Direct structural parameter identification by modal test results

NASA Technical Reports Server (NTRS)

Chen, J.-C.; Kuo, C.-P.; Garba, J. A.

1983-01-01

A direct identification procedure is proposed to obtain the mass and stiffness matrices based on the test measured eigenvalues and eigenvectors. The method is based on the theory of matrix perturbation in which the correct mass and stiffness matrices are expanded in terms of analytical values plus a modification matrix. The simplicity of the procedure enables real time operation during the structural testing.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALCULATING INGESTION EXPOSURE FROM DAY 4 COMPOSITE MEASUREMENTS, THE DIRECT METHOD OF EXPOSURE ESTIMATION (IIT-A-6.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken for calculating ingestion exposure from Day 4 composite measurements from duplicate diet using the direct method of exposure estimation. This SOP uses data that have been properly coded and certified with appropria...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION OF HARVARD PM SAMPLERS (UA-L-6.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for calibrating Harvard particulate matter (PM) samplers. This procedure applies directly to the Harvard particulate matter (PM) samplers used during the Arizona NHEXAS project and the "Border" study. Keywords: lab; equipmen...

Comparison of piezosurgery and conventional rotative instruments in direct sinus lifting.

PubMed

Delilbasi, Cagri; Gurler, Gokhan

2013-12-01

The purpose of this study was to compare the intraoperative and postoperative effects of Piezosurgery and conventional rotative instruments in direct sinus lifting procedure. Twenty-three patients requiring direct sinus lifting were enrolled. The osteotomy and sinus membrane elevation were performed either with Piezosurgery tips or rotative diamond burs and manual membrane elevators. Time elapsed between bony window opening and completion of membrane elevation (duration), incidence of membrane perforation, visibility of the operation site, postoperative pain, swelling, sleeping, eating, phonetics, daily routine, and missed work as well as patient's expectation before and experience after the operation were evaluated. There was no significant difference between Piezosurgery and conventional groups regarding incidence of membrane perforation, duration, and operation site visibility as well as patient's expectation before and experience after the operation (P > 0.05). However, there were significantly more pain and swelling in the conventional group compared with the Piezosurgery group (P ≤ 0.05). Sinus lifting procedure performed with Piezosurgery causes less pain and swelling postoperatively compared with conventional technique. Patients' daily life activities and experience about the operation are not affected from the surgical technique.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PROBABILISTIC APPROACH FOR CALCULATING INGESTION EXPOSURE FROM DAY 4 COMPOSITE MEASUREMENTS, THE DIRECT METHOD OF EXPOSURE ESTIMATION (IIT-A-15.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate the ingestion exposure using composite food chemical residue values from the day of direct measurements. The calculation is based on the probabilistic approach. This SOP uses data that have been proper...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION OF HARVARD PM SAMPLERS (UA-L-6.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for calibrating Harvard particulate matter (PM) samplers. This procedure applies directly to the Harvard particulate matter (PM) samplers used during the Arizona NHEXAS project and the Border study. Keywords: lab; equipment;...

Transfer of knowledge in international cooperation: the Farmanguinhos - SMM case.

PubMed

Silva, Samuel Araujo Gomes da; Duarte, Roberto Gonzalez; Castro, José Márcio de

2017-01-01

To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity.

Revised Planning Methodology For Signalized Intersections And Operational Analysis Of Exclusive Left-Turn Lanes, Part-II: Models And Procedures (Final Report)

DOT National Transportation Integrated Search

1996-04-01

THIS REPORT ALSO DESCRIBES THE PROCEDURES FOR DIRECT ESTIMATION OF INTERSECTION CAPACITY WITH SIMULATION, INCLUDING A SET OF RIGOROUS STATISTICAL TESTS FOR SIMULATION PARAMETER CALIBRATION FROM FIELD DATA.

Satellite freeze forecast system. Operating/troubleshooting manual

NASA Technical Reports Server (NTRS)

Martsolf, J. D. (Principal Investigator)

1983-01-01

Examples of operational procedures are given to assist users of the satellites freeze forecasting system (SFFS) in logging in on to the computer, executing the programs in the menu, logging off the computer, and setting up the automatic system. Directions are also given for displaying, acquiring, and listing satellite maps; for communicating via terminal and monitor displays; and for what to do when the SFFS doesn't work. Administrative procedures are included.

RADIATION PROTECTION CABIN FOR CATHETER-DIRECTED LIVER INTERVENTIONS: OPERATOR DOSE ASSESSMENT.

PubMed

Maleux, Geert; Bergans, Niki; Bosmans, Hilde; Bogaerts, Ria

2016-09-01

The number and complexity of interventional radiological procedures and in particular catheter-directed liver interventions have increased substantially. The current study investigates the reduction of personal doses when using a dedicated radiation protection cabin (RPC) for these procedures. Operator and assistant doses were assessed for 3 series of 20 chemoinfusion/chemoembolisation interventions, including an equal number of procedures with and without RPC. Whole body doses, finger doses and doses at the level of knees and eyes were evaluated with different types of TLD-100 Harshaw dosemeters. Dosemeters were also attached on the three walls of the RPC. The operator doses were significantly reduced by the RPC, but also without RPC, the doses appear to be limited as a result of thorough optimisation with existing radiation protection tools. The added value of the RPC should thus be determined by the outcome of balancing dose reduction and other aspects such as ergonomic benefits. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Conceptual Knowledge of Fraction Arithmetic

ERIC Educational Resources Information Center

Siegler, Robert S.; Lortie-Forgues, Hugues

2015-01-01

Understanding an arithmetic operation implies, at minimum, knowing the direction of effects that the operation produces. However, many children and adults, even those who execute arithmetic procedures correctly, may lack this knowledge on some operations and types of numbers. To test this hypothesis, we presented preservice teachers (Study 1),…

Degenerate R-S perturbation theory

NASA Technical Reports Server (NTRS)

Hirschfelder, J. O.; Certain, P. R.

1973-01-01

A concise, systematic procedure is given for determining the Rayleigh-Schrodinger energies and wave functions of degenerate states to arbitrarily high orders even when the degeneracies of the various states are resolved in arbitrary orders. The procedure is expressed in terms of an iterative cycle in which the energy through the (2n+1)st order is expressed in terms of the partially determined wave function through the n-th order. Both a direct and an operator derivation are given. The two approaches are equivalent and can be transcribed into each other. The direct approach deals with the wave functions (without the use of formal operators) and has the advantage that it resembles the usual treatment of nondegenerate perturbations and maintains close contact with the basic physics. In the operator approach, the wave functions are expressed in terms of infinite order operators which are determined by the successive resolution of the space of the zeroth order functions.

Degenerate RS perturbation theory. [Rayleigh-Schroedinger energies and wave functions

NASA Technical Reports Server (NTRS)

Hirschfelder, J. O.; Certain, P. R.

1974-01-01

A concise, systematic procedure is given for determining the Rayleigh-Schroedinger energies and wave functions of degenerate states to arbitrarily high orders even when the degeneracies of the various states are resolved in arbitrary orders. The procedure is expressed in terms of an iterative cycle in which the energy through the (2n + 1)-th order is expressed in terms of the partially determined wave function through the n-th order. Both a direct and an operator derivation are given. The two approaches are equivalent and can be transcribed into each other. The direct approach deals with the wave functions (without the use of formal operators) and has the advantage that it resembles the usual treatment of nondegenerate perturbations and maintains close contact with the basic physics. In the operator approach, the wave functions are expressed in terms of infinite-order operators which are determined by the successive resolution of the space of the zeroth-order functions.

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR HARVARD PM IMPACTOR CALIBRATION AND LEAK TESTING (UA-L-7.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for the periodic calibration and leak testing of Harvard particulate matter (PM) impactor units. This procedure applies directly to the calibration and leak testing of Harvard PM impactor units used during the Arizona NHEXAS ...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR HARVARD PM IMPACTOR CALIBRATION AND LEAK TESTING (UA-L-7.1)

EPA Science Inventory

The purpose of this SOP is to describe the procedures for the periodic calibration and leak testing of Harvard particulate matter (PM) impactor units. This procedure applies directly to the calibration and leak testing of Harvard PM impactor units used during the Arizona NHEXAS ...

Venous vascular malformations of the craniofacial region: pre-operative embolisation with direct percutaneous puncture and N-butyl cyanoacrylate.

PubMed

Cil, B E; Vargel, I; Geyik, S; Peynircioglu, B; Cavusoglu, T

2008-12-01

Craniofacial venous vascular malformations cause severe cosmetic problems and yet these lesions are not candidates for transcatheter embolisation owing to the lack of arterial feeders. The purpose of this study was to evaluate the effectiveness of pre-operative embolisation of these lesions with N-butyl 2-cyanoacrylate (NBCA) via direct puncture. Between September 2003 and April 2006, 13 patients (7 female; age range, 6-64 years; mean, 16.7 years) were embolised with direct puncture and injection of NBCA. All of the patients were referred from plastic surgery with an operational plan. Angiography performed in all patients showed no or little arterial staining. NBCA diluted with iodized oil at a ratio of 1:6 (18%) was injected via a percutaneously placed 21 gauge needle. Complete embolisation was achieved in 8 patients and partial embolisation in the remaining 5. A total of 18 sessions of embolisation were performed on 13 patients. Nine patients underwent only one embolisation session, three patients underwent two sessions and only one patient underwent three sessions. The mean volume of NBCA used per session was 5.8 ml, ranging from 1-12 ml. All patients underwent a successful surgical resection to improve cosmetic disfigurement within 10-15 days after the embolisation procedure. Mean follow-up time was 22 months. One patient experienced skin necrosis on her nose after embolisation. No other complications related to the procedure were observed. In conclusion, pre-operative NBCA embolisation with direct puncture is a safe and easy procedure. It can increase the success of the surgical treatment of these lesions.

Transfer of knowledge in international cooperation: the Farmanguinhos – SMM case

PubMed Central

da Silva, Samuel Araujo Gomes; Duarte, Roberto Gonzalez; de Castro, José Márcio

2017-01-01

ABSTRACT OBJECTIVE To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. METHODS We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. RESULTS Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. CONCLUSIONS Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity. PMID:29166441

Syringe size: does it matter in physician-performed procedures?

PubMed

Michael, Adrian A; Moorjani, Gautam R; Peisajovich, Andres; Park, Kye S; Sibbitt, Wilmer L; Bankhurst, Arthur D

2009-03-01

We hypothesized that the size of syringe influenced needle control in physician-performed procedures. Operators were tested for their ability to control a 1-, 3-, 5-, 10-, and 20-mL syringe and equivalent sizes of the new safety device, the reciprocating procedure device (RPD), using the quantitative needle-based displacement method. Three hundred twenty clinical syringe procedures were then randomized to either a 3- or 10-mL conventional syringe or to a 3- or 10-mL RPD. Patient pain was measured with the Visual Analog Pain Scale (VAPS). Increasing syringe size was associated with the undesirable characteristic of unintended forward penetration (loss of control of the needle in the forward direction) (r(2) = 0.97, slope = 2.14, 95% CI: 1.54-2.76, P < 0.002), and unintended retraction (loss of control of the needle in the reverse direction) (r(2) = 0.97, slope 2.15, 95% CI: 1.54-2.76, P < 0.002). In addition, 2-handed operation of a syringe resulted in greater control than 1-handed operation of a syringe (P < 0.001). When 1-handed operation was required, the RPD control syringe reduced unintended penetration by 52.3% (P >or= 0.001), unintended retraction by 56.8% (P >or= 0.001), and patient pain by 54.7% (P >or= 0.001) at each device size. For greater safety and control when operating the conventional syringe, smaller syringe sizes and 2 hands instead of 1 hand should be used whenever possible. If 1-handed operation of a syringe is necessary, a safety technology like the RPD control syringe should be used.

47 CFR 80.142 - Ships using radiotelegraphy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Ships using radiotelegraphy. 80.142 Section 80... STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Special Procedures-Ship Stations § 80.142 Ships using radiotelegraphy. (a) Calling by narrow-band direct-printing. (1) NB-DP ship...

47 CFR 80.142 - Ships using radiotelegraphy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Ships using radiotelegraphy. 80.142 Section 80... STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Special Procedures-Ship Stations § 80.142 Ships using radiotelegraphy. (a) Calling by narrow-band direct-printing. (1) NB-DP ship...

47 CFR 80.142 - Ships using radiotelegraphy.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Ships using radiotelegraphy. 80.142 Section 80... STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Special Procedures-Ship Stations § 80.142 Ships using radiotelegraphy. (a) Calling by narrow-band direct-printing. (1) NB-DP ship...

47 CFR 80.142 - Ships using radiotelegraphy.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Ships using radiotelegraphy. 80.142 Section 80... STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Special Procedures-Ship Stations § 80.142 Ships using radiotelegraphy. (a) Calling by narrow-band direct-printing. (1) NB-DP ship...

47 CFR 80.142 - Ships using radiotelegraphy.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Ships using radiotelegraphy. 80.142 Section 80... STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Special Procedures-Ship Stations § 80.142 Ships using radiotelegraphy. (a) Calling by narrow-band direct-printing. (1) NB-DP ship...

JSC Design and Procedural Standards, JSC-STD-8080

NASA Technical Reports Server (NTRS)

Punch, Danny T.

2011-01-01

This document provides design and procedural requirements appropriate for inclusion in specifications for any human spaceflight program, project, spacecraft, system, or end item. The term "spacecraft" as used in the standards includes launch vehicles, orbital vehicles, non-terrestrial surface vehicles, and modules. The standards are developed and maintained as directed by Johnson Space Center (JSC) Policy Directive JPD 8080.2, JSC Design and Procedural Standards for Human Space Flight Equipment. The Design and Procedural Standards contained in this manual represent human spacecraft design and operational knowledge applicable to a wide range of spaceflight activities. These standards are imposed on JSC human spaceflight equipment through JPD 8080.2. Designers shall comply with all design standards applicable to their design effort.

An operating guide for the control of residential cut-through traffic.

DOT National Transportation Integrated Search

1990-01-01

The objective of this operating guide was to provide direction in conducting studies in accordance with the Policy and Procedures for Control of Residential Cut-Through Traffic" of the Virginia Department of Transportation. The guide is in eight part...

49 CFR 193.2707 - Operations and maintenance.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (c) Corrosion control procedures under § 193.2605(b), including those for the design, installation, operation, and maintenance of cathodic protection systems, must be carried out by, or under the direction of, a person qualified by experience and training in corrosion control technology. ...

49 CFR 193.2707 - Operations and maintenance.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... (c) Corrosion control procedures under § 193.2605(b), including those for the design, installation, operation, and maintenance of cathodic protection systems, must be carried out by, or under the direction of, a person qualified by experience and training in corrosion control technology. ...

Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series.

PubMed

Morgan, Lauren; New, Steve; Robertson, Eleanor; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; Pickering, Sharon P; Hadi, Mohammed; Griffin, Damian; McCulloch, Peter

2015-02-01

Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. In a controlled interrupted time series, we evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. Process measures were evaluated by direct observation, using Oxford Non-Technical Skills II for non-technical skills and the 'glitch count' for technical performance. All staff in two orthopaedic operating theatres were trained in the principles of SOPs and then assisted to develop standardised procedures. Staff in a control operating theatre underwent the same observations but received no training. The change in difference between active and control groups was compared before and after the intervention using repeated measures analysis of variance. We observed 50 operations before and 55 after the intervention and analysed clinical data on 1022 and 861 operations, respectively. The staff chose to structure their efforts around revising the 'whiteboard' which documented and prompted tasks, rather than directly addressing specific task problems. Although staff preferred and sustained the new system, we found no significant differences in process or outcome measures before/after intervention in the active versus the control group. There was a secular trend towards worse outcomes in the postintervention period, seen in both active and control theatres. SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

28 CFR 65.84 - Procedures for the Attorney General when seeking State or local assistance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...

28 CFR 65.84 - Procedures for the Attorney General when seeking State or local assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...

28 CFR 65.84 - Procedures for the Attorney General when seeking State or local assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...

28 CFR 65.84 - Procedures for the Attorney General when seeking State or local assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...

What is the learning curve for the anterior approach for total hip arthroplasty?

PubMed

de Steiger, Richard Noel; Lorimer, Michelle; Solomon, Michael

2015-12-01

There are many factors that may affect the learning curve for total hip arthroplasty (THA) and surgical approach is one of these. There has been renewed interest in the direct anterior approach for THA with variable outcomes reported, but few studies have documented a surgeon's individual learning curve when using this approach. (1) What was the revision rate for all surgeons adopting the anterior approach for placement of a particular implant? (2) What was the revision rate for surgeons who performed > 100 cases in this fashion? (3) Is there a minimum number of cases required to complete a learning curve for this procedure? The Australian Orthopaedic Association National Joint Replacement Registry prospectively collects data on all primary and revision joint arthroplasty surgery. We analyzed all conventional THAs performed up to December 31, 2013, with a primary diagnosis of osteoarthritis using a specific implant combination and secondarily those associated with surgeons performing more than 100 procedures. Ninety-five percent of these procedures were performed through the direct anterior approach. Procedures using this combination were ordered from earliest (first procedure date) to latest (last procedure date) for each individual surgeon. Using the order number for each surgeon, five operation groups were defined: one to 15 operations, 16 to 30 operations, 31 to 50 operations, 51 to 100 operations, and > 100 operations. The primary outcome measure was time to first revision using Kaplan-Meier estimates of survivorship. Sixty-eight surgeons performed 5499 THAs using the specified implant combination. The cumulative percent revision at 4 years for all 68 surgeons was 3% (95% confidence interval [CI], 2.5-3.8). For surgeons who had performed over 100 operations, the cumulative revision rate was 3% (95% CI, 2.0-3.5). It was not until surgeons had performed over 50 operations that there was no difference in the cumulative percent revision compared with over 100 operations. The cumulative percent revision for surgeons performing 51 to 100 operations at 4 years was 3% (95% CI, 1.5-5.4) and over 100 operations 2% (95% CI, 1.2-2.7; hazard ratio, 1.40 [95% CI, 0.7-2.7]; p = 0.33). There is a learning curve for the anterior approach for THA even when using a prosthesis combination specifically marketed for that approach. We found that 50 or more procedures need to be performed by a surgeon before the rate of revision is no different from performing 100 or more procedures. Surgeons should be aware of this initial higher rate of revision when deciding which approach delivers the best outcome for their patients.

Generalized Weyl-Wigner map and Vey quantum mechanics

NASA Astrophysics Data System (ADS)

Dias, Nuno Costa; Prata, João Nuno

2001-12-01

The Weyl-Wigner map yields the entire structure of Moyal quantum mechanics directly from the standard operator formulation. The covariant generalization of Moyal theory, also known as Vey quantum mechanics, was presented in the literature many years ago. However, a derivation of the formalism directly from standard operator quantum mechanics, clarifying the relation between the two formulations, is still missing. In this article we present a covariant generalization of the Weyl order prescription and of the Weyl-Wigner map and use them to derive Vey quantum mechanics directly from the standard operator formulation. The procedure displays some interesting features: it yields all the key ingredients and provides a more straightforward interpretation of the Vey theory including a direct implementation of unitary operator transformations as phase space coordinate transformations in the Vey idiom. These features are illustrated through a simple example.

Aircraft operations management manual

NASA Technical Reports Server (NTRS)

1992-01-01

The NASA aircraft operations program is a multifaceted, highly diverse entity that directly supports the agency mission in aeronautical research and development, space science and applications, space flight, astronaut readiness training, and related activities through research and development, program support, and mission management aircraft operations flights. Users of the program are interagency, inter-government, international, and the business community. This manual provides guidelines to establish policy for the management of NASA aircraft resources, aircraft operations, and related matters. This policy is an integral part of and must be followed when establishing field installation policy and procedures covering the management of NASA aircraft operations. Each operating location will develop appropriate local procedures that conform with the requirements of this handbook. This manual should be used in conjunction with other governing instructions, handbooks, and manuals.

Determining Directional Emittance With An Infrared Imager

NASA Technical Reports Server (NTRS)

Daryabeigi, Kamran; Alderfer, David W.; Wright, Robert E., Jr.; Puram, Chith K.

1994-01-01

Directional emittances of flat specimen of smooth-surfaced, electrically nonconductive material at various temperatures computed from measurements taken by infrared radiometric imager operating in conjunction with simple ancillary equipment. Directional emittances useful in extracting detailed variations of surface temperatures from infrared images of curved, complexly shaped other specimens of same material. Advantages: simplification of measurement procedure and reduction of cost.

Automated Instructional Management Systems (AIMS) Version III, Users Manual.

ERIC Educational Resources Information Center

New York Inst. of Tech., Old Westbury.

This document sets forth the procedures necessary to utilize and understand the operating characteristics of the Automated Instructional Management System - Version III, a computer-based system for management of educational processes. Directions for initialization, including internal and user files; system and operational input requirements;…

Recent research on emergent verbal behavior: clinical applications and future directions.

PubMed

Grow, Laura L; Kodak, Tiffany

2010-01-01

This paper describes recent studies that have evaluated the functional independence of verbal operants. Procedures that facilitate the emergence of untrained verbal operants and important areas of future research to increase efficiency of language programs for children diagnosed with developmental disabilities are discussed.

XV-15 Tiltrotor Low Noise Terminal Area Operations

NASA Technical Reports Server (NTRS)

Conner, David A.; Marcolini, Michael A.; Edwards, Bryan D.; Brieger, John T.

1998-01-01

Acoustic data have been acquired for the XV-15 tiltrotor aircraft performing a variety of terminal area operating procedures. This joint NASA/Bell/Army test program was conducted in two phases. During Phase 1 the XV-15 was flown over a linear array of microphones, deployed perpendicular to the flight path, at a number of fixed operating conditions. This documented the relative noise differences between the various conditions. During Phase 2 the microphone array was deployed over a large area to directly measure the noise footprint produced during realistic approach and departure procedures. The XV-15 flew approach profiles that culminated in IGE hover over a landing pad, then takeoffs from the hover condition back out over the microphone array. Results from Phase 1 identify noise differences between selected operating conditions, while those from Phase 2 identify differences in noise footprints between takeoff and approach conditions and changes in noise footprint due to variation in approach procedures.

Recommended operating procedure No. 51: Glass source assessment sampling system (glass SASS). Final report, Jul 90-Jan 91

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

Grote, R.A.

1991-05-01

The report is a recommended operating procedure (ROP), prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). The method described is applicable to the stack sampling of flue gas from a rotary kiln and to associated equipment of AEERL's Combustion Research Branch. It has been the standard method of sampling kiln flue gas due to the transient nature of the puff development and its capability to sample the maximum volume over the shortest time period. ROPs describe non-routine or experimental research operations where some judgment in application may be warranted. ROPs may notmore » be applicable to activities conducted by other research groups, and should not be used in place of standard operating procedures. Use of ROPs must be accompanied by an understanding of the purpose and scope. Questions should be directed to the author.« less

Automated Essay Scoring: Psychometric Guidelines and Practices

ERIC Educational Resources Information Center

Ramineni, Chaitanya; Williamson, David M.

2013-01-01

In this paper, we provide an overview of psychometric procedures and guidelines Educational Testing Service (ETS) uses to evaluate automated essay scoring for operational use. We briefly describe the e-rater system, the procedures and criteria used to evaluate e-rater, implications for a range of potential uses of e-rater, and directions for…

Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

PubMed

Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

2013-06-01

Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P < .0001), 27.4 minutes for a parotidectomy (P = .028), 38.3 minutes for a septoplasty (P < .0001), and 51 minutes for tympanomastoidectomy (P < .0021). Thyroidectomy showed no operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

PubMed

Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

2016-12-01

To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

GSFC Systems Test and Operation Language (STOL) functional requirements and language description

NASA Technical Reports Server (NTRS)

Desjardins, R.; Hall, G.; Mcguire, J.; Merwarth, P.; Mocarsky, W.; Truszkowski, W.; Villasenor, A.; Brosi, F.; Burch, P.; Carey, D.

1978-01-01

The Systems Tests and Operation Language (STOL) provides the means for user communication with payloads, applications programs, and other ground system elements. It is a systems operation language that enables an operator or user to communicate a command to a computer system. The system interprets each high level language directive from the user and performs the indicated action, such as executing a program, printing out a snapshot, or sending a payload command. This document presents the following: (1) required language features and implementation considerations; (2) basic capabilities; (3) telemetry, command, and input/output directives; (4) procedure definition and control; (5) listing, extension, and STOL nucleus capabilities.

30 CFR 56.14219 - Brakeman signals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Brakeman signals. 56.14219 Section 56.14219... Safety Practices and Operational Procedures § 56.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 56.14219 - Brakeman signals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Brakeman signals. 56.14219 Section 56.14219... Safety Practices and Operational Procedures § 56.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 57.14219 - Brakeman signals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Brakeman signals. 57.14219 Section 57.14219... Equipment Safety Practices and Operational Procedures § 57.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 57.14219 - Brakeman signals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Brakeman signals. 57.14219 Section 57.14219... Equipment Safety Practices and Operational Procedures § 57.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

RECENT RESEARCH ON EMERGENT VERBAL BEHAVIOR: CLINICAL APPLICATIONS AND FUTURE DIRECTIONS

PubMed Central

Grow, Laura L; Kodak, Tiffany

2010-01-01

This paper describes recent studies that have evaluated the functional independence of verbal operants. Procedures that facilitate the emergence of untrained verbal operants and important areas of future research to increase efficiency of language programs for children diagnosed with developmental disabilities are discussed. PMID:21541166

75 FR 38945 - Airworthiness Directives; The Boeing Company Model 777-200 and -300 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-07

..., 2006. The service bulletin describes procedures for installing new operational software in the cabin... loading the new cabin services system central storage device software and CSCP OPS into the MMC. FAA's... cabin services system central storage device software and cabin system control panel operational...

30 CFR 56.14219 - Brakeman signals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Brakeman signals. 56.14219 Section 56.14219... Safety Practices and Operational Procedures § 56.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 56.14219 - Brakeman signals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Brakeman signals. 56.14219 Section 56.14219... Safety Practices and Operational Procedures § 56.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 56.14219 - Brakeman signals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Brakeman signals. 56.14219 Section 56.14219... Safety Practices and Operational Procedures § 56.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 57.14219 - Brakeman signals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Brakeman signals. 57.14219 Section 57.14219... Equipment Safety Practices and Operational Procedures § 57.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 57.14219 - Brakeman signals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Brakeman signals. 57.14219 Section 57.14219... Equipment Safety Practices and Operational Procedures § 57.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

30 CFR 57.14219 - Brakeman signals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Brakeman signals. 57.14219 Section 57.14219... Equipment Safety Practices and Operational Procedures § 57.14219 Brakeman signals. When a train is under the direction of a brakeman and the train operator cannot clearly recognize the brakeman's signals, the train...

Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study.

PubMed

Ajmal, Muhammad; Power, Susan; Smith, Tim; Shorten, George D

2011-02-01

To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral nerve block (FNB) in an acute hospital setting. Pilot prospective observational study. Orthopedic operating room of a regional trauma hospital. 15 anesthesiologists of various levels of experience in US-guided FNB (estimated minimum experience < 10 procedures; maximum about 50 procedures, and from basic trainees to consultants); and 15 patients (5 men and 10 women), aged 77 ± 15 (mean ± SD yrs) years. MEASUREMENTS/OBSERVATIONS: A data capture "tool", which was modified from one previously developed for ergonomic study of spinal anesthesia, was studied. Patient, operator, and heterogeneous environmental factors related to ergonomic performance of US-guided FNB were identified. The observation period started immediately before commencement of positioning the patient and ended on completion of perineural injection. Data were acquired using direct observations, photography, and application of a questionnaire. The quality of ergonomic performance was generally suboptimal and varied greatly among operators. Eight (experience < 10 procedures) of 15 operators excessively rotated their head, neck, and/or back to visualize the image on the ultrasound machine. Eight operators (experience < 10 procedures) performed the procedure with excessive thoracolumbar flexion. Performance of US-guided FNB presents ergonomic challenges and was suboptimal during most of the procedures observed. Formal training in US-guided peripheral nerve blockade should include reference to ergonomic factors. Copyright © 2011 Elsevier Inc. All rights reserved.

Variability as a Subject Matter in a Science of Behavior: Reply to Commentaries

ERIC Educational Resources Information Center

Barba, Lourenco de Souza

2012-01-01

In his article, the author claimed that studies of operant variability that use a lag-"n" or threshold procedure and measure the obtained variability through the change in U value fail to provide direct evidence that variability is an operant dimension of behavior. To do so, he adopted Catania's (1973) concept of the operant, which takes the…

An evaluation of the ATM man/machine interface. Phase 3: Analysis of SL-3 and SL-4 data

NASA Technical Reports Server (NTRS)

Bathurst, J. R., Jr.; Pain, R. F.; Ludewig, D. B.

1974-01-01

The functional adequacy of human factored crew operated systems under operational zero-gravity conditions is considered. Skylab ATM experiment operations generated sufficient telemetry and voice transcript data to support such an assessment effort. Discussions are presented pertaining to the methodology and procedures used to evaluate the hardware, training and directive aspects of Skylab 3 and Skylab 4 manned ATM experiment operations.

Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos).

PubMed

Chen, Yang K; Parsi, Mansour A; Binmoeller, Kenneth F; Hawes, Robert H; Pleskow, Douglas K; Slivka, Adam; Haluszka, Oleh; Petersen, Bret T; Sherman, Stuart; Devière, Jacques; Meisner, Søren; Stevens, Peter D; Costamagna, Guido; Ponchon, Thierry; Peetermans, Joyce A; Neuhaus, Horst

2011-10-01

The feasibility of single-operator cholangioscopy (SOC) for biliary diagnostic and therapeutic procedures was previously reported. To confirm the utility of SOC in more widespread clinical use. Prospective clinical cohort study. Fifteen endoscopy referral centers in the United States and Europe. Two hundred ninety-seven patients requiring evaluation of bile duct disease or biliary stone therapy. SOC examination and, as indicated, SOC-directed stone therapy or forceps biopsy. Procedural success defined as ability to (1) visualize target lesions and, if indicated, collect biopsy specimens adequate for histological evaluation or (2) visualize biliary stones and initiate fragmentation and removal. The overall procedure success rate was 89% (95% CI, 84%-92%). Adequate tissue for histological examination was secured in 88% of 140 patients who underwent biopsy. Overall sensitivity in diagnosing malignancy was 78% for SOC visual impression and 49% for SOC-directed biopsy. Sensitivity was higher (84% and 66%, respectively) for intrinsic bile duct malignancies. Diagnostic SOC procedures altered clinical management in 64% of patients. Procedure success was achieved in 92% of 66 patients with stones and complete stone clearance during the study SOC session in 71%. The incidence of serious procedure-related adverse events was 7.5% for diagnostic SOC and 6.1% for SOC-directed stone therapy. The study was observational in design with no control group. Evaluation of bile duct disease and biliary stone therapy can be safely performed with a high success rate by using the SOC system. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Regulations and Procedures Manual

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

Young, Lydia

The purpose of the Regulations and Procedures Manual (RPM) is to provide Laboratory personnel with a reference to University and Lawrence Berkeley National Laboratory policies and regulations by outlining the normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory departments. Much of the information in this manual has been condensed from detail provided in Laboratory procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. The sections on personnel apply only to employees who are not represented by unions. Personnel policies pertainingmore » to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the department responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which department should be called, please contact the Associate Laboratory Director of Operations.« less

Post-operative ventricular flow dynamics following atrioventricular valve surgical and device therapies: A review.

PubMed

Nguyen, Yen Ngoc; Ismail, Munirah; Kabinejadian, Foad; Tay, Edgar Lik Wui; Leo, Hwa Liang

2018-04-01

Intra-ventricular flow dynamics has recently emerged as an important evaluation and diagnosis tool in different cardiovascular conditions. The formation of vortex pattern during the cardiac cycle has been suggested to play important epigenetic and energy-modulation roles in cardiac remodelling, adaptations and mal-adaptations. In this new perspective, flow alterations due to different cardiovascular procedures can affect the long-term outcome of those procedures. Especially, repairs and replacements performed on atrioventricular valves are likely to exert direct impact on intra-ventricular flow pattern. In this review, current consensus around the roles of vortex dynamics in cardiac function is discussed. An overview of physiological vortex patterns found in healthy left and right ventricles as well as post-operative ventricular flow phenomenon owing to different atrioventricular valvular procedures are reviewed, followed by the summary of different vortex identification schemes used to characterise intraventricular flow. This paper also emphasises on future research directions towards a comprehensive understanding of intra-cardiac flow and its clinical relevance. The knowledge could encourage more effective pre-operative planning and better outcomes for current clinical practices. Copyright © 2018. Published by Elsevier Ltd.

A balloon system for profiling smoke plumes from forest fires

Treesearch

Paul W. Ryan; Charles D. Tangren; Charles K. McMahon

1979-01-01

This paper is directed to those interested in techniques for measuring emission rates and emission factors for forest fires and other open combustion sources. A source-sampling procedure that involved the use of a vertical array of lightweight, battery-operated instruments suspended from a helium-filled aerodynamic balloon is described. In this procedure, plume...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF PM AND URG IMPACTORS AND IMPACTION PLATES (UA-L-8.1)

EPA Science Inventory

The purpose of this SOP is to describe the stages of preparation required for Harvard particulate matter (PM) sampler impactor: (1) prior to in-field use of the particulate sampling system, (2) in-field sampling, and (3) disassembly after field use. This procedure applies direct...

Hybrid procedure for orbital venous malformation in the endovascular operation room.

PubMed

Cheng, A C O; Li, E Y M; Chan, T C Y; Wong, A C W; Chan, P C M; Poon, W W L; Fung, D H S; Yuen, H K L

2015-08-01

To describe a hybrid procedure for orbital venous malformation in the endovascular operating room (EVOR). Five consecutive patients with venous malformation in the periocular and orbital region were included. All patients received a one-stage direct puncture venogram, image-guided glue injection, and surgical resection in the EVOR equipped with a biplane digital subtraction angiography system (BDSAS). The mean age at the time of operation was 37.4 years (range, 22-69 years). The mean operative time was 193 min (range, 138-324 min). No intraoperative complications were noted. The mean follow-up duration was 18.8 months (range, 10-24 months). Three patients had complete removal of the vascular lesions. At the latest follow-up, no recurrence of symptoms related to the lesions was noted. All patients had an uneventful recovery and satisfactory outcome. The hybrid procedure of orbital venous malformation in the EVOR is a novel application in ophthalmology. It is a safe and well-controlled procedure with real-time high-quality BDSAS surveillance to facilitate surgical resection. Its success requires collaboration between the interventional radiologist, the surgeon, and the ophthalmologist.

Integrated human-machine intelligence in space systems.

PubMed

Boy, G A

1992-07-01

This paper presents an artificial intelligence approach to integrated human-machine intelligence in space systems. It discusses the motivations for Intelligent Assistant Systems in both nominal and abnormal situations. The problem of constructing procedures is shown to be a very critical issue. In particular, keeping procedural experience in both design and operation is critical. We suggest what artificial intelligence can offer in this direction. Some crucial problems induced by this approach are discussed in detail. Finally, we analyze the various roles that would be shared by both astronauts, ground operators, and the intelligent assistant system.

Costs and benefits in item-method directed forgetting: differential effects of encoding and retrieval.

PubMed

Lee, Yuh-Shiow

2013-01-01

This study examined how encoding and retrieval factors affected directed forgetting costs and benefits in an item-method procedure. Experiment 1 used a typical item-method procedure and revealed a levels-of-processing effect in overall recall. However, the deep encoding condition showed a smaller directed forgetting effect than the shallow encoding conditions. More importantly, "remember" (R) words were selectively rehearsed as indicated by greater recall from the primacy portion of the list and more apt to be recalled before "forget" (F) words. Experiment 2 showed that a deep encoding operation reduced directed forgetting costs and that directed forgetting benefits occurred only when R words were recalled before F words. These findings supported the hypotheses that encoding manipulation affected directed forgetting costs and that directed forgetting benefits were associated with output order bias. Results were discussed in terms of mechanisms that produce item-method directed forgetting.

The ATA-67 Formula for Direct Operating Cost

NASA Technical Reports Server (NTRS)

Faulkner, H. B.

1972-01-01

The ATA formulas for direct operating cost were developed for the purpose of comparing different aircraft, existing or not, on the same route or the same aircraft on different routes. Such characteristics of the airline as crew pay, maintenance procedures, and depreciation schedules are kept constant. In air transportation systems analysis the 1967 ATA formula is usually used with appropriate exceptions or modifications, such as: different maintenance labor rate, total maintenance multiplied by a factor, maintenance burden deleted, different depreciation schedule, or different spares percentages.

[Surgical learning curve for creation of vascular accesses for haemodialysis: value of medico-radio-surgical collaboration].

PubMed

Van Glabeke, Emmanuel; Belenfant, Xavier; Barrou, Benoît; Adhemar, Jean-Pierre; Laedrich, Joëlle; Mavel, Marie-Christine; Challier, Emmanuel

2005-04-01

Creation of a vascular access (VA) for haemodialysis is a surgical procedure which comprises a failure rate related to the quality of the vessels and the operator's experience. The authors report the first 2 years of a young urologist's experience with this procedure in a local hospital in collaboration with the nephrology team. Patients undergoing creation of VA were divided into 2 chronological groups. The patient's age and gender, the cause of renal failure, the presence of diabetes, clinical examination of the upper limb, preoperative assessment of upper limb vessels, the type of anaesthesia, the operating time and the start of dialysis after the operation, as well as the functional results of the VA at 6 months were studied. Results concerning the patients of the first period were discussed by the operator and the nephrology team. During the first 9 months, 28 patients were operated, corresponding to 36 operations including 32 direct fistulas. Over the following 15 months, 61 patients were operated, with the creation of 63 VAs, including 55 direct fistulas. The failure rate (thrombosis or non-functioning VA) decreased from 32.1% to 11.1% (p=0.07), while the 2 groups were globally comparable. Evaluation of a new surgical procedure shows a number of failures, as for all learning curves. However, it helps to improve the results. Collaboration with nephrologists must comprise a discussion allowing the acceptance of certain failures, as they reflect compliance with a strategy of preservation of the vascular capital and a rational attempt to avoid a non-essential proximal access or bypass graft. The support of a motivated radiology team (preoperative assessment and management of complications) and the assistance of a more experienced operator are essential.

Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis.

PubMed

Rodríguez-Álvarez, María Xosé; Roca-Pardiñas, Javier; Cadarso-Suárez, Carmen; Tahoces, Pablo G

2018-03-01

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

Operator Priming and Generalization of Practice in Adults' Simple Arithmetic

ERIC Educational Resources Information Center

Chen, Yalin; Campbell, Jamie I. D.

2016-01-01

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

Unified treatment of microscopic boundary conditions and efficient algorithms for estimating tangent operators of the homogenized behavior in the computational homogenization method

NASA Astrophysics Data System (ADS)

Nguyen, Van-Dung; Wu, Ling; Noels, Ludovic

2017-03-01

This work provides a unified treatment of arbitrary kinds of microscopic boundary conditions usually considered in the multi-scale computational homogenization method for nonlinear multi-physics problems. An efficient procedure is developed to enforce the multi-point linear constraints arising from the microscopic boundary condition either by the direct constraint elimination or by the Lagrange multiplier elimination methods. The macroscopic tangent operators are computed in an efficient way from a multiple right hand sides linear system whose left hand side matrix is the stiffness matrix of the microscopic linearized system at the converged solution. The number of vectors at the right hand side is equal to the number of the macroscopic kinematic variables used to formulate the microscopic boundary condition. As the resolution of the microscopic linearized system often follows a direct factorization procedure, the computation of the macroscopic tangent operators is then performed using this factorized matrix at a reduced computational time.

Aerial Radiological Measuring System (ARMS): systems, procedures and sensitivity (1976)

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

Boyns, P K

1976-07-01

This report describes the Aerial Radiological Measuring System (ARMS) designed and operated by EG and G, Inc., for the Energy Research and Development Administration's (ERDA) Division of Operational Safety with the cooperation of the Nuclear Regulatory Commission. Designed to rapidly survey large areas for low-level man-made radiation, the ARMS has also proven extremely useful in locating lost radioactive sources of relatively low activity. The system consists of sodium iodide scintillation detectors, data formatting and recording equipment, positioning equipment, meteorological instruments, direct readout hardware, and data analysis equipment. The instrumentation, operational procedures, data reduction techniques and system sensitivities are described, togethermore » with their applications and sample results.« less

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF PM AND URG IMPACTORS AND IMPACTION PLATES (UA-L-8.1)

EPA Science Inventory

The purpose of this SOP is to describe the stages of preparation required for Harvard particulate matter (PM) sampler impactor: (1) prior to in-field use of the particulate sampling system, (2) in-field sampling, and (3) disassembly after field use. This procedure applies direct...

A combination of HARMONIE short time direct normal irradiance forecasts and machine learning: The #hashtdim procedure

NASA Astrophysics Data System (ADS)

Gastón, Martín; Fernández-Peruchena, Carlos; Körnich, Heiner; Landelius, Tomas

2017-06-01

The present work describes the first approach of a new procedure to forecast Direct Normal Irradiance (DNI): the #hashtdim that treats to combine ground information and Numerical Weather Predictions. The system is centered in generate predictions for the very short time. It combines the outputs from the Numerical Weather Prediction Model HARMONIE with an adaptive methodology based on Machine Learning. The DNI predictions are generated with 15-minute and hourly temporal resolutions and presents 3-hourly updates. Each update offers forecasts to the next 12 hours, the first nine hours are generated with 15-minute temporal resolution meanwhile the last three hours present hourly temporal resolution. The system is proved over a Spanish emplacement with BSRN operative station in south of Spain (PSA station). The #hashtdim has been implemented in the framework of the Direct Normal Irradiance Nowcasting methods for optimized operation of concentrating solar technologies (DNICast) project, under the European Union's Seventh Programme for research, technological development and demonstration framework.

Reasoning about procedural knowledge

NASA Technical Reports Server (NTRS)

Georgeff, M. P.

1985-01-01

A crucial aspect of automated reasoning about space operations is that knowledge of the problem domain is often procedural in nature - that is, the knowledge is often in the form of sequences of actions or procedures for achieving given goals or reacting to certain situations. In this paper a system is described that explicitly represents and reasons about procedural knowledge. The knowledge representation used is sufficiently rich to describe the effects of arbitrary sequences of tests and actions, and the inference mechanism provides a means for directly using this knowledge to reach desired operational goals. Furthermore, the representation has a declarative semantics that provides for incremental changes to the system, rich explanatory capabilities, and verifiability. The approach also provides a mechanism for reasoning about the use of this knowledge, thus enabling the system to choose effectively between alternative courses of action.

Function Allocation in Complex Socio-Technical Systems: Procedure usage in nuclear power and the Context Analysis Method for Identifying Design Solutions (CAMIDS) Model

NASA Astrophysics Data System (ADS)

Schmitt, Kara Anne

This research aims to prove that strict adherence to procedures and rigid compliance to process in the US Nuclear Industry may not prevent incidents or increase safety. According to the Institute of Nuclear Power Operations, the nuclear power industry has seen a recent rise in events, and this research claims that a contributing factor to this rise is organizational, cultural, and based on peoples overreliance on procedures and policy. Understanding the proper balance of function allocation, automation and human decision-making is imperative to creating a nuclear power plant that is safe, efficient, and reliable. This research claims that new generations of operators are less engaged and thinking because they have been instructed to follow procedures to a fault. According to operators, they were once to know the plant and its interrelations, but organizationally more importance is now put on following procedure and policy. Literature reviews were performed, experts were questioned, and a model for context analysis was developed. The Context Analysis Method for Identifying Design Solutions (CAMIDS) Model was created, verified and validated through both peer review and application in real world scenarios in active nuclear power plant simulators. These experiments supported the claim that strict adherence and rigid compliance to procedures may not increase safety by studying the industry's propensity for following incorrect procedures, and when it directly affects the outcome of safety or security of the plant. The findings of this research indicate that the younger generations of operators rely highly on procedures, and the organizational pressures of required compliance to procedures may lead to incidents within the plant because operators feel pressured into following the rules and policy above performing the correct actions in a timely manner. The findings support computer based procedures, efficient alarm systems, and skill of the craft matrices. The solution to the problems facing the industry include in-depth, multiple fault failure training which tests the operator's knowledge of the situation. This builds operator collaboration, competence and confidence to know what to do, and when to do it in response to an emergency situation. Strict adherence to procedures and rigid compliance to process may not prevent incidents or increase safety; building operators' fundamental skills of collaboration, competence and confidence will.

Establishing powder-handling workflow practices and standard operating procedures: compounding pharmacy and safety.

PubMed

Prince, Bryan; Lundevall, Jeremy

2014-01-01

This is an ongoing discussion and analysis of powder-handling safety in the compounding pharmacy laboratory that started in the November/December 2013 issue of the International Journal of Pharmaceutical Compounding. In the previous technical article, we established that most chemical powders handled during compounding procedures have an established occupational exposure limits and that powders are micronized during manipulation. All micronized powders handled on an open bench create health hazards to the technicians and create a potential for cross-contamination to the lab environment. Proper identification of the chemical hazard and established standard operating procedures in direct correlation to Good Lab Practices when working inside a powder hood will positively improve the compounding pharmacy's work environment.

A computer program for detailed analysis of the takeoff and approach performance capabilities of transport category aircraft

NASA Technical Reports Server (NTRS)

Foss, W. E., Jr.

1979-01-01

The takeoff and approach performance of an aircraft is calculated in accordance with the airworthiness standards of the Federal Aviation Regulations. The aircraft and flight constraints are represented in sufficient detail to permit realistic sensitivity studies in terms of either configuration modifications or changes in operational procedures. The program may be used to investigate advanced operational procedures for noise alleviation such as programmed throttle and flap controls. Extensive profile time history data are generated and are placed on an interface file which can be input directly to the NASA aircraft noise prediction program (ANOPP).

Analysis of aircraft tires via semianalytic finite elements

NASA Technical Reports Server (NTRS)

Noor, Ahmed K.; Kim, Kyun O.; Tanner, John A.

1990-01-01

A computational procedure is presented for the geometrically nonlinear analysis of aircraft tires. The tire was modeled by using a two-dimensional laminated anisotropic shell theory with the effects of variation in material and geometric parameters included. The four key elements of the procedure are: (1) semianalytic finite elements in which the shell variables are represented by Fourier series in the circumferential direction and piecewise polynomials in the meridional direction; (2) a mixed formulation with the fundamental unknowns consisting of strain parameters, stress-resultant parameters, and generalized displacements; (3) multilevel operator splitting to effect successive simplifications, and to uncouple the equations associated with different Fourier harmonics; and (4) multilevel iterative procedures and reduction techniques to generate the response of the shell.

Managing direct oral anticoagulants in patients undergoing dentoalveolar surgery.

PubMed

Patel, J P; Woolcombe, S A; Patel, R K; Obisesan, O; Roberts, L N; Bryant, C; Arya, R

2017-02-24

Our objective was to describe our experience of managing a cohort of adult patients prescribed direct oral anticoagulants (DOACs) undergoing dentoalveolar procedures between November 2012 and May 2016. Prior to conducting a procedure a formal assessment was made of each patient's anticoagulation treatment. A specific plan was then formulated, balancing the risk of bleeding with the risk of thrombosis. Patients received a telephone consultation one week following treatment to assess any post-operative bleeding. Eighty-two patients underwent 111 oral surgical procedures, the majority of which were dental extractions. In the case of 35 (32%) procedures, advice was given to omit the DOAC, either before or after treatment. There was no bleeding following the majority of procedures. Persistent bleeding followed 15 (13.5%) procedures, of which 7 (6.3%) procedures required specific intervention. The majority of patients prescribed DOACs can undergo dentoalveolar procedures safely. Important considerations when planning treatment are: (i) when the patient usually takes their dose of DOAC, (ii) the time the procedure is performed and, (iii) when the DOAC is taken post-procedure. In our experience, if these factors are considered carefully, omission of DOAC doses is unlikely to be required for most patients.

10 CFR Appendix O to Part 110 - Illustrative List of Fuel Element Fabrication Plant Equipment and Components Under NRC's Export...

Code of Federal Regulations, 2010 CFR

2010-01-01

... performance and safety during reactor operation. Also, in all cases precise control of processes, procedures... elements include equipment that: (1) Normally comes in direct contact with, or directly processes or... pellets; (2) Automatic welding machines especially designed or prepared for welding end caps onto the fuel...

Real Time Maintenance Approval and Required IMMT Coordination

NASA Technical Reports Server (NTRS)

Burchell, S.

2016-01-01

Payloads are assessed for nominal operations. Payload Developers have the option of performing a maintenance hazard assessment (MHA) for potential maintenance activities. When POIC (Payload Operations and Integration Center) Safety reviews an OCR calling for a maintenance procedure, we cannot approve it without a MHA. If no MHA exists, we contact MER (Mission Evaluation Room) Safety. Depending on the nature of the problem, MER Safety has the option to: Analyze and grant approval themselves; Direct the payload back to the ISRP (Integrated Safety Review Panel); Direct the payload to the IMMT (Increment Mission Management Team).

Preliminary Airspace Operations Simulations Findings Report

NASA Technical Reports Server (NTRS)

2005-01-01

Provides preliminary findings of the initial series (normal operations and contingency management) of airspace operations simulations. The key elements of this report discuss feedback from controller subjects for UAS flight above FL430. Findings provide initial evaluation of routine UAS operations above dense ARTCC airspace (ZOB), and identify areas of further research, policy direction and procedural development. This document further serves as an addendum to the detailed AOS simulation plan (Deliverable SIM001), incorporating feedback from FAA air traffic personnel and Access 5 IPTs.

Surgical Management of Common Disorders of Feedlot Calves.

PubMed

Miesner, Matt D; Anderson, David E

2015-11-01

Procedures to improve animal and handler safety, shape production parameters, and directly address the prosperity of individuals in need of assistance are performed routinely. Techniques to accomplish these tasks have been described in many venues. Painful procedures are expected in feedlot practice. Assessing and managing pain and welfare for these procedures has strengthened significantly over the past decade to address increased public concerns and also to support the desires of the operators/managers to progress. Methods to perform common procedures are described, including evidence and techniques for managing the pain and distress while performing them. Published by Elsevier Inc.

Journal of Special Operations Medicine. Training Supplement to Fall 2008. Tactics, Techniques, and Procedures

DTIC Science & Technology

2008-01-01

Special Operations Medicine Staphylococcus, E. coli, and alimentary tract anaerobes (AI). Initial antibacterial activity should not be directed at multidrug... active service. 6. Hospital ships (T-AH) may provide support to major amphibious operations or be designated as a theater-level 3 support capability...USSOCOM is actively engaged in the JLLP, where the goal is to improve interoperability between all LL centers in the community of practice to enhance

Direct cost comparison of minimally invasive punch technique versus traditional approaches for percutaneous bone anchored hearing devices.

PubMed

Sardiwalla, Yaeesh; Jufas, Nicholas; Morris, David P

2017-06-12

Minimally Invasive Ponto Surgery (MIPS) was recently described as a new technique to facilitate the placement of percutaneous bone anchored hearing devices. The procedure has resulted in a simplification of the surgical steps and a dramatic reduction in surgical time while maintaining excellent patient outcomes. Given these developments, our group sought to move the procedure from the main operating suite where they have traditionally been performed. This study aims to test the null hypothesis that MIPS and open approaches have the same direct costs for the implantation of percutaneous bone anchored hearing devices in a Canadian public hospital setting. A retrospective direct cost comparison of MIPS and open approaches for the implantation of bone conduction implants was conducted. Indirect and future costs were not included in the fiscal analysis. A simple cost comparison of the two approaches was made considering time, staff and equipment needs. All 12 operations were performed on adult patients from 2013 to 2016 by the same surgeon at a single hospital site. MIPS has a total mean reduction in cost of CAD$456.83 per operation from the hospital perspective when compared to open approaches. The average duration of the MIPS operation was 7 min, which is on average 61 min shorter compared with open approaches. The MIPS technique was more cost effective than traditional open approaches. This primarily reflects a direct consequence of a reduction in surgical time, with further contributions from reduced staffing and equipment costs. This simple, quick intervention proved to be feasible when performed outside the main operating room. A blister pack of required equipment could prove convenient and further reduce costs.

Catheter-Directed Thrombolysis

MedlinePlus

... in the operating room. You will be positioned on the examining table. You may be connected to monitors that track your heart rate, blood pressure and pulse during the procedure. A nurse or technologist will insert an intravenous (IV) line into a ...

Logistics Management Systems in Desert Shield/Desert Storm - How Well Did They Do?

DTIC Science & Technology

1992-04-07

were grovped into five major categories: Containerization and Packaging; Distribution Management ; Automation/Communications; Peace versus War Operations...incorporated into normal operating procedures. Distribution ManaQement. Distribution management was plagued with confusion throughout DS\\DS. This...to carrier terminals, depots and vendors. TDS recommendations to address the distribution management issue focused on: 1. Authorization of direct

Launch COLA Operations: An Examination of Data Products, Procedures, and Thresholds

NASA Technical Reports Server (NTRS)

Hejduk, M. D.; Plakalovic, D.; Hametz, M. E.; Newman, L. K.; Ollivierre, J. C.; Beaver, B. A.; Thompson, R. C.

2015-01-01

NASA GSFC and KSC, acting in response to headquarters NASA direction, performed a year-long study of launch collision avoidance (LCOLA) operations in order to determine and recommend best risk assessment and mitigation practices. The following condenses the findings and recommendations of the study into one short summary, a more expanded version of which appears as Section 10.

Preintervention lesion remodelling affects operative mechanisms of balloon optimised directional coronary atherectomy procedures: a volumetric study with three dimensional intravascular ultrasound

PubMed Central

von Birgelen, C; Mintz, G; de Vrey, E A; Serruys, P; Kimura, T; Nobuyoshi, M; Popma, J; Leon, M; Erbel, R; de Feyter, P J

2000-01-01

AIMS—To classify atherosclerotic coronary lesions on the basis of adequate or inadequate compensatory vascular enlargement, and to examine changes in lumen, plaque, and vessel volumes during balloon optimised directional coronary atherectomy procedures in relation to the state of adaptive remodelling before the intervention.
DESIGN—29 lesion segments in 29 patients were examined with intravascular ultrasound before and after successful balloon optimised directional coronary atherectomy procedures, and a validated volumetric intravascular ultrasound analysis was performed off-line to assess the atherosclerotic lesion remodelling and changes in plaque and vessel volumes that occurred during the intervention. Based on the intravascular ultrasound data, lesions were classified according to whether there was inadequate (group I) or adequate (group II) compensatory enlargement.
RESULTS—There was no significant difference in patient and lesion characteristics between groups I and II (n = 10 and 19), including lesion length and details of the intervention. Quantitative coronary angiographic data were similar for both groups. However, plaque and vessel volumes were significantly smaller in group I than in II. In group I, 9 (4)% (mean (SD)) of the plaque volume was ablated, while in group II 16 (11)% was ablated (p = 0.01). This difference was reflected in a lower lumen volume gain in group I than in group II (46 (18) mm3 v 80 (49) mm3 (p < 0.02)).
CONCLUSIONS—Preintervention lesion remodelling has an impact on the operative mechanisms of balloon optimised directional coronary atherectomy procedures. Plaque ablation was found to be particularly low in lesions with inadequate compensatory vascular enlargement.


Keywords: intravascular ultrasound; ultrasonics; remodelling; coronary artery disease; atherectomy PMID:10648496

Cost Accounting as a Tool for Increasing Cost Transparency in Selective Hepatic Transarterial Chemoembolization.

PubMed

Ahmed, Osman; Patel, Mikin; Ward, Thomas; Sze, Daniel Y; Telischak, Kristen; Kothary, Nishita; Hofmann, Lawrence V

2015-12-01

To increase cost transparency and uncover potential areas for savings in patients receiving selective transarterial chemoembolization at a tertiary care academic center. The hospital cost accounting system charge master sheet for direct and total costs associated with selective transarterial chemoembolization in fiscal years 2013 and 2014 was queried for each of the four highest volume interventional radiologists at a single institution. There were 517 cases (range, 83-150 per physician) performed; direct costs incurred relating to care before, during, and after the procedure with respect to labor, supply, and equipment fees were calculated. A median of 48 activity codes were charged per selective transarterial chemoembolization from five cost centers, represented by the angiography suite, units for care before and after the procedure, pharmacy, and observation floors. The average direct cost of selective transarterial chemoembolization did not significantly differ among operators at $9,126.94, $8,768.77, $9,027.33, and $8,909.75 (P = .31). Intraprocedural costs accounted for 82.8% of total direct costs and provided the greatest degree in cost variability ($7,268.47-$7,691.27). The differences in intraprocedural expense among providers were not statistically significant (P = .09), even when separated into more specific procedure-related labor and supply costs. Cost accounting systems could effectively be interrogated as a method for calculating direct costs associated with selective transarterial chemoembolization. The greatest source of expenditure and variability in cost among providers was shown to be intraprocedural labor and supplies, although the effect did not appear to be operator dependent. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

PubMed Central

Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P < .05) and greater in the following costs: hospital operating direct cost (29.2% greater), hospital operating total cost (28.8% greater), direct hospital cost (24.7% greater), and total hospital cost (26.4% greater). Conclusions Based on greater hospital operating direct cost, hospital operating total cost, direct hospital cost, and total hospital cost, conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

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

PubMed

Chen, Yalin; Campbell, Jamie I D

2016-04-01

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

An English language interface for constrained domains

NASA Technical Reports Server (NTRS)

Page, Brenda J.

1989-01-01

The Multi-Satellite Operations Control Center (MSOCC) Jargon Interpreter (MJI) demonstrates an English language interface for a constrained domain. A constrained domain is defined as one with a small and well delineated set of actions and objects. The set of actions chosen for the MJI is from the domain of MSOCC Applications Executive (MAE) Systems Test and Operations Language (STOL) directives and contains directives for signing a cathode ray tube (CRT) on or off, calling up or clearing a display page, starting or stopping a procedure, and controlling history recording. The set of objects chosen consists of CRTs, display pages, STOL procedures, and history files. Translation from English sentences to STOL directives is done in two phases. In the first phase, an augmented transition net (ATN) parser and dictionary are used for determining grammatically correct parsings of input sentences. In the second phase, grammatically typed sentences are submitted to a forward-chaining rule-based system for interpretation and translation into equivalent MAE STOL directives. Tests of the MJI show that it is able to translate individual clearly stated sentences into the subset of directives selected for the prototype. This approach to an English language interface may be used for similarly constrained situations by modifying the MJI's dictionary and rules to reflect the change of domain.

75 FR 67634 - Parts and Accessories Necessary for Safe Operation: Antilock Brake Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... trailer with an antilock brake system be equipped with an external malfunction indicator lamp. DATES: This... malfunction indicator lamp. FMCSA used the Agency's direct final rule procedures (75 FR 29915, May 28, 2010...

242A Distributed Control System Year 2000 Acceptance Test Report

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

TEATS, M.C.

1999-08-31

This report documents acceptance test results for the 242-A Evaporator distributive control system upgrade to D/3 version 9.0-2 for year 2000 compliance. This report documents the test results obtained by acceptance testing as directed by procedure HNF-2695. This verification procedure will document the initial testing and evaluation of the potential 242-A Distributed Control System (DCS) operating difficulties across the year 2000 boundary and the calendar adjustments needed for the leap year. Baseline system performance data will be recorded using current, as-is operating system software. Data will also be collected for operating system software that has been modified to correct yearmore » 2000 problems. This verification procedure is intended to be generic such that it may be performed on any D/3{trademark} (GSE Process Solutions, Inc.) distributed control system that runs with the VMSTM (Digital Equipment Corporation) operating system. This test may be run on simulation or production systems depending upon facility status. On production systems, DCS outages will occur nine times throughout performance of the test. These outages are expected to last about 10 minutes each.« less

Evaluating Stimulus-Stimulus Pairing and Direct Reinforcement in the Establishment of an Echoic Repertoire of Children Diagnosed with Autism

PubMed Central

Esch, Barbara E; Carr, James E; Michael, Jack

2005-01-01

Many children with autism do not imitate adult vocalizations, an important skill in learning to talk. Pairing adult vocalizations with preferred stimuli has been shown to increase free-operant vocalizations but effects are temporary; thus, direct reinforcement may be necessary to establish durable vocal behaviors. In Experiment 1, directly reinforced echoic responses did not increase following stimulus-stimulus pairings in three children with autism. Similarly, pairings did not increase free-operant vocalizations in Experiment 2, a replication of Miguel et al. (2002). Experiment 3 demonstrated that shaping increased vowel frequency for one participant. Results suggest that variables are yet to be delineated that influence effectiveness of a stimulus-stimulus pairing procedure on vocalization frequency and acquisition of a verbal operant following such pairings. PMID:22477313

Effect of Direct Ligament Repair and Tenodesis Reconstruction on Simulated Subtalar Joint Instability.

PubMed

Choisne, Julie; Hoch, Matthew C; Alexander, Ian; Ringleb, Stacie I

2017-03-01

Subtalar instability is associated with up to 80% of patients presenting with chronic ankle instability but is often not considered in the diagnosis or treatment. Operative procedures to repair ankle instability have shown good clinical results, but the effects of these reconstruction procedures on isolated subtalar instability are not well understood. The goal of this study was to investigate the effect of the Gould modification of the Broström procedure and a new tenodesis reconstruction procedure on ankle and subtalar joint kinematics after simulating a subtalar injury. Kinematic data were collected on 7 cadaveric ankles during inversion through the range of ankle flexion and during internal rotation. Testing was performed on the intact foot; after sectioning the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament; after the Gould modification of the Broström procedure was performed; and after tenodesis was performed and sutures from the Gould modification removed. The Gould modification of the Broström procedure significantly decreased subtalar and ankle inversion motion and subtalar internal rotation compared to the unstable condition. The tenodesis method restricted internal rotation at the subtalar joint and ankle inversion compared to the intact state. Both operative procedures improved stability of the ankle complex, but tenodesis was unable to restore subtalar inversion and restricted ankle inversion in maximum plantarflexion. The Gould modification of Broström ligament repair may be a favorable operative procedure for the restoration of subtalar and ankle joint kinematics.

Safe Operation of Mobile Unmanned Ground Vehicle (UGV) Systems

DTIC Science & Technology

2010-07-13

vehicle could go during uncommanded movement and full throttle acceleration. 4. TEST PROCEDURES. 4.1 Vehicle Subsystem Tests. These tests identify...time required to go from straight ahead to full deflection in one direction. (sec) i. Observations on ability of the remote operator to maintain...were well below the lateral acceleration limits of the vehicle resulting in very predictable handling traits. The primary concern , albeit subjective

Effect of the full implementation of the European Working Time Directive on operative training in adult cardiac surgery.

PubMed

Mahesh, Balakrishnan; Sharples, Linda; Codispoti, Massimiliano

2014-01-01

Surgical specialties rely on practice and apprenticeship to acquire technical skills. In 2009, the final reduction in working hours to 48 per week, in accordance with the European Working Time Directive (EWTD), has also led to an expansion in the number of trainees. We examined the effect of these changes on operative training in a single high-volume [>1500 procedures/year] adult cardiac surgical center. Setting: A single high-volume [>1500 procedures/year] adult cardiac surgical center. Design: Consecutive data were prospectively collected into a database and retrospectively analyzed. Procedures and Main Outcome Measures: Between January 2006 and August 2010, 6688 consecutive adult cardiac surgical procedures were analyzed. The proportion of cases offered for surgical training were compared for 2 non-overlapping consecutive time periods: 4504 procedures were performed before the final implementation of the EWTD (Phase 1: January 2006-December 2008) and 2184 procedures after the final implementation of the EWTD (Phase 2: January 2009-August 2010). Other predictors of training considered in the analysis were grade of trainee, logistic European system for cardiac operative risk evaluation (EuroSCORE), type of surgical procedure, weekend or late procedure, and consultant. Logistic regression analysis was used to determine the predictors of training cases (procedure performed by trainee) and to evaluate the effect of the EWTD on operative surgical training after correcting for confounding factors. Proportion of training cases rose from 34.6% (1558/4504) during Phase 1 to 43.6% (953/2184) in Phase 2 (p < 0.0001), despite higher mean logistic EuroSCORE [4.29 (6.8) during Phase 1 vs 4.95 (7.2) during Phase 2, p < 0.0001] and higher proportion of cases performed out of hours [153 (3.4) during Phase 1 vs 116 (5.3) during Phase 2, p < 0.0001]. During Phase 1, senior trainees (last 2 years of training) performed 803 (17.8%) procedures, whereas other trainees (first 4 years of training) performed 755(16.8%) cases. During Phase 2, senior trainees performed 763 (34.9%) procedures, whereas other trainees performed 190 (8.7%) cases (p < 0.0001). Independent positive predictors of training cases emerging from the multivariable logistic regression model included consultant in charge, final EWTD, and senior trainees. Independent negative predictors of training cases included logistic EuroSCORE, out-of-hours' procedures, and surgery other than coronary artery bypass grafts. Implementation of the final phase of EWTD has not decreased training in a high-volume center. The positive adjustment of trainers' attitudes and efforts to match trainees' needs allow maintenance of adequate training, despite reduction in working hours and increasing patients' risk profile. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

23 CFR 630.1002 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1002 Purpose. Work zones directly impact the safety and mobility of road users and highway workers. These safety and mobility impacts are exacerbated by an aging...

23 CFR 630.1002 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1002 Purpose. Work zones directly impact the safety and mobility of road users and highway workers. These safety and mobility impacts are exacerbated by an aging...

23 CFR 630.1002 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1002 Purpose. Work zones directly impact the safety and mobility of road users and highway workers. These safety and mobility impacts are exacerbated by an aging...

12 CFR 792.51 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... appeals must be made directly to the other agency. (b) Handling and safeguarding national security... in relation to materials classified for national security purposes. [63 FR 14338, Mar. 25, 1998, as... Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT...

12 CFR 792.51 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... appeals must be made directly to the other agency. (b) Handling and safeguarding national security... in relation to materials classified for national security purposes. [63 FR 14338, Mar. 25, 1998, as... Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT...

12 CFR 792.51 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... appeals must be made directly to the other agency. (b) Handling and safeguarding national security... in relation to materials classified for national security purposes. [63 FR 14338, Mar. 25, 1998, as... Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT...

Prescription Drugs: Comparison of DOD, Medicaid, and Medicare Part D Retail Reimbursement Prices

DTIC Science & Technology

2014-06-01

information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215...Medicaid Services DIR direct and indirect remuneration DOD Department of Defense FCP federal ceiling price HCPCS Healthcare Common Procedure...prices, we used PDTS data from DOD; unit rebate amount (URA) and CMS-64 data from Medicaid; and the 2010 Direct and Indirect Remuneration (DIR

Knowledge engineering for temporal dependency networks as operations procedures. [in space communication

NASA Technical Reports Server (NTRS)

Fayyad, Kristina E.; Hill, Randall W., Jr.; Wyatt, E. J.

1993-01-01

This paper presents a case study of the knowledge engineering process employed to support the Link Monitor and Control Operator Assistant (LMCOA). The LMCOA is a prototype system which automates the configuration, calibration, test, and operation (referred to as precalibration) of the communications, data processing, metric data, antenna, and other equipment used to support space-ground communications with deep space spacecraft in NASA's Deep Space Network (DSN). The primary knowledge base in the LMCOA is the Temporal Dependency Network (TDN), a directed graph which provides a procedural representation of the precalibration operation. The TDN incorporates precedence, temporal, and state constraints and uses several supporting knowledge bases and data bases. The paper provides a brief background on the DSN, and describes the evolution of the TDN and supporting knowledge bases, the process used for knowledge engineering, and an analysis of the successes and problems of the knowledge engineering effort.

Quantitative analysis of intraoperative communication in open and laparoscopic surgery.

PubMed

Sevdalis, Nick; Wong, Helen W L; Arora, Sonal; Nagpal, Kamal; Healey, Andrew; Hanna, George B; Vincent, Charles A

2012-10-01

Communication is important for patient safety in the operating room (OR). Several studies have assessed OR communications qualitatively or have focused on communication in crisis situations. This study used prospective, quantitative observation based on well-established communication theory to assess similarities and differences in communication patterns between open and laparoscopic surgery. Based on communication theory, a standardized proforma was developed for assessment in the OR via real-time observation of communication types, their purpose, their content, and their initiators/recipients. Data were collected prospectively in real time in the OR for 20 open and 20 laparoscopic inguinal hernia repairs. Assessors were trained and calibrated, and their reliability was established statistically. During 1,884 min of operative time, 4,227 communications were observed and analyzed (2,043 laparoscopic vs 2,184 open communications). The mean operative duration (laparoscopic, 48 min vs open, 47 min), mean communication frequency (laparoscopic, 102 communications/procedure vs open, 109 communications/procedure), and mean communication rate (laparoscopic, 2.13 communications/min vs open, 2.23 communications/min) did not differ significantly across laparoscopic and open procedures. Communications were most likely to be initiated by surgeons (80-81 %), to be received by either other surgeons (46-50%) or OR nurses (38-40 %), to be associated with equipment/procedural issues (39-47 %), and to provide direction for the OR team (38-46%) in open and laparoscopic cases. Moreover, communications in laparoscopic cases were significantly more equipment related (laparoscopic, 47 % vs open, 39 %) and aimed significantly more at providing direction (laparoscopic, 46 % vs open, 38 %) and at consulting (laparoscopic, 17 % vs open, 12 %) than at sharing information (laparoscopic, 17 % vs open, 31 %) (P < 0.001 for all). Numerous intraoperative communications were found in both laparoscopic and open cases during a relatively low-risk procedure (average, 2 communications/min). In the observed cases, surgeons actively directed and led OR teams in the intraoperative phase. The lack of communication between surgeons and anesthesiologists ought to be evaluated further. Simple, inexpensive interventions shown to streamline intraoperative communication and teamworking (preoperative briefing, surgeons' mental practice) should be considered further.

Surgical “Buy-in”: the Contractual Relationship between Surgeons and Patients that Influences Decisions Regarding Life-Supporting Therapy

PubMed Central

Schwarze, Margaret L.; Bradley, Ciaran T.; Brasel, Karen J.

2011-01-01

Context There is a general consensus by intensivists and non-surgical providers that surgeons hesitate to withdraw life-sustaining therapy on their operative patients despite a patient’s or surrogate’s request to do so. Objective To examine the culture and practice of surgeons in order to assess attitudes and concerns regarding advance directives for their patients who have high-risk surgical procedures. Design A qualitative investigation using one-on-one, in-person interviews with open-ended questions about the use of advance directives during peri-operative planning. Consensus coding was performed using a grounded theory approach. Data accrual continued until theoretical saturation was achieved. Modeling identified themes and trends, ensuring maximal fit and faithful data representation. Setting Surgical practices in Madison and Milwaukee, Wisconsin. Subjects Physicians involved in the performance of high risk surgical procedures. Main Results We describe here the concept of surgical “buy-in”: a complex process by which surgeons negotiate with patients a commitment to post-operative care prior to undertaking high-risk surgical procedures. Surgeons describe seeking a commitment from the patient to abide prescribed postoperative care: “This is a package deal, this is what this operation entails.” or a specific number of postoperative days: “I will contract with them and say look if we are going to do this I am going to need thirty days to get you through this operation.” “Buy-in” is grounded in surgeons’ strong sense of responsibility for surgical outcomes and can lead to surgeon unwillingness to operate or surgeon reticence to withdraw life-sustaining therapy post-operatively. If negotiations regarding life-sustaining interventions result in treatment limitation, surgeons may shift responsibility for unanticipated outcomes to the patient. Conclusions A complicated relationship exists between surgeon and patient that begins in the preoperative setting. It reflects a bidirectional contract that is assumed by the surgeon with distinct implications and consequences for surgeon behavior and patient care. PMID:20048678

NRL Fact Book

DTIC Science & Technology

1976-07-01

Systems Division ......... ........................ 60 Oceanology Area ........... ............................ 62 Shipboard Computing Group...directed toward new and improved materials, equipment, techniques, systems , and related operational procedures for the Navy. In fulfillment of this...Within areas of technological expertise, develops prototype systems applicable to specific projects. (d) Performs scientific research development for

The Objective of Financial Reporting.

ERIC Educational Resources Information Center

Schermann, Kenneth R.

1986-01-01

Alerts public school business officials to a financial reporting concepts statement to be issued by the Governmental Accounting Standards Board in late 1986. The new directive will outline four objectives concerned with accountability procedures, resource management and compliance information, operating results, and future financial capabilities.…

Computerizing Maintenance Management Improves School Processes.

ERIC Educational Resources Information Center

Conroy, Pat

2002-01-01

Describes how a Computerized Maintenance Management System (CMMS), a centralized maintenance operations database that facilitates work order procedures and staff directives, can help individual school campuses and school districts to manage maintenance. Presents the benefits of CMMS and things to consider in CMMS selection. (EV)

7 CFR 2610.2 - Headquarters organization.

Code of Federal Regulations, 2013 CFR

2013-01-01

... units. (b) Operational units. (1) The Assistant Inspector General for Policy Development and Resources Management (AIG/PD&RM) formulates OIG policies and procedures; develops, administers and directs... action. The immediate office of the AIG/PD&RM and two divisions carry out these functions. (2) The...

7 CFR 2610.2 - Headquarters organization.

Code of Federal Regulations, 2012 CFR

2012-01-01

... units. (b) Operational units. (1) The Assistant Inspector General for Policy Development and Resources Management (AIG/PD&RM) formulates OIG policies and procedures; develops, administers and directs... action. The immediate office of the AIG/PD&RM and two divisions carry out these functions. (2) The...

Coordinate Systems, Numerical Objects and Algorithmic Operations of Computational Experiment in Fluid Mechanics

NASA Astrophysics Data System (ADS)

Degtyarev, Alexander; Khramushin, Vasily

2016-02-01

The paper deals with the computer implementation of direct computational experiments in fluid mechanics, constructed on the basis of the approach developed by the authors. The proposed approach allows the use of explicit numerical scheme, which is an important condition for increasing the effciency of the algorithms developed by numerical procedures with natural parallelism. The paper examines the main objects and operations that let you manage computational experiments and monitor the status of the computation process. Special attention is given to a) realization of tensor representations of numerical schemes for direct simulation; b) realization of representation of large particles of a continuous medium motion in two coordinate systems (global and mobile); c) computing operations in the projections of coordinate systems, direct and inverse transformation in these systems. Particular attention is paid to the use of hardware and software of modern computer systems.

Orbital transfer vehicle concept definition and system analysis study. Volume 4, Appendix A: Space station accommodations. Revision 1

NASA Technical Reports Server (NTRS)

Randall, Roger M.

1987-01-01

Orbit Transfer Vehicle (OTV) processing at the space station is divided into two major categories: OTV processing and assembly operations, and support operations. These categories are further subdivided into major functional areas to allow development of detailed OTV processing procedures and timelines. These procedures and timelines are used to derive the specific space station accommodations necessary to support OTV activities. The overall objective is to limit impact on OTV processing requirements on space station operations, involvement of crew, and associated crew training and skill requirements. The operational concept maximizes use of automated and robotic systems to perform all required OTV servicing and maintenance tasks. Only potentially critical activities would require direct crew involvement or supervision. EVA operations are considered to be strictly contingency back-up to failure of the automated and robotic systems, with the exception of the initial assembly of Space-Based OTV accommodations at the space station, which will require manned involvement.

Repair or replacement of defective direct resin-based composite restorations: contemporary teaching in U.S. and Canadian dental schools.

PubMed

Lynch, Christopher D; Blum, Igor R; Frazier, Kevin B; Haisch, Larry D; Wilson, Nairn H F

2012-02-01

Opportunities exist to promote minimally invasive dentistry by repairing rather than replacing defective and failing direct resin-based composite restorations. The authors conducted a study to investigate the current teaching of such techniques in U.S. and Canadian dental schools. In late 2010, the authors, with the assistance of the Consortium of Operative Dentistry Educators, invited 67 U.S. and Canadian dental schools to participate in an Internet-based survey. The response rate was 72 percent. Eighty-eight percent of the dental schools taught repair of defective direct resin-based composite restorations. Of these schools, 79 percent reported providing both didactic and clinical teaching. Although teaching repair of defective resin-based composite restorations was included in the didactic curricula of most schools, students in some schools did not gain experience in minimally invasive management of defective resin-based composite restorations by means of performing repair procedures. The American Dental Association's Code on Dental Procedures and Nomenclature does not have a procedure code for resin-based composite restoration repairs, which may limit patients' access to this dental treatment. Teaching dental students minimally invasive dentistry procedures, including restoration repair, extends the longevity of dental restorations and reduces detrimental effects on teeth induced by invasive procedures, thereby serving the interests of patients.

Multinational Experiment 7. Outcome 3 - Cyber Domain Objective 3.4: Cyber Situational Awareness Standard Operating Procedure

DTIC Science & Technology

2012-12-01

and activity coordination (for example, SOC management ). 10. In Reference D the information sharing framework represents a hub & node model in... management , vulnerabilities, critical assets, threats, impacts on operations etc. UNCLASSIFIED UNCLASSIFIED 6 PART 3 - CYBER SITUATIONAL AWARENESS...limit the effect of cyber incidents. 23. Tasks of the SOC include: • System maintenance and management including applying the directed security

Engineering Guide for Fire Protection and Detection Systems at Army Ammunition Plants. Volume 1. Selection and Design

DTIC Science & Technology

1980-12-01

type of personnel likely to he using them, (3) the physical environment , (4) health and operational safety considerations. Carefully selected portable...operated apparatus must have the battery and energy-limiting components located outside the hazardous environment , and be so constructed that a direct...designate effect on equipment or personnel), based upon the most severe result of personnel error, procedural deficiencies, environment , design

Contracts and management services site support program plan WBS 6.10.14

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

Knoll, J.M. Jr.

1994-09-01

Contracts and Management Services is recognized as the central focal point for programs having company or sitewide application in pursuit of the Hanford Missions`s financial and operational objectives. Contracts and Management Services actively pursues cost savings and operational efficiencies through: Management Standards by ensuring all employees have an accessible, integrated system of clear, complete, accurate, timely, and useful management control policies and procedures; Contract Reform by restructuring the contract, organization, and cost accounting systems to refocus Hanford contract activities on output products; Systems and Operations Evaluation by directing the Cost Reduction program, Great Ideas, and Span of Management activities; Programmore » Administration by enforcing conditions of Accountability (whether DEAR-based or FAR-based) for WHC, BCSR, ICF KH, and BHI; Contract Performance activities; chairing the WHC Cost Reduction Review Board; and analyzing companywide Performance Measures; Data Standards and Administration by establishing and directing the company data management program; giving direction to the major RL programs and mission areas for implementation of cost-effective and efficient data management practices; directing all operations, application, and interfaces contained within the Hanford PeopleCore System; directing accomplishment and delivery of TPA data management milestones; and directing the sitewide data management processes for Data Standards and the Data Directory.« less

12 CFR 48.13 - Trading and operational standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... controls required. A national bank engaging in retail forex transactions must establish and implement internal policies, procedures, and controls designed, at a minimum, to: (1) Ensure, to the extent... orders, directly or indirectly, with another person in a manner designed to circumvent the provisions of...

12 CFR 48.13 - Trading and operational standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... controls required. A national bank engaging in retail forex transactions must establish and implement internal policies, procedures, and controls designed, at a minimum, to: (1) Ensure, to the extent... orders, directly or indirectly, with another person in a manner designed to circumvent the provisions of...

12 CFR 48.13 - Trading and operational standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... controls required. A national bank engaging in retail forex transactions must establish and implement internal policies, procedures, and controls designed, at a minimum, to: (1) Ensure, to the extent... orders, directly or indirectly, with another person in a manner designed to circumvent the provisions of...

Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting.

PubMed

Matsui, Yusuke; Hiraki, Takao; Gobara, Hideo; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Kawabata, Takahiro; Yamauchi, Takatsugu; Yamaguchi, Takuya; Kanazawa, Susumu

2016-06-01

Computed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking. Radiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator's finger skin was measured using thermoluminescent dosimeter rings. The mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator's finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA. Radiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

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.

Design Guidelines and Criteria for User/Operator Transactions with Battlefield Automated Systems. Volume 2. Technical Discussion

DTIC Science & Technology

1981-02-01

Continue on tevetee «Id* If necemtery mid Identify br black number) Battlefield automated systems Human- computer interaction. Design criteria System...Report (this report) In-Depth Analyses of Individual Systems A. Tactical Fire Direction System (TACFIRE) (RP 81-26) B. Tactical Computer Terminal...select the design features and operating procedures of the human- computer Interface which best match the require- ments and capabilities of anticipated

Modeling and analysis of the space shuttle nose-gear tire with semianalytic finite elements

NASA Technical Reports Server (NTRS)

Kim, Kyun O.; Noor, Ahmed K.; Tanner, John A.

1990-01-01

A computational procedure is presented for the geometrically nonlinear analysis of aircraft tires. The Space Shuttle Orbiter nose gear tire was modeled by using a two-dimensional laminated anisotropic shell theory with the effects of variation in material and geometric parameters included. The four key elements of the procedure are: (1) semianalytic finite elements in which the shell variables are represented by Fourier series in the circumferential direction and piecewise polynominals in the meridional direction; (2) a mixed formulation with the fundamental unknowns consisting of strain parameters, stress-resultant parameters, and generalized displacements; (3) multilevel operator splitting to effect successive simplifications, and to uncouple the equations associated with different Fourier harmonics; and (4) multilevel iterative procedures and reduction techniques to generate the response of the shell. Numerical results of the Space Shuttle Orbiter nose gear tire model are compared with experimental measurements of the tire subjected to inflation loading.

32 CFR 260.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., signifying its agreement or alternate selection of a location and its selection of type of vending facility... owned building in which the lessor or any of its tenants have an existing restaurant or other food... substantial direct competition with such restaurant or other food operation, the requirement to provide a...

12 CFR 349.13 - Trading and operational standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... controls designed, at a minimum, to: (1) Ensure, to the extent reasonable, that each order received from a...) Internal rules, procedures, and controls required. An FDIC-supervised insured depository institution... related persons from placing orders, directly or indirectly, with another person in a manner designed to...

12 CFR 349.13 - Trading and operational standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... controls designed, at a minimum, to: (1) Ensure, to the extent reasonable, that each order received from a...) Internal rules, procedures, and controls required. An FDIC-supervised insured depository institution... related persons from placing orders, directly or indirectly, with another person in a manner designed to...

12 CFR 349.13 - Trading and operational standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... controls designed, at a minimum, to: (1) Ensure, to the extent reasonable, that each order received from a...) Internal rules, procedures, and controls required. An FDIC-supervised insured depository institution... related persons from placing orders, directly or indirectly, with another person in a manner designed to...

23 CFR 660.505 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Scope. 660.505 Section 660.505 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.505 Scope. This regulation focuses on procedures as they apply to the defense...

23 CFR 660.505 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Scope. 660.505 Section 660.505 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.505 Scope. This regulation focuses on procedures as they apply to the defense...

23 CFR 660.505 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Scope. 660.505 Section 660.505 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.505 Scope. This regulation focuses on procedures as they apply to the defense...

23 CFR 660.505 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Scope. 660.505 Section 660.505 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.505 Scope. This regulation focuses on procedures as they apply to the defense...

23 CFR 660.505 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Scope. 660.505 Section 660.505 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS SPECIAL PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.505 Scope. This regulation focuses on procedures as they apply to the defense...

Parallel noise barrier prediction procedure : report 2 user's manual revision 1

DOT National Transportation Integrated Search

1987-11-01

This report defines the parameters which are used to input the data required to run Program Barrier and BarrierX on a microcomputer such as an IBM PC or compatible. Directions for setting up and operating a working disk are presented. Examples of inp...

Safer Soldering Guidelines and Instructional Resources

ERIC Educational Resources Information Center

Love, Tyler S.; Tomlinson, Joel

2018-01-01

Soldering is a useful and necessary process for many classroom, makerspace, Fab Lab, technology and engineering lab, and science lab activities. As described in this article, soldering can pose many safety risks without proper engineering controls, standard operating procedures, and direct instructor supervision. There are many safety hazards…

Cost accounting in radiation oncology: a computer-based model for reimbursement.

PubMed

Perez, C A; Kobeissi, B; Smith, B D; Fox, S; Grigsby, P W; Purdy, J A; Procter, H D; Wasserman, T H

1993-04-02

The skyrocketing cost of medical care in the United States has resulted in multiple efforts in cost containment. The present work offers a rational computer-based cost accounting approach to determine the actual use of resources in providing a specific service in a radiation oncology center. A procedure-level cost accounting system was developed by using recorded information on actual time and effort spent by individual staff members performing various radiation oncology procedures, and analyzing direct and indirect costs related to staffing (labor), facilities and equipment, supplies, etc. Expenditures were classified as direct or indirect and fixed or variable. A relative value unit was generated to allocate specific cost factors to each procedure. Different costs per procedure were identified according to complexity. Whereas there was no significant difference in the treatment time between low-energy (4 and 6 MV) or high-energy (18 MV) accelerators, there were significantly higher costs identified in the operation of a high-energy linear accelerator, a reflection of initial equipment investment, quality assurance and calibration procedures, maintenance costs, service contract, and replacement parts. Utilization of resources was related to the complexity of the procedures performed and whether the treatments were delivered to inpatients or outpatients. In analyzing time motion for physicians and other staff, it was apparent that a greater effort must be made to train the staff to accurately record all times involved in a given procedure, and it is strongly recommended that each institution perform its own time motion studies to more accurately determine operating costs. Sixty-six percent of our facility's global costs were for labor, 20% for other operating expenses, 10% for space, and 4% for equipment. Significant differences were noted in the cost allocation for professional or technical functions, as labor, space, and equipment costs are higher in the latter. External beam treatment-related procedures accounted for more than 50% of all technical and professional revenues, simulation for 8% to 10%, and other physics/dosimetry procedures for 11% to 14% of revenues. Some discrepancies were identified between the actual cost and level of reimbursement of various procedures. Details are described in the manuscript. It is imperative to develop an equitable reimbursement system for radiation oncology services, based on cost accounting and other measures that may enhance productivity and reduce the cost per procedure unit, while at the same time preserving the highest quality of service provided to patients.

Operational Interventions to Maintenance Error

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.; Walter, Diane; Dulchinos, VIcki

1997-01-01

A significant proportion of aviation accidents and incidents are known to be tied to human error. However, research of flight operational errors has shown that so-called pilot error often involves a variety of human factors issues and not a simple lack of individual technical skills. In aircraft maintenance operations, there is similar concern that maintenance errors which may lead to incidents and accidents are related to a large variety of human factors issues. Although maintenance error data and research are limited, industry initiatives involving human factors training in maintenance have become increasingly accepted as one type of maintenance error intervention. Conscientious efforts have been made in re-inventing the team7 concept for maintenance operations and in tailoring programs to fit the needs of technical opeRAtions. Nevertheless, there remains a dual challenge: 1) to develop human factors interventions which are directly supported by reliable human error data, and 2) to integrate human factors concepts into the procedures and practices of everyday technical tasks. In this paper, we describe several varieties of human factors interventions and focus on two specific alternatives which target problems related to procedures and practices; namely, 1) structured on-the-job training and 2) procedure re-design. We hope to demonstrate that the key to leveraging the impact of these solutions comes from focused interventions; that is, interventions which are derived from a clear understanding of specific maintenance errors, their operational context and human factors components.

Reduction of Maintenance Error Through Focused Interventions

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.; Walter, Diane; Rosekind, Mark R. (Technical Monitor)

1997-01-01

It is well known that a significant proportion of aviation accidents and incidents are tied to human error. In flight operations, research of operational errors has shown that so-called "pilot error" often involves a variety of human factors issues and not a simple lack of individual technical skills. In aircraft maintenance operations, there is similar concern that maintenance errors which may lead to incidents and accidents are related to a large variety of human factors issues. Although maintenance error data and research are limited, industry initiatives involving human factors training in maintenance have become increasingly accepted as one type of maintenance error intervention. Conscientious efforts have been made in re-inventing the "team" concept for maintenance operations and in tailoring programs to fit the needs of technical operations. Nevertheless, there remains a dual challenge: to develop human factors interventions which are directly supported by reliable human error data, and to integrate human factors concepts into the procedures and practices of everyday technical tasks. In this paper, we describe several varieties of human factors interventions and focus on two specific alternatives which target problems related to procedures and practices; namely, 1) structured on-the-job training and 2) procedure re-design. We hope to demonstrate that the key to leveraging the impact of these solutions comes from focused interventions; that is, interventions which are derived from a clear understanding of specific maintenance errors, their operational context and human factors components.

Cost Analysis of Spinal Versus General Anesthesia for Lumbar Diskectomy and Laminectomy Spine Surgery.

PubMed

Agarwal, Prateek; Pierce, John; Welch, William C

2016-05-01

Lumbar spine surgery can be performed using various anesthetic modalities, most notably general or spinal anesthesia. Because data comparing the cost of these anesthetic modalities in spine surgery are scarce, this study asks whether spinal anesthesia is less costly than general anesthesia. A total of 542 patients who underwent elective lumbar diskectomy or laminectomy spine surgery between 2007 and 2011 were retrospectively identified, with 364 having received spinal anesthesia and 178 having received general anesthesia. Mean direct operating cost, indirect cost (general support staff, insurance, taxes, floor space, facility, and administrative costs), and total cost were compared among patients who received general and spinal anesthesia. Linear multiple regression analysis was used to identify the effect of anesthesia type on cost and determine the factors underlying this effect, while controlling for patient and procedure characteristics. When controlling for patient and procedure characteristics, use of spinal anesthesia was associated with a 41.1% lower direct operating cost (-$3629 ± $343, P < 0.001), 36.6% lower indirect cost (-$1603 ± $168, P < 0.001), and 39.6% lower total cost (-$5232 ± $482, P < 0.001) compared with general anesthesia. Shorter hospital stay, shorter duration of anesthesia, shorter duration of operation, and lower estimated blood loss contributed to lower costs for spinal anesthesia, but other factors beyond these were also responsible for lower direct operating and total costs. When comparing the benefits of spinal and general anesthesia, spinal anesthesia is less costly when used in patients undergoing lumbar diskectomy and laminectomy spine surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

[Rectal carcinoma in a 24-year-old man with Hirschsprung's disease].

PubMed

Henriksen, Jeppe; Green, Charlotte; Ljungmann, Ken

2018-06-18

This case report presents an incident of rectal carcinoma in a 24-year-old man with Hirschsprung's disease, for which he was operated in his early childhood, with a Soave pull-through procedure. No direct association between Hirschsprung's disease and rectal cancer was found in our review of the literature. However, several case reports of rectal cancers following pull-through procedures exist. A low threshold for further clinical investigations is recommended, if these patients are presenting with gastrointestinal symptoms.

Novel Transparent Urinary Tract Simulator Improves Teaching of Urological Operation Skills at a Single Institution.

PubMed

Zhong, Xiao; Wang, Pingxian; Feng, Jiayu; Hu, Wengang; Huang, Chibing

2015-01-01

This randomized controlled study compared a novel transparent urinary tract simulator with the traditional opaque urinary tract simulator as an aid for efficiently teaching urological surgical procedures. Senior medical students were tested on their understanding of urological theory before and after lectures concerning urinary system disease. The students received operative training using the transparent urinary tract simulator (experimental group, n = 80) or the J3311 opaque plastic urinary tract simulator (control, n = 80), specifically in catheterization and retrograde double-J stent implantation. The operative training was followed by a skills test and student satisfaction survey. The test scores for theory were similar between the two groups, before and after training. Students in the experimental group performed significantly better than those in the control group on the procedural skills test, and also had significantly better self-directed learning skills, analytical skills, and greater motivation to learn. During the initial step of training, the novel transparent urinary tract simulator significantly improved the efficiency of teaching urological procedural skills compared with the traditional opaque device. © 2015 S. Karger AG, Basel.

Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis.

PubMed

Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A

2017-05-01

There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2015-01-01

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

The use of a reconstituted collagen foil dura mater substitute in paediatric neurosurgical procedures--experience in 47 patients.

PubMed

Pettorini, Benedetta Ludovica; Tamburrini, Gianpiero; Massimi, Luca; Paternoster, Giovanna; Caldarelli, Massimo; Di Rocco, Concezio

2010-02-01

CSF leakage is a common complication of neurosurgical procedures, with defective dural suture thought to be the most frequent cause. We report our experience with a new collagen foil (TissuDura, Baxter Healthcare SA, Switzerland) utilized as dural substitute in paediatric neurosurgical procedures. TissuDura was used in children consecutively operated on at the department of paediatric neurosurgery, Catholic University, Rome, from March 2004 to August 2007. Children underwent surgical procedures in supratentorial, infratentorial and spinal compartments. In supratentorial and spinal procedures, the dural graft was used according to the overlay technique. In the posterior fossa procedures, the underlay technique was used. Forty-seven patients received TissuDura during surgery. Thirty-one patients underwent surgery for the removal of posterior fossa tumours, nine for supratentorial tumours and seven for spinal dysraphisms. No CSF leakage was observed following the use of TissuDura in supratentorial procedures. Two post-operative CSF leaks occurred in patients who had undergone spinal surgery. No post-operative hydrocephalus was noted in these two surgery groups. Three cases of CSF leakage occurred in patients who had undergone posterior cranial fossa surgery. All 3 cases had an associated supratentorial ventricular dilation present prior to the removal of the tumour (one case) or occurring after the tumour excision (two cases). No clinically evident adverse reactions directly related to TissuDura were observed. The main advantages of TissuDura were its apparent ability to prevent CSF leakage when utilized in a specific subset of patients, and the absence of reactions or postoperative infections.

Test, Control and Monitor System (TCMS) operations plan

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

Efficacy of a radiation absorbing shield in reducing dose to the interventionalist during peripheral endovascular procedures: a single centre pilot study.

PubMed

Power, S; Mirza, M; Thakorlal, A; Ganai, B; Gavagan, L D; Given, M F; Lee, M J

2015-06-01

This prospective pilot study was undertaken to evaluate the feasibility and effectiveness of using a radiation absorbing shield to reduce operator dose from scatter during lower limb endovascular procedures. A commercially available bismuth shield system (RADPAD) was used. Sixty consecutive patients undergoing lower limb angioplasty were included. Thirty procedures were performed without the RADPAD (control group) and thirty with the RADPAD (study group). Two separate methods were used to measure dose to a single operator. Thermoluminescent dosimeter (TLD) badges were used to measure hand, eye, and unshielded body dose. A direct dosimeter with digital readout was also used to measure eye and unshielded body dose. To allow for variation between control and study groups, dose per unit time was calculated. TLD results demonstrated a significant reduction in median body dose per unit time for the study group compared with controls (p = 0.001), corresponding to a mean dose reduction rate of 65 %. Median eye and hand dose per unit time were also reduced in the study group compared with control group, however, this was not statistically significant (p = 0.081 for eye, p = 0.628 for hand). Direct dosimeter readings also showed statistically significant reduction in median unshielded body dose rate for the study group compared with controls (p = 0.037). Eye dose rate was reduced for the study group but this was not statistically significant (p = 0.142). Initial results are encouraging. Use of the shield resulted in a statistically significant reduction in unshielded dose to the operator's body. Measured dose to the eye and hand of operator were also reduced but did not reach statistical significance in this pilot study.

An implicit fast Fourier transform method for integration of the time dependent Schrodinger equation

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

Riley, M.E.; Ritchie, A.B.

1997-12-31

One finds that the conventional exponentiated split operator procedure is subject to difficulties when solving the time-dependent Schrodinger equation for Coulombic systems. By rearranging the kinetic and potential energy terms in the temporal propagator of the finite difference equations, one can find a propagation algorithm for three dimensions that looks much like the Crank-Nicholson and alternating direction implicit methods for one- and two-space-dimensional partial differential equations. The authors report investigations of this novel implicit split operator procedure. The results look promising for a purely numerical approach to certain electron quantum mechanical problems. A charge exchange calculation is presented as anmore » example of the power of the method.« less

Introducing a teaching module to impart communication skills in the learning anaesthesiologists

PubMed Central

Gadre, Vaijayanti Nitin; Kelkar, Kalpana V; Kelkar, Vidya S; Jamkar, Maya A

2015-01-01

Background and Aims: Pre-operative negative valence communications adversely affect intra and post-operative pain experience. This study was conducted to evaluate the teaching of communication skills by teachers in anaesthesia department and whether the post-operative pain is effectively modified due to the skill of communication acquired by students. Methods: All students and teachers in the department participated in the study. Patients with uncomplicated pregnancy posted for elective lower segment caesarean section were involved. Students were taught to explain the anaesthesia plan pre-operatively to the patients in a positive manner. They were taught the practice of giving positive suggestions before any potentially painful stimulus. Pre-operatively all students informed the patients about the conduct of spinal anaesthesia. The teachers evaluated the students performing spinal block. The performance was rated for procedural and interpersonal skills (direct observation of procedural skills [DOPS] and Smith and Kendall Behavioural scale [SKBS] respectively). The extent of cooperation and the ease with which spinal block could be administered correctly by the student was judged by the teacher. Post-operatively students were randomly provided questionnaires to elicit answers from patients. Results: P value DOPS and SKBS (0.567, 0.867) show no significant statistical variation. P > 0.05 = not significant, indicates no significant variation in procedural and behavioural skills of students in two groups. Conclusion: Teaching of communication skills to students showed a demonstrable effect on their pre-operative dialogue with patients. Pain mechanism was effectively modulated by improving patients’ psychology to undergo anaesthesia. PMID:26195834

Cost Accounting: Production and Equipment Services.

ERIC Educational Resources Information Center

Schmid, William T.

Cost accounting for audiovisual productions should include direct costs, and, in some cases, the media administrator may have to calculate a per-hour surcharge for general operating overhead as well. Such procedures enable the administrator to determine cost effectiveness, to control cost overruns, and to generate more staff efficiency. Cost…

14 CFR 21.99 - Required design changes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Changes to Type Certificates § 21.99 Required design changes. (a) When an Airworthiness Directive is issued under Part 39 the holder of the type certificate for the... approval of the design changes, make available the descriptive data covering the changes to all operators...

14 CFR 21.99 - Required design changes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Changes to Type Certificates § 21.99 Required design changes. (a) When an Airworthiness Directive is issued under Part 39 the holder of the type certificate for the... approval of the design changes, make available the descriptive data covering the changes to all operators...

14 CFR 21.99 - Required design changes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Changes to Type Certificates § 21.99 Required design changes. (a) When an Airworthiness Directive is issued under Part 39 the holder of the type certificate for the... approval of the design changes, make available the descriptive data covering the changes to all operators...

Guidelines for Vocational Education Program in Nebraska Public Schools.

ERIC Educational Resources Information Center

Nebraska State Dept. of Education, Lincoln. Div. of Vocational Education.

The publication serves as a supplement to the Nebraska State plan of vocational education and outlines detailed directions that are needed for a more comprehensive treatment of program development and operational procedures. The report is structured in seven sections: (1) general provisions; (2) financial participation; (3) educational programs in…

NOAA Office of Exploration and Research > Data Access > Overview

Science.gov Websites

Management of Environmental Data and Information and related Procedural Directives inform OER INFORMATION ON THE NOAA OFFICE OF OCEAN EXPLORATION AND RESEARCH, VISIT: OCEANEXPLORER.NOAA.GOV weather oceans Science Overview Data Access Overview Operational Data Management Publications Education Overview Alliance

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2011 CFR

2011-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

76 FR 21827 - Proposed Amendment of Class E Airspace; El Dorado, KS

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

...-directional beacon (NDB) at Captain Jack Thomas/El Dorado Airport, El Dorado, KS, has made this action necessary for the safety and management of Instrument Flight Rules (IFR) operations at Captain Jack Thomas... instrument approach procedures at Captain Jack Thomas/El Dorado Airport, El Dorado, KS. Airspace...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2012 CFR

2012-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2013 CFR

2013-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

49 CFR 192.931 - How may Confirmatory Direct Assessment (CDA) be used?

Code of Federal Regulations, 2014 CFR

2014-10-01

... corrosion or internal corrosion. (b) External corrosion plan. An operator's CDA plan for identifying external corrosion must comply with § 192.925 with the following exceptions. (1) The procedures for... criteria of scheduled action must be excavated in each ECDA region. (c) Internal corrosion plan. An...

75 FR 61655 - Airworthiness Directives; Piper Aircraft, Inc. Model PA-28-161 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... (FADEC) backup battery, replacing the supplement pilot's operating handbook and FAA approved airplane... can allow the FADEC to shut down or reset if the main battery is depleted and the electrical charging... service information describes procedures for installation of a FADEC backup battery. FAA's Determination...

An analysis of fuel conserving operational procedures and design modifications for bomber/transport aircraft. Volume I. Executive summary. Final report, 7 June 1976-7 July 1978

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

Aggarwal, R.

1978-07-01

Various proposed improvements in the design and operational procedures for bomber/transport aircraft are evaluated. The evaluation is performed in terms of the estimated savings in fuel consumption and in Direct Operating Cost (DOC). As an aid in the evaluation of design modifications, graphs of fuel and DOC savings as a function of the design parameters are developed. These graphs are based on actual mission trajectory data rather than some type trajectory profile. The actual mission data is presented in terms of histograms which provide statistical information concerning altitude, air speed, take-off weight, landing weights, and mission time. Separate analyses aremore » performed on the following aircraft: the B-52G, the B-52H, the KC-135, the C-141, the C-130, and the C-5A.« less

An analysis of fuel conserving operational procedures and design modifications for bomber/transport aircraft. volume ii. Final report, 7 June 1976-7 July 1978

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

Aggarwal, R.K.

1978-07-01

Various proposed improvements in the design and operational procedures for bomber/transport aircraft are evaluated. The evaluation is performed in terms of the estimated savings in fuel consumption and in Direct Operating Cost (DOC). As an aid in the evaluation of design modifications, graphs of fuel and DOC savings as a function of the design parameters are developed. These graphs are based on actual mission trajectory data rather than some typical trajectory profile. The actual mission data is presented in terms of histograms which provide statistical information concerning altitude, air speed, take-off weight, landing weight, and mission time. Separate analyses aremore » performed on the following aircraft: the B-52G, the B-52H, the KC-135, the C-141, the C-130, and the C-5A. (Author)« less

Multi-objective Optimization of Departure Procedures at Gimpo International Airport

NASA Astrophysics Data System (ADS)

Kim, Junghyun; Lim, Dongwook; Monteiro, Dylan Jonathan; Kirby, Michelle; Mavris, Dimitri

2018-04-01

Most aviation communities have increasing concerns about the environmental impacts, which are directly linked to health issues for local residents near the airport. In this study, the environmental impact of different departure procedures using the Aviation Environmental Design Tool (AEDT) was analyzed. First, actual operational data were compiled at Gimpo International Airport (March 20, 2017) from an open source. Two modifications were made in the AEDT to model the operational circumstances better and the preliminary AEDT simulations were performed according to the acquired operational procedures. Simulated noise results showed good agreements with noise measurement data at specific locations. Second, a multi-objective optimization of departure procedures was performed for the Boeing 737-800. Four design variables were selected and AEDT was linked to a variety of advanced design methods. The results showed that takeoff thrust had the greatest influence and it was found that fuel burn and noise had an inverse relationship. Two points representing each fuel burn and noise optimum on the Pareto front were parsed and run in AEDT to compare with the baseline. The results showed that the noise optimum case reduced Sound Exposure Level 80-dB noise exposure area by approximately 5% while the fuel burn optimum case reduced total fuel burn by 1% relative to the baseline for aircraft-level analysis.

Data Elements for Workload Analysis of Armored Vehicle Crews

DTIC Science & Technology

1990-09-01

weapon status, terrain, enemy, etc.) and 2) managing the operation of the various mental processes through which the operator interacts with the...contrive, or plan a process or procedure for carrying out a tactical action. DICTATE - To speak aloud into a recorder. DIRECT - To manage the action of...To mark or note on a map or chart; to locate by means of coordinates. POSITION - To place oneself or others in a location or posture. PREPARE - To

Common Ada (tradename) Missile Package (CAMP) Project. Missile Software Parts. Volume 8. Detail Design Document

DTIC Science & Technology

1988-03-01

PACKAGE BODY ) TLCSC P661 (CATALOG #P106-0) This package contains the CAMP parts required to do the vaypoint steering portion of navigation. The...3.3.4.1.6 PROCESSING The following describes the processing performed by this part: package body WaypointSteering is package body ...Steering_Vector_Operations is separate; package body Steering_Vector_Operations_with_Arcsin is separate; procedure Compute Turn_Angle_and Direction (UnitNormal C

Study of the application of advanced technologies to laminar flow control systems for subsonic transports. Volume 1: Summary

NASA Technical Reports Server (NTRS)

Sturgeon, R. F.; Bennett, J. A.; Etchberger, F. R.; Ferrill, R. S.; Meade, L. E.

1976-01-01

A study was conducted to evaluate the technical and economic feasibility of applying laminar flow control to the wings and empennage of long-range subsonic transport aircraft compatible with initial operation in 1985. For a design mission range of 10,186 km (5500 n mi), advanced technology laminar-flow-control (LFC) and turbulent-flow (TF) aircraft were developed for both 200 and 400-passenger payloads, and compared on the basis of production costs, direct operating costs, and fuel efficiency. Parametric analyses were conducted to establish the optimum geometry for LFC and TF aircraft, advanced LFC system concepts and arrangements were evaluated, and configuration variations maximizing the effectiveness of LFC were developed. For the final LFC aircraft, analyses were conducted to define maintenance costs and procedures, manufacturing costs and procedures, and operational considerations peculiar to LFC aircraft. Compared to the corresponding advanced technology TF transports, the 200- and 400-passenger LFC aircraft realized reductions in fuel consumption up to 28.2%, reductions in direct operating costs up to 8.4%, and improvements in fuel efficiency, in ssm/lb of fuel, up to 39.4%. Compared to current commercial transports at the design range, the LFC study aircraft demonstrate improvements in fuel efficiency up to 131%. Research and technology requirements requisite to the development of LFC transport aircraft were identified.

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

PubMed

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

2017-10-01

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

Image-Directed Fine-needle Aspiration Biopsy of the Thyroid with Safety-engineered Devices

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

Sibbitt, Randy R., E-mail: THESIBB2@aol.com; Palmer, Dennis J., E-mail: lyonscreek@aol.com; Sibbitt, Wilmer L., E-mail: wsibbitt@salud.unm.edu

2011-10-15

Purpose: The purpose of the present study was to integrate safety-engineered devices into outpatient fine-needle aspiration (FNA) biopsy of the thyroid in an interventional radiology practice. Materials and Methods: The practice center is a tertiary referral center for image-directed FNA thyroid biopsies in difficult patients referred by the primary care physician, endocrinologist, or otolaryngologist. As a departmental quality of care and safety improvement program, we instituted integration of safety devices into our thyroid biopsy procedures and determined the effect on outcome (procedural pain, diagnostic biopsies, inadequate samples, complications, needlesticks to operator, and physician satisfaction) before institution of safety devices (54more » patients) and after institution of safety device implementation (56 patients). Safety devices included a patient safety technology-the mechanical aspirating syringe (reciprocating procedure device), and a health care worker safety technology (antineedlestick safety needle). Results: FNA of thyroid could be readily performed with the safety devices. Safety-engineered devices resulted in a 49% reduction in procedural pain scores (P < 0.0001), a 56% reduction in significant pain (P < 0.002), a 21% increase in operator satisfaction (P < 0.0001), and a 5% increase in diagnostic specimens (P = 0.5). No needlesticks to health care workers or patient injuries occurred during the study. Conclusions: Safety-engineered devices to improve both patient and health care worker safety can be successfully integrated into diagnostic FNA of the thyroid while maintaining outcomes and improving safety.« less

Investigation of grafted ETFE-based polymer membranes as alternative electrolyte for direct methanol fuel cells

NASA Astrophysics Data System (ADS)

Aricò, A. S.; Baglio, V.; Cretı̀, P.; Di Blasi, A.; Antonucci, V.; Brunea, J.; Chapotot, A.; Bozzi, A.; Schoemans, J.

Low cost ethylene-tetrafluoroethylene (ETFE)-based grafted membranes have been prepared by a process based on electron beam irradiation, subsequent grafting, cross-linking and sulfonation procedure. Two different grafted membranes varying by their grafting and cross-linking levels have been investigated for applications in direct methanol fuel cells (DMFCs) operating between 90 and 130 °C. DMFC assemblies based on these membranes showed cell resistance and performance values comparable to Nafion 117. Stable electrochemical performance was recorded during 1 month of cycled operation. Tailoring of grafting and cross-linking properties allows a significant reduction of methanol cross-over while maintaining suitable conductivity and performance levels.

Guide to good practices for operations and administration updates through required reading

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

NONE

1998-12-01

This Guide to Good Practices is written to enhance understanding of, and provide direction for, Required Reading, Chapter XIV of Department of Energy (DOE) Order 5480.19, Conduct of Operations Requirements for DOE Facilities. The practices in this guide should be considered when planning or reviewing programs for updating personnel with operations and administration information through required reading. Contractors are advised to adopt procedures that meet the intent of DOE Order 5480.19. Required Reading is an element of an effective Conduct of Operations program. The complexity and array of activities performed in DOE facilities dictate the necessity for a coordinated requiredmore » reading program to promote safe and efficient operations.« less

Use of a formal assessment instrument for evaluation of resident operative skills in pediatric neurosurgery.

PubMed

Hadley, Caroline; Lam, Sandi K; Briceño, Valentina; Luerssen, Thomas G; Jea, Andrew

2015-08-28

OBJECT Currently there is no standardized tool for assessment of neurosurgical resident performance in the operating room. In light of enhanced requirements issued by the Accreditation Council for Graduate Medical Education's Milestone Project and the Matrix Curriculum Project from the Society of Neurological Surgeons, the implementation of such a tool seems essential for objective evaluation of resident competence. Beyond compliance with governing body guidelines, objective assessment tools may be useful to direct early intervention for trainees performing below the level of their peers so that they may be given more hands-on teaching, while strong residents can be encouraged by faculty members to progress to conducting operations more independently with passive supervision. The aims of this study were to implement a validated assessment tool for evaluation of operative skills in pediatric neurosurgery and determine its feasibility and reliability. METHODS All neurosurgery residents completing their pediatric rotation over a 6-month period from January 1, 2014, to June 30, 2014, at the authors' institution were enrolled in this study. For each procedure, residents were evaluated by means of a form, with one copy being completed by the resident and a separate copy being completed by the attending surgeon. The evaluation form was based on the validated Objective Structured Assessment of Technical Skills for Surgery (OSATS) and used a 5-point Likert-type scale with 7 categories: respect for tissue; time and motion; instrument handling; knowledge of instruments; flow of operation; use of assistants; and knowledge of specific procedure. Data were then stratified by faculty versus resident (self-) assessment; postgraduate year level; and difficulty of procedure. Descriptive statistics (means and SDs) were calculated, and the results were compared using the Wilcoxon signed-rank test and Student t-test. A p value < 0.05 was considered statistically significant. RESULTS Six faculty members, 1 fellow, and 8 residents completed evaluations for 299 procedures, including 32 ventriculoperitoneal (VP) shunt revisions, 23 VP shunt placements, 19 endoscopic third ventriculostomies, and 18 craniotomies for tumor resection. There was no significant difference between faculty and resident self-assessment scores overall or in any of the 7 domains scores for each of the involved residents. On self-assessment, senior residents scored themselves significantly higher (p < 0.02) than junior residents overall and in all domains except for "time and motion." Faculty members scored senior residents significantly higher than junior residents only for the "knowledge of instruments" domain (p = 0.05). When procedure difficulty was considered, senior residents' scores from faculty members were significantly higher (p = 0.04) than the scores given to junior residents for expert procedures only. Senior residents' self-evaluation scores were significantly higher than those of junior residents for both expert (p = 0.03) and novice (p = 0.006) procedures. CONCLUSIONS OSATS is a feasible and reliable assessment tool for the comprehensive evaluation of neurosurgery resident performance in the operating room. The authors plan to use this tool to assess resident operative skill development and to improve direct resident feedback.

An industrial sewing machine variable speed controller

NASA Technical Reports Server (NTRS)

Estes, Christa; Spiggle, Charles; Swift, Shannon; Vangeffen, Stephen; Youngner, Frank

1992-01-01

The apparel industry is attempting to move in a new direction in the coming decade. Since the invention of an electrically powered sewing machine, the operator has been seated. Today, companies are switching from a sit down operation to a stand up operation involving modular stations. The old treadle worked well with the sitting operator, but problems have been found when trying to use the same treadle with a standing operator. This report details a new design for a treadle to operate an industrial sewing machine that has a standing operator. Emphasis is placed on the ease of use by the operator, as well as the ergonomics involved. Procedures for testing the design are included along with possible uses for the treadle in other applications besides an industrial sewing machine.

An industrial sewing machine variable speed controller

NASA Astrophysics Data System (ADS)

Estes, Christa; Spiggle, Charles; Swift, Shannon; Vangeffen, Stephen; Youngner, Frank

The apparel industry is attempting to move in a new direction in the coming decade. Since the invention of an electrically powered sewing machine, the operator has been seated. Today, companies are switching from a sit down operation to a stand up operation involving modular stations. The old treadle worked well with the sitting operator, but problems have been found when trying to use the same treadle with a standing operator. This report details a new design for a treadle to operate an industrial sewing machine that has a standing operator. Emphasis is placed on the ease of use by the operator, as well as the ergonomics involved. Procedures for testing the design are included along with possible uses for the treadle in other applications besides an industrial sewing machine.

SOHO Mission Interruption Joint NASA/ESA Investigation Board

NASA Technical Reports Server (NTRS)

1998-01-01

Contact with the SOlar Heliospheric Observatory (SOHO) spacecraft was lost in the early morning hours of June 25, 1998, Eastern Daylight Time (EDT), during a planned period of calibrations, maneuvers, and spacecraft reconfigurations. Prior to this the SOHO operations team had concluded two years of extremely successful science operations. A joint European Space Agency (ESA)/National Aeronautics and Space Administration (NASA) engineering team has been planning and executing recovery efforts since loss of contact with some success to date. ESA and NASA management established the SOHO Mission Interruption Joint Investigation Board to determine the actual or probable cause(s) of the SOHO spacecraft mishap. The Board has concluded that there were no anomalies on-board the SOHO spacecraft but that a number of ground errors led to the major loss of attitude experienced by the spacecraft. The Board finds that the loss of the SOHO spacecraft was a direct result of operational errors, a failure to adequately monitor spacecraft status, and an erroneous decision which disabled part of the on-board autonomous failure detection. Further, following the occurrence of the emergency situation, the Board finds that insufficient time was taken by the operations team to fully assess the spacecraft status prior to initiating recovery operations. The Board discovered that a number of factors contributed to the circumstances that allowed the direct causes to occur. The Board strongly recommends that the two Agencies proceed immediately with a comprehensive review of SOHO operations addressing issues in the ground procedures, procedure implementation, management structure and process, and ground systems. This review process should be completed and process improvements initiated prior to the resumption of SOHO normal operations.

Robotics in Cardiac Surgery: Past, Present, and Future

PubMed Central

Bush, Bryan; Nifong, L. Wiley; Chitwood, W. Randolph

2013-01-01

Robotic cardiac operations evolved from minimally invasive operations and offer similar theoretical benefits, including less pain, shorter length of stay, improved cosmesis, and quicker return to preoperative level of functional activity. The additional benefits offered by robotic surgical systems include improved dexterity and degrees of freedom, tremor-free movements, ambidexterity, and the avoidance of the fulcrum effect that is intrinsic when using long-shaft endoscopic instruments. Also, optics and operative visualization are vastly improved compared with direct vision and traditional videoscopes. Robotic systems have been utilized successfully to perform complex mitral valve repairs, coronary revascularization, atrial fibrillation ablation, intracardiac tumor resections, atrial septal defect closures, and left ventricular lead implantation. The history and evolution of these procedures, as well as the present status and future directions of robotic cardiac surgery, are presented in this review. PMID:23908867

Helicopter Flight Procedures for Community Noise Reduction

NASA Technical Reports Server (NTRS)

Greenwood, Eric

2017-01-01

A computationally efficient, semiempirical noise model suitable for maneuvering flight noise prediction is used to evaluate the community noise impact of practical variations on several helicopter flight procedures typical of normal operations. Turns, "quick-stops," approaches, climbs, and combinations of these maneuvers are assessed. Relatively small variations in flight procedures are shown to cause significant changes to Sound Exposure Levels over a wide area. Guidelines are developed for helicopter pilots intended to provide effective strategies for reducing the negative effects of helicopter noise on the community. Finally, direct optimization of flight trajectories is conducted to identify low noise optimal flight procedures and quantify the magnitude of community noise reductions that can be obtained through tailored helicopter flight procedures. Physically realizable optimal turns and approaches are identified that achieve global noise reductions of as much as 10 dBA Sound Exposure Level.

78 FR 54173 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Maintenance Plan Update...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

... direct final rule in the Federal Register informing the public that the rule will not take effect... maintenance period, a commitment to maintain the existing monitoring network, factors and procedures to be... Network Indiana currently operates two SO 2 monitors in Lake County, Indiana. Indiana has committed to...

Isolating USB connections in medical equipment.

PubMed

Broeders, Jan-Hein

2009-01-01

Although offering several benefits, the universal serial bus (USB) port has not been rapidly adopted for connecting medical equipment. This is because it could affect safety procedures, with equipment not operating isolated from the mains. To overcome this, a single package isolation device has been developed that can be inserted directly into the USB signal path.

Joint road safety operations in tunnels and open roads

NASA Astrophysics Data System (ADS)

Adesiyun, Adewole; Avenoso, Antonio; Dionelis, Kallistratos; Cela, Liljana; Nicodème, Christophe; Goger, Thierry; Polidori, Carlo

2017-09-01

The objective of the ECOROADS project is to overcome the barrier established by the formal interpretation of the two Directives 2008/96/EC and 2004/54/EC, which in practice do not allow the same Road Safety Audits/Inspections to be performed inside tunnels. The projects aims at the establishment of a common enhanced approach to road infrastructure and tunnel safety management by using the concepts and criteria of the Directive 2008/96/CE on road infrastructure safety management and the results of related European Commission (EC) funded projects. ECOROADS has already implemented an analysis of national practices regarding Road Safety Inspections (RSI), two Workshops with the stakeholders, and an exchange of best practices between European tunnel experts and road safety professionals, which led to the definition of common agreed safety procedures. In the second phase of the project, different groups of experts and observers applied the above common procedures by inspecting five European road sections featuring both open roads and tunnels in Belgium, Albania, Germany, Serbia and Former Yugoslav Republic of Macedonia. This paper shows the feedback of the 5 joint safety operations and how they are being used for a set of - recommendations and guidelines for the application of the RSA and RSI concepts within the tunnel safety operations.

JMOSFET: A MOSFET parameter extractor with geometry-dependent terms

NASA Technical Reports Server (NTRS)

Buehler, M. G.; Moore, B. T.

1985-01-01

The parameters from metal-oxide-silicon field-effect transistors (MOSFETs) that are included on the Combined Release and Radiation Effects Satellite (CRRES) test chips need to be extracted to have a simple but comprehensive method that can be used in wafer acceptance, and to have a method that is sufficiently accurate that it can be used in integrated circuits. A set of MOSFET parameter extraction procedures that are directly linked to the MOSFET model equations and that facilitate the use of simple, direct curve-fitting techniques are developed. In addition, the major physical effects that affect MOSFET operation in the linear and saturation regions of operation for devices fabricated in 1.2 to 3.0 mm CMOS technology are included. The fitting procedures were designed to establish single values for such parameters as threshold voltage and transconductance and to provide for slope matching between the linear and saturation regions of the MOSFET output current-voltage curves. Four different sizes of transistors that cover a rectangular-shaped region of the channel length-width plane are analyzed.

Standard Procedures for Air Force Operational Test and Evaluation. Volume I.

DTIC Science & Technology

1974-10-01

of the foregoing, and assuming the successful advocacy of the prcposed OT&E a Test Directive is drafted by AFTEC, reviewed by HQ USAF, and upon...design purposes. A successful approach to this problem used by both Air Force and Army OT&E agencies is to conduct an analysis of the operational mission...conduct an analysis of the mission structure involved in the OT&E. This constitutes a top level structure of the scenario with identification of the players

Information Presentation

NASA Technical Reports Server (NTRS)

Holden, Kritina; Sandor, A.; Thompson, S. G.; McCann, R. S.; Kaiser, M. K.; Begault, D. R.; Adelstein, B. D.; Beutter, B. R.; Stone, L. S.

2008-01-01

The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew on flight vehicles, surface landers and habitats, and during extra-vehicular activities (EVA). Designers of displays and controls for exploration missions must be prepared to select the text formats, label styles, alarms, electronic procedure designs, and cursor control devices that provide for optimal crew performance on exploration tasks. The major areas of work, or subtasks, within the Information Presentation DRP are: 1) Controls, 2) Displays, 3) Procedures, and 4) EVA Operations.

A study of human performance in a rotating environment

NASA Technical Reports Server (NTRS)

Green, J. A.; Peacock, J. L.; Holm, A. P.

1971-01-01

Consideration is given to the lack of sufficient data relative to the response of man to the attendant oculovestibular stimulations induced by multi-directional movement of an individual within the rotating environment to provide the required design criteria. This was done to determine the overall impact of artificial gravity simulations on potential design configurations and crew operational procedures. Gross locomotion and fine motor performance were evaluated. Results indicate that crew orientation, rotational rates, vehicle design configurations, and operational procedures may be used to reduce the severity of the adverse effects of the Coriolis and cross-coupled angular accelerations acting on masses moving within a rotating environment. Results further indicate that crew selection, motivation, and short-term exposures to the rotating environment may be important considerations for future crew indoctrination and training programs.

Strategy over operation: neural activation in subtraction and multiplication during fact retrieval and procedural strategy use in children.

PubMed

Polspoel, Brecht; Peters, Lien; Vandermosten, Maaike; De Smedt, Bert

2017-09-01

Arithmetic development is characterized by strategy shifts between procedural strategy use and fact retrieval. This study is the first to explicitly investigate children's neural activation associated with the use of these different strategies. Participants were 26 typically developing 4th graders (9- to 10-year-olds), who, in a behavioral session, were asked to verbally report on a trial-by-trial basis how they had solved 100 subtraction and multiplication items. These items were subsequently presented during functional magnetic resonance imaging. An event-related design allowed us to analyze the brain responses during retrieval and procedural trials, based on the children's verbal reports. During procedural strategy use, and more specifically for the decomposition of operands strategy, activation increases were observed in the inferior and superior parietal lobes (intraparietal sulci), inferior to superior frontal gyri, bilateral areas in the occipital lobe, and insular cortex. For retrieval, in comparison to procedural strategy use, we observed increased activity in the bilateral angular and supramarginal gyri, left middle to inferior temporal gyrus, right superior temporal gyrus, and superior medial frontal gyrus. No neural differences were found between the two operations under study. These results are the first in children to provide direct evidence for alternate neural activation when different arithmetic strategies are used and further unravel that previously found effects of operation on brain activity reflect differences in arithmetic strategy use. Hum Brain Mapp 38:4657-4670, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Direct Estimation of Power Distribution in Reactors for Nuclear Thermal Space Propulsion

NASA Astrophysics Data System (ADS)

Aldemir, Tunc; Miller, Don W.; Burghelea, Andrei

2004-02-01

A recently proposed constant temperature power sensor (CTPS) has the capability to directly measure the local power deposition rate in nuclear reactor cores proposed for space thermal propulsion. Such a capability reduces the uncertainties in the estimated power peaking factors and hence increases the reliability of the nuclear engine. The CTPS operation is sensitive to the changes in the local thermal conditions. A procedure is described for the automatic on-line calibration of the sensor through estimation of changes in thermal .conditions.

The Government of Islamic Republic of Afghanistan’s Controls Over the Contract Management Process for U.S. Direct Assistance Need Improvement

DTIC Science & Technology

2015-02-25

develop, award, execute, or monitor individual contracts funded with U.S. direct assistance. This occurred because the Ministry of Finance ( MoF ...trained staff to collaborate with the Ministry of Finance ( MoF ), MoD, and MoI for budgeting, acquisition planning, procurement, financial management...and contract management and oversight. Finally, CSTC-A must ensure MoF , MoD, and MoI establish standard operating procedures and maintain adequate

The cost of open heart surgery in Nigeria.

PubMed

Falase, Bode; Sanusi, Michael; Majekodunmi, Adetinuwe; Ajose, Ifeoluwa; Idowu, Ariyo; Oke, David

2013-01-01

Open Heart Surgery (OHS) is not commonly practiced in Nigeria and most patients who require OHS are referred abroad. There has recently been a resurgence of interest in establishing OHS services in Nigeria but the cost is unknown. The aim of this study was to determine the direct cost of OHS procedures in Nigeria. The study was performed prospectively from November to December 2011. Three concurrent operations were selected as being representative of the scope of surgery offered at our institution. These procedures were Atrial Septal Defect (ASD) Repair, Off Pump Coronary Artery Bypass Grafting (OPCAB) and Mitral Valve Replacement (MVR). Cost categories contributing to direct costs of OHS (Investigations, Drugs, Perfusion, Theatre, Intensive Care, Honorarium and Hospital Stay) were tracked to determine the total direct cost for the 3 selected OHS procedures. ASD repair cost $ 6,230 (Drugs $600, Intensive Care $410, Investigations $955, Perfusion $1080, Theatre $1360, Honorarium $925, Hospital Stay $900). OPCAB cost $8,430 (Drugs $740, Intensive Care $625, Investigations $3,020, Perfusion $915, Theatre $1305, Honorarium $925, Hospital Stay $900). MVR with a bioprosthetic valve cost $11,200 (Drugs $1200, Intensive Care $500, Investigations $3040, Perfusion $1100, Theatre $3,535, Honorarium $925, Hospital Stay $900). The direct cost of OHS in Nigeria currently ranges between $6,230 and $11,200. These costs compare favorably with the cost of OHS abroad and can serve as a financial incentive to patients, sponsors and stakeholders to have OHS procedures done in Nigeria.

Multimedia article: Transvaginal laparoscopic cholecystectomy: laparoscopically assisted.

PubMed

Bessler, Marc; Stevens, Peter D; Milone, Luca; Hogle, Nancy J; Durak, Evren; Fowler, Dennis

2008-07-01

Natural orifice transluminal endoscopic surgery (NOTES) is considered the new frontier for minimally invasive surgery. NOTES procedures such as peritoneoscopy, splenectomy, and cholecystectomy in animal models have been described. The aim of our experiment was to determine the feasibility and technical aspects of a new endoluminal surgical procedure. After approval from Columbia's IACUC, a transvaginal laparoscopically assisted endoscopic cholecystectomy was performed on four 30 kg Yorkshire pigs. The first step was to insert a 1.5 cm endoscope into the vagina under direct laparoscopic vision. Then the gallbladder was reached and, with the help of a laparoscopic grasper to hold up the gallbladder, the operation was performed. At the end of the procedure the gallbladder was snared out through the vagina attached to the endoscope. There were no intraoperative complications such as bleeding, common bile duct or endo-abdominal organ damage. Total operative time ranged between 110 and 155 min. Based on our experience in the porcine model, we believe that a transvaginal endoscopic cholecystectomy is feasible in humans.

The importance of protection glasses during neuroangiographies: A study on radiation exposure at the lens of the primary operator.

PubMed

Tavares, J B; Sacadura-Leite, E; Matoso, T; Neto, L L; Biscoito, L; Campos, J; Sousa-Uva, A

2016-06-01

In interventional neuroradiology, few operators routinely use radiation protection glasses. Moreover, in most centers, radiation dose data only accounts for whole body dose without specific information on lens dose. In 2012, the International Commission on Radiological Protection advised that the threshold limit value for the lens should be 20 mSv/year instead of the previous 150 mSv/year limit. The purpose of this study was to compare the radiation dose in the operator's lens during real diagnostic and interventional neuroangiographies, either using or without lead protection glasses. Using the Educational Direct Dosimeter (EDD30 dosimeter), accumulated radiation dose in the lens was measured in 13 neuroangiographies: seven diagnostic and six interventional. Operators with and without radiation protection glasses were included and the sensor was placed near their left eye, closest to the radiation beam. Without glasses, the corrected mean dose of radiation in the lens was 8.02 µSv for diagnostic procedures and 168.57 µSv for interventional procedures. Using glasses, these values were reduced to 1.74 µSv and 33.24 µSv, respectively. Considering 20 mSv as the suggested annual limit of equivalent dose in the lens, neuroradiologists may perform up to 2,494 diagnostic procedures per year without protecting glasses, a number that increases to 11,494 when glasses are used consistently. Regarding intervention, a maximum of 119 procedures per year is advised if glasses are not used, whereas up to 602 procedures/year may be performed using this protection. Therefore, neuroradiologists should always wear radiation protection glasses. © The Author(s) 2016.

The transduodenal per-ampullary approach to common bile duct calculi.

PubMed Central

Carter, A. E.

1983-01-01

A method of management of 212 patients whose common bile duct calculi were removed through the Ampulla of Vater across the duodenum is described. One patient died from haemorrhagic pancreatitis directly related to the procedure and 11 others died from causes related to the need for a major procedure in people relatively late in life: an overall mortality of 5.7% and of 0.5% for directly related causes. Ten patients suffered non-fatal complications. Ninety three left hospital within 14 days after operation and 79 within 21 days. Although one patient, for a special reason, continued to form stones and discharged them without any difficulty, no others have formed stones that have been recognised symptomatically or clinically. No patient has had cholangitis or common duct stenosis. PMID:6859782

Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Cohen, Robert; Adini, Bruria

2010-04-01

In December 2007, the European Society of Intensive Care Medicine established a Task Force to develop standard operating procedures (SOPs) for operating intensive care units (ICU) during an influenza epidemic or mass disaster. To provide direction for health care professionals in the preparation and management of emergency ICU situations during an influenza epidemic or mass disaster, standardize activities, and promote coordination and communication among the medical teams. Based on a literature review and contributions of content experts, a list of essential categories for managing emergency situations in the ICU were identified. Based on three cycles of a modified Delphi process, consensus was achieved regarding the categories. A primary author along with an expert group drafted SOPs for each category. Based on the Delphi cycles, the following key topics were found to be important for emergency preparedness: triage, infrastructure, essential equipment, manpower, protection of staff and patients, medical procedures, hospital policy, coordination and collaboration with interface units, registration and reporting, administrative policies and education. The draft SOPs serve as benchmarks for emergency preparedness and response of ICUs to emergencies or outbreak of pandemics.

Percutaneous dilatational versus conventional surgical tracheostomy in intensive care patients

PubMed Central

Youssef, Tarek F.; Ahmed, Mohamed Rifaat; Saber, Aly

2011-01-01

Background: Tracheostomy is usually performed in patients with difficult weaning from mechanical ventilation or some catastrophic neurologic insult. Conventional tracheostomy involves dissection of the pretracheal tissues and insertion of the tracheostomy tube into the trachea under direct vision. Percutaneous dilatational tracheostomy is increasingly popular and has gained widespread acceptance in many intensive care unit and trauma centers. Aim: Aim of the study was to compare percutaneous dilatational tracheostomy versus conventional tracheostomy in intensive care patients. Patients and Methods: 64 critically ill patients admitted to intensive care unit subjected to tracheostomy and randomly divided into two groups; percutaneous dilatational tracheostomy and conventional tracheostomy. Results: Mean duration of the procedure was similar between the two procedures while the mean size of tracheostomy tube was smaller in percutaneous technique. In addition, the Lowest SpO2 during procedure, PaCO2 after operation and intra-operative bleeding for both groups were nearly similar without any statistically difference. Postoperative infection after 7 days seen to be statistically lowered and the length of scar tend to be smaller among PDT patients. Conclusion: PDT technique is effective and safe as CST with low incidence of post operative complication. PMID:22361497

Obtaining accreditation by the pharmacy compounding accreditation board, part 2: developing essential standard operating procedures.

PubMed

Cabaleiro, Joe

2007-01-01

A key component of qualifying for accreditation with the Pharmacy Compounding Accreditation Board is having a set of comprehensive standard operating procedures that are being used by the pharmacy staff. The three criteria in standard operating procedures for which the Pharmacy Compounding Accreditation Board looks are: (1)written standard operating procedures; (2)standard operating procedures that reflect what the organization actualy does; and (3) whether the written standard operating procedures are implemented. Following specified steps in the preparation of standard operating procedures will result in procedures that meet Pharmacy Compounding Accreditation Board Requirements, thereby placing pharmacies one step closer to qualifying for accreditation.

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 32 2014-07-01 2014-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

First negative ion beam measurement by the Short-Time Retractable Instrumented Kalorimeter Experiment (STRIKE)

NASA Astrophysics Data System (ADS)

Serianni, G.; De Muri, M.; Muraro, A.; Veltri, P.; Bonomo, F.; Chitarin, G.; Pasqualotto, R.; Pavei, M.; Rizzolo, A.; Valente, M.; Franzen, P.; Ruf, B.; Schiesko, L.

2014-02-01

The Source for Production of Ion of Deuterium Extracted from Rf plasma (SPIDER) test facility is under construction in Padova to optimise the operation of the beam source of ITER neutral beam injectors. The SPIDER beam will be characterised by the instrumented calorimeter STRIKE, whose main components are one-directional carbon-fibre-carbon-composite tiles. A small-scale version of the entire system has been employed in the BAvarian Test MAchine for Negative ions (BATMAN) testbed by arranging two prototype tiles in the vertical direction. The paper presents a description of the mini-STRIKE system and of the data analysis procedures, as well as some results concerning the BATMAN beam under varying operating conditions.

First negative ion beam measurement by the Short-Time Retractable Instrumented Kalorimeter Experiment (STRIKE)

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

Serianni, G., E-mail: gianluigi.serianni@igi.cnr.it; De Muri, M.; Veltri, P.

2014-02-15

The Source for Production of Ion of Deuterium Extracted from Rf plasma (SPIDER) test facility is under construction in Padova to optimise the operation of the beam source of ITER neutral beam injectors. The SPIDER beam will be characterised by the instrumented calorimeter STRIKE, whose main components are one-directional carbon-fibre-carbon-composite tiles. A small-scale version of the entire system has been employed in the BAvarian Test MAchine for Negative ions (BATMAN) testbed by arranging two prototype tiles in the vertical direction. The paper presents a description of the mini-STRIKE system and of the data analysis procedures, as well as some resultsmore » concerning the BATMAN beam under varying operating conditions.« less

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

Bates, L.D.

Oak Ridge National Laboratory (ORNL) is a principle Department of Energy (DOE) Research Institution operated by the Union Carbide Corporation - Nuclear Division (UCC-ND) under direction of the DOE Oak Ridge Operations Office (DOE-ORO). The Laboratory was established in east Tennessee, near what is now the city of Oak Ridge, in the mid 1940s as a part of the World War II effort to develop a nuclear weapon. Since its inception, disposal of radioactively contaminated materials, both solid and liquid, has been an integral part of Laboratory operations. The purpose of this document is to provide a detailed description ofmore » the ORNL Solid Waste Storage Areas, to describe the practice and procedure of their operation, and to address the health and safety impacts and concerns of that operation.« less

Reevaluation of needlescopic surgery.

PubMed

Tagaya, Nobumi; Kubota, Keiichi

2012-01-01

Although the use of single-incision laparoscopic surgery (SILS) has spread rapidly, most procedures employ additional needlescopic instruments to ensure safety and shorten the operation time. Therefore, on the basis of results obtained in our department, the present study was conducted to reevaluate the current state of needlescopic surgery (NS) to improve the cosmetic results and postoperative quality of life of patients and to reduce cost and degree of stress on surgeons. Between May 1998 and February 2011, we performed NS in 202 patients. The diagnoses included gallbladder diseases in 151 patients, spontaneous pneumothorax in 11, thyroid tumor and axillary lymph node metastases in 10 patients each, splenic cyst and appendicitis in 4 patients each, idiopathic thrombocytopenic purpura and postoperative abdominal wall hernia in 3 patients each, primary aldosteronism and hepatic cyst in 2 patients each, and adhesional bowel obstruction and gastric stromal tumor in 1 patient each. Under general anesthesia, one 12-mm and tow or three 2- or 3-mm ports were introduced into the operative field. The specimen was retrieved via the 12-mm wound using a plastic bag. The operations were completed in all patients without the need to convert to an open procedure. In 8 (5.3%) of the 151 cholecystectomies, a change to 5-mm instruments was required. There were no perioperative complications. Pertinent technical points included avoidance of direct organ mobilization to minimize injury, rotation of the operating table and utilization of organ gravity to create a better operative field, minimum use of needlescope to ensure safe maneuvering, and improvement of the bi-hand technique. NS is a safe and feasible procedure that allows experienced surgeons to achieve minimally invasive surgery with low morbidity, without the need to convert to a conventional or open procedure.

Duration of hospital stay following orthognathic surgery at the jordan university hospital.

PubMed

Jarab, Fadi; Omar, Esam; Bhayat, Ahmed; Mansuri, Samir; Ahmed, Sami

2012-09-01

Major oral and maxillofacial surgery procedures have been routinely performed on an inpatient basis in order to manage both, the recovery from anesthesia and any unpredictable morbidity that may be associated with the surgery. The use of inpatient beds is extremely expensive and if the surgical procedures could be done on an outpatient setting, it would reduce the costs and the need for inpatient care. The aim was to determine the length of hospital stay (LHS) and the factors which influence the LHS following orthognathic surgery at the Jordan University Hospital over 5 years (2005-2009). This was a retrospective record review of patients who underwent orthognathic surgery at Jordan University Hospital between 2005 and 2009. The variables were recorded on a data capture form which was adapted and developed from previous studies. Descriptive and analytical statistical methods were used to correlate these variables to the LHS. Ninety two patients were included in the study and 74% of them were females. The mean age was 23.7 years and the mean LHS was 4 days. The complexity of the procedure, length of operation time, intensive care unit (ICU) stay and year of operation were significantly correlated with a positive LHS (P < 0.05). Patients' hospital stay was directly related to the complexity of the orthognathic procedure, the operation time, time spent in ICU and the year in which the operation was done. There was a significant reduction in the LHS over the progressing years and this could be due to an increase in experience and knowledge of the operators and an improvement in the hospital facilities.

10-MWe solar-thermal central-receiver pilot plant. Operating and maintenance manual

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

Not Available

1979-08-01

Information required to perform the initial program loading and operation of the Heliostat Array Controller (HAC) is provided. Operating activities are described as required for heliostat control. All computer console command steps, from power up to power down are described. Detailed steps are provided to wake up the system and direct heliostat beams to standby, on target, standby to stow and power down. Maintenance requirements (preventive and corrective), reparability (reparable - non-reparable decisions), spares identification, spares storage location, replacement levels, replacement location and repair location are established. Individual system breakdown block diagrams are provided for each system/assembly/subassembly. Maintenance and repairmore » description sheets are provided for each maintenance significant item. The manual provides support of the following equipment: (a) helostat assembly; (b) heliostat control assembly; and (c) maintenance and installation equipment. The safety requirements for the operating and maintenance functions are established. These procedures will assist in eliminating or controlling the accident potentials caused by human error, environment, or component malfunctions or interactions that could result in major injury or fatality to operating or visiting personnel, or damage to subsystem components or support equipment. These procedures are for normal and test operating conditions and emergency situations, and apply to all Martin Marietta Corporation, governmental, operating and visitor personnel. (LEW)« less

Synthetic Vision Enhanced Surface Operations and Flight Procedures Rehearsal Tool

NASA Technical Reports Server (NTRS)

Arthur, Jarvis J., III; Prinzel, Lawrence J., III; Williams, Steven P.; Kramer, Lynda J.

2006-01-01

Limited visibility has been cited as predominant causal factor for both Controlled-Flight-Into-Terrain (CFIT) and runway incursion accidents. NASA is conducting research and development of Synthetic Vision Systems (SVS) technologies which may potentially mitigate low visibility conditions as a causal factor to these accidents while replicating the operational benefits of clear day flight operations, regardless of the actual outside visibility condition. Two experimental evaluation studies were performed to determine the efficacy of two concepts: 1) head-worn display application of SVS technology to enhance transport aircraft surface operations, and 2) three-dimensional SVS electronic flight bag display concept for flight plan preview, mission rehearsal and controller-pilot data link communications interface of flight procedures. In the surface operation study, pilots evaluated two display devices and four display modes during taxi under unlimited and CAT II visibility conditions. In the mission rehearsal study, pilots flew approaches and departures in an operationally-challenged airport environment, including CFIT scenarios. Performance using the SVS concepts was compared to traditional baseline displays with paper charts only or EFB information. In general, the studies evince the significant situation awareness and enhanced operational capabilities afforded from these advanced SVS display concepts. The experimental results and conclusions from these studies are discussed along with future directions.

The effects of verbal operant training and response interruption and redirection on appropriate and inappropriate vocalizations.

PubMed

Colón, Candice L; Ahearn, William H; Clark, Kathleen M; Masalsky, Jessica

2012-01-01

Past research has shown that response interruption and redirection (RIRD) can effectively decrease automatically reinforced motor behavior (Hagopian & Adelinis, 2001). Ahearn, Clark, MacDonald, and Chung (2007) found that a procedural adaptation of RIRD reduced vocal stereotypy and increased appropriate vocalizations for some children, although appropriate vocalizations were not targeted directly. The purpose of the current study was to examine the effects of directly targeting appropriate language (i.e., verbal operant training) on vocal stereotypy and appropriate speech in 3 children with an autism spectrum disorder. The effects of verbal operant (i.e., tact) training were evaluated in a nonconcurrent multiple baseline design across participants. In addition, RIRD was implemented with 2 of the 3 participants to further decrease levels of vocal stereotypy. Verbal operant training alone produced slightly lower levels of stereotypy and increased appropriate vocalizations for all 3 participants; however, RIRD was required to produce acceptably low levels of stereotypy for 2 of the 3 participants.

Exploring the initial steps of the testing process: frequency and nature of pre-preanalytic errors.

PubMed

Carraro, Paolo; Zago, Tatiana; Plebani, Mario

2012-03-01

Few data are available on the nature of errors in the so-called pre-preanalytic phase, the initial steps of the testing process. We therefore sought to evaluate pre-preanalytic errors using a study design that enabled us to observe the initial procedures performed in the ward, from the physician's test request to the delivery of specimens in the clinical laboratory. After a 1-week direct observational phase designed to identify the operating procedures followed in 3 clinical wards, we recorded all nonconformities and errors occurring over a 6-month period. Overall, the study considered 8547 test requests, for which 15 917 blood sample tubes were collected and 52 982 tests undertaken. No significant differences in error rates were found between the observational phase and the overall study period, but underfilling of coagulation tubes was found to occur more frequently in the direct observational phase (P = 0.043). In the overall study period, the frequency of errors was found to be particularly high regarding order transmission [29 916 parts per million (ppm)] and hemolysed samples (2537 ppm). The frequency of patient misidentification was 352 ppm, and the most frequent nonconformities were test requests recorded in the diary without the patient's name and failure to check the patient's identity at the time of blood draw. The data collected in our study confirm the relative frequency of pre-preanalytic errors and underline the need to consensually prepare and adopt effective standard operating procedures in the initial steps of laboratory testing and to monitor compliance with these procedures over time.

HIGH POWER BEAM DUMP AND TARGET / ACCELERATOR INTERFACE PROCEDURES

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

Blokland, Willem; Plum, Michael A; Peters, Charles C

Satisfying operational procedures and limits for the beam target interface is a critical concern for high power operation at spallation neutron sources. At the Oak Ridge Spallation Neutron Source (SNS) a number of protective measures are instituted to ensure that the beam position, beam size and peak intensity are within acceptable limits at the target and high power Ring Injection Dump (RID). The high power beam dump typically handles up to 50 100 kW of beam power and its setup is complicated by the fact that there are two separate beam components simultaneously directed to the dump. The beam onmore » target is typically in the 800-1000 kW average power level, delivered in sub- s 60 Hz pulses. Setup techniques using beam measurements to quantify the beam parameters at the target and dump will be described. However, not all the instrumentation used for the setup and initial qualification is available during high power operation. Additional techniques are used to monitor the beam during high power operation to ensure the setup conditions are maintained, and these are also described.« less

Numerical study of a novel procedure for installing the tower and Rotor Nacelle Assembly of offshore wind turbines based on the inverted pendulum principle

NASA Astrophysics Data System (ADS)

Guachamin Acero, Wilson; Gao, Zhen; Moan, Torgeir

2017-09-01

Current installation costs of offshore wind turbines (OWTs) are high and profit margins in the offshore wind energy sector are low, it is thus necessary to develop installation methods that are more efficient and practical. This paper presents a numerical study (based on a global response analysis of marine operations) of a novel procedure for installing the tower and Rotor Nacelle Assemblies (RNAs) on bottom-fixed foundations of OWTs. The installation procedure is based on the inverted pendulum principle. A cargo barge is used to transport the OWT assembly in a horizontal position to the site, and a medium-size Heavy Lift Vessel (HLV) is then employed to lift and up-end the OWT assembly using a special upending frame. The main advantage of this novel procedure is that the need for a huge HLV (in terms of lifting height and capacity) is eliminated. This novel method requires that the cargo barge is in the leeward side of the HLV (which can be positioned with the best heading) during the entire installation. This is to benefit from shielding effects of the HLV on the motions of the cargo barge, so the foundations need to be installed with a specific heading based on wave direction statistics of the site and a typical installation season. Following a systematic approach based on numerical simulations of actual operations, potential critical installation activities, corresponding critical events, and limiting (response) parameters are identified. In addition, operational limits for some of the limiting parameters are established in terms of allowable limits of sea states. Following a preliminary assessment of these operational limits, the duration of the entire operation, the equipment used, and weather- and water depth-sensitivity, this novel procedure is demonstrated to be viable.

Annual Report by Aerospace Safety Advisory Panel

NASA Technical Reports Server (NTRS)

1980-01-01

Elements of the shuttle program that directly affect the mission success and crew safety were investigated. These elements included the shuttle orbiter, the main engine, the solid rocket boosters, avionic system, ground support equipment and the approach and landing operations. The thermal protection systems were studied in detail. Crew training and ground simulation test procedures were reviewed.

Some Direct and Generalized Effects of Replacing an Autistic Man's Echolalia with Correct Responses to Questions.

ERIC Educational Resources Information Center

McMorrow, Martin J.; Foxx, R. M.

1986-01-01

The use of operant procedures was extended to decrease immediate echolalia and increase appropriate responding to questions of a 21-year-old autistic man. Multiple baseline designs demonstrated that echolalia was rapidly replaced with correct stimulus-specific responses. A variety of generalized improvements were observed in verbal responses to…

AUTOMOTIVE DIESEL MAINTENANCE 2 UNIT IV, AUTOMATIC TRANSMISSIONS--HYDRAULICS (PART II).

ERIC Educational Resources Information Center

Human Engineering Inst., Cleveland, OH.

THIS MODULE OF A 25-MODULE COURSE IS DESIGNED TO DEVELOP AN UNDERSTANDING OF THE OPERATION AND MAINTENANCE OF VALVES UTILIZED IN HYDRAULIC TRANSMISSIONS USED ON DIESEL POWERED VEHICLES. TOPICS ARE (1) REVIEWING FACTS ABOUT PUMPS, (2) USING VALVES FOR CONTROL, (3) TROUBLESHOOTING PROCEDURES ON RELIEF VALVES, (4) USING DIRECTIONAL CONTROL VALVES,…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR THE TRANSMITTAL OF SAMPLING MATERIALS FROM BATTELLE (BCO-G-1.0)

EPA Science Inventory

The purpose of this SOP is to describe the steps to be taken when materials, such as field sampling materials, are shipped from Battelle. A transmittal form accompanies every shipment of such materials or other test articles, substances, paper data, or any other item directly re...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2013-10-01 2013-10-01 false Operating procedures. 193.2503 Section 193.2503...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2011-10-01 2011-10-01 false Operating procedures. 193.2503 Section 193.2503...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2014-10-01 2014-10-01 false Operating procedures. 193.2503 Section 193.2503...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2012-10-01 2012-10-01 false Operating procedures. 193.2503 Section 193.2503...

Development of Facial Rejuvenation Procedures: Thirty Years of Clinical Experience with Face Lifts

PubMed Central

Kim, Byung Jun; Choi, Jun Ho

2015-01-01

Facial rejuvenation procedures can be roughly divided into face lift surgery and nonoperative, less invasive procedures, such as fat grafts, fillers, botulinum toxin injections, thread lifts, or laserbrasion. Face lift surgery or rhytidectomy is the procedure most directly associated with rejuvenation, due to its fundamental ability to restore the anatomical changes caused by aging. Various methods of face lift surgery have been developed over the last hundred years, thanks to advances in the understanding of facial anatomy and the mechanisms of aging, as well as the dedication of innovative surgeons. However, no generally applicable standard method exists, because the condition of each patient is different, and each operative method has advantages and disadvantages. Specific characteristics of the skin of Asians and their skeletal anatomy should be considered when determining the operative method to be used on Asian patients. Plastic surgeons should improve their ability to analyze the original aesthetic properties and problem areas of each patient, drawing on scientific knowledge about the aging process, and they should develop the skills necessary to perform various rejuvenative techniques. In the present article, we reviewed various face lift procedures and the current methods of modified double plane face lift, based on our clinical experience of over 30 years. PMID:26430622

Estimating Surgical Procedure Times Using Anesthesia Billing Data and Operating Room Records.

PubMed

Burgette, Lane F; Mulcahy, Andrew W; Mehrotra, Ateev; Ruder, Teague; Wynn, Barbara O

2017-02-01

The median time required to perform a surgical procedure is important in determining payment under Medicare's physician fee schedule. Prior studies have demonstrated that the current methodology of using physician surveys to determine surgical times results in overstated times. To measure surgical times more accurately, we developed and validated a methodology using available data from anesthesia billing data and operating room (OR) records. We estimated surgical times using Medicare 2011 anesthesia claims and New York Statewide Planning and Research Cooperative System 2011 OR times. Estimated times were validated using data from the National Surgical Quality Improvement Program. We compared our time estimates to those used by Medicare in the fee schedule. We estimate surgical times via piecewise linear median regression models. Using 3.0 million observations of anesthesia and OR times, we estimated surgical time for 921 procedures. Correlation between these time estimates and directly measured surgical time from the validation database was 0.98. Our estimates of surgical time were shorter than the Medicare fee schedule estimates for 78 percent of procedures. Anesthesia and OR times can be used to measure surgical time and thereby improve the payment for surgical procedures in the Medicare fee schedule. © Health Research and Educational Trust.

Code Blue on Orbit: Treating Cardiac Arrest on the ISS

NASA Technical Reports Server (NTRS)

Bacal, Kira; Redmond, Melissa

2004-01-01

As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program.

Application of a real-time three-dimensional navigation system to various oral and maxillofacial surgical procedures.

PubMed

Ohba, Seigo; Yoshimura, Hitoshi; Ishimaru, Kyoko; Awara, Kousuke; Sano, Kazuo

2015-09-01

The aim of this study was to confirm the effectiveness of a real-time three-dimensional navigation system for use during various oral and maxillofacial surgeries. Five surgeries were performed with this real-time three-dimensional navigation system. For mandibular surgery, patients wore acrylic surgical splints when they underwent computed tomography examinations and the operation to maintain the mandibular position. The incidence of complications during and after surgery was assessed. No connection with the nasal cavity or maxillary sinus was observed at the maxilla during the operation. The inferior alveolar nerve was not injured directly, and any paresthesia around the lower lip and mental region had disappeared within several days after the surgery. In both maxillary and mandibular cases, there was no abnormal hemorrhage during or after the operation. Real-time three-dimensional computer-navigated surgery allows minimally invasive, safe procedures to be performed with precision. It results in minimal complications and early recovery.

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

This paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility strives to use spot prices which maximize itsmore » revenues from any given Small Power Producing Facility, SPPF, a schedule while respecting the general regulatory and contractual framework. the proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

The present paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility will strive to use spot prices whichmore » maximize its revenues from any given Small Power Producing Facility, SPPF, schedule while respecting the general regulatory and contractual framework. The proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Joint Forward Operating Base Elements of Command and Control

NASA Astrophysics Data System (ADS)

Summers, William C.

2002-01-01

Since the 1986 Goldwater-Nichols Act directed the Chairman of the Joint Chiefs of Staff to develop doctrine for the joint employment of the armed forces, tactics, techniques, and procedures have evolved at different rates depending on the competency. Whereas the command of joint air forces is well prescribed within the structure of the air operations center and its associated leadership, command of air assets at a joint forward operating base lacks guidance. Today, the United States prosecutes an air war over Afghanistan from bases in Uzbekistan, Pakistan, and Afghanistan. Elements of the United States Army, Air Force, and Marines combine at these geographically minute locations, each bringing a certain complement of support and command and control. Evidence from operations during the 1999 air war for Kosovo at Tirana Rinas Airport in Albania suggests that when these service elements meet at the airfield for the first time, there are problems associated with local procedure. At best, time is wasted creating local joint systems to overcome the difficulties. At worst, safety and mission accomplishment are jeopardized. This thesis will address the need to develop doctrine and a jointly integrated organization to support the command and control function at a forward operating base.

Natural language generation of surgical procedures.

PubMed

Wagner, J C; Rogers, J E; Baud, R H; Scherrer, J R

1999-01-01

A number of compositional Medical Concept Representation systems are being developed. Although these provide for a detailed conceptual representation of the underlying information, they have to be translated back to natural language for used by end-users and applications. The GALEN programme has been developing one such representation and we report here on a tool developed to generate natural language phrases from the GALEN conceptual representations. This tool can be adapted to different source modelling schemes and to different destination languages or sublanguages of a domain. It is based on a multilingual approach to natural language generation, realised through a clean separation of the domain model from the linguistic model and their link by well defined structures. Specific knowledge structures and operations have been developed for bridging between the modelling 'style' of the conceptual representation and natural language. Using the example of the scheme developed for modelling surgical operative procedures within the GALEN-IN-USE project, we show how the generator is adapted to such a scheme. The basic characteristics of the surgical procedures scheme are presented together with the basic principles of the generation tool. Using worked examples, we discuss the transformation operations which change the initial source representation into a form which can more directly be translated to a given natural language. In particular, the linguistic knowledge which has to be introduced--such as definitions of concepts and relationships is described. We explain the overall generator strategy and how particular transformation operations are triggered by language-dependent and conceptual parameters. Results are shown for generated French phrases corresponding to surgical procedures from the urology domain.

An efficient cardiac mapping strategy for radiofrequency catheter ablation with active learning.

PubMed

Feng, Yingjing; Guo, Ziyan; Dong, Ziyang; Zhou, Xiao-Yun; Kwok, Ka-Wai; Ernst, Sabine; Lee, Su-Lin

2017-07-01

A major challenge in radiofrequency catheter ablation procedures is the voltage and activation mapping of the endocardium, given a limited mapping time. By learning from expert interventional electrophysiologists (operators), while also making use of an active-learning framework, guidance on performing cardiac voltage mapping can be provided to novice operators or even directly to catheter robots. A learning from demonstration (LfD) framework, based upon previous cardiac mapping procedures performed by an expert operator, in conjunction with Gaussian process (GP) model-based active learning, was developed to efficiently perform voltage mapping over right ventricles (RV). The GP model was used to output the next best mapping point, while getting updated towards the underlying voltage data pattern as more mapping points are taken. A regularized particle filter was used to keep track of the kernel hyperparameter used by GP. The travel cost of the catheter tip was incorporated to produce time-efficient mapping sequences. The proposed strategy was validated on a simulated 2D grid mapping task, with leave-one-out experiments on 25 retrospective datasets, in an RV phantom using the Stereotaxis Niobe ® remote magnetic navigation system, and on a tele-operated catheter robot. In comparison with an existing geometry-based method, regression error was reduced and was minimized at a faster rate over retrospective procedure data. A new method of catheter mapping guidance has been proposed based on LfD and active learning. The proposed method provides real-time guidance for the procedure, as well as a live evaluation of mapping sufficiency.

Assessing possible exposures of ground troops to Agent Orange during the Vietnam War: the use of contemporary military records.

PubMed

Young, Alvin L; Cecil, Paul F; Guilmartin, John F

2004-01-01

Potential exposure of ground troops in Vietnam to Agent Orange and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) remains controversial despite the passage of 30 years since the Vietnam War. Because of uncertainty over the serum dioxin levels in ground troops at the end of their service in Vietnam, attempts have been made to develop a methodology for characterizing exposure of ground troops in Vietnam to Agent Orange and other herbicides based upon historical reconstruction from military records. Historical information is often useful in evaluating and modeling exposure, but such information should be reasonably accurate, complete, and reliable. This paper reviews the procedures and supporting historical information related to the spraying of herbicides in Vietnam. The historical information is classified into two categories: procedural information and operational information. Procedural information covered the process and procedures followed in spraying herbicides from US Air Force fixed wing aircraft (Operation RANCH HAND) in Vietnam, and included approval procedures for spray missions, the criteria required to conduct a mission, the control exercised by the Forward Air Controller and the Tactical Air Control Center and the characteristics of the equipment used to apply the herbicides. Operational information includes data from the RANCH HAND Daily Air Activities Reports, which included geographic locations of specific spray missions, the amount of herbicide sprayed by a specific mission, reports of battle damage to spray aircraft, reports of fighter aircraft support for aerial spray missions, and any comments, such as reasons for canceling a mission. Historical information demonstrates that herbicide spray missions were carefully planned and that spraying only occurred when friendly forces were not located in the target area. RANCH HAND spray missions were either not approved or cancelled if approved when there were friendly forces in the area designated for spraying. Stringent criteria had to be met before spray missions could be approved. The operational information shows that spray missions for both defoliation and crop destruction were conducted in an extremely hostile environment. Heavy 'fighter suppression' with antipersonnel ordnance was used to minimize the impact of hostile ground fire on RANCH HAND aircraft. Procedures were in place that prohibited movement of troops into sprayed areas immediately after a mission due to the possible presence of unexploded ordnance delivered by fighter aircraft supporting RANCH HAND missions. The optimal nature of the spray equipment and application procedures minimized the possibility of significant spray drift. Conclusions. Few friendly troops were sprayed by fixed wing aircraft during Operation RANCH HAND, which delivered 95% of all defoliants used in Vietnam. Similarly, few troops were sprayed during helicopter or surface-based spray operations, which constituted the remaining 5% of defoliants. Detailed policies and procedures for approval and execution of spray missions ensured that friendly forces were not located in the areas targeted for spraying. Fighter aircraft assigned to accompany each spray mission frequently suppressed much of the hostile fire with bombs and other ordnance. Confirmed clearance of the target area was necessary to avoid friendly casualties. Historical records establish that these policies and procedures were strictly followed. Exposure of troops whether from direct spraying or movement through areas recently sprayed was very unlikely. The wartime military records of troop positions and herbicide operations are valuable for some purposes, but have specific limitations in exposure reconstruction. The completeness and accuracy of the geographic data (maps used by RANCH HAND and military ground units) were dependent upon the inherent precision of the map, the accuracy with which it depicted surface features, and the completeness and accuracy of the information on which it is based. Navigation by the crew using visual orientation and reference to the map was the only means that aircrew on spray missions had for establishing their locations. A Forward Air Controller independent of Operation RANCH HAND was present at the location of each spray target immediately before and during spraying operations to verify the target location and ensure that friendly forces were clear of the target area. Anecdotal reports of direct spraying of troops in Vietnam likely reflect the RANCH HAND missions spraying insecticide for mosquito control at regular intervals from March 1967 through February 1972. Outlook. The distribution and levels of serum dioxin in RANCH HAND veterans and the US Army Chemical Corps Vietnam veterans (the unit responsible for helicopter and ground-based spray operations) are distinguishable from typical levels in the population decades after the Vietnam conflict. An exposure model similar to that proposed in the 2003 report of the Institute of Medicine's Committee on 'Characterizing Exposure of Veterans to Agent Orange and Other Herbicides Used in Vietnam' was tested in 1988 by the Centers for Disease Control and Prevention and found to be a poor predictor of absorbed dose of TCDD. Military records during the Vietnam War lack the precision to determine that troops were directly sprayed with herbicides during Operation RANCH HAND, especially given the procedures in place to ensure clearance of friendly forces from the target area and the lack of elevated serum levels of TCDD in ground troops judged to have operated in heavily sprayed areas.

Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

PubMed

Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

2016-01-01

Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears.

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

Perspectives on three issues facing the transportation manager in the nineties. Research report

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

Lewis, C.A.; Marzette, D.; McCoy, B.

1999-03-01

The nineties have been a period of tremendous change for the transportation industry. The Intermodal Surface Transportation Efficiency Act, Clean Air Act Amendments, Americans with Disabilities Act, and increasing gender and ethnic diversity have caused agencies to reassess their standard operating procedures. Greater knowledge has been sought by senior level transportation officials in an effort to prepare agencies for the changing policy, including, seminars and workshops, revisions to policy manuals, and strengthened procedures regarding how issues will be resolved. This research examines the level and nature of direct impacts on the transportation organization. Major legislative changes and mandates have imposedmore » the need for changes in how transportation systems operate. Transportation professionals continue to be challenged to develop plans and implement services that respond to mandates within the framework of the legislation.« less

Image-guided surgery and therapy: current status and future directions

NASA Astrophysics Data System (ADS)

Peters, Terence M.

2001-05-01

Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

The use of AlloDerm in postmastectomy alloplastic breast reconstruction: part II. A cost analysis.

PubMed

Jansen, Leigh A; Macadam, Sheina A

2011-06-01

Increasingly, AlloDerm is being used in alloplastic breast reconstruction, and has been the subject of a recent systematic review. The authors' objective was to perform a cost analysis comparing direct-to-implant with AlloDerm reconstruction to two-stage non-AlloDerm reconstruction. Seven clinically important health outcomes and their probabilities for both types of reconstruction were derived from the recent review. A decision analytic model from the Canadian provincial payer's perspective was constructed based on these health states. Direct medical costs were estimated from a university-based hospital, yielding expected costs for direct-to-implant reconstruction with AlloDerm and two-stage non-AlloDerm reconstruction. Sensitivity analyses were conducted. Baseline and expected costs were calculated for direct-to-implant AlloDerm and two-stage non-AlloDerm reconstruction. Direct-to-implant reconstruction with AlloDerm was found to be less expensive in the baseline ($10,240 versus $10,584) and expected cost ($10,734 versus $11,251) using a 6 × 16-cm AlloDerm sheet. With a 6 × 12-cm sheet, expected cost falls to $9673. By increasing direct-to-implant operative time from 2 hours to 2.5 hours, expected cost rises to $11,784. If capsular contracture rate requiring revision is set at 15 percent for both procedures, expected costs are $10,926 and $11,251 for direct-to-implant and two-stage procedures, respectively. If the capsular contracture rate is lowered for either procedure, this has minimal impact on expected cost. Although AlloDerm is expensive, it appears to be cost-effective if used for direct-to-implant breast reconstruction. The methods used here may be extrapolated to different centers incorporating local costs and complication rates. A formal randomized controlled trial, including costs, is recommended.

Representing operations procedures using temporal dependency networks

NASA Technical Reports Server (NTRS)

Fayyad, Kristina E.; Cooper, Lynne P.

1993-01-01

DSN Link Monitor & Control (LMC) operations consist primarily of executing procedures to configure, calibrate, test, and operate a communications link between an interplanetary spacecraft and its mission control center. Currently the LMC operators are responsible for integrating procedures into an end-to-end series of steps. The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks (TDN's) to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures. Results of operational tests of this concept, as implemented in the LMC Operator Assistant Prototype (LMCOA), are also presented.

Visual servoing in medical robotics: a survey. Part I: endoscopic and direct vision imaging - techniques and applications.

PubMed

Azizian, Mahdi; Khoshnam, Mahta; Najmaei, Nima; Patel, Rajni V

2014-09-01

Intra-operative imaging is widely used to provide visual feedback to a clinician when he/she performs a procedure. In visual servoing, surgical instruments and parts of tissue/body are tracked by processing the acquired images. This information is then used within a control loop to manoeuvre a robotic manipulator during a procedure. A comprehensive search of electronic databases was completed for the period 2000-2013 to provide a survey of the visual servoing applications in medical robotics. The focus is on medical applications where image-based tracking is used for closed-loop control of a robotic system. Detailed classification and comparative study of various contributions in visual servoing using endoscopic or direct visual images are presented and summarized in tables and diagrams. The main challenges in using visual servoing for medical robotic applications are identified and potential future directions are suggested. 'Supervised automation of medical robotics' is found to be a major trend in this field. Copyright © 2013 John Wiley & Sons, Ltd.

The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases.

PubMed

Park, Hyung-Ki; Jho, Hae-Dong

2012-12-01

Anterior cervical spine operations (ACSO) are generally considered to be safe and effective, but the vertebral artery (VA) is at risk during the procedure. Because the consequences of VA injury can be catastrophic, properly managing a VA injury is very important. However, due to the rarity of these injuries, there is no agreed upon treatment strategy. Studies were identified for inclusion in the review via sensitive searches of electronic databases through 31 December 2011. All cases included in the review were qualitatively analyzed to explore the relationship between type of VA injury management and neurological complications. Seventeen articles describing 39 cases of VA injury during ACSO were included in this study. Seven patients (17.9 %) had neurological complications followed by VA insufficiency. Two patients (5.1 %) had root damage due to ligation. One case (2.6 %) resulted in intraoperative death due to fatal bleeding. Delayed vascular complications were identified in nine (45.0 %) of the 20 patients that underwent only tamponade or hemostatic agent during the operation. Four patients underwent intraoperative endovascular treatment, and three of these patients had a cerebral infarction. All three patients who underwent clipping also had neurological complications. The five patients treated by direct repair did not have any complications. Our review suggests the management of VA injury should be considered in order listed: (1) performing tamponade with a hemostatic agent, (2) direct repair, (3) postoperative endovascular procedures to prevent delayed complications. If tamponade fails to achieve proper hemostasis, additional procedures as endovascular embolization, clipping and ligation should be considered but carry the risk of neurological complications. Because of the limitations of this review, further studies are recommended with larger sample sizes.

Designing Flightdeck Procedures: Literature Resources

NASA Technical Reports Server (NTRS)

Feldman, Jolene; Barshi, Immanuel; Degani, Asaf; Loukopoulou, Loukia; Mauro, Robert

2017-01-01

This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.

The procedure execution manager and its application to Advanced Photon Source operation

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

Borland, M.

1997-06-01

The Procedure Execution Manager (PEM) combines a complete scripting environment for coding accelerator operation procedures with a manager application for executing and monitoring the procedures. PEM is based on Tcl/Tk, a supporting widget library, and the dp-tcl extension for distributed processing. The scripting environment provides support for distributed, parallel execution of procedures along with join and abort operations. Nesting of procedures is supported, permitting the same code to run as a top-level procedure under operator control or as a subroutine under control of another procedure. The manager application allows an operator to execute one or more procedures in automatic, semi-automatic,more » or manual modes. It also provides a standard way for operators to interact with procedures. A number of successful applications of PEM to accelerator operations have been made to date. These include start-up, shutdown, and other control of the positron accumulator ring (PAR), low-energy transport (LET) lines, and the booster rf systems. The PAR/LET procedures make nested use of PEM`s ability to run parallel procedures. There are also a number of procedures to guide and assist tune-up operations, to make accelerator physics measurements, and to diagnose equipment. Because of the success of the existing procedures, expanded use of PEM is planned.« less

Intraoperative sonographic assessment of graft patency during extracranial-intracranial bypass.

PubMed

Badie, B; Lee, F T; Pozniak, M A; Strother, C M

2000-09-01

Extracranial-intracranial (EC-IC) bypass may be necessary to facilitate treatment of unclippable posterior circulation fusiform aneurysms. Although intraoperative digital subtraction angiography (DSA) allows assessment of graft patency, this technique, because of difficulties inherent in performing selective catheterization and angiography in the operating room, has limitations. Duplex sonography, in contrast, is easily performed, and provides information regarding graft patency and blood flow direction during EC-IC bypass procedures. This latter information proved useful in determining the time of parent artery occlusion after two EC-IC bypass procedures performed for treatment of a fusiform midbasilar artery aneurysm.

Structural Tailoring of Advanced Turboprops (STAT)

NASA Technical Reports Server (NTRS)

Brown, Kenneth W.

1988-01-01

This interim report describes the progress achieved in the structural Tailoring of Advanced Turboprops (STAT) program which was developed to perform numerical optimizations on highly swept propfan blades. The optimization procedure seeks to minimize an objective function, defined as either direct operating cost or aeroelastic differences between a blade and its scaled model, by tuning internal and external geometry variables that must satisfy realistic blade design constraints. This report provides a detailed description of the input, optimization procedures, approximate analyses and refined analyses, as well as validation test cases for the STAT program. In addition, conclusions and recommendations are summarized.

From creation and annihilation operators to statistics

NASA Astrophysics Data System (ADS)

Hoyuelos, M.

2018-01-01

A procedure to derive the partition function of non-interacting particles with exotic or intermediate statistics is presented. The partition function is directly related to the associated creation and annihilation operators that obey some specific commutation or anti-commutation relations. The cases of Gentile statistics, quons, Polychronakos statistics, and ewkons are considered. Ewkons statistics was recently derived from the assumption of free diffusion in energy space (Hoyuelos and Sisterna, 2016); an ideal gas of ewkons has negative pressure, a feature that makes them suitable for the description of dark energy.

Surgical "buy-in": the contractual relationship between surgeons and patients that influences decisions regarding life-supporting therapy.

PubMed

Schwarze, Margaret L; Bradley, Ciaran T; Brasel, Karen J

2010-03-01

There is a general consensus by intensivists and nonsurgical providers that surgeons hesitate to withdraw life-sustaining therapy on their operative patients despite a patient's or surrogate's request to do so. The objective of this study was to examine the culture and practice of surgeons to assess attitudes and concerns regarding advance directives for their patients who have high-risk surgical procedures. A qualitative investigation using one-on-one, in-person interviews with open-ended questions about the use of advance directives during perioperative planning. Consensus coding was performed using a grounded theory approach. Data accrual continued until theoretical saturation was achieved. Modeling identified themes and trends, ensuring maximal fit and faithful data representation. Surgical practices in Madison and Milwaukee, WI. Physicians involved in the performance of high-risk surgical procedures. None. We describe the concept of surgical "buy-in," a complex process by which surgeons negotiate with patients a commitment to postoperative care before undertaking high-risk surgical procedures. Surgeons describe seeking a commitment from the patient to abide by prescribed postoperative care, "This is a package deal, this is what this operation entails," or a specific number of postoperative days, "I will contract with them and say, 'look, if we are going to do this, I am going to need 30 days to get you through this operation.'" "Buy-in" is grounded in a surgeon's strong sense of responsibility for surgical outcomes and can lead to surgeon unwillingness to operate or surgeon reticence to withdraw life-sustaining therapy postoperatively. If negotiations regarding life-sustaining interventions result in treatment limitation, a surgeon may shift responsibility for unanticipated outcomes to the patient. A complicated relationship exists between the surgeon and patient that begins in the preoperative setting. It reflects a bidirectional contract that is assumed by the surgeon with distinct implications and consequences for surgeon behavior and patient care.

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 3 2013-07-01 2013-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 3 2012-07-01 2012-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

D0 Central Tracking Solenoid Energization, Controls, Interlocks and Quench Protection Operating Procedures

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

Hance, R.; /Fermilab

1998-08-26

This procedure is used when it is necessary to operate the solenoid energization, controls, interlocks and quench detection system. Note that a separate procedure exists for operating the solenoid 'cryogenic' systems. Only D0 Control Room Operators or the Project Electrical Engineer are qualified to execute these procedures or operate the solenoid system. This procedure assumes that the operator is familiar with using the Distributed Manufacturing Automation and Control Software (DMACS).

Message Received How to Bridge the Communication Gap and Save Lives

DTIC Science & Technology

2004-03-01

safety during an emergency depend on the ability of first responders to talk via radio, directly, without dispatch and in real time. Many technologies are...Words interoperability Coast Guard first responders procedures interagency communications policies 18...communication interoperability for public safety first responders entails far more than finding and emplacing a technology and training the operators. The

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR THE TRANSMITTAL OF SAMPLING MATERIALS FROM BATTELLE (BCO-G-1.0)

EPA Science Inventory

The purpose of this SOP is to describe the steps to be taken when materials, such as field sampling materials, are shipped from Battelle. A transmittal form accompanies every shipment of such materials or other test articles, substances, paper data, or any other item directly re...

Anthro-Centric Multisensory Interfaces for Sensory Augmentation of Telesurgery

DTIC Science & Technology

2011-06-01

compares favorably to standing astride an operating table using laparoscopic instruments, the most favorable ergonomics would facilitate free movement...either through direct contact with the tissues or indirect contact via rigid laparoscopic instruments), opportunities now exist to utilize other...tele-surgical methods. Laparoscopic instruments were initially developed as extended versions of their counterparts used in open procedures (e.g

76 FR 36011 - Airworthiness Directives; Fokker Services B.V. Model F.27 Mark 050, 200, 300, 400, 500, 600, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-21

...: Comments Invited We invite you to send any written relevant data, views, or arguments about this proposed...-operate in developing and implementing common safety regulatory standards and procedures.) Under this...-28-042, including Drawing June 23, 2010. W41192, Sheet 012, Issue AG, dated June 23, 2010, Drawing...

Obfuscated authentication systems, devices, and methods

DOEpatents

Armstrong, Robert C; Hutchinson, Robert L

2013-10-22

Embodiments of the present invention are directed toward authentication systems, devices, and methods. Obfuscated executable instructions may encode an authentication procedure and protect an authentication key. The obfuscated executable instructions may require communication with a remote certifying authority for operation. In this manner, security may be controlled by the certifying authority without regard to the security of the electronic device running the obfuscated executable instructions.

Scorecard cardiovascular medicine. Its impact and future directions.

PubMed

Topol, E J; Califf, R M

1994-01-01

Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statistical, and logistic standpoint. Scorecard medicine may appropriately promote regionalization of medical centers and consolidation of services, but unless the process is directed effectively, it may impair the development of new treatments because of a more restrictive clinical practice environment. We propose revamping our current system to facilitate rapid and accurate access to outcome data in the local practice environment so that improvement in practice occurs on a voluntary basis rather than in response to punitive restrictions. A rational plan needs to be developed for dealing with high-risk patients, perhaps through compensation in regression models used to calculate expected outcomes, and for the start-up of novice physicians. Special provisions are needed to promote clinical research. Before procedures are done, it would be ideal to provide a full disclosure informed consent, whereby the physician reports operator-specific data and the patient's decision-making process is facilitated. Overall, appropriate implementation of scorecards could ultimately lead to a substantial improvement in the quality of U.S. cardiovascular medicine.

A simple technique of laparoscopic port closure.

PubMed

Aziz, Homayara Haque

2013-01-01

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

Characterization of robotics parallel algorithms and mapping onto a reconfigurable SIMD machine

NASA Technical Reports Server (NTRS)

Lee, C. S. G.; Lin, C. T.

1989-01-01

The kinematics, dynamics, Jacobian, and their corresponding inverse computations are six essential problems in the control of robot manipulators. Efficient parallel algorithms for these computations are discussed and analyzed. Their characteristics are identified and a scheme on the mapping of these algorithms to a reconfigurable parallel architecture is presented. Based on the characteristics including type of parallelism, degree of parallelism, uniformity of the operations, fundamental operations, data dependencies, and communication requirement, it is shown that most of the algorithms for robotic computations possess highly regular properties and some common structures, especially the linear recursive structure. Moreover, they are well-suited to be implemented on a single-instruction-stream multiple-data-stream (SIMD) computer with reconfigurable interconnection network. The model of a reconfigurable dual network SIMD machine with internal direct feedback is introduced. A systematic procedure internal direct feedback is introduced. A systematic procedure to map these computations to the proposed machine is presented. A new scheduling problem for SIMD machines is investigated and a heuristic algorithm, called neighborhood scheduling, that reorders the processing sequence of subtasks to reduce the communication time is described. Mapping results of a benchmark algorithm are illustrated and discussed.

Formalizing procedures for operations automation, operator training and spacecraft autonomy

NASA Technical Reports Server (NTRS)

Lecouat, Francois; Desaintvincent, Arnaud

1994-01-01

The generation and validation of operations procedures is a key task of mission preparation that is quite complex and costly. This has motivated the development of software applications providing support for procedures preparation. Several applications have been developed at MATRA MARCONI SPACE (MMS) over the last five years. They are presented in the first section of this paper. The main idea is that if procedures are represented in a formal language, they can be managed more easily with a computer tool and some automatic verifications can be performed. One difficulty is to define a formal language that is easy to use for operators and operations engineers. From the experience of the various procedures management tools developed in the last five years (including the POM, EOA, and CSS projects), MMS has derived OPSMAKER, a generic tool for procedure elaboration and validation. It has been applied to quite different types of missions, ranging from crew procedures (PREVISE system), ground control centers management procedures (PROCSU system), and - most relevant to the present paper - satellite operation procedures (PROCSAT developed for CNES, to support the preparation and verification of SPOT 4 operation procedures, and OPSAT for MMS telecom satellites operation procedures).

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits? (a...-specific operating limits in your operation and maintenance plan according to the procedures in paragraphs... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

PubMed

Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

2016-01-01

Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p <0.01). When factoring in differences in time spent in training, this amounts to a weekly average difference of 1.2 cases throughout training. In this study, we find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The design, production and clinical application of 3D patient-specific implants with drilling guides for acetabular surgery.

PubMed

Merema, B J; Kraeima, J; Ten Duis, K; Wendt, K W; Warta, R; Vos, E; Schepers, R H; Witjes, M J H; IJpma, F F A

2017-11-01

An innovative procedure for the development of 3D patient-specific implants with drilling guides for acetabular fracture surgery is presented. By using CT data and 3D surgical planning software, a virtual model of the fractured pelvis was created. During this process the fracture was virtually reduced. Based on the reduced fracture model, patient-specific titanium plates including polyamide drilling guides were designed, 3D printed and milled for intra-operative use. One of the advantages of this procedure is that the personalised plates could be tailored to both the shape of the pelvis and the type of fracture. The optimal screw directions and sizes were predetermined in the 3D model. The virtual plan was translated towards the surgical procedure by using the surgical guides and patient-specific osteosynthesis. Besides the description of the newly developed multi-disciplinary workflow, a clinical case example is presented to demonstrate that this technique is feasible and promising for the operative treatment of complex acetabular fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment and Calibration of Ultrasonic Measurement Errors in Estimating Weathering Index of Stone Cultural Heritage

NASA Astrophysics Data System (ADS)

Lee, Y.; Keehm, Y.

2011-12-01

Estimating the degree of weathering in stone cultural heritage, such as pagodas and statues is very important to plan conservation and restoration. The ultrasonic measurement is one of commonly-used techniques to evaluate weathering index of stone cultual properties, since it is easy to use and non-destructive. Typically we use a portable ultrasonic device, PUNDIT with exponential sensors. However, there are many factors to cause errors in measurements such as operators, sensor layouts or measurement directions. In this study, we carried out variety of measurements with different operators (male and female), different sensor layouts (direct and indirect), and sensor directions (anisotropy). For operators bias, we found that there were not significant differences by the operator's sex, while the pressure an operator exerts can create larger error in measurements. Calibrating with a standard sample for each operator is very essential in this case. For the sensor layout, we found that the indirect measurement (commonly used for cultural properties, since the direct measurement is difficult in most cases) gives lower velocity than the real one. We found that the correction coefficient is slightly different for different types of rocks: 1.50 for granite and sandstone and 1.46 for marble. From the sensor directions, we found that many rocks have slight anisotropy in their ultrasonic velocity measurement, though they are considered isotropic in macroscopic scale. Thus averaging four different directional measurement (0°, 45°, 90°, 135°) gives much less errors in measurements (the variance is 2-3 times smaller). In conclusion, we reported the error in ultrasonic meaurement of stone cultural properties by various sources quantitatively and suggested the amount of correction and procedures to calibrate the measurements. Acknowledgement: This study, which forms a part of the project, has been achieved with the support of national R&D project, which has been hosted by National Research Institute of Cultural Heritage of Cultural Heritage Administration(No. NRICH-1107-B01F).

A Modified, Direct Neck Lift Technique: The Cervical Wave-Plasty

PubMed Central

Castel, Nikki; Parsa, Natalie Niloufar

2016-01-01

Background Major problems with cervicoplasty by direct skin excision include the subjective nature of skin markings preoperatively and the confusing array of procedures offered. This technique incorporates curved incisions, resulting in a wave-like scar, which is why the procedure is called a "wave-plasty". Methods This prospective study includes 37 patients who underwent wave-plasty procedures from 2004 to 2015. Skin pinching technique was used to mark the anterior neck preoperatively in a reproducible fashion. Intra-operatively, redundant skin was excised, along with excess fat when necessary, and closed to form a wave-shaped scar. Patients were asked to follow up at 1 week, 6 weeks, and 6 months after surgery. Results The mean operation time was 70.8 minutes. The majority (81.3%) was satisfied with their progress. On a scale of 1 to 10 (1 being the worst, and 10 being the best), the scars were objectively graded on average 5.5 when viewed from the front and 7.3 when seen from the side 6 months after surgery. Complications consisted of one partial wound dehiscence (2.3%), one incidence of hypertrophic scarring (2.3%), and two cases of under-resection requiring revision (5.4%). Conclusions In select patients, surgical rejuvenation of the neck may be obtained through wave-like incisions to remove redundant cervical skin when other options are not available. The technique is reproducible, easily teachable and carries low morbidity and high patient satisfaction in carefully chosen patients. PMID:27019811

Representing Operations Procedures Using Temporal Dependency Algorithms

NASA Technical Reports Server (NTRS)

Fayyad, K.; Cooper, L.

1992-01-01

The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures.

Factors associated with adverse clinical outcomes among obstetric trainees

PubMed Central

Aiken PhD, Catherine E.; Aiken, Abigail; Park, Hannah; Brockelsby, Jeremy C.; Prentice, Andrew

2016-01-01

Objective To determine whether UK obstetric trainees transitioning from directly to indirectly-supervised practice have a higher likelihood of adverse patient outcomes from operative deliveries compared to other indirectly supervised trainees and to examine whether performing more procedures under direct supervision is associated with fewer adverse outcomes in initial indirect practice. Methods We examined all deliveries (13,861) conducted by obstetricians at a single centre over 5 years (2008-2013). Mixed-effects logistic regression models were used to compare estimated blood loss, maternal trauma, umbilical arterial pH, delayed neonatal respiration, failed instrumental delivery, and critical incidents for trainees in their first indirectly-supervised year with trainees in all other years of indirect practice. Outcomes for trainees in their first indirectly-supervised 3 months were compared to their outcomes for the remainder of the year. Linear regression was used to examine the relationship between number of procedures performed under direct supervision and initial outcomes under indirect supervision. Results Trainees in their first indirectly-supervised year had a higher likelihood of >2 litres estimated blood loss at any delivery (OR 1.32;CI(1.01-1.64) p<0.05) and of failed instrumental delivery (OR 2.33;CI(1.37-3.29) p<0.05) compared with other indirectly-supervised trainees. Other measured outcomes showed no significant differences. Within the first three months of indirect supervision, the likelihood of operative vaginal deliveries with >1litre estimated blood loss (OR 2.54;CI(1.88-3.20) p<0.05) was higher compared to the remainder of the first year. Performing more deliveries under direct supervision prior to beginning indirectly-supervised training was associated with decreased risk of >1litre estimated blood loss (p<0.05). Conclusions Obstetric trainees in their first year of indirectly-supervised practice have a higher likelihood of immediate adverse delivery outcomes, which are primarily maternal rather than neonatal. Undertaking more directly supervised procedures prior to transitioning to indirectly-supervised practice may reduce adverse outcomes, suggesting that experience is a key consideration in obstetric training programme design. PMID:26077215

Orbital operations study. Appendix B: Operational procedures

NASA Technical Reports Server (NTRS)

Galvin, D. M.; Mattson, H. L.; True, D. M.; Anderson, N. R.; Mehrbach, E.; Gianformaggio, A.; Steinwachs, W. L.; Turkel, S. H.

1972-01-01

Operational procedures for each alternate approach for each interfacing activity of the orbital operations study are presented. The applicability of the procedures to interfacing element pairs is identified.

Test Operations Procedure (TOP) 03-2-827 Test Procedures for Video Target Scoring Using Calibration Lights

DTIC Science & Technology

2016-04-04

Final 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Test Operations Procedure (TOP) 03-2-827 Test Procedures for Video Target Scoring Using...ABSTRACT This Test Operations Procedure (TOP) describes typical equipment and procedures to setup and operate a Video Target Scoring System (VTSS) to...lights. 15. SUBJECT TERMS Video Target Scoring System, VTSS, witness screens, camera, target screen, light pole 16. SECURITY

[Learning from the experiences of an arbitration unit for medical liability questions].

PubMed

Scheppokat, K D

2005-03-01

While other countries', e.g. the United States', experience with alternative dispute resolution (ADR) in medical malpractice has been disappointing, German physicians have instituted extrajudicial claims resolution as an alternative to civil litigation: Established by the Arztekammern (corporate bodies of professional self-governance) in the mid-1970s, the Schlichtungsstellen (SchlSt--claims resolution panels) offer patients and doctors, on a voluntary basis, proceedings directed toward achieving a settlement. The number of cases submitted to these panels has been constantly growing since. In 90% of cases decided upon by the panel, civil litigation was avoided. Doctors can, as exemplified by the operation of the SchlSt, tackle difficult and complex problems and solve them--without being funded or directed by outside agencies. What can be learnt from being, as a physician member, associated with a SchlSt for several years? (1) Physicians--as Eddy has pointed out--must make decisions about complex problems under difficult conditions on the basis of inadequate information. Expert testimony suffers from similar uncertainties. Decisions on individual cases cannot be improved by external and necessarily generalized ruling (disease management programs, other directives). (2) Errors and adverse events in medical care have to be accepted as principally unavoidable. Most claims heard by the panel have to do with operations and--in the non-surgical specialties--with invasive procedures. Medical tasks of high complexity, as many operative and invasive procedures indeed are, seem to have an inherent accident-proneness. Therefore decisions as to operations and invasive procedures should be weighed with utmost care. More is not always better (3) 25% of the patients filing claims with the SchlSt complain of deficient doctor-patient-communication. Failure of doctors and staff to communicate adequately with the patients and with their professional contacts plays an important role as risk factor for negligence and injury and even as cause of disputes and claims. (4) The GP, the generalist in a profession characterized by specialization, has to treat a wide spectrum of diseases, wider than any specialist. As far as can be seen, he does his job well. He needs adequate--if possible personal--contact with and support by his colleagues involved in the treatment of the same patient.

Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

PubMed

Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

2010-01-01

Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges.

Magnetic resonance imaging-guided surgical design: can we optimise the Fontan operation?

PubMed

Haggerty, Christopher M; Yoganathan, Ajit P; Fogel, Mark A

2013-12-01

The Fontan procedure, although an imperfect solution for children born with a single functional ventricle, is the only reconstruction at present short of transplantation. The haemodynamics associated with the total cavopulmonary connection, the modern approach to Fontan, are severely altered from the normal biventricular circulation and may contribute to the long-term complications that are frequently noted. Through recent technological advances, spear-headed by advances in medical imaging, it is now possible to virtually model these surgical procedures and evaluate the patient-specific haemodynamics as part of the pre-operative planning process. This is a novel paradigm with the potential to revolutionise the approach to Fontan surgery, help to optimise the haemodynamic results, and improve patient outcomes. This review provides a brief overview of these methods, presents preliminary results of their clinical usage, and offers insights into its potential future directions.

XV-15 Low-Noise Terminal Area Operations Testing

NASA Technical Reports Server (NTRS)

Edwards, B. D.

1998-01-01

Test procedures related to XV-15 noise tests conducted by NASA-Langley and Bell Helicopter Textron, Inc. are discussed. The tests. which took place during October and November 1995, near Waxahachie, Texas, documented the noise signature of the XV-15 tilt-rotor aircraft at a wide variety of flight conditions. The stated objectives were to: -provide a comprehensive acoustic database for NASA and U.S. Industry -validate noise prediction methodologies, and -develop and demonstrate low-noise flight profiles. The test consisted of two distinct phases. Phase 1 provided an acoustic database for validating analytical noise prediction techniques; Phase 2 directly measured noise contour information at a broad range of operating profiles, with emphasis on minimizing 'approach' noise. This report is limited to a documentation of the test procedures, flight conditions, microphone locations, meteorological conditions, and test personnel used in the test. The acoustic results are not included.

Probabilistic Nowcasting of Low-Visibility Procedure States at Vienna International Airport During Cold Season

NASA Astrophysics Data System (ADS)

Kneringer, Philipp; Dietz, Sebastian J.; Mayr, Georg J.; Zeileis, Achim

2018-04-01

Airport operations are sensitive to visibility conditions. Low-visibility events may lead to capacity reduction, delays and economic losses. Different levels of low-visibility procedures (lvp) are enacted to ensure aviation safety. A nowcast of the probabilities for each of the lvp categories helps decision makers to optimally schedule their operations. An ordered logistic regression (OLR) model is used to forecast these probabilities directly. It is applied to cold season forecasts at Vienna International Airport for lead times of 30-min out to 2 h. Model inputs are standard meteorological measurements. The skill of the forecasts is accessed by the ranked probability score. OLR outperforms persistence, which is a strong contender at the shortest lead times. The ranked probability score of the OLR is even better than the one of nowcasts from human forecasters. The OLR-based nowcasting system is computationally fast and can be updated instantaneously when new data become available.

Regulations and Procedures Manual

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

Young, Lydia J.

The purpose of the Regulations and Procedures Manual (RPM) is to provide LBNL personnel with a reference to University and Lawrence Berkeley National Laboratory (LBNL or Laboratory) policies and regulations by outlining normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory organizations. Much of the information in this manual has been condensed from detail provided in LBNL procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. RPM sections on personnel apply only to employees who are not represented by unions. Personnelmore » policies pertaining to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the LBNL organization responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which organization is responsible for a policy, please contact Requirements Manager Lydia Young or the RPM Editor.« less

Feynman formulae and phase space Feynman path integrals for tau-quantization of some Lévy-Khintchine type Hamilton functions

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

Butko, Yana A., E-mail: yanabutko@yandex.ru, E-mail: kinderknecht@math.uni-sb.de; Grothaus, Martin, E-mail: grothaus@mathematik.uni-kl.de; Smolyanov, Oleg G., E-mail: Smolyanov@yandex.ru

2016-02-15

Evolution semigroups generated by pseudo-differential operators are considered. These operators are obtained by different (parameterized by a number τ) procedures of quantization from a certain class of functions (or symbols) defined on the phase space. This class contains Hamilton functions of particles with variable mass in magnetic and potential fields and more general symbols given by the Lévy-Khintchine formula. The considered semigroups are represented as limits of n-fold iterated integrals when n tends to infinity. Such representations are called Feynman formulae. Some of these representations are constructed with the help of another pseudo-differential operator, obtained by the same procedure ofmore » quantization; such representations are called Hamiltonian Feynman formulae. Some representations are based on integral operators with elementary kernels; these are called Lagrangian Feynman formulae. Langrangian Feynman formulae provide approximations of evolution semigroups, suitable for direct computations and numerical modeling of the corresponding dynamics. Hamiltonian Feynman formulae allow to represent the considered semigroups by means of Feynman path integrals. In the article, a family of phase space Feynman pseudomeasures corresponding to different procedures of quantization is introduced. The considered evolution semigroups are represented as phase space Feynman path integrals with respect to these Feynman pseudomeasures, i.e., different quantizations correspond to Feynman path integrals with the same integrand but with respect to different pseudomeasures. This answers Berezin’s problem of distinguishing a procedure of quantization on the language of Feynman path integrals. Moreover, the obtained Lagrangian Feynman formulae allow also to calculate these phase space Feynman path integrals and to connect them with some functional integrals with respect to probability measures.« less

Improved Equivalent Linearization Implementations Using Nonlinear Stiffness Evaluation

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Muravyov, Alexander A.

2001-01-01

This report documents two new implementations of equivalent linearization for solving geometrically nonlinear random vibration problems of complicated structures. The implementations are given the acronym ELSTEP, for "Equivalent Linearization using a STiffness Evaluation Procedure." Both implementations of ELSTEP are fundamentally the same in that they use a novel nonlinear stiffness evaluation procedure to numerically compute otherwise inaccessible nonlinear stiffness terms from commercial finite element programs. The commercial finite element program MSC/NASTRAN (NASTRAN) was chosen as the core of ELSTEP. The FORTRAN implementation calculates the nonlinear stiffness terms and performs the equivalent linearization analysis outside of NASTRAN. The Direct Matrix Abstraction Program (DMAP) implementation performs these operations within NASTRAN. Both provide nearly identical results. Within each implementation, two error minimization approaches for the equivalent linearization procedure are available - force and strain energy error minimization. Sample results for a simply supported rectangular plate are included to illustrate the analysis procedure.

Toolbox of assessment tools of technical skills in otolaryngology-head and neck surgery: A systematic review.

PubMed

Labbé, Mathilde; Young, Meredith; Nguyen, Lily H P

2017-10-08

To support the development of programs of assessment of technical skills in the operating room (OR), we systematically reviewed the literature to identify assessment tools specific to otolaryngology-head and neck surgery (OTL-HNS) core procedures and summarized their characteristics. We systematically searched Embase, MEDLINE, PubMed, and Cochrane to identify and report on assessment tools that can be used to assess residents' technical surgical skills in the operating room for OTL-HNS core procedures. Of the 736 unique titles retrieved, 16 articles met inclusion criteria, covering 11 different procedures (in otology, rhinology, laryngology, head and neck, and general otolaryngology). The tools were composed of a task-specific checklist and/or global rating scale and were developed in the OR, on human cadavers, or in a simulation setting. Our study reports on published tools for assessing technical skills for OTL-HNS residents during core procedures conducted in the OR. These assessment tools could facilitate the provision of timely feedback to trainees including specific goals for improvement. However, the paucity of publications suggests little agreement on how to best perform work-based direct-observation assessment for core surgical procedures in OTL-HNS. The sparsity of tools specific to OTL-HNS may become a barrier to a fluid transition to competency-based medical education. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

A Quality-Control-Oriented Database for a Mesoscale Meteorological Observation Network

NASA Astrophysics Data System (ADS)

Lussana, C.; Ranci, M.; Uboldi, F.

2012-04-01

In the operational context of a local weather service, data accessibility and quality related issues must be managed by taking into account a wide set of user needs. This work describes the structure and the operational choices made for the operational implementation of a database system storing data from highly automated observing stations, metadata and information on data quality. Lombardy's environmental protection agency, ARPA Lombardia, manages a highly automated mesoscale meteorological network. A Quality Assurance System (QAS) ensures that reliable observational information is collected and disseminated to the users. The weather unit in ARPA Lombardia, at the same time an important QAS component and an intensive data user, has developed a database specifically aimed to: 1) providing quick access to data for operational activities and 2) ensuring data quality for real-time applications, by means of an Automatic Data Quality Control (ADQC) procedure. Quantities stored in the archive include hourly aggregated observations of: precipitation amount, temperature, wind, relative humidity, pressure, global and net solar radiation. The ADQC performs several independent tests on raw data and compares their results in a decision-making procedure. An important ADQC component is the Spatial Consistency Test based on Optimal Interpolation. Interpolated and Cross-Validation analysis values are also stored in the database, providing further information to human operators and useful estimates in case of missing data. The technical solution adopted is based on a LAMP (Linux, Apache, MySQL and Php) system, constituting an open source environment suitable for both development and operational practice. The ADQC procedure itself is performed by R scripts directly interacting with the MySQL database. Users and network managers can access the database by using a set of web-based Php applications.

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

PubMed

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

2009-03-01

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

In-office vs. operating room procedures for recurrent respiratory papillomatosis.

PubMed

Miller, Anya J; Gardner, Glendon M

2017-01-01

We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

[The European Working Time Directive and surgical residents' expertise: no effect on the number of operations].

PubMed

Guicherit, Onno R

2015-01-01

Residents' working hours in the Netherlands were first capped in the early 1990 s. In 2003, European legislation consolidated restrictions to a 48-hour week. No adverse effects were seen on the number of surgical operations performed either in the first or the second decade following these measures. Either the effect on surgical training is minimal, or the number of operations carried out during a residency is not a meaningful indicator of its quality. Personalized modular rotations in both university and teaching hospitals are needed for residents with sub-specializations. Training activities, in combination with more supervision, have to focus on a broader set of competencies beyond simply mastering surgical procedures.

Measurement of the exposure of workers to pesticides*

PubMed Central

Durham, William F.; Wolfe, Homer R.

1962-01-01

There is not a single pesticide for which the interrelationships between occupational exposure by different routes, the fate of the compound in the human body, and its clinical effects are all adequately known. Results of the direct measurement of exposure to pesticides may be used in evaluating the relative hazard of different routes of exposure, different operational procedures, and different protective devices. Results of the indirect measurement of exposure may be of use for the same purpose; in addition, these indirect measures may be used in relating exposures under observed conditions to clinical effects. This paper describes and evaluates detailed procedures for the use of air samples, pads, and washes in the direct measurement of the dermal and respiratory exposure of workers to pesticides. Good methods are not available for measuring oral exposure. Any measure of the absorption, storage, physiological effect, or excretion of a compound constitutes an indirect indication of exposure to it. ImagesFIG. 2 PMID:13888659

New transurethral system for interstitial radiation of prostate cancer

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

Baumgartner, G.; Callahan, D.; McKiel, C.F. Jr.

Direct endoscopic implantation of radioactive materials for carcinoma of the prostate without an open operation was accomplished by the use of modified existing transurethral instrumentation and techniques. The closed approach seems applicable particularly to the geriatric population, which is afflicted more commonly but is frequently not treated because of concurrent diseases or because the patient had transurethral resection of the prostate as a diagnostic procedure. Eleven patients were implanted using the transurethral route. Implantations were accomplished successfully with extremely low morbidity. Along with more conventional dosimetry studies, computer tomography was used to assess the placement of seeds. The direct visualizationmore » of the method suggests a potential for greater precision of seed placement as illustrated by computer tomography. In addition, this new instrumentation and method offers a low-risk procedure for carcinoma of the prostate that can be performed on an outpatient basis for selected patients.« less

Current challenges in the recognition, prevention and treatment of perioperative pulmonary atelectasis.

PubMed

Restrepo, Ruben D; Braverman, Jane

2015-02-01

Innovations in surgery have significantly increased the number of procedures performed every year. While more individuals benefit from better surgical techniques and technology, a larger group of patients previously deemed ineligible for surgery now undergo high-complexity surgical procedures. Despite continuous improvements in the operating room and post-operative care, post-operative pulmonary complications (PPCs) continue to pose a serious threat to successful outcomes. PPCs are common, serious and costly. Growing awareness of the impact of PPCs has led to intensified efforts to understand the underlying causes. Current evidence demonstrates that a high proportion of PPCs are directly traceable to the pre-operative risk for and perioperative development of atelectasis. The substantial costs and losses associated with PPCs demand strategies to reduce their prevalence and impact. Effective interventions will almost certainly produce cost savings that significantly offset current economic and human resource expenditures. The purpose of this review is to describe the most common challenges encountered in the recognition, prevention and management of perioperative atelectasis. Expanding awareness and understanding of the role of atelectasis as a cause of PPCs can reduce their prevalence, impact important clinical outcomes and reduce the financial burden associated with treating these complications.

76 FR 80261 - National Emission Standards for Hazardous Air Pollutants: Area Source Standards for Prepared...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... specifications and operating instructions, if available, or standard operating procedures must be developed by... manufacturer's specifications and operating instructions, if available, or standard operating procedures must... operating specifications or standard operating procedures developed by the prepared feeds manufacturer be...

Impact of Aneurysm Projection on Intraoperative Complications During Surgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

PubMed

Fukuda, Hitoshi; Hayashi, Kosuke; Yoshino, Kumiko; Koyama, Takashi; Lo, Benjamin; Kurosaki, Yoshitaka; Yamagata, Sen

2016-03-01

Surgical clipping of ruptured posterior communicating artery (PCoA) aneurysms is a well-established procedure to date. However, preoperative factors associated with procedure-related risk require further elucidation. To investigate the impact of the direction of aneurysm projection on the incidence of procedure-related complications during surgical clipping of ruptured PCoA aneurysms. A total of 65 patients with ruptured PCoA aneurysms who underwent surgical clipping were retrospectively analyzed from a single-center, prospective, observational cohort database in this study. The aneurysms were categorized into lateral and posterior projection groups, depending on direction of the dome. Characteristics and operative findings of each projection group were identified. We also evaluated any correlation of aneurysm projection with the incidence of procedure-related complications. Patients with ruptured PCoA aneurysms with posterior projection more likely presented with good-admission-grade subarachnoid hemorrhage (P = .01, χ test) and were less to also have intracerebral hematoma (P = .01). These aneurysms were found to be associated with higher incidence of intraoperative rupture (P = .02), complex clipping with fenestrated clips (P = .02), and dense adherence to PCoA or its perforators (P = .04) by univariate analysis. Aneurysms with posterior projection were also correlated with procedure-related complications, including postoperative cerebral infarction or hematoma formation (odds ratio, 5.87; 95% confidence interval, 1.11-31.1; P = .04) by multivariable analysis. Ruptured PCoA aneurysms with posterior projection carried a higher risk of procedure-related complications of surgical clipping than those with lateral projection.

Checkout and Standard Use Procedures for the Mark III Space Suit Assembly

NASA Technical Reports Server (NTRS)

Valish, Dana J.

2012-01-01

The operational pressure range is the range to which the suit can be nominally operated for manned testing. The top end of the nominal operational pressure range is equivalent to 1/2 the proof pressure. Structural pressure is 1.5 times the specified test pressure for any given test. Proof pressure is the maximum unmanned pressure to which the suit was tested by the vendor prior to delivery. The maximum allowable working pressure (MAWP) is 90% of the proof pressure. The pressure systems RVs are set to keep components below their MAWPs. If the suit is pressurized over its MAWP, the suit will be taken out of service and an in-depth inspection/review of the suit will be performed before the suit is put back in service. The procedures outlined in this document should be followed as written. However, the suit test engineer (STE) may make redline changes real-time, provided those changes are recorded in the anomaly section of the test data sheet. If technicians supporting suit build-up, check-out, and/or test execution believe that a procedure can be improved, they should notify their lead. If procedures are incorrect to the point of potentially causing hardware damage or affecting safety, bring the problem to the technician lead and/or STE s attention and stop work until a solution (temporary or permanent) is authorized. Certain steps in the procedure are marked with a DV , for Designated Verifier. The Designated Verifier for this procedure is an Advanced Space Suit Technology Development Laboratory technician, not directly involved in performing the procedural steps, who will verify that the step was performed as stated. The steps to be verified by the DV were selected based on one or more of the following criteria: the step was deemed significant in ensuring the safe performance of the test, the data recorded in the step is of specific interest in monitoring the suit system operation, or the step has a strong influence on the successful completion of test objectives. Prior to all manned test activities, Advanced Suit Test Data Sheet (TDS) Parts A-E shall be completed to verify system and team are ready for test. Advanced Suit TDS Parts F-G shall be completed at the end of the suited activity. Appendix B identifies tha appropriate Mark III suit emergency event procedures.

Robotic general surgery experience: a gradual progress from simple to more complex procedures.

PubMed

Al-Naami, M; Anjum, M N; Aldohayan, A; Al-Khayal, K; Alkharji, H

2013-12-01

Robotic surgery was introduced at our institution in 2003, and we used a progressive approach advancing from simple to more complex procedures. A retrospective chart review. Cases included totalled 129. Set-up and operative times have improved over time and with experience. Conversion rates to standard laparoscopic or open techniques were 4.7% and 1.6%, respectively. Intraoperative complications (6.2%), blood loss and hospital stay were directly proportional to complexity. There were no mortalities and the postoperative complication rate (13.2%) was within accepted norms. Our findings suggest that robot technology is presently most useful in cases tailored toward its advantages, i.e. those confined to a single space, those that require performance of complex tasks, and re-do procedures. Copyright © 2013 John Wiley & Sons, Ltd.

Pneumoperitoneum pressures during pelvic laparoscopic surgery: a systematic review and meta-analysis.

PubMed

Bogani, Giorgio; Martinelli, Fabio; Ditto, Antonino; Chiappa, Valentina; Lorusso, Domenica; Ghezzi, Fabio; Raspagliesi, Francesco

2015-12-01

Growing evidence suggests that the level of pneumoperitoneal pressure is directly correlated with postoperative pain in patients undergoing laparoscopic procedures. However, only limited evidence is available in the field of gynaecologic surgery. Therefore, this study aimed to compare the effects of low (8mmHg), standard (12mmHg) and high (15mmHg) pneumoperitoneal pressures (LPP

[Establishment and management of electronic appointment library for dental implant patients].

PubMed

Dong, Zheng-jie; Xu, Kan

2013-10-01

To design an excel form which can prompt dental implant patient appointment through color change, which can scientifically manage implant EMR library through appropriate interlinkage and number. An excel form based on operating system Windows XP was designed and software 2003 Microsoft excel was used, which was configured to change color with the passage of time by the use of command "conditional format". An excel form was designed. The color turned to red automatically on the day the patient underwent implant surgery. It turned to yellow when the patient recalled 2 weeks after the first operation, to green when the patient underwent secondary operation. It was designed to be gray when all the procedures of implant restoration was finished. In addition, we could know patients' main implant situation through directly opening his EMR when clicking on his name or number. Dentists can remind the implant patient appointment schedule through color change of an excel form, and can consult the implant patient EMR directly through interlinkage or number.

Sub-microradian Surface Slope Metrology with the ALS Developmental Long Trace Profiler

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

Yashchuk, Valeriy V; Barber, Samuel; Domning, Edward E.

2009-09-11

A new low budget slope measuring instrument, the Developmental Long Trace Profiler (DLTP), was recently brought to operation at the ALS Optical Metrology Laboratory. The design, instrumental control and data acquisition system, initial alignment and calibration procedures, as well as the developed experimental precautions and procedures are described in detail. The capability of the DLTP to achieve sub-microradian surface slope metrology is verified via cross-comparison measurements with other high performance slope measuring instruments when measuring the same high quality test optics. The directions of future work to develop a surface slope measuring profiler with nano-radian performance are also discussed.

Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

PubMed

Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

2017-05-08

Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... accordance with its standard operating procedure of the information identified in paragraphs (a)(1), (a)(2... shall establish a written standard operating procedure for the collection, maintenance, and auditing of... standard operating procedure: (1) Data collection and recording procedures, which shall include a procedure...

Paratonia: a Delphi procedure for consensus definition.

PubMed

Hobbelen, Johannes S M; Koopmans, Raymond T C M; Verhey, Frans R J; Van Peppen, Roland P S; de Bie, Rob A

2006-01-01

Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia. The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia. Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon. The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.

Tensor methodology and computational geometry in direct computational experiments in fluid mechanics

NASA Astrophysics Data System (ADS)

Degtyarev, Alexander; Khramushin, Vasily; Shichkina, Julia

2017-07-01

The paper considers a generalized functional and algorithmic construction of direct computational experiments in fluid dynamics. Notation of tensor mathematics is naturally embedded in the finite - element operation in the construction of numerical schemes. Large fluid particle, which have a finite size, its own weight, internal displacement and deformation is considered as an elementary computing object. Tensor representation of computational objects becomes strait linear and uniquely approximation of elementary volumes and fluid particles inside them. The proposed approach allows the use of explicit numerical scheme, which is an important condition for increasing the efficiency of the algorithms developed by numerical procedures with natural parallelism. It is shown that advantages of the proposed approach are achieved among them by considering representation of large particles of a continuous medium motion in dual coordinate systems and computing operations in the projections of these two coordinate systems with direct and inverse transformations. So new method for mathematical representation and synthesis of computational experiment based on large particle method is proposed.

New risk indicator approach for Operators, Workers, Bystanders and Residents for a sustainable use of plant protection products.

PubMed

Sacchettini, Gabriele; Calliera, Maura; Marchis, Alexandru; Glass, Richard; Ellis, Clare Butler; Machera, Kyriaki; Gerritsen-Ebben, Rianda; Spanoghe, Pieter; Capri, Ettore

2015-11-01

In 2009, the European Union adopted the Directive on Sustainable Use of pesticides (SUD, Directive 2009/128/EC) establishing a framework for achieving a sustainable use of Plant Protection Products (PPPs) through reducing the risks and impacts of PPP use on human health and the environment, promoting integrated pest management and stimulating effective non-chemical alternatives. The core idea of the SUD is that it is necessary to monitor the use of PPPs through the implementation of an appropriate set of risk indicators to monitor progress and trends in risk reduction within the Member States. To contribute to this direction, following a comprehensive analysis of the risk (including procedures of risk assessment and risk management) and involving stakeholders in the decision process, specific toolboxes of practical indirect risk indicators of exposure of Operators, Workers, Bystanders and Residents were developed and are now available to be used by Member States (MSs) based on their specific context.

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

Bower, J.C.; Burford, M.J.; Downing, T.R.

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Nuclear and Chemical Agency (USANCA). The IBS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain a site-specific map database. Data and system managers use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of the IBS. This document provides a description of the data files and structures necessary for running the IBS software and using themore » site map database.« less

[Principles of direct surgical procedures on the pancreas in surgical treatment of chronic pancreatitis].

PubMed

Kopchak, V M; Khomiak, I V; Cheverdiuk, D A; Kopchak, K V; Duvalko, A V; Serdiuk, V P

2012-01-01

An analysis of treatment of 584 patients with complicated forms of chronic pancreatitis operated during 2000-2100 years was carried out. Quality of life of postoperative patients was estimated according to a technique of calculations of modules EORTC QLQ-C30 and EORTC QLQ-PAN26. The indicators of quality of life have improved by 19.7% in performance of saving duodenal outflow of operations of pancreatic juice. Change of the surgical strategy has led to decreased number of postoperative complications by 4.6% and to satisfactory long-term results in 92.6% of the patients.

The role of simulation in surgical training.

PubMed Central

Torkington, J.; Smith, S. G.; Rees, B. I.; Darzi, A.

2000-01-01

Surgical training has undergone many changes in the last decade. One outcome of these changes is the interest that has been generated in the possibility of training surgical skills outside the operating theatre. Simulation of surgical procedures and human tissue, if perfect, would allow complete transfer of techniques learnt in a skills laboratory directly to the operating theatre. Several techniques of simulation are available including artificial tissues, animal models and virtual reality computer simulation. Each is discussed in this article and their advantages and disadvantages considered. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:10743423

Does advanced operative obstetrics still have a place in contemporary practice?

PubMed

Tempest, Nicola; Navaratnam, Kate; Hapangama, Dharani Kosala

2015-04-01

This article reviews recent significant contributions to the literature concerning advanced operative obstetric procedures used for rotational vaginal deliveries and their alternative, primary caesarean section. Rising caesarean section rates are a global concern. Caesarean section in the second stage of labour is associated with high rates of maternal and fetal morbidity. Rotational vaginal deliveries may reduce the caesarean section rate without additional adverse effects on maternal and fetal outcomes. A recent national trainees' survey highlighted that training in the management of operative birth in the second stage of labour, especially when there is malposition of the fetal head, is a priority. There is a need for evidence-based guidelines, including standardized documentation of these advanced procedures. Training strategies for junior practitioners to acquire these skills and for experienced practitioners to maintain and disseminate their skills should be prioritized. The safety of rotational delivery methods versus primary caesarean section is likely to prove difficult to assess directly, in the context of a randomized controlled trial, but may be approximated via a national prospective audit.

Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

PubMed

Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C; Wamberg, Peter; Thomsen, Jørn Bo

2017-09-01

Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. Therapeutic, IV.

40 CFR 160.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 160.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 160.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 160.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 160.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

TDRSS telecommunications system, PN code analysis

NASA Technical Reports Server (NTRS)

Dixon, R.; Gold, R.; Kaiser, F.

1976-01-01

The pseudo noise (PN) codes required to support the TDRSS telecommunications services are analyzed and the impact of alternate coding techniques on the user transponder equipment, the TDRSS equipment, and all factors that contribute to the acquisition and performance of these telecommunication services is assessed. Possible alternatives to the currently proposed hybrid FH/direct sequence acquisition procedures are considered and compared relative to acquisition time, implementation complexity, operational reliability, and cost. The hybrid FH/direct sequence technique is analyzed and rejected in favor of a recommended approach which minimizes acquisition time and user transponder complexity while maximizing probability of acquisition and overall link reliability.

Test procedures and performance measures sensitive to automobile steering dynamics. [considering operator/vehicle responses

NASA Technical Reports Server (NTRS)

Klein, R. H.; Mcruer, D. T.; Weir, D.

1975-01-01

A maneuver complex and related performance measures used to evaluate driver/vehicle system responses as effected by variations in the directional response characteristics of passenger cars are described. The complex consists of normal and emergency maneuvers (including random and discrete disturbances) which, taken as a whole, represent all classes of steering functions and all modes of driver response behavior. Measures of driver/vehicle system response and performance in regulation tasks included direct describing function measurements and rms yaw velocity. In transient maneuvers, measures such as steering activity and cone strikes were used.

Philosophy, policies, and procedures - The three P's of flight-deck operations

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl L.

1991-01-01

Standard operating procedures are drafted and provided to flightcrews to dictate the manner in which tasks are carried out. Failure to conform to Standard Operating Procedures (SOP) is frequently listed as the cause of violations, incidents, and accidents. However, procedures are often designed piecemeal, rather than being based on a sound philosophy of operations and policies that follow from such a philosophy. A framework of philosophy, policies, and procedures is proposed.

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you elect the operating...-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1) and (2) of this... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2014 CFR

2014-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 792.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 792.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

21 CFR 58.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 792.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

21 CFR 58.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

21 CFR 58.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

21 CFR 58.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 792.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 792.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

21 CFR 58.63 - Maintenance and calibration of equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

40 CFR 68.54 - Training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

40 CFR 68.54 - Training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

40 CFR 68.54 - Training.

Code of Federal Regulations, 2010 CFR

2010-07-01

... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

40 CFR 68.54 - Training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

40 CFR 68.54 - Training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

The effects of predictor method factors on selection outcomes: A modular approach to personnel selection procedures.

PubMed

Lievens, Filip; Sackett, Paul R

2017-01-01

Past reviews and meta-analyses typically conceptualized and examined selection procedures as holistic entities. We draw on the product design literature to propose a modular approach as a complementary perspective to conceptualizing selection procedures. A modular approach means that a product is broken down into its key underlying components. Therefore, we start by presenting a modular framework that identifies the important measurement components of selection procedures. Next, we adopt this modular lens for reviewing the available evidence regarding each of these components in terms of affecting validity, subgroup differences, and applicant perceptions, as well as for identifying new research directions. As a complement to the historical focus on holistic selection procedures, we posit that the theoretical contributions of a modular approach include improved insight into the isolated workings of the different components underlying selection procedures and greater theoretical connectivity among different selection procedures and their literatures. We also outline how organizations can put a modular approach into operation to increase the variety in selection procedures and to enhance the flexibility in designing them. Overall, we believe that a modular perspective on selection procedures will provide the impetus for programmatic and theory-driven research on the different measurement components of selection procedures. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Automated procedure execution for space vehicle autonomous control

NASA Technical Reports Server (NTRS)

Broten, Thomas A.; Brown, David A.

1990-01-01

Increased operational autonomy and reduced operating costs have become critical design objectives in next-generation NASA and DoD space programs. The objective is to develop a semi-automated system for intelligent spacecraft operations support. The Spacecraft Operations and Anomaly Resolution System (SOARS) is presented as a standardized, model-based architecture for performing High-Level Tasking, Status Monitoring and automated Procedure Execution Control for a variety of spacecraft. The particular focus is on the Procedure Execution Control module. A hierarchical procedure network is proposed as the fundamental means for specifying and representing arbitrary operational procedures. A separate procedure interpreter controls automatic execution of the procedure, taking into account the current status of the spacecraft as maintained in an object-oriented spacecraft model.

29 CFR 1915.508 - Training.

Code of Federal Regulations, 2010 CFR

2010-07-01

... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

29 CFR 1915.508 - Training.

Code of Federal Regulations, 2013 CFR

2013-07-01

... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

29 CFR 1915.508 - Training.

Code of Federal Regulations, 2014 CFR

2014-07-01

... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

29 CFR 1915.508 - Training.

Code of Federal Regulations, 2012 CFR

2012-07-01

... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

29 CFR 1915.508 - Training.

Code of Federal Regulations, 2011 CFR

2011-07-01

... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

76 FR 80314 - National Emission Standards for Hazardous Air Pollutants: Area Source Standards for Prepared...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... operating instructions, if available, or standard operating procedures must be developed by the facility... operating instructions, if available, or standard operating procedures must be developed by the facility... standard operating procedures developed by the prepared feeds manufacturer be required as part of the...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

Apollo Operations Handbook Lunar Module (LM 11 and Subsequent) Vol. 2 Operational Procedures

NASA Technical Reports Server (NTRS)

1971-01-01

The Apollo Operations Handbook (AOH) is the primary means of documenting LM descriptions and procedures. The AOH is published in two separately bound volumes. This information is useful in support of program management, engineering, test, flight simulation, and real time flight support efforts. This volume contains crew operational procedures: normal, backup, abort, malfunction, and emergency. These procedures define the sequence of actions necessary for safe and efficient subsystem operation.

Teamwork and error in the operating room: analysis of skills and roles.

PubMed

Catchpole, K; Mishra, A; Handa, A; McCulloch, P

2008-04-01

To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. The value of team skills in reducing adverse events in the operating room is presently receiving considerable attention. Current work has not yet identified in detail how the teamwork and communication skills of surgeons, anesthetists, and nurses affect the course of an operation. Twenty-six laparoscopic cholecystectomies and 22 carotid endarterectomies were studied using direct observation methods. For each operation, teams' skills were scored for the whole team, and for nursing, surgical, and anesthetic subteams on 4 dimensions (leadership and management [LM]; teamwork and cooperation; problem solving and decision making; and situation awareness). Operating time, errors in surgical technique, and other procedural problems and errors were measured as outcome parameters for each operation. The relationships between teamwork scores and these outcome parameters within each operation were examined using analysis of variance and linear regression. Surgical (F(2,42) = 3.32, P = 0.046) and anesthetic (F(2,42) = 3.26, P = 0.048) LM had significant but opposite relationships with operating time in each operation: operating time increased significantly with higher anesthetic but decreased with higher surgical LM scores. Errors in surgical technique had a strong association with surgical situation awareness (F(2,42) = 7.93, P < 0.001) in each operation. Other procedural problems and errors were related to the intraoperative LM skills of the nurses (F(5,1) = 3.96, P = 0.027). Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.

47 CFR 36.412 - Apportionment procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Operating Taxes § 36.412... groups as follows: (1) Operating Federal, State and local income taxes and (2) all other operating taxes...

Increasing Slew Performance of Reaction Wheel Attitude Control Systems

DTIC Science & Technology

2013-09-01

vectors in any arbitrary direction creates the momentum envelope (Chapter IV). The shape of the reaction wheel momentum envelope is a polyhedron [15...performance. This procedural limitation further reduces the operable reaction wheel momentum space polyhedron to the largest inscribed sphere, which...respective plane. These minima are also the global minima, each marked in magenta. The four-wheel polyhedron is again shown in three orthogonal views in

Miniaturizing RFID for magnamosis.

PubMed

Jiang, Hao; Chen, Shijie; Kish, Shad; Loh, Lokkee; Zhang, Junmin; Zhang, Xiaorong; Kwiat, Dillon; Harrison, Michael; Roy, Shuvo

2014-01-01

Anastomosis is a common surgical procedure using staples or sutures in an open or laparoscopic surgery. A more effective and much less invasive alternative is to apply the mechanical pressure on the tissue over a few days [1]. Since the pressure is produced by the attractive force between two permanent magnets, the procedure is called magnamosis[1]. To ensure the two magnets are perfectly aligned during the surgery, a miniaturized batteryless Radio Frequency IDentification (RFID) tag is developed to wirelessly telemeter the status of a pressure sensitive mechanical switch. Using the multi-layer circular spiral coil design, the diameter of the RFID tag is shrunk to 10, 15, 19 and 27 mm to support the magnamosis for children as well as adults. With the impedance matching network, the operating distance of these four RFID tags are longer than 10 cm in a 20 × 22 cm(2) area, even when the tag's normal direction is 45° off the antenna's normal direction. Measurement results also indicate that there is no noticeable degradation on the operating distance when the tag is immersed in saline or placed next to the rare-earth magnet. The miniaturized RFID tag presented in this paper is able to support the magnamosis and other medical applications that require the miniaturized RFID tag.

Operating room data management: improving efficiency and safety in a surgical block.

PubMed

Agnoletti, Vanni; Buccioli, Matteo; Padovani, Emanuele; Corso, Ruggero M; Perger, Peter; Piraccini, Emanuele; Orelli, Rebecca Levy; Maitan, Stefano; Dell'amore, Davide; Garcea, Domenico; Vicini, Claudio; Montella, Teresa Maria; Gambale, Giorgio

2013-03-11

European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety. The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011. Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures and overtime show a positive impact of the project on OR management. Despite a consistency in the complexity of procedures (19% in 2009 and 21% in 2011), surgical groups have been successful in reducing the number of unscheduled procedures (from 25% in 2009 to 14% in 2011) and overtime (from 28% in 2009 to 21% in 2011). The developed project gives healthcare managers, anesthesiologists and surgeons useful information to increase surgical theaters efficiency and patient safety. In difficult economic times is possible to develop something that is of some value to the patient and healthcare system too.

Operating room data management: improving efficiency and safety in a surgical block

PubMed Central

2013-01-01

Background European Healthcare Systems are facing a difficult period characterized by increasing costs and spending cuts due to economic problems. There is the urgent need for new tools which sustain Hospitals decision makers work. This project aimed to develop a data recording system of the surgical process of every patient within the operating theatre. The primary goal was to create a practical and easy data processing tool to give hospital managers, anesthesiologists and surgeons the information basis to increase operating theaters efficiency and patient safety. Methods The developed data analysis tool is embedded in an Oracle Business Intelligence Environment, which processes data to simple and understandable performance tachometers and tables. The underlying data analysis is based on scientific literature and the projects teams experience with tracked data. The system login is layered and different users have access to different data outputs depending on their professional needs. The system is divided in the tree profile types Manager, Anesthesiologist and Surgeon. Every profile includes subcategories where operators can access more detailed data analyses. The first data output screen shows general information and guides the user towards more detailed data analysis. The data recording system enabled the registration of 14.675 surgical operations performed from 2009 to 2011. Results Raw utilization increased from 44% in 2009 to 52% in 2011. The number of high complexity surgical procedures (≥120 minutes) has increased in certain units while decreased in others. The number of unscheduled procedures performed has been reduced (from 25% in 2009 to 14% in 2011) while maintaining the same percentage of surgical procedures. The number of overtime events decreased in 2010 (23%) and in 2011 (21%) compared to 2009 (28%) and the delays expressed in minutes are almost the same (mean 78 min). The direct link found between the complexity of surgical procedures, the number of unscheduled procedures and overtime show a positive impact of the project on OR management. Despite a consistency in the complexity of procedures (19% in 2009 and 21% in 2011), surgical groups have been successful in reducing the number of unscheduled procedures (from 25% in 2009 to 14% in 2011) and overtime (from 28% in 2009 to 21% in 2011). Conclusions The developed project gives healthcare managers, anesthesiologists and surgeons useful information to increase surgical theaters efficiency and patient safety. In difficult economic times is possible to develop something that is of some value to the patient and healthcare system too. PMID:23496977

Economic Impact of Revision Surgery for Proximal Junctional Failure After Adult Spinal Deformity Surgery: A Cost Analysis of 57 Operations in a 10-year Experience at a Major Deformity Center.

PubMed

Theologis, Alexander A; Miller, Liane; Callahan, Matt; Lau, Darryl; Zygourakis, Corinna; Scheer, Justin K; Burch, Shane; Pekmezci, Murat; Chou, Dean; Tay, Bobby; Mummaneni, Praveen; Berven, Sigurd; Deviren, Vedat; Ames, Christopher P

2016-08-15

Retrospective cohort analysis. To evaluate the economic impact of revision surgery for proximal junctional failures (PJF) after thoracolumbar fusions for adult spinal deformity (ASD). PJF after fusions for ASD is a major cause of disability. Although clinical sequelae are described, PJF-revision operation costs are incompletely defined. Consecutive adults who underwent thoracolumbar fusions for ASD (August, 2003 to January, 2013) were evaluated. Inclusion criteria include construct from pelvis to L2 or above and minimum 6 months follow-up after the index ASD operation. Direct costs (surgical supplies/implants, room/care, pharmacy, services) were identified from medical billing data and calculated for index ASD operations and subsequent surgeries for PJF. Not included in direct cost data were indirect costs, charges, surgeon fees, or revision operations for indications other than PJF (i.e., pseudarthrosis). Patients were compared based on the construct's upper-instrumented vertebra: upper thoracic (UT: T1-6) versus thoracolumbar junction (TLjxn: T9-L2). Of 501 patients, 382 met inclusion criteria. Fifty-one patients [UT:14; TLjxn: 40 at index; average follow-up 32.6 months (6-92 months)] had revisions for PJF, which summed to $3.2 million total direct cost. Average direct cost of index operations for the cohort ($68,294) was significantly greater than PJF-revisions ($55,547). Compared with TLjxn, UT had a significantly higher average cost for index operations ($79,860 vs. $65,868). However, PJF-revision cases were similar in average cost (UT:$60,103; TLjxn:$53,920; P = 0.09). Costs of PJF amounted to an additional 12.1% of the total index surgical cost in 382 patients. Revision operations for PJF after long thoracolumbar fusions for ASD are associated with an average direct cost of $55,547 per case. Revision costs for PJF are similar based on the index procedure's upper-instrumented vertebra level. At a major tertiary center over a 10-year period, PJF came at a very significant economic expense amounting to $3.2 million for 57 cases. 3.

Procedures in complex systems: the airline cockpit.

PubMed

Degani, A; Wiener, E L

1997-05-01

In complex human-machine systems, successful operations depend on an elaborate set of procedures which are specified by the operational management of the organization. These procedures indicate to the human operator (in this case the pilot) the manner in which operational management intends to have various tasks done. The intent is to provide guidance to the pilots and to ensure a safe, logical, efficient, and predictable (standardized) means of carrying out the objectives of the job. However, procedures can become a hodge-podge. Inconsistent or illogical procedures may lead to noncompliance by operators. Based on a field study with three major airlines, the authors propose a model for procedure development called the "Four P's": philosophy, policies, procedures, and practices. Using this model as a framework, the authors discuss the intricate issue of designing flight-deck procedures, and propose a conceptual approach for designing any set of procedures. The various factors, both external and internal to the cockpit, that must be considered for procedure design are presented. In particular, the paper addresses the development of procedures for automated cockpits--a decade-long, and highly controversial issue in commercial aviation. Although this paper is based on airline operations, we assume that the principles discussed here are also applicable to other high-risk supervisory control systems, such as space flight, manufacturing process control, nuclear power production, and military operations.

40 CFR 63.548 - Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

40 CFR 63.548 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

40 CFR 63.548 - Monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

US line-ups outperform UK line-ups

PubMed Central

Seale-Carlisle, Travis M.

2016-01-01

In the USA and the UK, many thousands of police suspects are identified by eyewitnesses every year. Unfortunately, many of those suspects are innocent, which becomes evident when they are exonerated by DNA testing, often after having been imprisoned for years. It is, therefore, imperative to use identification procedures that best enable eyewitnesses to discriminate innocent from guilty suspects. Although police investigators in both countries often administer line-up procedures, the details of how line-ups are presented are quite different and an important direct comparison has yet to be conducted. We investigated whether these two line-up procedures differ in terms of (i) discriminability (using receiver operating characteristic analysis) and (ii) reliability (using confidence–accuracy characteristic analysis). A total of 2249 participants watched a video of a crime and were later tested using either a six-person simultaneous photo line-up procedure (USA) or a nine-person sequential video line-up procedure (UK). US line-up procedure yielded significantly higher discriminability and significantly higher reliability. The results do not pinpoint the reason for the observed difference between the two procedures, but they do suggest that there is much room for improvement with the UK line-up. PMID:27703695

Redo mitral surgery using the Estech endoclamp.

PubMed

Van Nooten, G; Van Belleghem, Y; Van Overbeke, H; Caes, F; François, K; De Pauw, M; De Rijcke, F; Poelaert, J

2001-01-01

Redo-CABG surgery remains extremely hazardous in the presence of open bypass grafts. In our patients with mitral valve pathology with open and well-functioning bypass grafts, we explored alternative approaches in order to avoid damage to the grafts by extensive dissection and direct clamping of the ascending aorta. The "Estech procedure," which uses the Estech remote access perfusion (RAP) endoclamp catheter (Estech Inc., Danville, CA), was selected for these patients. From January 1998 to January 2000, 10 patients underwent an Estech procedure for redo mitral surgery. All patients had previous cardiac operations such as coronary artery bypass grafting (CABG) and/or mitral valve procedures. The Estech procedure consisted of an anterior left thoracotomy and peripheral cannulation at femoral site using the Estech endovascular balloon technique. The series was comprised of seven mitral valve replacements, two valve reconstructions, and one closure of a paravalvular leak. One procedure had to be converted to a standard re-sternotomy due to extreme arteriosclerosis of the descending aorta with plaque dislocation at the time of catheter insertion. However, no damage was inflicted to the open bypass grafts. The follow-up period ranged from six to 30 months and was 100% complete. We encountered one hospital death in our group, which was due to a late post-operative intestinal infarction and multiple organ failure (MOF), and was not procedure related. As expected, morbidity was high in this compromised cohort, but no late death has occurred prior to submission of this article. All survivors progressed to an acceptable NYHA functional class. The excellent results in this complex patient group inspired us to use the Estech procedure as a standard approach for redo mitral surgery.

[Modern operations management in workflow operation. Spectrum of responsibilities and challenges for the future].

PubMed

Riedl, S

2002-02-01

The operating unit is one of the cost-intensive facilities in a surgical clinic with a pacemaking function for most of the internal procedures. The power of performance of the operating unit is based on the co-operation of all disciplines and professions involved. The key to management of the operating unit is not only to co-ordinate the daily procedures, but also to interact with support personnel. To ensure successful OR management, the internal structure of the OR must fit the clinical tasks and the available quantity of personnel in each profession must be co-ordinated. Sufficient utilization of resources and equipment must be guaranteed without cost-intensive over-capacities and patient flow must be orientated to OR capacities. The development of such a business structure requires the management to clearly define the goal, to know the actual on-site data in detail with regard to the idiosyncratic workings of each speciality and to clearly assign the competence of each member of the team working in the OR. Co-ordination of the operating unit is the main task of OR management, which must ensure the following: transparent and co-ordinated schedule management in the various operative specialities, goal-directed changes of the schedule with incorporation of emergencies, as well as effective organization of staff. In order to realize these tasks, it is reasonable to implement interdisciplinary rules of procedures. In addition, the assignment of a neutral decision-making body within the OR and the creation of an information center for all OR personnel. The challenge of OR organization in the future is to implement more effective documentation systems and active controlling within the OR. One can ensure adequate utilization of resources in the OR with prospectively oriented planning. Better transparence of operations in the OR contributes to increased efficiency. Implementation of quality management is the foundation for a successfully operating surgical hospital. Not only the productivity of individual members of the staff, but also the precise documentation of the quality of results will become important parameters in a successful surgical hospital, whose nucleus is the OR.

Hybrid procedure in living donor liver transplantation.

PubMed

Soyama, A; Takatsuki, M; Hidaka, M; Adachi, T; Kitasato, A; Kinoshita, A; Natsuda, K; Baimakhanov, Z; Kuroki, T; Eguchi, S

2015-04-01

We have previously reported a hybrid procedure that uses a combination of laparoscopic mobilization of the liver and subsequent hepatectomy under direct vision in living donor liver transplantation (LDLT). We present the details of this hybrid procedure and the outcomes of the procedure. Between January 1997 and August 2014, 204 LDLTs were performed at Nagasaki University Hospital. Among them, 67 recent donors underwent hybrid donor hepatectomy. Forty-one donors underwent left hemihepatectomy, 25 underwent right hemihepatectomy, and 1 underwent posterior sectionectomy. First, an 8-cm subxiphoid midline incision was made; laparoscopic mobilization of the liver was then achieved with a hand-assist through the midline incision under the pneumoperitoneum. Thereafter, the incision was extended up to 12 cm for the right lobe and posterior sector graft and 10 cm left lobe graft procurement. Under direct vision, parenchymal transection was performed by means of the liver-hanging maneuver. The hybrid procedure for LDLT recipients was indicated only for selected cases with atrophic liver cirrhosis without a history of upper abdominal surgery, significant retroperitoneal collateral vessels, or hypertrophic change of the liver (n = 29). For total hepatectomy and splenectomy, the midline incision was sufficiently extended. All of the hybrid donor hepatectomies were completed without an extra subcostal incision. No significant differences were observed in the blood loss or length of the operation compared with conventional open procedures. All of the donors have returned to their preoperative activity level, with fewer wound-related complaints compared with those treated with the use of the conventional open procedure. In recipients treated with the hybrid procedure, no clinically relevant drawbacks were observed compared with the recipients treated with a regular Mercedes-Benz-type incision. Our hybrid procedure was safely conducted with the same quality as the conventional open procedure in both LDLT donors and recipients. Copyright © 2015 Elsevier Inc. All rights reserved.

49 CFR 193.2713 - Training: operations and maintenance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

49 CFR 193.2713 - Training: operations and maintenance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

49 CFR 193.2713 - Training: operations and maintenance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

49 CFR 193.2713 - Training: operations and maintenance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

49 CFR 193.2713 - Training: operations and maintenance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

Operational Control Procedures for the Activated Sludge Process, Part III-A: Calculation Procedures.

ERIC Educational Resources Information Center

West, Alfred W.

This is the second in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. This document deals exclusively with the calculation procedures, including simplified mixing formulas, aeration tank…

46 CFR 130.480 - Test procedure and operations manual.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Test procedure and operations manual. 130.480 Section... VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Automation of Unattended Machinery Spaces § 130.480 Test procedure and operations manual. (a) A procedure for tests to be conducted on automated...

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (G01)

EPA Science Inventory

The purpose of this SOP is to develop a consistent method and style for all Emory University/Harvard University/Johns Hopkins University standard operating procedures. SOPs are necessary to document all procedures, methods, and techniques used in the NHEXAS investigations. Deve...

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

None

The purpose of this document is to provide the technical requirements for operation, inspection and maintenance of a TRUPACT-II Shipping Package and directly related components. This document shall supply the minimum requirements as specified in the TRUPACT-II Safety Analysis Report for Packaging (SARP) and Certificate of Compliance (C of C) 9218. In the event there is a conflict between this document and the TRUPACT-II SARP (NRC Certificate of Compliance No. 9218), the TRUPACT-II SARP shall govern. This document details the operations, maintenance, repair, replacement of components, as well as the documentation required and the procedures to be followed to maintainmore » the integrity of the TRUPACT-II container. These procedures may be modified for site use, but as a minimum all parameters and format listed herein must be included in any site modified version. For convenience and where applicable steps may be performed out of sequence. Packaging and payload handling equipment and transport trailers have been specifically designed for use with the TRUPACT-II Packaging. This document discusses the minimum required procedures for use of the adjustable center of gravity lift fixture and the TRUPACT-II transport trailer in conjunction with the TRUPACT-II Packaging.« less

Operative record using intraoperative digital data in neurosurgery.

PubMed

Houkin, K; Kuroda, S; Abe, H

2000-01-01

The purpose of this study was to develop a new method for more efficient and accurate operative records using intra-operative digital data in neurosurgery, including macroscopic procedures and microscopic procedures under an operating microscope. Macroscopic procedures were recorded using a digital camera and microscopic procedures were also recorded using a microdigital camera attached to an operating microscope. Operative records were then recorded digitally and filed in a computer using image retouch software and database base software. The time necessary for editing of the digital data and completing the record was less than 30 minutes. Once these operative records are digitally filed, they are easily transferred and used as database. Using digital operative records along with digital photography, neurosurgeons can document their procedures more accurately and efficiently than by the conventional method (handwriting). A complete digital operative record is not only accurate but also time saving. Construction of a database, data transfer and desktop publishing can be achieved using the intra-operative data, including intra-operative photographs.

Office-based narrow band imaging-guided flexible laryngoscopy tissue sampling: A cost-effectiveness analysis evaluating its impact on Taiwanese health insurance program.

PubMed

Fang, Tuan-Jen; Li, Hsueh-Yu; Liao, Chun-Ta; Chiang, Hui-Chen; Chen, I-How

2015-07-01

Narrow band imaging (NBI)-guided flexible laryngoscopy tissue sampling for laryngopharyngeal lesions is a novel technique. Patients underwent the procedure in an office-based setting without being sedated, which is different from the conventional technique performed using direct laryngoscopy. Although the feasibility and effects of this procedure were established, its financial impact on the institution and Taiwanese National Health Insurance program was not determined. This is a retrospective case-control study. From May 2010 to April 2011, 20 consecutive patients who underwent NBI flexible laryngoscopy tissue sampling were recruited. During the same period, another 20 age-, sex-, and lesion-matched cases were enrolled in the control group. The courses for procedures and financial status were analyzed and compared between groups. Office-based NBI flexible laryngoscopy tissue sampling procedure took 27 minutes to be completed, while 191 minutes were required for the conventional technique. Average reimbursement for each case was New Taiwan Dollar (NT$)1264 for patients undergoing office-based NBI flexible laryngoscopy tissue sampling, while NT$10,913 for those undergoing conventional direct laryngoscopy in the operation room (p < 0.001). The institution suffered a loss of at least NT$690 when performing NBI flexible laryngoscopy tissue sampling. Office-based NBI flexible laryngoscopy tissue sampling is a cost-saving procedure for patients and the Taiwanese National Health Insurance program. It also saves the procedure time. However, the net financial loss for the institution and physician would limit its popularization unless reimbursement patterns are changed. Copyright © 2013. Published by Elsevier B.V.

[Outsourced service management of the catheterization laboratory in the cardiology department: lights and shadows].

PubMed

Inama, Giuseppe; Claus, Marco; Nossai, Wanda S Pinna; Pedrinazzi, Claudio; Durin, Ornella; Catanoso, Antonio; Cacucci, Michele; Valentini, Paolo; Rizzini, Angelo Lodi; Agricola, Pietro; Romagnoli, Giulio; Magarini, Anna Maria; Bruni, Ezio; Aguzzi, Regolo; Soccini, Fulvio; Maltagliati, Diego

2008-04-01

The aim of this study was to compare the economic impact and results achieved by recourse to outsourced management of the procedures carried out in the electrophysiology and catheterization laboratory of the Department of Cardiology of the Crema Hospital with the in-house setting up and operation of the same activities. The comparison between the two possible options, "make" or "buy in", was made using the methodology of advanced direct costing, which provides for the allocation of only direct fixed and variable costs to clinical procedures, the subject of calculation. In addition to the financial evaluation, the quality variables showing the advantages and limitations of outsourcing in terms of organizational improvements, streamlining of the organizational structure, operational efficiency and improvement of the quality of service, were examined. The financial evaluation from 2002 to 2006 came out in favor of "make" as opposed to "buy in". Income derived from diagnosis-related-group payments for the more than 4000 procedures carried out was Euro26.239.034,96. On the basis of the economical evaluation the second contribution margin was slightly inferior with the "buy in" than with the "make" hypothesis. Specifically, it is Euro16.397.669,96 in the "buy in" and Euro16.753.579,16 in the "make" hypothesis, with a difference of Euro355.909,20 (-2%). The economic advantage lies with the "make" alternative compared with "buy in", nevertheless, outsourcing offers greater operational efficiency, better cost control, setting up of the laboratory within a very short time, simplified administration (single point of contact) and an opportunity to concentrate on core business. However, there are limitations due to greater dependence on the supplier, not all the equipment provided for under the contract was used, and loss of management know-how in non-core business areas.

Efficacy of a Radiation Absorbing Shield in Reducing Dose to the Interventionalist During Peripheral Endovascular Procedures: A Single Centre Pilot Study

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

Power, S.; Mirza, M.; Thakorlal, A.

PurposeThis prospective pilot study was undertaken to evaluate the feasibility and effectiveness of using a radiation absorbing shield to reduce operator dose from scatter during lower limb endovascular procedures.Materials and MethodsA commercially available bismuth shield system (RADPAD) was used. Sixty consecutive patients undergoing lower limb angioplasty were included. Thirty procedures were performed without the RADPAD (control group) and thirty with the RADPAD (study group). Two separate methods were used to measure dose to a single operator. Thermoluminescent dosimeter (TLD) badges were used to measure hand, eye, and unshielded body dose. A direct dosimeter with digital readout was also used tomore » measure eye and unshielded body dose. To allow for variation between control and study groups, dose per unit time was calculated.ResultsTLD results demonstrated a significant reduction in median body dose per unit time for the study group compared with controls (p = 0.001), corresponding to a mean dose reduction rate of 65 %. Median eye and hand dose per unit time were also reduced in the study group compared with control group, however, this was not statistically significant (p = 0.081 for eye, p = 0.628 for hand). Direct dosimeter readings also showed statistically significant reduction in median unshielded body dose rate for the study group compared with controls (p = 0.037). Eye dose rate was reduced for the study group but this was not statistically significant (p = 0.142).ConclusionInitial results are encouraging. Use of the shield resulted in a statistically significant reduction in unshielded dose to the operator’s body. Measured dose to the eye and hand of operator were also reduced but did not reach statistical significance in this pilot study.« less

Optimizing sensor cover energy for directional sensors

NASA Astrophysics Data System (ADS)

Astorino, Annabella; Gaudioso, Manlio; Miglionico, Giovanna

2016-10-01

The Directional Sensors Continuous Coverage Problem (DSCCP) aims at covering a given set of targets in a plane by means of a set of directional sensors. The location of these sensors is known in advance and they are characterized by a discrete set of possible radii and aperture angles. Decisions to be made are about orientation (which in our approach can vary continuously), radius and aperture angle of each sensor. The objective is to get a minimum cost coverage of all targets, if any. We introduce a MINLP formulation of the problem and define a Lagrangian heuristics based on a dual ascent procedure operating on one multiplier at a time. Finally we report the results of the implementation of the method on a set of test problems.

Ultrasound guided V3 segment vertebral artery direct percutaneous puncture for basilar artery mechanical thrombectomy in acute stroke: a technical report.

PubMed

Desai, Jamsheed A; Almekhlafi, Mohammed A; Hill, Michael D; Goyal, Mayank; Eesa, Muneer

2014-04-01

A middle aged patient presented with acute ischemic stroke due to basilar artery occlusion. The patient clinically deteriorated despite intravenous thrombolysis and was referred for mechanical thrombectomy. The right vertebral artery was occluded and could not be accessed despite attempting various shaped catheters, even when a radial artery access was used. The left vertebral artery ended in the posterior inferior cerebellar artery. Eventually, ultrasound guided V3 segment vertebral artery direct puncture was successfully done and the procedure was completed. No access related complications were encountered. Direct cervical arterial puncture can be safely used by experienced operators as a last resort in acute stroke cases with difficult access.

A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

ERIC Educational Resources Information Center

Perley, Gordon F.

This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

Computer assisted surgery with 3D robot models and visualisation of the telesurgical action.

PubMed

Rovetta, A

2000-01-01

This paper deals with the support of virtual reality computer action in the procedures of surgical robotics. Computer support gives a direct representation of the surgical theatre. The modelization of the procedure in course and in development gives a psychological reaction towards safety and reliability. Robots similar to the ones used by the manufacturing industry can be used with little modification as very effective surgical tools. They have high precision, repeatability and are versatile in integrating with the medical instrumentation. Now integrated surgical rooms, with computer and robot-assisted intervention, are operating. The computer is the element for a decision taking aid, and the robot works as a very effective tool.

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations.

PubMed

Riva, Ivano; Roberti, Gloria; Katsanos, Andreas; Oddone, Francesco; Quaranta, Luciano

2017-04-01

The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

Evolution of catalytic function

NASA Technical Reports Server (NTRS)

Joyce, G. F.

1993-01-01

An RNA-based evolution system was constructed in the laboratory and used to develop RNA enzymes with novel catalytic function. By controlling the nature of the catalytic task that the molecules must perform in order to survive, it is possible to direct the evolving population toward the expression of some desired catalytic behavior. More recently, this system has been coupled to an in vitro translation procedure, raising the possibility of evolving protein enzymes in the laboratory to produce novel proteins with desired catalytic properties. The aim of this line of research is to reduce darwinian evolution, the fundamental process of biology, to a laboratory procedure that can be made to operate in the service of organic synthesis.

ERS-1 scatterometer calibration and validation activities at ECMWF. B: From radar backscatter characteristics to wind vector solutions

NASA Technical Reports Server (NTRS)

Stoffelen, AD; Anderson, David L. T.; Woiceshyn, Peter M.

1992-01-01

Calibration and validation activities for the ERS-1 scatterometer were carried out at ECMWF (European Center for Medium range Weather Forecast) complementary to the 'Haltenbanken' field campaign off the coast of Norway. At a Numerical Weather Prediction (NWP) center a wealth of verifying data is available both in time and space. This data is used to redefine the wind retrieval procedure given the instrumental characteristics. It was found that a maximum likelihood estimation procedure to obtain the coefficients of a reformulated sigma deg to wind relationship should use radar measurements in logarithmic rather than physical space, and use winds as the wind components rather than wind speed and direction. Doing this, a much more accurate transfer function than the one currently operated by ESA was derived. Sigma deg measurement space shows no signature of a separation in an upwind solution cone and a downwind solution cone. As such signature was anticipated in ESA's wind direction ambiguity removal algorithm, reconsideration of the procedure is necessary. Despite the fact that revisions have to be made in the process of wind retrieval; a grid potential is shown for scatterometry in meteorology and climatology.

On the design of flight-deck procedures

DOT National Transportation Integrated Search

1994-06-01

In complex human-machine systems, operations, training, and standardization depend on an elaborate set of procedures which are specified and mandated by the operational management of the organization. These procedures indicate to the human operator (...

14 CFR 61.87 - Solo requirements for student pilots.

Code of Federal Regulations, 2014 CFR

2014-01-01

... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

14 CFR 61.87 - Solo requirements for student pilots.

Code of Federal Regulations, 2010 CFR

2010-01-01

... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

14 CFR 61.87 - Solo requirements for student pilots.

Code of Federal Regulations, 2013 CFR

2013-01-01

... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

14 CFR 61.87 - Solo requirements for student pilots.

Code of Federal Regulations, 2012 CFR

2012-01-01

... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

14 CFR 61.87 - Solo requirements for student pilots.

Code of Federal Regulations, 2011 CFR

2011-01-01

... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

Basics of compounding: considerations for implementing United States pharmacopeia chapter 797 pharmaceutical compounding-sterile preparations, part 16: suggested standard operating procedures.

PubMed

Okeke, Claudia C; Allen, Loyd V

2009-01-01

The standard operating procedures suggested in this article are presented to compounding pharmacies to ensure the quality of the environment in which a CSP is prepared. Since United States Pharmacopeia Chapter 797 provides minimum standards, each facility should aim for best practice gold standard. The standard operating procedures should be tailored to meet the expectations and design of each facility. Compounding personnel are expected to know and understand each standard operating procedure to allow for complete execution of the procedures.

Revisional bariatric surgery.

PubMed

Kellogg, Todd Andrew

2011-12-01

With the increase in bariatric surgical procedures, an increase in revision operations is expected. A thorough preoperative work-up is essential to formulate an appropriate revision strategy. Outcomes vary according to the primary operation and chosen approach to revision. Recent studies have shown acceptably low complication rates and good weight loss with the associated health benefits. Although there is no direct evidence in the form of randomized studies indicating which patients with inadequate weight loss or weight regain will benefit most from revision, or to support one particular revision approach rather than another, it is possible to develop general, effective strategies. Copyright © 2011 Elsevier Inc. All rights reserved.

Concurrent variation of response bias and sensitivity in an operant-psychophysical test.

NASA Technical Reports Server (NTRS)

Terman, M.; Terman, J. S.

1972-01-01

The yes-no signal detection procedure was applied to a single-response operant paradigm in which rats discriminated between a standard auditory intensity and attenuated comparison values. The payoff matrix was symmetrical (with reinforcing brain stimulation for correct detections and brief time-out for errors), but signal probability and intensity differences were varied to generate a family of isobias and isosensitivity functions. The d' parameter remained fairly constant across a wide range of bias levels. Isobias functions deviated from a strict matching strategy as discrimination difficulty increased, although an orderly relation was maintained between signal probability value and the degree and direction of response bias.

Measurements methodology for evaluation of Digital TV operation in VHF high-band

NASA Astrophysics Data System (ADS)

Pudwell Chaves de Almeida, M.; Vladimir Gonzalez Castellanos, P.; Alfredo Cal Braz, J.; Pereira David, R.; Saboia Lima de Souza, R.; Pereira da Soledade, A.; Rodrigues Nascimento Junior, J.; Ferreira Lima, F.

2016-07-01

This paper describes the experimental setup of field measurements carried out for evaluating the operation of the ISDB-TB (Integrated Services Digital Broadcasting, Terrestrial, Brazilian version) standard digital TV in the VHF-highband. Measurements were performed in urban and suburban areas in a medium-sized Brazilian city. Besides the direct measurements of received power and environmental noise, a measurement procedure involving the injection of Gaussian additive noise was employed to achieve the signal to noise ratio threshold at each measurement site. The analysis includes results of static reception measurements for evaluating the received field strength and the signal to noise ratio thresholds for correct signal decoding.

Soft X-ray Foucault test: A path to diffraction-limited imaging

NASA Astrophysics Data System (ADS)

Ray-Chaudhuri, A. K.; Ng, W.; Liang, S.; Cerrina, F.

1994-08-01

We present the development of a soft X-ray Foucault test capable of characterizing the imaging properties of a soft X-ray optical system at its operational wavelength and its operational configuration. This optical test enables direct visual inspection of imaging aberrations and provides real-time feedback for the alignment of high resolution soft X-ray optical systems. A first application of this optical test was carried out on a Mo-Si multilayer-coated Schwarzschild objective as part of the MAXIMUM project. Results from the alignment procedure are presented as well as the possibility for testing in the hard X-ray regime.

Design data package and operating procedures for MSFC solar simulator test facility

NASA Technical Reports Server (NTRS)

1981-01-01

Design and operational data for the solar simulator test facility are reviewed. The primary goal of the facility is to evaluate the performance capacibility and worst case failure modes of collectors, which utilize either air or liquid transport media. The facility simulates environmental parameters such as solar radiation intensity, solar spectrum, collimation, uniformity, and solar attitude. The facility also simulates wind conditions of velocity and direction, solar system conditions imposed on the collector, collector fluid inlet temperature, and geometric factors of collector tilt and azimuth angles. Testing the simulator provides collector efficiency data, collector time constant, incident angle modifier data, and stagnation temperature values.

Vision-Based Pose Estimation for Robot-Mediated Hand Telerehabilitation.

PubMed

Airò Farulla, Giuseppe; Pianu, Daniele; Cempini, Marco; Cortese, Mario; Russo, Ludovico O; Indaco, Marco; Nerino, Roberto; Chimienti, Antonio; Oddo, Calogero M; Vitiello, Nicola

2016-02-05

Vision-based Pose Estimation (VPE) represents a non-invasive solution to allow a smooth and natural interaction between a human user and a robotic system, without requiring complex calibration procedures. Moreover, VPE interfaces are gaining momentum as they are highly intuitive, such that they can be used from untrained personnel (e.g., a generic caregiver) even in delicate tasks as rehabilitation exercises. In this paper, we present a novel master-slave setup for hand telerehabilitation with an intuitive and simple interface for remote control of a wearable hand exoskeleton, named HX. While performing rehabilitative exercises, the master unit evaluates the 3D position of a human operator's hand joints in real-time using only a RGB-D camera, and commands remotely the slave exoskeleton. Within the slave unit, the exoskeleton replicates hand movements and an external grip sensor records interaction forces, that are fed back to the operator-therapist, allowing a direct real-time assessment of the rehabilitative task. Experimental data collected with an operator and six volunteers are provided to show the feasibility of the proposed system and its performances. The results demonstrate that, leveraging on our system, the operator was able to directly control volunteers' hands movements.

The power of simplification: Operator interface with the AP1000{sup R} during design-basis and beyond design-basis events

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

Williams, M. G.; Mouser, M. R.; Simon, J. B.

2012-07-01

The AP1000{sup R} plant is an 1100-MWe pressurized water reactor with passive safety features and extensive plant simplifications that enhance construction, operation, maintenance, safety and cost. The passive safety features are designed to function without safety-grade support systems such as component cooling water, service water, compressed air or HVAC. The AP1000 passive safety features achieve and maintain safe shutdown in case of a design-basis accident for 72 hours without need for operator action, meeting the expectations provided in the European Utility Requirements and the Utility Requirement Document for passive plants. Limited operator actions may be required to maintain safe conditionsmore » in the spent fuel pool (SFP) via passive means. This safety approach therefore minimizes the reliance on operator action for accident mitigation, and this paper examines the operator interaction with the Human-System Interface (HSI) as the severity of an accident increases from an anticipated transient to a design basis accident and finally, to a beyond-design-basis event. The AP1000 Control Room design provides an extremely effective environment for addressing the first 72 hours of design-basis events and transients, providing ease of information dissemination and minimal reliance upon operator actions. Symptom-based procedures including Emergency Operating Procedures (EOPs), Abnormal Operating Procedures (AOPs) and Alarm Response Procedures (ARPs) are used to mitigate design basis transients and accidents. Use of the Computerized Procedure System (CPS) aids the operators during mitigation of the event. The CPS provides cues and direction to the operators as the event progresses. If the event becomes progressively worse or lasts longer than 72 hours, and depending upon the nature of failures that may have occurred, minimal operator actions may be required outside of the control room in areas that have been designed to be accessible using components that have been designed to be reliable in these conditions. The primary goal of any such actions is to maintain or refill the passive inventory available to cool the core, containment and spent fuel pool in the safety-related and seismically qualified Passive Containment Cooling Water Storage Tank (PCCWST). The seismically-qualified, ground-mounted Passive Containment Cooling Ancillary Water Storage Tank (PCCAWST) is also available for this function as appropriate. The primary effect of these actions would be to increase the coping time for the AP1000 during design basis events, as well as events such as those described above, from 72 hours without operator intervention to 7 days with minimal operator actions. These Operator actions necessary to protect the health and safety of the public are addressed in the Post-72 Hour procedures, as well as some EOPs, AOPs, ARPs and the Severe Accident Management Guidelines (SAMGs). Should the event continue to become more severe and plant conditions degrade further with indications of inadequate core cooling, the SAMGs provide guidance for strategies to address these hypothetical severe accident conditions. The AP1000 SAMG diagnoses and actions are prioritized to first utilize the AP1000 features that are expected to retain a damaged core inside the reactor vessel. Only one strategy is undertaken at any time. This strategy will be followed and its effectiveness evaluated before other strategies are undertaken. This is a key feature of both the symptom-oriented AP1000 EOPs and the AP1000 SAMGs which maximizes the probability of retaining a damaged core inside the reactor vessel and containment while minimizing the chances for confusion and human errors during implementation. The AP1000 SAMGs are simple and straight-forward and have been developed with considerable input from human factors and plant operations experts. Most importantly, and different from severe accident management strategies for other plants, the AP1000 SAMGs do not require diagnosis of the location of the core (i.e., whether reactor vessel failure has occurred). This is a fundamental consequence of the AP1000 In-Vessel Retention approach, which allows severe accident management to be based on fundamental principles (e.g. provide coolant as close as possible to the core) that do not change during a specific event. This eliminates the need for one of the more difficult diagnostic requirements, since reactor vessel failure does not directly relate to any measurable plant parameter, and differs from other designs in that an engineered failure of the pressure vessel' (e.g. core catcher) is never required. (authors)« less

New flexible endoscope for otologic application

NASA Astrophysics Data System (ADS)

Marchan, Mark L.

1993-07-01

Endoscopy has become an important procedure in many medical specialties. For the Otologist, however, space limitations within the ear have restricted development of endoscopic procedures. The desire for minimally invasive techniques in Otology has demonstrated itself through the work of numerous physicians who have performed procedures ranging from diagnostic inspection of the middle ear to viewing the interior of the cochlea. To assist in performing such endoscopic procedures, Xomed-Treace has developed a line of flexible fiberoptic endoscopes for use by the Otologist. These scopes combine illumination and imaging fiber bundles within a small diameter unit ranging in size from 0.8 mm to 1.2 mm. The 1.2 mm scope is produced with an angled, rigid stainless steel sheath. The 0.8 mm scope is flexible with the ability to articulate 120 degree(s) in one direction. The fiberscopes have been designed for the Otologist to produce a good resolution image while allowing ease of operation through ergonomics and consideration of the surgical anatomy.

(Dry) arthroscopic partial wrist arthrodesis: tips and tricks.

PubMed

del Piñal, F; Tandioy-Delgado, F

2014-10-01

One of the options for performing a partial wrist arthrodesis is the arthroscopic technique. As a first advantage arthroscopy allows us to directly assess the state of the articular surface of the carpal bones and define the best surgical option during the salvage operation. Furthermore, it allows performance of the procedure with minimal ligament damage and minimal interference with the blood supply of the carpals. These will (presumably) entail less capsular scarring and more rapid healing. Lastly, there is cosmetic benefit by reducing the amount of external scarring. The procedure has a steep learning curve even for accomplished arthroscopists but can be performed in a competitive manner to the open procedure if the dry technique is used. The aim of this paper is to present the technical details, tricks and tips to make the procedure accessible to all hand specialists with an arthroscopic interest. As it is paramount that the surgeon is acquainted with the "dry" technique, some technical details about it will also be presented. © Georg Thieme Verlag KG Stuttgart · New York.

Financial Management Regulation. Volume 15. Security Assistance Policy and Procedures

DTIC Science & Technology

1993-03-01

Definitions DEFINITIONS case level, i.e., commitments, obligations and 1. Above-the-line-Cost. Cost identified as disbursements resulting from contract award...of the asset or was a direct result of O ment is made when SAAC determines it does negligence, simple or gross. not have the accounting capability to... resulting from ments leaving the DoD system, contracts with operation of the FMS program: commercial firms, General Services Administra- tion

Apollo experience report. Crew-support activities for experiments performed during manned space flight

NASA Technical Reports Server (NTRS)

Mckee, J. W.

1974-01-01

Experiments are performed during manned space flights in an attempt to acquire knowledge that can advance science and technology or that can be applied to operational techniques for future space flights. A description is given of the procedures that the personnel who are directly assigned to the function of crew support at the NASA Lyndon B. Johnson Space Center use to prepare for and to conduct experiments during space flight.

Test Operations Procedure (TOP) 01-1-020 Tropical Regions Environmental Considerations

DTIC Science & Technology

2013-02-08

and Soldier systems tests. 1.3 Purpose. This is an overview TOP and is organized to provide background information on the humid tropical region...processes that foul materiel and interfere with equipment and systems under test. Military testing at present and in the future requires much greater...accordance with the Holdridge Life Zone Classification System18. This system is based on the theory that vegetation structure (type) is directly

Sea wind parameters retrieval using Y-configured Doppler navigation system data. Performance and accuracy

NASA Astrophysics Data System (ADS)

Khachaturian, A. B.; Nekrasov, A. V.; Bogachev, M. I.

2018-05-01

The authors report the results of the computer simulations of the performance and accuracy of the sea wind speed and direction retrieval. The analyzed measurements over the sea surface are made by the airborne microwave Doppler navigation system (DNS) with three Y-configured beams operated as a scatterometer enhancing its functionality. Single- and double-stage wind measurement procedures are proposed and recommendations for their implementation are described.

Test Operations Procedure (TOP) 08-2-188 Chemical Point Detector Vapor Testing

DTIC Science & Technology

2018-04-27

Evaluation Command 6617 Aberdeen Boulevard Aberdeen Proving Ground, MD 21005-5001 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S...AND EVALUATION COMMAND TEST OPERATIONS PROCEDURE *Test Operations Procedure 08-2-188 27 April 2018 DTIC AD No. CHEMICAL POINT DETECTOR VAPOR...188 27 April 2018 2 1. SCOPE. This Test Operations Procedure (TOP), which has been endorsed by the Test and Evaluation Capabilities and

Designing Flight-Deck Procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, L.; Shafto, Mike (Technical Monitor)

1995-01-01

A complex human-machine system consists of more than merely one or more human operators and a collection of hardware components. In order to operate a complex system successfully, the human-machine system must be supported by an organizational infrastructure of operating concepts, rules, guidelines, and documents. The coherency of such operating concepts, in terms of consistency and logic, is vitally important for the efficiency and safety of any complex system. In high-risk endeavors such as aircraft operations, space flight, nuclear power production, manufacturing process control, and military operations, it is essential that such support be flawless, as the price of operational error can be high. When operating rules are not adhered to, or the rules are inadequate for the task at hand, not only will the system's goals be thwarted, but there may also be tragic human and material consequences. To ensure safe and predictable operations, support to the operators, in this case flight crews, often comes in the form of standard operating procedures. These provide the crew with step-by-step guidance for carrying out their operations. Standard procedures do indeed promote uniformity, but they do so at the risk of reducing the role of human operators to a lower level. Management, however, must recognize the danger of over-procedurization, which fails to exploit one of the most valuable assets in the system, the intelligent operator who is "on the scene." The alert system designer and operations manager recognize that there cannot be a procedure for everything, and the time will come in which the operators of a complex system will face a situation for which there is no written procedure. Procedures, whether executed by humans or machines, have their place, but so does human cognition.

The 1979 Southeastern Virginia Urban Plume Study (SEV-UPS): Surface and airborne studies

NASA Technical Reports Server (NTRS)

White, J. H.; Eaton, W. C.; Saeger, M. L.; Strong, R. B.; Tommerdahl, J. B.

1980-01-01

The operation of two surface monitoring stations (one in downtown Norfolk, Virginia, one south of the city near the Great Dismal Swamp) and the collection of 40 hours of airborne measurements is described. Surface site measurements of ozone, oxides of nitrogen, sulfur dioxide, temperature, dew point, b sub seat, and condensation nuclei were made. Instrument calibrations, quality assurance audits, and preliminary data analysis in support of the Urban Plume Study were also made. The air pollution problems that were addressed are discussed. Data handling procedures followed for the surface stations are presented. The operation of the aircraft sampling platform is described. Aircraft sampling procedures are discussed. A preliminary descriptive analysis of the aircraft data is given along with data or plots for surface sites, airborne studies, hydrocarbon species, and instrument performance audits. Several of the aircraft flights clearly show the presence of an urban ozone plume downwind of Norfolk in the direction of the mean wind flow.

Study report recommendations for the next generation Range Safety System (RSS) Integrated Receiver/Decoder (IRD)

NASA Technical Reports Server (NTRS)

Crosby, Robert H.

1992-01-01

The Integrated Receiver/Decoder (IRD) currently used on the Space Shuttle was designed in the 1980 and prior time frame. Over the past 12 years, several parts have become obsolete or difficult to obtain. As directed by the Marshall Space Flight Center, a primary objective is to investigate updating the IRD design using the latest technology subsystems. To take advantage of experience with the current designs, an analysis of failures and a review of discrepancy reports, material review board actions, scrap, etc. are given. A recommended new design designated as the Advanced Receiver/Decoder (ARD) is presented. This design uses the latest technology components to simplify circuits, improve performance, reduce size and cost, and improve reliability. A self-test command is recommended that can improve and simplify operational procedures. Here, the new design is contrasted with the old. Possible simplification of the total Range Safety System is discussed, as is a single-step crypto technique that can improve and simplify operational procedures.

How much tumor surgery do early-career orthopaedic oncologists perform?

PubMed

Miller, Benjamin J; Rajani, Rajiv; Leddy, Lee; Carmody Soni, Emily E; White, Jeremy R

2015-02-01

There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early employment discontent and enhance workforce discussions. The aim of the study was to use the objective case log volumes of a cross-section of early career orthopaedic oncologists to describe (1) the number of operations performed annually; (2) the proportion of tumor, trauma, adult reconstruction, and other operations for individual participants, (3) individual practice characteristics that were associated with the number of tumor procedures; and (4) the sources of satisfaction and challenges in each individual's career and surgical practice. Fifteen fellowship-trained orthopaedic oncologists out of a potential pool of 33 (45%) in their first 4 years of practice responded to a survey by submitting complete operative case lists for a 2-year period. We recorded the type of procedure and determined associations between the annual number of tumor operations and total operative caseload, years in practice, and some details of individual practice patterns. Each participant completed a survey regarding practice-related sources of stress and satisfaction. A total of 5611 surgical cases were available for review. For the entire cohort, there were 3303 (59%) tumor procedures, 973 (17%) trauma, 890 (16%) adult reconstruction, and 445 (8%) other. The median annual number of total operations was 214 (range, 63-356) and median annual number of tumor operations was 135 (range, 47-216). The median proportion of tumor operations in an individual practice was 56% (range, 43%-94%). The annual number of tumor operations correlated with the total annual number of operations (r = 0.73, p < 0.001). Sources of stress and satisfaction were similar to the general membership of the Musculoskeletal Tumor Society (MSTS), apart from more early-career surgeons regarding case volume as important (29 of 104 [28%] of MSTS versus 11 of 15 [73%] of early-career, p < 0.001). The typical early-career orthopaedic tumor surgeon had fewer than 60% of his or her operative procedures directly related to the subject of his or her fellowship training in orthopaedic oncology. Overall, the challenges and rewards of clinical practice are similar to oncologic surgeons later in their career. This study is a first step in assessing early practice characteristics and may be of value to the prospective orthopaedic oncologist, fellowship educators, and the society in workforce discussions. Early-career practice patterns have not been previously presented, to our knowledge, for any subspecialty of orthopaedic surgery, and we hope that this study will stimulate similar efforts throughout the field. Level IV, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.

A semi-direct procedure using a local relaxation factor and its application to an internal flow problem

NASA Technical Reports Server (NTRS)

Chang, S. C.

1984-01-01

Generally, fast direct solvers are not directly applicable to a nonseparable elliptic partial differential equation. This limitation, however, is circumvented by a semi-direct procedure, i.e., an iterative procedure using fast direct solvers. An efficient semi-direct procedure which is easy to implement and applicable to a variety of boundary conditions is presented. The current procedure also possesses other highly desirable properties, i.e.: (1) the convergence rate does not decrease with an increase of grid cell aspect ratio, and (2) the convergence rate is estimated using the coefficients of the partial differential equation being solved.

Assessing the surgical skills of trainees in the operating theatre: a prospective observational study of the methodology.

PubMed

Beard, J D; Marriott, J; Purdie, H; Crossley, J

2011-01-01

To compare user satisfaction and acceptability, reliability and validity of three different methods of assessing the surgical skills of trainees by direct observation in the operating theatre across a range of different surgical specialties and index procedures. A 2-year prospective, observational study in the operating theatres of three teaching hospitals in Sheffield. The assessment methods were procedure-based assessment (PBA), Objective Structured Assessment of Technical Skills (OSATS) and Non-technical Skills for Surgeons (NOTSS). The specialties were obstetrics and gynaecology (O&G) and upper gastrointestinal, colorectal, cardiac, vascular and orthopaedic surgery. Two to four typical index procedures were selected from each specialty. Surgical trainees were directly observed performing typical index procedures and assessed using a combination of two of the three methods (OSATS or PBA and NOTSS for O&G, PBA and NOTSS for the other specialties) by the consultant clinical supervisor for the case and the anaesthetist and/or scrub nurse, as well as one or more independent assessors from the research team. Information on user satisfaction and acceptability of each assessment method from both assessor and trainee perspectives was obtained from structured questionnaires. The reliability of each method was measured using generalisability theory. Aspects of validity included the internal structure of each tool and correlation between tools, construct validity, predictive validity, interprocedural differences, the effect of assessor designation and the effect of assessment on performance. Of the 558 patients who were consented, a total of 437 (78%) cases were included in the study: 51 consultant clinical supervisors, 56 anaesthetists, 39 nurses, 2 surgical care practitioners and 4 independent assessors provided 1635 assessments on 85 trainees undertaking the 437 cases. A total of 749 PBAs, 695 NOTSS and 191 OSATSs were performed. Non-O&G clinical supervisors and trainees provided mixed, but predominantly positive, responses about a range of applications of PBA. Most felt that PBA was important in surgical education, and would use it again in the future and did not feel that it added time to the operating list. The overall satisfaction of O&G clinical supervisors and trainees with OSATS was not as high, and a majority of those who used both preferred PBA. A majority of anaesthetists and nurses felt that NOTSS allowed them to rate interpersonal skills (communication, teamwork and leadership) more easily than cognitive skills (situation awareness and decision-making), that it had formative value and that it was a valuable adjunct to the assessment of technical skills. PBA demonstrated high reliability (G > 0.8 for only three assessor judgements on the same index procedure). OSATS had lower reliability (G > 0.8 for five assessor judgements on the same index procedure). Both were less reliable on a mix of procedures because of strong procedure-specific factors. A direct comparison of PBA between O&G and non-O&G cases showed a striking difference in reliability. Within O&G, a good level of reliability (G > 0.8) could not be obtained using a feasible number of assessments. Conversely, the reliability within non-O&G cases was exceptionally high, with only two assessor judgements being required. The reasons for this difference probably include the more summative purpose of assessment in O&G and the much higher proportion of O&G trainees in this study with training concerns (42% vs 4%). The reliability of NOTSS was lower than that for PBA. Reliability for the same procedure (G > 0.8) required six assessor judgements. However, as procedure-specific factors exerted a lesser influence on NOTSS, reliability on a mix of procedures could be achieved using only eight assessor judgements. NOTSS also demonstrated a valid internal structure. The strongest correlations between NOTSS and PBA or OSATS were in the 'decision-making' domain. PBA and NOTSS showed better construct validity than OSATS, the year of training and the number of recent index procedures performed being significant independent predictors of performance. There was little variation in scoring between different procedures or different designations of assessor. The results suggest that PBA is a reliable and acceptable method of assessing surgical skills, with good construct validity. Specialties that use OSATS may wish to consider changing the design or switching to PBA. Whatever workplace-based assessment method is used, the purpose, timing and frequency of assessment require detailed guidance. NOTSS is a promising tool for the assessment of non-technical skills, and surgical specialties may wish to consider its inclusion in their assessment framework. Further research is required into the use of health-care professionals other than consultant surgeons to assess trainees, the relationship between performance and experience, the educational impact of assessment and the additional value of video recording.

Application of QC_DR software for acceptance testing and routine quality control of direct digital radiography systems: initial experiences using the Italian Association of Physicist in Medicine quality control protocol.

PubMed

Nitrosi, Andrea; Bertolini, Marco; Borasi, Giovanni; Botti, Andrea; Barani, Adriana; Rivetti, Stefano; Pierotti, Luisa

2009-12-01

Ideally, medical x-ray imaging systems should be designed to deliver maximum image quality at an acceptable radiation risk to the patient. Quality assurance procedures are employed to ensure that these standards are maintained. A quality control protocol for direct digital radiography (DDR) systems is described and discussed. Software to automatically process and analyze the required images was developed. In this paper, the initial results obtained on equipment of different DDR manufacturers were reported. The protocol was developed to highlight even small discrepancies in standard operating performance.

Apollo-Soyuz test project. Operations handbook command/service/docking modules (CSM 119/DM 1): Operational procedures reference issue

NASA Technical Reports Server (NTRS)

1974-01-01

Operational and configuration checks for the Apollo-Soyuz Test Project are presented. The checks include: backup crew prelaunch, prime crew prelaunch, boost and insertion, G and C reference data, G and N reference modes, rendezvous, navigation, Apollo-Soyuz operations, abort procedures, and emergency procedures.

Future of operating rooms.

PubMed

Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

2005-01-01

Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

40 CFR 68.52 - Operating procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.52 Operating procedures. (a) The... for safely conducting activities associated with each covered process consistent with the safety information for that process. Operating procedures or instructions provided by equipment manufacturers or...

49 CFR 389.39 - Direct final rulemaking procedures

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Direct final rulemaking procedures 389.39 Section 389.39 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER... PROCEDURES-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.39 Direct final...

49 CFR 389.39 - Direct final rulemaking procedures

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Direct final rulemaking procedures 389.39 Section 389.39 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER... PROCEDURES-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.39 Direct final...

Metal-clad waveguide characterization for contact-based light transmission into tissue

NASA Astrophysics Data System (ADS)

Chininis, Jeffrey; Whiteside, Paul; Hunt, Heather K.

2016-02-01

As contemporary laser dermatology procedures, like tattoo removal and skin resurfacing, become more popular, the complications of their operation are also becoming more prevalent. Frequent incidences of over-exposure, ocular injury, and excessive thermal damage represent mounting concerns for those seeking such procedures; moreover, each of these problems is a direct consequence of the standard, free-space method of laser transmission predominantly used in clinical settings. Therefore, an alternative method of light transmission is needed to minimize these problems. Here, we demonstrate and characterize an alternative method that uses planar waveguides to deliver light into sample tissue via direct contact. To do this, slab substrates made from glass were clad in layers of titanium and silver, constraining the light within the waveguide along the waveguide's length. By creating active areas on the waveguide surface, the propagating light could then optically tunnel into the tissue sample, when the waveguide was brought into contact with the tissue. SEM and EDS were used to characterize the metal film thickness and deposition rates onto the glass substrates. Laser light from a Q-switched Nd:YAG source operating at 532nm was coupled into the waveguide and transmitted into samples of pig skin. The amount of light transmitted was measured using photoacoustics techniques, in conjunction with a photodiode and integrating sphere. Transmitting light into tissue in this manner effectively resolves or circumvents the complications caused by free-space propagation methods as it reduces the operating distance to 0, which prevents hazardous back-reflections and allows for the ready incorporation of contact cooling technologies.

Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

PubMed

Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

2017-06-20

Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

PubMed

Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

2012-11-01

To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. Number of procedures needed to become sufficient was demonstrated in the current study.

Restorative dentistry productivity of senior students engaged in comprehensive care.

PubMed

Blalock, John S; Callan, Richard S; Lazarchik, David A; Frank Caughman, W; Looney, Stephen

2012-12-01

In dental education, various clinical delivery models are used to educate dental students. The quantitative and qualitative measures used to assess the outcomes of these models are varied. Georgia Health Sciences University College of Dental Medicine has adopted a version of a general dentistry comprehensive care dental education hybrid model. Outcome assessments were developed to evaluate the effectiveness of this delivery model. The aim of this study was to compare the number of restorative procedures performed by senior dental students under a discipline-based model versus senior student productivity engaged in comprehensive care as part of a hybrid model. The rate of senior students' productivity in performing various restorative procedures was tracked over four years, and a comparison was made. In the first two years, the seniors operated in a discipline-based model, while in the last two years the seniors operated in a comprehensive care hybrid model. The results showed that there was a significant increase in productivity by the students in terms of direct and indirect restorations. This increase in productivity may indicate that the comprehensive care model may be a more productive model, thereby enhancing clinical experiences for the students, improving operating efficiency for the schools, and ultimately increasing clinical income.

14 CFR 125.287 - Initial and recurrent pilot testing requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS... air navigation aids appropriate to the operation of pilot authorization, including, when applicable, instrument approach facilities and procedures; (5) Air traffic control procedures, including IFR procedures...

7 CFR 610.23 - State Technical Committee meetings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

7 CFR 610.23 - State Technical Committee meetings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

7 CFR 610.23 - State Technical Committee meetings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

7 CFR 610.23 - State Technical Committee meetings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

7 CFR 610.23 - State Technical Committee meetings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

Technical and operational users' opinions of a handheld device to detect directed energy.

PubMed

Boyd, Andrew D; Naiman, Melissa; Stevenson, Greer W; Preston, Richard; Valenta, Annette L

2013-05-01

Lasers, a form of directed energy (DE), are a threat to pilots and Air Force personnel. In light of this threat, a handheld medical device called the "Tricorder" is under development to improve situational awareness of DE. Current operational procedures do not include methods for recording or handling new information regarding DE. The purpose of this study was to understand Air Force personnel opinions and beliefs about desired features and operational use to enhance user acceptance of the Tricorder. Q-methodology was implemented to study opinions and beliefs related to DE. Two groups were approached, medical personnel in the Illinois Air National Guard and four active duty members of an Air Force Rescue Squadron. Both groups completed the same Q-sort of both operational and equipment concerns. Six opinion sets regarding operational concerns described 61% of the total variation in perceptions among participants. The factors were: concern over health effects, implications to individuals, combat/tactical concerns, force health protection, and theater/tactical concerns. Five opinion sets described 68% of the variation in the equipment functions perceived as most important. The participants indicated that ideally the device should measure exposure, enhance laser detection/response, support night vision and ease of use, detect threats, and enhance combat medicine. This survey revealed the complexity of equipment and the operational implications of detecting DE. Q-methodology is a unique strategy to both evaluate technology and explore users' concerns.

Computerized procedures system

DOEpatents

Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

2010-10-12

An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

Validation and refinement of a rule to predict emergency intervention in adult trauma patients.

PubMed

Haukoos, Jason S; Byyny, Richard L; Erickson, Catherine; Paulson, Stephen; Hopkins, Emily; Sasson, Comilla; Bender, Brooke; Gravitz, Craig S; Vogel, Jody A; Colwell, Christopher B; Moore, Ernest E

2011-08-01

Trauma centers use "secondary triage" to determine the necessity of trauma surgeon involvement. A clinical decision rule, which includes penetrating injury, an initial systolic blood pressure less than 100 mm Hg, or an initial pulse rate greater than 100 beats/min, was developed to predict which trauma patients require emergency operative intervention or emergency procedural intervention (cricothyroidotomy or thoracotomy) in the emergency department. Our goal was to validate this rule in an adult trauma population and to compare it with the American College of Surgeons' major resuscitation criteria. We used Level I trauma center registry data from September 1, 1995, through November 30, 2008. Outcomes were confirmed with blinded abstractors. Sensitivity, specificity, and 95% confidence intervals (CIs) were calculated. Our patient sample included 20,872 individuals. The median Injury Severity Score was 9 (interquartile range 4 to 16), 15.3% of patients had penetrating injuries, 13.5% had a systolic blood pressure less than 100 mm Hg, and 32.5% had a pulse rate greater than 100 beats/min. Emergency operative intervention or procedural intervention was required in 1,099 patients (5.3%; 95% CI 5.0% to 5.6%). The sensitivities and specificities of the rule and the major resuscitation criteria for predicting emergency operative intervention or emergency procedural intervention were 95.6% (95% CI 94.3% to 96.8%) and 56.1% (95% CI 55.4% to 56.8%) and 85.5% (95% CI 83.3% to 87.5%) and 80.9% (95% CI 80.3% to 81.4%), respectively. This new rule was more sensitive for predicting the need for emergency operative intervention or emergency procedural intervention directly compared with the American College of Surgeons' major resuscitation criteria, which may improve the effectiveness and efficiency of trauma triage. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

A Novel Procedure for Evaluating the Reinforcing Properties of Tastants in Laboratory Rats: Operant Intraoral Self-administration

PubMed Central

Levy, AnneMarie; Limebeer, Cheryl L.; Ferdinand, Justin; Shillingford, Ucal; Parker, Linda A.; Leri, Francesco

2014-01-01

This paper describes a novel method for studying the bio-behavioral basis of addiction to food. This method combines the surgical component of taste reactivity with the behavioral aspects of operant self-administration of drugs. Under very brief general anaesthesia, rats are implanted with an intraoral (IO) cannula that allows delivery of test solutions directly in the oral cavity. Animals are then tested in operant self-administration chambers whereby they can press a lever to receive IO infusions of test solutions. IO self-administration has several advantages over experimental procedures that involve drinking a solution from a spout or operant responding for solid pellets or solutions delivered in a receptacle. Here, we show that IO self-administration can be employed to study self-administration of high fructose corn syrup (HFCS). Rats were first tested for self-administration on a progressive ratio (PR) schedule, which assesses the maximum amount of operant behavior that will be emitted for different concentrations of HFCS (i.e. 8%, 25%, and 50%). Following this test, rats self-administered these concentrations on a continuous schedule of reinforcement (i.e. one infusion for each lever press) for 10 consecutive days (1 session/day; each lasting 3 hr), and then they were retested on the PR schedule. On the continuous reinforcement schedule, rats took fewer infusions of higher concentrations, although the lowest concentration of HFCS (8%) maintained more variable self-administration. Furthermore, the PR tests revealed that 8% had lower reinforcing value than 25% and 50%. These results indicate that IO self-administration can be employed to study acquisition and maintenance of responding for sweet solutions. The sensitivity of the operant response to differences in concentration and schedule of reinforcement makes IO self-administration an ideal procedure to investigate the neurobiology of voluntary intake of sweets. PMID:24561923

A contribution to the design specification of single-cell multi-resonant converters

NASA Astrophysics Data System (ADS)

Franck, F.; Schroeder, D.

The state plane technique is used to develop a design-specification procedure that enables the designer to directly calculate the stresses on all elements of the different topologies for quasi-resonant converters. If parasitic elements are considered, multiresonant topologies are obtained. These topologies can be calculated for the design specification if the procedure for quasi-resonant topologies is adapted to this situation. A novel theoretical approach for describing the internal behavior of multiresonant converters and for visualizing the switching conditions and the points of maximum component stresses is proposed. The multiresonant switching technique combines two advantages: the lossless snubbing of both the transistor and the diode is achieved by only three reactive elements, and a controllable no-load operation is possible. This analysis procedure is well suited for calculating dc-dc converter with an output power up to several hundred watts.

Chemistry and Microphysics of Lower Stratospheric Aerosols Determined by Satellite Remote Sensing

NASA Astrophysics Data System (ADS)

Zasetsky, A. Y.; Khalizov, A.; Sloan, J.

2003-12-01

Observations of broadband Infrared satellites such as ILAS-II (Ministry of the Environment, Japan, launched 14 December 2002) and SciSat-1 (Canadian Space Agency, launched 12 August 2003) can provide details of the chemical composition and particle size of atmospheric aerosols by direct inversion without recourse to models. During the past decade, we have developed mathematical methods to achieve this inversion by working with FTIR observations of model atmospheric aerosols in cryogenic flowtubes. More recently, we have converted these to operational algorithms for use in the above missions. In this presentation, we will briefly outline these procedures and illustrate their capabilities using laboratory data. These laboratory results show that the chemical compositions, phases and sizes of ensembles of particles can be obtained simultaneously using these procedures. We will also report chemical and microphysical properties of lower stratospheric clouds and aerosols derived by applying these procedures to observations from space.

A prospective outcomes analysis of palliative procedures performed for malignant intestinal obstruction due to recurrent ovarian cancer.

PubMed

Chi, Dennis S; Phaëton, Rebecca; Miner, Thomas J; Kardos, Steven V; Diaz, John P; Leitao, Mario M; Gardner, Ginger; Huh, Jae; Tew, William P; Konner, Jason A; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Jaques, David P

2009-08-01

To obtain prospective outcomes data on patients (pts) undergoing palliative operative or endoscopic procedures for malignant bowel obstruction due to recurrent ovarian cancer. An institutional study was conducted from July 2002 to July 2003 to prospectively identify pts who underwent an operative or endoscopic procedure to palliate the symptoms of advanced cancer. This report focuses on pts with malignant bowel obstruction due to recurrent ovarian cancer. Procedures performed with an upper or lower gastrointestinal (GI) endoscope were considered "endoscopic." All other cases were classified as "operative." Following the procedure, the presence or absence of symptoms was determined and followed over time. All pts were followed until death. Palliative interventions were performed on 74 gynecologic oncology pts during the study period, of which 26 (35%) were for malignant GI obstruction due to recurrent ovarian cancer. The site of obstruction was small bowel in 14 (54%) cases and large bowel in 12 (46%) cases. Palliative procedures were operative in 14 (54%) pts and endoscopic in the other 12 (46%). Overall, symptomatic improvement or resolution within 30 days was achieved in 23 (88%) of 26 patients, with 1 (4%) postprocedure mortality. At 60 days, 10 (71%) of 14 pts who underwent operative procedures and 6 (50%) of 12 pts who had endoscopic procedures had symptom control. Median survival from the time of the palliative procedure was 191 days (range, 33-902) for those undergoing an operative procedure and 78 days (range, 18-284) for those undergoing an endoscopic procedure. Patients with malignant bowel obstructions due to recurrent ovarian cancer have a high likelihood of experiencing relief of symptoms with palliative procedures. Although recurrence of symptoms is common, durable palliation and extended survival are possible, especially in those patients selected for operative intervention.

Document control and Conduct of Operations

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

Collins, S.K.; Meltzer, F.L.

1993-01-01

Department of Energy (DOE) Order 5480.19, Conduct of operations, places stringent requirements on a wide range of activities at DOE facilities. These requirements directly affect personnel at the Advanced Test Reactor (ATR), which is located in the Test Reactor Area of the Idaho National Engineering Laboratory and operated for DOE by EG G Idaho, Inc. In order for the ATR to comply with 5480.19, the very personality of the reactor facility's document control unit has had to undergo a major change. The Facility and Administrative Support Unit (FAS) is charged with nudntenance of ATR's controlled ddcuments-diousands of operating and administrativemore » procedures. Prior to the imposition of 5480.19, FAS was content to operate in a clerical support mode, seldom questioning or seeking to improve. This numer of doing business is inappropriate within the framework of DOE 5480.19 and is also at odds with the approach to Total Quality Management (TQM) promulgated by EG G Idaho.To comply with the requirements of 5480.19, FAS has Actively applied TQM principles. Empowered personnel to unprove operations through the establishment of a teatn approach. Begun an automation process that is already paying large dividends in terms of improved procedure accuracy and compliance. A state-of-the-art text retrival system is already in place. We are vigorously pursuing fully automated document tmcidng and document management. This paper describes in detail the steps taken to date, the improvements and the lessons learned. It aLw discusses plans for the future that will enable FAS to support the ATR in inccreasing its responsiveness to the Conduct of Operations Order.« less

Computer simulation of a single pilot flying a modern high-performance helicopter

NASA Technical Reports Server (NTRS)

Zipf, Mark E.; Vogt, William G.; Mickle, Marlin H.; Hoelzeman, Ronald G.; Kai, Fei; Mihaloew, James R.

1988-01-01

Presented is a computer simulation of a human response pilot model able to execute operational flight maneuvers and vehicle stabilization of a modern high-performance helicopter. Low-order, single-variable, human response mechanisms, integrated to form a multivariable pilot structure, provide a comprehensive operational control over the vehicle. Evaluations of the integrated pilot were performed by direct insertion into a nonlinear, total-force simulation environment provided by NASA Lewis. Comparisons between the integrated pilot structure and single-variable pilot mechanisms are presented. Static and dynamically alterable configurations of the pilot structure are introduced to simulate pilot activities during vehicle maneuvers. These configurations, in conjunction with higher level, decision-making processes, are considered for use where guidance and navigational procedures, operational mode transfers, and resource sharing are required.

Psychological screening program overview.

PubMed

Wright, Kathleen M; Huffman, Ann H; Adler, Amy B; Castro, Carl A

2002-10-01

This article reviews the literature on health surveillance conducted during military deployments, focusing on models for assessing the impact of operational deployments on peacekeepers. A discussion of the stressors and potential mental health consequences of peacekeeping operations follows with relevant examples of findings from U.S. and international military forces. Psychological screening in different peacekeeping operations conducted in U.S. Army-Europe is reviewed. The review begins with the redeployment screening of military personnel deployed to Bosnia mandated under the Joint Medical Surveillance Program, and continues through the present screening of units deployed to Kosovo. The detailed description of the screening program includes a discussion of procedures and measures and demonstrates the evolution of the program. A summary of key findings from the screening program and a discussion of future research directions are provided.

40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2011 CFR

2011-07-01

...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2012 CFR

2012-07-01

...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2014 CFR

2014-07-01

...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2013 CFR

2013-07-01

...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2010 CFR

2010-07-01

...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

24 CFR 291.210 - Direct sales procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Direct sales procedures. 291.210... URBAN DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF HUD-ACQUIRED SINGLE FAMILY PROPERTY Sales Procedures § 291.210 Direct sales procedures. When HUD conducts the sales listed in § 291.90(c), it will sell...

24 CFR 291.210 - Direct sales procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Direct sales procedures. 291.210... URBAN DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF HUD-ACQUIRED SINGLE FAMILY PROPERTY Sales Procedures § 291.210 Direct sales procedures. When HUD conducts the sales listed in § 291.90(c), it will sell...

24 CFR 291.210 - Direct sales procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Direct sales procedures. 291.210... URBAN DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF HUD-ACQUIRED SINGLE FAMILY PROPERTY Sales Procedures § 291.210 Direct sales procedures. When HUD conducts the sales listed in § 291.90(c), it will sell...

A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis.

PubMed

Mohammed, Nasser; Patra, Devi Prasad; Narayan, Vinayak; Savardekar, Amey R; Dossani, Rimal Hanif; Bollam, Papireddy; Bir, Shyamal; Nanda, Anil

2018-01-01

OBJECTIVE Spondylosis with or without spondylolisthesis that does not respond to conservative management has an excellent outcome with direct pars interarticularis repair. Direct repair preserves the segmental spinal motion. A number of operative techniques for direct repair are practiced; however, the procedure of choice is not clearly defined. The present study aims to clarify the advantages and disadvantages of the different operative techniques and their outcomes. METHODS A meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following databases were searched: PubMed, Cochrane Library, Web of Science, and CINAHL ( Cumulative Index to Nursing and Allied Health Literature). Studies of patients with spondylolysis with or without low-grade spondylolisthesis who underwent direct repair were included. The patients were divided into 4 groups based on the operative technique used: the Buck repair group, Scott repair group, Morscher repair group, and pedicle screw-based repair group. The pooled data were analyzed using the DerSimonian and Laird random-effects model. Tests for bias and heterogeneity were performed. The I 2 statistic was calculated, and the results were analyzed. Statistical analysis was performed using StatsDirect version 2. RESULTS Forty-six studies consisting of 900 patients were included in the study. The majority of the patients were in their 2nd decade of life. The Buck group included 19 studies with 305 patients; the Scott group had 8 studies with 162 patients. The Morscher method included 5 studies with 193 patients, and the pedicle group included 14 studies with 240 patients. The overall pooled fusion, complication, and outcome rates were calculated. The pooled rates for fusion for the Buck, Scott, Morscher, and pedicle screw groups were 83.53%, 81.57%, 77.72%, and 90.21%, respectively. The pooled complication rates for the Buck, Scott, Morscher, and pedicle screw groups were 13.41%, 22.35%, 27.42%, and 12.8%, respectively, and the pooled positive outcome rates for the Buck, Scott, Morscher, and pedicle screw groups were 84.33%, 82.49%, 80.30%, and 80.1%, respectively. The pedicle group had the best fusion rate and lowest complication rate. CONCLUSIONS The pedicle screw-based direct pars repair for spondylolysis and low-grade spondylolisthesis is the best choice of procedure, with the highest fusion and lowest complication rates, followed by the Buck repair. The Morscher and Scott repairs were associated with a high rate of complication and lower rates of fusion.

Standard operating procedures improve acute neurologic care in a sub-Saharan African setting

PubMed Central

Jaiteh, Lamin E.S.; Helwig, Stefan A.; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman

2017-01-01

Objective: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Methods: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. Results: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p < 0.05) and assessments of respiratory rate (98.0% vs 81.9%, p < 0.001), temperature (60.0% vs 36.2%; p < 0.001), and glucose levels (73.0% vs 58.1%; p < 0.05), in addition to written directives by physicians (96.0% vs 88.6%, p < 0.05), whereas assessments of other vital signs remained unchanged. In stroke patients, rates of stroke-related procedures increased: early CT scanning (24.3% vs 9.9%; p < 0.05), blood count (73.0% vs 49.3%; p < 0.01), renal and liver function tests (50.0% vs 5.6%, p < 0.001), aspirin prophylaxis (47.3% vs 9.9%; p < 0.001), and physiotherapy (41.9% vs 4.2%; p < 0.001). Most effects persisted until the second-year evaluation. SOP implementation was similarly feasible and beneficial at the Brikama hospital. However, outcomes did not significantly differ in the hospitals. Conclusions: Implementing SOPs is a realistic, low-cost option for improving process quality of neurologic emergency management in under-resourced settings. Classification of evidence: This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. PMID:28600460

Performance of advanced trauma life support procedures in microgravity

NASA Technical Reports Server (NTRS)

Campbell, Mark R.; Billica, Roger D.; Johnston, Smith L 3rd; Muller, Matthew S.

2002-01-01

BACKGROUND: Medical operations on the International Space Station will emphasize the stabilization and transport of critically injured personnel and so will need to be capable of advanced trauma life support (ATLS). METHODS: We evaluated the ATLS invasive procedures in the microgravity environment of parabolic flight using a porcine animal model. Included in the procedures evaluated were artificial ventilation, intravenous infusion, laceration closure, tracheostomy, Foley catheter drainage, chest tube insertion, peritoneal lavage, and the use of telemedicine methods for procedural direction. RESULTS: Artificial ventilation was performed and appeared to be unaltered from the 1-G environment. Intravenous infusion, laceration closure, percutaneous dilational tracheostomy, and Foley catheter drainage were achieved without difficulty. Chest tube insertion and drainage were performed with no more difficulty than in the 1-G environment due to the ability to restrain patient, operator and supplies. A Heimlich valve and Sorenson drainage system were both used to provide for chest tube drainage collection with minimal equipment, without the risk of atmospheric contamination, and with the capability to auto-transfuse blood drained from a hemothorax. The use of telemedicine in chest tube insertion was demonstrated to be useful and feasible. Peritoneal lavage using a percutaneous technique, although requiring less training to perform, was found to be dangerous in weightlessness due to the additional pressure of the bowel on the anterior abdominal wall creating a high risk of bowel perforation. CONCLUSIONS: The performance of ATLS procedures in microgravity appears to be feasible with the exception of diagnostic peritoneal lavage. Minor modifications to equipment and techniques are required in microgravity to effect surgical drainage in the presence of altered fluid dynamics, to prevent atmospheric contamination, and to provide for the restraint requirements. A parabolic simulation system was developed for equipment and procedure verification, physiological research, and possible crew medical officer training in the future.

21 CFR 680.1 - Allergenic Products.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

21 CFR 680.1 - Allergenic Products.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

21 CFR 680.1 - Allergenic Products.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

21 CFR 680.1 - Allergenic Products.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

14 CFR 23.1585 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Operating procedures. 23.1585 Section 23.1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information Airplane Flight Manual and Approved Manual Material § 23.1585 Operating procedures. (a) For all...

Rolling Deck to Repository (R2R): Building the Data Pipeline - Initial Results

NASA Astrophysics Data System (ADS)

Arko, R. A.; Clark, P. D.; Rioux, M. A.; McGovern, T. M.; Deering, T. W.; Hagg, R. K.; Payne, A. A.; Fischman, D. E.; Ferrini, V.

2009-12-01

The NSF-funded Rolling Deck to Repository (R2R) project is working with U.S. academic research vessel operators to ensure the documentation and preservation of data from routine “underway” (meteorological, geophysical, and oceanographic) sensor systems. A standard pipeline is being developed in which data are submitted by vessel operators directly to a central repository; inventoried in an integrated fleet-wide catalog; organized into discrete data sets with persistent unique identifiers; associated with essential cruise-level metadata; and delivered to the National Data Centers for archiving and dissemination. Several vessels including Atlantis, Healy, Hugh R. Sharp, Ka'imikai-O-Kanaloa, Kilo Moana, Knorr, Marcus G. Langseth, Melville, Oceanus, Roger Revelle, and Thomas G. Thompson began submitting data and documentation to R2R during the project’s pilot phase, and a repository infrastructure has been established. Cruise metadata, track maps, and data inventories are published at the R2R Web portal, with controlled vocabularies drawn from community standards (e.g. International Council for the Exploration of the Sea (ICES) ship codes). A direct connection has been established to the University-National Oceanographic Laboratory System (UNOLS) Ship Time Request and Scheduling System (STRS) via Web services to synchronize port codes and cruise schedules. A secure portal is being developed where operators may login to upload sailing orders, review data inventories, and create vessel profiles. R2R has established a standard procedure for submission of data to the National Geophysical Data Center (NGDC) that incorporates persistent unique identifiers for cruises, data sets, and individual files, using multibeam data as a test bed. Once proprietary holds are cleared and a data set is delivered to NGDC, the R2R catalog record is updated with the URL for direct download and it becomes immediately available to integration and synthesis projects such as the NSF-funded Global Multi-Resolution Topography (GMRT) synthesis. Similar procedures will be developed for delivery of data to other National Data Centers as appropriate.

The Investigation of Laparoscopic Instrument Movement Control and Learning Effect

PubMed Central

Lin, Chiuhsiang Joe

2013-01-01

Laparoscopic surgery avoids large incisions for intra-abdominal operations as required in conventional open surgery. Whereas the patient benefits from laparoscopic techniques, the surgeon encounters new difficulties that were not present during open surgery procedures. However, limited literature has been published in the essential movement characteristics such as magnification, amplitude, and angle. For this reason, the present study aims to investigate the essential movement characteristics of instrument manipulation via Fitts' task and to develop an instrument movement time predicting model. Ten right-handed subjects made discrete Fitts' pointing tasks using a laparoscopic trainer. The experimental results showed that there were significant differences between the three factors in movement time and in throughput. However, no significant differences were observed in the improvement rate for movement time and throughput between these three factors. As expected, the movement time was rather variable and affected markedly by direction to target. The conventional Fitts' law model was extended by incorporating a directional parameter into the model. The extended model was shown to better fit the data than the conventional model. These findings pointed to a design direction for the laparoscopic surgery training program, and the predictive model can be used to establish standards in the training procedure. PMID:23984348

Editorial Commentary: The Wake of the Dragon: Will the Orthopaedic Community Adopt the Shoulder Arthroscopic Latarjet Procedure as We Adopted the Arthroscopic Rotator Cuff Repair?

PubMed

Boileau, Pascal; Saliken, David

2017-12-01

The Latarjet procedure is a complex and difficult operation when performed both with an open approach and arthroscopically. The difficulties come from the fact that it is a combined intra- and extra-articular procedure, and that working close to the brachial plexus may be frightening for surgeons. Because of the high complication and reoperation rates reported in the literature, this procedure is, at the moment, rejected by a large part of the orthopaedic community, specifically in North America. The Chinese experience shows, after the European one, that arthroscopic Latarjet is an efficient and irreplaceable option for the treatment of recurrent anterior shoulder instability in the context of capsular and/or glenoid deficiency. A recent study shows that the arthroscopic procedure provides accurate bone block positioning and high rates of healing, excellent clinical results (no recurrence of instability at 2-year follow-up), and low rates of complications (no neurovascular injury). Although the arthroscopic Latarjet should be approached with caution, the learning curve should not be thought of as prohibitive. To learn how to perform an arthroscopic Latarjet, surgeons should visit an experienced surgeon and take a course to practice on cadavers first. Although it will take time and effort to learn and perform this operation correctly, we should command our Chinese colleagues to encourage us to follow their path. There is no reason that in the near future the orthopaedic community does not adopt the arthroscopic Latarjet procedure, as we adopted the arthroscopic rotator cuff repair and other complex surgical procedures. Among the strongest reasons to perform the Latarjet procedure arthroscopically are the accuracy of graft placement, the safety for neurovascular structures provided by direct visualization and magnification, and the excellent clinical results allowing young people to go back to sport, including high-risk (contact, overhead) sports. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Operating manual for the R200 downhole recorder with husky hunter retriever

USGS Publications Warehouse

Johnson, Roy A.; Rorabaugh, James I.

1988-01-01

The R200 Downhole Recorder is a battery-powered device that, when placed in a well casing, monitors water levels for a period of up to 1 year. This instrument measures a 1- to 70-foot range of water levels. These water-level data can be retrieved through use of a commercially available portable microcomputer. The R200 Downhole Recorder was developed at the U.S. Geological Survey 's Hydrologic Instrumentation Facility, Stennis Space Center, Mississippi. This operating manual describes the R200 Downhole Recorder, provides initial set-up instructions, and gives directions for on-site operation. Design specifications and routine maintenance steps are included. The R200 data-retriever program is a user-friendly, menu-driven program. The manual guides the user through the procedures required to perform specific operations. Numerous screens are reproduced in the text with a discussion of user input for desired responses. Help is provided for specific problems. (USGS)

Operating manual for the R200 downhole recorder with Tandy 102 retriever

USGS Publications Warehouse

Johnson, Roy A.; Rorabaugh, James I.

1988-01-01

The R200 Downhole Recorder is a battery-powered device that, when placed in a well casing, monitors water levels for a period of up to 1 year. This instrument measures a 1- to 70-ft range of water levels. These water level data can be retrieved through use of a commercially available portable microcomputer. The R200 Downhole Recorder was developed at the U. S. Geological Survey 's Hydrologic Instrumentation Facility, Stennis Space Center, Mississippi. This operating manual describes the R200 Downhole Recorder, provides initial set-up instructions, and gives directions for on-site operation. Design specifications and routine maintenance steps are included. The R200 data-retriever program is a user-friendly, menu-driven program. The manual guides the user through the procedures required to perform specific operations. Numerous screens are reproduced in the text with a discussion of user input for desired responses. Help is provided for specific problems. (USGS)

Importance of preoperative imaging with 64-row three-dimensional multidetector computed tomography for safer video-assisted thoracic surgery in lung cancer.

PubMed

Akiba, Tadashi; Marushima, Hideki; Harada, Junta; Kobayashi, Susumu; Morikawa, Toshiaki

2009-01-01

Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. 3D-MDCT imaging is useful for preoperatively understanding the individual thoracic anatomy in lung cancer surgery. This modality can therefore contribute to safer anatomical pulmonary operations, especially in VATS.

Foveal light exposure is increased at the time of removal of silicone oil with the potential for phototoxicity.

PubMed

Dogramaci, Mahmut; Williams, Katie; Lee, Ed; Williamson, Tom H

2013-01-01

There is sudden and dramatic visual function deterioration in 1-10 % of eyes filled with silicone oil at the time of removal of silicon oil. Transmission of high-energy blue light is increased in eyes filled with silicone oil. We sought to identify if increased foveal light exposure is a potential factor in the pathophysiology of the visual loss at the time of removal of silicone oil. A graphic ray tracing computer program and laboratory models were used to determine the effect of the intraocular silicone oil bubble size on the foveal illuminance at the time of removal of silicone oil under direct microscope light. The graphic ray tracing computer program revealed a range of optical vignetting effects created by different sizes of silicone oil bubble within the vitreous cavity giving rise to an uneven macular illumination. The laboratory model was used to quantify the variation of illuminance at the foveal region with different sizes of silicone oil bubble with in the vitreous cavity at the time of removal of silicon oil under direct microscope light. To substantiate the hypothesis of the light toxicity during removal of silicone oil, The outcome of oil removal procedures performed under direct microscope illumination in compared to those performed under blocked illumination. The computer program showed that the optical vignetting effect at the macula was dependent on the size of the intraocular silicone oil bubble. The laboratory eye model showed that the foveal illuminance followed a bell-shaped curve with 70 % greater illuminance demonstrated at with 50-60 % silicone oil fill. The clinical data identified five eyes with unexplained vision loss out of 114 eyes that had the procedure performed under direct microscope illumination compared to none out of 78 eyes that had the procedure under blocked illumination. Foveal light exposure, and therefore the potential for phototoxicity, is transiently increased at the time of removal of silicone oil. This is due to uneven macular illumination resulting from the optical vignetting effect of different silicone oil bubble sizes. The increase in foveal light exposure may be significant when the procedure is performed under bright operating microscope light on already stressed photoreceptors of an eye filled with silicon oil. We advocate the use of precautions, such as central shadow filter on the operating microscope light source to reduce foveal light exposure and the risk of phototoxicity at the time of removal of silicone oil. The graphic ray tracing computer program used in this study shows promise in eye modeling for future studies.

10 CFR 455.62 - Contents of a technical assistance program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

10 CFR 455.62 - Contents of a technical assistance program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...