A formulation to analyze system-of-systems problems: A case study of airport metroplex operations

NASA Astrophysics Data System (ADS)

Ayyalasomayajula, Sricharan Kishore

A system-of-systems (SoS) can be described as a collection of multiple, heterogeneous, distributed, independent components interacting to achieve a range of objectives. A generic formulation was developed to model component interactions in an SoS to understand their influence on overall SoS performance. The formulation employs a lexicon to aggregate components into hierarchical interaction networks and understand how their topological properties affect the performance of the aggregations. Overall SoS performance is evaluated by monitoring the changes in stakeholder profitability due to changes in component interactions. The formulation was applied to a case study in air transportation focusing on operations at airport metroplexes. Metroplexes are geographical regions with two or more airports in close proximity to one another. The case study explored how metroplex airports interact with one another, what dependencies drive these interactions, and how these dependencies affect metroplex throughput and capacity. Metrics were developed to quantify runway dependencies at a metroplex and were correlated with its throughput and capacity. Operations at the New York/New Jersey metroplex (NYNJ) airports were simulated to explore the feasibility of operating very large aircraft (VLA), such as the Airbus A380, as a delay-mitigation strategy at these airports. The proposed formulation was employed to analyze the impact of this strategy on different stakeholders in the national air transportation system (ATS), such as airlines and airports. The analysis results and their implications were used to compare the pros and cons of operating VLAs at NYNJ from the perspectives of airline profitability, and flight delays at NYNJ and across the ATS.

Network Centric Warfare Case Study: U.S. V Corps and 3rd Infantry Division (Mechanized) During Operation Iraqi Freedom Combat Operations (Mar-Apr 2003). Volume 3. Network Centric Warfare Insights

DTIC Science & Technology

2003-01-01

OPSEC), military deception, psychological operations (PSYOPS), special information operations (IO), information assurance, physical security...nonlethal effects, such as operational 8 Network Centric Warfare Case Study security (OPSEC), military deception, psychological operations (PSYOP...Support Operations Group ASR Alternate Supply Route; or, Ammunition Supply Rate ATACMS Army Tactical Missile System ATARS Advanced

Traffic operational evaluation of traffic impact analysis (TIA) case sites.

DOT National Transportation Integrated Search

2010-09-22

This report summarizes traffic operational evaluation of six select traffic impact analysis (TIA) case sites and the effectiveness of forecasting methods used in TIA studies. Six TIA case sites comprising 15 signalized intersections and 2 unsignalize...

Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: a retrospective case study in Southeast China

PubMed Central

Guo, Wan-liang; Zhan, Yang; Fang, Fang; Deng, Yan-bing; Zhao, Jun-gang

2018-01-01

Objective The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). Design A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. Setting This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China. Participants Sixty-five paediatric patients with CCM were included in this study. We derived all available information on patient demographics, clinical characteristics, preoperative complications and surgical methods from the charts of all these patients. Interventions Univariate and multivariate logistic regression analyses were used to evaluate factors significantly affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM. Results Twenty-three of the 65 case surgeries were performed using laparoscopic technique, and 42 surgeries were performed by conventional open surgery. The median operating time was 215 min (range 120–430 min). The morphological subtype of CCM and the presence of cholecystitis or cholangitis were the only factors found to affect the operating time (p<0.05). Logistic regression analysis confirmed cholangitis as an independent risk factor. Conclusions The morphological subtype of CMM and the presence of cholecystitis or cholangitis are factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM, whereas cholangitis is an independent risk factor. PMID:29804066

IVHS institutional issues and case studies : ADVANCE case study

DOT National Transportation Integrated Search

1994-04-01

This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

Effect of the 16-hour work limit on general surgery intern operative case volume: a multi-institutional study.

PubMed

Schwartz, Samuel I; Galante, Joseph; Kaji, Amy; Dolich, Matthew; Easter, David; Melcher, Marc L; Patel, Kevin; Reeves, Mark E; Salim, Ali; Senagore, Anthony J; Takanishi, Danny M; de Virgilio, Christian

2013-09-01

The 80-hour work-week limit for all residents was instituted in 2003 and studies looking at its effect have been mixed. Since the advent of the 16-hour mandate for postgraduate year 1 residents in July 2011, no data have been published regarding the effect of this additional work-hour restriction. To determine whether the 16-hour intern work limit, implemented in July 2011, has adversely affected operative experience. A retrospective review of categorical postgraduate year 1 Accreditation Council for Graduate Medical Education case logs from the intern class (N = 52) (with 16-hour work limit) compared with the 4 preceding years (2007-2010; N = 197) (without 16-hour work limit). A total of 249 categorical general surgery interns from 10 general surgery residency programs in the western United States were included. Total, major, first-assistant, and defined-category case totals. As compared with the preceding 4 years, the 2011-2012 interns recorded a 25.8% decrease in total operative cases (65.9 vs 88.8, P = .005), a 31.8% decrease in major cases (54.9 vs 80.5, P < .001), and a 46.3% decrease in first-assistant cases (11.1 vs 20.7, P = .008). There were statistically significant decreases in cases within the defined categories of abdomen, endocrine, head and neck, basic laparoscopy, complex laparoscopy, pediatrics, thoracic, and soft tissue/breast surgery in the 16-hour shift intern era, whereas there was no decrease in trauma, vascular, alimentary, endoscopy, liver, and pancreas cases. The 16-hour work limit for interns, implemented in July 2011, is associated with a significant decrease in categorical intern operative experience. If the 16-hour shift were to be extended to all postgraduate year levels, one can anticipate that additional years of training will be needed to maintain the same operative volume.

Expert system development methodology and the transition from prototyping to operations: FIESTA, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

Expert system development methodology and the transition from prototyping to operations - Fiesta, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

The Value of SysML Modeling During System Operations: A Case Study

NASA Technical Reports Server (NTRS)

Dutenhoffer, Chelsea; Tirona, Joseph

2013-01-01

System models are often touted as engineering tools that promote better understanding of systems, but these models are typically created during system design. The Ground Data System (GDS) team for the Dawn spacecraft took on a case study to see if benefits could be achieved by starting a model of a system already in operations. This paper focuses on the four steps the team undertook in modeling the Dawn GDS: defining a model structure, populating model elements, verifying that the model represented reality, and using the model to answer system-level questions and simplify day-to-day tasks. Throughout this paper the team outlines our thought processes and the system insights the model provided.

The value of SysML modeling during system operations: A case study

NASA Astrophysics Data System (ADS)

Dutenhoffer, C.; Tirona, J.

System models are often touted as engineering tools that promote better understanding of systems, but these models are typically created during system design. The Ground Data System (GDS) team for the Dawn spacecraft took on a case study to see if benefits could be achieved by starting a model of a system already in operations. This paper focuses on the four steps the team undertook in modeling the Dawn GDS: defining a model structure, populating model elements, verifying that the model represented reality, and using the model to answer system-level questions and simplify day-to-day tasks. Throughout this paper the team outlines our thought processes and the system insights the model provided.

Communicating for Climate Change Adaptation: Lessons from a Case Study with Nature-Based Tour Operators

NASA Astrophysics Data System (ADS)

Timm, K.; Sparrow, E. B.; Pettit, E. C.; Trainor, S. F.; Taylor, K.

2014-12-01

Increasing temperatures are projected to have a positive effect on the length of Alaska's tourism season, but the natural attractions that tourism relies on, such as glaciers, wildlife, fish, or other natural resources, may change. In order to continue to derive benefits from these resources, nature-based tour operators may have to adapt to these changes, and communication is an essential, but poorly understood, component of the climate change adaptation process. The goal of this study was to determine how to provide useful climate change information to nature-based tour operators by answering the following questions: 1. What environmental changes do nature-based tour operators perceive? 2. How are nature-based tour operators responding to climate and environmental change? 3. What climate change information do nature-based tour operators need? To answer these questions, twenty-four nature-based tour operators representing 20 different small and medium sized businesses in Juneau, Alaska were interviewed. The results show that many of Juneau's nature-based tour operators are observing, responding to, and in some cases, actively planning for further changes in the environment. The types of responses tended to vary depending on the participants' certainty in climate change and the perceived risks to their organization. Using these two factors, this study proposes a framework to classify climate change responses for the purpose of generating meaningful information and communication processes that promote adaptation and build adaptive capacity. During the course of the study, several other valuable lessons were learned about communicating about adaptation. The results of this study demonstrate that science communication research has an important place in the practice of promoting and fostering climate change adaptation. While the focus of this study was tour operators, the lessons learned may be valuable to other organizations striving to engage unique groups in climate

Network Centric Warfare Case Study. U.S. V Corps and 3rd Infantry Division (Mechanized) During Operation Iraq Freedom Combat Operations (Mar-Apr 2003). Volume 1: Operations

DTIC Science & Technology

2003-11-01

Command Historian , and the personnel from the Center for Army Lessons Learned (CALL) for their assistance in gaining access to the many documents that...after the Network Centric Warfare Case Study operations. The Center for Army Lessons Learned (CALL), the V Corps Command Historian , and other... Historian , Dr. Charles Kirkpatrick, in Heidelberg, Germany, assisted in this effort. Nu- merous documents were collected, both unclassified and classified

The impact of resident involvement on post-operative morbidity and mortality following orthopaedic procedures: a study of 43,343 cases.

PubMed

Schoenfeld, Andrew J; Serrano, Jose A; Waterman, Brian R; Bader, Julia O; Belmont, Philip J

2013-11-01

Few studies have addressed the role of residents' participation in morbidity and mortality after orthopaedic surgery. The present study utilized the 2005-2010 National Surgical Quality Improvement Program (NSQIP) dataset to assess the risk of 30-day post-operative complications and mortality associated with resident participation in orthopaedic procedures. The NSQIP dataset was queried using codes for 12 common orthopaedic procedures. Patients identified as having received one of the procedures had their records abstracted to obtain demographic data, medical history, operative time, and resident involvement in their surgical care. Thirty-day post-operative outcomes, including complications and mortality, were assessed for all patients. A step-wise multivariate logistic regression model was constructed to evaluate the impact of resident participation on mortality- and complication-risk while controlling for other factors in the model. Primary analyses were performed comparing cases where the attending surgeon operated alone to all other case designations, while a subsequent sensitivity analysis limited inclusion to cases where resident participation was reported by post-graduate year. In the NSQIP dataset, 43,343 patients had received one of the 12 orthopaedic procedures queried. Thirty-five percent of cases were performed with resident participation. The mortality rate, overall, was 2.5 and 10 % sustained one or more complications. Multivariate analysis demonstrated a significant association between resident participation and the risk of one or more complications [OR 1.3 (95 % CI 1.1, 1.4); p < 0.001] as well as major systemic complications [OR 1.6 (95 % CI 1.3, 2.0); p < 0.001] for primary joint arthroplasty procedures only. These findings persisted even after sensitivity testing. A mild to moderate risk for complications was noted following resident involvement in joint arthroplasty procedures. No significant risk of post-operative morbidity or mortality was

Exploring Operational Test and Evaluation of Unmanned Aircraft Systems: A Qualitative Case Study

NASA Astrophysics Data System (ADS)

Saliceti, Jose A.

The purpose of this qualitative case study was to explore and identify strategies that may potentially remedy operational test and evaluation procedures used to evaluate Unmanned Aircraft Systems (UAS) technology. The sample for analysis consisted of organizations testing and evaluating UASs (e.g., U.S. Air Force, U.S. Navy, U.S. Army, U.S. Marine Corps, U.S. Coast Guard, and Customs Border Protection). A purposeful sampling technique was used to select 15 subject matter experts in the field of operational test and evaluation of UASs. A questionnaire was provided to participants to construct a descriptive and robust research. Analysis of responses revealed themes related to each research question. Findings revealed operational testers utilized requirements documents to extrapolate measures for testing UAS technology and develop critical operational issues. The requirements documents were (a) developed without the contribution of stakeholders and operational testers, (b) developed with vague or unrealistic measures, and (c) developed without a systematic method to derive requirements from mission tasks. Four approaches are recommended to develop testable operational requirements and assist operational testers: (a) use a mission task analysis tool to derive requirements for mission essential tasks for the system, (b) exercise collaboration among stakeholders and testers to ensure testable operational requirements based on mission tasks, (c) ensure testable measures are used in requirements documents, and (d) create a repository list of critical operational issues by mission areas. The preparation of operational test and evaluation processes for UAS technology is not uniform across testers. The processes in place are not standardized, thus test plan preparation and reporting are different among participants. A standard method to prepare and report UAS technology should be used when preparing and reporting on UAS technology. Using a systematic process, such as mission

American Association of University Women: Branch Operations Data Modeling Case

ERIC Educational Resources Information Center

Harris, Ranida B.; Wedel, Thomas L.

2015-01-01

A nationally prominent woman's advocacy organization is featured in this case study. The scenario may be used as a teaching case, an assignment, or a project in systems analysis and design as well as database design classes. Students are required to document the system operations and requirements, apply logical data modeling concepts, and design…

Going Boldly Into the Future: A Series of Case Studies of Co-Operative Research Centres and Their Relationships with the VET Sector.

ERIC Educational Resources Information Center

Ferrier, Fran; Trood, Clifford; Whittingham, Karen

This document presents case studies of 10 cooperative research centers (CRCs) across Australia and their relationships with the vocational education and training (VET) sector. The CRCs profiled in the case studies are as follows: Co-operative Research Centre for Sustainable Rice Production; Cast Alloy and Solidification Technology Co-operative…

Visualizing feasible operating ranges within tissue engineering systems using a "windows of operation" approach: a perfusion-scaffold bioreactor case study.

PubMed

McCoy, Ryan J; O'Brien, Fergal J

2012-12-01

Tissue engineering approaches to developing functional substitutes are often highly complex, multivariate systems where many aspects of the biomaterials, bio-regulatory factors or cell sources may be controlled in an effort to enhance tissue formation. Furthermore, success is based on multiple performance criteria reflecting both the quantity and quality of the tissue produced. Managing the trade-offs between different performance criteria is a challenge. A "windows of operation" tool that graphically represents feasible operating spaces to achieve user-defined levels of performance has previously been described by researchers in the bio-processing industry. This paper demonstrates the value of "windows of operation" to the tissue engineering field using a perfusion-scaffold bioreactor system as a case study. In our laboratory, perfusion bioreactor systems are utilized in the context of bone tissue engineering to enhance the osteogenic differentiation of cell-seeded scaffolds. A key challenge of such perfusion bioreactor systems is to maximize the induction of osteogenesis but minimize cell detachment from the scaffold. Two key operating variables that influence these performance criteria are the mean scaffold pore size and flow-rate. Using cyclooxygenase-2 and osteopontin gene expression levels as surrogate indicators of osteogenesis, we employed the "windows of operation" methodology to rapidly identify feasible operating ranges for the mean scaffold pore size and flow-rate that achieved user-defined levels of performance for cell detachment and differentiation. Incorporation of such tools into the tissue engineer's armory will hopefully yield a greater understanding of the highly complex systems used and help aid decision making in future translation of products from the bench top to the market place. Copyright © 2012 Wiley Periodicals, Inc.

Study of the performances of nano-case treatment cutting tools on carbon steel work material during turning operation

NASA Astrophysics Data System (ADS)

Afolalu, S. A.; Okokpujie, I. P.; Salawu, E. Y.; Abioye, A. A.; Abioye, O. P.; Ikumapayi, O. M.

2018-04-01

The degree of holding temperature and time play a major role in nano-case treatment of cutting tools which immensely contributed to its performance during machining operation. The objective of this research work is to carryout comparative study of performance of nano-case treatment tools developed using low and medium carbon steel as work piece. Turning operation was carried out under two different categories with specific work piece on universal lathe machine using HSS cutting tools 100 mm × 12mm × 12mm that has been nano-case treated under varying conditions of temperatures and timeof 800,850, 900, 950°C and 60, 90, 120 mins respectively. The turning parameters used in evaluating this experiment were cutting speed of 270, 380 and 560mm/min, feed rate of 0.15, 0.20 and 0.25 mm/min, depth of cut of 2mm, work piece diameter of 25mm and rake angle of 7° each at three levels. The results of comparative study of their performances revealed that the timespent in the machining of low carbon steel material at a minimum temperature and time of 800°C, 60 mins were1.50, 2.17 mins while at maximum temperature and time of 950°C, 120 mins were 1.19, 2.02 mins. It was also observed that at a corresponding constant speed of 270,380 and 560mm/min at higher temperature and time, a relative increased in the length of cut were observed. Critical observation of the result showed that at higher case hardening temperature and time (950°C/120mins), the HSS cutting tool gave a better performance as lesser time was consumed during the turning operation.

Benefit of an operating vehicle preventing peritonitis in peritoneal dialysis patients: a retrospective, case-controlled study.

PubMed

Fang, Pan; Lu, Jia; Liu, Ying-Hong; Deng, Hong-Mei; Zhang, Lei; Zhang, Hong-Qing

2018-06-01

Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis. Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange. A single-center, retrospective, case-control study was undertaken to determine whether this operating vehicle has a protective role in preventing peritonitis. In total, 462 continuous ambulatory peritoneal dialysis patients were included in this study from October 2014 to March 2017. According to their personal will, these patients chose to use operating vehicle or traditional method during their bag exchange. The demographic, clinical and laboratory data of these patients in the two groups were collected, analyzed and compared. Of 462 patients with home dialysis, operating vehicle group consisted of 61 patients, and control group consisted of 401 patients. In the control group, over 677 patient-years, peritonitis occurred in 69 of 401 patients (17.2%), while in the operating vehicle group, over 60 patient-years, only 4 of 61 patients (6.6%) had episodes of peritonitis. The number of patients suffered from peritonitis was significantly decreased in the operating vehicle group (P = 0.034). Besides, there were a total of 99 episodes of peritonitis, and the rate was 1 episode every 7.2 patient-years in control group and 1 episode every 12 patient-years in the operating vehicle group. There was significant difference between the two groups (0.013). Positive dialysate cultures were obtained in majority of the peritonitis episodes (60.6%). Operating vehicle might help to reduce PD-related peritonitis by preventing contamination during bag

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales

PubMed Central

2013-01-01

Background This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs involving common contracting technologies and management cultures that meant that differences in on-the-ground contracting practices might be smaller than headline policy differences suggested. Methods The nature of real-world contracting behaviour was investigated by undertaking two qualitative case studies in England and two in Wales, each based on a local purchaser/provider network. The case studies involved ethnographic observations and interviews with staff in primary care trusts (PCTs) or local health boards (LHBs), NHS or Foundation trusts, and the overseeing Strategic Health Authority or NHS Wales regional office, as well as scrutiny of relevant documents. Results Wider policy differences between the two NHS systems were reflected in differing contracting frameworks, involving regional commissioning in Wales and commissioning by either a PCT, or co-operating pair of PCTs in our English case studies, and also in different oversight arrangements by higher tiers of the service. However, long-term relationships and trust between purchasers and providers had an important role in both systems when the financial viability of organisations was at risk. In England, the study found examples where both PCTs and trusts relaxed contractual requirements to assist partners faced with deficits. In Wales, news of plans to end the purchaser/provider split meant a return to less precisely-specified block contracts and a renewed concern to build cooperation between LHB and trust staff

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales.

PubMed

Hughes, David; Allen, Pauline; Doheny, Shane; Petsoulas, Christina; Vincent-Jones, Peter

2013-01-01

This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990 s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs involving common contracting technologies and management cultures that meant that differences in on-the-ground contracting practices might be smaller than headline policy differences suggested. The nature of real-world contracting behaviour was investigated by undertaking two qualitative case studies in England and two in Wales, each based on a local purchaser/provider network. The case studies involved ethnographic observations and interviews with staff in primary care trusts (PCTs) or local health boards (LHBs), NHS or Foundation trusts, and the overseeing Strategic Health Authority or NHS Wales regional office, as well as scrutiny of relevant documents. Wider policy differences between the two NHS systems were reflected in differing contracting frameworks, involving regional commissioning in Wales and commissioning by either a PCT, or co-operating pair of PCTs in our English case studies, and also in different oversight arrangements by higher tiers of the service. However, long-term relationships and trust between purchasers and providers had an important role in both systems when the financial viability of organisations was at risk. In England, the study found examples where both PCTs and trusts relaxed contractual requirements to assist partners faced with deficits. In Wales, news of plans to end the purchaser/provider split meant a return to less precisely-specified block contracts and a renewed concern to build cooperation between LHB and trust staff. The interdependency of local

ACGME case logs: Surgery resident experience in operative trauma for two decades

PubMed Central

Drake, Frederick Thurston; Van Eaton, Erik G.; Huntington, Ciara R.; Jurkovich, Gregory J.; Aarabi, Shahram; Gow, Kenneth W.

2014-01-01

BACKGROUND Surgery resident education is based on experiential training, which is influenced by changes in clinical management strategies, technical and technologic advances, and administrative regulations. Trauma care has been exposed to each of these factors, prompting concerns about resident experience in operative trauma. The current study analyzed the reported volume of operative trauma for the last two decades; to our knowledge, this is the first evaluation of nationwide trends during such an extended time line. METHODS The Accreditation Council for Graduate Medical Education (ACGME) database of operative logs was queried from academic year (AY) 1989–1990 to 2009–2010 to identify shifts in trauma operative experience. Annual case log data for each cohort of graduating surgery residents were combined into approximately 5-year blocks, designated Period I (AY1989–1990 to AY1993–1994), Period II (AY1994–1995 to AY1998–1999), Period III (AY1999–2000 to AY2002–2003), and Period IV (AY2003–2004 to AY2009–2010). The latter two periods were delineated by the year in which duty hour restrictions were implemented. RESULTS Overall general surgery caseload increased from Period I to Period II (p < 0.001), remained stable from Period II to Period III, and decreased from Period III to Period IV (p < 0.001). However, for ACGME-designated trauma cases, there were significant declines from Period I to Period II (75.5 vs. 54.5 cases, p < 0.001) and Period II to Period III (54.5 vs. 39.3 cases, p < 0.001) but no difference between Period III and Period IV (39.3 vs. 39.4 cases). Graduating residents in Period I performed, on average, 31 intra-abdominal trauma operations, including approximately five spleen and four liver operations. Residents in Period IV performed 17 intra-abdominal trauma operations, including three spleen and approximately two liver operations. CONCLUSION Recent general surgery trainees perform fewer trauma operations than previous trainees

The operating room case-mix problem under uncertainty and nurses capacity constraints.

PubMed

Yahia, Zakaria; Eltawil, Amr B; Harraz, Nermine A

2016-12-01

Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms' time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs' performance.

Exploring Pre-Operational and Concrete Operational Children's Thinking on Nutrition: A Case Study

ERIC Educational Resources Information Center

Brouse, Corey H.; Chow, Tracy H. F.

2009-01-01

Objective: In this exploratory study, we observed the process in which children make food choices from a cognitive development perspective and the implications that these choices have on the areas of cognitive development and health and nutrition education. Design: This was a cross-sectional case study that involved an in-depth examination of the…

Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

ERIC Educational Resources Information Center

Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

2016-01-01

Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

Early post-operative cerebrospinal fluid hypovolemia: Report of 7 cases.

PubMed

Hou, Kun; Zhu, Xiaobo; Zhang, Yang; Gao, Xianfeng; Suo, Shihuan; Zhao, Jinchuan; Li, Guichen

2018-06-01

Cerebrospinal fluid (CSF) hypovolemia is a common neurosurgical condition, which may be spontaneous or iatrogenic. At our institution, a substantial number of the reported cases of early post-operative CSF hypovolemia were identified to have unintentional or unrecognized post-operative continuous excessive CSF leakage. Cases who presented with post-operative CSF hypovolemia several days after uneventful intracranial surgeries without continuous CSF leakage were rarely reported. A retrospective review of the medical records of these patients was performed to identify those patients who developed early post-operative CSF hypovolemia without the presence of post-operative continuous CSF leakage. A total of 7 patients, 5 of which were males, were identified in this retrospective study. They experienced CSF hypovolemia between days 1 and 7 after emergency or scheduled intracranial surgeries. Ventricular collapse, cisternal effacement and midline shift are the most common radiological observations. With early diagnosis and management, 4 of the patients achieved a Glasgow Outcome Scale (GOS) score of 5, 1 achieved a GOS score of 4 and the remaining 2 had a GOS score of 3. No mortality was noted in this series. Although rare in incidence, early post-operative CSF hypovolemia may occur without the existence of post-operative continuous CSF leakage. When the diagnosis of CSF hypovolemia is reached, factors that may exacerbate CSF compensation should be promptly terminated. Trendelenburg position and sufficient intravenous hydration are practical and effective managements, and CSF hypovolemia may thereby be reversed in a substantial number of patients.

A case study in programming a quantum annealer for hard operational planning problems

NASA Astrophysics Data System (ADS)

Rieffel, Eleanor G.; Venturelli, Davide; O'Gorman, Bryan; Do, Minh B.; Prystay, Elicia M.; Smelyanskiy, Vadim N.

2015-01-01

We report on a case study in programming an early quantum annealer to attack optimization problems related to operational planning. While a number of studies have looked at the performance of quantum annealers on problems native to their architecture, and others have examined performance of select problems stemming from an application area, ours is one of the first studies of a quantum annealer's performance on parametrized families of hard problems from a practical domain. We explore two different general mappings of planning problems to quadratic unconstrained binary optimization (QUBO) problems, and apply them to two parametrized families of planning problems, navigation-type and scheduling-type. We also examine two more compact, but problem-type specific, mappings to QUBO, one for the navigation-type planning problems and one for the scheduling-type planning problems. We study embedding properties and parameter setting and examine their effect on the efficiency with which the quantum annealer solves these problems. From these results, we derive insights useful for the programming and design of future quantum annealers: problem choice, the mapping used, the properties of the embedding, and the annealing profile all matter, each significantly affecting the performance.

Integrated Operations Architecture Technology Assessment Study

NASA Technical Reports Server (NTRS)

2001-01-01

As part of NASA's Integrated Operations Architecture (IOA) Baseline, NASA will consolidate all communications operations. including ground-based, near-earth, and deep-space communications, into a single integrated network. This network will make maximum use of commercial equipment, services and standards. It will be an Internet Protocol (IP) based network. This study supports technology development planning for the IOA. The technical problems that may arise when LEO mission spacecraft interoperate with commercial satellite services were investigated. Commercial technology and services that could support the IOA were surveyed, and gaps in the capability of existing technology and techniques were identified. Recommendations were made on which gaps should be closed by means of NASA research and development funding. Several findings emerged from the interoperability assessment: in the NASA mission set, there is a preponderance of small. inexpensive, low data rate science missions; proposed commercial satellite communications services could potentially provide TDRSS-like data relay functions; and. IP and related protocols, such as TCP, require augmentation to operate in the mobile networking environment required by the space-to-ground portion of the IOA. Five case studies were performed in the technology assessment. Each case represented a realistic implementation of the near-earth portion of the IOA. The cases included the use of frequencies at L-band, Ka-band and the optical spectrum. The cases also represented both space relay architectures and direct-to-ground architectures. Some of the main recommendations resulting from the case studies are: select an architecture for the LEO/MEO communications network; pursue the development of a Ka-band space-qualified transmitter (and possibly a receiver), and a low-cost Ka-band ground terminal for a direct-to-ground network, pursue the development of an Inmarsat (L-band) space-qualified transceiver to implement a global, low

Environmental Impacts of Metal Cladding Operations and Remedial Measures: A Case Study

NASA Astrophysics Data System (ADS)

Roy, P. P.; Sawmliana, C.; Singh, R. K.

2014-04-01

In metal cladding operations, a mixture of 11 % TNT flakes, 44 % ammonium nitrate (non-explosive) and 45 % dehydrated salt (non-explosive) are mixed uniformly to produce an explosive mixture with velocity of detonation 1,800-2,000 m/s. To study the environmental impacts of such operations which led to serious complaints from neighbouring villagers and even closure of some units, a study was carried out to investigate the levels of ground vibration, air overpressure and noise generated by blasting operations of different explosive charge quantities during the metal cladding operations and their impacts on the surrounding villages. Following the safety norms of Central Pollution Control Board (CPCB, Model Rules of the Factories Act on Noise Pollution Control) [1] and Directorate General of Mines Safety (DGMS, Damage to the structures due to blast induced ground vibration in the mining areas) [2] of India, generalised guidelines for such safe operations were framed. This paper describes the operational aspects of metal cladding, experimental results and scientific analyses of data to propose certain guidelines for safe metal cladding operations.

Improving Operating Room Efficiency: First Case On-Time Start Project.

PubMed

Phieffer, Laura; Hefner, Jennifer L; Rahmanian, Armin; Swartz, Jason; Ellison, Christopher E; Harter, Ronald; Lumbley, Joshua; Moffatt-Bruce, Susan D

Operating rooms (ORs) are costly to run, and multiple factors influence efficiency. The first case on-time start (FCOS) of an OR is viewed as a harbinger of efficiency for the daily schedule. Across 26 ORs of a large, academic medical center, only 49% of cases started on time in October 2011. The Perioperative Services Department engaged an interdisciplinary Operating Room Committee to apply Six Sigma tools to this problem. The steps of this project included (1) problem mapping, (2) process improvements to preoperative readiness, (3) informatics support improvements, and (4) continuous measurement and feedback. By June 2013, there was a peak of 92% first case on-time starts across service lines, decreasing to 78% through 2014, still significantly above the preintervention level of 49% (p = .000). Delay minutes also significantly decreased through the study period (p = .000). Across 2013, the most common delay owners were the patient, the surgeon, the facility, and the anesthesia department. Continuous and sustained improvement of first case on-time starts is attributed to tracking the FCOS metric, establishing embedded process improvement resources and creating transparency of data. This article highlights success factors and barriers to program success and sustainability.

Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

PubMed

Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

2017-06-01

To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

A simple method to equalize the workload when operating several small wastewater treatment plants: a case study.

PubMed

De Feo, G; De Gisi, S; Galasso, M

2013-01-01

The aim of the present study is to define a simple (and easy to use) method to equalize the workload of personnel operating several small wastewater treatment plants (SWWTPs). The approach is illustrated through a case study which is the result of collaboration between researchers and a water and wastewater management company operating in Southern Italy. The topic is important since personnel have a significant impact on the operating costs of SWWTPs, and the approach outlined results in the minimum number of staff being required to assure the management of the service. Four kinds of work units are considered: plant managers, assistant plant managers, laboratory technicians and executives. In order to develop a practical, feasible and easy to use method, the workload was evaluated considering only the population equivalent (PE) and the number of plants managed. The core of the method is the evaluation of the percentage of time that the personnel units devote to the operation of SWWTPs of the municipality considered. The proposed procedure offers a useful tool to equalize the workload, both in terms of PE and the number of plants managed, the procedure being easily modifiable to introduce other evaluation criteria. By using familiar concepts such as PE and number of plants managed, the approach of the method can easily be understood by management. It can also be readily adapted to other similar situations.

Performance after rotator cuff tear and operative treatment: a case-control study of major league baseball pitchers.

PubMed

Namdari, Surena; Baldwin, Keith; Ahn, Albert; Huffman, G Russell; Sennett, Brian J

2011-01-01

Little is known about pitching performance or lack of it among Major League Baseball (MLB) pitchers who undergo operative treatment of rotator cuff tears. To assess pitching performance outcomes in MLB players who needed operative treatment of rotator cuff tears and to compare performance in these athletes with that in a control group of MLB players. Case-control study. Publicly available player profiles, press releases, and team injury reports. Thirty-three MLB pitchers with documented surgery to treat rotator cuff tears and 117 control pitchers who did not have documented rotator cuff tears were identified. Major League Baseball pitching attrition and performance variables. Players who underwent rotator cuff surgery were no more likely not to play than control players. Performance variables of players who underwent surgery improved after surgery but never returned to baseline preoperative status. Players who needed rotator cuff surgery typically were more experienced and had better earned run averages than control players. Pitchers who had symptomatic rotator cuff tears that necessitated operative treatment tended to decline gradually in performance leading up to their operations and to improve gradually over the next 3 seasons. In contrast to what we expected, they did not have a greater attrition rate than their control counterparts; however, their performances did not return to preoperative levels over the course of the study.

What happened to the no-wait hospital? A case study of implementation of operational plans for reduced waits.

PubMed

Hansson, Johan; Tolf, Sara; Øvretveit, John; Carlsson, Jan; Brommels, Mats

2012-01-01

Both research and practice show that waiting lists are hard to reduce. Implementing complex interventions for reduced waits is an intricate and challenging process that requires special attention for surrounding factors helping and hindering the implementation. This article reports a case study of a hospital implementation of operational plans for reduced waits, with an emphasis on the process of change. A case study research design, theoretically informed by the Pettigrew and Whipp model of strategic change, was applied. Data were gathered from individual and focus group interviews with informants from different organizational levels at different times and from documents and plans. The findings revealed arrangements both helping and hindering the implementation work. Helping factors were the hospital's contemporary savings requirements and experiences from similar change initiatives. Those hindering the actions to plan and agree the changes were unclear support functions and unclear task prioritization. One contribution of this study is to demonstrate the advantages, disadvantages, and challenges of a contextualized case study for increased understanding of factors influencing organizational change implementation. One lesson for current policy is to regard context factors that are critical for successful implementation.

Effect of the new standards for case logging on resident operative volume: doing better cases or better numbers?

PubMed

Murthy, Raghav; Shepard, Alex; Swartz, Andrew; Woodward, Ann; Reickert, Craig; Horst, Mathilda; Rubinfeld, Ilan

2012-01-01

The Accreditation Council for Graduate Medical Education (ACGME) modified the designation of major (index) operative cases to include those previously considered "minor." This study assessed the potential effect of these changes on resident operative experience. With Institutional Review Board approval, we analyzed National Surgical Quality Improvement Program participant use files for 2005-2008 for general and vascular surgery cases. Primary CPT case coding was mapped to the ACGME major case category using both the old and new classification schemes. The variables were analyzed using χ(2) analysis in SPSS IBM 19 (IBM, Armonk, New York). A total of 576,019 cases were reviewed. Major cases as defined by the new classification represented an increasing proportion of the cases each year, rising from 88.3% in 2005 to 95% by 2008 (p < 0.001). Major cases as defined by the old scheme decreased from 71% in 2005 to 62% by 2008 (p < 0.001). The cases covered by a resident dropped from 82% in 2005 to 61% in 2008 (p < 0.001). When comparing the new to the old scheme, 364,366 (63.3%) cases were considered major and 30,587 (5.3%) were minor by both standards; 7089 (1.2%) cases previously classified as major were changed to minor, whereas 173,977 (30.2%) (p < 0.001) previously classified as minor were now major. This latter group showed top procedures to include excision of breast lesion (22,175 [12.7%]), laparoscopic gastric bypass (18,825 [10.8%]), ventral hernia repair (14,732 [8.5%]), and appendectomy (10,190 [5.9%]). Of these newly designated major cases, the proportion not covered by residents increased from 22% in 2005 to 44% in 2007 and 2008 (p < 0.001). Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may

Coalition Logistics: A Case Study in Operation Restore Hope

DTIC Science & Technology

1994-06-03

coalition operations."° In Seland’s interview with Colonel Wolfgang Kopp, chief of staff, German/Franco Brigade, Colonel Kopp stated that key members...February 1994. 21William G. Pagonis and Michael D. Krause , "Operational Logistics and the Gulf War," The Institute of Land Warfare: The Land Warfare...Headquarters, 1989. Pagonis, William G. and Michael D. Krause . "Operational Logistics and the Gulf War." The Land Warfare Paper No. 13. Arlington, Virginia

General Walter Krueger: A Case Study in Operational Command

DTIC Science & Technology

1989-05-05

far more than anything he says or writes, Second, he is the dlor of his staff and subordinate commanders through his teaching, training, and coaching ...the t’wo services n -eply he p-esr,? , .,. ,: brief n it fF c .t r, p, ati o ns be w n it mie i Am i c 11:e Navy, and a study of cases that had been

Planning for avian flu disruptions on global operations: a DMAIC case study.

PubMed

Kumar, Sameer

2012-01-01

The author aims to assess the spread of avian flu, its impact on businesses operating in the USA and overseas, and the measures required for corporate preparedness. Six Sigma DMAIC process is used to analyze avian flu's impact and how an epidemic could affect large US business operations worldwide. Wal-Mart and Dell Computers were chosen as one specializes in retail and the other manufacturing. The study identifies avian flu pandemic risks including failure modes on Wal-Mart and Dell Computers global operations. It reveals the factors that reinforce avian-flu pandemic's negative impact on company global supply chains. It also uncovers factors that balance avian-flu pandemic's impact on their global supply chains. Avian flu and its irregularity affect the research outcomes because its spread could fluctuate based on so many factors that could come into play. Further, the potential cost to manufacturers and other supply chain partners is relatively unknown. As a relatively new phenomenon, quantitative data were not available to determine immediate costs. In this decade, the avian influenza H5N1 virus has killed millions of poultry in Asia, Europe and Africa. This flu strain can infect and kill humans who come into contact with this virus. An avian influenza H5N1 outbreak could lead to a devastating effect on global food supply, business services and business operations. The study provides guidance on what global business operation managers can do to prepare for such events, as well as how avian flu progression to a pandemic can disrupt such operations. This study raises awareness about avian flu's impact on businesses and humans and also highlights the need to create contingency plans for corporate preparedness to avoid incurring losses.

A Human Proximity Operations System test case validation approach

NASA Astrophysics Data System (ADS)

Huber, Justin; Straub, Jeremy

A Human Proximity Operations System (HPOS) poses numerous risks in a real world environment. These risks range from mundane tasks such as avoiding walls and fixed obstacles to the critical need to keep people and processes safe in the context of the HPOS's situation-specific decision making. Validating the performance of an HPOS, which must operate in a real-world environment, is an ill posed problem due to the complexity that is introduced by erratic (non-computer) actors. In order to prove the HPOS's usefulness, test cases must be generated to simulate possible actions of these actors, so the HPOS can be shown to be able perform safely in environments where it will be operated. The HPOS must demonstrate its ability to be as safe as a human, across a wide range of foreseeable circumstances. This paper evaluates the use of test cases to validate HPOS performance and utility. It considers an HPOS's safe performance in the context of a common human activity, moving through a crowded corridor, and extrapolates (based on this) to the suitability of using test cases for AI validation in other areas of prospective application.

The use of standard operating procedures in day case anterior cruciate ligament reconstruction.

PubMed

Khan, T; Jackson, W F; Beard, D J; Marfin, A; Ahmad, M; Spacie, R; Jones, R; Howes, S; Barker, K; Price, A J

2012-08-01

The current rate of day-case anterior cruciate ligament reconstruction (ACLR) in the UK remains low. Although specialised care pathways with standard operating procedures (SOPs) have been effective in reducing length of stay following some surgical procedures, this has not been previously reported for ACLR. We evaluate the effectiveness of SOPs for establishing day-case ACLR in a specialist unit. Fifty patients undergoing ACLR between May and September 2010 were studied prospectively ("study group"). SOPs were designed for pre-operative assessment, anaesthesia, surgical procedure, mobilisation and discharge. We evaluated length of stay, readmission rates, patient satisfaction and compliance to SOPs. A retrospective analysis of 50 patients who underwent ACLR prior to implementation of the day-case pathway was performed ("standard practice group"). Eighty percent of patients in the study group were discharged on the day of surgery (mean length of stay=5.3h) compared to 16% in the standard practice group (mean length of stay=21.6h). This difference was statistically significant (p<0.05, Mann-Whitney U test). All patients were satisfied with the day case pathway. Ninety-two percent of the study group were discharged on the day of surgery when all SOPs were followed and 46% where they were not. High rates of day-case ACLR with excellent patient satisfaction can be achieved with the use of a specialised patient pathway with SOPs. Copyright © 2011 Elsevier B.V. All rights reserved.

Making adaptable systems work for mission operations: A case study

NASA Technical Reports Server (NTRS)

Holder, Barbara E.; Levesque, Michael E.

1993-01-01

The Advanced Multimission Operations System (AMMOS) at NASA's Jet Propulsion Laboratory is based on a highly adaptable multimission ground data system (MGDS) for mission operations. The goal for MGDS is to support current flight project science and engineering personnel and to meet the demands of future missions while reducing associated operations and software development costs. MGDS has become a powerful and flexible mission operations system by using a network of heterogeneous workstations, emerging open system standards, and selecting an adaptable tools-based architecture. Challenges in developing adaptable systems for mission operations and the benefits of this approach are described.

Case study: design, operation, maintenance and water quality management of sustainable storm water ponds for roof runoff.

PubMed

Scholz, Miklas

2004-12-01

The purpose of this case study was to optimise design, operation and maintenance guidelines, and to assess the water treatment potential of a storm water pond system after 15 months of operation. The system was based on a combined silt trap, attenuation pond and vegetated infiltration basin. This combination was used as the basis for construction of a roof water runoff system from a single domestic property. United Kingdom Building Research Establishment and Construction Industry Research and Information Association, and German Association for Water, Wastewater and Waste design guidelines were tested. These design guidelines failed because they did not consider local conditions. The infiltration function for the infiltration basin was logarithmic. Algal control techniques were successfully applied, and treatment of rainwater runoff from roofs was found to be largely unnecessary for recycling (e.g., watering plants). However, seasonal and diurnal variations of biochemical oxygen demand, dissolved oxygen and pH were recorded.

Decision support for green supply chain operations by integrating dynamic simulation and LCA indicators: diaper case study.

PubMed

Adhitya, Arief; Halim, Iskandar; Srinivasan, Rajagopalan

2011-12-01

As the issue of environmental sustainability is becoming an important business factor, companies are now looking for decision support tools to assess the fuller picture of the environmental impacts associated with their manufacturing operations and supply chain (SC) activities. Lifecycle assessment (LCA) is widely used to measure the environmental consequences assignable to a product. However, it is usually limited to a high-level snapshot of the environmental implications over the product value chain without consideration of the dynamics arising from the multitiered structure and the interactions along the SC. This paper proposes a framework for green supply chain management by integrating a SC dynamic simulation and LCA indicators to evaluate both the economic and environmental impacts of various SC decisions such as inventories, distribution network configuration, and ordering policy. The advantages of this framework are demonstrated through an industrially motivated case study involving diaper production. Three distinct scenarios are evaluated to highlight how the proposed approach enables integrated decision support for green SC design and operation.

Development and Execution of End-of-Mission Operations Case Study of the UARS and ERBS End-of-Mission Plans

NASA Technical Reports Server (NTRS)

Hughes, John; Marius, Julio L.; Montoro, Manuel; Patel, Mehul; Bludworth, David

2006-01-01

This Paper is a case study of the development and execution of the End-of-Mission plans for the Earth Radiation Budget Satellite (ERBS) and the Upper Atmosphere Research Satellite (UARS). The goals of the End-of-Mission Plans are to minimize the time the spacecraft remains on orbit and to minimize the risk of creating orbital debris. Both of these Missions predate the NASA Management Instructions (NMI) that directs missions to provide for safe mission termination. Each spacecrafts had their own unique challenges, which required assessing End-of-Mission requirements versus spacecraft limitations. Ultimately the End-of- Mission operations were about risk mitigation. This paper will describe the operational challenges and the lessons learned executing these End-of-Mission Plans

Operational and Strategic Controlling Tools in Microenterprises - Case Study

NASA Astrophysics Data System (ADS)

Konsek-Ciechońska, Justyna

2017-12-01

Globalisation and increasing requirements of the environment cause the executives and supervisors to search for more and more perfect solutions, allowing them to streamline and improve the effectiveness of company operations. One of such tools, used more and more often, is controlling, the role of which has substantially increased in the recent years. It is already implemented not only in large companies with foreign capital, but also in increasingly smaller entities, which begin to notice the positive effects of the implications of the principles and tools of controlling - both operational and strategic. The purpose of the article is to demonstrate the practical side of controlling tools that can be used for the purposes of operations conducted by microenterprises.

Operational value of ensemble streamflow forecasts for hydropower production: A Canadian case study

NASA Astrophysics Data System (ADS)

Boucher, Marie-Amélie; Tremblay, Denis; Luc, Perreault; François, Anctil

2010-05-01

Ensemble and probabilistic forecasts have many advantages over deterministic ones, both in meteorology and hydrology (e.g. Krzysztofowicz, 2001). Mainly, they inform the user on the uncertainty linked to the forecast. It has been brought to attention that such additional information could lead to improved decision making (e.g. Wilks and Hamill, 1995; Mylne, 2002; Roulin, 2007), but very few studies concentrate on operational situations involving the use of such forecasts. In addition, many authors have demonstrated that ensemble forecasts outperform deterministic forecasts in terms of performance (e.g. Jaun et al., 2005; Velazquez et al., 2009; Laio and Tamea, 2007). However, such performance is mostly assessed on the basis of numerical scoring rules, which compare the forecasts to the observations, and seldom in terms of management gains. The proposed case study adopts an operational point of view, on the basis that a novel forecasting system has value only if it leads to increase monetary and societal gains (e.g. Murphy, 1994; Laio and Tamea, 2007). More specifically, Environment Canada operational ensemble precipitation forecasts are used to drive the HYDROTEL distributed hydrological model (Fortin et al., 1995), calibrated on the Gatineau watershed located in Québec, Canada. The resulting hydrological ensemble forecasts are then incorporated into Hydro-Québec SOHO stochastic management optimization tool that automatically search for optimal operation decisions for the all reservoirs and hydropower plants located on the basin. The timeline of the study is the fall season of year 2003. This period is especially relevant because of high precipitations that nearly caused a major spill, and forced the preventive evacuation of a portion of the population located near one of the dams. We show that the use of the ensemble forecasts would have reduced the occurrence of spills and flooding, which is of particular importance for dams located in populous area, and

Public health foodborne illness case study during a Special Operations Forces deployment to South America.

PubMed

McCown, Michael; Grzeszak, Benjamin

2010-01-01

Although many public health articles have been published detailing foodborne illness outbreaks, a medical literature search revealed no articles that detail a case study or a specific response of a deployed U.S. military unit to a potential foodborne illness. This article describes a recent public health case study of a U.S. Special Operations Forces (SOF) team sickened while deployed to South America. It highlights public health factors which may affect U.S. personnel deployed or serving overseas and may serve as a guide for a deployed SOF medic to reference in response to a potential food- or waterborne illness outbreak. Eight food samples and five water samples were collected. The food samples were obtained from the host nation kitchen that provided food to the SOF team. The water samples were collected from the kitchen as well as from multiple sites on the host nation base. These samples were packaged in sterile containers, stored at appropriate temperatures, and submitted to a U.S. Army diagnostic laboratory for analysis. Laboratory results confirmed the presence of elevated aerobic plate counts (APCs) in the food prepared by the host nation and consumed by the SOF team. High APCs in food are the primary indicator of improper sanitation of food preparation surfaces and utensils. This case study concluded that poor kitchen sanitation, improper food storage, preparation, and/or holding were the probable conditions that led to the team?s symptoms. These results emphasize the importance of ensuring safe food and water for U.S. personnel serving overseas, especially in a deployment or combat setting. Contaminated food and/or water will negatively impact the health and availability of forces, which may lead to mission failure. The SOF medic must respond to potential outbreaks and be able to (1) critically inspect food preparation areas and accurately advise commanders in order to correct deficiencies and (2) perform food/water surveillance testing consistently

Mineral scale management. Part 1, Case studies

Treesearch

Peter W. Hart; Alan W. Rudie

2006-01-01

Mineral scale increases operating costs, extends downtime, and increases maintenance requirements. This paper presents several successful case studies detailing how mills have eliminated scale. Cases presented include calcium carbonate scale in a white liquor strainer, calcium oxalate scale in the D0 stage of the bleach plant, enzymatic treatment of brown stock to...

Case Studies in Library Computer Systems.

ERIC Educational Resources Information Center

Palmer, Richard Phillips

Twenty descriptive case studies of computer applications in a variety of libraries are presented in this book. Computerized circulation, serial and acquisition systems in public, high school, college, university and business libraries are included. Each of the studies discusses: 1) the environment in which the system operates, 2) the objectives of…

Novel ways to explore surgical interventions in randomised controlled trials: applying case study methodology in the operating theatre.

PubMed

Blencowe, Natalie S; Blazeby, Jane M; Donovan, Jenny L; Mills, Nicola

2015-12-28

Multi-centre randomised controlled trials (RCTs) in surgery are challenging. It is particularly difficult to establish standards of surgery and ensure that interventions are delivered as intended. This study developed and tested methods for identifying the key components of surgical interventions and standardising interventions within RCTs. Qualitative case studies of surgical interventions were undertaken within the internal pilot phase of a surgical RCT for obesity (the By-Band study). Each case study involved video data capture and non-participant observation of gastric bypass surgery in the operating theatre and interviews with surgeons. Methods were developed to transcribe and synchronise data from video recordings with observational data to identify key intervention components, which were then explored in the interviews with surgeons. Eight qualitative case studies were undertaken. A novel combination of video data capture, observation and interview data identified variations in intervention delivery between surgeons and centres. Although surgeons agreed that the most critical intervention component was the size and shape of the gastric pouch, there was no consensus regarding other aspects of the procedure. They conceded that evidence about the 'best way' to perform bypass was lacking and, combined with the pragmatic nature of the By-Band study, agreed that strict standardisation of bypass might not be required. This study has developed and tested methods for understanding how surgical interventions are designed and delivered delivered in RCTs. Applying these methods more widely may help identify key components of interventions to be delivered by surgeons in trials, enabling monitoring of key components and adherence to the protocol. These methods are now being tested in the context of other surgical RCTs. Current Controlled Trials ISRCTN00786323 , 05/09/2011.

Oncoplastic round block technique has comparable operative parameters as standard wide local excision: a matched case-control study.

PubMed

Lim, Geok-Hoon; Allen, John Carson; Ng, Ruey Pyng

2017-08-01

Although oncoplastic breast surgery is used to resect larger tumors with lower re-excision rates compared to standard wide local excision (sWLE), criticisms of oncoplastic surgery include a longer-albeit, well concealed-scar, longer operating time and hospital stay, and increased risk of complications. Round block technique has been reported to be very suitable for patients with relatively smaller breasts and minimal ptosis. We aim to determine if round block technique will result in operative parameters comparable with sWLE. Breast cancer patients who underwent a round block procedure from 1st May 2014 to 31st January 2016 were included in the study. These patients were then matched for the type of axillary procedure, on a one to one basis, with breast cancer patients who had undergone sWLE from 1st August 2011 to 31st January 2016. The operative parameters between the 2 groups were compared. 22 patients were included in the study. Patient demographics and histologic parameters were similar in the 2 groups. No complications were reported in either group. The mean operating time was 122 and 114 minutes in the round block and sWLE groups, respectively (P=0.64). Length of stay was similar in the 2 groups (P=0.11). Round block patients had better cosmesis and lower re-excision rates. A higher rate of recurrence was observed in the sWLE group. The round block technique has comparable operative parameters to sWLE with no evidence of increased complications. Lower re-excision rate and better cosmesis were observed in the round block patients suggesting that the round block technique is not only comparable in general, but may have advantages to sWLE in selected cases.

Case Studies in Broadcast Management.

ERIC Educational Resources Information Center

Coleman, Howard W.

This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

Enhanced genetic algorithm optimization model for a single reservoir operation based on hydropower generation: case study of Mosul reservoir, northern Iraq.

PubMed

Al-Aqeeli, Yousif H; Lee, T S; Abd Aziz, S

2016-01-01

Achievement of the optimal hydropower generation from operation of water reservoirs, is a complex problems. The purpose of this study was to formulate and improve an approach of a genetic algorithm optimization model (GAOM) in order to increase the maximization of annual hydropower generation for a single reservoir. For this purpose, two simulation algorithms were drafted and applied independently in that GAOM during 20 scenarios (years) for operation of Mosul reservoir, northern Iraq. The first algorithm was based on the traditional simulation of reservoir operation, whilst the second algorithm (Salg) enhanced the GAOM by changing the population values of GA through a new simulation process of reservoir operation. The performances of these two algorithms were evaluated through the comparison of their optimal values of annual hydropower generation during the 20 scenarios of operating. The GAOM achieved an increase in hydropower generation in 17 scenarios using these two algorithms, with the Salg being superior in all scenarios. All of these were done prior adding the evaporation (Ev) and precipitation (Pr) to the water balance equation. Next, the GAOM using the Salg was applied by taking into consideration the volumes of these two parameters. In this case, the optimal values obtained from the GAOM were compared, firstly with their counterpart that found using the same algorithm without taking into consideration of Ev and Pr, secondly with the observed values. The first comparison showed that the optimal values obtained in this case decreased in all scenarios, whilst maintaining the good results compared with the observed in the second comparison. The results proved the effectiveness of the Salg in increasing the hydropower generation through the enhanced approach of the GAOM. In addition, the results indicated to the importance of taking into account the Ev and Pr in the modelling of reservoirs operation.

Preparing Safety Cases for Operating Outside Prescriptive Fatigue Risk Management Regulations.

PubMed

Gander, Philippa; Mangie, Jim; Wu, Lora; van den Berg, Margo; Signal, Leigh; Phillips, Adrienne

2017-07-01

Transport operators seeking to operate outside prescriptive fatigue management regulations are typically required to present a safety case justifying how they will manage the associated risk. This paper details a method for constructing a successful safety case. The method includes four elements: 1) scope (prescriptive rules and operations affected); 2) risk assessment; 3) risk mitigation strategies; and 4) monitoring ongoing risk. A successful safety case illustrates this method. It enables landing pilots in 3-pilot crews to choose the second or third in-flight rest break, rather than the regulatory requirement to take the third break. Scope was defined using a month of scheduled flights that would be covered (N = 4151). These were analyzed in the risk assessment using existing literature on factors affecting fatigue to estimate the maximum time awake at top of descent and sleep opportunities in each break. Additionally, limited data collected before the new regulations showed that pilots flying at landing chose the third break on only 6% of flights. A prospective survey comparing subjective reports (N = 280) of sleep in the second vs. third break and fatigue and sleepiness ratings at top of descent confirmed that the third break is not consistently superior. The safety case also summarized established systems for fatigue monitoring, risk assessment and hazard identification, and multiple fatigue mitigation strategies that are in place. Other successful safety cases have used this method. The evidence required depends on the expected level of risk and should evolve as experience with fatigue risk management systems builds.Gander P, Mangie J, Wu L, van den Berg M, Signal L, Phillips A. Preparing safety cases for operating outside prescriptive fatigue risk management regulations. Aerosp Med Hum Perform. 2017; 88(7):688-696.

Case Study: Testing with Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

Operations analysis for lunar surface construction: Results of two office of exploration case studies

NASA Astrophysics Data System (ADS)

Bell, Lisa Y.; Boles, Walter; Smith, Alvin

1991-08-01

In an environment of intense competition for Federal funding, the U.S. space research community is responsible for developing a feasible, cost-effective approach to establishing a surface base on the moon to fulfill long-term Government objectives. This report presents the results of a construction operations analysis of two lunar scenarios provided by the National Aeronautics and Space Administration (NASA). Activities necessary to install the lunar base surface elements are defined and scheduled, based on the productivities and availability of the base resources allocated to the projects depicted in each scenario. The only construction project in which the required project milestones were not completed within the nominal timeframe was the initial startup phase of NASA's FY89 Lunar Evolution Case Study (LECS), primarily because this scenario did not include any Earth-based telerobotic site preparation before the arrival of the first crew. The other scenario analyzed. Reference Mission A from NASA's 90-Day Study of the Human Exploration of the Moon and Mars, did use telerobotic site preparation before the manned phase of the base construction. Details of the analysis for LECS are provided, including spreadsheets indicating quantities of work and Gantt charts depicting the general schedule for the work. This level of detail is not presented for the scenario based on the 90-Day Study because many of the projects include the same (or similar) surface elements and facilities.

Non-operative management of abdominal gunshot injuries: Is it safe in all cases?

PubMed

İflazoğlu, Nidal; Üreyen, Orhan; Öner, Osman Zekai; Meral, Ulvi Mehmet; Yülüklü, Murat

2018-01-01

In line with advances in diagnostic methods and expectation of a decrease in the number of negative laparotomies, selective non-operative management of abdominal gunshot wounds has been increasingly used over the last three decades. We aim to detect the possibility of treatment without surgery and present our experience in selected cases referred from Syria to a hospital at the Turkish-Syrian border. Between February 2012 and June 2014, patients admitted with abdominal gunshot wounds were analyzed. Computed tomography was performed for all patients on admission. Patients who were hemodynamically stable and did not have symptoms of peritonitis at the time of presentation were included in the study. The primary outcome parameters were mortality and morbidity. Successful selective non-operative management (Group 1) and unsuccessful selective non-operative management (Group 2) groups were compared in terms of complications, blood transfusion, injury site, injury severity score (ISS), and hospital stay. Of 158 truncal injury patients, 18 were considered feasible for selective non-operative management. Of these, 14 (78%) patients were treated without surgery. Other Four patients were operated upon progressively increasing abdominal pain and tenderness during follow-up. On diagnostic exploration, all of these cases had intestinal perforations. No mortality was observed in selective non-operative management. There was no statistically significant difference between Group 1 and Group 2, in terms of length of hospital stay (96 and 127 h, respectively). Also, there was no difference between groups in terms of blood transfusion necessity, injury site, complication rate, and injury severity score (p>0.05). Decision making on patient selection for selective non-operative management is critical to ensure favorable outcomes. It is not possible to predict the success of selective non-operative management in advance. Cautious clinical examination and close monitoring of these

Design aspects of zeppelin operations from case histories

NASA Technical Reports Server (NTRS)

Maiersperger, W. P.

1975-01-01

Some widely held beliefs concerning the practicability of rigid airships in air carrier operations are discussed. It is shown by a review of past operational experience, and some basic aerostatic theory, their actual record and the reasons for their demise. Problems of atmospheric density and temperature variations, meteorological factors, aerodynamic stability and control, and mooring difficulties are discussed and related to actual case histories. Structural and flight efficiencies are compared to airplane efficiencies for airplanes contemporary with the zeppelin as well as modern designs. The difficulty of supporting new, commercial airship developments on an economic basis is made clear.

The Use of Case Studies in OR Teaching

ERIC Educational Resources Information Center

Penn, Marion L.; Currie, Christine S. M.; Hoad, Kathryn A.; O'Brien, Frances A.

2016-01-01

This article investigates the current use of case studies in the teaching of Operational Research (OR) in the UK: how and where they are used; how they are developed; and whether there is an interest in training this area. It is aimed at lecturers teaching OR who are using or planning to use case studies in their teaching. It may also be of…

Enhancing the quality of case studies in health services research.

PubMed Central

Yin, R K

1999-01-01

OBJECTIVE: To provide guidance on improving the quality of case studies in health services research. DATA SOURCES: Secondary data, drawing from previous case study research. RESEARCH DESIGN: Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (four additional items). PRINCIPAL FINDINGS: The guidance demonstrates that many operational steps can be undertaken to improve the quality of case studies. These steps have been a hallmark of high-quality case studies in related fields but have not necessarily been practiced in health services research. CONCLUSIONS: Given higher-quality case studies, the case study method can become a valuable tool for health services research. Images Figure 3 PMID:10591280

13 CFR 120.839 - Case-by-case application to make a 504 loan outside of a CDC's Area of Operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 504 loan outside of a CDC's Area of Operations. 120.839 Section 120.839 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Extending A Cdc's Area of Operations § 120.839 Case-by-case application to make a 504 loan outside of a CDC's Area of...

13 CFR 120.839 - Case-by-case application to make a 504 loan outside of a CDC's Area of Operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 504 loan outside of a CDC's Area of Operations. 120.839 Section 120.839 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Extending A Cdc's Area of Operations § 120.839 Case-by-case application to make a 504 loan outside of a CDC's Area of...

13 CFR 120.839 - Case-by-case application to make a 504 loan outside of a CDC's Area of Operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 504 loan outside of a CDC's Area of Operations. 120.839 Section 120.839 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Extending A Cdc's Area of Operations § 120.839 Case-by-case application to make a 504 loan outside of a CDC's Area of...

13 CFR 120.839 - Case-by-case application to make a 504 loan outside of a CDC's Area of Operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 504 loan outside of a CDC's Area of Operations. 120.839 Section 120.839 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Extending A Cdc's Area of Operations § 120.839 Case-by-case application to make a 504 loan outside of a CDC's Area of...

13 CFR 120.839 - Case-by-case application to make a 504 loan outside of a CDC's Area of Operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 504 loan outside of a CDC's Area of Operations. 120.839 Section 120.839 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Extending A Cdc's Area of Operations § 120.839 Case-by-case application to make a 504 loan outside of a CDC's Area of...

Late post-operative recurrent osteosarcoma: Three case reports with a review of the literature

PubMed Central

YU, XIUCHUN; WU, SUJIA; WANG, XUQUAN; XU, MING; XU, SONGFENG; YUAN, YE

2013-01-01

The aim of the present study was to investigate the clinical characteristics and treatment of late recurrent osteosarcoma following surgery. The cases of three patients with late recurrent osteosarcoma, who were treated at the General Hospital of Jinan Military Command, General Hospital of Nanjing Military Command and Xinan Hospital of The Third Military Medical University, were analyzed retrospectively. Furthermore, 10 cases of late recurrent osteosarcoma were retrieved from the literature. In total, eight male and five female cases were selected for the present study. The mean age at recurrence was 25.56 years (range, 13–42 years). The locations of the osteosarcomas were as follows: five cases in the distal femur, two cases in the distal tibia and acetabulum, respectively, and one case in the proximal tibia (the remaining cases were not described). The tumors were histologically classified into three cases of fibroblastic, two cases of traditional-type; two cases of mixed-type and one case each of osteoblastic-, chondroblastic- and telangiectasia-type osteosarcoma (the remaining cases were not described). The mean recurrence time following surgery was 10.02 years (range, 5.2–19.3 years). With regard to the treatment modalities, five patients accepted surgery and chemotherapy, one patient accepted surgery and radiotherapy, two patients accepted surgery alone and one patient did not complete the treatment (the remaining cases were not described). From the 12 cases that were followed-up for between 0.5 and 4.7 years (mean, 2.28 years), one case was lost to follow-up, six patients survived (up to 4.5 years) and six patients succumbed to their condition (0.6–4.7 years). The present study highlights the fact that more focus should be placed upon the long-term follow-up of patients with osteosarcoma. A follow-up is required once every six months, from five years after the diagnosis. The abnormal changes in the surgical site should also receive further attention

Real Time Locations Systems or Outsourcing: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Khumalo, Floyd

2013-01-01

Information Technology has transformed almost all aspects of modern healthcare and is playing a vital role in the administration of hospitals around the world. This case study examines one hospital's struggle to solve crucial operational problems related to the efficient management of medical equipment inventory. This case study is the result of…

[Post-operative peritoneal washing cytology in cases of stage IIIa endometrial carcinoma with positive peritoneal cytology].

PubMed

Kato, T; Hirai, Y; Hasumi, K

1995-07-01

According to the new FIGO staging of corpus cancer, the cases with positive peritoneal cytology alone belong in stage IIIa. The authors previously reported, however, good prognosis of IIIa cases with only positive peritoneal cytology. In order to assess the potential of malignant cells in the peritoneal cavity to metastasize, post-operative peritoneal washing cytology was undertaken. This study was conducted on a total of 115 consecutive patients with endometrial carcinoma who underwent primary surgical therapy at the Cancer Institute Hospital during the 25-month period from December, 1991 to December, 1993. Fifteen cases were included in stage IIIa with positive intraoperative peritoneal cytology alone. In 12 cases with endometrioid adenocarcinoma, a Silascon tube was indwelt in the abdominal cavity before closure of the abdomen. The peritoneal cavity was washed with 500 ml of physiological saline through the indwelt tube 14 days after the operation. The cytology of recovered washings was negative in all cases. Only two cases received postoperative chemotherapy owing to other prognostic factors. These 12 cases are alive with no evidence of disease after 12 to 36 months. The present study demonstrated that malignant cells in the peritoneal cavity appear to have a very low potential for implantation into the peritoneum.

[An operative case of ulcerative colitis associated with hyperthyroidism].

PubMed

Kohyama, Atsushi; Funayama, Yuji; Fukushima, Kouhei; Shibata, Chikashi; Miura, Koh; Takahashi, Ken-ichi; Ogawa, Hitoshi; Ueno, Tatsuya; Sasaki, Iwao; Hiwatashi, Nobuo

2009-06-01

We encountered a rare operative case of hyperthyroidism followed by ulcerative colitis (UC). A 26-year-old mam was referred to our department to undergo an operation. We suspected the possible complication of adrenal insufficiency, since he suffered from severe weight loss, a high fever and palpitation on admission. We diagnosed hyperthyroidism, however, based on the presence of high serum free T3 and T4 levels and a decreased TSH level. After improving the symptoms and the thyroid function by administering thiamazole, we then performed a total proctocolectomy. Although a high rate of association of autoimmune thyroid diseases with UC has been suggested, only 9 cases of hyperthyroidism coexisting with UC have so far been reported in Japan. A common immunological process has been suggested to be implicated in the pathogenesis of this association, however, the exact mechanism needs to be elucidated in the future.

Stability Operations in East Timor 1999-2000: A Case Study

DTIC Science & Technology

2016-04-11

Institute April 11, 2016 Raymond A. Millen Senior Editor The views expressed in this report are those of the authors and do not necessarily reflect...Stability Operations Institute (PKSOI) publications enjoy full academic freedom, pro- vided they do not disclose classified information, jeopardize...to this report are invited and should be forwarded to: Director, Peacekeeping and Stability Operations Institute , U.S. Army War College, 22 Ashburn

Case Studies of Predictive Analysis Applications in Law Enforcement

DTIC Science & Technology

2015-12-01

analysis to crime problems to be considered effective. To test this hypothesis, case studies were conducted on municipal police departments in the...Forecasting in Law Enforcement Operations. 6 Vlahos, “The Department of Pre -Crime.” 4 studies were conducted on municipal police departments in the... case studies are described and recommendations for future research , as well as recommendations for police executives considering an investment in

How do strategic decisions and operative practices affect operating room productivity?

PubMed

Peltokorpi, Antti

2011-12-01

Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

Case Study: Writing a Journal Case Study

ERIC Educational Resources Information Center

Prud'homme-Genereux, Annie

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

Study of VLCC tanker ship damage stability during off-shore operation

NASA Astrophysics Data System (ADS)

Hanzu-Pazara, R.; Arsenie, P.; Duse, A.; Varsami, C.

2016-08-01

Today, for the carriage of crude oil on sea are used larger tanker ships, especially from VLCC class. The operation of this type of ships requires in many cases special conditions, mainly related to water depth in the terminal area and enough maneuvering space for entrance and departure. Because, many ports from all over the world don't have capacity to operate this type of ships inside, in designed oil terminal, have chosen for development of outside terminals, off-shore oil terminals. In case of this type of terminals, the problems of water depth and manoeuvring space are fixed, but other kind of situations appears, regarding the safety in operation and environment factors impact on ship during mooring at oil transfer buoy. In the present paper we intend to show a study made using simulation techniques about VLCC class tanker ship in case of a damage condition resulted after a possible collision with another ship during loading operation at an off-shore terminal. From the beginning, we take in consideration that the ship intact stability, during all loading possible situations, has to be high enough, so that in case of some damage with flooding of different compartments due to hypothetical dimension water hole, the ship stability in the final stage of flooding to correspond to the requirements for damage stability and, also, to complementary requirements for damage ship stability.

Systems Engineering Case Studies: Synopsis of the Learning Principles

DTIC Science & Technology

2010-05-17

Engineering Case Study HST refers to the Hubble Space Telescope Systems Engineering Case Study TBMCS refers to the Theater Battle Management Core System...going to orbit undetected in spite of substantial evidence that could have been used to prevent this occurrence. TBMCS /1 Requirements Definition...baseline was volatile up to system acceptance, which took place after TBMCS passed operational test and evaluation. TBMCS /2 System Architecture The

The role of smart traffic centers in regional system operations : a Hampton Roads case study.

DOT National Transportation Integrated Search

2005-01-01

The objectives of this study were to define the role of smart traffic centers (STCs) in regional systems operations and to help identify performance measures for monitoring the performance of STCs in the scope of regional systems operations. Without ...

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.

Evaluation of operational, economic, and environmental performance of mixed and selective collection of municipal solid waste: Porto case study.

PubMed

Teixeira, Carlos A; Russo, Mário; Matos, Cristina; Bentes, Isabel

2014-12-01

This article describes an accurate methodology for an operational, economic, and environmental assessment of municipal solid waste collection. The proposed methodological tool uses key performance indicators to evaluate independent operational and economic efficiency and performance of municipal solid waste collection practices. These key performance indicators are then used in life cycle inventories and life cycle impact assessment. Finally, the life cycle assessment environmental profiles provide the environmental assessment. We also report a successful application of this tool through a case study in the Portuguese city of Porto. Preliminary results demonstrate the applicability of the methodological tool to real cases. Some of the findings focus a significant difference between average mixed and selective collection effective distance (2.14 km t(-1); 16.12 km t(-1)), fuel consumption (3.96 L t(-1); 15.37 L t(-1)), crew productivity (0.98 t h(-1) worker(-1); 0.23 t h(-1) worker(-1)), cost (45.90 € t(-1); 241.20 € t(-1)), and global warming impact (19.95 kg CO2eq t(-1); 57.47 kg CO2eq t(-1)). Preliminary results consistently indicate: (a) higher global performance of mixed collection as compared with selective collection; (b) dependency of collection performance, even in urban areas, on the waste generation rate and density; (c) the decline of selective collection performances with decreasing source-separated material density and recycling collection rate; and (d) that the main threats to collection route efficiency are the extensive collection distances, high fuel consumption vehicles, and reduced crew productivity. © The Author(s) 2014.

Aspect-Oriented Approach to Operating System Development Empirical Study

NASA Astrophysics Data System (ADS)

Kuusela, Jaakko; Tuominen, Harri

This paper presents a case-study where a new programming technique is applied to an established branch of software development. The purpose of the study was to test whether or not aspect-oriented programming (AOP) could be used in operating systems development. Instead of any real world operating system an educational OS with the name Nachos was used. This was because Nachos is written in Java which makes it easy to introduce aspect-oriented techniques. In this paper a new file system for the Nachos OS is developed and then it is analyzed by profiling and metrics. The results show that it is possible to use AOP in OS development and that it is also beneficial to do so.

Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases.

PubMed Central

Wadley, J.; Dorward, N.; Kitchen, N.; Thomas, D.

1999-01-01

Operative neurosurgery has recently entered an exciting era of image guided surgery or neuronavigation and application of this novel technology is beginning to have a significant impact in many ways in a variety of intracranial procedures. In order to fully assess the advantages of image guided techniques over conventional planning and surgery in selected cases, detailed prospective evaluation has been carried out during the advanced development of an optically tracked neuronavigation system. Over a 2-year period, 300 operative neurosurgical procedures have been performed with the assistance of interactive image guidance, as well as the development of new software applications and hardware tools. A broad range of intracranial neurosurgical procedures were seen to benefit from image guidance, including 163 craniotomies, 53 interactive stereotactic biopsies, 7 tracked neuroendoscopies and 37 complex skull base procedures. The most common pathological diagnoses were cerebral glioma in 98 cases, meningioma in 64 and metastasis in 23. Detailed analysis of a battery of postoperative questions revealed benefits in operative planning, appreciation of anatomy, lesion location, safety of surgery and greatly enhanced surgical confidence. The authors believe that image guided surgical technology, with new developments such as those described, has a significant role to play in contemporary neurosurgery and its widespread adoption in practice will be realised in the near future. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:10615186

Two-tier Haddon matrix approach to fault analysis of accidents and cybernetic search for relationship to effect operational control: a case study at a large construction site.

PubMed

Mazumdar, Atmadeep; Sen, Krishna Nirmalya; Lahiri, Balendra Nath

2007-01-01

The Haddon matrix is a potential tool for recognizing hazards in any operating engineering system. This paper presents a case study of operational hazards at a large construction site. The fish bone structure helps to visualize and relate the chain of events, which led to the failure of the system. The two-tier Haddon matrix approach helps to analyze the problem and subsequently prescribes preventive steps. The cybernetic approach has been undertaken to establish the relationship among event variables and to identify the ones with most potential. Those event variables in this case study, based on the cybernetic concepts like control responsiveness and controllability salience, are (a) uncontrolled swing of sheet contributing to energy, (b) slippage of sheet from anchor, (c) restricted longitudinal and transverse swing or rotation about the suspension, (d) guilt or uncertainty of the crane driver, (e) safe working practices and environment.

First-year Analysis of the Operating Room Black Box Study.

PubMed

Jung, James J; Jüni, Peter; Lebovic, Gerald; Grantcharov, Teodor

2018-06-18

To characterize intraoperative errors, events, and distractions, and measure technical skills of surgeons in minimally invasive surgery practice. Adverse events in the operating room (OR) are common contributors of morbidity and mortality in surgical patients. Adverse events often occur due to deviations in performance and environmental factors. Although comprehensive intraoperative data analysis and transparent disclosure have been advocated to better understand how to improve surgical safety, they have rarely been done. We conducted a prospective cohort study in 132 consecutive patients undergoing elective laparoscopic general surgery at an academic hospital during the first year after the definite implementation of a multiport data capture system called the OR Black Box to identify intraoperative errors, events, and distractions. Expert analysts characterized intraoperative distractions, errors, and events, and measured trainee involvement as main operator. Technical skills were compared, crude and risk-adjusted, among the attending surgeon and trainees. Auditory distractions occurred a median of 138 times per case [interquartile range (IQR) 96-190]. At least 1 cognitive distraction appeared in 84 cases (64%). Medians of 20 errors (IQR 14-36) and 8 events (IQR 4-12) were identified per case. Both errors and events occurred often in dissection and reconstruction phases of operation. Technical skills of residents were lower than those of the attending surgeon (P = 0.015). During elective laparoscopic operations, frequent intraoperative errors and events, variation in surgeons' technical skills, and a high amount of environmental distractions were identified using the OR Black Box.

Re-operative thyroid surgery: a 20-year prospective cohort study at a tertiary referral centre.

PubMed

Hardman, John C; Smith, J A; Nankivell, P; Sharma, N; Watkinson, J C

2015-06-01

Re-operative thyroid surgery is a relatively uncommon procedure complicated by distorted anatomy and post-operative tissue changes. Surgery may follow initial benign or malignant pathology. Published outcomes vary widely in the literature. This study aims to report our outcomes from re-operative thyroid surgery. Patient demographics and complication rates for consecutive thyroidectomies performed by a single surgeon at a tertiary centre were collected between 1993 and 2013. Outcomes in re-operative surgery are analysed and compared with local and national data. Cases of re-operative surgery following benign disease are further analysed for histology, re-presenting symptoms and time between procedures. Our cohort comprised 1,657 cases including 164 re-operative procedures (101 malignant, 63 benign). Within our cohort re-operative cases were on average 4 years older (mean 49.9 vs 45.9 years, p = 0.001) and had a higher incidence of haematoma formation (4.3 vs 1.7 %, p = 0.033) and transient recurrent laryngeal nerve palsy (5.5 vs 2.5 %, p = 0.044) compared to primary surgery. Rates of permanent hypocalcaemia (2.4 vs 1.8 %, p = 0.540) and permanent RLN palsy (1.8 vs 0.4 %, p = 0.051) were higher in the re-operative group but did not reach significance. Comparison of complications following re-operation for benign and malignant disease revealed no significant differences. Mean interval to re-operation for benign cases was 17.4 years with 74.6 % found to have multinodular goitre at repeat procedure. Re-operative procedures comprised around 10 % of thyroid surgery at our centre. Re-operative cases experienced more complications than primary surgery but permanent rates were low. Re-operative surgery may therefore be safely considered in experienced hands.

New Jersey I-80 and I-287 HOV lane case study

DOT National Transportation Integrated Search

2000-07-01

This report documents the New Jersey I-80 and I-287 high-occupancy vehicle (HOV) lane case study. Information is presented on planning, implementing, operating, and redesignating the HOV lanes on the two freeways. The operation of the lanes is compar...

Procurement Integrity in Contingency Operations: A Case Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory

DTIC Science & Technology

2011-12-01

Study of Army Contracting Officer Corruption in Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory By: Amanda H...Operations Iraqi and Enduring Freedom Utilizing Occupational Fraud Theory 6. AUTHOR(S) Amanda H. Flint 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION...CCOs) during Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) by applying occupational fraud theory, specifically the classic sociological

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

Assessing the Flipped Classroom in Operations Management: A Pilot Study

ERIC Educational Resources Information Center

Prashar, Anupama

2015-01-01

The author delved into the results of a flipped classroom pilot conducted for an operations management course module. It assessed students' perception of a flipped learning environment after making them experience it in real time. The classroom environment was construed using a case research approach and students' perceptions were studied using…

The Case for Addressing Operator Fatigue

PubMed Central

Duffy, Jeanne F.; Zitting, Kirsi-Marja; Czeisler, Charles A.

2015-01-01

Sleep deficiency, which can be caused by acute sleep deprivation, chronic insufficient sleep, untreated sleep disorders, disruption of circadian timing, and other factors, is endemic in the U.S., including among professional and non-professional drivers and operators. Vigilance and attention are critical for safe transportation operations, but fatigue and sleepiness compromise vigilance and attention by slowing reaction times and impairing judgment and decision-making abilities. Research studies, polls, and accident investigations indicate that many Americans drive a motor vehicle or operate an aircraft, train or marine vessel while drowsy, putting themselves and others at risk for error and accident. In this chapter, we will outline some of the factors that contribute to sleepiness, present evidence from laboratory and field studies demonstrating how sleepiness impacts transportation safety, review how sleepiness is measured in laboratory and field settings, describe what is known about interventions for sleepiness in transportation settings, and summarize what we believe are important gaps in our knowledge of sleepiness and transportation safety. PMID:26056516

[Study on relationship between operation timing and clinical prognosis of cases with Bell palsy].

PubMed

Liu, Sufu; Li, Jiandong; Wang, Xueyong; Zhao, Liang; Ji, Wei; Wang, Jia; Bai, Juan; Wei, Bojun

2013-07-01

To study on relationship between diverse handling time following onset and clinical prognosis of cases with Bell palsy. Two hundred and sixteen cases with Bell palsy, who were admitted in our department between Jun. 2006 and Dec. 2009, were collected and divided into 6 groups according to disease time: 1-2 months, > 2 - 3 months, > 3 - 4 months, > 4 - 5 months, > 5 - 6 months, and > 6 months. Cases in all groups received subtotal course decompression of facial nerve and other compound treatment, and the relationship between handling timing and clinical prognosis were compared. It was found that the difference of prognosis and handling timing was statistically significant, after comparison between all groups with Facial Grading Standards (H-B) as the standard to assess prognosis. Clinical prognosis of cases with Bell palsy was related to alternative handling time, and subtotal course decompression of facial nerve was recommended to be performed as early as possible for those cases who were irresponsive after conservative treatment for one month.

Systematic review of general thoracic surgery articles to identify predictors of operating room case durations.

PubMed

Dexter, Franklin; Dexter, Elisabeth U; Masursky, Danielle; Nussmeier, Nancy A

2008-04-01

Previous studies of operating room (OR) information systems data over the past two decades have shown how to predict case durations using the combination of scheduled procedure(s), individual surgeon and assistant(s), and type of anesthetic(s). We hypothesized that the accuracy of case duration prediction could be improved by the use of other electronic medical record data (e.g., patient weight or surgeon notes using standardized vocabularies). General thoracic surgery was used as a model specialty because much of its workload is elective (scheduled) and many of its cases are long. PubMed was searched for thoracic surgery papers reporting operative time, surgical time, etc. The systematic literature review identified 48 papers reporting statistically significant differences in perioperative times. There were multiple reports of differences in OR times based on the procedure(s), perioperative team including primary surgeon, and type of anesthetic, in that sequence of importance. All such detail may not be known when the case is originally scheduled and thus may require an updated duration the day before surgery. Although the use of these categorical data from OR systems can result in few historical data for estimating each case's duration, bias and imprecision of case duration estimates are unlikely to be affected. There was a report of a difference in case duration based on additional information. However, the incidence of the procedure for the diagnosis was so uncommon as to be unlikely to affect OR management. Matching findings of prior studies using OR information system data, multiple case series show that it is important to rely on the precise procedure(s), surgical team, and type of anesthetic when estimating case durations. OR information systems need to incorporate the statistical methods designed for small numbers of prior surgical cases. Future research should focus on the most effective methods to update the prediction of each case's duration as these

Specialty hospitals emulating focused factories: a case study.

PubMed

Kumar, Sameer

2010-01-01

For 15 years general hospital managers faced new competition from for-profit specialty hospitals that operate on a "focused factory" model, which threaten to siphon-off the most profitable patients. This paper aims to discuss North American specialty hospitals and to review rising costs impact on general hospital operations. The focus is to discover whether specialty hospitals are more efficient than general hospitals; if so, how significant is the difference and also what can general hospitals do in light of the rising specialty hospitals. The case study involves stochastic frontier regression analysis using Cobb-Douglas and Translog cost functions to compare Minnesota general and specialty hospital efficiency. Analysis is based on data from 117 general and 19 specialty hospitals. The results suggest that specialty hospitals are significantly more efficient than general hospitals. Overall, general hospitals were found to be more than twice as inefficient compared with specialty hospitals in the sample. Some cost-cutting factors highlighted can be implemented to trim rising costs. The case study highlights some managerial levers that general hospital operational managers might use to control rising costs. This also helps them compete with specialty hospitals by reducing overheads and other major costs. The study is based on empirical modeling for an important healthcare operational challenge and provides additional in-depth information that has health policy implications. The analysis and findings enable healthcare managers to guide their institutions in a new direction during a time of change within the industry.

Applying analysis tools in planning for operations : case study #1 -- operations strategy impact reference and deployment guidance

DOT National Transportation Integrated Search

2009-09-01

More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

Case Studies in Modelling, Control in Food Processes.

PubMed

Glassey, J; Barone, A; Montague, G A; Sabou, V

This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

A Proposed Resident's Operative Case Tracking and Evaluation System.

PubMed

Sehli, Deema N; Esene, Ignatius N; Baeesa, Saleh S

2016-03-01

Neurosurgery program trainers are continuously searching for new methods to evaluate trainees' competency besides number of cases and training duration. Recently, efforts are made on the development of reliable methods to teach competency and valid methods to measure teaching efficacy. Herein, we propose the "Resident's Operative Case Tracking and Evaluation System" (ROCTES) for the assessment and monitoring of the resident's performance quality during each procedure. We developed a data-based website and smartphone application for neurosurgical attending physicians, residents, and resident review committees in our accredited neurosurgical institutions. ROCTES runs through five steps: Login (Resident), Case Entry, Login (Attending Physician), Case Approval and Evaluation, and Report. The Resident enters each case record under "Case Entry" field and can "save," "edit," or "submit" the case data to the Attending Physician. The latter from the attending physician login profile will be able to "approve and evaluate" the resident's "knowledge," "skills," and "attitude" ranking from 1 to 15 for that particular case; add his comments and then "save," "edit," or "submit" the data, which can be viewed by users as a "report." Program Directors can also "login" to monitor the resident's progress. The implementation of this communication tool should enable the filtering and retrieval of information needed for the better assessment and monitoring of residents' exposure to variety of cases in each training center. This proposed evaluation system will provide a transparent assessment for residency training programs and should convert trainees into competent neurosurgeons. Copyright © 2016 Elsevier Inc. All rights reserved.

Validating an artificial intelligence human proximity operations system with test cases

NASA Astrophysics Data System (ADS)

Huber, Justin; Straub, Jeremy

2013-05-01

An artificial intelligence-controlled robot (AICR) operating in close proximity to humans poses risk to these humans. Validating the performance of an AICR is an ill posed problem, due to the complexity introduced by the erratic (noncomputer) actors. In order to prove the AICR's usefulness, test cases must be generated to simulate the actions of these actors. This paper discusses AICR's performance validation in the context of a common human activity, moving through a crowded corridor, using test cases created by an AI use case producer. This test is a two-dimensional simplification relevant to autonomous UAV navigation in the national airspace.

The general surgery chief resident operative experience: 23 years of national ACGME case logs.

PubMed

Drake, Frederick Thurston; Horvath, Karen D; Goldin, Adam B; Gow, Kenneth W

2013-09-01

The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. To evaluate changes in operative experience for general surgery CRs. Review of Accreditation Council for Graduate Medical Education case logs from 1989-1990 through 2011-2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. Total cases and defined categories were evaluated for changes over time. The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P < .001). Total CR cases dropped to their lowest following implementation of the 80-hour work week (236 cases), but rebounded in period 5. The percentage of residents' 5-year operative experience performed as CRs has decreased (30% in period 1 vs 25.6% in period 5, P < .001). Regarding case mix: thoracic, trauma, and vascular cases declined steadily, while alimentary and intra-abdominal operations increased. Recent graduates averaged 80 alimentary and 78 intra-abdominal procedures during their CR years. Compared with period 1, in which these 2 categories represented 47.1% of CR experience, in period 5, they represented 65.2% (P < .001). Endocrine experience has been relatively unchanged. Total CR cases declined especially acutely following implementation of the 80-hour work week but have since rebounded. Chief resident cases contribute less to overall experience, although this proportion stabilized before the 80-hour work week. Case mix has narrowed, with significant increases in alimentary and intra-abdominal cases. Broad-based general surgery training may be jeopardized by reduced case diversity. Chief

Better Assessment of Operational Suitability. Volume 2. Case Studies

DTIC Science & Technology

1992-01-01

August to 25 October 1988. Although declared operationally effective and suitable by OTEA, a Corrective Action Plan (CAP) was instituted on 5 December 1988...to correct performance deficiencies encountered in FOT&E. The option year 3 procureiaent was exercised on 8 December 1988. An OTEA assessment of the...Hughes developed and tested airframe design modifications to correct deficiencies noted in DT POT I, to improve flight handling characteristics, and to

Study on casing treatment and stator matching on multistage fan

NASA Astrophysics Data System (ADS)

Wu, Chuangliang; Yuan, Wei; Deng, Zhe

2017-10-01

Casing treatments are required for expanding the stall margin of multi-stage high-load turbofans designed with high blade-tip Mach numbers and high leakage flow. In the case of a low mass flow, the casing treatment effectively reduces the blockages caused by the leakage flow and enlarges the stall margin. However, in the case of a high mass flow, the casing treatment affects the overall flow capacity of the fan, the thrust when operating at the high speeds usually required by design-point specifications. Herein, we study a two-stage high-load fan with three-dimensional numerical simulations. We use the simulation results to propose a scheme that enlarges the stall margin of multistage high-load fans without sacrificing the flow capacity when operating with a large mass flow. Furthermore, a circumferential groove casing treatment is used and adjustments are made to the upstream stator angle to match the casing treatment. The stall margin is thus increased to 16.3%, with no reduction in the maximum mass flow rate or the design thrust performance.

CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

EPA Science Inventory

Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

Switch Panel wear loading - a parametric study regarding governing train operational factors

NASA Astrophysics Data System (ADS)

Hiensch, E. J. M.; Burgelman, N.

2017-09-01

The acting forces and resulting material degradation at the running surfaces of wheels and rail are determined by vehicle, track, interface and operational characteristics. To effectively manage the experienced wear, plastic deformation and crack development at wheels and rail, the interaction between vehicle and track demands a system approach both in maintenance and in design. This requires insight into the impact of train operational parameters on rail- and wheel degradation, in particular at switches and crossings due to the complex dynamic behaviour of a railway vehicle at a turnout. A parametric study was carried out by means of vehicle-track simulations within the VAMPIRE® multibody simulation software, performing a sensitivity analysis regarding operational factors and their impact on expected switch panel wear loading. Additionally, theoretical concepts were cross-checked with operational practices by means of a case study in response to a dramatic change in lateral rail wear development at specific switches in Dutch track. Data from train operation, track maintenance and track inspection were analysed, providing further insight into the operational dependencies. From the simulations performed in this study, it was found that switch rail lateral wear loading at the diverging route of a 1:9 type turnout is significantly influenced by the level of wheel-rail friction and to a lesser extent by the direction of travel (facing or trailing). The influence of other investigated parameters, being vehicle speed, traction, gauge widening and track layout is found to be small. Findings from the case study further confirm the simulation outcome. This research clearly demonstrates the contribution flange lubrication can have in preventing abnormal lateral wear at locations where the wheel-rail interface is heavily loaded.

To study the effect of orbital sling on post operative vision in cases of maxillary carcinoma undergoing total maxillectomy.

PubMed

Shukla, Anirudh; Dudeja, Vivek

2014-06-01

To study effect of orbital sling on post operative vision in cases of maxillary carcinoma undergoing total maxillectomy. All patients with the principal procedure of "total maxillectomy" for histopathologically proven cases of carcinoma maxilla in department of otorhinolaryngology and head-neck surgery, N.S.C.B. medical college, Jabalapur, Madhya Pradesh, India from July 2011 to October 2013 were included. Out of the 20 patients irrespective of whether orbital sling was created or not, maximum number of patients 8 (40 %) showed a 3 step improvement, and maximum improvement seen was up to five steps. Out of the 14 patients in which orbital sling was created maximum number of patients 7 (50 %) showed a 3 step improvement, and maximum improvement seen was up to five steps. Out of the 6 patients in whom orbital sling was not created maximum number of patients 3 (50 %) showed a 2 step improvement, and maximum improvement seen was up to three steps. Infraorbital repair with the help of sling results in better improvement of vision as compared to those in whom sling was not or could not be made with no significant difference on eye movements.

Simplifying Operational Design

DTIC Science & Technology

2012-05-01

centuries of historical case studies, tracing the 9 evolution and development of what was then in 1997 operational theory. Naveh called his...major cases against operational design is the IDF’s application of SOD in 2006 against Hezbollah in Lebanon. While many blamed Israel’s lack of success...networked centricity.68 This is not the case . War, like ecosystems and economies, is a complex adaptive system. The interactive complexity that comprises

Chronic post-operative iris prosthesis endophthalmitis in a patient with traumatic aniridia: a case report.

PubMed

Firl, Kevin C; Montezuma, Sandra R

2016-11-09

Post-operative endophthalmitis is a serious complication of intraocular surgery which may present acutely or chronically. Chronic post-operative endophthalmitis is characterized by decreased visual acuity, mild pain, and low-grade uveitis several weeks or months after intraocular surgery which may be responsive to corticosteroids, but recur upon tapering. Low virulence organisms such as Propionibacterium acnes are the most common culprit organisms, and treatment most often consists of both intravitreal antibiotic injections and surgery. Aniridia is a condition defined by total or partial loss of the iris and leads to decreased visual quality marked by glare and photophobia. Treatment of complex or severe cases of traumatic aniridia in which surgical repair is difficult may consist of implantation of iris prostheses, devices designed to reduce symptoms of aniridia. Though chronic, post-operative endophthalmitis has been associated with most intraocular surgeries including intraocular lens implantation after cataract removal, it has never been described in a patient with an iris prosthesis. In this case report, we describe the case of a 49 year old, male construction worker with traumatic aniridia who experienced chronic, recurrent low-grade intraocular inflammation and irritation for months after implantation of the Ophtec 311 prosthetic iris. Symptoms and signs of inflammation improved temporarily with sub-Tenon's capsule triamcinolone injections. Ultimately after more than 2 post-operative years, the iris prosthesis was explanted, and intravitreal cultures showed P. acnes growth after 5 days. Intravitreal antibiotics treated the infection successfully. To our knowledge, this is the first reported case of chronic, post-operative endophthalmitis in a patient with an iris prosthesis. Chronic, post-operative endophthalmitis may be a difficult to identify in the context of traumatic aniridia and iris prosthesis implantation due to other potential etiologies of

Financial Indicators of Reduced Impact Logging Performance in Brazil: Case Study Comparisons

Treesearch

Thomas P. Holmes; Frederick Boltz; Douglas R. Carter

2001-01-01

Indicators of financial performance are compared for three case studies in the Brazilian Amazon. Each case study presents parameters obtained from monitoring initial harvest entries into primary forests for reduced impact logging (RIL) and conventional logging (CL) operations. Differences in cost definitions and data collection protocols complicate the analysis, and...

Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

PubMed

Pugliese, Raffaele; Forgione, Antonello; Sansonna, Fabio; Ferrari, Giovanni Carlo; Di Lernia, Stefano; Magistro, Carmelo

2010-03-01

Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series of hybrid transvaginal cholecystectomy. Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a hybrid technique in 18 women (mean age 54 years), including four women with a body mass index >30 kg/m(2). Dissection was conducted in the first four cases by a round-tip unipolar electrode (UE) introduced through the operative channel of the endoscope coming from the vagina and in the last 14 cases by a ultrasonic scalpel (US) introduced through a 5-mm abdominal port. The short-term outcomes and the long-term results of the two methods were compared. The transvaginal approach entailed no intraoperative complication and no conversion. The overall mean duration of procedures was 75 min (range 40-190). In the first four cases (UE), the operating time was 148 min (range 140-190), whilst in the last 14 (US), it was considerably shorter, 53 min (range 40-60, p < 0.01). We experienced one biliary leak in the UE group, whilst morbidity with US was nil (p < 0.005). The biliary leak healed in 7 days with nasobiliary drainage. No other complications were encountered in either group. The mean follow-up was 12 months (range 1-22), and none of the patients has complained of dyspareunia or other colpotomy-related complications so far. Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.

[Case allocation of extensive operations on head and neck within the German DRG system 2004-2007: what is the net result of the continued developments in case allocation?].

PubMed

Franz, D; Franz, K; Roeder, N; Hörmann, K; Fischer, R-J; Alberty, Jürgen

2007-07-01

When the German DRG system was implemented there was some doubt about whether patients with extensive head and neck surgery would be properly accounted for. Significant efforts have therefore been invested in analysis and case allocation of those in this group. The object of this study was to investigate whether the changes within the German DRG system have led to improved case allocation. Cost data received from 25 ENT departments on 518 prospective documented cases of extensive head and neck surgery were compared with data from the German institute dealing with remuneration in hospitals (InEK). Statistical measures used by InEK were used to analyse the quality of the overall system and the homogeneity of the individual case groups. The reduction of variance of inlier costs improved by about 107.3% from the 2004 version to the 2007 version of the German DRG system. The average coefficient of cost homogeneity rose by about 9.7% in the same period. Case mix index and DRG revenues were redistributed from less extensive to the more complex operations. Hospitals with large numbers of extensive operations and university hospitals will gain most benefit from this development. Appropriate case allocation of extensive operations on the head and neck has been improved by the continued development of the German DRG system culminating in the 2007 version. Further adjustments will be needed in the future.

A flash from the past: a case on long term follow-up of a "corridor" operation.

PubMed

Ricciardi, Danilo; Sarkozy, Andrea; Wauters, Kristel; Brugada, Pedro

2013-01-01

An electrophysiological study in a patient with a previous corridor operation was performed because of syncope. The atrial electrograms showed the persistence of the sinus rhythm in the right atrial corridor despite an organized atrial fibrillation in the left atrium. The first case described of a long term follow-up in a corridor operation, one of the first described surgical approach for the treatment of atrial fibrillation, that gave the beginning to the non-pharmacological approach of this arrhythmia. Copyright © 2013 Elsevier Inc. All rights reserved.

Sustainability of Social Programs: A Comparative Case Study Analysis

ERIC Educational Resources Information Center

Savaya, Riki; Spiro, Shimon; Elran-Barak, Roni

2008-01-01

The article reports on the findings of a comparative case study of six projects that operated in Israel between 1980 and 2000. The study findings identify characteristics of the programs, the host organizations, and the social and political environment, which differentiated programs that are sustained from those that are not. The findings reaffirm…

Development of the safety control framework for shield tunneling in close proximity to the operational subway tunnels: case studies in mainland China.

PubMed

Li, Xinggao; Yuan, Dajun

2016-01-01

China's largest cities like Beijing and Shanghai have seen a sharp increase in subway network development as a result of the rapid urbanization in the last decade. The cities are still expanding their subway networks now, and many shield tunnels are being or will be constructed in close proximity to the existing operational subway tunnels. The execution plans for the new nearby shield tunnel construction calls for the development of a safety control framework-a set of control standards and best practices to help organizations manage the risks involved. Typical case studies and relevant key technical parameters are presented with a view to presenting the resulting safety control framework. The framework, created through collaboration among the relevant parties, addresses and manages the risks in a systematic way based on actual conditions of each tunnel crossing construction. The framework consists of six parts: (1) inspecting the operational subway tunnels; (2) deciding allowed movements of the existing tunnels and tracks; (3) simulating effects of the shield tunneling on the existing tunnels; (4) doing preparation work; (5) monitoring design and information management; and (6) measures and activation mechanism of the countermeasures. The six components are explained and demonstrated in detail. In the end, discussions made involve construction and post-construction settlement of the operational tunnel, application of the remedial grouting to rectify excessive settlements of the operational tunnel, and use of the innovative tool of the optical fiber measurement for tunnel movement monitoring. It is concluded that the construction movement of the tunnel can be controlled within 15 mm when the shield machine is <7 m in excavation diameter. The post-construction settlement of the tunnel buried in the very soft ground is much greater than its construction settlement, and last several years until reaching a final stable state. Two cases are outlined to demonstrate the

[Pre-operation evaluation and intra-operation management of cochlear implantation].

PubMed

Zhang, Dao-xing; Hu, Bao-hua; Xiao, Yu-li; Shi, Bo-ning

2004-10-01

To summarize pre-operation evaluation experiences in cochlear implantation. Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Among the total 158 cases, 116 cases with normal structure, 42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37.6 dB SPL. Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.

Training Factory Workers: Three Case Studies. Contractor Report.

ERIC Educational Resources Information Center

Hirschhorn, Larry D.

Case studies examined the context and impact of training in three factories: a bakery, a circuit assembly plant, and a plant that produces microchips. Cookie-Foods, Inc. used Statistical Process Control (SPC) and a course on problem solving to increase the operators' productivity. Impact of the SPC program was limited, because workers who…

Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

PubMed

Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

2017-04-01

Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A case of a power failure in the operating room.

PubMed

Yasny, Jeffrey; Soffer, Robert

2005-01-01

In the operating room, safely administering anesthesia amidst a major power failure can instantly present one with a formidable challenge. A case is presented involving a 23-year-old healthy woman who underwent a complex oral and maxillofacial surgery to correct a dentofacial deformity. Three hours into the case and with the patient's maxilla downfractured, the overhead surgical lights blacked out, and there was an apparent loss of the anesthesia machine's ability to function. Providing adequate oxygenation, ventilation, anesthesia levels, monitoring of vital signs, and transportation of the patient were some of the challenges faced, and the response to this unexpected event is recounted. The importance of one's familiarity with an anesthesia machine's backup battery supply, routinely checking machinery, ensuring that appropriate and sufficient supplies are readily available, exercising calm leadership with clear communication, and formulating a clear plan with backup alternatives are discussed. Various recommendations are proposed with respect to the preparation for and the prevention of a power failure in the operating room. This report's account of events is aimed to "shed some light" on this topic, serve as a check of one's own preparedness, and facilitate the optimal management of a similarly unexpected incident.

Does temproray bilateral balloon occlusion of the common iliac arteries reduce the need for intra-operative blood transfusion in cases of placenta accretism?

PubMed

Al-Hadethi, Sinan; Fernando, Shane; Hughes, Simon; Thakorlal, Ajay; Seruga, Adam; Scurry, Bonnie

2017-06-01

Bilateral balloon occlusion has been employed as a prophylactic measure in cases of placenta accretism prior to caesarean section with the aim of reducing blood loss and its associated morbidity/mortality. There is however no clear consensus on its efficacy in the current literature. The objective of this study was to assess the efficacy of bilateral balloon occlusion of the common iliac arteries (CIA) in reducing intra-operative morbidity in cases of placenta accretism. The databases of the pathology department and radiology interventional suite were reviewed over a nine year period. Fifty-two cases of confirmed placental accretism who underwent caesarean section with or without hysterectomy were identified and divided into two groups. Twenty-five cases had temporary occlusion of the common iliac arteries (CIA) during delivery and these were considered the study group. The reminder 27 cases did not have temporary occlusion of the CIA and were considered the control group. The two groups were compared based on gravidity, age group, post-operative haemoglobin, drop in haemoglobin, estimated blood loss (EBL), transfusion requirement and the histopathological sub-types of placenta accretism. There was no statistically difference between the study and the control groups regarding EBL, post-operative haemoglobin drop, transfusion requirement or in the placenta accretism histopathological subtype. Two cases in the study group had acute thromboembolic complications. Both groups had a single patient requiring a massive intra-operative transfusion. Our study was not able to detect a significant difference in blood loss or blood product requirement between patients who underwent CIA balloon in the setting of caesarean section for placenta accreta. This remains a challenging scenario requiring a multidisciplinary approach. © 2016 The Royal Australian and New Zealand College of Radiologists.

The Military Assistance Command-Vietnam Studies and Observations Group-A Case Study in Special Operations Campaigning

DTIC Science & Technology

2016-06-10

viewed as the panacea for all military problems. Politicians view SOF as a low risk minimalist investment that produces results; even for problems...of published work that has been dedicated to discussing special operations theory as an element of military strategy. A good starting point to...utility. Doctrine As a starting point for framing understanding of special operations, Joint Publication (JP) 3-05 Special Operations, provides the basis

Production practices affecting worker task demands in concrete operations: A case study.

PubMed

Memarian, Babak; Mitropoulos, Panagiotis

2015-01-01

Construction work involves significant physical, mental, and temporal task demands. Excessive task demands can have negative consequences for safety, errors and production. This exploratory study investigates the magnitude and sources of task demands on a concrete operation, and examines the effect of the production practices on the workers' task demands. The NASA Task Load Index was used to measure the perceived task demands of two work crews. The operation involved the construction of a cast-in-place concrete building under high schedule pressures. Interviews with each crew member were used to identify the main sources of the perceived demands. Extensive field observations and interviews with the supervisors and crews identified the production practices. The workers perceived different level of task demands depending on their role. The production practices influenced the task demands in two ways: (1) practices related to work organization, task design, resource management, and crew management mitigated the task demands; and (2) other practices related to work planning and crew management increased the crew's ability to cope with and adapt to high task demands. The findings identify production practices that regulate the workers' task demands. The effect of task demands on performance is mitigated by the ability to cope with high demands.

A case study of packaging waste collection systems in Portugal - Part I: Performance and operation analysis.

PubMed

Martinho, Graça; Gomes, Ana; Santos, Pedro; Ramos, Mário; Cardoso, João; Silveira, Ana; Pires, Ana

2017-03-01

The need to increase packaging recycling rates has led to the study and analysis of recycling schemes from various perspectives, including technical, economic, social, and environmental. This paper is part one of a three-part study devoted to comparing two recyclable packaging waste collection systems operating in western Portugal: a mixed collection system, where curbside and drop-off collections are operated simultaneously (but where the curbside system was introduced after the drop-off system), and an exclusive drop-off system. This part of the study focuses on analyzing the operation and performance of the two waste collection systems. The mixed collection system is shown to yield higher material separation rates, higher recycling rates, and lower contamination rates compared with the exclusive drop-off system, a result of the curbside component in the former system. However, the operational efficiency of the curbside collection in the mixed system is lower than the drop-off collection in the mixed system and the exclusive drop-off system, mainly because of inefficiency of collection. A key recommendation is to ensure that the systems should be optimized in an attempt to improve performance. Optimization should be applied not only to logistical aspects but also to citizens' participation, which could be improved by conducting curbside collection awareness campaigns in the neighborhoods that have a mixed system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Kraus Operators for a Pair of Interacting Qubits: a Case Study

NASA Astrophysics Data System (ADS)

Arsenijević, M.; Jeknić-Dugić, J.; Dugić, M.

2018-04-01

The Kraus form of the completely positive dynamical maps is appealing from the mathematical and the point of the diverse applications of the open quantum systems theory. Unfortunately, the Kraus operators are poorly known for the two-qubit processes. In this paper, we derive the Kraus operators for a pair of interacting qubits, while the strength of the interaction is arbitrary. One of the qubits is subjected to the x-projection spin measurement. The obtained results are applied to calculate the dynamics of the entanglement in the qubits system. We obtain the loss of the correlations in the finite time interval; the stronger the inter-qubit interaction, the longer lasting entanglement in the system.

Kraus Operators for a Pair of Interacting Qubits: a Case Study

NASA Astrophysics Data System (ADS)

Arsenijević, M.; Jeknić-Dugić, J.; Dugić, M.

2018-06-01

The Kraus form of the completely positive dynamical maps is appealing from the mathematical and the point of the diverse applications of the open quantum systems theory. Unfortunately, the Kraus operators are poorly known for the two-qubit processes. In this paper, we derive the Kraus operators for a pair of interacting qubits, while the strength of the interaction is arbitrary. One of the qubits is subjected to the x-projection spin measurement. The obtained results are applied to calculate the dynamics of the entanglement in the qubits system. We obtain the loss of the correlations in the finite time interval; the stronger the inter-qubit interaction, the longer lasting entanglement in the system.

Alcohol based surgical prep solution and the risk of fire in the operating room: a case report

PubMed Central

Batra, Sumit; Gupta, Rajiv

2008-01-01

A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room. PMID:18439304

Reservoirs performances under climate variability: a case study

NASA Astrophysics Data System (ADS)

Longobardi, A.; Mautone, M.; de Luca, C.

2014-09-01

A case study, the Piano della Rocca dam (southern Italy) is discussed here in order to quantify the system performances under climate variability conditions. Different climate scenarios have been stochastically generated according to the tendencies in precipitation and air temperature observed during recent decades for the studied area. Climate variables have then been filtered through an ARMA model to generate, at the monthly scale, time series of reservoir inflow volumes. Controlled release has been computed considering the reservoir is operated following the standard linear operating policy (SLOP) and reservoir performances have been assessed through the calculation of reliability, resilience and vulnerability indices (Hashimoto et al. 1982), comparing current and future scenarios of climate variability. The proposed approach can be suggested as a valuable tool to mitigate the effects of moderate to severe and persistent droughts periods, through the allocation of new water resources or the planning of appropriate operational rules.

Strategically Focused Training in Six Sigma Way: A Case Study

ERIC Educational Resources Information Center

Pandey, Ashish

2007-01-01

Purpose: The purpose of the current study is to examine the utility of Six Sigma interventions as a performance measure and explore its applicability for making the training design and delivery operationally efficient and strategically effective. Design/methodology/approach: This is a single revelatory case study. Data were collected from multiple…

Case review analysis of operating room decisions to cancel surgery.

PubMed

Chang, Ju-Hsin; Chen, Ke-Wei; Chen, Kuen-Bao; Poon, Kin-Shing; Liu, Shih-Kai

2014-07-23

Cancellation of surgery close to scheduled time causes a waste of healthcare resources. The current study analyzes surgery cancellations occurring after the patient has been prepared for the operating room, in order to see whether improvements in the surgery planning process may reduce the number of cancellations. In a retrospective chart review of operating room surgery cancellations during the period from 2006 to 2011, cancellations were divided into the following categories: inadequate NPO; medical; surgical; system; airway; incomplete evaluation. The relative use of these reasons in relation to patient age and surgical department was then evaluated. Forty-one percent of cancellations were for other than medical reasons. Among these, 17.7% were due to incomplete evaluation, and 8.2% were due to family issues. Sixty seven percent of cancelled cases eventually received surgery. The relative use of individual reasons for cancellation varied with patient age and surgical department. The difference between cancellations before and after anesthesia was dependent on the causes of cancellation, but not age, sex, ASA status, or follow-up procedures required. Almost half of the cancellations were not due to medical reasons, and these cancellations could be reduced by better administrative and surgical planning and better communication with the patient and/or his family.

Promoting operational research through fellowships: a case study from the South-East Asia Union Office.

PubMed

Kumar, A M V; Satyanarayana, S; Berger, S Dar; Chadha, S S; Singh, R J; Lal, P; Tonsing, J; Harries, A D

2015-03-21

In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) jointly developed a new paradigm for operational research (OR) capacity building and started a new process of appointing and supporting OR fellows in the field. This case study describes 1) the appointment of two OR fellows in The Union South-East Asia Office (USEA), New Delhi, India; 2) how this led to the development of an OR unit in that organisation; 3) achievements over the 5-year period from June 2009 to June 2014; and 4) challenges and lessons learnt. In June 2009, the first OR fellow in India was appointed on a full-time basis and the second was appointed in February 2012-both had limited previous experience in OR. From 2009 to 2014, annual research output and capacity building initiatives rose exponentially, and included 1) facilitation at 61 OR training courses/modules; 2) publication of 96 papers, several of which had a lasting impact on national policy and practice; 3) providing technical assistance in promoting OR; 4) building the capacity of medical college professionals in data management; 5) support to programme staff for disseminating their research findings; 6) reviewing 28 scientific papers for national or international peer-reviewed journals; and 7) developing 45 scientific abstracts for presentation at national and international conferences. The reasons for this success are highlighted along with ongoing challenges. This experience from India provides good evidence for promoting similar models elsewhere.

An operational hydrological ensemble prediction system for the city of Zurich (Switzerland): skill, case studies and scenarios

NASA Astrophysics Data System (ADS)

Addor, N.; Jaun, S.; Zappa, M.

2011-01-01

The Sihl River flows through Zurich, Switzerland's most populated city, for which it represents the largest flood threat. To anticipate extreme discharge events and provide decision support in case of flood risk, a hydrometeorological ensemble prediction system (HEPS) was launched operationally in 2008. This models chain relies on limited-area atmospheric forecasts provided by the deterministic model COSMO-7 and the probabilistic model COSMO-LEPS. These atmospheric forecasts are used to force a semi-distributed hydrological model (PREVAH), coupled to a hydraulic model (FLORIS). The resulting hydrological forecasts are eventually communicated to the stakeholders involved in the Sihl discharge management. This fully operational setting provides a real framework to compare the potential of deterministic and probabilistic discharge forecasts for flood mitigation. To study the suitability of HEPS for small-scale basins and to quantify the added-value conveyed by the probability information, a reforecast was made for the period June 2007 to December 2009 for the Sihl catchment (336 km2). Several metrics support the conclusion that the performance gain can be of up to 2 days lead time for the catchment considered. Brier skill scores show that COSMO-LEPS-based hydrological forecasts overall outperform their COSMO-7 based counterparts for all the lead times and event intensities considered. The small size of the Sihl catchment does not prevent skillful discharge forecasts, but makes them particularly dependent on correct precipitation forecasts, as shown by comparisons with a reference run driven by observed meteorological parameters. Our evaluation stresses that the capacity of the model to provide confident and reliable mid-term probability forecasts for high discharges is limited. The two most intense events of the study period are investigated utilising a novel graphical representation of probability forecasts and used to generate high discharge scenarios. They

[Digital gigantism of the foot: a clinical study of 12 cases].

PubMed

Wang, Hai-hua; Tian, Guang-lei; Zhu, Yin; Zhang, You-le; Zhao, Jun-hui; Tian, Wen

2008-03-15

To summarize the clinical characteristic and outcome of digital gigantism of the foot. Retrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis. Seven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair. Digital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

Maternal sepsis: a Scottish population-based case-control study.

PubMed

Acosta, C D; Bhattacharya, S; Tuffnell, D; Kurinczuk, J J; Knight, M

2012-03-01

To describe the risk of maternal sepsis associated with obesity and other understudied risk factors such as operative vaginal delivery. Population-based, case-control study. North NHS region of Scotland. All cases of pregnant, intrapartum and postpartum women with International Classification of Disease-9 codes for sepsis or severe sepsis recorded in the Aberdeen Maternal and Neonatal Databank (AMND) from 1986 to 2009. Four controls per case selected from the AMND were frequency matched on year-of-delivery. Cases and controls were compared; significant variables from univariable regression were adjusted in a multivariable logistic regression model. Dependent variables were uncomplicated sepsis or severe ('near-miss') sepsis. Independent variables were demographic, medical and clinical delivery characteristics. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (95% CI) are reported. Controlling for mode of delivery and demographic and clinical factors, obese women had twice the odds of uncomplicated sepsis (OR 2.12; 95% CI 1.14-3.89) compared with women of normal weight. Age <25 years (OR 5.15; 95% CI 2.43-10.90) and operative vaginal delivery (OR 2.20; 95% CI 1.02-4.87) were also significant predictors of sepsis. Known risk factors for maternal sepsis were also significant in this study (OR for uncomplicated and severe sepsis respectively): multiparity (OR 6.29, 12.04), anaemia (OR 3.43, 18.49), labour induction (OR 3.92 severe only), caesarean section (OR 3.23, 13.35), and preterm birth (OR 2.46 uncomplicated only). Obesity, operative vaginal delivery and age <25 years are significant risk factors for sepsis and should be considered in clinical obstetric care. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Case Studies of Postponement in the Supply Chain

DTIC Science & Technology

2006-06-14

postponement it is still an underutilized strategy across manufacturing. Costs and benefits are sometimes hard to quantify. However, successful case studies...savings in inventory because the value of the product increases through the addition of each successive component. Manufacturing postponement usually...the instrument during the shipment process. Shortly after achieving successful packaging operations, DB initiated another post- ponement strategy in

Implementation of the Chelsea School Project: A Case Study.

ERIC Educational Resources Information Center

Pelavin, Diane; And Others

A case study was done of the Boston University management and operation of the Chelsea (Massachusetts) school system including perceptions of key participants and outcomes of the first year of the partnership. Despite unanticipated levels of hostility between various groups and slow funding, which slowed some first year objectives, the project…

A Case Study of Information Resource Management in the Department of Defense

DTIC Science & Technology

1992-03-01

prepared to make effective decisions in a military environment. The justification for the use of information technology (IT) in support of operations...t ement No PfICt NO [ask No r 11 TITLE (Include Security Classification) A Case Study ofinformation Resourcc Management in the Departnentufl)clelse...block number) FIELD GROUP SUBGROUP Case study,Corporate Information Management, CIM. Information Hesource Munagenitnt IRM 19 ABSTRACT (continue on

The Roles of Decision Makers in Special Operations

DTIC Science & Technology

2016-12-01

question and hypotheses. 9 II. CASE STUDIES A. OPERATION THUNDERBOLT (THE RAID ON ENTEBBE) The Israeli Special Forces’ hostage rescue operation...Operations Warfare, 338. 28 Herzog, “The War Against Terrorism: Entebbe,” 338. 29 Chaitanya Arun Sathe, “A Case Study on Crisis Management with a...Assessment of the Roles of Decision Makers This assessment is based on this case study , and the decision makers’ roles in the three phases of a

Otoplasty: the case for skin incision by higher volume operators.

PubMed

Arkoulis, Nikolaos; Reid, Jenny; Neill, Conor O '; Stewart, Kenneth J

2015-02-01

Prominent ear correction in the paediatric population is a common and popular procedure, with demonstrable benefit in alleviating psychological distress. Posterior cartilage-sparing techniques for otoplasty have been shown to be consistently safer and better than cartilage-scoring alternatives, however excision of the posterior auricular skin during otoplasty, although a common first step, has not been shown to have any benefits over skin incision alone. In this study, we examined the association between skin excision and recurrence of ear prominence, by examining the collective surgical outcomes of five plastic surgeons, performing 118 otoplasties at the Royal Hospital for Sick Children Edinburgh, between January 2011 and December 2013. Recurrence of prominence at the first follow-up appointment (mean follow-up 3.4 months) was 10.2%. Surgeons with low case volumes had significantly higher recurrence rates than high volume operators. There was no statistically significant association between skin excision and recurrence of prominence. We still favour posterior, cartilage-sparing otoplasties, but based on our findings we do not advocate any skin excision at any stage of the procedure. Surgeons should not include paediatric otoplasty in their portfolio unless they are undertaking significant number of cases each year. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Case-mix analysis and variation in rates of non-surgical treatment of older women with operable breast cancer.

PubMed

Morgan, J; Richards, P; Ward, S; Francis, M; Lawrence, G; Collins, K; Reed, M; Wyld, L

2015-08-01

Non-surgical management of older women with oestrogen receptor (ER)-positive operable breast cancer is common in the UK, with up to 40 per cent of women aged over 70 years receiving primary endocrine therapy. Although this may be appropriate for frailer patients, for some it may result in treatment failure, contributing to the poor outcomes seen in this age group. Wide variation in the rates of non-operative management of breast cancer in older women exists across the UK. Case mix may explain some of this variation in practice. Data from two UK regional cancer registries were analysed to determine whether variation in treatment observed between 2002 and 2010 at hospital and clinician level persisted after adjustment for case mix. Expected case mix-adjusted surgery rates were derived by logistic regression using the variables age, proxy Charlson co-morbidity score, deprivation quintile, method of cancer detection, tumour size, stage, grade and node status. Data on 17,129 women aged 70 years or more with ER-positive operable breast cancer were analysed. There was considerable variation in rates of surgery at both hospital and clinician level. Despite adjusting for case mix, this variation persisted at hospital level, although not at clinician level. This study demonstrates variation in selection criteria for older women for operative treatment of early breast cancer, indicating that some older women may be undertreated or overtreated, and may partly explain the inferior disease outcomes in this age group. It emphasizes the urgent need for evidence-based guidelines for treatment selection criteria in older women with breast cancer. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Using RFID Tagging in a Mining Industry Maintenance, Repair, and Operating (MRO) Supply Warehouse: A Case Study

ERIC Educational Resources Information Center

Smith, George D.

2008-01-01

The use of Radio Frequency Identification (RFID) technology has been shown to be successful by reducing operating costs in the retail and manufacturing industries, but has never been considered in the literature for a mining industry maintenance, repair, and operating (MRO) supply chain. This field study was conducted to determine whether or not…

Resonance Frequency Breathing Biofeedback to Reduce Symptoms of Subthreshold PTSD with an Air Force Special Tactics Operator: A Case Study.

PubMed

Petta, Lorene M

2017-06-01

The prevalence rates of post-traumatic stress disorder (PTSD) have been estimated to be several times higher in military populations compared to the national average. Special Tactics operators are a group that is more likely to avoid seeking psychological care due to the stigma and other consequences the diagnosis may have on their military careers. There is a need for more effective and less stigmatizing interventions to treat this population. Psychophysiological methods have been proven to be efficacious in treating PTSD, yet have received less attention as an adjunctive intervention. Resonance frequency (RF) biofeedback is a form of cardiorespiratory intervention that has shown promise as an effective treatment. The current case study examined the use of RF biofeedback in combination with other physiological and evidence-based methods as part of a comprehensive treatment approach. The client showed a significant drop from his initial scores on a screening assessment by the end of treatment, and demonstrated continued progress despite a 3-month break from the therapy. This author proposed that the synergistic effects of the multi-phased treatment approach contributed to the client's progress. Furthermore, a case was made for using multiple techniques when treating subthreshold PTSD and related symptoms within a treatment resistant population.

Evaluation of short-duration unscheduled absences among transit operators : TriMet case study

DOT National Transportation Integrated Search

2009-09-01

This report analyzes factors contributing to short duration (one to three days) unscheduled absences among operators : at TriMet, the transit provider for the Portland, Oregon metropolitan region. The analysis draws on a wide array of : operator-spec...

Evaluation of short-duration, unscheduled absences among transit operators: TriMet case study.

DOT National Transportation Integrated Search

2009-09-01

This report analyzes factors contributing to short duration (one to three days) unscheduled absences among operators at TriMet, the transit provider for the Portland, Oregon metropolitan region. The analysis draws on a wide array of operator-specific...

Emergency Support Function 15 Standard Operating Procedures

DTIC Science & Technology

2013-08-01

learned from numerous incidents to include the BP oil spill, the Fukushima nuclear incident, Hurricane Sandy and the Boston Marathon attack. Guidance is...Staffing  Operations  Activation  Incident Operations  Case Study - 2013 Boston Marathon Bombing  Case Study - 2011 Fukushima Nuclear Crisis...Quick Summary  Radiological Dispersal Device (RDD)  Improvised Nuclear Device (IND)  Federal Response  Case Studies – 2011 Fukushima Nuclear

Applying analysis tools in planning for operations : case study #3 -- using archived data as a tool for operations planning

DOT National Transportation Integrated Search

2009-09-01

More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

Six sigma tools in integrating internal operations of a retail pharmacy: a case study.

PubMed

Kumar, Sameer; Kwong, Anthony M

2011-01-01

This study was initiated to integrate information and enterprise-wide healthcare delivery system issues specifically within an inpatient retail pharmacy operation in a U.S. community hospital. Six Sigma tools were used to examine the effects to an inpatient retail pharmacy service process. Some of the tools used include service blueprints, cause-effect diagram, gap analysis derived from customer and employee surveys, mistake proofing was applied in various business situations and results were analyzed to identify and propose process improvements and integration. The research indicates that the Six Sigma tools in this discussion are very applicable and quite effective in helping to streamline and integrate the pharmacy process flow. Additionally, gap analysis derived from two different surveys was used to estimate the primary areas of focus to increase customer and employee satisfaction. The results of this analysis were useful in initiating discussions of how to effectively narrow these service gaps. This retail pharmaceutical service study serves as a framework for the process that should occur for successful process improvement tool evaluation and implementation. Pharmaceutical Service operations in the U.S. that use this integration framework must tailor it to their individual situations to maximize their chances for success.

Space Shuttle Proximity Operation Sensor Study

NASA Technical Reports Server (NTRS)

Weber, C. L.; Alem, W. K.

1978-01-01

The performance of the Kuband radar was analyzed in detail, and the performance was updated and summarized. In so doing, two different radar design philosophies were described, and the corresponding differences in losses were enumerated. The resulting design margins were determined for both design philosophies and for both the designated and nondesignated range modes of operation. In some cases, the design margin was about zero, and in other cases it was significantly less than zero. With the point of view described above, the recommended solution is to allow more scan time but at the present scan rate. With no other changes in the present configuration, the radar met design detection specifications for all design philosophies at a range of 11.3 nautical miles.

Malaria on a military peacekeeping operation: a case study with no cases.

PubMed

Houston, David J K; Tuck, Jeremy J H

2005-03-01

Malaria continues to be a disease of importance to travelers and the military is no exception. Individual protection measures based on advice, bite avoidance, chemoprophylaxis, and diagnosis are advocated for protection against the disease. However, the military has an additional strand to malaria protection--the chain of command. To describe the experience of a British military deployment where the Force Commander took a proactive approach to malaria protection. In 512 person-weeks of exposure in a theater with high rates of transmission of malaria, with an enduring threat of asymmetric military action and with a proactive approach by the chain of command to the implementation of malaria protection policy, no malaria cases developed. The chain of command can have a significant impact on compliance with malaria protection measures, which might reduce incidence of the disease in the deployed population.

Case Study Teaching

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2011-01-01

This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

NASA's Advanced Multimission Operations System: A Case Study in Formalizing Software Architecture Evolution

NASA Technical Reports Server (NTRS)

Barnes, Jeffrey M.

2011-01-01

All software systems of significant size and longevity eventually undergo changes to their basic architectural structure. Such changes may be prompted by evolving requirements, changing technology, or other reasons. Whatever the cause, software architecture evolution is commonplace in real world software projects. Recently, software architecture researchers have begun to study this phenomenon in depth. However, this work has suffered from problems of validation; research in this area has tended to make heavy use of toy examples and hypothetical scenarios and has not been well supported by real world examples. To help address this problem, I describe an ongoing effort at the Jet Propulsion Laboratory to re-architect the Advanced Multimission Operations System (AMMOS), which is used to operate NASA's deep-space and astrophysics missions. Based on examination of project documents and interviews with project personnel, I describe the goals and approach of this evolution effort and then present models that capture some of the key architectural changes. Finally, I demonstrate how approaches and formal methods from my previous research in architecture evolution may be applied to this evolution, while using languages and tools already in place at the Jet Propulsion Laboratory.

Promoting operational research through fellowships: a case study from the South-East Asia Union Office

PubMed Central

Satyanarayana, S.; Berger, S. Dar; Chadha, S. S.; Singh, R. J.; Lal, P.; Tonsing, J.; Harries, A. D.

2015-01-01

In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) jointly developed a new paradigm for operational research (OR) capacity building and started a new process of appointing and supporting OR fellows in the field. This case study describes 1) the appointment of two OR fellows in The Union South-East Asia Office (USEA), New Delhi, India; 2) how this led to the development of an OR unit in that organisation; 3) achievements over the 5-year period from June 2009 to June 2014; and 4) challenges and lessons learnt. In June 2009, the first OR fellow in India was appointed on a full-time basis and the second was appointed in February 2012—both had limited previous experience in OR. From 2009 to 2014, annual research output and capacity building initiatives rose exponentially, and included 1) facilitation at 61 OR training courses/modules; 2) publication of 96 papers, several of which had a lasting impact on national policy and practice; 3) providing technical assistance in promoting OR; 4) building the capacity of medical college professionals in data management; 5) support to programme staff for disseminating their research findings; 6) reviewing 28 scientific papers for national or international peer-reviewed journals; and 7) developing 45 scientific abstracts for presentation at national and international conferences. The reasons for this success are highlighted along with ongoing challenges. This experience from India provides good evidence for promoting similar models elsewhere. PMID:26400596

Effect of Aggregation Operators on Network-Based Disease Gene Prioritization: A Case Study on Blood Disorders.

PubMed

Grewal, Nivit; Singh, Shailendra; Chand, Trilok

2017-01-01

Owing to the innate noise in the biological data sources, a single source or a single measure do not suffice for an effective disease gene prioritization. So, the integration of multiple data sources or aggregation of multiple measures is the need of the hour. The aggregation operators combine multiple related data values to a single value such that the combined value has the effect of all the individual values. In this paper, an attempt has been made for applying the fuzzy aggregation on the network-based disease gene prioritization and investigate its effect under noise conditions. This study has been conducted for a set of 15 blood disorders by fusing four different network measures, computed from the protein interaction network, using a selected set of aggregation operators and ranking the genes on the basis of the aggregated value. The aggregation operator-based rankings have been compared with the "Random walk with restart" gene prioritization method. The impact of noise has also been investigated by adding varying proportions of noise to the seed set. The results reveal that for all the selected blood disorders, the Mean of Maximal operator has relatively outperformed the other aggregation operators for noisy as well as non-noisy data.

Case-control study of surgical site infections associated with pacemakers and implantable cardioverter-defibrillators.

PubMed

Marschall, Jonas; Hopkins-Broyles, Diane; Jones, Marilyn; Fraser, Victoria J; Warren, David K

2007-11-01

In 2000, the rate of surgical site infections (SSIs) associated with pacemaker and implantable cardioverter-defibrillator (ICD) procedures performed in the cardiothoracic operating rooms of hospital A was 16% (19 of 116 procedures resulted in infections). This study investigates risks for SSI associated with these procedures in the cardiothoracic operating room. Unmatched 1 : 3 case-control study performed over a 12-month period among patients who had undergone implantation of a pacemaker and/or ICD. A standardized observation scrutinized infection control practices in the area where the procedures were performed. The cardiothoracic operating rooms of hospital A, which belongs to a hospital consortium in the midwestern United States. Patients with SSI were identified as case patients. Control patients were chosen from the group of uninfected patients who had procedures performed during the same period as case patients. A total of 19 SSIs associated with pacemaker and ICD procedures were retrospectively identified among the patients who underwent procedures in these cardiothoracic operating rooms. Culture samples were obtained from 7 patients; 2 yielded coagulase-negative Staphylococcus on culture, 2 yielded Staphylococcus aureus, 1 yielded Serratia marcescens, and 2 showed no growth. In the case-control study, age, race, sex, diabetes mellitus, smoking history, timing of antibiotic therapy, and hair removal did not differ significantly between case patients and control patients. Case patients were more likely to have an abdominal device in place (odds ratio [OR], 5.5 [95% confidence interval {CI}, 1.6-19.3]; P=.006) and less likely to have received a new implant (OR 0.3 [95% CI, 0.1-0.8]; P=.02) or to have had new leads placed (OR, 0.2 [95% CI, 0.1-0.6]; P=.003). Abdominal placement of implanted devices was associated with occurrence of an SSI after pacemaker and/or ICD procedures.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 3: Operations technology

NASA Technical Reports Server (NTRS)

Vilja, John O.

1990-01-01

The study was initiated to identify operational problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the OEPSS study were organized into a series of OEPSS Data Books. This volume describes operations technologies that will enhance operational efficiency of propulsion systems. A total of 15 operations technologies were identified that will eliminate or mitigate operations problems described in Volume 2. A recommended development plan is presented for eight promising technologies that will simplify the propulsion system and reduce operational requirements.

Application of underground microseismic monitoring for ground failure and secure longwall coal mining operation: A case study in an Indian mine

NASA Astrophysics Data System (ADS)

Ghosh, G. K.; Sivakumar, C.

2018-03-01

Longwall mining technique has been widely used around the globe due to its safe mining process. However, mining operations are suspended when various problems arise like collapse of roof falls, cracks and fractures propagation in the roof and complexity in roof strata behaviors. To overcome these colossal problems, an underground real time microseismic monitoring technique has been implemented in the working panel-P2 in the Rajendra longwall underground coal mine at South Eastern Coalfields Limited (SECL), India. The target coal seams appears at the panel P-2 within a depth of 70 m to 76 m. In this process, 10 to 15 uniaxial geophones were placed inside a borehole at depth range of 40 m to 60 m located over the working panel-P2 with high rock quality designation value for better seismic signal. Various microseismic events were recorded with magnitude ranging from -5 to 2 in the Richter scale. The time-series processing was carried out to get various seismic parameters like activity rate, potential energy, viscosity rate, seismic moment, energy index, apparent volume and potential energy with respect to time. The used of these parameters helped tracing the events, understanding crack and fractures propagation and locating both high and low stress distribution zones prior to roof fall occurrence. In most of the cases, the events were divided into three stage processes: initial or preliminary, middle or building, and final or falling. The results of this study reveal that underground microseismic monitoring provides sufficient prior information of underground weighting events. The information gathered during the study was conveyed to the mining personnel in advance prior to roof fall event. This permits to take appropriate action for safer mining operations and risk reduction during longwall operation.

[The case-case-time-control study design].

PubMed

Wang, Jing; Zhuo, Lin; Zhan, Siyan

2014-12-01

Although the 'self-matched case-only studies' (such as the case-cross-over or self-controlled case-series method) can control the time-invariant confounders (measured or unmeasured) through design of the study, however, they can not control those confounders that vary with time. A bidirectional case-crossover design can be used to adjust the exposure-time trends. In the areas of pharmaco-epidemiology, illness often influence the future use of medications, making a bidirectional study design problematic. Suissa's case-time-control design combines the case-crossover and the case-control design which could adjust for exposure-trend bias, but the control group may reintroduce selection bias, if the matching does not go well. We propose a "case-case-time-control" design which is an extension of the case-time-control design. However, rather than using a sample of external controls, we choose those future cases as controls for current cases to counter the bias that arising from temporal trends caused by exposure to the target of interest. In the end of this article we will discuss the strength and limitations of this design based on an applied example.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved

[Clinical evaluation on the operation of the deviated nose and the deviated nasal septum with the plastic operation--report of 268 cases].

PubMed

Wang, Gang; Liu, Liu; Li, Fang

2011-04-01

To explore the feasibility of combination plastic operation on the deviation nose and the deviation nasal septum. Design the butterfly cut from the root of the columella nasi to the middle part of each alae nasi. So that the nasal septum, the cartilage septodorsalis and the nose bones could be exposed well. It was key to separate and fix the arch keystone area in the plastic operation of the deviation nose. It was key to separate septal cartilage of nose from the perpendicular plate of ethmoid bone and maxilla nose pun in plastic operation of the deviation nasal septum. Pack the vaseline oil gauze or chitosan reshaping PVA into two side of nasal cavity in order to internal fixation of nasal cavity and prevent the hematoma of nasal septum. The vaseline oil gauze can be pull out on the morning and on the afternoon 24 hours after which can reduce the pain. The external fixation of nasal cavity is not important to which can be omitted. Two hundred and sixty-eight cases after 6 to 24 months follow-up. Two hundred and twenty-eight cases were satisfied. None was unsatisfied. The combination plastic operation on the deviation nose and the deviation nasal septum, could cope with both the beauty problem and reconstruct the nose function.

Energy management study: A proposed case of government building

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

2015-05-01

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

Operating room clinicians' ratings of workload: a vignette simulation study.

PubMed

Wallston, Kenneth A; Slagle, Jason M; Speroff, Ted; Nwosu, Sam; Crimin, Kimberly; Feurer, Irene D; Boettcher, Brent; Weinger, Matthew B

2014-06-01

Increased clinician workload is associated with medical errors and patient harm. The Quality and Workload Assessment Tool (QWAT) measures anticipated (pre-case) and perceived (post-case) clinical workload during actual surgical procedures using ratings of individual and team case difficulty from every operating room (OR) team member. The purpose of this study was to examine the QWAT ratings of OR clinicians who were not present in the OR but who read vignettes compiled from actual case documentation to assess interrater reliability and agreement with ratings made by clinicians involved in the actual cases. Thirty-six OR clinicians (13 anesthesia providers, 11 surgeons, and 12 nurses) used the QWAT to rate 6 cases varying from easy to moderately difficult based on actual ratings made by clinicians involved with the cases. Cases were presented and rated in random order. Before rating anticipated individual and team difficulty, the raters read prepared clinical vignettes containing case synopses and much of the same written case information that was available to the actual clinicians before the onset of each case. Then, before rating perceived individual and team difficulty, they read part 2 of the vignette consisting of detailed role-specific intraoperative data regarding the anesthetic and surgical course, unusual events, and other relevant contextual factors. Surgeons had higher interrater reliability on the QWAT than did OR nurses or anesthesia providers. For the anticipated individual and team workload ratings, there were no statistically significant differences between the actual ratings and the ratings obtained from the vignettes. There were differences for the 3 provider types in perceived individual workload for the median difficulty cases and in the perceived team workload for the median and more difficult cases. The case difficulty items on the QWAT seem to be sufficiently reliable and valid to be used in other studies of anticipated and perceived clinical

Behavioral Treatment of Hysterical Coughing and Mutism: A Case Study

ERIC Educational Resources Information Center

Munford, Paul R.; And Others

1976-01-01

This case study demonstrates the value of conceptualizing functional somatic disorders as operants. The subject, an adolescent girl, diagnosed as having a "hysterical neurosis," manifested the symptoms of incessant coughing and mutism. The cough and mutism were treated by extinction and shaping, respectively. Positive results were obtained.…

Audit of the Functioning of the Elective Neurosurgical Operation Theater in India: A Prospective Study and Review of Literature.

PubMed

Saikia, Amrit Kumar; Sriganesh, Kamath; Ranjan, Manish; Claire, Marie; Mittal, Mohit; Pandey, Paritosh

2015-08-01

Knowledge about the utilization of the operation theater (OT) is essential to improve its efficiency. This study evaluated the neurosurgical operation theater utilization in a neurosciences teaching hospital. Data collected included OT start time, delay in start, anesthesia induction time, surgical preparation time, anesthesia recovery time, operating time, time between cases, and theater closing time. Five hundred thirty-seven surgeries were performed during the study period. The percentage of time used for anesthesia induction, actual surgical procedure, recovery from anesthesia, and theater preparation between the two cases were 8%, 70%, 6% and 5%, respectively. Fourteen percent of scheduled cases were cancelled. On 220 occasions (70.51%), theater was over-run. Late start contributed to loss of 8370 minutes (140 hours) of theater time. This study identified the proportion of time spent on each activity in the neurosurgical OT. This knowledge is likely to facilitate better planning of neurosurgical theater schedule and result in optimal utilization. Copyright © 2015 Elsevier Inc. All rights reserved.

Landfill mining: Case study of a successful metals recovery project.

PubMed

Wagner, Travis P; Raymond, Tom

2015-11-01

Worldwide, the generation of municipal solid waste (MSW) is increasing and landfills continue to be the dominant method for managing solid waste. Because of inadequate diversion of reusable and recoverable materials, MSW landfills continue to receive significant quantities of recyclable materials, especially metals. The economic value of landfilled metals is significant, fostering interest worldwide in recovering the landfilled metals through mining. However, economically viable landfill mining for metals has been elusive due to multiple barriers including technological challenges and high costs of processing waste. The objective of this article is to present a case study of an economically successful landfill mining operation specifically to recover metals. The mining operation was at an ashfill, which serves a MSW waste-to-energy facility. Landfill mining operations began in November 2011. Between December 2011 and March 2015, 34,352 Mt of ferrous and non-ferrous metals were recovered and shipped for recycling, which consisted of metals >125 mm (5.2%), 50-125 mm (85.9%), <50mm (3.4%), zorba (4.6%), and mixed products (0.8%). The conservative estimated value of the recovered metal was $7.42 million. Mining also increased the landfill's airspace by 10,194 m(3) extending the life of the ashfill with an estimated economic value of $267,000. The estimated per-Mt cost for the extraction of metal was $158. This case study demonstrates that ashfills can be profitably mined for metals without financial support from government. Although there are comparatively few ashfills, the results and experience obtained from this case study can help foster further research into the potential recovery of metals from raw, landfilled MSW. Copyright © 2015 Elsevier Ltd. All rights reserved.

Operating room management and operating room productivity: the case of Germany.

PubMed

Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

2008-09-01

We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

From R&D to end users applications in operational oceanography: The navy's "SOAP" case study

NASA Astrophysics Data System (ADS)

Giraud Saint-Albin, S.; Jourdan, D.

2003-04-01

For the last ten years, the CMO/BRESM has conducted an operational program for Ocean Analysis and Prediction SOAP, whose goal has been to support sea activities with high resolution mesoscale ocean nowcast products. Successive prototypes have been generated, operated and improved in tandem with a continuous re-evaluation of Navy Needs. This strategy played a key-role in defining the concept of “real-time integrated oceanography” which relies on remote and in situ ocean observations, (a hierarchy of) ocean models and data assimilation methods. The paper focuses on the results of the latter feasability study for next SOAP prototype: the military motivation for developing new prototypes is to extend the application domain of SOAP operational products from the operative (~ a description of the synoptic scale) to the tactical ( ~ a tailored product to strategic needs) relevance. Current SOAP P2 system is as a transition system pulled by end-user’s requirements and designed by research oceanographers from existing tools and models. The development of SOAP P3 has just started and will benefit from the emergence of an increasing offer of ocean modelling results, pushed by the GODAE initiative. It will be based on MERCATOR high resolution prototypes. From that starting point future developments will have to address both issues of defense specific requirements for high resolution ocean modeling and computation of relevant acoustical products for military applications. Especially, the crucial needs for assessing the end-users’ products reliability should be explored.

Operationally efficient propulsion system study (OEPSS) data book. Volume 6; Space Transfer Propulsion Operational Efficiency Study Task of OEPSS

NASA Technical Reports Server (NTRS)

Harmon, Timothy J.

1992-01-01

This document is the final report for the Space Transfer Propulsion Operational Efficiency Study Task of the Operationally Efficient Propulsion System Study (OEPSS) conducted by the Rocketdyne Division of Rockwell International. This Study task studied, evaluated and identified design concepts and technologies which minimized launch and in-space operations and optimized in-space vehicle propulsion system operability.

Systems Engineering Case Studies, Synopsis of the Learning Principles

DTIC Science & Technology

2009-08-24

TBMCS refers to the Theater Battle Management Core System Systems Engineering Case Study Peacekeeper refers to the Peacekeeper Intercontinental...primary mirror defect going to orbit undetected in spite of substantial evidence that could have been used to prevent this occurrence. TBMCS /1...The requirements baseline was volatile up to system acceptance, which took place after TBMCS passed operational test and evaluation. Approved for

[Case and studies].

PubMed

Schubert, András

2015-11-15

Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

Operative reports: form and function.

PubMed

Stewart, Lygia; Hunter, John G; Wetter, Alberto; Chin, Brian; Way, Lawrence W

2010-09-01

Little is known about how closely operative reports reflect what was actually performed during an operation, nor has the construction of operative reports been adequately studied with the aims of clarifying the objectives of those reports and improving their efficacy. We hypothesized that if more attention is paid to the objectives of operative reports, their content will more predictably contain the most relevant information, which might channel thinking in beneficial directions during performance of the operation. Multivariate analysis of 250 laparoscopic cholecystectomy operative reports (125 uncomplicated and 125 with bile duct injury). Academic research. University (105 cases) and community (145 cases) hospitals. Variations in content and design of operative reports. Cognitive task analysis of laparoscopic cholecystectomy was conducted, and a model operative report was generated and compared with the actual operative reports. Descriptions of key elements in adequate dissection of the Calot triangle were present in 24.8% and 0.0% of operative reports from uncomplicated and bile duct injury cases, respectively. Thorough dissection of the Calot triangle, identification of the cystic duct-infundibulum junction, and lateral retraction of the infundibulum correlated with uncomplicated cases, while irregular cues (eg, perceived anatomic or other deviations) correlated with bile duct injury cases. Current practice generates operative reports that vary widely in content and too often omit important elements. This research suggests that the construction of operative reports should be constrained such that the reports routinely include the fundamental goals of the operation and what was performed to meet them. Cognitive task analysis is based on the ways the mind controls the performance of tasks; it is an excellent method for determining the extra content needed in operative reports. The resulting designs should also serve as mental guidelines to facilitate learning and

Corps G-2 Staff Competencies: A Desert Storm Case Study

DTIC Science & Technology

2017-06-09

processing and exploiting new information or produce updated analytic products for dissemination. 43 Intelligence Operations The corps directs IO by...CORPS G-2 STAFF COMPETENCIES: A DESERT STORM CASE STUDY A thesis presented to the Faculty of the US Army Command and General Staff...College in partial fulfillment of the requirements for the degree MASTER OF MILITARY ART AND SCIENCE General Studies by ERIK W

Making intelligent systems team players: Additional case studies

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

1993-01-01

Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study

PubMed Central

Mattioli, Stefano; Baldasseroni, Alberto; Bovenzi, Massimo; Curti, Stefania; Cooke, Robin MT; Campo, Giuseppe; Barbieri, Pietro G; Ghersi, Rinaldo; Broccoli, Marco; Cancellieri, Maria Pia; Colao, Anna Maria; dell'Omo, Marco; Fateh-Moghadam, Pirous; Franceschini, Flavia; Fucksia, Serenella; Galli, Paolo; Gobba, Fabriziomaria; Lucchini, Roberto; Mandes, Anna; Marras, Teresa; Sgarrella, Carla; Borghesi, Stefano; Fierro, Mauro; Zanardi, Francesca; Mancini, Gianpiero; Violante, Francesco S

2009-01-01

Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Methods Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. Results At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. Conclusion This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS. PMID:19758429

Energy management study: A proposed case of government building

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

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount ofmore » energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.« less

A case-control study of bladder cancer in the United States rubber and tyre industry.

PubMed

Checkoway, H; Smith, A H; McMichael, A J; Jones, F S; Monson, R R; Tyroler, H A

1981-08-01

A case-control study of bladder cancer was conducted in five United States rubber and tyre companies to determine if there were high-risk jobs and work areas within the industry. The study included 220 male cases of bladder cancer, of whom 107 were identified from hospital record reviews and 113 from death certificates. Each case was matched individually with two industry controls by sex, race, year of birth, and company. One control was matched additionally by year of hire and duration of employment. Comparisons of cases and controls not matched by year of hire and age of hire showed no differences for those variables, which suggests that age and calendar period of first exposure to the industry were not risk determinants. When the work histories of both cases and controls were contrasted it was found that cases were more likely than controls to have worked in milling (odds ratio (OR) = 1.91) and calender operation (OR = 2.21) jobs. The relative risk estimates for milling and calender operation both exhibited linear trends of increase with duration of exposure. Milling and calender operation jobs entail potential exposures to volatilised reaction products from heated rubber stock. A better understanding of aetiological associations with job type will require more detailed characterisation of the work environment with regard to the sources and levels of aromatic amines and other suspected bladder carcinogens.

A case-control study of bladder cancer in the United States rubber and tyre industry.

PubMed Central

Checkoway, H; Smith, A H; McMichael, A J; Jones, F S; Monson, R R; Tyroler, H A

1981-01-01

A case-control study of bladder cancer was conducted in five United States rubber and tyre companies to determine if there were high-risk jobs and work areas within the industry. The study included 220 male cases of bladder cancer, of whom 107 were identified from hospital record reviews and 113 from death certificates. Each case was matched individually with two industry controls by sex, race, year of birth, and company. One control was matched additionally by year of hire and duration of employment. Comparisons of cases and controls not matched by year of hire and age of hire showed no differences for those variables, which suggests that age and calendar period of first exposure to the industry were not risk determinants. When the work histories of both cases and controls were contrasted it was found that cases were more likely than controls to have worked in milling (odds ratio (OR) = 1.91) and calender operation (OR = 2.21) jobs. The relative risk estimates for milling and calender operation both exhibited linear trends of increase with duration of exposure. Milling and calender operation jobs entail potential exposures to volatilised reaction products from heated rubber stock. A better understanding of aetiological associations with job type will require more detailed characterisation of the work environment with regard to the sources and levels of aromatic amines and other suspected bladder carcinogens. PMID:7272236

What Makes for Successful Speaker-Listener Technique? Two Case Studies

ERIC Educational Resources Information Center

Wood, Mary R.

2010-01-01

This article reviews some of the controversy surrounding the use and effectiveness of active listening or the Speaker-Listener Technique (SL) in relational counseling. The purpose and function of SL is described and two case studies are presented to illustrate how SL operates in a therapeutic setting and how the outcomes can vary. These case…

A Collection of JPME Operational Contract Support Case Studies and Vignettes

DTIC Science & Technology

2016-12-01

Contracting for goods and services in the contingency operational environment is a mission-enabling necessity; however, analyzing the strategic effects...choosing to contract for goods or services are largely ignored. This project explores the use of OCS in contingency environments, and the positive and...think of the costs literally, as tax dollars spent to enhance mission effectiveness. However, the less literal costs and the associated effects of

Hexavalent chromium emissions from aerospace operations: A case study

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

Chaurushia, A.; Bajza, C.

1994-12-31

Northrop Aircraft Division (NAD) is subject to several air toxic regulations such as EPA SARA Title 3, California Assembly Bill 2588 (AB2588), and Proposition 65 and is a voluntary participant in air toxic emissions reduction programs such as the EPA 33/50 and MERIT Program. To quantify emissions, NAD initially followed regulatory guidelines which recommend that emission inventories of air toxics be based on engineering assumptions and conservative emission factors in absence of specific source test data. NAD was concerned that Chromium VI emissions from NAD`s spray coating and chemical tank line operations were not representative due to these techniques. Moremore » recently, NAD has relied upon information from its ongoing source testing program to determine emission rates of Chromium VI. Based on these source test results, NAD revised emission calculations for use in Chromium VI inventories, impact assessments and control strategies. NAD has been successful in demonstrating a significant difference between emissions calculated utilizing the source test results and emissions based on the traditional mass balance using agency suggested methods.« less

[Non-operation management of 12 cases with brain abscess demonstrated by CT scan].

PubMed

Long, J

1990-12-01

This paper reported 12 cases with brain abscess demonstrated by CT scan. Using antibiotic management without surgical intervention, in 10 cases the curative effects were satisfactory. The paper indicated that CT scan was very useful in prompt and correct diagnosis of brain abscess and with sequential CT scan medical therapy was feasible. It is significant in treatment of brain abscess especially for the patients who have a poor general condition, have the brain abscess located in important functional area or have multiple abscesses so that the operation is difficult for them.

Using the Internship as a Tool for Assessment: A Case Study.

ERIC Educational Resources Information Center

Graham, Beverly; Bourland-Davis, Pamela G.; Fulmer, Hal W.

1997-01-01

States communication programs are expected to operate in some harmony with communication activities of organizations outside the university in professional settings. Describes one possible activity in this matrix: use of student internships as a means of assessing the communication program. Presents a case study involving public relations…

Retrospective testing and case series study of porcine delta coronavirus in U.S. swine herds.

PubMed

McCluskey, Brian J; Haley, Charles; Rovira, Albert; Main, Rodger; Zhang, Yan; Barder, Sunny

2016-01-01

Porcine deltacoronavirus (PDCoV) was first reported in the United States (US) in February 2014. This was the second novel swine enteric coronavirus detected in the US since May 2013. In this study, we conducted retrospective testing of samples submitted to three veterinary diagnostic laboratories where qualifying biological samples were derived from previously submitted diagnostic case submissions from US commercial swine farms with a clinical history of enteric disease or from cases that had been previously tested for transmissible gastroenteritis virus, PEDV, or rotavirus. Overall, 2286 banked samples were tested from 27 States. Samples were collected in 3 separate years and in 17 different months. Test results revealed 4 positive samples, 3 collected in August 2013 and 1 collected in October 2013. In addition, a case series including 42 operations in 10 States was conducted through administration of a survey. Survey data collected included information on characteristics of swine operations that had experienced PDCoV clinical signs. Special emphasis was placed on obtaining descriptive estimates of biosecurity practices and disease status over time of each operation. Clinical signs of PDCoV were reported to be similar to those of PEDV. The average number of animals on each operation exhibiting clinical signs (morbidity) and the average number of case fatalities was greatest for suckling and weaned pigs. Average operation-level weaned pig morbidity was greatest in the first week of the outbreak while average operation-level suckling pig case fatality was greatest in the second week of the outbreak. The survey included questions regarding biosecurity practices for visitors and operation employees; trucks, equipment and drivers; and feed sources. These questions attempted to identify a likely pathway of introduction of PDCoV onto the operations surveyed. Published by Elsevier B.V.

IUS/TUG orbital operations and mission support study. Volume 3: Space tug operations

NASA Technical Reports Server (NTRS)

1975-01-01

A study was conducted to develop space tug operational concepts and baseline operations plan, and to provide cost estimates for space tug operations. Background data and study results are presented along with a transition phase analysis (the transition from interim upper state to tug operations). A summary is given of the tug operational and interface requirements with emphasis on the on-orbit checkout requirements, external interface operational requirements, safety requirements, and system operational interface requirements. Other topics discussed include reference missions baselined for the tug and details for the mission functional flows and timelines derived for the tug mission, tug subsystems, tug on-orbit operations prior to the tug first burn, spacecraft deployment and retrieval by the tug, operations centers, mission planning, potential problem areas, and cost data.

At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.

PubMed

Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

2017-11-01

Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. The important mathematical parameter for the prior observations is the percentage of surgeon lists of elective cases that include 1 or 2 cases; "list" meaning a combination of surgeon, hospital, and date. We measure the incidence among many hospitals. Observational cohort study. 117 hospitals in Iowa from July 2013 through September 2015. Surgeons with same identifier among hospitals. Surgeon lists of cases including at least one outpatient surgical case, so that Relative Value Units (RVU's) could be measured. Averaging among hospitals in Iowa, more than half of the surgeons' lists included 1 or 2 cases (77%; P<0.00001 vs. 50%). Approximately half had 1 case (54%; P=0.0012 vs. 50%). These percentages exceeded 50% even though nearly all the surgeons operated at just 1 hospital on days with at least 1 case (97.74%; P<0.00001 vs. 50%). The cases were not of long durations; among the 82,928 lists with 1 case, the median was 6 intraoperative RVUs (e.g., adult inguinal herniorrhaphy). Accurate confidence intervals for raw or adjusted utilizations are so wide for individual surgeons that decisions based on utilization are equivalent to decisions based on random error. The implication of the current study is generalizability of that finding from the largest teaching hospital in the state to the other hospitals in the state. Copyright © 2017 Elsevier Inc. All rights reserved.

Supply chain analysis of e-tailing versus retailing operation - a case study

NASA Astrophysics Data System (ADS)

Kumar, Sameer; Tiffany, Maryellen; Vaidya, Salil

2016-07-01

The swift growth of e-commerce or e-tailing as a consumer retail channel has made it a serious competitor to traditional retail channels and is changing consumers' purchasing behaviour. The purpose of this case study, based on Target and Amazon.com, is to analyse the attributes of traditional retailing, e-tailing, and hybrid supply chain models to form conclusions about the feasibility of an idealised supply chain model for the future. An integrated and generalised modelling framework is used that incorporates Six Sigma - define, measure, analyse, improve, control methodology leveraging various tools, including process flow maps, cause and effect diagram, performance efficiency metrics, failure mode and effects analysis (FMEA), and Monte Carlo simulation. Based on this analysis and research, the conclusion is that the idealised supply chain of the future may evolve into a hybrid supply chain, which includes both e-tail and retail channels. The main recommendations from this study include assessing the risks of migrating to such a hybrid supply chain and to leverage the recommended actions provided in the hybrid FMEA. To facilitate more effective and mature processes, this study can guide researchers in exhaustive empirical evaluations of hybrid supply chains, gather experiences and lessons learned for practitioners.

Metropolitan transportation management center : a case study : COMPASS : effectively managing traffic and incidents

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of the Downsview, Ontario transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting ...

IUS/TUG orbital operations and mission support study. Volume 2: Interim upper stage operations

NASA Technical Reports Server (NTRS)

1975-01-01

Background data and study results are presented for the interim upper stage (IUS) operations phase of the IUS/tug orbital operations study. The study was conducted to develop IUS operational concepts and an IUS baseline operations plan, and to provide cost estimates for IUS operations. The approach used was to compile and evaluate baseline concepts, definitions, and system, and to use that data as a basis for the IUS operations phase definition, analysis, and costing analysis. Both expendable and reusable IUS configurations were analyzed and two autonomy levels were specified for each configuration. Topics discussed include on-orbit operations and interfaces with the orbiter, the tracking and data relay satellites and ground station support capability analysis, and flight control center sizing to support the IUS operations.

Geomechanical Assessments of Simultaneous Operation in the Case of Transition from Open Pit to Underground Mine in Vietnam

NASA Astrophysics Data System (ADS)

Niedbalski, Zbigniew; Nguyen, Phu Minh Vuong; Widzyk-Capehart, Eleonora

2018-03-01

Nowadays, for a number of reasons, many open pit mines are considering a transition from Open Pit (OP) to Underground (UG) to remain competitive. In OP-UG transition, UG operation is operated simultaneously with the OP operation for a certain period of time. Guidelines for the simultaneous operation of OP and UG are very difficult to establish, as there are very few case studies available. Yet, because of the OP-UG interactions; the operation has a higher safety, technical and management requirements than the OP or UG methods when considered separately. In Vietnam, Cao Son is one of many OP mines, which decided to change the operational system from OP to UG. Simultaneous operation started in 2015 and will be conducted until 2030 when the OP mine Cao Son ends its mining activities. In this paper, selected geomechanical considerations of the simultaneous operation are presented. A number of numerical modelling calculations using finitedifference software with code FLAC were carried out for calibration process, slope stability analysis and the OP-UG interaction analysis for the Cao Son - Khe Cham II-IV mine. Based on the results obtained from numerical modelling, the geomechanical assessments of simultaneous operation Cao Son - Khe Cham II-IV are discussed in this paper.

Field and modeling framework and case study of truck weigh station operations

DOT National Transportation Integrated Search

2002-01-01

Weigh-in-Motion (WIM) systems improve the capacity of weigh station operations significantly by screening trucks while traveling at high speeds and only requiring trucks within a threshold of a maximum permissible gross of axle weight to be weighed o...

Quantifying VOC emissions from polymers: A case study

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

Schulze, J.K.; Qasem, J.S.; Snoddy, R.

1996-12-31

Evaluating residual volatile organic compound emissions emanating from low-density polyethylene can pose significant challenges. These challenges include quantifying emissions from: (a) multiple process lines with different operating conditions; (b) several different comonomers; (c) variations of comonomer content in each grade; and (d) over 120 grades of LDPE. This presentation is a Case Study outlining a project to develop grade-specific emission data for low-density polyethylene pellets. This study included extensive laboratory analyses and required the development of a relational database to compile analytical results, calculate the mean concentration and standard deviation, and generate emissions reports.

An operational hydrological ensemble prediction system for the city of Zurich (Switzerland): skill, case studies and scenarios

NASA Astrophysics Data System (ADS)

Addor, N.; Jaun, S.; Fundel, F.; Zappa, M.

2011-07-01

The Sihl River flows through Zurich, Switzerland's most populated city, for which it represents the largest flood threat. To anticipate extreme discharge events and provide decision support in case of flood risk, a hydrometeorological ensemble prediction system (HEPS) was launched operationally in 2008. This model chain relies on limited-area atmospheric forecasts provided by the deterministic model COSMO-7 and the probabilistic model COSMO-LEPS. These atmospheric forecasts are used to force a semi-distributed hydrological model (PREVAH), coupled to a hydraulic model (FLORIS). The resulting hydrological forecasts are eventually communicated to the stakeholders involved in the Sihl discharge management. This fully operational setting provides a real framework with which to compare the potential of deterministic and probabilistic discharge forecasts for flood mitigation. To study the suitability of HEPS for small-scale basins and to quantify the added-value conveyed by the probability information, a reforecast was made for the period June 2007 to December 2009 for the Sihl catchment (336 km2). Several metrics support the conclusion that the performance gain can be of up to 2 days lead time for the catchment considered. Brier skill scores show that overall COSMO-LEPS-based hydrological forecasts outperforms their COSMO-7-based counterparts for all the lead times and event intensities considered. The small size of the Sihl catchment does not prevent skillful discharge forecasts, but makes them particularly dependent on correct precipitation forecasts, as shown by comparisons with a reference run driven by observed meteorological parameters. Our evaluation stresses that the capacity of the model to provide confident and reliable mid-term probability forecasts for high discharges is limited. The two most intense events of the study period are investigated utilising a novel graphical representation of probability forecasts, and are used to generate high discharge

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.

Seasat-A ASVT: Commercial demonstration experiments. Results analysis methodology for the Seasat-A case studies

NASA Technical Reports Server (NTRS)

1979-01-01

The SEASAT-A commercial demonstration program ASVT is described. The program consists of a set of experiments involving the evaluation of a real time data distributions system, the SEASAT-A user data distribution system, that provides the capability for near real time dissemination of ocean conditions and weather data products from the U.S. Navy Fleet Numerical Weather Central to a selected set of commercial and industrial users and case studies, performed by commercial and industrial users, using the data gathered by SEASAT-A during its operational life. The impact of the SEASAT-A data on business operations is evaluated by the commercial and industrial users. The approach followed in the performance of the case studies, and the methodology used in the analysis and integration of the case study results to estimate the actual and potential economic benefits of improved ocean condition and weather forecast data are described.

Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough?

PubMed

Malhotra, Monika; Sharma, Jai Bhagwan; Wadhwa, Leena; Arora, Raksha

2004-08-01

To assess the glove perforation rate, efficacy of double gloving, effect of duration of surgery, expertise of surgeon and operative urgency on the glove perforation rate in obstetrical and gynecologic operations. From February to September 2002, double glove protocol was made necessary for all major obstetrical and gynecologic procedures. The operating surgeon, first and second assistant were included in the study. Gloves damage was noted (overt by inspection, occult by hydroinsufflation technique). Of the 156 procedures included in study, 32 procedures were performed (all emergency operations) single-gloved because surgeons found double gloving clumsy (56%), made it difficult to tie knots due to lack of dexterity (24%), or were too tight (20%). One thousand one hundred and twenty single gloves were examined after each procedure by hydroinsufflation. The overall perforation rate was 13.6% (single versus double outer gloves, 13.8% versus l3.2%, P > 0.05). Matching perforations were found in six cases (4.6%). Thus, the protection offered by double gloves was 95.4% even if the outer gloves were perforated. Four inner gloves had preexisting perforations. Sixty unused gloves checked similarly revealed a perforation rate of 1.6%. Emergency cases had higher perforation rate compared to elective surgeries (16.6% versus 10.8%, P < 0.00 1). Surgeries lasting for more than 40 min had a higher perforation rate compared to those finished in less than or equal to 40 min (18.6% versus 7.6%, P < 0.001). The middle finger of the left hand was the most commonly involved. The surgeon, first assistant and second assistant were involved in 73.6, 23.3 and 3.2% cases, respectively. Double gloving offers considerable protection against exposure to contaminants in the blood and body fluids of the patient and should be made routine, especially in developing countries where HIV, hepatitis B and C are widely prevalent. Double gloving should be made mandatory in emergency procedures, which

Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency.

PubMed

Abouleish, Amr E; Dexter, Franklin; Epstein, Richard H; Lubarsky, David A; Whitten, Charles W; Prough, Donald S

2003-04-01

Determination of operating room (OR) block allocation and case scheduling is often not based on maximizing OR efficiency, but rather on tradition and surgeon convenience. As a result, anesthesiology groups often incur additional labor costs. When negotiating financial support, heads of anesthesiology departments are often challenged to justify the subsidy necessary to offset these additional labor costs. In this study, we describe a method for calculating a statistically sound estimate of the excess labor costs incurred by an anesthesiology group because of inefficient OR allocation and case scheduling. OR information system and anesthesia staffing data for 1 yr were obtained from two university hospitals. Optimal OR allocation for each surgical service was determined by maximizing the efficiency of use of the OR staff. Hourly costs were converted to dollar amounts by using the nationwide median compensation for academic and private-practice anesthesia providers. Differences between actual costs and the optimal OR allocation were determined. For Hospital A, estimated annual excess labor costs were $1.6 million (95% confidence interval, $1.5-$1.7 million) and $2.0 million ($1.89-$2.05 million) when academic and private-practice compensation, respectively, was calculated. For Hospital B, excess labor costs were $1.0 million ($1.08-$1.17 million) and $1.4 million ($1.32-1.43 million) for academic and private-practice compensation, respectively. This study demonstrates a methodology for an anesthesiology group to estimate its excess labor costs. The group can then use these estimates when negotiating for subsidies with its hospital, medical school, or multispecialty medical group. We describe a new application for a previously reported statistical method to calculate operating room (OR) allocations to maximize OR efficiency. When optimal OR allocations and case scheduling are not implemented, the resulting increase in labor costs can be used in negotiations as a

A Study and Model of Operating Level Financial Management Philosophy Under RMS.

DTIC Science & Technology

The lack of financial management education has prevented base level managers from using PRIME data as intended. This study examines the Air Force...operating level financial management philosophy before and after PRIME and the environment of PRIME adoption. A model in the form of two case problems...with solutions is created to portray the financial management concepts under PRIME to help educate base level Air Force logistic managers. The model

[Surgery in aged patients: a study on 476 surgical cases].

PubMed

Guglielminetti, D; Angelini, L; Pasi, L; Carosi, V

1990-06-01

The Authors report their experience from 1984 to 1989 with surgery in the elderly. Patients aged 75 years were considered as geriatric and entered the study. Mortality and morbidity rates were analysed in 476 cases operated. Pre-existent diseases were related to postoperative complications. The Authors conclude underlining the feasibility of geriatric surgery as well as the acceptable risk rate.

Operation Joint Endeavor in Bosnia: telemedicine systems and case reports.

PubMed

Calcagni, D E; Clyburn, C A; Tomkins, G; Gilbert, G R; Cramer, T J; Lea, R K; Ehnes, S G; Zajtchuk, R

1996-01-01

For the last several years the U.S. Department of Defense (DoD) has operated a telemedicine test bed at the U.S. Army Medical Research and Material Command's Medical Advanced Technology Management Office. The goal of this test bed is to reengineer the military health service system from the most forward deployed forces to tertiary care teaching medical centers within the United States by exploiting emerging telemedicine technologies. The test bed has conducted numerous proof-of-concept telemedicine demonstrations as part of military exercises and in support of real-world troop deployments. The most ambitious of those demonstrations is Primetime III, an ongoing effort to provide telemedicine and other advanced technology support to medical units supporting Operation Joint Endeavor in Bosnia. Several of the first instances of the clinical use of the Primetime III systems are presented as case reports in this paper. These reports demonstrate capabilities and limitations of telemedicine. The Primetime III system demonstrates the technical ability to provide current telecommunications capabilities to medical units stationed in the remote, austere, difficult-to-serve environment of Bosnia. Telemedicine capabilities cannot be used without adequate training, operations, and sustainment support. Video consultations have eliminated the need for some evacuations. The system has successfully augmented the clinical capability of physicians assigned to these medical units. Fullest clinical utilization of telemedicine technologies requires adjustment of conventional clinical practice patterns.

Space station operating system study

NASA Technical Reports Server (NTRS)

Horn, Albert E.; Harwell, Morris C.

1988-01-01

The current phase of the Space Station Operating System study is based on the analysis, evaluation, and comparison of the operating systems implemented on the computer systems and workstations in the software development laboratory. Primary emphasis has been placed on the DEC MicroVMS operating system as implemented on the MicroVax II computer, with comparative analysis of the SUN UNIX system on the SUN 3/260 workstation computer, and to a limited extent, the IBM PC/AT microcomputer running PC-DOS. Some benchmark development and testing was also done for the Motorola MC68010 (VM03 system) before the system was taken from the laboratory. These systems were studied with the objective of determining their capability to support Space Station software development requirements, specifically for multi-tasking and real-time applications. The methodology utilized consisted of development, execution, and analysis of benchmark programs and test software, and the experimentation and analysis of specific features of the system or compilers in the study.

Open-Source as a strategy for operational software - the case of Enki

NASA Astrophysics Data System (ADS)

Kolberg, Sjur; Bruland, Oddbjørn

2014-05-01

Since 2002, SINTEF Energy has been developing what is now known as the Enki modelling system. This development has been financed by Norway's largest hydropower producer Statkraft, motivated by a desire for distributed hydrological models in operational use. As the owner of the source code, Statkraft has recently decided on Open Source as a strategy for further development, and for migration from an R&D context to operational use. A current cooperation project is currently carried out between SINTEF Energy, 7 large Norwegian hydropower producers including Statkraft, three universities and one software company. Of course, the most immediate task is that of software maturing. A more important challenge, however, is one of gaining experience within the operational hydropower industry. A transition from lumped to distributed models is likely to also require revision of measurement program, calibration strategy, use of GIS and modern data sources like weather radar and satellite imagery. On the other hand, map based visualisations enable a richer information exchange between hydrologic forecasters and power market traders. The operating context of a distributed hydrology model within hydropower planning is far from settled. Being both a modelling framework and a library of plugin-routines to build models from, Enki supports the flexibility needed in this situation. Recent development has separated the core from the user interface, paving the way for a scripting API, cross-platform compilation, and front-end programs serving different degrees of flexibility, robustness and security. The open source strategy invites anyone to use Enki and to develop and contribute new modules. Once tested, the same modules are available for the operational versions of the program. A core challenge is to offer rigid testing procedures and mechanisms to reject routines in an operational setting, without limiting the experimentation with new modules. The Open Source strategy also has

Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

PubMed

Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

2018-01-27

Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

EPA Hydraulic Fracturing Study Technical Workshop #2 March 10-11, 2011: Well Integrity Case Study by Lloyd H. Hetrick

EPA Pesticide Factsheets

This case study defines well integrity by the prevention of vertical migration of fluids to protect drinking water resources. A generic shale development well is presented, including design, construction, operational phase, and its plug and abandonment.

Effect of Resident Involvement on Operative Time and Operating Room Staffing Costs.

PubMed

Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M

The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of

We still need to operate at night!

PubMed Central

Faiz, Omar; Banerjee, Saswata; Tekkis, Paris; Papagrigoriadis, Savvas; Rennie, John; Leather, Andrew

2007-01-01

Introduction In the past the National Confidential Enquiry into Peri-operative deaths (NCEPOD) have advocated a reduction in non-essential night-time operating in NHS hospitals. In this study a retrospective analysis of the emergency general surgical operative workload at a London Teaching centre was performed. Methods All general surgical and vascular emergency operations recorded prospectively on the theatre database between 1997 and 2004 were included in the study. Operations were categorised according to whether they commenced during the daytime(08:01–18:00 hours), evening(18:01–00:00 hours) or night-time(00:01–08:00 hours). The procedure type and grade of the participating surgical personnel were also recorded. Bivariate correlation was used to analyse changing trends in the emergency workload. Results In total 5,316 emergency operations were performed over the study period. The numbers of daytime, evening and night-time emergency procedures performed were 2,963(55.7%), 1,832(34.5%), and 521(9.8%) respectively. Laparotomies and complex vascular procedures collectively accounted for half of all cases performed after midnight whereas they represented only 30% of the combined daytime and evening emergency workload. Thirty-two percent (n = 166) of all night-time operations were supervised or performed by a consultant surgeon. The annual volume of emergency cases performed increased significantly throughout the study period. Enhanced daytime (r = 0.741, p < 0.01) and evening (r = 0.548, p < 0.01) operating absorbed this increase in workload. There was no significant change in the absolute number of cases performed at night but the proportion of the emergency workload that took place after midnight decreased significantly throughout the study (r = -0.742, p < 0.01). Conclusion A small but consistent volume of complex cases require emergency surgery after midnight. Provision of an emergency general surgical service must incorporate this need. PMID:17973987

Scheduling job shop - A case study

NASA Astrophysics Data System (ADS)

Abas, M.; Abbas, A.; Khan, W. A.

2016-08-01

The scheduling in job shop is important for efficient utilization of machines in the manufacturing industry. There are number of algorithms available for scheduling of jobs which depend on machines tools, indirect consumables and jobs which are to be processed. In this paper a case study is presented for scheduling of jobs when parts are treated on available machines. Through time and motion study setup time and operation time are measured as total processing time for variety of products having different manufacturing processes. Based on due dates different level of priority are assigned to the jobs and the jobs are scheduled on the basis of priority. In view of the measured processing time, the times for processing of some new jobs are estimated and for efficient utilization of the machines available an algorithm is proposed and validated.

[Laparoscopic-assisted vaginal hysterectomy after multiple abdominal surgeries--case study].

PubMed

Malinowski, Andrzej; Wiecka-Płusa, Monika; Mołas, Justyna

2009-11-01

At present the laparoscopic-assisted vaginal hysterectomy (LAVH) is the most widespread and most frequently executed variation of hysterectomy. It is an effective and safe operating alternative for the traditional way--abdominal hysterectomy. Good cosmetic effects, short post-operative stay at hospital and, first of all, a small risk of intra- and postoperative complications are the major driving factors justifying the choice of this method of surgery. In the following article we describe a case of a 43-year-old woman who underwent many interventions in the peritoneal cavity (abdominal surgery) and was shortlisted for the laparoscopic-assisted vaginal hysterectomy. The cause of the operation was recurrent bilateral ovary cystis that could not be treated neither conservatively nor surgically, as well as the uterus myoma leading to abnormal uterus bleeding and hypermenorrhoea. Surgery in patients who have previously undergone abdominal operations is always difficult and the risk of complications is high indeed. In this case, while selecting the method of the next surgical procedure, surgeons must not exclude the vaginal and laparoscopic methods, or use them simultaneously. Experiences of other surgeons, as well as the unique case of a treated patient, show that previous abdominal surgical procedures are not a contraindication for either vaginal or laparoscopic procedures, and in some cases they might be safer than yet another laparotomy.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 1: Generic ground operations data

NASA Technical Reports Server (NTRS)

Byrd, Raymond J.

1990-01-01

This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advance Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. This volume presents ground processing data for a generic LOX/LH2 booster and core propulsion system based on current STS experience. The data presented includes: top logic diagram, process flow, activities bar-chart, loaded timelines, manpower requirements in terms of duration, headcount and skill mix per operations and maintenance instruction (OMI), and critical path tasks and durations.

Case Study of Using Resources about Sonar Operators To Teach Instructional Design.

ERIC Educational Resources Information Center

Mclellan, Hilary

1993-01-01

Describes a fictional account of the work of a submarine sonar operator ("The Hunt for Red October" by Tom Clancy) that captures the practitioner in a complex real-world work context featuring sophisticated electronic technologies. Describes how fiction can be adapted for and used as a basis for instructional design students to explore…

National Environmental Change Information System Case Study

NASA Technical Reports Server (NTRS)

Goodman, S. J.; Ritschard, R.; Estes, M. G., Jr.; Hatch, U.

2001-01-01

The Global Hydrology and Climate Center and NASA's Marshall Space Flight Center conducted a fact-finding case study for the Data Management Working Group (DMWG), now referred to as the Data and Information Working Group (DIWG), of the U.S. Global Change Research Program (USGCRP) to determine the feasibility of an interagency National Environmental Change Information System (NECIS). In order to better understand the data and information needs of policy and decision makers at the national, state, and local level, the DIWG asked the case study team to choose a regional water resources issue in the southeastern United States that had an impact on a diverse group of stakeholders. The southeastern United States was also of interest because the region experiences interannual climatic variations and impacts due to El Nino and La Nina. Jointly, with input from the DIWG, a focus on future water resources planning in the Apalachicola-Chattahoochee-Flint (ACF) River basins of Alabama, Georgia, and Florida was selected. A tristate compact and water allocation formula is currently being negotiated between the states and U.S. Army Corps of Engineers (COE) that will affect the availability of water among competing uses within the ACF River basin. All major reservoirs on the ACF are federally owned and operated by the U.S. Army COE. A similar two-state negotiation is ongoing that addresses the water allocations in the adjacent Alabama-Coosa-Tallapoosa (ACT) River basin, which extends from northwest Georgia to Mobile Bay. The ACF and ACT basins are the subject of a comprehensive river basin study involving many stakeholders. The key objectives of this case study were to identify specific data and information needs of key stakeholders in the ACF region, determine what capabilities are needed to provide the most practical response to these user requests, and to identify any limitations in the use of federal data and information. The NECIS case study followed the terms of reference

The current status of emergency operations at a high-volume cancer center.

PubMed

Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Natsume, Seiji; Kawai, Ryosuke; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Tsutsuyama, Masayuki; Shigeyoshi, Itaru; Shimizu, Yasuhiro

2014-01-01

This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.

Exploring Community College Peer Mentoring Practices within Central California: A Multiple Case Study

ERIC Educational Resources Information Center

Brown, Lenis Colton

2017-01-01

The purpose of this qualitative, multiple case study was to illuminate the prevalence and configurations of peer mentoring programs at Central California Community Colleges with emphasis on how the programs impacted student retention. The study's sample was drawn from ten campuses and five centers that operate within five California Community…

[Case-non case studies: Principles, methods, bias and interpretation].

PubMed

Faillie, Jean-Luc

2017-10-31

Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Case study of restaurant successfully designed, constructed, and operated for excellent dining acoustics

NASA Astrophysics Data System (ADS)

Bollard, Paul; Des Jardins, Stephen

2005-09-01

Prior to the construction of La Provence Restaurant in Roseville, California in 2004, the owner, Stephen Des Jardins, traveled with his cook, architect, and engineer to the Provence Region of France to study the cuisine, architecture, and acoustics of the local restaurants. This information was incorporated into the design, construction, and operation of his restaurant, with acoustical design assistance provided by the author, Paul Bollard. The result of the owner's painstaking attention to detail is a restaurant which has received very positive reviews for its architecture, quality of food, service, and acoustic ambience. This paper documents the measures included in the construction of the restaurant to ensure that the building acoustics enhance the dining experience, rather than detract from it. Photographs of acoustic treatments are included, as are reverberation time (RT60) test results and ambient noise level measurement results.

Airpower Projection in the Anti-Access/Area Denial Environment: Dispersed Operations

DTIC Science & Technology

2015-02-01

Raptor Case Study.....................................................................6 Risks to Dispersed Operations...project airpower, this paper breaks down a case study of the Rapid Raptor concept. The risks with executing a dispersed model are analyzed and mitigation...will force leaders to look at alternative ways to project power. Alternative Option: Rapid Raptor Case Study The ability to defend forward operating

Operator Certification Study Guide.

ERIC Educational Resources Information Center

American Water Works Association, Denver, CO.

This study guide contains typical questions and answers that all levels of water treatment plant operators might expect to find on a certification examination. The manual covers the basic sciences, treatment techniques, testing procedures, and federal legislation. (Author/SB)

Global identification of stochastic dynamical systems under different pseudo-static operating conditions: The functionally pooled ARMAX case

NASA Astrophysics Data System (ADS)

Sakellariou, J. S.; Fassois, S. D.

2017-01-01

The identification of a single global model for a stochastic dynamical system operating under various conditions is considered. Each operating condition is assumed to have a pseudo-static effect on the dynamics and be characterized by a single measurable scheduling variable. Identification is accomplished within a recently introduced Functionally Pooled (FP) framework, which offers a number of advantages over Linear Parameter Varying (LPV) identification techniques. The focus of the work is on the extension of the framework to include the important FP-ARMAX model case. Compared to their simpler FP-ARX counterparts, FP-ARMAX models are much more general and offer improved flexibility in describing various types of stochastic noise, but at the same time lead to a more complicated, non-quadratic, estimation problem. Prediction Error (PE), Maximum Likelihood (ML), and multi-stage estimation methods are postulated, and the PE estimator optimality, in terms of consistency and asymptotic efficiency, is analytically established. The postulated estimators are numerically assessed via Monte Carlo experiments, while the effectiveness of the approach and its superiority over its FP-ARX counterpart are demonstrated via an application case study pertaining to simulated railway vehicle suspension dynamics under various mass loading conditions.

Technical assistance for law-enforcement communications: Case study report two

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Two case histories are presented. In one study the feasibility of consolidating dispatch center operations for small agencies is considered. System load measurements were taken and queueing analysis applied to determine numbers of personnel required for each separate agency and for a consolidated dispatch center. Functional requirements were developed and a cost model was designed to compare relative costs of various alternatives including continuation of the present system, consolidation of a manual system, and consolidated computer-aided dispatching. The second case history deals with the consideration of a multi-regional, intrastate radio frequency for improved interregional communications. Sample standards and specifications for radio equipment are provided.

Transit Operations Decision Support System (TODSS) core requirements prototype development case study and lessons learned.

DOT National Transportation Integrated Search

2010-02-01

Transit Operations Decision Support Systems (TODSS) are systems designed to support dispatchers and others in real-time operations : management in response to incidents, special events, and other changing conditions. As part of a joint Federal Transi...

Space Operations Training Concepts Benchmark Study (Training in a Continuous Operations Environment)

NASA Technical Reports Server (NTRS)

Johnston, Alan E.; Gilchrist, Michael; Underwood, Debrah (Technical Monitor)

2002-01-01

The NASA/USAF Benchmark Space Operations Training Concepts Study will perform a comparative analysis of the space operations training programs utilized by the United States Air Force Space Command with those utilized by the National Aeronautics and Space Administration. The concentration of the study will be focused on Ground Controller/Flight Controller Training for the International Space Station Payload Program. The duration of the study is expected to be five months with report completion by 30 June 2002. The U.S. Air Force Space Command was chosen as the most likely candidate for this benchmark study because their experience in payload operations controller training and user interfaces compares favorably with the Payload Operations Integration Center's training and user interfaces. These similarities can be seen in the dynamics of missions/payloads, controller on-console requirements, and currency/proficiency challenges to name a few. It is expected that the report will look at the respective programs and investigate goals of each training program, unique training challenges posed by space operations ground controller environments, processes of setting up controller training programs, phases of controller training, methods of controller training, techniques to evaluate adequacy of controller knowledge and the training received, and approaches to training administration. The report will provide recommendations to the respective agencies based on the findings. Attached is a preliminary outline of the study. Following selection of participants and an approval to proceed, initial contact will be made with U.S. Air Force Space Command Directorate of Training to discuss steps to accomplish the study.

Targeting Terrorist Leaders: A Case Study

DTIC Science & Technology

2011-03-01

PRESSURE .................................38 IV. STATISTICAL ANALYSIS ON ISRAELI LEADERSHIP TARGETING ...43 V. CONCLUSION: HAVE ISRAELI ATTEMPTS TO...organization. D. POTENTIAL WEAKNESSES The use of one case to evaluate the efficacy of the terrorist-leadership targeting model is problematic...times who was in charge. In addition, the literature on Hamas is widely split on the role that inspirational leaders had on operational matters

Tisettanta case study: the interoperation of furniture production companies

NASA Astrophysics Data System (ADS)

Amarilli, Fabrizio; Spreafico, Alberto

This chapter presents the Tisettanta case study, focusing on the definition of the possible innovations that ICT technologies can bring to the Italian wood-furniture industry. This sector is characterized by industrial clusters composed mainly of a few large companies with international brand reputations and a large base of SMEs that manufacture finished products or are specialized in the production of single components/processes (such as the Brianza cluster, where Tisettanta operates). In this particular business ecosystem, ICT technologies can bring relevant support and improvements to the supply chain process, where collaborations between enterprises are put into action through the exchange of business documents such as orders, order confirmation, bills of lading, invoices, etc. The analysis methodology adopted in the Tisettanta case study refers to the TEKNE Methodology of Change (see Chapter 2), which defines a framework for supporting firms in the adoption of the Internetworked Enterprise organizational paradigm.

The Influence of Lean on K-12 District Management: A Case Study

ERIC Educational Resources Information Center

Brown, Beverly

2011-01-01

For decades, policymakers and educators have focused on public school equity and adequacy, while paying little attention to efficiency. This qualitative single case study was designed to capture explicit information about Lean management, operations, and culture in a K-12 Michigan school district engaged in Lean training and implementation for a…

Treatment of Chronic Breath-Holding in an Adult with Severe Mental Retardation: A Clinical Case Study

ERIC Educational Resources Information Center

Reed, Derek D.; Martens, Brian K.

2008-01-01

We describe a clinical case study surrounding the behavioral assessment and operant treatment of, an adult with severe mental retardation who engaged in chronic breath-holding. In this clinical case, previous neurological and medical testing had ruled out biological bases for the individual's breath-holding. A functional behavioral assessment…

The Perceived Effect of Hidden Costs on the Operational Management of Information Technology Outsourcing: A Qualitative Study

ERIC Educational Resources Information Center

Swift, Ian

2011-01-01

Information technology (IT) outsourcing is a business trend aimed at reducing costs and enabling companies to concentrate on their core competencies. This qualitative multiple case design research study explored the effects of hidden costs on the operational management of IT outsourcing. The study involved analyzing IT outsourcing agreements as…

Case-control studies in neurosurgery.

PubMed

Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

2014-08-01

Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

Evaluating the improvements of the BOLAM meteorological model operational at ISPRA: A case study approach - preliminary results

NASA Astrophysics Data System (ADS)

Mariani, S.; Casaioli, M.; Lastoria, B.; Accadia, C.; Flavoni, S.

2009-04-01

Fritsch. A fully updated serial version of the BOLAM code has been recently acquired. Code improvements include a more precise advection scheme (Weighted Average Flux); explicit advection of five hydrometeors, and state-of-the-art parameterization schemes for radiation, convection, boundary layer turbulence and soil processes (also with possible choice among different available schemes). The operational implementation of the new code into the SIMM model chain, which requires the development of a parallel version, will be achieved during 2009. In view of this goal, the comparative verification of the different model versions' skill represents a fundamental task. On this purpose, it has been decided to evaluate the performance improvement of the new BOLAM code (in the available serial version, hereinafter BOLAM 2007) with respect to the version with the Kain-Fritsch scheme (hereinafter KF version) and to the older one employing the Kuo scheme (hereinafter Kuo version). In the present work, verification of precipitation forecasts from the three BOLAM versions is carried on in a case study approach. The intense rainfall episode occurred on 10th - 17th December 2008 over Italy has been considered. This event produced indeed severe damages in Rome and its surrounding areas. Objective and subjective verification methods have been employed in order to evaluate model performance against an observational dataset including rain gauge observations and satellite imagery. Subjective comparison of observed and forecast precipitation fields is suitable to give an overall description of the forecast quality. Spatial errors (e.g., shifting and pattern errors) and rainfall volume error can be assessed quantitatively by means of object-oriented methods. By comparing satellite images with model forecast fields, it is possible to investigate the differences between the evolution of the observed weather system and the predicted ones, and its sensitivity to the improvements in the model code

Analysis of the embodied and operational energy: Study of a suburban house in Athens, Greece

NASA Astrophysics Data System (ADS)

Ghiata, Maria

Operational energy can establish how successful a building is, in terms of environmentally 'considerate' design. Though embodied energy of construction materials also comprises an important indicator of the environmental impact of the material, the construction industry does not really promote it as such. This report enhances the significance of embodied energy and its relationship to operational energy (energy in use). Since buildings are becoming less energy demanding, operational energy will be decreasing, so that embodied energy will be gaining ground in the attempt to protect the environment. By the use of an 'environmentally friendly' house as a case study, it was proven that, though changes of the wall, floor, and insulation materials can take place, the operational energy does not change. What is greatly affected is the embodied energy of these construction materials.

Evaluating hospital design from an operations management perspective.

PubMed

Vos, Leti; Groothuis, Siebren; van Merode, Godefridus G

2007-12-01

This paper describes an evaluation method for the assessment of hospital building design from the viewpoint of operations management to assure that the building design supports the efficient and effective operating of care processes now and in the future. The different steps of the method are illustrated by a case study. In the case study an experimental design is applied to assess the effect of used logistical concepts, patient mix and technologies. The study shows that the evaluation method provides a valuable tool for the assessment of both functionality and the ability to meet future developments in operational control of a building design.

Technology Solutions Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois

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

None

2014-09-01

In multifamily building hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. In this case study , Partnership for Advanced Residential Retrofit and Elevate Energy. explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs.

Communications Processor Operating System Study. Executive Summary,

DTIC Science & Technology

1980-11-01

AD-A095 b36 ROME AIR DEVELOPMENT CENTER GRIFFISS AFB NY F/e 17/2 COMMUNICATIONS PROCESSOR OPERATING SYSTEM STUDY. EXECUTIVE SUMM—ETC(U) NOV 80 J...COMMUNICATIONS PROCESSOR OPERATING SYSTEM STUDY Julian Gitlih SPTIC ELECTE«^ FEfi 2 6 1981^ - E APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED "a O...Subtitle) EXECUTIVE^SUMMARY 0F> COMMUNICATIONS PROCESSOR OPERATING SYSTEM $t - • >X W tdLl - ’•• • 7 AUTHORf«! ! , Julian

The Power of Natural Selection: A Guided Investigation of Three Case Studies

ERIC Educational Resources Information Center

Beachly, William

2010-01-01

I describe a quantitative approach to three case studies in evolution that can be used to challenge college freshmen to explore the power of natural selection and ask questions that foster a deeper understanding of its operation and relevance. Hemochromatosis, the peppered moth, and hominid cranial capacity are investigated with a common algebraic…

When virginity does matter: rigid hysteroscopy for diagnostic and operative vaginoscopy--a series of 26 cases.

PubMed

Küçük, Tansu

2007-01-01

Virginity in adult women, although a personal decision, is a limiting factor for gynecologists in diagnosis and treatment. This report presents 26 cases of virgin patients with various gynecologic problems: 11 with vaginal bleeding, 7 with heavy discharge and foul odor, 6 with protruding vaginal mass, and 2 with a sensation of vaginal pressure and pain. A rigid hysteroscopy setting was used for diagnostic and operative vaginoscopy. Eleven foreign bodies were removed, mostly clothing fibers and a piece of plastic. In 5 cases, cervical polyps and a subserous myoma were resected and cut into pieces for removal through the hymenal opening. In conclusion, the use of a rigid hysteroscope as a vaginoscope to replace the speculum in adult virgin patients is feasible and introduces an operative option as well.

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

PubMed

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment

PubMed Central

Lempainen, Lasse; Kosola, Jussi; Pruna, Ricard; Puigdellivol, Jordi; Sarimo, Janne; Niemi, Pekka; Orava, Sakari

2018-01-01

Background: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. Purpose: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Study Design: Case series; Level of evidence, 4. Methods: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored. Results: Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up. Conclusion: Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures. PMID:29479545

Case Study: The Use of a Hypercard Simulation to Aid in the Teaching of Laboratory Apparatus Operation.

ERIC Educational Resources Information Center

Waddick, John

1994-01-01

Compares the effect of a chemistry computer simulation, written by the author, with the effect of an instructor demonstration. The study indicates that in this particular situation the operation of a spectrophotometer can be effectively taught by computer simulation method. The program is written using HyperTalk, the HyperCard programming…

Innovations in Site Characterization Case Study: Hanscom Air Force Base, Operable Unit 1

EPA Pesticide Factsheets

This document is a condensation of the information provided in the much more detailed Hanscom AFB Report entitled A Dynamic Site Investigation: Adaptive Sampling and Analysis Program for Operable Unit 1 at Hanscom Air Force Base, Bedford, Massachusetts.

Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

ERIC Educational Resources Information Center

Carloye, Lisa

2017-01-01

In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

The case study of biomaterials and biominerals

NASA Astrophysics Data System (ADS)

Del Hoyo Martínez, Carmen

2013-04-01

The teaching of biomaterials as case study by on-line platform , susceptible to develop both individually and in groups, got different objectives proposed by the European Higher Education System, among which include: participate actively in the teaching-learning process by students, interpreting situations, adapt processes and solutions. It also improves oral and written communication, analytical skills and synthesis and also the ability to think critically. Biomaterials have their origin in biominerals. These are solid inorganic compounds of defined structure, consisting of molecular control mechanisms that operate in biological systems. Its main functions are: structural support, a reservoir of essential elements, sensors, mechanical protection and storage of toxic elements. Following the demand of materials compatible with certain functional systems of our body, developed biomaterials. Always meet the condition of biocompatibility. Should be tolerated by the body and do not provoke rejection. This involves a comprehensive study of physiological conditions and the anatomy of the body where a biomaterial has to be implemented. The possibility of generating new materials from biominerals has a major impact in medicine and other fields could reach as geology, construction, crystallography, etc. While the study of these issues is in its infancy today, can be viewed as an impact on the art and future technology. Planning case study that students would prepare its report for discussion in subgroups. Occurs then the pooling of individual analysis, joint case discussion and adoption by the subgroup of a consensual solution to the problem. The teacher as facilitator and coordinator of the final case analysis, sharing leads to group-wide class and said the unanimous decision reached by the students and gives his opinion on the resolution of the case. REFERENCES D.P. Ausubel. Psicología Educativa. Un punto de vista cognoscitivo. Trillas. Ed. 1983. E.W. Eisner. Procesos

Impacts of Base-Case and Post-Contingency Constraint Relaxations on Static and Dynamic Operational Security

NASA Astrophysics Data System (ADS)

Salloum, Ahmed

Constraint relaxation by definition means that certain security, operational, or financial constraints are allowed to be violated in the energy market model for a predetermined penalty price. System operators utilize this mechanism in an effort to impose a price-cap on shadow prices throughout the market. In addition, constraint relaxations can serve as corrective approximations that help in reducing the occurrence of infeasible or extreme solutions in the day-ahead markets. This work aims to capture the impact constraint relaxations have on system operational security. Moreover, this analysis also provides a better understanding of the correlation between DC market models and AC real-time systems and analyzes how relaxations in market models propagate to real-time systems. This information can be used not only to assess the criticality of constraint relaxations, but also as a basis for determining penalty prices more accurately. Constraint relaxations practice was replicated in this work using a test case and a real-life large-scale system, while capturing both energy market aspects and AC real-time system performance. System performance investigation included static and dynamic security analysis for base-case and post-contingency operating conditions. PJM peak hour loads were dynamically modeled in order to capture delayed voltage recovery and sustained depressed voltage profiles as a result of reactive power deficiency caused by constraint relaxations. Moreover, impacts of constraint relaxations on operational system security were investigated when risk based penalty prices are used. Transmission lines in the PJM system were categorized according to their risk index and each category was as-signed a different penalty price accordingly in order to avoid real-time overloads on high risk lines. This work also extends the investigation of constraint relaxations to post-contingency relaxations, where emergency limits are allowed to be relaxed in energy market models

Two gimbal bearing case studies: Some lessons learned

NASA Technical Reports Server (NTRS)

Loewenthal, Stuart H.

1988-01-01

Two troublesome, torque related problems associated with gimbal actuators are discussed. Large, thin section angular contact bearings can have a surprisingly high torque sensitivity to radial thermal gradients. A predictive thermal-mechanical bearing analysis, as described, was helpful in establishing a safe temperature operating envelope. In the second example, end-of-travel torque limits of an oscillatory gimbal bearing appoached motor stall during limit cycling life tests. Bearing modifications required to restore acceptable torque performance are described. The lessons learned from these case studies should benefit designers of precision gimbals where singular bearing torque related problems are not uncommon.

Case studies from Oman for coiled tubing deployed completion techniques

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

Taylor, R.W.; Conrad, B.

1996-09-01

Although the use of ultra-large coiled tubing to complete wells is relatively new, it is gaining widespread industry application. This paper will detail the equipment necessary to perform an operation of this type and will present information from several case studies in Oman in which an operator has successfully deployed completion equipment on 3-1/2-inch-OD coiled tubing. In addition to a discussion of the equipment required to perform the necessary operations, the trial parameters that were established by this operator will be given. The information presented has been selected to allow an initial evaluation to be made of coiled tubing completionsmore » in general and will help to determine whether this method can prove to be less expensive than traditional rig-based completions. The topics presented have been chosen to provide the reader with a thorough understanding of the techniques and preparation needed to execute a coiled tubing completion. The summary of experiences will conclude that this innovative completion technique can be a viable method for completing wells. Although long-term advantages regarding production and well maintenance cannot yet be determined, the operator`s experiences to date have confirmed his initial belief that use of coiled tubing in ultra-large continuous-pipe applications can be cost effective.« less

Risk factors for Propionibacterium acnes infection after neurosurgery: A case-control study.

PubMed

Haruki, Yuto; Hagiya, Hideharu; Takahashi, Yu; Yoshida, Hideyuki; Kobayashi, Kazuki; Yukiue, Tadato; Tsuboi, Nobushige; Sugiyama, Tetsuhiro

2017-04-01

Propionibacterium acnes is increasingly known as a causative organism for post-neurosurgical infection; however, no clinical studies have examined the risk factors associated with P. acnes infections. Clinical data obtained from 14 cases of P. acnes infection and 28 controls infected with other pathogens were analyzed. Craniotomy, malignancy, and prolonged duration of operation were significantly associated with the onset of P. acnes infection. No fatal cases were reported. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Operations dashboard: comparative study

NASA Astrophysics Data System (ADS)

Ramly, Noor Nashriq; Ismail, Ahmad Zuhairi; Aziz, Mohd Haris; Ahmad, Nurul Haszeli

2011-10-01

In this present days and age, there are increasing needs for companies to monitor application and infrastructure health. Apart from having proactive measures to secure their application and infrastructure, many see monitoring dashboards as crucial investment in disaster preparedness. As companies struggle to find the best solution to cater for their needs and interest for monitoring their application and infrastructure's health, this paper summarizes the studies made on several known off-the-shelf operations dashboard and in-house developed dashboard. A few criteria of good dashboard are collected from previous studies carried out by several researchers and rank them according to importance and business needs. The finalized criteria that will be discussed in later sections are data visualization, performance indicator, dashboard personalization, audit capability and alert/ notification. Comparative studies between several popular dashboards were then carried out to determine whether they met these criteria that we derived from the first exercise. The findings hopefully can be used to educate and provide an overview of selecting the best IT application and infrastructure operations dashboard that suit business needs, thus become the main contribution of this paper.

A case of transient central diabetes insipidus after aorto-coronary bypass operation.

PubMed

Yu, Chung-Hoon; Cho, Jang-Hee; Jung, Hee-Yeon; Lim, Jeong-Hoon; Jin, Mi-Kyung; Kwon, Owen; Hong, Kyung-Deuk; Choi, Ji-Young; Yoon, Se-Hee; Kim, Chan-Duck; Kim, Yong-Lim; Kim, Gun-Jik; Park, Sun-Hee

2012-09-01

Diabetes insipidus (DI) is characterized by excessive urination and thirst. This disease results from inadequate output of antidiuretic hormone (ADH) from the pituitary gland or the absence of the normal response to ADH in the kidney. We present a case of transient central DI in a patient who underwent a cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG). A 44-yr-old male underwent a CABG operation. An hour after the operation, the patient developed polyuria and was diagnosed with central DI. The patient responded to desmopressin and completely recovered five days after surgery. It is probable that transient cerebral ischemia resulted in the dysfunction of osmotic receptors in the hypothalamus or hypothalamus-pituitary axis during CPB. It is also possible that cardiac standstill altered the left atrial non-osmotic receptor function and suppressed ADH release. Therefore, we suggest that central DI is a possible cause of polyuria after CPB.

Cow Power: A Case Study of Renewable Compressed Natural Gas as a Transportation Fuel

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

Mintz, Marianne; Tomich, Matthew

This case study explores the production and use of renewable compressed natural gas (R-CNG)—derived from the anaerobic digestion (AD) of dairy manure—to fuel 42 heavy-duty milk tanker trucks operating in Indiana, Michigan, Tennessee, and Kentucky.

The cephaloceles: A clinical, epidemiological and therapeutic study of 50 cases.

PubMed

Kabré, A; Zabsonre, D S; Sanou, A; Bako, Y

2015-08-01

Cephaloceles are congenital malformations characterized by externalization of the meninges and/or brain tissue through a congenital skull bone defect. In developed countries, this malformation is rare but in our developing countries, this pathology remains one of our concerns. To describe the epidemiological, clinical and therapeutic aspects of the cephaloceles. A retrospective study was conducted from 2007 to 2013 on all cases of cephalocele supported in the department of neurosurgery of the Yalgado Ouédraogo University Teaching Hospital of Ouagadougou. The malformations were supplemented by CT scan. All patients were operated. The surgical procedure in cephaloceles of the convexity consisted of a direct approach. Sincipital cephaloceles were operated by transcranial approach or combined approach associating transcranial and transnasal approaches. Fifty patients were gathered during the 7-year period. There were 18 boys and 32 girls. The ages ranged from 1 day to 11 years. The cephaloceles were located on the vault of the skull in 78%; the lesion was sincipital in 22%. The malformation was covered with normal skin in 92%; it was pediculated in 78%. CT scan allowed the classification of cases as meningo-encephaloceles in 31 cases (62%) and meningoceles in 18 cases (36%) and one pure encephalocele. The immediate postoperative course was uneventful in 42 cases (84%); 8 postoperative deaths were recorded. At medium and long term, 4 patients (8%) developed complications of psychomotor deficiency in 3 cases and hydrocephalus in 1 case. The main reasons for the poor prognosis were superinfection, hydrocephalus and/or other brain malformations. Cephaloceles remain relatively frequent in our practice. After surgery, mental failure and hydrocephalus can occur impairing the prognosis. The most suitable solution is a policy of prevention with folic acid treatment before and during pregnancy and following up adequate pregnancies. Copyright © 2015 Elsevier Masson SAS. All

Case Studies Behavior Modification.

ERIC Educational Resources Information Center

Wark, David M.

The case histories of five students enrolled in a university course in how to study are reported. The students ranged in age from 18 to 35, included two males and three females, and varied in school experience from no college in one case and some college in two cases to college degrees in two cases. Students were initially taught to chart their…

[Case-control study on accuracy and safety of patient-specific drill-guide templates used in scoliosis cases].

PubMed

Zhang, Yu-peng; Shi, Ya-min; Wang, Hua-dong; Hou, Shu-xun

2015-10-01

To evaluate the accuracy and safety of pedicle screw insertion with the aid of novel patient-specific drill-guide templates in scoliosis cases. Ten patients with scoliosis were selected to participate in the research (the observation group) from December 2013 to December 2014. The data was obtained from CT scanning, and put into the computer to perform reconstruction of spine, simulation of pedicle screw insertion, and design of patient-specific drill-guide templates with software. The templates were made with rapid prototyping technique. After sterilization, the templates were used to aid the pedicle screw insertion intraoperatively. The blood loss, operation duration, change of creatinine level pre- and post-operation, and complications related to pedicle screw insertion were recorded. The location of pedicle screws were graded so as to evaluate the accuracy. A comparative study was then performed with the data of ten scoliosis cases operated with free-hand method during the same period (control group). There were 5 cases of idiopathic scoliosis and 5 cases of congenital scoliosis in the observation group, including 3 males and 7 females. Their average age was 11.9 years old (ranged, 4 to 18 years old), and the average Cobb angle of main curve was 54.9° (ranged, 42.1° to 78.4°). There were also 5 cases of idiopathic scoliosis and 5 cases of congenital scoliosis in the control group,including 2 males and 8 females. Their average age was 12.6 years old (ranged, 6 to 17 years old), and the average Cobb angle of main curve was 56.6° (ranged, 38.2° to 93.4°). A total of 167 pedicle screws were inserted intraoperatively, with 138 screws (82.6%) in grade I, 26 screws (15.0%) in grade II, 4 screws in grade III (2.4%), but no screws in grade IV according to the CT image. There were 29 (17.4%) screws perforated, and 163 (97.6%) screws could be accepted. In the control group, a total of 165 pedicle screws were inserted intraoperatively, with 98 screws (59.4%) in grade

Metropolitan transportation management center : a case study : Long Island INFORM : identifying incidents and informing travelers

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Long Island's INFORM transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting St...

0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.

PubMed

Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L

2016-01-01

Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p < 0.0001). This difference was consistent over the first 3 years of training. The most frequently logged open general surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of

Orbital operations study. Volume 2: Interfacing activities analysis. Part 4: Support operations activity group

NASA Technical Reports Server (NTRS)

Steinwachs, W. L.; Patrick, J. W.; Galvin, D. M.; Turkel, S. H.

1972-01-01

The findings of the support operations activity group of the orbital operations study are presented. Element interfaces, alternate approaches, design concepts, operational procedures, functional requirements, design influences, and approach selection are presented. The following areas are considered: (1) crew transfer, (2) cargo transfer, (3) propellant transfer, (4) attached element operations, and (5) attached element transport.

A concordance index for matched case-control studies with applications in cancer risk.

PubMed

Brentnall, Adam R; Cuzick, Jack; Field, John; Duffy, Stephen W

2015-02-10

In unmatched case-control studies, the area under the receiver operating characteristic (ROC) curve (AUC) may be used to measure how well a variable discriminates between cases and controls. The AUC is sometimes used in matched case-control studies by ignoring matching, but it lacks interpretation because it is not based on an estimate of the ROC for the population of interest. We introduce an alternative measure of discrimination that is the concordance of risk factors conditional on the matching factors. Parametric and non-parametric estimators are given for different matching scenarios, and applied to real data from breast and lung cancer case-control studies. Diagnostic plots to verify the constancy of discrimination over matching factors are demonstrated. The proposed simple measure is easy to use, interpret, more efficient than unmatched AUC statistics and may be applied to compare the conditional discrimination performance of risk factors. Copyright © 2014 John Wiley & Sons, Ltd.

Operator pencil passing through a given operator

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

Biggs, A., E-mail: khudian@manchester.ac.uk, E-mail: adam.biggs@student.manchester.ac.uk; Khudaverdian, H. M., E-mail: khudian@manchester.ac.uk, E-mail: adam.biggs@student.manchester.ac.uk

Let Δ be a linear differential operator acting on the space of densities of a given weight λ{sub 0} on a manifold M. One can consider a pencil of operators Π-circumflex(Δ)=(Δ{sub λ}) passing through the operator Δ such that any Δ{sub λ} is a linear differential operator acting on densities of weight λ. This pencil can be identified with a linear differential operator Δ-circumflex acting on the algebra of densities of all weights. The existence of an invariant scalar product in the algebra of densities implies a natural decomposition of operators, i.e., pencils of self-adjoint and anti-self-adjoint operators. We studymore » lifting maps that are on one hand equivariant with respect to divergenceless vector fields, and, on the other hand, with values in self-adjoint or anti-self-adjoint operators. In particular, we analyze the relation between these two concepts, and apply it to the study of diff (M)-equivariant liftings. Finally, we briefly consider the case of liftings equivariant with respect to the algebra of projective transformations and describe all regular self-adjoint and anti-self-adjoint liftings. Our constructions can be considered as a generalisation of equivariant quantisation.« less

The role of post-operative radiographs in predicting risk of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures - a case control study.

PubMed

Selvan, D R; Perry, D; Machin, D G; Brown, D J

2014-12-01

Volar plating of distal radius fractures is one of the common procedures performed in trauma surgery. Flexor pollicis longus (FPL) rupture has been described as complication following volar plating of distal radius fractures. The aim of our study was to investigate the possible relation between parameters measured on post-operative radiographs and the occurrence of FPL ruptures. This was a case control study. The post-operative radiographs of 11 FPL rupture, and 22 non-FPL rupture patients were reviewed with respect to fracture reduction and plate position and the various parameters were calculated by five independent people. Logistic regression was used to examine the importance of the variables. We identified two significant factors to predict FPL rupture after volar plating of distal radial fractures. These were radial tilt and plate distance from the joint line. The odds ratio of ruptures was 0.74 (95% CI 0.57-0.95) for every degree of radial tilt <25° and 0.50 (95% CI 0.28-0.88) for every millimetre that the distal end of the plate was away from the volar lip of the distal radius at the wrist joint. Post-operative radiographs could help us predict FPL rupture after distal radius volar plating. The findings also highlight the need for good fracture reduction and thoughtful placement of the volar plate intraoperatively to minimise the risk of FPL tendon rupture. Copyright © 2014 Elsevier Ltd. All rights reserved.

There Can Be Only One: An Analysis of Operational Artists in Vietnam

DTIC Science & Technology

2017-05-05

elevated, in the case of the Vietnam comparative study here, to the theater commander. 6...factors in identifying the true Operational Artist in the Vietnam case study as well as future conflicts. This is where the creativity that defines...difference between successful and unsuccessful Operational Artists in the sense this monograph proposes. This is a comparative case study between GEN Paul

How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

ERIC Educational Resources Information Center

Fallek, Max

This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

Natural Learning Case Study Archives

ERIC Educational Resources Information Center

Lawler, Robert W.

2015-01-01

Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

[Injuries to the duodenum and pancreas in 42 operated cases].

PubMed

Kiss, L; Remescu, A

2001-01-01

42 consecutive patients who sustained injuries to the duodenum or/and pancreas were admitted to our hospital. Over a twenty year period 32 blunt injuries and 10 penetrating injuries were encountered. Penetrating injuries were always suspected and treated by time: following blunt injury diagnostic delay was encountered in 14 patients and insufficient surgical procedure because of intra-operative misinterpretation in 2 patients. Most of the patients had associated intra-abdominal organ injuries. Adjusts to diagnosis such as abdominal roentgenograms, serum amylase levels and gastroduodenography was not helpful. CT scan and ultrasound allowed to confirm the suspected diagnosis in 3 cases only. Intraoperative diagnosis was also challenging. Complete mobilization of the strictures surrounding the duodenum and the pancreas to provide entire exposure was necessary in 12 patients treated first in a peripheral hospital, diagnosis of the injury have been missed at first laparotomy and reoperation was necessary in all of them. Suture closure of the duodenum and drainage of the pancreatic region wee the most common reparative techniques used. More complicated procedures with pancreatic and/or duodenal resection were performed in 12 patients. Overall mortality in patients surviving more than 24 hours was 14%. Suture live dehiscence after delayed operation (4) and 2 deaths due to brain injury.

[Comparison study on two operations for treatment of extra-articular distal tibial fracture].

PubMed

Qi, Haotian; Li, Weikang; Zhao, Yongjie; Zhang, Yinguang; Liu, Zhaojie; Jia, Jian

2013-11-01

To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) for treatment of extra-articular distal tibial fracture. Between March 2009 and March 2012, 57 patients with extra-articular distal tibial fractures were treated, and the clinical data were retrospectively analyzed. Of 57 cases, 31 were treated with MIPO (MIPO group), and 26 with ORIF (ORIF group). There was no significant difference in gender, age, cause of injury, type of fractures, complication, and time from injury to operation between 2 groups (P > 0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were compared between 2 groups. There was no significant difference in operation time and intraoperative blood loss between 2 groups (P > 0.05). Wound infection occurred in 5 cases [2 in MIPO group (6.5%) and 3 in ORIF group (11.5%)] showing no significant difference (Chi(2)=0.651, P=0.499). The other wound obtained healing by first intention. All cases were followed up 13-24 months (mean, 15 months). No significant difference was found in the average healing time between 2 groups and between patients with types A and B by AO classification (P > 0.05); in patients with type C, the healing time in MIPO group was significantly shorter than that in ORIF group (t= -2.277, P=0.033). Delayed union was observed in 3 cases of MIPO group (9.7%) and in 4 cases of ORIF group (15.4%), showing no significant difference (Chi(2)=0.428, P=0.691). Mal-union occurred in 4 cases of MIPO group (12.9%) and in 1 case of ORIF group (3.8%), showing no significant difference (Chi(2)=1.449, P=0.362). No significant difference was found in Mazur score between 2 groups (t=0.480, P=0.633). The excellent and good rate was 93.5% in MIPO group (excellent in 24 cases, good in 5 cases, fair in 1 case, and poor in 1 case) and was 92.3% in ORIF group (excellent in 18 cases, good in 6 cases, and poor in 2 cases), and the

Design of a receiver operating characteristic (ROC) study of 10:1 lossy image compression

NASA Astrophysics Data System (ADS)

Collins, Cary A.; Lane, David; Frank, Mark S.; Hardy, Michael E.; Haynor, David R.; Smith, Donald V.; Parker, James E.; Bender, Gregory N.; Kim, Yongmin

1994-04-01

The digital archiving system at Madigan Army Medical Center (MAMC) uses a 10:1 lossy data compression algorithm for most forms of computed radiography. A systematic study on the potential effect of lossy image compression on patient care has been initiated with a series of studies focused on specific diagnostic tasks. The studies are based upon the receiver operating characteristic (ROC) method of analysis for diagnostic systems. The null hypothesis is that observer performance with approximately 10:1 compressed and decompressed images is not different from using original, uncompressed images for detecting subtle pathologic findings seen on computed radiographs of bone, chest, or abdomen, when viewed on a high-resolution monitor. Our design involves collecting cases from eight pathologic categories. Truth is determined by committee using confirmatory studies performed during routine clinical practice whenever possible. Software has been developed to aid in case collection and to allow reading of the cases for the study using stand-alone Siemens Litebox workstations. Data analysis uses two methods, ROC analysis and free-response ROC (FROC) methods. This study will be one of the largest ROC/FROC studies of its kind and could benefit clinical radiology practice using PACS technology. The study design and results from a pilot FROC study are presented.

Recruiting Young Volunteers in an Area of Selective Education: A Qualitative Case Study

ERIC Educational Resources Information Center

Dean, Jon

2016-01-01

This article presents findings from a small qualitative case study of a youth volunteering brokerage organisation in England, operating in an area of selective state education. Data show how brokerage workers felt grammar schools managed their students in a concerted way to improve students' chances of attending university. Conversely, workers…

Television-Centered, Instructional Delivery Systems: Costs and Case Studies. A Review of Research.

ERIC Educational Resources Information Center

Maher, Thomas G.

This paper reviews the post-1975 research on the capacities, logistics, and costs of the various delivery technologies used in educational television, and details case studies of television-centered operations, particularly in relationship to adult learners. The paper begins with a section on general definitions and the capacities of various…

[Case-control study on measurement of coracoclavicular and acromioclavicular ligament injuries during internal fixation operation for the treatment of fresh acromioclavicular joint dislocation of Tossy type III].

PubMed

Guan, Ting-Jin; Sun, Peng; Zheng, Liang-Guo; Qi, Xiang-Yang

2014-01-01

To study measurement methods of acromioclavicular and coracoclavicular ligament injuries,its therapeutic effects and complications during internal fixation operation for the treatment of fresh acromioclavicular joint dislocations of Tossy type III. From July 2003 to May 2012,127 patients with acromioclavicular joint dislocations of Tossy type III were treated with wire fixation from coracoid process to clavicle or hook-plate fixation. The patients were divided into group A (63 cases) and group B (64 cases) according to whether acromioclavicular ligament and coracoclavicular ligament were repaired or not. In group A (ligaments repaired), there were 39 males and 24 females with an average age of (33.25 +/- 8.46) years old (ranged from 17 to 59 years). And in group B (no ligaments repaired), there were 41 males and 23 females with an average age of (34.10 +/- 7.19) years (ranged from 19 to 57 years). The operation times, intraoperative blood loss, postoperative infections, internal fixation failure, recurrence and other complications, together with therapeutic effects were compared between two groups. The outcome was analyzed according to Karlsson standard. In group A, 54 patients got an excellent result and 9 good according to Karlsson standard;the average operative time was (55.90 +/- 26.56) min; the average intraoperative bleeding amount was (99.80 +/- 50.30) ml; 1 patient had wire broken without re-dislocation at 16 weeks after operation, 3 patients got wound fat liquefaction and recovered after treatment, 1 patient had pain after shoulder joint motion and pain disappeared after implants were taken out. In group B, 52 patients got an excellent result and 12 good according to Karlsson standard; the average operative time was (49.50 +/- 23.14) min; the average intraoperative bleeding amount was (87.30 +/- 46.41) ml; 2 patients got wound fat liquefaction, and 2 patients had pain after shoulder joint motion. All the patients were followed up, and the duration ranged

The Improvement of Particle Swarm Optimization: a Case Study of Optimal Operation in Goupitan Reservoir

NASA Astrophysics Data System (ADS)

Li, Haichen; Qin, Tao; Wang, Weiping; Lei, Xiaohui; Wu, Wenhui

2018-02-01

Due to the weakness in holding diversity and reaching global optimum, the standard particle swarm optimization has not performed well in reservoir optimal operation. To solve this problem, this paper introduces downhill simplex method to work together with the standard particle swarm optimization. The application of this approach in Goupitan reservoir optimal operation proves that the improved method had better accuracy and higher reliability with small investment.

Fuzzy-Set Case Studies

ERIC Educational Resources Information Center

Mikkelsen, Kim Sass

2017-01-01

Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

SETDA Case Studies 2012

ERIC Educational Resources Information Center

State Educational Technology Directors Association, 2012

2012-01-01

The State Educational Technology Directors Association (SETDA) published a series of case studies from 28 states to showcase examples of how ARRA EETT ("American Recovery and Reinvestment Act of 2009 Enhancing Education Through Technology") grant funds have impacted teaching and learning. SETDA collected data for the case studies through…

Operant Conditioning and Education.

ERIC Educational Resources Information Center

de Noronha, Mario

A case study of a learning disabled 8-year-old with behavior disturbancs is presented to highlight the use of operant conditioning in cutting down educational costs and easing the teacher's class management problems. (CL)

Delays in the operating room: signs of an imperfect system.

PubMed

Wong, Janice; Khu, Kathleen Joy; Kaderali, Zul; Bernstein, Mark

2010-06-01

Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays. One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon's practice. A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays. Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.

A Case of Transient Central Diabetes Insipidus after Aorto-Coronary Bypass Operation

PubMed Central

Yu, Chung-Hoon; Cho, Jang-Hee; Jung, Hee-Yeon; Lim, Jeong-Hoon; Jin, Mi-Kyung; Kwon, Owen; Hong, Kyung-Deuk; Choi, Ji-Young; Yoon, Se-Hee; Kim, Chan-Duck; Kim, Yong-Lim; Kim, Gun-Jik

2012-01-01

Diabetes insipidus (DI) is characterized by excessive urination and thirst. This disease results from inadequate output of antidiuretic hormone (ADH) from the pituitary gland or the absence of the normal response to ADH in the kidney. We present a case of transient central DI in a patient who underwent a cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG). A 44-yr-old male underwent a CABG operation. An hour after the operation, the patient developed polyuria and was diagnosed with central DI. The patient responded to desmopressin and completely recovered five days after surgery. It is probable that transient cerebral ischemia resulted in the dysfunction of osmotic receptors in the hypothalamus or hypothalamus-pituitary axis during CPB. It is also possible that cardiac standstill altered the left atrial non-osmotic receptor function and suppressed ADH release. Therefore, we suggest that central DI is a possible cause of polyuria after CPB. PMID:22969261

Implications Of The Security Cooperation Office Transition in Afghanistan For Special Operations Forces: An Abbreviated Report of the Study’s Primary Findings

DTIC Science & Technology

2017-01-01

for working in an interagency environment can lead to mission success. From the Iraq case study , one former U.S. Forces–Iraq official felt that...of six historical case studies in which the mission of special operations forces (SOF) in country transitioned over time to some level of inclusion...explanation of the methodology applied for case study selec- tion, as well as adopted interview protocols, are provided in the long- form version of

Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

ERIC Educational Resources Information Center

Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

2017-01-01

Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

Operative management of acute pavement burns: a case series.

PubMed

Silver, A G; Zamboni, W A; Baynosa, R C

2014-11-01

Acute burns suffered from contact with environmentally heated roadways and walkways are a rare entity. The aim of this report is to assess the information gained from the treatment of a series of patients. A retrospective review of a consecutive series of cases, where operative treatment was necessary, that occurred during July 2010 in southern Arizona. Seven patients were included, with an average total body surface area burn of 10.2%. Direct fascial excision and tangential excision were carried out on three and four patients, respectively. Although tangential excision was carried out to normal endpoints, there was commonly a need for repetitive debridement. The total hospital costs were over $4,400,000 (£2,730,000). Burns suffered from contact with roadways/walkways are often deeper than suggested by their appearance. Direct fascial excision minimises the number of debridement sessions. We hypothesise that the failure to offload pressure on these wounds may be a causative factor in their observed deepening.

Pathology informatics fellowship retreats: The use of interactive scenarios and case studies as pathology informatics teaching tools.

PubMed

Lee, Roy E; McClintock, David S; Balis, Ulysses J; Baron, Jason M; Becich, Michael J; Beckwith, Bruce A; Brodsky, Victor B; Carter, Alexis B; Dighe, Anand S; Haghighi, Mehrvash; Hipp, Jason D; Henricks, Walter H; Kim, Jiyeon Y; Klepseis, Veronica E; Kuo, Frank C; Lane, William J; Levy, Bruce P; Onozato, Maristela L; Park, Seung L; Sinard, John H; Tuthill, Mark J; Gilbertson, John R

2012-01-01

Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012) and involved both local and visiting faculty and fellows. Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions). Case studies have become an important component of our fellowship's educational platform.

A Study of the Optimal Planning Model for Reservoir Sustainable Management- A Case Study of Shihmen Reservoir

NASA Astrophysics Data System (ADS)

Chen, Y. Y.; Ho, C. C.; Chang, L. C.

2017-12-01

The reservoir management in Taiwan faces lots of challenge. Massive sediment caused by landslide were flushed into reservoir, which will decrease capacity, rise the turbidity, and increase supply risk. Sediment usually accompanies nutrition that will cause eutrophication problem. Moreover, the unevenly distribution of rainfall cause water supply instability. Hence, how to ensure sustainable use of reservoirs has become an important task in reservoir management. The purpose of the study is developing an optimal planning model for reservoir sustainable management to find out an optimal operation rules of reservoir flood control and sediment sluicing. The model applies Genetic Algorithms to combine with the artificial neural network of hydraulic analysis and reservoir sediment movement. The main objective of operation rules in this study is to prevent reservoir outflow caused downstream overflow, minimum the gap between initial and last water level of reservoir, and maximum sluicing sediment efficiency. A case of Shihmen reservoir was used to explore the different between optimal operating rule and the current operation of the reservoir. The results indicate optimal operating rules tended to open desilting tunnel early and extend open duration during flood discharge period. The results also show the sluicing sediment efficiency of optimal operating rule is 36%, 44%, 54% during Typhoon Jangmi, Typhoon Fung-Wong, and Typhoon Sinlaku respectively. The results demonstrate the optimal operation rules do play a role in extending the service life of Shihmen reservoir and protecting the safety of downstream. The study introduces a low cost strategy, alteration of operation reservoir rules, into reservoir sustainable management instead of pump dredger in order to improve the problem of elimination of reservoir sediment and high cost.

Co-Operation: The Antidote to Isolated Misery

ERIC Educational Resources Information Center

Jones, Sarah

2013-01-01

This is a case study demonstrating the impact the co-operative movement has had on one co-operative school in south-west England. Lipson Co-operative Academy in Plymouth was one of the first schools to convert to become a co-operative school in 2009. The article has been co-written by members of the Academy and focuses on three transformational…

Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study.

PubMed

Pelissari, Daniele Maria; Rocha, Marli Souza; Bartholomay, Patricia; Sanchez, Mauro Niskier; Duarte, Elisabeth Carmen; Arakaki-Sanchez, Denise; Dantas, Cíntia Oliveira; Jacobs, Marina Gasino; Andrade, Kleydson Bonfim; Codenotti, Stefano Barbosa; Andrade, Elaine Silva Nascimento; Araújo, Wildo Navegantes de; Costa, Fernanda Dockhorn; Ramalho, Walter Massa; Diaz-Quijano, Fredi Alexander

2018-06-06

To identify scenarios based on socioeconomic, epidemiological and operational healthcare factors associated with tuberculosis incidence in Brazil. Ecological study. The study was based on new patients with tuberculosis and epidemiological/operational variables of the disease from the Brazilian National Information System for Notifiable Diseases and the Mortality Information System. We also analysed socioeconomic and demographic variables. The units of analysis were the Brazilian municipalities, which in 2015 numbered 5570 but 5 were excluded due to the absence of socioeconomic information. Tuberculosis incidence rate in 2015. We evaluated as independent variables the socioeconomic (2010), epidemiological and operational healthcare indicators of tuberculosis (2014 or 2015) using negative binomial regression. Municipalities were clustered by the k-means method considering the variables identified in multiple regression models. We identified two clusters according to socioeconomic variables associated with the tuberculosis incidence rate (unemployment rate and household crowding): a higher socioeconomic scenario (n=3482 municipalities) with a mean tuberculosis incidence rate of 16.3/100 000 population and a lower socioeconomic scenario (2083 municipalities) with a mean tuberculosis incidence rate of 22.1/100 000 population. In a second stage of clusterisation, we defined four subgroups in each of the socioeconomic scenarios using epidemiological and operational variables such as tuberculosis mortality rate, AIDS case detection rate and proportion of vulnerable population among patients with tuberculosis. Some of the subscenarios identified were characterised by fragility in their information systems, while others were characterised by the concentration of tuberculosis cases in key populations. Clustering municipalities in scenarios allowed us to classify them according to the socioeconomic, epidemiological and operational variables associated with tuberculosis

33 CFR 154.1120 - Operating restrictions and interim operating authorization.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Facility Operating in Prince William Sound, Alaska § 154.1120 Operating restrictions and interim operating authorization. (a) The owner or operator of a TAPAA facility may not operate in Prince William Sound, Alaska... practicable, a worst case discharge or a discharge of 200,000 barrels of oil, whichever is grater, in Prince...

Work Sharing Case Studies.

ERIC Educational Resources Information Center

McCarthy, Maureen E.; And Others

Designed to provide private sector employers with the practical information necessary to select and then to design and implement work sharing arrangements, this book presents case studies of some 36 work sharing programs. Topics covered in the case studies include the circumstances leading to adoption of the program, details of compensation and…

Optimation of Operation System Integration between Main and Feeder Public Transport (Case Study: Trans Jakarta-Kopaja Bus Services)

NASA Astrophysics Data System (ADS)

Miharja, M.; Priadi, Y. N.

2018-05-01

Promoting a better public transport is a key strategy to cope with urban transport problems which are mostly caused by a huge private vehicle usage. A better public transport service quality not only focuses on one type of public transport mode, but also concerns on inter modes service integration. Fragmented inter mode public transport service leads to a longer trip chain as well as average travel time which would result in its failure to compete with a private vehicle. This paper examines the optimation process of operation system integration between Trans Jakarta Bus as the main public transport mode and Kopaja Bus as feeder public transport service in Jakarta. Using scoring-interview method combined with standard parameters in operation system integration, this paper identifies the key factors that determine the success of the two public transport operation system integrations. The study found that some key integration parameters, such as the cancellation of “system setoran”, passenger get in-get out at official stop points, and systematic payment, positively contribute to a better service integration. However, some parameters such as fine system, time and changing point reliability, and information system reliability are among those which need improvement. These findings are very useful for the authority to set the right strategy to improve operation system integration between Trans Jakarta and Kopaja Bus services.

Application of Decision Tree to Obtain Optimal Operation Rules for Reservoir Flood Control Considering Sediment Desilting-Case Study of Tseng Wen Reservoir

NASA Astrophysics Data System (ADS)

ShiouWei, L.

2014-12-01

Reservoirs are the most important water resources facilities in Taiwan.However,due to the steep slope and fragile geological conditions in the mountain area,storm events usually cause serious debris flow and flood,and the flood then will flush large amount of sediment into reservoirs.The sedimentation caused by flood has great impact on the reservoirs life.Hence,how to operate a reservoir during flood events to increase the efficiency of sediment desilting without risk the reservoir safety and impact the water supply afterward is a crucial issue in Taiwan. 　Therefore,this study developed a novel optimization planning model for reservoir flood operation considering flood control and sediment desilting,and proposed easy to use operating rules represented by decision trees.The decision trees rules have considered flood mitigation,water supply and sediment desilting.The optimal planning model computes the optimal reservoir release for each flood event that minimum water supply impact and maximum sediment desilting without risk the reservoir safety.Beside the optimal flood operation planning model,this study also proposed decision tree based flood operating rules that were trained by the multiple optimal reservoir releases to synthesis flood scenarios.The synthesis flood scenarios consists of various synthesis storm events,reservoir's initial storage and target storages at the end of flood operating. 　Comparing the results operated by the decision tree operation rules(DTOR) with that by historical operation for Krosa Typhoon in 2007,the DTOR removed sediment 15.4% more than that of historical operation with reservoir storage only8.38×106m3 less than that of historical operation.For Jangmi Typhoon in 2008,the DTOR removed sediment 24.4% more than that of historical operation with reservoir storage only 7.58×106m3 less than that of historical operation.The results show that the proposed DTOR model can increase the sediment desilting efficiency and extend the

Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

ERIC Educational Resources Information Center

Pai, Aditi

2014-01-01

A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

Instability study for LOFT for L2-1, L2-2, and L2-3 pretest steady-state operating conditions

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

Eide, S.A.

The results are presented of a thermal-hydrodynamic flow instability study of the LOFT reactor for the L2-1, L2-2, and L2-3 pretest steady-state operating conditions. Comparison is made between the LOFT reactor and a typical PWR, and the effects on stability of differences in operating parameters and geometry are discussed. Results indicate that the LOFT reactor will be thermal-hydrodynamically stable for nominal and worst case operating conditions. The study supports the LOFT Experimental Safety Analyses for the L2-1, L2-2, and L2-3 tests.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 2: Ground operations problems

NASA Technical Reports Server (NTRS)

Waldrop, Glen S.

1990-01-01

Operations problems and cost drivers were identified for current propulsion systems and design and technology approaches were identified to increase the operational efficiency and to reduce operations costs for future propulsion systems. To provide readily usable data for the ALS program, the results of the OEPSS study were organized into a series of OEPSS Data Books. This volume presents a detailed description of 25 major problems encountered during launch processing of current expendable and reusable launch vehicles. A concise description of each problem and its operational impact on launch processing is presented, along with potential solutions and technology recommendation.

Using Aspen to Teach Chromatographic Bioprocessing: A Case Study in Weak Partitioning Chromatography for Biotechnology Applications

ERIC Educational Resources Information Center

Evans, Steven T.; Huang, Xinqun; Cramer, Steven M.

2010-01-01

The commercial simulator Aspen Chromatography was employed to study and optimize an important new industrial separation process, weak partitioning chromatography. This case study on antibody purification was implemented in a chromatographic separations course. Parametric simulations were performed to investigate the effect of operating parameters…

Music and communication in the operating theatre.

PubMed

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

2015-12-01

To observe the extent and the detail with which playing music can impact on communication in the operating theatre. According to the cited sources, music is played in 53-72% of surgical operations performed. Noise levels in the operating theatre already exceed World Health Organisation recommendations. There is currently a divide in opinions on the playing of music in operating theatres, with few studies conducted and no policies or guidance provided. An ethnographic observational study of teamwork in operating theatres through video recordings. Quantitative and qualitative data analysis approaches were used. This study was conducted between 2012-2013 in the UK. Video recordings of 20 operations over six months in two operating theatres were captured. The recordings were divided into music and non-music playing cases. Each case was logged using a request/response sequence identified through interactional analysis. Statistical analysis, using a χ(2) , explored the difference between the proportion of request repetitions and whether music was playing or not. Further interactional analysis was conducted for each request repetition. Request/response observations (N = 5203) were documented. A chi-square test revealed that repeated requests were five times more likely to occur in cases that played music than those that did not. A repeated request can add 4-68 seconds each to operation time and increased tensions due to frustration at ineffective communication. Music played in the operating theatre can interfere with team communication, yet is seldom recognized as a potential safety hazard. Decisions around whether music is played and around the choice of music and its volume, are determined largely by surgeons. Frank discussions between clinicians, managers, patients and governing bodies should be encouraged for recommendations and guidance to be developed. © 2015 John Wiley & Sons Ltd.

Case study on risk evaluation of printed electronics using nanosilver ink.

PubMed

Kim, Ellen; Lee, Ji Hyun; Kim, Jin Kwon; Lee, Gun Ho; Ahn, Kangho; Park, Jung Duck; Yu, Il Je

2016-01-01

With the ever-increasing development of nanotechnology, our society is being surrounded by possible risks related to exposure to manufactured nanomaterials. The consumer market already includes many products that contain silver nanoparticles (AgNPs), including various household products, such as yoga mats, cutting boards, running shirts, and socks. There is a growing concern over the release of AgNPs in workplaces related to the manufacture and application of nanomaterials. This study investigated the release of AgNPs during the operation of a printed electronics printer. Using an exposure simulation chamber, a nanoparticle collector, scanning mobility particle sizer (SMPS), condensation particle counter (CPC), dust monitor, and mixed cellulose ester (MCE) filters are all connected to measure the AgNP exposure levels when operating a printed electronics printer. A very small amount of AgNPs was released during the operation of the printed electronics printer, and the number of AgNPs inside the exposure simulation chamber was lower than that outside background. In addition, when evaluating the potential risks for consumers and workers using a margin of exposure (MOE) approach and target MOE of 1000, the operational results far exceeded the target MOE in this simulation study and in a previous workplace exposure study. The overall results indicate a no-risk concern level in the case of printed electronics using nanosilver ink.

Methods of operation of apparatus measuring formation resistivity from within a cased well having one measurement and two compensation steps

DOEpatents

Vail, III, William B.

1993-01-01

Methods of operation of an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. First and second order errors of measurement are identified, and the measurement step and two compensation steps provide methods to substantially eliminate their influence on the results. A multiple frequency apparatus adapted to movement within the well is described which simultaneously provide the measurement and two compensation steps.

Is routine postoperative gastrografin study needed after laparoscopic sleeve gastrectomy? Experience of 712 cases.

PubMed

Wahby, M; Salama, A F; Elezaby, A F; Belgrami, F; Abd Ellatif, M E; El-Kaffas, H F; Al-Katary, M

2013-11-01

The current standard of care is to perform a postoperative gastrografin study following laparoscopic sleeve gastrectomy (LSG) to detect leakage or obstruction. This study evaluated the usefulness of this routine procedure. A retrospective chart review was performed in December 2012. All patients had routine intraoperative methylene blue testing to check for possible leakage from the staple line, and any leaking points were oversewn. We also performed postoperative contrast study (gastrografin) routinely in the first 24-48 h for all patients. From June 2007 to December 2012, 712 cases underwent LSG during the study period. Patients included in this study were 556 women (78.1%) and 156 men (21.9%). The mean age was 35 years. The mean BMI was 48 kg/m2. The operative time was 107 ± 29 min, and there were no conversions to open surgery. Intraoperative methylene blue test detected leakage in 28 cases (3.93%). Postoperative contrast study (gastrografin) was negative for leakage in all cases. Computed tomography (CT) scan with oral contrast study detected leakage in 1.4% (ten cases); none of these cases were detected by regular contrast study. Our study showed that intraoperative methylene blue test for leakage is a very sensitive and effective method for detecting leakage during sleeve gastrectomy and should be done routinely in all cases. Routine postoperative contrast study is not needed to detect leakage unless clinically indicated in selected cases, and in such cases contrast-enhanced CT scans are the modality of choice.

Evaluation of noise pollution level in the operating rooms of hospitals: A study in Iran.

PubMed

Giv, Masoumeh Dorri; Sani, Karim Ghazikhanlou; Alizadeh, Majid; Valinejadi, Ali; Majdabadi, Hesamedin Askari

2017-06-01

Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter. The gathered data were compared with national and international standards. Statistical analysis was performed using descriptive statistics and one-way ANOVA, t -test, and Pearson's correlation test. Noise pollution level at majority of surgical procedures is higher than national and international documented standards. The highest level of noise pollution is related to orthopedic procedures, and the lowest one related to laparoscopic and heart surgery procedures. The highest and lowest registered sound level during the operation was 93 and 55 dB, respectively. Sound level generated by equipments (69 ± 4.1 dB), trolley movement (66 ± 2.3 dB), and personnel conversations (64 ± 3.9 dB) are the main sources of noise. The noise pollution of operating rooms are higher than available standards. The procedure needs to be corrected for achieving the proper conditions.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

[Bladder injury during sling operation in the treatment of SUI--review of literature and case report].

PubMed

Gałczyński, Krzysztof; Futyma, Konrad; Bar, Krzysztof; Rechberger, Tomasz

2012-10-01

Sling operations have been performed for over 15 years. In recent years these operations have become the gold standard in the treatment of stress urinary incontinence (SUI) due to their efficacy safety and low invasiveness. Approximately 4% of women will undergo a surgery for SUI in the course of their life. As with any surgical intervention, there may be some technical problems, as well as intra- and postoperative complications, the most common of which is bladder injury Other complications encountered during mid-urethral slings procedures include bleeding (retropubic or vaginal hematomas), urethral perforation, urinary tract infections, postoperative vaginal or urethral erosions, bowel perforation, chronic pelvic pain, wound infection, nerve injury transient and persistent voiding dysfunction such as de novo urgency incomplete bladder emptying or urinary retention. Below we present a case of a patient with diagnosed vesicovaginal fistula after sling operation (TVT-tension-free vaginal tape). Upon admission the patient reported dysuria, persistent urinary leakage and abnormal, abundant vaginal discharge. Case report and review of literature concerning surgical treatment of stress urinary incontinence and its complications. Analysis of medical documentation of the patient treated at the Second Department of Gynecology Medical University of Lublin. Review of abstracts or papers in the Medline database related to surgical treatment of urinary incontinence and its complications. Bladder perforation is one of the most common complications of the retropubic approach for MUS placement. The presence of mesh within the bladder may arise from direct bladder perforation or from subsequent erosion of the sling. Such lesions do not cause any serious health consequences for patients on condition they are detected intraoperatively and appropriately repaired, but when unrecognized, they results in the development of considerable symptoms and negatively influence the quality of

Four canals in the mesial root of a mandibular first molar. A case report under the operating microscope.

PubMed

Kontakiotis, Evangelos G; Tzanetakis, Giorgos N

2007-08-01

In this era of microscope-assisted endodontics, finding variations in root canal system anatomy is not uncommon. Operating microscopes combined with careful clinical examination and radiographic interpretation can aid the clinician to successfully treat cases with such internal anatomy. The understanding of this view enables the possible location of additional canals in any tooth requiring endodontic treatment. The present clinical article demonstrates a rare anatomical complexity in the mesial root of a mandibular first molar. Four independent root canal orifices were found in this root by clinical detection with the aid of a dental operating microscope. This case shows that additional canals can be located in any root undergoing endodontic treatment and clinicians should always be aware of aberrant internal anatomy.

Theoretical pluralism in psychoanalytic case studies.

PubMed

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

Theoretical pluralism in psychoanalytic case studies

PubMed Central

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

The Impact of Different Postgraduate Year Training in Neurosurgery Residency on 30-Day Return to Operating Room: A National Surgical Quality Improvement Program Study.

PubMed

Macki, Mohamed; Fakih, Mohamed; Kandagatla, Pridvi; Rubinfeld, Ilan; Chang, Victor

2018-06-01

Because of the health care initiative on quality improvement projects in academic medicine, this study explores the impact of different postgraduate years (PGYs) on unexpected re-operation rates. Using the National Surgical Quality Improvement Program 2005-2014, adult neurosurgical cases were divided into subspecialties: spine, open vascular, cranial, and functional. Comparison groups were cases involving junior residents (PGY 1-PGY 3), mid-level residents (PGY 4 + PGY 5), and senior residents (PGY 6 + PGY 7). Comorbidity disease burden was measured by frailty index. The primary outcome measure was 30-day unintended return to the operating room. Of the 9782 cases, re-operations were higher for those cases featuring a senior resident (5.6%) compared with mid-level resident (4.1%) and junior resident (3.8%) (P = 0.001). Although senior residents operated on patients with a statistically significantly higher neurologic disease burden, greater relative value units, longer operative times, and more 30-day postoperative adverse events, the level of resident training did not have an impact on revision surgery after multivariable logistical regression. The strongest predictors of return to the operating room included the frailty index (adjusted odds ratio [OR adj ] = 5.18, P < 0.001), functional subspecialty (OR adj  = 2.65, P < 0.001), and Wound Class 4 - dirty/infected wound (OR adj  = 2.33, P = 0.016). Resident participation in neurosurgical cases does not affect 30-day unplanned re-operation rates, which were affected by frailty index, functional subspecialty, and wound class. Copyright © 2018 Elsevier Inc. All rights reserved.

Teaching astronomy with case studies

NASA Astrophysics Data System (ADS)

Slater, Timothy F.

2015-11-01

Breaking the students into small, collaborative learning groups to solve a meaningful task together is one of the most successful and fully evaluated teaching techniques implemented over the last century. Although there are many ways to accomplish small group learning, a long-standing and consistently successful collaborative class activity is to use the case study teaching strategy. The use of case studies is common in medical schools and law schools, but not so common in the teaching of astronomy. Case studies create meaningful conversations among students and with the professor by focusing on life-like dilemmas to be solved. Case study tasks ask audience members to synthesize several ideas or evaluate scenarios that have not been explicitly presented to them in the lecture or in available readings.

[Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint].

PubMed

Qi, Yue-Feng; Chen, Fa-Lin; Bao, Shu-Ren; Li, Cheng-Huan; Zhao, Xing-Wei; Liu, Shi-Ming; Chen, Wen-Xue; Li, Ye; Wang, Peng

2012-08-01

To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism. From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment. All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05). Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

Evaluating the Implications of Climate Phenomenon Indices in Supporting Reservoir Operation Using the Artificial Neural Network and Decision-Tree Methods: A Case Study on Trinity Lake in Northern California

NASA Astrophysics Data System (ADS)

Yang, T.; Akbari Asanjan, A.; Gao, X.; Sorooshian, S.

2016-12-01

Reservoirs are fundamental human-built infrastructures that collect, store, and deliver fresh surface water in a timely manner for all kinds of purposes, including residential and industrial water supply, flood control, hydropower, and irrigation, etc. Efficient reservoir operation requires that policy makers and operators understand how reservoir inflows, available storage, and discharges are changing under different climatic conditions. Over the last decade, the uses of Artificial Intelligence and Data Mining (AI & DM) techniques in assisting reservoir management and seasonal forecasts have been increasing. Therefore, in this study, two distinct AI & DM methods, Artificial Neural Network (ANN) and Random Forest (RF), are employed and compared with respect to their capabilities of predicting monthly reservoir inflow, managing storage, and scheduling reservoir releases. A case study on Trinity Lake in northern California is conducted using long-term (over 50 years) reservoir operation records and 17 known climate phenomenon indices, i.e. PDO and ENSO, etc., as predictors. Results show that (1) both ANN and RF are capable of providing reasonable monthly reservoir storage, inflow, and outflow prediction with satisfactory statistics, and (2) climate phenomenon indices are useful in assisting monthly or seasonal forecasts of reservoir inflow and outflow. It is also found that reservoir storage has a consistent high autocorrelation effect, while inflow and outflow are more likely to be influenced by climate conditions. Using a Gini diversity index, RF method identifies that the reservoir discharges are associated with Southern Oscillation Index (SOI) and reservoir inflows are influenced by multiple climate phenomenon indices during different seasons. Furthermore, results also show that, during the winter season, reservoir discharges are controlled by the storage level for flood-control purposes, while, during the summer season, the flood-control operation is not as

A mathematical model of case-ascertainment bias: Applied to case-control studies nested within a randomized screening trial.

PubMed

Jansen, Rick J; Alexander, Bruce H; Hayes, Richard B; Miller, Anthony B; Wacholder, Sholom; Church, Timothy R

2018-01-01

When some individuals are screen-detected before the beginning of the study, but otherwise would have been diagnosed symptomatically during the study, this results in different case-ascertainment probabilities among screened and unscreened participants, referred to here as lead-time-biased case-ascertainment (LTBCA). In fact, this issue can arise even in risk-factor studies nested within a randomized screening trial; even though the screening intervention is randomly allocated to trial arms, there is no randomization to potential risk-factors and uptake of screening can differ by risk-factor strata. Under the assumptions that neither screening nor the risk factor affects underlying incidence and no other forms of bias operate, we simulate and compare the underlying cumulative incidence and that observed in the study due to LTBCA. The example used will be constructed from the randomized Prostate, Lung, Colorectal, and Ovarian cancer screening trial. The derived mathematical model is applied to simulating two nested studies to evaluate the potential for screening bias in observational lung cancer studies. Because of differential screening under plausible assumptions about preclinical incidence and duration, the simulations presented here show that LTBCA due to chest x-ray screening can significantly increase the estimated risk of lung cancer due to smoking by 1% and 50%. Traditional adjustment methods cannot account for this bias, as the influence screening has on observational study estimates involves events outside of the study observation window (enrollment and follow-up) that change eligibility for potential participants, thus biasing case ascertainment.

Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

DTIC Science & Technology

2008-05-01

or CRNA in training. The training of staff and the use of advanced technology, such as the Davinci Surgical Robot, may lead to an increase in time...gynecology performed during block-time will involve the use of the Davinci robot. When using the robot for a case, the set-up and prep-time before...1999). It is because of the cost of surgical staff that block-time lost to delays is concerning. MCA implemented block-time because it provides a tool

The effect of class imbalance on case selection for case-based classifiers: An empirical study in the context of medical decision support

PubMed Central

Malof, Jordan M.; Mazurowski, Maciej A.; Tourassi, Georgia D.

2013-01-01

Case selection is a useful approach for increasing the efficiency and performance of case-based classifiers. Multiple techniques have been designed to perform case selection. This paper empirically investigates how class imbalance in the available set of training cases can impact the performance of the resulting classifier as well as properties of the selected set. In this study, the experiments are performed using a dataset for the problem of detecting breast masses in screening mammograms. The classification problem was binary and we used a k-nearest neighbor classifier. The classifier’s performance was evaluated using the Receiver Operating Characteristic (ROC) area under the curve (AUC) measure. The experimental results indicate that although class imbalance reduces the performance of the derived classifier and the effectiveness of selection at improving overall classifier performance, case selection can still be beneficial, regardless of the level of class imbalance. PMID:21820273

Rapid Operational Access and Maneuver Support (ROAMS) Platform for Improved Military Logistics Lines of Communication and Operational Vessel Routing

DTIC Science & Technology

2017-06-01

case study in a northeastern American metropolitan area. METHODOLOGY : The ROAMS platform provides expanded analysis, model automation, and enhanced...shoals. An initial route for such operations is selected much like the military logistics case . Subsequent adjustments to routes may be done on an ad...IX-45 June 2017 8 CASE STUDY: The ROAMS platform was applied to a large, northeast American metropolitan region to demonstrate the capability of

Case Studies in Wilderness Medicine.

ERIC Educational Resources Information Center

Gray, Melissa; Tarter, Shana Lee

Five case studies explore issues in wilderness medicine, with emphasis on evacuation decision making. The cases describe medical problems encountered during wilderness trips involving college or high school students. In each case, the situation and facts of the case are outlined, including the patient's medical history and vital signs, and at…

Best Practices for Port Operations

EPA Pesticide Factsheets

This page provides links to best practice resources for port authorities, terminal operators and fleet owners, drayage truckers, and rail and locomotives as well as a link to case studies on best practice.

[Risk factors associated with trigger finger. Case-control study].

PubMed

De la Parra-Márquez, Miguel Leonardo; Tamez-Cavazos, Roberto; Zertuche-Cedillo, Luis; Martínez-Pérez, Juan José; Velasco-Rodríguez, Víctor; Cisneros-Pérez, Vicente

2008-01-01

We undertook this study to identify risk factors in our population associated with trigger finger. The study was conducted at the Instituto Mexicano del Seguro Social, UMAE 21, Monterrey, Nuevo Leon, Mexico. This was a case-control, retrospective, and observational study. There were 250 patients in each group. For cases, patients who were operated on for trigger finger from March 2006 to August 2006 were included. Controls included patients admitted to the Emergency Department with hand injuries that fulfilled the selection criteria. Risk factors analyzed were diabetes, hypertension, smoking, sex, age, weight, and 19 different occupations. Mean age of the cases was 52 years (SE +/- 14.19 years) with a median and mode of 53 years. The right hand was the most common with the middle, thumb, ring, index and little fingers, respectively. A significant statistical relationship was found: females (OR 7.57, 95% CI 5.07-11.31); diabetes (OR 3.72, 95% CI 2.43-5.70); obesity (OR 1.49, 95% CI 1.02-2.19). With regard to occupation, a statistical relationship was found: homemaker (OR 2.44, 95% CI 1.62-3.69); seamstress (OR 4.8, 95% CI 1.3-21.6); and secretary (OR 2.74, 95% CI 1.38-5.52). Trigger finger is a common pathology in our population and is more frequent in women >53 years old. It may be related to diabetes, body mass index (obesity) and certain occupations such as secretary, seamstress and homemaker.

Shuttle Ground Operations Efficiencies/Technologies (SGOE/T) study. Volume 2: Ground Operations evaluation

NASA Technical Reports Server (NTRS)

Scholz, A. L.; Hart, M. T.; Lowry, D. J.

1987-01-01

The Ground Operations Evaluation describes the breath and depth of the various study elements selected as a result of an operational analysis conducted during the early part of the study. Analysis techniques used for the evaluation are described in detail. Elements selected for further evaluation are identified; the results of the analysis documented; and a follow-on course of action recommended. The background and rationale for developing recommendations for the current Shuttle or for future programs is presented.

Chattanooga Electric Power Board Case Study Distribution Automation

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

Glass, Jim; Melin, Alexander M.; Starke, Michael R.

In 2009, the U.S. Department of Energy under the American Recovery and Reinvestment Act (ARRA) awarded a grant to the Chattanooga, Tennessee, Electric Power Board (EPB) as part of the Smart Grid Investment Grant Program. The grant had the objective “to accelerate the transformation of the nation’s electric grid by deploying smart grid technologies.” This funding award enabled EPB to expedite the original smart grid implementation schedule from an estimated 10-12 years to 2.5 years. With this funding, EPB invested heavily in distribution automation technologies including installing over 1,200 automated circuit switches and sensors on 171 circuits. For utilities consideringmore » a commitment to distribution automation, there are underlying questions such as the following: “What is the value?” and “What are the costs?” This case study attempts to answer these questions. The primary benefit of distribution automation is increased reliability or reduced power outage duration and frequency. Power outages directly impact customer economics by interfering with business functions. In the past, this economic driver has been difficult to effectively evaluate. However, as this case study demonstrates, tools and analysis techniques are now available. In this case study, the impact on customer costs associated with power outages before and after the implementation of distribution automation are compared. Two example evaluations are performed to demonstrate the benefits: 1) a savings baseline for customers under normal operations1 and 2) customer savings for a single severe weather event. Cost calculations for customer power outages are performed using the US Department of Energy (DOE) Interruption Cost Estimate (ICE) calculator2. This tool uses standard metrics associated with outages and the customers to calculate cost impact. The analysis shows that EPB customers have seen significant reliability improvements from the implementation of distribution automation

[Pneumonectomy for tuberculosis destroyed lung: A series of 26 operated cases].

PubMed

Issoufou, I; Sani, R; Belliraj, L; Ammor, F Z; Moussa Ounteini, A; Ghalimi, J; Lakranbi, M; Ouadnouni, Y; Smahi, M

2016-10-01

Pneumonectomy keeps a greatest place in the treatment of tuberculosis lung destroyed despite high morbidity and mortality. The aim of our study was to analyze the results of pneumonectomy in the treatment of tuberculosis lung destroyed in our institution. A retrospective study over a period of 5 years (2009 to 2014) was realized. Are involved in the study all patients admitted to the thoracic surgery department of CHU Hassan II with tuberculosis lung destroyed and operated during the study period. This is a series of 26 patients, including 17 men and 9 women treated and cured for pulmonary tuberculosis of which 2 for multiresistant tuberculosis. The average age was 38.8 years. Hemoptysis (77 %) and recurrent respiratory infections (65.4 %) were the major clinical signs. Aspergilloma have been reported on cavitary lesion in 23 % of cases and in 11.5 % pyothorax was associated. Extra-pericardial pneumonectomy was performed in 65.4 %, intra-pericardial pneumonectomy in 19.3 % and pleural-pneumonectomy in 15.3 %. The outcome was favorable in 23 patients. We noted a pyothorax on pneumonectomy cavity in 3 patients. Postoperative mortality was 7.7 %. The regularly clinical and radiological control of all patients is satisfactory with a mean of 41 months. Pneumonectomy for tuberculosis lung destroyed remains effective in young patients with an acceptable complication rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Operational fog collection and its role in environmental education and social reintegration: A case study in Colombia

NASA Astrophysics Data System (ADS)

Escobar, C. M.; Lopez, A.; Aristizabal, H. F.; Molina, J. M.

2010-07-01

Experimental efforts with fog collection in Colombia began eight years ago, and in recent papers we have suggested the implementation of operational fog collection as an alternative to meet water requirements in rural areas of the Andes Mountain Range. Since then, an increasing number of individuals from academia and environmental organizations in the country have shown a remarkable interest on this appropriate technology, and some started its exploration in a larger scale. In this work we describe the implementation process of the first operational fog collection project in Colombia and discuss its role in rural water supply, in environmental education issues and in the process of "social reintegration" of people who have been victims of forced displacement. Both the fog collection evaluation stage and construction and administration of the operational system involved the participation of the community of a rural village. The study zone, located in the Andes Mountains of the Valle del Cauca Department and with altitudes ranging from 2600 to 2800 meters a.s.l., has serious limitations in water availability. Eight standard fog collectors (SFC) were implemented and used during the period May/2008 - Feb/2009 in order to assess the water yield from fog. The best average monthly collection rate in the period of study was around 2.0 l.m-2.day-1. The constructed large fog collector (LFC), with a vertical collection surface of 25 m2, and the associated hydraulic system are currently managed and administered by the village inhabitants. The fog collection system benefits a rural school, and the water is mainly used in small-scale irrigation activities for horticultural crops and livestock development. The project has also brought positive impacts in the community organization, mainly comprising people who have been forced out of their rural homes by the country's nearly half-century old armed conflict. The system also allows agriculture- and environment-related issues to be

Metropolitan transportation management center : a case study : Milwaukee MONITOR : addressing congestion while improving safety and air quality

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Milwaukee's MONITOR transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stu...

Real-Life Case Studies for Teachers.

ERIC Educational Resources Information Center

Hayes, William

Case studies described in this book reflect conditions present in today's public schools. Situations described in these case studies are intended to introduce education students to the variety of problems existing in today's schools. The 38 case studies highlight: student cheating; teacher's observation by administrator; inclusion; contract…

Harvard University: Green Loan Fund. Green Revolving Funds in Action: Case Study Series

ERIC Educational Resources Information Center

Foley, Robert

2011-01-01

The Green Loan Fund at Harvard University has been an active source of capital for energy efficiency and waste reduction projects for almost a decade. This case study examines the revolving fund's history from its inception as a pilot project in the 1990s to its regeneration in the early 2000s to its current operations today. The green revolving…

Culture and Character Education in a Jewish Day School: A Case Study of Life and Experience

ERIC Educational Resources Information Center

Roso, Calvin G.

2013-01-01

This article addresses how to teach character comprehensively by studying ways a school's concurrent curricula (the official curriculum, the operational curriculum, the extra curriculum, and the hidden curriculum) can be used to teach character to students. A single case study analyzes the curriculum at a Jewish day school by examining school…

Metropolitan Transportation Management Center : a case study : Houston TranStar maximizing safety and mobility for the public

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Houston's TranStar transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stud...

The Resident-Run Minor Surgery Clinic: A Pilot Study to Safely Increase Operative Autonomy.

PubMed

Wojcik, Brandon M; Fong, Zhi Ven; Patel, Madhukar S; Chang, David C; Petrusa, Emil; Mullen, John T; Phitayakorn, Roy

General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program. Single institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort. Massachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program. Ten third-year general surgery residents. Overall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing

Case Studies in Science Ethics

NASA Astrophysics Data System (ADS)

Williams, Karen

2010-03-01

Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

Introduction on the operational storm surge forecasting system in Korea Operational Oceanographic System (KOOS)

NASA Astrophysics Data System (ADS)

Kwon, Jae-Il; Park, Kwang-Soon; Choi, Jung-Woon; Lee, Jong-Chan; Heo, Ki-Young; Kim, Sang-Ik

2017-04-01

During last more than 50 years, 258 typhoons passed and affected the Korean peninsula in terms of high winds, storm surges and extreme waves. In this study we explored the performance of the operational storm surge forecasting system in the Korea Operational Oceanographic System (KOOS) with 8 typhoons from 2010 to 2016. The operation storm surge forecasting system for the typhoon in KOOS is based on 2D depth averaged model with tides and CE (U.S. Army Corps of Engineers) wind model. Two key parameters of CE wind model, the locations of typhoon center and its central atmospheric pressure are based from Korea Meteorological administrative (KMA)'s typhoon information provided from 1 day to 3 hour intervals with the approach of typhoon through the KMA's web-site. For 8 typhoons cases, the overall errors, other performances and analysis such as peak time and surge duration are presented in each case. The most important factor in the storm surge errors in the operational forecasting system is the accuracy of typhoon passage prediction.

Analysis of projectile motion: A comparative study using fractional operators with power law, exponential decay and Mittag-Leffler kernel

NASA Astrophysics Data System (ADS)

Gómez-Aguilar, J. F.; Escobar-Jiménez, R. F.; López-López, M. G.; Alvarado-Martínez, V. M.

2018-03-01

In this paper, the two-dimensional projectile motion was studied; for this study two cases were considered, for the first one, we considered that there is no air resistance and, for the second case, we considered a resisting medium k . The study was carried out by using fractional calculus. The solution to this study was obtained by using fractional operators with power law, exponential decay and Mittag-Leffler kernel in the range of γ \\in (0,1] . These operators were considered in the Liouville-Caputo sense to use physical initial conditions with a known physical interpretation. The range and the maximum height of the projectile were obtained using these derivatives. With the aim of exploring the validity of the obtained results, we compared our results with experimental data given in the literature. A multi-objective particle swarm optimization approach was used for generating Pareto-optimal solutions for the parameters k and γ for different fixed values of velocity v0 and angle θ . The results showed some relevant qualitative differences between the use of power law, exponential decay and Mittag-Leffler law.

Operability score: an innovative tool for quantitative assessment of operability in comparative studies on surgical anatomy.

PubMed

Gagliardi, Filippo; Boari, Nicola; Roberti, Fabio; Caputy, Anthony J; Mortini, Pietro

2014-09-01

Comparative anatomical studies have proved to be invaluable in the evaluation of advantages and drawbacks of single approaches to access established target areas. Approach-related exposed areas do not necessarily represent useful areas when performing surgical manoeuvres. Accordingly the concept of "operability" has recently been introduced as a qualitative assessment of the ability to execute surgical manoeuvres. The authors propose an innovative model for the quantitative assessment of the operability, defined as "operability score" (OS), which can be effectively and easily applied to comparative studies on surgical anatomy. A microanatomical study was conducted on six cadaveric heads. Morphometric measurements were collected and operability scores in selected target points of the surgical field were calculated. As illustrative example, the operability score was applied to the extradural subtemporal transzygomatic approach (ESTZ). The operability score is effective in grading system of surgical operability, and instruments manipulation capability. It is a useful tool to evaluate, in a single approach, areas that can be exposed, and to quantify how those areas are suitable for surgical manoeuvres. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

[Vertebral aneurysmatic bone cyst: study of three cases].

PubMed

Vale, Benjamim Pessoa; Alencar, Francisco José; de Aguiar, Guilherme Brasileiro; de Almeida, Bruno Ribeiro

2005-12-01

Aneurysmatic bone cyst is a hypervascularized, benign lesion locally destructive by its progressive growth with greater incidence in the second decade of life. It lodges preferably in the long bones and vertebrae. The clinical picture varies from pain to local edema and even neurological symptoms when in vertebral location. Three cases of vertebral aneurysmatic bone cyst occurring in childhood and all with neurologic deficit symptoms are described. Computerized tomography and/or magnetic resonance imaging confirmed the diagnosis. Patients underwent surgery to remove the tumor. In one of the cases, pre-operative selective arterial embolization of the lesion was performed. The three patients progressed satisfactorily with neurological improvement, which demonstrated the efficiency of the microsurgical technique for the resection of the spinal tumor. The evolution of the cases and the current treatment are discussed.

Home Start Evaluation Study. Interim Case Studies IIa.

ERIC Educational Resources Information Center

Fein, Robert

This formative evaluation study of Home Start uses a case study approach. A brief case study focuses on the administrative structure and staff resources and responsibilities of National Home Start. Also included are reports on seven local programs developed after two field visits had been made to each program. In the first visit, objectives chosen…

Business and Consumer Education Case Studies.

ERIC Educational Resources Information Center

Delta Pi Epsilon, Minneapolis, Minn. Phi Chapter.

This publication contains 58 case studies for classroom use in teaching various business and consumer education subjects at the high school level. A supplement to a previous Phi Chapter publication, "Office Education Case Studies" (1973), the case studies are intended to create class discussions and help students acquire the ability to analyze…

Case Studies

ERIC Educational Resources Information Center

Ritter, Lois A., Ed.; Sue, Valerie M., Ed.

2007-01-01

This article presents two case studies using online surveys for evaluation. The authors begin with an example of a needs assessment survey designed to measure the amount of help new students at a university require in their first year. They then discuss the follow-up survey conducted by the same university to measure the effectiveness of the…

Significance of radiological variables studied on orthopantamogram to pridict post-operative inferior alveoler nerve paresthesia after third molar extraction.

PubMed

Pathak, Sachin; Mishra, Nitin; Rastogi, Madhur Kant; Sharma, Shalini

2014-05-01

Removal of impacted third molar is a procedure that is often associated with post-operative complications. The rate of complications is somewhat high because of its proximity to the vital structures. Inferior alveolar nerve paresthesia is one of the common complications of impacted their molar surgery. This is due to intimate relationship between roots of mandibular third molar and inferior alveolar canal. To access the proximity of inferior alveolar canal to third molar many diagnostic methods are suggested but in conventional radiography orthopantamogram is considered as the best. There are many findings onorthopantamogram that are suggestive of close proximity of nerve to the canal. In this study authors reviewed seven radiographic findings related to proximity of roots to the inferior alveolar nerve as seen on orthopantamogram and try to find a relationship between these radiographic variables and presence of post-operative paresthesia. The study containd 100 impacted third molars need to be removed. Presence of radiographic findings on orthopantamogram were noted and analyzed, to find a relationship with occurrence of post-operative inferior alveolar nerve paresthesia. This study comprises of 100 impacted third molar teeth indicated for extraction. Cases were randomly selected from the patients, needs to undergo extraction of impacted mandibular third molar. After extraction cases were evaluated for occurrence of inferior alveolar nerve paresthesia. Stastical Analyisis: Data was transferred to SPss 21 software for frequency calculation, and two tailed p-values were obtained betweens these variables and post-operative paresthesia, by applying Fischer's exact test (GRAPH PAD SOFTWARE). Out of seven, four radiological findings that are grooving of roots, hooked roots, bifid roots and obliteration of white line are significantly related to post-operative paresthesia while bending of canal, narrow canal and darkening of tooth roots over the canal are not

Qualitative Case Study Guidelines

DTIC Science & Technology

2013-11-01

Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

Dissociation between facial and bodily expressions in emotion recognition: A case study.

PubMed

Leiva, Samanta; Margulis, Laura; Micciulli, Andrea; Ferreres, Aldo

2017-12-21

Existing single-case studies have reported deficit in recognizing basic emotions through facial expression and unaffected performance with body expressions, but not the opposite pattern. The aim of this paper is to present a case study with impaired emotion recognition through body expressions and intact performance with facial expressions. In this single-case study we assessed a 30-year-old patient with autism spectrum disorder, without intellectual disability, and a healthy control group (n = 30) with four tasks of basic and complex emotion recognition through face and body movements, and two non-emotional control tasks. To analyze the dissociation between facial and body expressions, we used Crawford and Garthwaite's operational criteria, and we compared the patient and the control group performance with a modified one-tailed t-test designed specifically for single-case studies. There were no statistically significant differences between the patient's and the control group's performances on the non-emotional body movement task or the facial perception task. For both kinds of emotions (basic and complex) when the patient's performance was compared to the control group's, statistically significant differences were only observed for the recognition of body expressions. There were no significant differences between the patient's and the control group's correct answers for emotional facial stimuli. Our results showed a profile of impaired emotion recognition through body expressions and intact performance with facial expressions. This is the first case study that describes the existence of this kind of dissociation pattern between facial and body expressions of basic and complex emotions.

[Non operative treatment for perforated peptic ulcer: results of a prospective study].

PubMed

Songne, B; Jean, F; Foulatier, O; Khalil, H; Scotté, M

2004-12-01

The conservative management of perforated peptic ulcer has not gained widespread acceptance despite introduction of proton-pomp inhibitors because surgical procedures can achieve immediate closure by eventually using a laparoscopic approach. The aim of this prospective study was to evaluate the results of Taylor's method and to identify predictive factors of failure of medical treatment in patients presenting with perforated peptic ulcer. Between 1990 and 2000, 82 consecutive patients, with diagnosis of perforated peptic ulcer were prospectively included in this study. They were initially treated with non-operative procedure (nasogastric suction and intravenous administration of H2-blockers or proton-pomp inhibitors). No clinical improvement after 24 hours required a surgical treatment. Predictive factors of failure of non-operative treatment were tested in univariate or multivariate analysis. Clinical improvement was obtained with non-operative treatment in 54% of the patients (44/82). The overall mortality rate was 1%. In univariate analysis, significant predictive factors of failure of non-operative treatment were: size of pneumoperitoneum, heart beat >94 bpm, abdominal meteorism, pain at digital rectal exam, and age >59 years. In multivariate analysis, the significant factors were the size of pneumoperitoneum, heart beat, and abdominal meteorism. The association of these criteria: size of pneumoperitoneum >size of the first lumbar vertebra, heart beat >94 bpm, pain at digital rectal exam and age > 59 years , led to surgical treatment in all cases. These results suggest that more than 50% of patients with perforated peptic ulcer respond to conservative treatment without surgery and that the association of few criteria (size of pneumoperitoneum, heart beat, pain at digital rectal exam and age) require emergency surgery.

Entropy Generation Minimization in Dimethyl Ether Synthesis: A Case Study

NASA Astrophysics Data System (ADS)

Kingston, Diego; Razzitte, Adrián César

2018-04-01

Entropy generation minimization is a method that helps improve the efficiency of real processes and devices. In this article, we study the entropy production (due to chemical reactions, heat exchange and friction) in a conventional reactor that synthesizes dimethyl ether and minimize it by modifying different operating variables of the reactor, such as composition, temperature and pressure, while aiming at a fixed production of dimethyl ether. Our results indicate that it is possible to reduce the entropy production rate by nearly 70 % and that, by changing only the inlet composition, it is possible to cut it by nearly 40 %, though this comes at the expense of greater dissipation due to heat transfer. We also study the alternative of coupling the reactor with another, where dehydrogenation of methylcyclohexane takes place. In that case, entropy generation can be reduced by 54 %, when pressure, temperature and inlet molar flows are varied. These examples show that entropy generation analysis can be a valuable tool in engineering design and applications aiming at process intensification and efficient operation of plant equipment.

SPICE for ESA Planetary Missions: geometry and visualization support to studies, operations and data analysis within your reach

NASA Astrophysics Data System (ADS)

Costa, Marc

2018-05-01

JUICE is a mission chosen in the framework of the Cosmic Vision 2015-2024 program of the SRE. JUICE will survey the Jovian system with a special focus on the three Galilean Moons. Currently the mission is under study activities during its Definition Phase. For this period the future mission scenarios are being studied by the Science Working Team (SWT). The Mission Analysis and Payload Support (MAPPS) and the Solar System Science Operations Laboratory (SOLab) tools are being used to provide active support to the SWT in synergy with other operational tools used in the Department in order to evaluate the feasibility of those scenarios. This contribution will outline the capabilities, synergies as well as use cases of the mentioned tools focusing on the support provided to JUICEís study phase on the study of its critical operational scenarios and the early developments of its Science Ground Segment demonstrating the added value that such a tool provides to planetary science missions.

Pontiac fever: an operational definition for epidemiological studies

PubMed Central

Tossa, Paul; Deloge-Abarkan, Magali; Zmirou-Navier, Denis; Hartemann, Philippe; Mathieu, Laurence

2006-01-01

Background Pontiac fever is usually described in epidemic settings. Detection of Pontiac fever is a marker of an environmental contamination by Legionella and should thereby call for prevention measures in order to prevent outbreak of Legionnaire's disease. The objective of this study is to propose an operational definition of Pontiac fever that is amenable to epidemiological surveillance and investigation in a non epidemic setting. Methods A population of 560 elderly subjects residing in 25 nursing homes was followed during 4 months in order to assess the daily incidence of symptoms associated, in the literature, with Pontiac fever. The water and aerosol of one to 8 showers by nursing home were characterized combining conventional bacterial culture of Legionella and the Fluorescence In Situ Hybridization (FISH) technique that used oligonucleotides probes specific for Legionellaceae. A definition of Pontiac fever was devised based on clinical symptoms described in epidemic investigations and on their timing after the exposure event. The association between incidence of Pontiac fever and shower contamination levels was evaluated to test the relevance of this definition. Results The proposed definition of Pontiac fever associated the following criteria: occurrence of at least one symptom among headache, myalgia, fever and shivers, possibly associated with other 'minor' symptoms, within three days after a shower contaminated by Legionella, during a maximum of 8 days (minimum 2 days). 23 such cases occurred during the study (incidence rate: 0.125 cases per person-year [95% CI: 0.122–0.127]). A concentration of Legionella in water equal to or greater than 104.L-1 (FISH method) was associated with a significant increase of incidence of Pontiac fever (p = 0.04). Conclusion Once validated in other settings, the proposed definition of Pontiac fever might be used to develop epidemiological surveillance and help draw attention on sources of Legionella. PMID:16646972

Integrating Army Aviation into the Combined Arms Team: Operational Art in Desert Shield and Desert Storm

DTIC Science & Technology

2017-05-25

new doctrine, the ideal organization, and what would eventually become a branch. The framework for the historical case study is the doctrinal...operational art were apparent in the case study , and were enabled, either directly or indirectly, by rotary-wing aviation. This case study illuminated the...would eventually become a branch. The framework for the historical case study is the doctrinal relationship between the elements of operational art

Ad-Hoc Queries over Document Collections - A Case Study

NASA Astrophysics Data System (ADS)

Löser, Alexander; Lutter, Steffen; Düssel, Patrick; Markl, Volker

We discuss the novel problem of supporting analytical business intelligence queries over web-based textual content, e.g., BI-style reports based on 100.000's of documents from an ad-hoc web search result. Neither conventional search engines nor conventional Business Intelligence and ETL tools address this problem, which lies at the intersection of their capabilities. "Google Squared" or our system GOOLAP.info, are examples of these kinds of systems. They execute information extraction methods over one or several document collections at query time and integrate extracted records into a common view or tabular structure. Frequent extraction and object resolution failures cause incomplete records which could not be joined into a record answering the query. Our focus is the identification of join-reordering heuristics maximizing the size of complete records answering a structured query. With respect to given costs for document extraction we propose two novel join-operations: The multi-way CJ-operator joins records from multiple relationships extracted from a single document. The two-way join-operator DJ ensures data density by removing incomplete records from results. In a preliminary case study we observe that our join-reordering heuristics positively impact result size, record density and lower execution costs.

Operationally Efficient Propulsion System Study (OEPSS) data book. Executive summary

NASA Technical Reports Server (NTRS)

Wong, George S.

1990-01-01

The study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advanced Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. Summarized here are the salient results of the first year. A synopsis of each volume listed above is presented.

Systems Operations Studies for Automated Guideway Transit Systems : Quantitative Analysis of Alternative AGT Operational Control Strategies

DOT National Transportation Integrated Search

1981-10-01

The objectives of the Systems Operation Studies (SOS) for automated guideway transit (AGT) systems are to develop models for the analysis of system operations, to evaluate performance and cost, and to establish guidelines for the design and operation...

[Histological study of a case of chondrocostal aspergillosis].

PubMed

Jlidi, R; Lagier, R; Abele, R; Auckenthaler, R

1988-01-01

Histological study of biopsy specimens successively taken from the 7th, 5th and 6th right chondrocostal regions in a 33 year-old man; the patient was under chemotherapy for a diffuse lymphoma and has been operated for an aspergilloma of the right lung superior lobe. Non-specific chronic osteomyelitis was observed as well as Aspergillus fumigatus perichondritis (acute and chronic) which had lead to cartilage fragmentation. Cartilage fragmentation could be attributed to an enzymatic chondrolysis induced by polymorphonuclears inflammation. Such matrix degradation seems to favour the penetration of aspergillus into the cartilage surface. This case report recalls that fungi (including Aspergillus despite it appears exceptional) must be considered as a possible cause of osteomyelitis, particularly in immunosuppressed patients.

Acute cholecystitis: comparing clinical outcomes with TG13 severity and intended laparoscopic versus open cholecystectomy in difficult operative cases.

PubMed

Gerard, Justin; Luu, Minh B; Poirier, Jennifer; Deziel, Daniel J

2018-03-09

The revised Tokyo Guidelines include criteria for determining the severity of acute cholecystitis with treatment algorithms based on severity. The aim of this study was to investigate the relationship of the revised Tokyo Guidelines severity grade to clinical outcomes of cholecystectomy for acute cholecystitis. We identified 66 patients with acute cholecystitis from a prior study of difficult cholecystectomy cases. We examined the relationship between severity grade and multiple variables related to perioperative and postoperative outcomes. A more severe revised Tokyo Guidelines grade was associated with a higher number of complications (p = 0.03) and a higher severity of complications (p = 0.01). Severity grade did not predict operative time, estimated blood loss, intensive care unit admission or length of stay. Compared to planned open cholecystectomy, intended laparoscopic cholecystectomy was associated with significantly fewer total and Clavien-Dindo grade 3 complications, fewer intensive care unit admissions, and shorter length of stay (p values range from 0.03 to < 0.0001). In technically difficult operations for acute cholecystitis, the revised Tokyo guidelines severity grade correlates with the number and severity of complications. However, intended performance of laparoscopic cholecystectomy rather than open cholecystectomy in difficult operations predicts broader beneficial outcomes than severity grade.

Case Study: The Chemistry of Cocaine

ERIC Educational Resources Information Center

Dewprashad, Brahmadeo

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

ERIC Educational Resources Information Center

Prud'homme-Généreux, Annie

2017-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

[Clinical study of induced abortion of early-early pregnancy: an analysis of 10, 404 cases].

PubMed

Kang, Jian; Wang, Xue-fen; Zhang, Li; Liu, Jian-hua

2012-01-03

To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA). A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA). The amount of hemorrhage and operative duration, degree of pain, rate of induced-abortion syndrome, rate of incomplete abortion, menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups. The average age, ratio of parous cases, ratio of the cases of first-pregnancy induced abortion were not different between 2 groups (P > 0.05). The amount of hemorrhage bleeding ((4.9 ± 3.2) ml), operative duration ((90.3 ± 12.4) s), degree of pain, rate of induced-abortion syndrome, menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P < 0.05). However, the rate of incomplete abortion (0.44%) in the EPIA group was significantly higher than that (0.21%) in the CIA group (P < 0.05). EPIA has the advantages of lesser hemorrhage, less pain, shorter operative duration and fewer complications over CIA. Therefore the recovery of EPIA cases is earlier than that of CIA cases. While the risk of incomplete abortion stays high.

Yangians and Yang-Baxter R-operators for ortho-symplectic superalgebras

NASA Astrophysics Data System (ADS)

Fuksa, J.; Isaev, A. P.; Karakhanyan, D.; Kirschner, R.

2017-04-01

Yang-Baxter relations symmetric with respect to the ortho-symplectic superalgebras are studied. We start with the formulation of graded algebras and the linear superspace carrying the vector (fundamental) representation of the ortho-symplectic supergroup. On this basis we study the analogy of the Yang-Baxter operators considered earlier for the cases of orthogonal and symplectic symmetries: the vector (fundamental) R-matrix, the L-operator defining the Yangian algebra and its first and second order evaluations. We investigate the condition for L (u) in the case of the truncated expansion in inverse powers of u and give examples of Lie algebra representations obeying these conditions. We construct the R-operator intertwining two superspinor representations and study the fusion of L-operators involving the tensor product of such representations.

Instructional Developer as Content Specialist: Three Case Studies Utilizing the Instructional Development-Operations Research Model.

ERIC Educational Resources Information Center

Faust, Stephen M.

1980-01-01

Presents a 3-phase model (content research, specification, delivery) for instructional development-operations research and describes its application in developing courses in zoology, geology, and paleontology. (MER)

Primary fusion in worker's compensation intraarticular calcaneus fracture. Prospective study of 169 consecutive cases.

PubMed

López-Oliva, Felipe; Sánchez-Lorente, Tomás; Fuentes-Sanz, Adela; Forriol, Francisco; Aldomar-Sanz, Yolanda

2012-12-01

To study the results of reconstruction and primary fusion in worker's compensation intraarticular calcaneus fractures. We carried out a prospective study of 169 acute intraarticular calcaneus fractures treated by reconstruction and primary fusion with the minimally invasive Vira® system, in severe calcaneus fractures. The evaluation was performed by clinical, radiological and biomechanical analysis. AOFAS score averaged 77.26 points at the end of follow up. Forty-two cases (24.9%) obtained excellent results, 108 (63.9%) good, 12 (7.1%) mild and 7 (4.1%) poor. The improvement in Börder's angle after surgery was significant (p = 0.05) and this did not vary during the follow up. Subtalar arthrodesis was achieved in all cases and only three cases needed bone grafting. Five major post-surgical complications were observed, and one deep infection in a case of open Gustilo Grade III fracture. In the kinetic study, the support time of the operated foot was lower than that of the contralateral foot (p<0.21). The axial force of the heel contact and the single limb support of the operated foot reduced the toe-off axial forces. In the foot with arthrodesis the posterior forces increased (p <0.01). The pressures were lower in the region of the heel and the mid-foot and in the external part of the forefoot, and increased in the big toe. Calcaneal workplace injuries are challenging to treat. Primary subtalar fusion with a minimally invasive method allows rapid recovery for these patients with a satisfactory clinical, functional and radiological outcome. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Arizona Border Wall Case Study

DTIC Science & Technology

2017-12-01

WALL CASE STUDY by Justin Alexander Bristow December 2017 Thesis Advisor: Erik Dahl Second Reader: Jorge Gonzalez THIS PAGE...4. TITLE AND SUBTITLE AN ARIZONA BORDER WALL CASE STUDY 5. FUNDING NUMBERS 6. AUTHOR(S) Justin Alexander Bristow 7. PERFORMING ORGANIZATION...PAGE INTENTIONALLY LEFT BLANK iii Approved for public release. Distribution is unlimited. AN ARIZONA BORDER WALL CASE STUDY Justin Alexander

Non-operative management versus operative management in high-grade blunt hepatic injury.

PubMed

Cirocchi, Roberto; Trastulli, Stefano; Pressi, Eleonora; Farinella, Eriberto; Avenia, Stefano; Morales Uribe, Carlos Hernando; Botero, Ana Maria; Barrera, Luis M

2015-08-24

Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions. In 1994, the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST) revised the Hepatic Injury Scale to have a range from grade I to VI. Minor injuries (grade I or II) are the most frequent liver injuries (80% to 90% of all cases); severe injuries are grade III-V lesions; grade VI lesions are frequently incompatible with survival. In the medical literature, the majority of patients who have undergone NOM have low-grade liver injuries. The safety of NOM in high-grade liver lesions, AAST grade IV and V, remains a subject of debate as a high incidence of liver and collateral extra-abdominal complications are still described. To assess the effects of non-operative management compared to operative management in high-grade (grade III-V) blunt hepatic injury. The search for studies was run on 14 April 2014. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (Ovid), PubMed, ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), clinical trials registries, conference proceedings, and we screened reference lists. All randomised trials that compare non-operative management versus operative management in high-grade blunt hepatic injury. Two authors independently

Qualitative Case Study Research as Empirical Inquiry

ERIC Educational Resources Information Center

Ellinger, Andrea D.; McWhorter, Rochell

2016-01-01

This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

How can sludge dewatering devices be assessed? Development of a new DSS and its application to real case studies.

PubMed

Bertanza, Giorgio; Papa, Matteo; Canato, Matteo; Collivignarelli, Maria Cristina; Pedrazzani, Roberta

2014-05-01

A key issue in biological Waste Water Treatment Plants (WWTPs) operation is represented by the sludge management. Mechanical dewatering is a crucial stage for sludge volume reduction; though, being a costly operation, its optimization is required. We developed an original experimental methodology to evaluate the technical (dewatering efficiency) and financial (total treatment costs) performance of dewatering devices, which might be used as a DSS (Decision Support System) for WWTP managers. This tool was then applied to two real case studies for comparing, respectively, three industrial size centrifuges, and two different operation modes of the same machine (fixed installation vs. outsourcing service). In both the cases, the best option was identified, based jointly on economic and (site-specific) technical evaluations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Teaching Business Demography Using Case Studies.

PubMed

Swanson, David A; Morrison, Peter A

2010-02-01

Many faculty members consider using case studies but not all end up using them. We provide a brief review of what cases are intended to do and identify three ways in which they can be used. We then use an example to illustrate how we have used the case study method in teaching business demography. Among other benefits, we note that the case studies method not only encourages the acquisition of skills by students, but can be used to promote "deep structure learning," an approach naturally accommodates other features associated with the case studies method-the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the "worthwhileness" of a course. As noted by others, we understand the limitations of the case study method. However, given its strengths, we believe it has a place in the instructional toolbox for courses in business demography. The fact that courses we teach is a testament to our perceived efficacy of this tool.

Laparoscopic sleeve gastrectomy in patients with abdominoplasty: a case-control study.

PubMed

Saber, Alan A; Shoar, Saeed; El-Matbouly, Moamena; Karem, Mohsen; Bashah, Moataz M; Al Najjar, Ahmad; Alkuwari, Mohammad J; Soltanian, Hooman

2017-02-01

Abdominoplasty is increasingly performed after weight loss surgery. However, performing a laparoscopic sleeve gastrectomy (LSG) after abdominoplasty poses technical challenges. The present study aimed to compare operative events and postoperative outcomes between LSG patients with and without a history of prior abdominoplasty. University hospital, Qatar. A case-control study was conducted on 2 groups of patients with (n = 33) and without (n = 69) prior abdominoplasty who underwent LSG. Patient demographics, baseline characteristics, as well as operative and postoperative events were compared between the 2 groups. A total of 102 patients with an average age of 39.6±7.7 years and body mass index (BMI) of 42.8±5.9 kg/m 2 were included. There were no significant differences between the 2 groups in terms of demographic characteristics, preoperative BMI, and co-morbidities. The number of ports required was significantly higher in the LSG patients with a history of prior abdominoplasty than in the nonabdominoplasty patients. The operation time was also significantly longer in the abdominoplasty patients than in the nonabdominoplasty patients (90.3±36.7 minutes versus 57.1±17.7 minutes; P<.0001). However, no significant differences were observed in terms of postoperative complications, length of hospital stay, and weight loss results. LSG after abdominoplasty is associated with longer operative times and the need for additional port placement to overcome the decreased working space. However, operative strategies should be considered to overcome the technical challenges during LSG in patients who underwent a prior abdominoplasty. Copyright © 2017. Published by Elsevier Inc.

A Case Study on Collective Cognition and Operation in Team-Based Computer Game Design by Middle-School Children

ERIC Educational Resources Information Center

Ke, Fengfeng; Im, Tami

2014-01-01

This case study examined team-based computer-game design efforts by children with diverse abilities to explore the nature of their collective design actions and cognitive processes. Ten teams of middle-school children, with a high percentage of minority students, participated in a 6-weeks, computer-assisted math-game-design program. Essential…

Performable Case Studies in Ethics Education.

PubMed

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Emotion, Engagement, and Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

2014-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

Metropolitan transportation management center : a case study : Arizona Trailmaster : providing a safe and efficient travel environment for users

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Arizona's TrailMaster statewide transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross...

Pre-operative prediction of cervical nodal metastasis in papillary thyroid cancer by 99mTc-MIBI SPECT/CT; a pilot study.

PubMed

Tangjaturonrasme, Napadon; Vasavid, Pataramon; Sombuntham, Premsuda; Keelawat, Somboon

2013-06-01

Papillary thyroid cancer has a high prevalence of cervical nodal metastasis. There is no "gold standard" imaging for pre-operative diagnosis. The aim of the present study was to assess the accuracy of pre-operative 99mTc-MBI SPECT/CT in diagnosis of cervical nodal metastasis in patients with papillary thyroid cancer Fifteen patients were performed 99Tc-MlBI SPECT/CT pre-operatively. Either positive pathological report of neck dissection or positive post-treatment I-131 whole body scan with SPECT/CT of neck was concluded for definite neck metastasis. The PPV, NPV, and accuracy of 99mTc-MIBI SPECT/CT were analyzed. The PPV NPV and accuracy were 80%, 88.89%, and 85.71%, respectively. 99mTc-MIBI SPECT/CT could localize the abnormal lymph nodes groups correctly in most cases when compared with pathological results. However the authors found one false positive case with caseating granulomatous lymphadenitis and one false negative case with positive post-treatment 1-131 whole body scan with SPECT/CT of neck on cervical nodes zone II and IV CONCLUSION: 99mTc-MIBI SPECT/CTseem promising for pre-operative staging of cervical nodal involvement in patients with papillary thyroid cancer without the need of using iodinated contrast that may complicate subsequence 1-131 treatment. However, false positive result in granulomatous inflammatory nodes should be aware of especially in endemic areas. 99mTc-MIBI SPECT/CT scan shows a good result when compared with previous study of CT or MRI imaging. The comparative study between different imaging modality and the extension of neck dissection according to MIBI result seems interesting.

Operative Landscape at Canadian Neurosurgery Residency Programs.

PubMed

Tso, Michael K; Dakson, Ayoub; Ahmed, Syed Uzair; Bigder, Mark; Elliott, Cameron; Guha, Daipayan; Iorio-Morin, Christian; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Wang, Bill; Winkler-Schwartz, Alexander; Sankar, Tejas; Christie, Sean D

2017-07-01

Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

Clinical waste incinerators in Cameroon--a case study.

PubMed

Mochungong, Peter Ikome Kuwoh; Gulis, Gabriel; Sodemann, Morten

2012-01-01

Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study. Three incinerators were randomly selected and investigated for site, design and operating standards. Empirical field observation was adopted and data collected through inventory and informal interviews. Bottom ash samples collected from the incinerators were prepared according to standard procedures and analyzed for heavy metals using Inductively Coupled Plasma (ICP) Emission Spectroscopy. Shortcomings associated with site selection, design and operation standards were identified. Chemical analysis revealed that Cr, Cu, Fe, Mn, Ni, Pb, Zn, Mg and Ca were present in the bottom ash with mean concentration ranging from 10 mg/kg for Pb to 178080 mg/kg for Ca. For logistic reasons, feedstock quantity and quality into the incinerators were not investigated. Neither were soil samples around and away from the incinerators. Although highly favored, clinical waste incineration methods in this region have to be reconsidered. A thorough health and environmental impact assessment is suggested before subsequent decisions on choice and disposal site is made. This will curb potential negative impacts to the environment and public health. This article adds a different perspective and sheds additional information to the debate on unsatisfactory clinical waste incinerators in resources-poor countries. Alternative methods to incineration are presented that will be helpful to practitioners.

Being altered by the unexpected: understanding the perioperative patient's experience: a case study.

PubMed

Rudolfsson, Gudrun

2014-08-01

The present paper focuses on the process of understanding the patient in the context of perioperative caring and reports a story narrated by a perioperative nurse as well as her emerging understanding of the patient prior to surgery at an operating department. This qualitative case study had a dual purpose; firstly, to describe how the perioperative nurse's understanding of the patient emerged and, secondly, to establish how the researcher interpreted the situation. As a perioperative nurse and researcher, the author is both the narrator and interpreter. To date we have rarely discussed the fact that, in a perioperative context, the patient might feel ashamed of his/her body, even before arriving at the operating department. This new understanding emerged from the hermeneutical dialogue in the present study. © 2013 Wiley Publishing Asia Pty Ltd.

The Operational Level of War

DTIC Science & Technology

1985-12-01

efforts at destruction, and subsequent bridging operations in the let U.S. Army area are described. SBounds, Gary L., et al. Larger Units: Theater Army...modern commanders. Chervonobab, V. P., et al. Army Operations. Moscow: Ministry of Defense, 1977. DTIC ADB-070776L. This Soviet study contains case...maneuver and mobility. His work is of limited value today. Crittenberger, W. D., Lt. Gen., et al. "Mobility in the Field Army. Armor 60 (September-October

Treatment of hematomas after anterior cervical spine surgery: A retrospective study of 15 cases.

PubMed

Miao, Weiliang; Ma, Xiaojun; Liang, Deyong; Sun, Yu

2018-05-04

Postoperative hematoma is a rare and dangerous complication of cervical spine surgery. The aim of this study was to investigate the incidence and related factors of postoperative hematoma, and to report on 15 cases at our institution over a 6-year period. Fifteen cases of postoperative hematoma were retrospectively identified. We investigated their neurological outcomes, characteristics, and surgical data, and identified risk factors associated with postoperative (PO) hematoma. Patients with hematoma were compared to those with no hematoma, in order to identify risk factors. Retropharyngeal hematomas developed in seven cases and epidural hematomas in eight. The total incidence of postoperative hematoma was 1.2%: 0.5% retropharyngeal hematomas and 0.6% spinal epidural hematomas. At time of onset, the severity of paralysis was assessed as grade B in one case, grade C in six cases, and grade D in eight cases. Risk factors for PO hematoma were: (1) presence of ossification of the posterior longitudinal ligament (OPLL) (P<0.001); (2) longer operative duration (P=0.048); (3) greater number of surgical levels (P=0.02); and (4) higher body mass index (BMI; P=0.035). There was no significant difference in modified Japan Orthopedic Association scores between the hematoma group and non-hematoma group (P>0.05). Precise preoperative preparation and systematic evaluation are central to successful management of PO hematoma after anterior cervical surgery. Risk factors for PO hematoma include multilevel decompression, OPLL, higher BMI, and longer operation time. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Transportation planning effectiveness: twenty case studies

DOT National Transportation Integrated Search

1977-12-31

This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

Library-ABE Projects. Case Studies.

ERIC Educational Resources Information Center

MacVicar, Phyllis

This document contains 41 case studies submitted to the Appalachian Adult Education Center by the staffs of four projects demonstrating library services to disadvantaged adults, in cooperation with adult basic education programs. Included in each case study is the coping skill area in which an individual need was recognized and met through the…

Teaching Business French through Case Studies: Presentation of a Marketing Case.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Case Study: Puttin' on the Ritz: How to Put Science into Cases

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2017-01-01

There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

A case study employing operant conditioning to reduce stress of capture for red-bellied tamarins (Saguinus labiatus).

PubMed

Owen, Yvonne; Amory, Jonathan R

2011-01-01

Traditional techniques used to capture New World monkeys, such as net capture, can induce high levels of acute stress detrimental to welfare. Alternatively, training nonhuman animals via operant conditioning to voluntarily participate in husbandry and/or veterinary practices is accepted as a humane process that can reduce stress and improve welfare. This study details the use of operant conditioning using positive reinforcement training (PRT) and target training to train a family of 5 captive red-bellied tamarins (Saguinus labiatus) in a wildlife park to voluntarily enter a transportation box and remain calm for 1 min after 54 training sessions. Observations of 2 unrelated net-capture processes provided measures of locomotion and vocalizations as indicators of stress behavior that were compared with those of the trained tamarins. Net-captured monkeys exhibited rapid erratic locomotion and emitted long, high-frequency vocalizations during capture whereas the trained tamarins exhibited minimal locomotion and emitted only 4 brief vocalizations (root mean square 35 dB) during capture. This indicates that the use of PRT considerably reduced potential for stress and improved welfare during the capture and containment of the tamarins. Copyright © Taylor & Francis Group, LLC

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk.

PubMed

Pettersson, David; Bottai, Matteo; Mathiesen, Tiit; Prochazka, Michaela; Feychting, Maria

2015-01-01

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

The "Reverse Case Study:" Enhancing Creativity in Case-Based Instruction in Leadership Studies

ERIC Educational Resources Information Center

Atkinson, Timothy N.

2014-01-01

In this application brief I share a case study assignment I used in my "Leadership in Complex Organizations" classes to promote creativity in problem solving. I sorted Ph.D. students into two teams and trained them to use creative writing techniques to "encode" theory into their own cases. A sense of competition emerged. Later,…

26 CFR 1.614-3 - Rules relating to separate operating mineral interests in the case of mines.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Rules relating to separate operating mineral interests in the case of mines. 1.614-3 Section 1.614-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1...

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals.

PubMed

Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

2017-01-01

Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

PubMed Central

Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

2017-01-01

Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

A Three Year Clinicopathological Study of Cases of Rupture Uterus

PubMed Central

Rathod, Setu; Swain, Sujata

2015-01-01

Introduction Rupture uterus is a life threatening obstetric complication with serious maternal and fetal side-effects. We report a 3 year (2010-2013) retrospective clinical study of pregnancy with rupture uterus cases attending a tertiary care hospital. Aim The aim of the study was to evaluate the incidence of rupture uterus, incidence as per age, parity, clinical presentations, risk factors, complications and management. Materials and Methods Retrospective data of 74 cases of rupture uterus in SCB Medical college, Cuttack was collected from case records of 26,547 deliveries during a 3 year span (2010-2013). Parameters like cause of rupture, type, site of rupture and outcome were recorded. The collected data was analysed by SPSS software v19. Results Out of 26,547 deliveries during the three year period, there were 74 cases of rupture uterus with an incidence of rupture 1 in 359 (0.28%). The mean age of rupture uterus was 27.4 years. 95.8% were multigravida and majority were referred cases from low socioeconomic status. Only 40.5% had the required minimum of four antenatal visits as recommended by WHO (World Health Organisation). A total of 48.6% of cases with rupture uterus had history of previous Caesarean section. Prolonged labour was present in 75.6% of the cases. Only 12.2% of the cases had history of oxytocin use whereas 9.5% had undergone an operative vaginal delivery. Obstructed labour was the cause in 24.3% of cases, 85.1% had complete rupture. Majority had a rupture in the anterior wall (69%) and 81.1% had rupture in lower segment of uterus. Only 17.6% had broad ligament haematoma, 10.8% colporrhexis and 6.8% had associated bladder injury. Repair was possible in only 39.2% of cases, whereas majority landed up in hysterectomy. Internal iliac ligation was done in 2.7% of cases. Perinatal mortality was 90.5% whereas maternal death was seen in 13.5% cases. One patient developed VVF (vesicovaginal fistula). Duration of hospital stay was upto 14 days in 81

14 CFR 121.553 - Restriction or suspension of operation: Supplemental operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Restriction or suspension of operation: Supplemental operations. 121.553 Section 121.553 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... conditions, that are a hazard to safe operations, the certificate holder or pilot in command, as the case may...

Metropolitan transportation management center : a case study : Georgia NaviGAtor : accurate and timely information to navigate Georgia roads

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Atlanta's NaviGAtor transportation management center. It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts of Operation - A Cross Cutting Stu...

[Study on the application of value of digital medical technology in the operation on primary liver cancer].

PubMed

Fang, Chi-hua; Lu, Chao-min; Huang, Yan-peng; Li, Xiao-feng; Fan, Ying-fang; Yang, Jian; Xiang, Nan; Pan, Jia-hui

2009-04-01

To study the clinical application of digital medical in the operation on primary liver cancer. The patients (n=11) with primary hepatic carcinoma treated between February and July 2008, including 9 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma, were scanned using 64 slices helicon computerized tomography (CT) and the datasets was collected. Segment and three-dimensional (3D) reconstruction of the CT image was carried out by the medical image processing system which was developed. And the 3D moulds were imported to the FreeForm Modeling System for smoothing. Then the hepatectomy in treatment of hepatoma and implanting of catheter were simulated with the force-feedback equipment (PHANToM). Finally, 3D models and results of simulation surgery were used for choosing mode of operation and comparing with the findings during the operation. The reconstructed models were true to life, and their spatial disposition and correlation were shown clearly; Blood supply of primary liver cancer could be seen easily. In the simulation surgery system, the process of virtual partial hepatectomy and implanting of catheter using simulation scalpel and catheter on 3D moulds with PHANToM was consistent with the clinical course of surgery. Life-like could be felt and power feeling can be touched during simulation operation. Digital medical benefited knowing the relationship between primary liver cancer and the intrahepatic pipe. It gave an advantage to complete primary liver cancer resection with more liver volume remained. It can improve the surgical effect and decrease the surgical risk and reduce the complication through demonstrating visualized operation before surgery.

Case Studies for Effective Business Instruction.

ERIC Educational Resources Information Center

McAlister-Kizzier, Donna

This book is designed as a resource for educators who teach business content in a variety of instructional settings. It contains case studies representing all functional areas of business, including corporate training, for grades 7 through graduate education. Chapter 1 provides an overview of the case study method. The history of the case method,…

Case management: a case study.

PubMed

Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

2000-01-01

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

HYDROGEOLOGIC CASE STUDIES

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Sensitivity of power system operations to projected changes in water availability due to climate change: the Western U.S. case study

NASA Astrophysics Data System (ADS)

Voisin, N.; Macknick, J.; Fu, T.; O'Connell, M.; Zhou, T.; Brinkman, G.

2017-12-01

Water resources provide multiple critical services to the electrical grid through hydropower technologies, from generation to regulation of the electric grid (frequency, capacity reserve). Water resources can also represent vulnerabilities to the electric grid, as hydropower and thermo-electric facilities require water for operations. In the Western U.S., hydropower and thermo-electric plants that rely on fresh surface water represent 67% of the generating capacity. Prior studies have looked at the impact of change in water availability under future climate conditions on expected generating capacity in the Western U.S., but have not evaluated operational risks or changes resulting from climate. In this study, we systematically assess the impact of change in water availability and air temperatures on power operations, i.e. we take into account the different grid services that water resources can provide to the electric grid (generation, regulation) in the system-level context of inter-regional coordination through the electric transmission network. We leverage the Coupled Model Intercomparison Project Phase 5 (CMIP5) hydrology simulations under historical and future climate conditions, and force the large scale river routing- water management model MOSART-WM along with 2010-level sectoral water demands. Changes in monthly hydropower potential generation (including generation and reserves), as well as monthly generation capacity of thermo-electric plants are derived for each power plant in the Western U.S. electric grid. We then utilize the PLEXOS electricity production cost model to optimize power system dispatch and cost decisions for the 2010 infrastructure under 100 years of historical and future (2050 horizon) hydroclimate conditions. We use economic metrics as well as operational metrics such as generation portfolio, emissions, and reserve margins to assess the changes in power system operations between historical and future normal and extreme water

The Big Read: Case Studies

ERIC Educational Resources Information Center

National Endowment for the Arts, 2009