power car cab layout... Specific Requirements for Tier II Passenger Equipment § 238.447 Train operator's controls and power car cab layout. (a) Train operator controls in the power car cab shall be arranged so as to minimize the chance...

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

PubMed

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

2017-03-01

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

Energy levels of one-dimensional systems satisfying the minimal length uncertainty relation

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

Bernardo, Reginald Christian S., E-mail: rcbernardo@nip.upd.edu.ph; Esguerra, Jose Perico H., E-mail: jesguerra@nip.upd.edu.ph

2016-10-15

The standard approach to calculating the energy levels for quantum systems satisfying the minimal length uncertainty relation is to solve an eigenvalue problem involving a fourth- or higher-order differential equation in quasiposition space. It is shown that the problem can be reformulated so that the energy levels of these systems can be obtained by solving only a second-order quasiposition eigenvalue equation. Through this formulation the energy levels are calculated for the following potentials: particle in a box, harmonic oscillator, Pöschl–Teller well, Gaussian well, and double-Gaussian well. For the particle in a box, the second-order quasiposition eigenvalue equation is a second-ordermore » differential equation with constant coefficients. For the harmonic oscillator, Pöschl–Teller well, Gaussian well, and double-Gaussian well, a method that involves using Wronskians has been used to solve the second-order quasiposition eigenvalue equation. It is observed for all of these quantum systems that the introduction of a nonzero minimal length uncertainty induces a positive shift in the energy levels. It is shown that the calculation of energy levels in systems satisfying the minimal length uncertainty relation is not limited to a small number of problems like particle in a box and the harmonic oscillator but can be extended to a wider class of problems involving potentials such as the Pöschl–Teller and Gaussian wells.« less

Traumeel S® for pain relief following hallux valgus surgery: a randomized controlled trial

PubMed Central

2010-01-01

Background In spite of recent advances in post-operative pain relief, pain following orthopedic surgery remains an ongoing challenge for clinicians. We examined whether a well known and frequently prescribed homeopathic preparation could mitigate post-operative pain. Method We performed a randomized, double blind, placebo-controlled trial to evaluate the efficacy of the homeopathic preparation Traumeel S® in minimizing post-operative pain and analgesic consumption following surgical correction of hallux valgus. Eighty consecutive patients were randomized to receive either Traumeel tablets or an indistinguishable placebo, and took primary and rescue oral analgesics as needed. Maximum numerical pain scores at rest and consumption of oral analgesics were recorded on day of surgery and for 13 days following surgery. Results Traumeel was not found superior to placebo in minimizing pain or analgesic consumption over the 14 days of the trial, however a transient reduction in the daily maximum post-operative pain score favoring the Traumeel arm was observed on the day of surgery, a finding supported by a treatment-time interaction test (p = 0.04). Conclusions Traumeel was not superior to placebo in minimizing pain or analgesic consumption over the 14 days of the trial. A transient reduction in the daily maximum post-operative pain score on the day of surgery is of questionable clinical importance. Trial Registration This study was registered at ClinicalTrials.gov. # NCT00279513 PMID:20380750

Comparison of the Operative Outcomes and Learning Curves between Laparoscopic and Robotic Gastrectomy for Gastric Cancer

PubMed Central

Huang, Kuo-Hung; Lan, Yuan-Tzu; Fang, Wen-Liang; Chen, Jen-Hao; Lo, Su-Shun; Li, Anna Fen-Yau; Chiou, Shih-Hwa; Wu, Chew-Wun; Shyr, Yi-Ming

2014-01-01

Background Minimally invasive surgery, including laparoscopic and robotic gastrectomy, has become more popular in the treatment of gastric cancer. However, few studies have compared the learning curves between laparoscopic and robotic gastrectomy for gastric cancer. Methods Data were prospectively collected between July 2008 and Aug 2014. A total of 145 patients underwent minimally invasive gastrectomy for gastric cancer by a single surgeon, including 73 laparoscopic and 72 robotic gastrectomies. The clinicopathologic characteristics, operative outcomes and learning curves were compared between the two groups. Results Compared with the laparoscopic group, the robotic group was associated with less blood loss and longer operative time. After the surgeon learning curves were overcome for each technique, the operative outcomes became similar between the two groups except longer operative time in the robotic group. After accumulating more cases of robotic gastrectomy, the operative time in the laparoscopic group decreased dramatically. Conclusions After overcoming the learning curves, the operative outcomes became similar between laparoscopic and robotic gastrectomy. The experience of robotic gastrectomy could affect the learning process of laparoscopic gastrectomy. PMID:25360767

Health protection and risks for rescuers in cases of floods.

PubMed

Janev Holcer, Nataša; Jeličić, Pavle; Grba Bujević, Maja; Važanić, Damir

2015-03-01

Floods can pose a number of safety and health hazards for flood-affected populations and rescuers and bring risk of injuries, infections, and diseases due to exposure to pathogenic microorganisms and different biological and chemical contaminants. The risk factors and possible health consequences for the rescuers involved in evacuation and rescuing operations during the May 2014 flood crisis in Croatia are shown, as well as measures for the prevention of injuries and illnesses. In cases of extreme floods, divers play a particularly important role in rescuing and first-response activities. Rescuing in contaminated floodwaters means that the used equipment such as diving suits should be disinfected afterwards. The need for securing the implementation of minimal health and safety measures for involved rescuers is paramount. Data regarding injuries and disease occurrences among rescuers are relatively scarce, indicating the need for medical surveillance systems that would monitor and record all injuries and disease occurrences among rescuers in order to ensure sound epidemiological data. The harmful effects of flooding can be reduced by legislation, improvement of flood forecasting, establishing early warning systems, and appropriate planning and education.

Biokinetic model-based multi-objective optimization of Dunaliella tertiolecta cultivation using elitist non-dominated sorting genetic algorithm with inheritance.

PubMed

Sinha, Snehal K; Kumar, Mithilesh; Guria, Chandan; Kumar, Anup; Banerjee, Chiranjib

2017-10-01

Algal model based multi-objective optimization using elitist non-dominated sorting genetic algorithm with inheritance was carried out for batch cultivation of Dunaliella tertiolecta using NPK-fertilizer. Optimization problems involving two- and three-objective functions were solved simultaneously. The objective functions are: maximization of algae-biomass and lipid productivity with minimization of cultivation time and cost. Time variant light intensity and temperature including NPK-fertilizer, NaCl and NaHCO 3 loadings are the important decision variables. Algal model involving Monod/Andrews adsorption kinetics and Droop model with internal nutrient cell quota was used for optimization studies. Sets of non-dominated (equally good) Pareto optimal solutions were obtained for the problems studied. It was observed that time variant optimal light intensity and temperature trajectories, including optimum NPK fertilizer, NaCl and NaHCO 3 concentration has significant influence to improve biomass and lipid productivity under minimum cultivation time and cost. Proposed optimization studies may be helpful to implement the control strategy in scale-up operation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Minimal disease detection of B-cell lymphoproliferative disorders by flow cytometry: multidimensional cluster analysis.

PubMed

Duque, Ricardo E

2012-04-01

Flow cytometric analysis of cell suspensions involves the sequential 'registration' of intrinsic and extrinsic parameters of thousands of cells in list mode files. Thus, it is almost irresistible to describe phenomena in numerical terms or by 'ratios' that have the appearance of 'accuracy' due to the presence of numbers obtained from thousands of cells. The concepts involved in the detection and characterization of B cell lymphoproliferative processes are revisited in this paper by identifying parameters that, when analyzed appropriately, are both necessary and sufficient. The neoplastic process (cluster) can be visualized easily because the parameters that distinguish it form a cluster in multidimensional space that is unique and distinguishable from neighboring clusters that are not of diagnostic interest but serve to provide a background. For B cell neoplasia it is operationally necessary to identify the multidimensional space occupied by a cluster whose kappa:lambda ratio is 100:0 or 0:100. Thus, the concept of kappa:lambda ratio is without meaning and would not detect B cell neoplasia in an unacceptably high number of cases.

Endoscopic mucosal resection for early gastric cancer. A case report.

PubMed

Gheorghe, Cristian; Sporea, Ioan; Becheanu, Gabriel; Gheorghe, Liana

2002-03-01

European experience in endoscopic mucosal resection (EMR) for early gastric cancer is still relatively low, since early stomach cancer is diagnosed at a much lower rate in Europe than in Japan and generally operable patients are referred to surgery for radical resection. Endoscopic mucosal resection or mucosectomy was developed as a promising technology to diagnose and treat mucosal lesions in the esophagus, stomach and colon. In contrast to surgical resection, EMR allows "early cancers" to be removed with a minimal cost, morbidity and mortality. We present the case of a patient with hepatic cirrhosis incidentally diagnosed with an elevated-type IIa early gastric cancer. Echoendoscopy was performed in order to assess the depth of invasion into the gastric wall confirming the only mucosal involvement. We performed an EMR using "cup and suction" method. After the procedure, the patient experienced an acute upper gastrointestinal bleeding from the ulcer bed requiring argon plasma coagulation. The histopathological examination confirmed an early cancer, without involvement of muscularis mucosae. The patient has had an uneventful evolution being well at six months after the procedure

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

40 CFR 63.11115 - What are my general duties to minimize emissions?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Dispensing Facilities Emission Limitations and Management Practices § 63.11115 What are my general duties to... consistent with safety and good air pollution control practices for minimizing emissions. Determination of... and maintenance procedures, review of operation and maintenance records, and inspection of the source...

Minimally Invasive Mitral Valve Surgery III

PubMed Central

Lehr, Eric J.; Guy, T. Sloane; Smith, Robert L.; Grossi, Eugene A.; Shemin, Richard J.; Rodriguez, Evelio; Ailawadi, Gorav; Agnihotri, Arvind K.; Fayers, Trevor M.; Hargrove, W. Clark; Hummel, Brian W.; Khan, Junaid H.; Malaisrie, S. Chris; Mehall, John R.; Murphy, Douglas A.; Ryan, William H.; Salemi, Arash; Segurola, Romualdo J.; Smith, J. Michael; Wolfe, J. Alan; Weldner, Paul W.; Barnhart, Glenn R.; Goldman, Scott M.; Lewis, Clifton T. P.

2016-01-01

Abstract Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program. PMID:27662478

Nutritional management of feedlot cattle to optimize performance and minimize environmental impact

USDA-ARS?s Scientific Manuscript database

The cattle feeding industry is a new but rapidly growing industry in Brazil and other parts of South America. This presentation/ manuscript provides a brief overview of potential environmental issues faced by concentrated cattle feeding operations, and methods to minimize adverse effects on the envi...

Music in the operating theatre: opinions of staff and patients of a Nigerian teaching hospital.

PubMed

Makama, J G; Ameh, E A; Eguma, S A

2010-12-01

The role of music during surgery has been studied, including its effect on theatre staff, users and patients. However, little attention has been paid to its application especially in our environment. It was a prospective study, involving theatre staff, users, and patients. Their opinions on acceptability and the role of music in operating theatre were determined. Information was obtained by questionnaire. There were 162 respondents; age range 25 to 76 years (median age 39). There were 109 (67.2%) males and 53 (32.7%) female. One hundred and forty five (89.5%) respondents agree that music should be played in the operating theatre. One fifty eight, (97.5%) considered low tone of music to be most appropriate in the theatre while 3(1.9%), and 1(0.6%) considered moderate and high tone respectively to be most appropriate. One hundred and sixteen, (71.6%) preferred jazz music while 19(11.7%) reggae, 11(6.8%) African music, 13 (8.0%) others (not specify), 2 (1.2%) classical, and 1(0.6%) Irish folk. The majority of the respondents were aware of the role of music in terms of its anxiolytic effect, reduction of stress and enhancement of performance when familiar music is played. Music in the operating theatre has immeasurable effects. It can prevent distraction, minimize annoyance, reduce stress and diminish the anxiety of patients, staff and users.

Quality of life in patients with cleft lip and palate after operation.

PubMed

Augsornwan, Darawan; Namedang, Sarakull; Pongpagatip, Sumalee; Surakunprapha, Palakorn

2011-12-01

Cleft lip and cleft palate are the most common craniofacial anomalies. Srinagarind Hospital has 150-200 cases each year. The operating process of care, requires continuity of care involving a multidisciplinary team. When the patients go to hospital for an operation they experience pain, limited activity and also food is very different from normal life. When attending school they suffer speech articulation problems and feel shy and isolated, which has a detrimental affect on their life style and quality of life. The main purpose of the study is to the present study quality of life in patients with cleft lip and palate after operation. The present study is descriptive research using qualitative and quantitative approaches. The studied population were patients age 8-18 years old who were admitted at 3C Ward and Outpatient Department, Srinagarind Hospital. 33 patients were interviewed for the quantitative approach. Guideline for in-depth interview with 15 patients were used for the qualitative approach. Quantitative data were analyzed and presented in frequency, percentage and standard deviation. The qualitative data were analyzed through content analysis. Patients consider their QOL is high level, but in detail they still worry about self concept psychological well-being. From indept interview patients would like to get further treatment to minimize their scar as soon as possible. Patients consider their quality of life as high level, but they would like to get further treatment.

Differences Between S/X and VLBI2010 Operation

NASA Technical Reports Server (NTRS)

Hase, Hayo; Himwich, Ed; Neidhardt, Alexander

2010-01-01

The intended VLBI2010 operation has some significant differences to the current S/X operation. The presentation focuses on the problem of extending the operation of a global VLBI network to continuous operation within the frame of the same given amount of human resources. Remote control operation is a suitable solution to minimize operational expenses. The implementation of remote control operation requires more site specific information. A concept of a distributed-centralized remote control of the operation and its implications is presented.

First-year Analysis of the Operating Room Black Box Study.

PubMed

Jung, James J; Jüni, Peter; Lebovic, Gerald; Grantcharov, Teodor

2018-06-18

To characterize intraoperative errors, events, and distractions, and measure technical skills of surgeons in minimally invasive surgery practice. Adverse events in the operating room (OR) are common contributors of morbidity and mortality in surgical patients. Adverse events often occur due to deviations in performance and environmental factors. Although comprehensive intraoperative data analysis and transparent disclosure have been advocated to better understand how to improve surgical safety, they have rarely been done. We conducted a prospective cohort study in 132 consecutive patients undergoing elective laparoscopic general surgery at an academic hospital during the first year after the definite implementation of a multiport data capture system called the OR Black Box to identify intraoperative errors, events, and distractions. Expert analysts characterized intraoperative distractions, errors, and events, and measured trainee involvement as main operator. Technical skills were compared, crude and risk-adjusted, among the attending surgeon and trainees. Auditory distractions occurred a median of 138 times per case [interquartile range (IQR) 96-190]. At least 1 cognitive distraction appeared in 84 cases (64%). Medians of 20 errors (IQR 14-36) and 8 events (IQR 4-12) were identified per case. Both errors and events occurred often in dissection and reconstruction phases of operation. Technical skills of residents were lower than those of the attending surgeon (P = 0.015). During elective laparoscopic operations, frequent intraoperative errors and events, variation in surgeons' technical skills, and a high amount of environmental distractions were identified using the OR Black Box.

Specification and Verification of Secure Concurrent and Distributed Software Systems

DTIC Science & Technology

1992-02-01

primitive search strategies work for operating systems that contain relatively few operations . As the number of operations increases, so does the the...others have granted him access to, etc . The burden of security falls on the operating system , although appropriate hardware support can minimize the...Guttag, J. Horning, and R. Levin. Synchronization primitives for a multiprocessor: a formal specification. Symposium on Operating System Principles

MIS Score: Prediction Model for Minimally Invasive Surgery.

PubMed

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

2017-03-01

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

Use Hierarchical Storage and Analysis to Exploit Intrinsic Parallelism

NASA Astrophysics Data System (ADS)

Zender, C. S.; Wang, W.; Vicente, P.

2013-12-01

Big Data is an ugly name for the scientific opportunities and challenges created by the growing wealth of geoscience data. How to weave large, disparate datasets together to best reveal their underlying properties, to exploit their strengths and minimize their weaknesses, to continually aggregate more information than the world knew yesterday and less than we will learn tomorrow? Data analytics techniques (statistics, data mining, machine learning, etc.) can accelerate pattern recognition and discovery. However, often researchers must, prior to analysis, organize multiple related datasets into a coherent framework. Hierarchical organization permits entire dataset to be stored in nested groups that reflect their intrinsic relationships and similarities. Hierarchical data can be simpler and faster to analyze by coding operators to automatically parallelize processes over isomorphic storage units, i.e., groups. The newest generation of netCDF Operators (NCO) embody this hierarchical approach, while still supporting traditional analysis approaches. We will use NCO to demonstrate the trade-offs involved in processing a prototypical Big Data application (analysis of CMIP5 datasets) using hierarchical and traditional analysis approaches.

A study on ship automatic berthing with assistance of auxiliary devices

NASA Astrophysics Data System (ADS)

Tran, Van Luong; Im, Namkyun

2012-09-01

The recent researches on the automatic berthing control problems have used various kinds of tools as a control method such as expert system, fuzzy logic controllers and artificial neural network (ANN). Among them, ANN has proved to be one of the most effective and attractive options. In a marine context, the berthing maneuver is a complicated procedure in which both human experience and intensive control operations are involved. Nowadays, in most cases of berthing operation, auxiliary devices are used to make the schedule safer and faster but none of above researches has taken into account. In this study, ANN is applied to design the controllers for automatic ship berthing using assistant devices such as bow thruster and tug. Using back-propagation algorithm, we trained ANN with set of teaching data to get a minimal error between output values and desired values of four control outputs including rudder, propeller revolution, bow thruster and tug. Then, computer simulations of automatic berthing were carried out to verify the effecttiveness of the system. The results of the simulations showed good performance for the proposed berthing control system.

Early closure of postinfarction ventricular septal defects.

PubMed

Martinelli, Luigi; Dottori, Vincenzo; Caputo, Enrico; Graffigna, Angelo; Pederzolli, Carlo

2003-05-01

According to the guidelines of the American College of Cardiology/American Heart Association early closure of postinfarction septal defects is now a class I indication although it still carries a relevant morbidity and mortality. The operative risk is related both to the critical hemodynamic conditions of the patient and to the technical difficulties posed by the friable tissue of the infarcted area. The most recent techniques involving the use of pericardial patches reinforced by acrylic glue have significantly reduced the hospital mortality. The aim of this study was to discuss the reliability of an aggressive, tissue-sparing surgical approach to this complication. We present a consecutive series of 12 patients operated upon between January 1998 and October 2001 within 12 hours of the onset of clinical evidence of postinfarction septal rupture. Repair was achieved with minimal septal debridement and the use of a large pericardial patch reinforced by a biological glue. Three cases of dehiscence required early reoperation with no hospital mortality. This procedure is technically feasible and allows early aggressive treatment of postinfarction septal rupture with satisfactory results.

Drilling Rig Operation Mode Recognition by an Artificial Neuronet

NASA Astrophysics Data System (ADS)

Abu-Abed, Fares; Borisov, Nikolay

2017-11-01

The article proposes a way to develop a drilling rig operation mode classifier specialized to recognize pre-emergency situations appearable in commercial oil-and-gas well drilling. The classifier is based on the theory of image recognition and artificial neuronet taught on real geological and technological information obtained while drilling. To teach the neuronet, a modified backpropagation algorithm that can teach to reach the global extremum of a target function has been proposed. The target function was a relative recognition error to minimize in the teaching. Two approaches to form the drilling rig pre-emergency situation classifier based on a taught neuronet have been considered. The first one involves forming an output classifier of N different signals, each of which corresponds to a single recognizable situation and, and can be formed on the basis of the analysis of M indications, that is using a uniform indication vocabulary for all recognized situations. The second way implements a universal classifier comprising N specialized ones, each of which can recognize a single pre-emergency situation and having a single output.

The Meaning Of Healing: Transcending Suffering

PubMed Central

Egnew, Thomas R.

2005-01-01

PURPOSE Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms beyond the physiological processes related to curing. The objective of this study was to determine a definition of healing that operationalizes its mechanisms and thereby identifies those repeatable actions that reliably assist physicians to promote holistic healing. METHODS This study was a qualitative inquiry consisting of in-depth, open-ended, semistructured interviews with Drs. Eric J. Cassell, Carl A. Hammerschlag, Thomas S. Inui, Elisabeth Kubler-Ross, Cicely Saunders, Bernard S. Siegel, and G. Gayle Stephens. Their perceptions regarding the definition and mechanisms of healing were subjected to grounded theory content analysis. RESULTS Healing was associated with themes of wholeness, narrative, and spirituality. Healing is an intensely personal, subjective experience involving a reconciliation of the meaning an individual ascribes to distressing events with his or her perception of wholeness as a person. CONCLUSIONS Healing may be operationally defined as the personal experience of the transcendence of suffering. Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering. PMID:15928230

The meaning of healing: transcending suffering.

PubMed

Egnew, Thomas R

2005-01-01

Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms beyond the physiological processes related to curing. The objective of this study was to determine a definition of healing that operationalizes its mechanisms and thereby identifies those repeatable actions that reliably assist physicians to promote holistic healing. This study was a qualitative inquiry consisting of in-depth, open-ended, semistructured interviews with Drs. Eric J. Cassell, Carl A. Hammerschlag, Thomas S. Inui, Elisabeth Kubler-Ross, Cicely Saunders, Bernard S. Siegel, and G. Gayle Stephens. Their perceptions regarding the definition and mechanisms of healing were subjected to grounded theory content analysis. Healing was associated with themes of wholeness, narrative, and spirituality. Healing is an intensely personal, subjective experience involving a reconciliation of the meaning an individual ascribes to distressing events with his or her perception of wholeness as a person. Healing may be operationally defined as the personal experience of the transcendence of suffering. Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering.

Process for treating alkaline wastes for vitrification

DOEpatents

Hsu, Chia-lin W.

1995-01-01

A process for treating alkaline wastes for vitrification. The process involves acidifying the wastes with an oxidizing agent such as nitric acid, then adding formic acid as a reducing agent, and then mixing with glass formers to produce a melter feed. The nitric acid contributes nitrates that act as an oxidant to balance the redox of the melter feed, prevent reduction of certain species to produce conducting metals, and lower the pH of the wastes to a suitable level for melter operation. The formic acid reduces mercury compounds to elemental mercury for removal by steam stripping, and MnO.sub.2 to the Mn(II) ion to prevent foaming of the glass melt. The optimum amounts of nitric acid and formic acid are determined in relation to the composition of the wastes, including the concentrations of mercury (II) and MnO.sub.2, noble metal compounds, nitrates, formates and so forth. The process minimizes the amount of hydrogen generated during treatment, while producing a redox-balanced feed for effective melter operation and a quality glass product.

Process for treating alkaline wastes for vitrification

DOEpatents

Hsu, C.L.W.

1995-07-25

A process is described for treating alkaline wastes for vitrification. The process involves acidifying the wastes with an oxidizing agent such as nitric acid, then adding formic acid as a reducing agent, and then mixing with glass formers to produce a melter feed. The nitric acid contributes nitrates that act as an oxidant to balance the redox of the melter feed, prevent reduction of certain species to produce conducting metals, and lower the pH of the wastes to a suitable level for melter operation. The formic acid reduces mercury compounds to elemental mercury for removal by steam stripping, and MnO{sub 2} to the Mn(II) ion to prevent foaming of the glass melt. The optimum amounts of nitric acid and formic acid are determined in relation to the composition of the wastes, including the concentrations of mercury (II) and MnO{sub 2}, noble metal compounds, nitrates, formates and so forth. The process minimizes the amount of hydrogen generated during treatment, while producing a redox-balanced feed for effective melter operation and a quality glass product. 4 figs.

Indonesian railway accidents--utilizing Human Factors Analysis and Classification System in determining potential contributing factors.

PubMed

Iridiastadi, Hardianto; Ikatrinasari, Zulfa Fitri

2012-01-01

The prevalence of Indonesian railway accidents has not been declining, with hundreds of fatalities reported in the past decade. As an effort to help the National Transportation Safety Committee (NTSC), this study was conducted that aimed at understanding factors that might have contributed to the accidents. Human Factors Analysis and Classification System (HFACS) was utilized for this purpose. A total of nine accident reports (provided by the Indonesian NTSC) involving fatalities were studied using the technique. Results of this study indicated 72 factors that were closely related to the accidents. Of these, roughly 22% were considered as operator acts while about 39% were related to preconditions for operator acts. Supervisory represented 14% of the factors, and the remaining (about 25%) were associated with organizational factors. It was concluded that, while train drivers indeed played an important role in the accidents, interventions solely directed toward train drivers may not be adequate. A more comprehensive approach in minimizing the accidents should be conducted that addresses all the four aspects of HFACS.

Project EGRESS: The design of an assured crew return vehicle for the space station

NASA Technical Reports Server (NTRS)

1990-01-01

Keeping preliminary studies by NASA in mind, an Assured Crew Return Vehicle (ACRV) was developed. The system allows the escape of one or more crew members from Space Station Freedom in case of emergency. The design of the vehicle addresses propulsion, orbital operations, reentry, landing and recovery, power and communication, and life support. In light of recent modifications in Space Station design, Project EGRESS (Earthbound Guaranteed ReEntry from Space Station) pays particular attention to its impact on Space Station operations, interfaces and docking facilities, and maintenance needs. A water landing, medium lift vehicle was found to best satisfy project goals of simplicity and cost efficiency without sacrificing the safety and reliability requirements. With a single vehicle, one injured crew member could be returned to Earth with minimal pilot involvement. Since the craft is capable of returning up to five crew members, two such permanently docked vehicles would allow full evacuation of the Space Station. The craft could be constructed entirely with available 1990 technology and launched aboard a shuttle orbiter.

Mapping of information and identification of construction waste at project life cycle

NASA Astrophysics Data System (ADS)

Wibowo, Mochamad Agung; Handayani, Naniek Utami; Nurdiana, Asri; Sholeh, Moh Nur; Pamungkas, Gita Silvia

2018-03-01

The development of construction project towards green construction is needed in order to improve the efficiency of construction projects. One that needs to be minimized is construction waste. Construction waste is waste generated from construction project activities, both solid waste and non solid waste. More specifically, the waste happens at every phase of the project life cycle. Project life cycle are the stage of idea, design, construction, and operation/maintenance. Each phase is managed by different stakeholders. Therefore it requires special handling from the involved stakeholders. The objective of the study is to map the information and identify the waste at each phase of the project life cycle. The purpose of mapping is to figure out the process of information and product flow and with its timeline. This mapping used Value Stream Mapping (VSM). Identification of waste was done by distributing questionnaire to respondents to know the waste according to owner, consultant planner, contractor, and supervisory consultant. The result of the study is the mapping of information flow and product flow at the phases of idea, design, construction, and operation/ maintenance.

Parental Involvement in Emergent Literacy Skills of Urban Head Start Children.

ERIC Educational Resources Information Center

Nespeca, Sue McCleaf

1995-01-01

Explored the impact of parental involvement and of public libraries on Head Start children's emerging literacy skills. Found differences in the amount of parental involvement in literacy activities and the types of activities. Library use was minimal for fear of damaging books, transportation problems, or lack of time or effort. Suggested…

A Framework for Robust Multivariable Optimization of Integrated Circuits in Space Applications

NASA Technical Reports Server (NTRS)

DuMonthier, Jeffrey; Suarez, George

2013-01-01

Application Specific Integrated Circuit (ASIC) design for space applications involves multiple challenges of maximizing performance, minimizing power and ensuring reliable operation in extreme environments. This is a complex multidimensional optimization problem which must be solved early in the development cycle of a system due to the time required for testing and qualification severely limiting opportunities to modify and iterate. Manual design techniques which generally involve simulation at one or a small number of corners with a very limited set of simultaneously variable parameters in order to make the problem tractable are inefficient and not guaranteed to achieve the best possible results within the performance envelope defined by the process and environmental requirements. What is required is a means to automate design parameter variation, allow the designer to specify operational constraints and performance goals, and to analyze the results in a way which facilitates identifying the tradeoffs defining the performance envelope over the full set of process and environmental corner cases. The system developed by the Mixed Signal ASIC Group (MSAG) at the Goddard Space Flight Center is implemented as framework of software modules, templates and function libraries. It integrates CAD tools and a mathematical computing environment, and can be customized for new circuit designs with only a modest amount of effort as most common tasks are already encapsulated. Customization is required for simulation test benches to determine performance metrics and for cost function computation. Templates provide a starting point for both while toolbox functions minimize the code required. Once a test bench has been coded to optimize a particular circuit, it is also used to verify the final design. The combination of test bench and cost function can then serve as a template for similar circuits or be re-used to migrate the design to different processes by re-running it with the new process specific device models. The system has been used in the design of time to digital converters for laser ranging and time-of-flight mass spectrometry to optimize analog, mixed signal and digital circuits such as charge sensitive amplifiers, comparators, delay elements, radiation tolerant dual interlocked (DICE) flip-flops and two of three voter gates.

Past, Present, and Future of Minimally Invasive Abdominal Surgery

PubMed Central

Antoniou, George A.; Antoniou, Athanasios I.; Granderath, Frank-Alexander

2015-01-01

Laparoscopic surgery has generated a revolution in operative medicine during the past few decades. Although strongly criticized during its early years, minimization of surgical trauma and the benefits of minimization to the patient have been brought to our attention through the efforts and vision of a few pioneers in the recent history of medicine. The German gynecologist Kurt Semm (1927–2003) transformed the use of laparoscopy for diagnostic purposes into a modern therapeutic surgical concept, having performed the first laparoscopic appendectomy, inspiring Erich Mühe and many other surgeons around the world to perform a wide spectrum of procedures by minimally invasive means. Laparoscopic cholecystectomy soon became the gold standard, and various laparoscopic procedures are now preferred over open approaches, in the light of emerging evidence that demonstrates less operative stress, reduced pain, and shorter convalescence. Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS) may be considered further steps toward minimization of surgical trauma, although these methods have not yet been standardized. Laparoscopic surgery with the use of a robotic platform constitutes a promising field of investigation. New technologies are to be considered under the prism of the history of surgery; they seem to be a step toward further minimization of surgical trauma, but not definite therapeutic modalities. Patient safety and medical ethics must be the cornerstone of future investigation and implementation of new techniques. PMID:26508823

Environmental management system for transportation maintenance operations : [technical brief].

DOT National Transportation Integrated Search

2014-04-01

This report provides the framework for the environmental management system to analyze : greenhouse gas emissions from transportation maintenance operations. The system enables user : to compare different scenarios and make informed decisions to minim...

Liquid and gaseous oxygen safety review, volume 3

NASA Technical Reports Server (NTRS)

Lapin, A.

1972-01-01

Practices employed in the oxygen systems maintenance programs to minimize both accident probabilities and consequences of accidents and/or incidents are described. Appropriate sections of the operations department and industrial gas operating manuals are discussed.

40 CFR 60.56a - Standards for municipal waste combustor operating practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... cause such facility to exceed the carbon monoxide standards shown in table 1. Table 1—MWC Operating..., at a minimum, address the following elements of MWC unit operation: (1) Summary of the applicable... periodic upset or off-specification conditions; (8) Procedures for minimizing particulate matter carryover...

40 CFR 60.56a - Standards for municipal waste combustor operating practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... cause such facility to exceed the carbon monoxide standards shown in table 1. Table 1—MWC Operating..., at a minimum, address the following elements of MWC unit operation: (1) Summary of the applicable... periodic upset or off-specification conditions; (8) Procedures for minimizing particulate matter carryover...

40 CFR 60.56a - Standards for municipal waste combustor operating practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... cause such facility to exceed the carbon monoxide standards shown in table 1. Table 1—MWC Operating..., at a minimum, address the following elements of MWC unit operation: (1) Summary of the applicable... periodic upset or off-specification conditions; (8) Procedures for minimizing particulate matter carryover...

40 CFR 60.56a - Standards for municipal waste combustor operating practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... cause such facility to exceed the carbon monoxide standards shown in table 1. Table 1—MWC Operating..., at a minimum, address the following elements of MWC unit operation: (1) Summary of the applicable... periodic upset or off-specification conditions; (8) Procedures for minimizing particulate matter carryover...

76 FR 30200 - Forging Machines; Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

...: 187,264. Estimated Cost (Operation and Maintenance): $0. IV. Public Participation--Submission of... ensures that information is in the desired format, reporting burden (time and costs) is minimal... operated valves and switches. Inspection of Forging Machines, Guards, and Point-of-Operation Protection...

The challenge of bonding treated wood

Treesearch

Charles R. Frihart

2004-01-01

Wood products are quite durable if exposure to moisture is minimized; however, most uses of wood involve considerable exposure to moisture. To preserve the wood, chemicals are used to minimize moisture pickup, to prevent insect attack, and/or to resist microbial growth. The chemicals used as preservatives can interfere with adhesive bonds to wood. Given the many...

Newton Methods for Large Scale Problems in Machine Learning

ERIC Educational Resources Information Center

Hansen, Samantha Leigh

2014-01-01

The focus of this thesis is on practical ways of designing optimization algorithms for minimizing large-scale nonlinear functions with applications in machine learning. Chapter 1 introduces the overarching ideas in the thesis. Chapters 2 and 3 are geared towards supervised machine learning applications that involve minimizing a sum of loss…

Minimally invasive aortic valve replacement surgery through lower half sternotomy

PubMed Central

Fenton, James R.

2013-01-01

Less invasive approaches to aortic valve surgery frequently rely upon the development of new technology and instrumentation. While not suitable for every patient requiring an aortic valve procedure, these less invasive operations can offer certain clinical benefits and are becoming an important part of the modern cardiothoracic surgeon’s skillset. A lower partial sternotomy approach provides excellent visualization of the operative field, efficient execution of the operation and many of the benefits of minimally invasive surgery. Importantly, the lower partial sternotomy requires no new or unusual instruments and presents a familiar view to the surgeon. The technique, therefore, lends itself well to being adapted and utilized quickly with a potentially shorter “learning curve” for maximal surgical flexibility and patient benefit. PMID:24251024

Efficiency of unconstrained minimization techniques in nonlinear analysis

NASA Technical Reports Server (NTRS)

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

1978-01-01

Unconstrained minimization algorithms have been critically evaluated for their effectiveness in solving structural problems involving geometric and material nonlinearities. The algorithms have been categorized as being zeroth, first, or second order depending upon the highest derivative of the function required by the algorithm. The sensitivity of these algorithms to the accuracy of derivatives clearly suggests using analytically derived gradients instead of finite difference approximations. The use of analytic gradients results in better control of the number of minimizations required for convergence to the exact solution.

Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

PubMed

Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

2018-02-01

Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the presurgical evaluation, particularly regarding CM location, responsiveness to antiepileptic drugs, and temporal lobe metabolism, are crucial parameters for choosing surgical approaches to CCM-associated temporal lobe epilepsy. By this operative strategy, patients may receive maximized seizure control and minimized postsurgical neurologic sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

Cost-effective system for facial imaging and three-dimensional reconstruction

NASA Astrophysics Data System (ADS)

Shokouhi, S. B.; Monro, D. M.; Sherlock, Barry G.

1998-06-01

Three dimensional (3-D) images have recently received wide attention in applications involving medical treatment. Most current 3-D imaging methods focus on the internal organs of the body. However, several medical image applications such as plastic surgery, body deformities, rehabilitation, dental surgery and orthodontics, make use of the surface contours of the body. Several techniques are currently available for producing 3-D images of the body surface and most of the systems which implement these techniques are expensive, requiring complex equipment with highly trained operators. The research involves the development of a simple, low cost and non-invasive contour capturing method for facial surfaces. This is achieved using the structured light technique, employing a standard commercial slide projector, CCD camera and a frame-grabber card linked to a PC. Structured light has already been used for many applications, but only to a limited extent in the clinical environment. All current implementations involve extensive manual intervention by highly skilled operators and this has proven to be a serious hindrance to clinical acceptance of 3-D imaging. A primary objective of this work is to minimize the amount of manual intervention required, so that the system can be used by clinicians who do not have specialist training in the use of this equipment. The eventual aim is to provide a software assisted surgical procedure, which by merging the facial data, allows the manipulation of soft tissue and gives the facility to predict and monitor post-surgical appearance. The research focuses on how the images are obtained using the structured light optic system and the subsequent image processing of data to give a realistic 3-D image.

Laparoscopic revolution in bariatric surgery

PubMed Central

Sundbom, Magnus

2014-01-01

The history of bariatric surgery is investigational. Dedicated surgeons have continuously sought for an ideal procedure to relieve morbidly obese patients from their burden of comorbid conditions, reduced life expectancy and low quality of life. The ideal procedure must have low complication risk, both in short- and long term, as well as minimal impact on daily life. The revolution of laparoscopic techniques in bariatric surgery is described in this summary. Advances in minimal invasive techniques have contributed to reduced operative time, length of stay, and complications. The development in bariatric surgery has been exceptional, resulting in a dramatic increase of the number of procedures performed world wide during the last decades. Although, a complex bariatric procedure can be performed with operative mortality no greater than cholecystectomy, specific procedure-related complications and other drawbacks must be taken into account. The evolution of laparoscopy will be the legacy of the 21st century and at present, day-care surgery and further reduction of the operative trauma is in focus. The impressive effects on comorbid conditions have prompted the adoption of minimal invasive bariatric procedures into the field of metabolic surgery. PMID:25386062

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

PubMed

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

2014-12-01

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

A Retrospective Comparison of Conventional versus Transverse Mini-Incision Technique for Carpal Tunnel Release

PubMed Central

Gülşen, İsmail; Ak, Hakan; Evcılı, Gökhan; Balbaloglu, Özlem; Sösüncü, Enver

2013-01-01

Background. In this retrospective study, we aimed to compare the results of two surgical techniques, conventional and transverse mini-incision. Materials and Methods. 95 patients were operated between 2011 and 2012 in Bitlis State Hospital. 50 patients were operated with conventional technique and 45 of them were operated with minimal transverse incision. Postoperative complications, incision site problems, and the time of starting to use their hands in daily activities were noted. Results. 95 patients were included in the study. The mean age was 48. 87 of them were female and 8 were male. There was no problem of incision site in both of the two surgical techniques. Only in one patient, anesthesia developed in minimal incision technique. The time of starting to use their hands in daily activities was 22,2 days and 17 days in conventional and minimal incision technique, respectively. Conclusion. Two surgical techniques did not show superiority to each other in terms of postoperative complications and incision site problems except the time of starting to use their hands in daily activities. PMID:24396607

Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer

PubMed Central

Caronia, Francesco Paolo; Arrigo, Ettore; Failla, Andrea Valentino; Sgalambro, Francesco; Giannone, Giorgio; Lo Monte, Attilio Ignazio; Cajozzo, Massimo; Santini, Mario

2018-01-01

A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis. No intraoperative and post-operative complications were seen. The patient was discharged in post-operative day 9. Pathological study confirmed the diagnosis of adenocarcinoma (T2N1M0-Stage IIB) and he underwent adjuvant chemotherapy. At the time of present paper, patient is alive and well without signs of recurrence or metastasis. Our minimally approach compared to standard open procedure would help reduce post-operative pain and favours early return to normal activity. However, future experiences with a control group are required before our strategy can be widely used. PMID:29850166

Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer.

PubMed

Caronia, Francesco Paolo; Arrigo, Ettore; Failla, Andrea Valentino; Sgalambro, Francesco; Giannone, Giorgio; Lo Monte, Attilio Ignazio; Cajozzo, Massimo; Santini, Mario; Fiorelli, Alfonso

2018-04-01

A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis. No intraoperative and post-operative complications were seen. The patient was discharged in post-operative day 9. Pathological study confirmed the diagnosis of adenocarcinoma (T2N1M0-Stage IIB) and he underwent adjuvant chemotherapy. At the time of present paper, patient is alive and well without signs of recurrence or metastasis. Our minimally approach compared to standard open procedure would help reduce post-operative pain and favours early return to normal activity. However, future experiences with a control group are required before our strategy can be widely used.

Next generation initiation techniques

NASA Technical Reports Server (NTRS)

Warner, Tom; Derber, John; Zupanski, Milija; Cohn, Steve; Verlinde, Hans

1993-01-01

Four-dimensional data assimilation strategies can generally be classified as either current or next generation, depending upon whether they are used operationally or not. Current-generation data-assimilation techniques are those that are presently used routinely in operational-forecasting or research applications. They can be classified into the following categories: intermittent assimilation, Newtonian relaxation, and physical initialization. It should be noted that these techniques are the subject of continued research, and their improvement will parallel the development of next generation techniques described by the other speakers. Next generation assimilation techniques are those that are under development but are not yet used operationally. Most of these procedures are derived from control theory or variational methods and primarily represent continuous assimilation approaches, in which the data and model dynamics are 'fitted' to each other in an optimal way. Another 'next generation' category is the initialization of convective-scale models. Intermittent assimilation systems use an objective analysis to combine all observations within a time window that is centered on the analysis time. Continuous first-generation assimilation systems are usually based on the Newtonian-relaxation or 'nudging' techniques. Physical initialization procedures generally involve the use of standard or nonstandard data to force some physical process in the model during an assimilation period. Under the topic of next-generation assimilation techniques, variational approaches are currently being actively developed. Variational approaches seek to minimize a cost or penalty function which measures a model's fit to observations, background fields and other imposed constraints. Alternatively, the Kalman filter technique, which is also under investigation as a data assimilation procedure for numerical weather prediction, can yield acceptable initial conditions for mesoscale models. The third kind of next-generation technique involves strategies to initialize convective scale (non-hydrostatic) models.

Time-Of-Flight Camera, Optical Tracker and Computed Tomography in Pairwise Data Registration.

PubMed

Pycinski, Bartlomiej; Czajkowska, Joanna; Badura, Pawel; Juszczyk, Jan; Pietka, Ewa

2016-01-01

A growing number of medical applications, including minimal invasive surgery, depends on multi-modal or multi-sensors data processing. Fast and accurate 3D scene analysis, comprising data registration, seems to be crucial for the development of computer aided diagnosis and therapy. The advancement of surface tracking system based on optical trackers already plays an important role in surgical procedures planning. However, new modalities, like the time-of-flight (ToF) sensors, widely explored in non-medical fields are powerful and have the potential to become a part of computer aided surgery set-up. Connection of different acquisition systems promises to provide a valuable support for operating room procedures. Therefore, the detailed analysis of the accuracy of such multi-sensors positioning systems is needed. We present the system combining pre-operative CT series with intra-operative ToF-sensor and optical tracker point clouds. The methodology contains: optical sensor set-up and the ToF-camera calibration procedures, data pre-processing algorithms, and registration technique. The data pre-processing yields a surface, in case of CT, and point clouds for ToF-sensor and marker-driven optical tracker representation of an object of interest. An applied registration technique is based on Iterative Closest Point algorithm. The experiments validate the registration of each pair of modalities/sensors involving phantoms of four various human organs in terms of Hausdorff distance and mean absolute distance metrics. The best surface alignment was obtained for CT and optical tracker combination, whereas the worst for experiments involving ToF-camera. The obtained accuracies encourage to further develop the multi-sensors systems. The presented substantive discussion concerning the system limitations and possible improvements mainly related to the depth information produced by the ToF-sensor is useful for computer aided surgery developers.

Analysis of plant nucleotide sugars by hydrophilic interaction liquid chromatography and tandem mass spectrometry.

PubMed

Ito, Jun; Herter, Thomas; Baidoo, Edward E K; Lao, Jeemeng; Vega-Sánchez, Miguel E; Michelle Smith-Moritz, A; Adams, Paul D; Keasling, Jay D; Usadel, Björn; Petzold, Christopher J; Heazlewood, Joshua L

2014-03-01

Understanding the intricate metabolic processes involved in plant cell wall biosynthesis is limited by difficulties in performing sensitive quantification of many involved compounds. Hydrophilic interaction liquid chromatography is a useful technique for the analysis of hydrophilic metabolites from complex biological extracts and forms the basis of this method to quantify plant cell wall precursors. A zwitterionic silica-based stationary phase has been used to separate hydrophilic nucleotide sugars involved in cell wall biosynthesis from milligram amounts of leaf tissue. A tandem mass spectrometry operating in selected reaction monitoring mode was used to quantify nucleotide sugars. This method was highly repeatable and quantified 12 nucleotide sugars at low femtomole quantities, with linear responses up to four orders of magnitude to several 100pmol. The method was also successfully applied to the analysis of purified leaf extracts from two model plant species with variations in their cell wall sugar compositions and indicated significant differences in the levels of 6 out of 12 nucleotide sugars. The plant nucleotide sugar extraction procedure was demonstrated to have good recovery rates with minimal matrix effects. The approach results in a significant improvement in sensitivity when applied to plant samples over currently employed techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

A new mild hyperthermia device to treat vascular involvement in cancer surgery.

PubMed

Ware, Matthew J; Nguyen, Lam P; Law, Justin J; Krzykawska-Serda, Martyna; Taylor, Kimberly M; Cao, Hop S Tran; Anderson, Andrew O; Pulikkathara, Merlyn; Newton, Jared M; Ho, Jason C; Hwang, Rosa; Rajapakshe, Kimal; Coarfa, Cristian; Huang, Shixia; Edwards, Dean; Curley, Steven A; Corr, Stuart J

2017-09-12

Surgical margin status in cancer surgery represents an important oncologic parameter affecting overall prognosis. The risk of disease recurrence is minimized and survival often prolonged if margin-negative resection can be accomplished during cancer surgery. Unfortunately, negative margins are not always surgically achievable due to tumor invasion into adjacent tissues or involvement of critical vasculature. Herein, we present a novel intra-operative device created to facilitate a uniform and mild heating profile to cause hyperthermic destruction of vessel-encasing tumors while safeguarding the encased vessel. We use pancreatic ductal adenocarcinoma as an in vitro and an in vivo cancer model for these studies as it is a representative model of a tumor that commonly involves major mesenteric vessels. In vitro data suggests that mild hyperthermia (41-46 °C for ten minutes) is an optimal thermal dose to induce high levels of cancer cell death, alter cancer cell's proteomic profiles and eliminate cancer stem cells while preserving non-malignant cells. In vivo and in silico data supports the well-known phenomena of a vascular heat sink effect that causes high temperature differentials through tissues undergoing hyperthermia, however temperatures can be predicted and used as a tool for the surgeon to adjust thermal doses delivered for various tumor margins.

Nephroureterectomy for emphysematous pyelonephritis: An aggressive approach is sometimes necessary. A case report and literature review.

PubMed

Nana, Gael R; Brodie, Andrew; Akhter, Waseem; Karim, Omer; Motiwala, Hanif

2015-01-01

Emphysematous pyelonephritis (EPN) is a life-threatening urological emergency. A high index of suspicion is required for diagnosis as such patients may present to physicians with typical features of pyelonephritis. A 67 year old lady presented atypically to the Emergency Department with symptoms of renal colic. The diagnosis of emphysematous pyelonephritis was established on prompt CT scanning. She did not respond to conservative management. Due to acute, critical deterioration, she underwent a radical right nephroureterectomy. The resected kidney involved a long segment of necrotic, gangrenous ureter. The patient had a smooth post-operative recovery and was successfully discharged. She remains well on follow-up after one year. Early radiological diagnosis is imperative for risk stratification of EPN. Current evidence recommends percutaneous catheter drainage with interval nephrectomy as the gold standard treatment. We review the literature for pathophysiology and clinical prognostic factors. This case adds onto the limited evidence base on ureteric involvement in EPN, suggesting a revision of EPN classification. Further research on ureteric involvement and treatment outcomes in EPN is required. Even in the current era of minimally invasive surgery and renal preservation therapies, early open nephrectomy still has a role in the management of EPN. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Development and implementation of a PACS network and resource manager

NASA Astrophysics Data System (ADS)

Stewart, Brent K.; Taira, Ricky K.; Dwyer, Samuel J., III; Huang, H. K.

1992-07-01

Clinical acceptance of PACS is predicated upon maximum uptime. Upon component failure, detection, diagnosis, reconfiguration and repair must occur immediately. Our current PACS network is large, heterogeneous, complex and wide-spread geographically. The overwhelming number of network devices, computers and software processes involved in a departmental or inter-institutional PACS makes development of tools for network and resource management critical. The authors have developed and implemented a comprehensive solution (PACS Network-Resource Manager) using the OSI Network Management Framework with network element agents that respond to queries and commands for network management stations. Managed resources include: communication protocol layers for Ethernet, FDDI and UltraNet; network devices; computer and operating system resources; and application, database and network services. The Network-Resource Manager is currently being used for warning, fault, security violation and configuration modification event notification. Analysis, automation and control applications have been added so that PACS resources can be dynamically reconfigured and so that users are notified when active involvement is required. Custom data and error logging have been implemented that allow statistics for each PACS subsystem to be charted for performance data. The Network-Resource Manager allows our departmental PACS system to be monitored continuously and thoroughly, with a minimal amount of personal involvement and time.

Minimal-change nephropathy and malignant thymoma.

PubMed

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

1980-05-01

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

Minimal but non-minimal inflation and electroweak symmetry breaking

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

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

2016-10-07

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

An Outcome and Cost Analysis Comparing Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Intraoperative Fluoroscopy versus Computed Tomography-Guided Navigation.

PubMed

Khanna, Ryan; McDevitt, Joseph L; Abecassis, Zachary A; Smith, Zachary A; Koski, Tyler R; Fessler, Richard G; Dahdaleh, Nader S

2016-10-01

Minimally invasive transforaminal lumbar interbody fusion (TLIF) has undergone significant evolution since its conception as a fusion technique to treat lumbar spondylosis. Minimally invasive TLIF is commonly performed using intraoperative two-dimensional fluoroscopic x-rays. However, intraoperative computed tomography (CT)-based navigation during minimally invasive TLIF is gaining popularity for improvements in visualizing anatomy and reducing intraoperative radiation to surgeons and operating room staff. This is the first study to compare clinical outcomes and cost between these 2 imaging techniques during minimally invasive TILF. For comparison, 28 patients who underwent single-level minimally invasive TLIF using fluoroscopy were matched to 28 patients undergoing single-level minimally invasive TLIF using CT navigation based on race, sex, age, smoking status, payer type, and medical comorbidities (Charlson Comorbidity Index). The minimum follow-up time was 6 months. The 2 groups were compared in regard to clinical outcomes and hospital reimbursement from the payer perspective. Average surgery time, anesthesia time, and hospital length of stay were similar for both groups, but average estimated blood loss was lower in the fluoroscopy group compared with the CT navigation group (154 mL vs. 262 mL; P = 0.016). Oswestry Disability Index, back visual analog scale, and leg visual analog scale scores similarly improved in both groups (P > 0.05) at 6-month follow-up. Cost analysis showed that average hospital payments were similar in the fluoroscopy versus the CT navigation groups ($32,347 vs. $32,656; P = 0.925) as well as payments for the operating room (P = 0.868). Single minimally invasive TLIF performed with fluoroscopy versus CT navigation showed similar clinical outcomes and cost at 6 months. Copyright © 2016 Elsevier Inc. All rights reserved.