33 CFR 401.97 - Closing procedures and ice navigation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Closing procedures and ice... Procedures § 401.97 Closing procedures and ice navigation. (a) No wintering vessel shall return downbound... nearest Seaway station. (f) Where ice conditions restrict navigation, (1) No upbound vessel that has a...

33 CFR 401.97 - Closing procedures and ice navigation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Closing procedures and ice... Procedures § 401.97 Closing procedures and ice navigation. (a) No wintering vessel shall return downbound... nearest Seaway station. (f) Where ice conditions restrict navigation, (1) No upbound vessel that has a...

33 CFR 401.97 - Closing procedures and ice navigation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Closing procedures and ice... Procedures § 401.97 Closing procedures and ice navigation. (a) No wintering vessel shall return downbound... nearest Seaway station. (f) Where ice conditions restrict navigation, (1) No upbound vessel that has a...

33 CFR 401.97 - Closing procedures and ice navigation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Closing procedures and ice... Procedures § 401.97 Closing procedures and ice navigation. (a) No wintering vessel shall return downbound... nearest Seaway station. (f) Where ice conditions restrict navigation, (1) No upbound vessel that has a...

33 CFR 401.97 - Closing procedures and ice navigation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Closing procedures and ice... Procedures § 401.97 Closing procedures and ice navigation. (a) No wintering vessel shall return downbound... nearest Seaway station. (f) Where ice conditions restrict navigation, (1) No upbound vessel that has a...

Line pilot perspectives on complexity of terminal instrument flight procedures

DOT National Transportation Integrated Search

2016-09-01

Many new Performance Based Navigation (PBN) Instrument Flight Procedures (IFPs) are being developed as the United States transforms its airspace to improve safety and efficiency. Despite significant efforts to prepare for operational implementation o...

Navigational ultrasound imaging: A novel imaging tool for aiding interventional therapies of equine musculoskeletal injuries.

PubMed

Lustgarten, M; Redding, W R; Schnabel, L V; Prange, T; Seiler, G S

2016-03-01

Navigational ultrasound imaging, also known as fusion imaging, is a novel technology that allows real-time ultrasound imaging to be correlated with a previously acquired computed tomography (CT) or magnetic resonance imaging (MRI) study. It has been used in man to aid interventional therapies and has been shown to be valuable for sampling and assessing lesions diagnosed with MRI or CT that are equivocal on ultrasonography. To date, there are no reports of the use of this modality in veterinary medicine. To assess whether navigational ultrasound imaging can be used to assist commonly performed interventional therapies for the treatment of equine musculoskeletal injuries diagnosed with MRI and determine the appropriateness of regional anatomical landmarks as registration sites. Retrospective, descriptive clinical study. Horses with musculoskeletal injuries of the distal limb diagnosed with MRI scheduled for ultrasound-guided interventional therapies were evaluated (n = 17 horses with a total of 29 lesions). Anatomical landmarks used for image registration for the navigational procedure were documented. Accuracy of lesion location and success of the procedure were assessed subjectively and described using a grading scale. All procedures were accurately registered using regional anatomical landmarks and considered successful based on our criteria. Anatomical landmarks were described for each lesion type. The addition of navigational imaging was considered to greatly aid the procedures in 59% of cases and added information to the remainder of the procedures. The technique was considered to improve the precision of these interventional procedures. Navigational ultrasound imaging is a complementary imaging modality that can be used for the treatment of equine soft tissue musculoskeletal injuries diagnosed with MRI. © 2015 EVJ Ltd.

33 CFR 67.35-1 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Procedure. 67.35-1 Section 67.35-1 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION AIDS TO NAVIGATION ON ARTIFICIAL ISLANDS AND FIXED STRUCTURES Applications § 67.35-1 Procedure. (a) An...

33 CFR 67.35-1 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Procedure. 67.35-1 Section 67.35-1 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION AIDS TO NAVIGATION ON ARTIFICIAL ISLANDS AND FIXED STRUCTURES Applications § 67.35-1 Procedure. (a) An...

Implant alignment in total elbow arthroplasty: conventional vs. navigated techniques

NASA Astrophysics Data System (ADS)

McDonald, Colin P.; Johnson, James A.; King, Graham J. W.; Peters, Terry M.

2009-02-01

Incorrect selection of the native flexion-extension axis during implant alignment in elbow replacement surgery is likely a significant contributor to failure of the prosthesis. Computer and image-assisted surgery is emerging as a useful surgical tool in terms of improving the accuracy of orthopaedic procedures. This study evaluated the accuracy of implant alignment using an image-based navigation technique compared against a conventional non-navigated approach. Implant alignment error was 0.8 +/- 0.3 mm in translation and 1.1 +/- 0.4° in rotation for the navigated alignment, compared with 3.1 +/- 1.3 mm and 5.0 +/- 3.8° for the non-navigated alignment. Five (5) of the 11 non-navigated alignments were malaligned greater than 5° while none of the navigated alignments were placed with an error of greater than 2.0°. It is likely that improved implant positioning will lead to reduced implant loading and wear, resulting in fewer implantrelated complications and revision surgeries.

Navigation strategy training using virtual reality in six chronic stroke patients: A novel and explorative approach to the rehabilitation of navigation impairment.

PubMed

Claessen, Michiel H G; van der Ham, Ineke J M; Jagersma, Elbrich; Visser-Meily, Johanna M A

2016-10-01

Recent studies have shown that navigation impairment is a common complaint after brain injury. Effective training programmes aiming to improve navigation ability in neurological patients are, however, scarce. The few reported programmes are merely focused on recalling specific routes rather than encouraging brain-damaged patients to use an alternative navigation strategy, applicable to any route. Our aim was therefore to investigate the feasibility of a (virtual reality) navigation training as a tool to instruct chronic stroke patients to adopt an alternative navigation strategy. Navigation ability was systematically assessed before the training. The training approach was then determined based on the individual pattern of navigation deficits of each patient. The use of virtual reality in the navigation strategy training in six middle-aged stroke patients was found to be highly feasible. Furthermore, five patients learned to (partially) apply an alternative navigation strategy in the virtual environment, suggesting that navigation strategies are mouldable rather than static. In the evaluation of their training experiences, the patients judged the training as valuable and proposed some suggestions for further improvement. The notion that the navigation strategy people use can be influenced after a short training procedure is a novel finding and initiates a direction for future studies.

Navigational Guidance and Ablation Planning Tools for Interventional Radiology.

PubMed

Sánchez, Yadiel; Anvari, Arash; Samir, Anthony E; Arellano, Ronald S; Prabhakar, Anand M; Uppot, Raul N

Image-guided biopsy and ablation relies on successful identification and targeting of lesions. Currently, image-guided procedures are routinely performed under ultrasound, fluoroscopy, magnetic resonance imaging, or computed tomography (CT) guidance. However, these modalities have their limitations including inadequate visibility of the lesion, lesion or organ or patient motion, compatibility of instruments in an magnetic resonance imaging field, and, for CT and fluoroscopy cases, radiation exposure. Recent advances in technology have resulted in the development of a new generation of navigational guidance tools that can aid in targeting lesions for biopsy or ablations. These navigational guidance tools have evolved from simple hand-held trajectory guidance tools, to electronic needle visualization, to image fusion, to the development of a body global positioning system, to growth in cone-beam CT, and to ablation volume planning. These navigational systems are promising technologies that not only have the potential to improve lesion targeting (thereby increasing diagnostic yield of a biopsy or increasing success of tumor ablation) but also have the potential to decrease radiation exposure to the patient and staff, decrease procedure time, decrease the sedation requirements, and improve patient safety. The purpose of this article is to describe the challenges in current standard image-guided techniques, provide a definition and overview for these next-generation navigational devices, and describe the current limitations of these, still evolving, next-generation navigational guidance tools. Copyright © 2017 Elsevier Inc. All rights reserved.

A multimodal image guiding system for Navigated Ultrasound Bronchoscopy (EBUS): A human feasibility study

PubMed Central

Hofstad, Erlend Fagertun; Amundsen, Tore; Langø, Thomas; Bakeng, Janne Beate Lervik; Leira, Håkon Olav

2017-01-01

Background Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is the endoscopic method of choice for confirming lung cancer metastasis to mediastinal lymph nodes. Precision is crucial for correct staging and clinical decision-making. Navigation and multimodal imaging can potentially improve EBUS-TBNA efficiency. Aims To demonstrate the feasibility of a multimodal image guiding system using electromagnetic navigation for ultrasound bronchoschopy in humans. Methods Four patients referred for lung cancer diagnosis and staging with EBUS-TBNA were enrolled in the study. Target lymph nodes were predefined from the preoperative computed tomography (CT) images. A prototype convex probe ultrasound bronchoscope with an attached sensor for position tracking was used for EBUS-TBNA. Electromagnetic tracking of the ultrasound bronchoscope and ultrasound images allowed fusion of preoperative CT and intraoperative ultrasound in the navigation software. Navigated EBUS-TBNA was used to guide target lymph node localization and sampling. Navigation system accuracy was calculated, measured by the deviation between lymph node position in ultrasound and CT in three planes. Procedure time, diagnostic yield and adverse events were recorded. Results Preoperative CT and real-time ultrasound images were successfully fused and displayed in the navigation software during the procedures. Overall navigation accuracy (11 measurements) was 10.0 ± 3.8 mm, maximum 17.6 mm, minimum 4.5 mm. An adequate sample was obtained in 6/6 (100%) of targeted lymph nodes. No adverse events were registered. Conclusions Electromagnetic navigated EBUS-TBNA was feasible, safe and easy in this human pilot study. The clinical usefulness was clearly demonstrated. Fusion of real-time ultrasound, preoperative CT and electromagnetic navigational bronchoscopy provided a controlled guiding to level of target, intraoperative overview and procedure documentation. PMID:28182758

The effect of respiratory motion on pulmonary nodule location during electromagnetic navigation bronchoscopy.

PubMed

Chen, Alexander; Pastis, Nicholas; Furukawa, Brian; Silvestri, Gerard A

2015-05-01

Electromagnetic navigation has improved the diagnostic yield of peripheral bronchoscopy for pulmonary nodules. For these procedures, a thin-slice chest CT scan is performed prior to bronchoscopy at full inspiration and is used to create virtual airway reconstructions that are used as a map during bronchoscopy. Movement of the lung occurs with respiratory variation during bronchoscopy, and the location of pulmonary nodules during procedures may differ significantly from their location on the initial planning full-inspiratory chest CT scan. This study was performed to quantify pulmonary nodule movement from full inspiration to end-exhalation during tidal volume breathing in patients undergoing electromagnetic navigation procedures. A retrospective review of electromagnetic navigation procedures was performed for which two preprocedure CT scans were performed prior to bronchoscopy. One CT scan was performed at full inspiration, and a second CT scan was performed at end-exhalation during tidal volume breathing. Pulmonary lesions were identified on both CT scans, and distances between positions were recorded. Eighty-five pulmonary lesions were identified in 46 patients. Average motion of all pulmonary lesions was 17.6 mm. Pulmonary lesions located in the lower lobes moved significantly more than upper lobe nodules. Size and distance from the pleura did not significantly impact movement. Significant movement of pulmonary lesions occurs between full inspiration and end-exhalation during tidal volume breathing. This movement from full inspiration on planning chest CT scan to tidal volume breathing during bronchoscopy may significantly affect the diagnostic yield of electromagnetic navigation bronchoscopy procedures.

Navigation within the heart and vessels in clinical practice.

PubMed

Beyar, Rafael

2010-02-01

The field of interventional cardiology has developed at an unprecedented pace on account of the visual and imaging power provided by constantly improving biomedical technologies. Transcatheter-based technology is now routinely used for coronary revascularization and noncoronary interventions using balloon angioplasty, stents, and many other devices. In the early days of interventional practice, the operating physician had to manually navigate catheters and devices under fluoroscopic imaging and was exposed to radiation, with its comcomitant necessity for wearing heavy lead aprons for protection. Until recently, very little has changed in the way procedures have been carried out in the catheterization laboratory. The technological capacity to remotely manipulate devices, using robotic arms and computational tools, has been developed for surgery and other medical procedures. This has brought to practice the powerful combination of the abilities afforded by imaging, navigational tools, and remote control manipulation. This review covers recent developments in navigational tools for catheter positioning, electromagnetic mapping, magnetic resonance imaging (MRI)-based cardiac electrophysiological interventions, and navigation tools through coronary arteries.

77 FR 52219 - Amendment of Class E Airspace; Lewistown, MT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Lewistown Municipal Airport. This improves the safety and management of Instrument Flight Rules (IFR...) standard instrument approach procedures at the airport. This action is necessary for the safety and...

78 FR 38197 - Establishment of Class E Airspace; Port Townsend, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Jefferson County International Airport. This improves the safety and management of Instrument Flight Rules... airport, to accommodate IFR aircraft executing new RNAV (GPS) standard instrument approach procedures...

33 CFR 230.20 - Integration with State and local procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Integration with State and local procedures. 230.20 Section 230.20 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.20 Integration with State and local procedures...

76 FR 82113 - Amendment of Class E Airspace; Show Low, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Show Low Regional Airport. This improves the safety and management of Instrument Flight Rules (IFR... executing RNAV (GPS) standard instrument approach procedures at the airport. This action is necessary for...

33 CFR 66.01-5 - Application procedure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Application procedure. 66.01-5 Section 66.01-5 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION Aids to Navigation Other Than Federal or State § 66.01-5 Application...

33 CFR 66.01-5 - Application procedure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Application procedure. 66.01-5 Section 66.01-5 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION Aids to Navigation Other Than Federal or State § 66.01-5 Application...

33 CFR 66.01-5 - Application procedure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Application procedure. 66.01-5 Section 66.01-5 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION Aids to Navigation Other Than Federal or State § 66.01-5 Application...

[The history and development of computer assisted orthopaedic surgery].

PubMed

Jenny, J-Y

2006-10-01

Computer assisted orthopaedic surgery (CAOS) was developed to improve the accuracy of surgical procedures. It has improved dramatically over the last years, being transformed from an experimental, laboratory procedure into a routine procedure theoretically available to every orthopaedic surgeon. The first field of application of computer assistance was neurosurgery. After the application of computer guided spinal surgery, the navigation of total hip and knee joints became available. Currently, several applications for computer assisted surgery are available. At the beginning of navigation, a preoperative CT-scan or several fluoroscopic images were necessary. The imageless systems allow the surgeon to digitize patient anatomy at the beginning of surgery without any preoperative imaging. The future of CAOS remains unknown, but there is no doubt that its importance will grow in the next 10 years, and that this technology will probably modify the conventional practice of orthopaedic surgery.

33 CFR 401.63 - Radio procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Radio procedures. 401.63 Section 401.63 Navigation and Navigable Waters SAINT LAWRENCE SEAWAY DEVELOPMENT CORPORATION, DEPARTMENT OF TRANSPORTATION SEAWAY REGULATIONS AND RULES Regulations Radio Communications § 401.63 Radio procedures. Every...

The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias.

PubMed

Bauernfeind, Tamas; Akca, Ferdi; Schwagten, Bruno; de Groot, Natasja; Van Belle, Yves; Valk, Suzanne; Ujvari, Barbara; Jordaens, Luc; Szili-Torok, Tamas

2011-07-01

We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities. In this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15±9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P=0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P=0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P=ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P<0.05). Less fluoroscopy was used in group MNS (30±20 vs. 35±25 min, P<0.01). There were no differences in procedure times and recurrence rates for the overall groups (168±67 vs. 159±75 min, P=ns; 14 vs. 11%, P=ns; respectively). Our data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs.

Evaluation of the ROSA™ Spine robot for minimally invasive surgical procedures.

PubMed

Lefranc, M; Peltier, J

2016-10-01

The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon. Development perspectives include (i) assistance at all levels of the spine, (ii) improved planning abilities (virtualization of the entire surgical procedure) and (iii) use for almost any percutaneous spinal procedures not limited in screw positioning such as percutaneous endoscopic lumbar discectomy, intracorporeal implant positioning, over te top laminectomy or radiofrequency ablation.

Area navigation and required navigation performance procedures and depictions

DOT National Transportation Integrated Search

2012-09-30

Area navigation (RNAV) and required navigation performance (RNP) procedures are fundamental to the implementation of a performance based navigation (PBN) system, which is a key enabling technology for the Next Generation Air Transportation System (Ne...

33 CFR 203.72 - Eligibility criteria and procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Eligibility criteria and procedures. 203.72 Section 203.72 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance...

33 CFR 203.72 - Eligibility criteria and procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Eligibility criteria and procedures. 203.72 Section 203.72 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance...

33 CFR 203.72 - Eligibility criteria and procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Eligibility criteria and procedures. 203.72 Section 203.72 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance...

Navigation and Robotics in Spinal Surgery: Where Are We Now?

PubMed

Overley, Samuel C; Cho, Samuel K; Mehta, Ankit I; Arnold, Paul M

2017-03-01

Spine surgery has experienced much technological innovation over the past several decades. The field has seen advancements in operative techniques, implants and biologics, and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and navigation capabilities along with the computing ability to process and reconstruct these data into an interactive three-dimensional spinal "map", so too have the applications of surgical robotic technology. While spinal robotics and navigation represent promising potential for improving modern spinal surgery, it remains paramount to demonstrate its superiority as compared to traditional techniques prior to assimilation of its use amongst surgeons.The applications for intraoperative navigation and image-guided robotics have expanded to surgical resection of spinal column and intradural tumors, revision procedures on arthrodesed spines, and deformity cases with distorted anatomy. Additionally, these platforms may mitigate much of the harmful radiation exposure in minimally invasive surgery to which the patient, surgeon, and ancillary operating room staff are subjected.Spine surgery relies upon meticulous fine motor skills to manipulate neural elements and a steady hand while doing so, often exploiting small working corridors utilizing exposures that minimize collateral damage. Additionally, the procedures may be long and arduous, predisposing the surgeon to both mental and physical fatigue. In light of these characteristics, spine surgery may actually be an ideal candidate for the integration of navigation and robotic-assisted procedures.With this paper, we aim to critically evaluate the current literature and explore the options available for intraoperative navigation and robotic-assisted spine surgery. Copyright © 2016 by the Congress of Neurological Surgeons.

International Agreement on Planetary Protection

NASA Technical Reports Server (NTRS)

2000-01-01

The maintenance of a NASA policy, is consistent with international agreements. The planetary protection policy management in OSS, with Field Center support. The advice from internal and external advisory groups (NRC, NAC/Planetary Protection Task Force). The technology research and standards development in bioload characterization. The technology research and development in bioload reduction/sterilization. This presentation focuses on: forward contamination - research on the potential for Earth life to exist on other bodies, improved strategies for planetary navigation and collision avoidance, and improved procedures for sterile spacecraft assembly, cleaning and/or sterilization; and backward contamination - development of sample transfer and container sealing technologies for Earth return, improvement in sample return landing target assessment and navigation strategy, planning for sample hazard determination requirements and procedures, safety certification, (liaison to NEO Program Office for compositional data on small bodies), facility planning for sample recovery system, quarantine, and long-term curation of 4 returned samples.

Magnetic navigation in ultrasound-guided interventional radiology procedures.

PubMed

Xu, H-X; Lu, M-D; Liu, L-N; Guo, L-H

2012-05-01

To evaluate the usefulness of magnetic navigation in ultrasound (US)-guided interventional procedures. Thirty-seven patients who were scheduled for US-guided interventional procedures (20 liver cancer ablation procedures and 17 other procedures) were included. Magnetic navigation with three-dimensional (3D) computed tomography (CT), magnetic resonance imaging (MRI), 3D US, and position-marking magnetic navigation were used for guidance. The influence on clinical outcome was also evaluated. Magnetic navigation facilitated applicator placement in 15 of 20 ablation procedures for liver cancer in which multiple ablations were performed; enhanced guidance in two small liver cancers invisible on conventional US but visible at CT or MRI; and depicted the residual viable tumour after transcatheter arterial chemoembolization for liver cancer in one procedure. In four of 17 other interventional procedures, position-marking magnetic navigation increased the visualization of the needle tip. Magnetic navigation was beneficial in 11 (55%) of 20 ablation procedures; increased confidence but did not change management in five (25%); added some information but did not change management in two (10%); and made no change in two (10%). In the other 17 interventional procedures, the corresponding numbers were 1 (5.9%), 2 (11.7%), 7 (41.2%), and 7 (41.2%), respectively (p=0.002). Magnetic navigation in US-guided interventional procedure provides solutions in some difficult cases in which conventional US guidance is not suitable. It is especially useful in complicated interventional procedures such as ablation for liver cancer. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Human factors research plan for instrument procedures : FY12 version 1.1

DOT National Transportation Integrated Search

2012-06-19

This research will support the development of instrument procedures for performance-based navigation (PBN) operations. These procedures include, but are not limited to, area navigation (RNAV) and required navigation performance (RNP) operations. The ...

Navigation errors encountered using weather-mapping radar for helicopter IFR guidance to oil rigs

NASA Technical Reports Server (NTRS)

Phillips, J. D.; Bull, J. S.; Hegarty, D. M.; Dugan, D. C.

1980-01-01

In 1978 a joint NASA-FAA helicopter flight test was conducted to examine the use of weather-mapping radar for IFR guidance during landing approaches to oil rig helipads. The following navigation errors were measured: total system error, radar-range error, radar-bearing error, and flight technical error. Three problem areas were identified: (1) operational problems leading to pilot blunders, (2) poor navigation to the downwind final approach point, and (3) pure homing on final approach. Analysis of these problem areas suggests improvement in the radar equipment, approach procedure, and pilot training, and gives valuable insight into the development of future navigation aids to serve the off-shore oil industry.

Analysis of safety reports involving area navigation and required navigation performance procedures.

DOT National Transportation Integrated Search

2010-11-03

In order to achieve potential operational and safety benefits enabled by Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures it is important to monitor emerging issues in their initial implementation. Reports from the Aviation...

Remote controlled robot assisted cardiac navigation: feasibility assessment and validation in a porcine model.

PubMed

Ganji, Yusof; Janabi-Sharifi, Farrokh; Cheema, Asim N

2011-12-01

Despite the recent advances in catheter design and technology, intra-cardiac navigation during electrophysiology procedures remains challenging. Incorporation of imaging along with magnetic or robotic guidance may improve navigation accuracy and procedural safety. In the present study, the in vivo performance of a novel remote controlled Robot Assisted Cardiac Navigation System (RACN) was evaluated in a porcine model. The navigation catheter and target sensor were advanced to the right atrium using fluoroscopic and intra-cardiac echo guidance. The target sensor was positioned at three target locations in the right atrium (RA) and the navigation task was completed by an experienced physician using both manual and RACN guidance. The navigation time, final distance between the catheter tip and target sensor, and variability in final catheter tip position were determined and compared for manual and RACN guided navigation. The experiments were completed in three animals and five measurements recorded for each target location. The mean distance (mm) between catheter tip and target sensor at the end of the navigation task was significantly less using RACN guidance compared with manual navigation (5.02 ± 0.31 vs. 9.66 ± 2.88, p = 0.050 for high RA, 9.19 ± 1.13 vs. 13.0 ± 1.00, p = 0.011 for low RA and 6.77 ± 0.59 vs. 15.66 ± 2.51, p = 0.003 for tricuspid valve annulus). The average time (s) needed to complete the navigation task was significantly longer by RACN guided navigation compared with manual navigation (43.31 ± 18.19 vs. 13.54 ± 1.36, p = 0.047 for high RA, 43.71 ± 11.93 vs. 22.71 ± 3.79, p = 0.043 for low RA and 37.84 ± 3.71 vs. 16.13 ± 4.92, p = 0.003 for tricuspid valve annulus. RACN guided navigation resulted in greater consistency in performance compared with manual navigation as evidenced by lower variability in final distance measurements (0.41 vs. 0.99 mm, p = 0.04). This study demonstrated the safety and feasibility of the RACN system for cardiac navigation. The results demonstrated that RACN performed comparably with manual navigation, with improved precision and consistency for targets located in and near the right atrial chamber. Copyright © 2011 John Wiley & Sons, Ltd.

Human factors research on performance-based navigation instrument procedures for NextGEN

DOT National Transportation Integrated Search

2012-10-14

Area navigation (RNAV) and required navigation performance (RNP) are key components of performance-based navigation (PBN). Instrument procedures that use RNAV and RNP can have more flexible and precise paths than conventional routes that are defined ...

The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias

PubMed Central

Bauernfeind, Tamas; Akca, Ferdi; Schwagten, Bruno; de Groot, Natasja; Van Belle, Yves; Valk, Suzanne; Ujvari, Barbara; Jordaens, Luc; Szili-Torok, Tamas

2011-01-01

Aims We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities. Methods and results In this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15 ± 9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P = 0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P = 0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P = ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P < 0.05). Less fluoroscopy was used in group MNS (30 ± 20 vs. 35 ± 25 min, P < 0.01). There were no differences in procedure times and recurrence rates for the overall groups (168 ± 67 vs. 159 ± 75 min, P = ns; 14 vs. 11%, P = ns; respectively). Conclusions Our data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs. PMID:21508006

Comparing conventional and computer-assisted surgery baseplate and screw placement in reverse shoulder arthroplasty.

PubMed

Venne, Gabriel; Rasquinha, Brian J; Pichora, David; Ellis, Randy E; Bicknell, Ryan

2015-07-01

Preoperative planning and intraoperative navigation technologies have each been shown separately to be beneficial for optimizing screw and baseplate positioning in reverse shoulder arthroplasty (RSA) but to date have not been combined. This study describes development of a system for performing computer-assisted RSA glenoid baseplate and screw placement, including preoperative planning, intraoperative navigation, and postoperative evaluation, and compares this system with a conventional approach. We used a custom-designed system allowing computed tomography (CT)-based preoperative planning, intraoperative navigation, and postoperative evaluation. Five orthopedic surgeons defined common preoperative plans on 3-dimensional CT reconstructed cadaveric shoulders. Each surgeon performed 3 computer-assisted and 3 conventional simulated procedures. The 3-dimensional CT reconstructed postoperative units were digitally matched to the preoperative model for evaluation of entry points, end points, and angulations of screws and baseplate. Values were used to find accuracy and precision of the 2 groups with respect to the defined placement. Statistical analysis was performed by t tests (α = .05). Comparison of the groups revealed no difference in accuracy or precision of screws or baseplate entry points (P > .05). Accuracy and precision were improved with use of navigation for end points and angulations of 3 screws (P < .05). Accuracy of the inferior screw showed a trend of improvement with navigation (P > .05). Navigated baseplate end point precision was improved (P < .05), with a trend toward improved accuracy (P > .05). We conclude that CT-based preoperative planning and intraoperative navigation allow improved accuracy and precision for screw placement and precision for baseplate positioning with respect to a predefined placement compared with conventional techniques in RSA. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

33 CFR 26.08 - Exemption procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Exemption procedures. 26.08 Section 26.08 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL VESSEL... redelegated to the Assistant Commandant for Marine Safety, Security and Environmental Protection, U.S. Coast...

33 CFR 26.08 - Exemption procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Exemption procedures. 26.08 Section 26.08 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL VESSEL... redelegated to the Assistant Commandant for Marine Safety, Security and Environmental Protection, U.S. Coast...

[Interest of non invasive navigation in total knee arthroplasty].

PubMed

Zorman, D; Leclercq, G; Cabanas, J Juanos; Jennart, H

2015-01-01

During surgery of total knee arthroplasty, we use a computerized non invasive navigation (Brainlab Victor Vision CT-free) to assess the accuracy of the bone cuts (navigation expresse). The purpose of this study is to evaluate non invasive navigation when a total knee arthroplasty is achieved by conventional instrumentation. The study is based on forty total knee arthroplasties. The accuracy of the tibial and distal femoral bone cuts, checked by non invasive navigation, is evaluated prospectively. In our clinical series, we have obtained, with the conventional instrumentation, a correction of the mechanical axis only in 90 % of cases (N = 36). With non invasive navigation, we improved the positioning of implants and obtained in all cases the desired axiometry in the frontal plane. Although operative time is increased by about 15 minutes, the non invasive navigation does not induce intraoperative or immediate postoperative complications. Despite the cost of this technology, we believe that the reliability of the procedure is enhanced by a simple and reproducible technique.

Simulation-based camera navigation training in laparoscopy-a randomized trial.

PubMed

Nilsson, Cecilia; Sorensen, Jette Led; Konge, Lars; Westen, Mikkel; Stadeager, Morten; Ottesen, Bent; Bjerrum, Flemming

2017-05-01

Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant. Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118-217) and 194 s (95% CI, 152-236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202-412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score. Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.

Mental distress and effort to engage an image-guided navigation system in the surgical training of endoscopic sinus surgery: a prospective, randomised clinical trial.

PubMed

Theodoraki, M N; Ledderose, G J; Becker, S; Leunig, A; Arpe, S; Luz, M; Stelter, K

2015-04-01

The use of image-guided navigation systems in the training of FESS is discussed controversy. Many experienced sinus surgeons report a better spatial orientation and an improved situational awareness intraoperatively. But many fear that the navigation system could be a disadvantage in the surgical training because of a higher mental demand and a possible loss of surgical skills. This clinical field study investigates mental and physical demands during transnasal surgery with and without the aid of a navigation system at an early stage in FESS training. Thirty-two endonasal sinus surgeries done by eight different trainee surgeons were included. After randomization, one side of each patient was operated by use of a navigation system, the other side without. During the whole surgery, the surgeons were connected to a biofeedback device measuring the heart rate, the heart rate variability, the respiratory frequency and the masticator EMG. Stress situations could be identified by an increase of the heart rate frequency and a decrease of the heart rate variability. The mental workload during a FESS procedure is high compared to the baseline before and after surgery. The mental workload level when using the navigation did not significantly differ from the side without using the navigation. Residents with more than 30 FESS procedures already done, showed a slightly decreased mental workload when using the navigation. An additional workload shift toward the navigation system could not be observed in any surgeon. Remarkable other stressors could be identified during this study: the behavior of the supervisor or the use of the 45° endoscope, other colleagues or students entering the theatre, poor vision due to bleeding and the preoperative waiting when measuring the baseline. The mental load of young surgeons in FESS surgery is tremendous. The application of a navigation system did not cause a higher mental workload or distress. The device showed a positive effort to engage for the trainees with more than 30 FESS procedures done. In this subgroup it even leads to decreased mental workload.

33 CFR 211.23 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Procedure. 211.23 Section 211.23 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Real Estate Claims § 211.23...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

33 CFR 62.65 - Procedure for reporting defects and discrepancies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM Public Participation in the Aids to Navigation System § 62.65 Procedure for reporting defects and discrepancies. (a) Mariners should notify the nearest Coast Guard facility immediately of any observed aids to navigation defects or...

Remote magnetic navigation in atrial fibrillation.

PubMed

Szili-Torok, Tamas; Akca, Ferdi

2012-05-01

Atrial fibrillation (AF) is of profound public health importance and is largely a disease of aging and is responsible for increased morbidity- and mortality-related healthcare expenditures. Catheter ablation to isolate the pulmonary veins has become the therapy of choice for treatment of drug-refractory AF. Procedures can be very challenging and multiple difficulties must be overcome in order to achieve a successful outcome. The magnetic navigation system (MNS) has advantages in catheter maneuverability, stability and reproducibility. Due to the catheter design safety and efficacy of AF, ablation has increased. New developments are being made to allow fully remote ablation procedures in combination with the MNS. However, new technologies are still necessary to improve MNS ablation for AF.

Advances in diagnostic interventional pulmonology

PubMed Central

Al-Zubaidi, Nassar; Soubani, Ayman O.

2015-01-01

The recent advances in diagnostic pulmonary procedures have revolutionized the evaluation of abnormal thoracic findings including lung nodules and masses, mediastinal lymphadenopathy, and pleural diseases. Bronchoscopies with endobronchial ultrasonography and electromagnetic navigation are examples of new technology that has significantly improved the specificity and sensitivity of these procedures in diagnosis and staging of lung cancer without the need for more invasive procedures. This report describes the different diagnostic pulmonary interventions providing a description of the procedures, their indications, diagnostic yield and drawback. PMID:26229756

Guidewire navigation in coronary artery stenoses using a novel magnetic navigation system: first clinical experience.

PubMed

Tsuchida, Keiichi; García-García, Héctor M; van der Giessen, Willem J; McFadden, Eugène P; van der Ent, Martin; Sianos, Georgios; Meulenbrug, Hans; Ong, Andrew T L; Serruys, Patrick W

2006-03-01

The objective of this study was to investigate the efficacy of guidewire navigation across coronary artery stenoses using magnetic navigation system (MNS) versus conventional navigation. The MNS is a novel option to facilitate access to target lesions, particularly in tortuous vessels. In an experimental study using a challenging vessel phantom, magnetic-navigated guidewire passage has been reported to reduce fluoroscopy and procedure time significantly. Both magnetic and manual guidewire navigation were attempted in 21 consecutive diseased coronary arteries. The study endpoint was defined as an intraluminal wire position distal to the stenosis. Procedural success was defined as successful guidewire passage without procedural events. Procedure time, amount of contrast, fluoroscopy time, and radiation dose/area product (DAP) were evaluated. There were no procedural events related to either guidewire. Although the lesions attempted had relatively simple and straightforward characteristics, significantly shorter procedure and fluoroscopy time were observed for manual guidewire navigation compared to MNS (median, 40 vs. 120 sec, P=0.001; 38 vs. 105 sec, P=0.001, respectively). Contrast amount and DAP were higher in MNS than in conventional method (median, 13 vs. 9 ml, P=0.018; 215 vs. 73 Gym2, P=0.002, respectively). The magnetic wire did not cross in two vessels. Guidewire navigation using MNS presented a novel, safe, and feasible approach to address coronary artery lesions. Clinical studies are needed to evaluate the potential benefit of the MNS in more complex coronary lesions and tortuous anatomy. Copyright (c) 2006 Wiley-Liss, Inc.

Electromagnetic navigation reduces surgical time and radiation exposure for proximal interlocking in retrograde femoral nailing.

PubMed

Somerson, Jeremy S; Rowley, David; Kennedy, Chad; Buttacavoli, Frank; Agarwal, Animesh

2014-07-01

To compare the time required for proximal locking screw placement between a standard freehand technique and the navigated technique, and to quantify the reduction in ionizing radiation exposure. A fresh frozen cadaver model was used for 48 proximal interlocking screw procedures. Each procedure consisted of insertion of 2 anteroposterior locking screws. Standard fluoroscopic technique was used for 24 procedures, and an electromagnetic navigation system was used for the remaining 24 procedures. Procedure duration was recorded using an electronic timer and radiation doses were documented. Mean total insertion time for both proximal interlocking screws was 405 ± 165.7 seconds with the freehand technique and 311 ± 78.3 seconds in the navigation group (P = 0.002). All procedures resulted in successful locking screw placement. Mean ionizing radiation exposure time for proximal locking was 29.5 ± 12.8 seconds. Proximal locking screw insertion using the navigation technique evaluated in this work was significantly faster than the standard fluoroscopic method. The navigated technique is effective and has the potential to prevent ionizing radiation exposure.

A novel navigation system for maxillary positioning in orthognathic surgery: Preclinical evaluation.

PubMed

Lutz, Jean-Christophe; Nicolau, Stéphane; Agnus, Vincent; Bodin, Frédéric; Wilk, Astrid; Bruant-Rodier, Catherine; Rémond, Yves; Soler, Luc

2015-11-01

Appropriate positioning of the maxilla is critical in orthognathic surgery. As opposed to splint-based positioning, navigation systems are versatile and appropriate in assessing the vertical dimension. Bulk and disruption to the line of sight are drawbacks of optical navigation systems. Our aim was to develop and assess a novel navigation system based on electromagnetic tracking of the maxilla, including real-time registration of head movements. Since the software interface has proved to greatly influence the accuracy of the procedure, we purposely designed and evaluated an original, user-friendly interface. A sample of 12 surgeons had to navigate the phantom osteotomized maxilla to eight given target positions using the software we have developed. Time and accuracy (translational error and angular error) were compared between a conventional and a navigated session. A questionnaire provided qualitative evaluation. Our system definitely allows a reduction in variability of time and accuracy among different operators. Accuracy was improved in all surgeons (mean terror difference = 1.11 mm, mean aerror difference = 1.32°). Operative time was decreased in trainees. Therefore, they would benefit from such a system that could also serve for educational purposes. The majority of surgeons who strongly agreed that such a navigation system would prove very helpful in complex deformities, also stated that it would be helpful in everyday orthognathic procedures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Evaluation of a technique to simplify area navigation and required navigation performance charts

DOT National Transportation Integrated Search

2013-06-30

Performance based navigation (PBN), an enabler for the Federal Aviation Administration's Next Generation Air Transportation System (NextGEN), supports the design of more precise flight procedures. However, these new procedures can be visually complex...

A novel platform for electromagnetic navigated ultrasound bronchoscopy (EBUS).

PubMed

Sorger, Hanne; Hofstad, Erlend Fagertun; Amundsen, Tore; Langø, Thomas; Leira, Håkon Olav

2016-08-01

Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes is essential for lung cancer staging and distinction between curative and palliative treatment. Precise sampling is crucial. Navigation and multimodal imaging may improve the efficiency of EBUS-TBNA. We demonstrate a novel EBUS-TBNA navigation system in a dedicated airway phantom. Using a convex probe EBUS bronchoscope (CP-EBUS) with an integrated sensor for electromagnetic (EM) position tracking, we performed navigated CP-EBUS in a phantom. Preoperative computed tomography (CT) and real-time ultrasound (US) images were integrated into a navigation platform for EM navigated bronchoscopy. The coordinates of targets in CT and US volumes were registered in the navigation system, and the position deviation was calculated. The system visualized all tumor models and displayed their fused CT and US images in correct positions in the navigation system. Navigating the EBUS bronchoscope was fast and easy. Mean error observed between US and CT positions for 11 target lesions (37 measurements) was [Formula: see text] mm, maximum error was 5.9 mm. The feasibility of our novel navigated CP-EBUS system was successfully demonstrated. An EBUS navigation system is needed to meet future requirements of precise mediastinal lymph node mapping, and provides new opportunities for procedure documentation in EBUS-TBNA.

Design and implementation of a patient navigation system in rural Nepal: Improving patient experience in resource-constrained settings.

PubMed

Raut, Anant; Thapa, Poshan; Citrin, David; Schwarz, Ryan; Gauchan, Bikash; Bista, Deepak; Tamrakar, Bibhu; Halliday, Scott; Maru, Duncan; Schwarz, Dan

2015-12-01

Patient navigation programs have shown to be effective across multiple settings in guiding patients through the care delivery process. Limited experience and literature exist, however, for such programs in rural and resource-constrained environments. Patients living in such settings frequently have low health literacy and substantially lower social status than their providers. They typically have limited experiences interfacing with formalized healthcare systems, and, when they do, their experience can be unpleasant and confusing. At a district hospital in rural far-western Nepal, we designed and implemented a patient navigation system that aimed to improve patients' subjective care experience. First, we hired and trained a team of patient navigators who we recruited from the local area. Their responsibility is exclusively to demonstrate compassion and to guide patients through their care process. Second, we designed visual cues throughout our hospital complex to assist in navigating patients through the buildings. Third, we incorporated the patient navigators within the management and communications systems of the hospital care team, and established standard operating procedures. We describe here our experiences and challenges in designing and implementing a patient navigator program. Such patient-centered systems may be relevant at other facilities in Nepal and globally where patient health literacy is low, patients come from backgrounds of substantial marginalization and disempowerment, and patient experience with healthcare facilities is limited. Copyright © 2015 Elsevier Inc. All rights reserved.

Electromagnetic tracking of flexible robotic catheters enables "assisted navigation" and brings automation to endovascular navigation in an in vitro study.

PubMed

Schwein, Adeline; Kramer, Benjamin; Chinnadurai, Ponraj; Virmani, Neha; Walker, Sean; O'Malley, Marcia; Lumsden, Alan B; Bismuth, Jean

2018-04-01

Combining three-dimensional (3D) catheter control with electromagnetic (EM) tracking-based navigation significantly reduced fluoroscopy time and improved robotic catheter movement quality in a previous in vitro pilot study. The aim of this study was to expound on previous results and to expand the value of EM tracking with a novel feature, assistednavigation, allowing automatic catheter orientation and semiautomatic vessel cannulation. Eighteen users navigated a robotic catheter in an aortic aneurysm phantom using an EM guidewire and a modified 9F robotic catheter with EM sensors at the tip of both leader and sheath. All users cannulated two targets, the left renal artery and posterior gate, using four visualization modes: (1) Standard fluoroscopy (control). (2) 2D biplane fluoroscopy showing real-time virtual catheter localization and orientation from EM tracking. (3) 2D biplane fluoroscopy with novel EM assisted navigation allowing the user to define the target vessel. The robotic catheter orients itself automatically toward the target; the user then only needs to advance the guidewire following this predefined optimized path to catheterize the vessel. Then, while advancing the catheter over the wire, the assisted navigation automatically modifies catheter bending and rotation in order to ensure smooth progression, avoiding loss of wire access. (4) Virtual 3D representation of the phantom showing real-time virtual catheter localization and orientation. Standard fluoroscopy was always available; cannulation and fluoroscopy times were noted for every mode and target cannulation. Quality of catheter movement was assessed by measuring the number of submovements of the catheter using the 3D coordinates of the EM sensors. A t-test was used to compare the standard fluoroscopy mode against EM tracking modes. EM tracking significantly reduced the mean fluoroscopy time (P < .001) and the number of submovements (P < .02) for both cannulation tasks. For the posterior gate, mean cannulation time was also significantly reduced when using EM tracking (P < .001). The use of novel EM assisted navigation feature (mode 3) showed further reduced cannulation time for the posterior gate (P = .002) and improved quality of catheter movement for the left renal artery cannulation (P = .021). These results confirmed the findings of a prior study that highlighted the value of combining 3D robotic catheter control and 3D navigation to improve safety and efficiency of endovascular procedures. The novel EM assisted navigation feature augments the robotic master/slave concept with automated catheter orientation toward the target and shows promising results in reducing procedure time and improving catheter motion quality. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Computed intraoperative navigation guidance--a preliminary report on a new technique.

PubMed

Enislidis, G; Wagner, A; Ploder, O; Ewers, R

1997-08-01

To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Comparative study of navigated versus freehand osteochondral graft transplantation of the knee.

PubMed

Koulalis, Dimitrios; Di Benedetto, Paolo; Citak, Mustafa; O'Loughlin, Padhraig; Pearle, Andrew D; Kendoff, Daniel O

2009-04-01

Osteochondral lesions are a common sports-related injury for which osteochondral grafting, including mosaicplasty, is an established treatment. Computer navigation has been gaining popularity in orthopaedic surgery to improve accuracy and precision. Navigation improves angle and depth matching during harvest and placement of osteochondral grafts compared with conventional freehand open technique. Controlled laboratory study. Three cadaveric knees were used. Reference markers were attached to the femur, tibia, and donor/recipient site guides. Fifteen osteochondral grafts were harvested and inserted into recipient sites with computer navigation, and 15 similar grafts were inserted freehand. The angles of graft removal and placement as well as surface congruity (graft depth) were calculated for each surgical group. The mean harvesting angle at the donor site using navigation was 4 degrees (standard deviation, 2.3 degrees ; range, 1 degrees -9 degrees ) versus 12 degrees (standard deviation, 5.5 degrees ; range, 5 degrees -24 degrees ) using freehand technique (P < .0001). The recipient plug removal angle using the navigated technique was 3.3 degrees (standard deviation, 2.1 degrees ; range, 0 degrees -9 degrees ) versus 10.7 degrees (standard deviation, 4.9 degrees ; range, 2 degrees -17 degrees ) in freehand (P < .0001). The mean navigated recipient plug placement angle was 3.6 degrees (standard deviation, 2.0 degrees ; range, 1 degrees -9 degrees ) versus 10.6 degrees (standard deviation, 4.4 degrees ; range, 3 degrees -17 degrees ) with freehand technique (P = .0001). The mean height of plug protrusion under navigation was 0.3 mm (standard deviation, 0.2 mm; range, 0-0.6 mm) versus 0.5 mm (standard deviation, 0.3 mm; range, 0.2-1.1 mm) using a freehand technique (P = .0034). Significantly greater accuracy and precision were observed in harvesting and placement of the osteochondral grafts in the navigated procedures. Clinical studies are needed to establish a benefit in vivo. Improvement in the osteochondral harvest and placement is desirable to optimize clinical outcomes. Navigation shows great potential to improve both harvest and placement precision and accuracy, thus optimizing ultimate surface congruity.

33 CFR 115.60 - Procedures for handling applications for bridge construction permits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... applications for bridge construction permits. 115.60 Section 115.60 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.60 Procedures for handling applications for bridge construction permits. The following procedures will be...

33 CFR 115.60 - Procedures for handling applications for bridge construction permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... applications for bridge construction permits. 115.60 Section 115.60 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.60 Procedures for handling applications for bridge construction permits. The following procedures will be...

33 CFR 157.415 - Bridge resource management policy and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Bridge resource management policy... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1... in charge of the navigational watch concerning the need for continuously reassessing how bridge-watch...

78 FR 67024 - Modification of Class E Airspace; Prineville, OR

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Prineville, OR, to accommodate Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Prineville Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. This action also adjusts the geographic coordinates of the...

76 FR 45180 - Modification of Class E Airspace; Alturas, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Alturas Municipal Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC, October 20, 2011. The Director of the Federal...

77 FR 44120 - Establishment of Class E Airspace; Roundup, MT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-27

... at Roundup Airport, Roundup, MT, to accommodate aircraft using new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Roundup Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901...

76 FR 45177 - Establishment of Class E Airspace; Kayenta, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Kayenta Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC, October 20, 2011. The Director of the Federal Register...

[An Experimental Set-Up for Navigated-Contrast-Agent and Radiation Sparing Endovascular Aortic Repair (Nav-CARS EVAR)].

PubMed

Horn, M; Nolde, J; Goltz, J P; Barkhausen, J; Schade, W; Waltermann, C; Modersitzki, J; Olesch, J; Papenberg, N; Keck, T; Kleemann, M

2015-10-01

Over the last decade endovascular stenting of aortic aneurysm (EVAR) has been developed from single centre experiences to a standard procedure. With increasing clinical expertise and medical technology advances treatment of even complex aneurysms are feasible by endovascular methods. One integral part for the success of this minimally invasive procedure is innovative and improved vascular imaging to generate exact measurements and correct placement of stent prosthesis. One of the greatest difficulty in learning and performing this endovascular therapy is the fact that the three-dimensional vascular tree has to be overlaid with the two-dimensional angiographic scene by the vascular surgeon. We report the development of real-time navigation software, which allows a three-dimensional endoluminal view of the vascular system during an EVAR procedure in patients with infrarenal aortic aneurysm. We used the preoperative planning CT angiography for three-dimensional reconstruction of aortic anatomy by volume-rendered segmentation. At the beginning of the intervention the relevant landmarks are matched in real-time with the two-dimensional angiographic scene. During the intervention the software continously registers the position of the guide-wire or the stent. An additional 3D-screen shows the generated endoluminal view during the whole intervention in real-time. We examined the combination of hardware and software components including complex image registration and fibre optic sensor technology (fibre-bragg navigation) with integration in stent graft introducer sheaths using patient-specific vascular phantoms in an experimental setting. From a technical point of view the feasibility of fibre-Bragg navigation has been proven in our experimental setting with patient-based vascular models. Three-dimensional preoperative planning including registration and simulation of virtual angioscopy in real time are realised. The aim of the Nav-CARS-EVAR concept is reduction of contrast medium and radiation dose by a three-dimensional navigation during the EVAR procedure. To implement fibre-Bragg navigation further experimental studies are necessary to verify accuracy before clinical application. Georg Thieme Verlag KG Stuttgart · New York.

Navigated Pattern Laser System versus Single-Spot Laser System for Postoperative 360-Degree Laser Retinopexy.

PubMed

Kulikov, Alexei N; Maltsev, Dmitrii S; Boiko, Ernest V

2016-01-01

Purpose . To compare three 360°-laser retinopexy (LRP) approaches (using navigated pattern laser system, single-spot slit-lamp (SL) laser delivery, and single-spot indirect ophthalmoscope (IO) laser delivery) in regard to procedure duration, procedural pain score, technical difficulties, and the ability to achieve surgical goals. Material and Methods . Eighty-six rhegmatogenous retinal detachment patients (86 eyes) were included in this prospective randomized study. The mean procedural time, procedural pain score (using 4-point Verbal Rating Scale), number of laser burns, and achievement of the surgical goals were compared between three groups (pattern LRP (Navilas® laser system), 36 patients; SL-LRP, 28 patients; and IO-LRP, 22 patients). Results . In the pattern LRP group, the amount of time needed for LRP and pain level were statistically significantly lower, whereas the number of applied laser burns was higher compared to those in the SL-LRP group and in the IO-LRP group. In the pattern LRP, SL-LRP, and IO-LRP groups, surgical goals were fully achieved in 28 (77.8%), 17 (60.7%), and 13 patients (59.1%), respectively ( p > 0.05). Conclusion . The navigated pattern approach allows improving the treatment time and pain in postoperative 360° LRP. Moreover, 360° pattern LRP is at least as effective in achieving the surgical goal as the conventional (slit-lamp or indirect ophthalmoscope) approaches with a single-spot laser.

Displays mounted on cutting blocks reduce the learning curve in navigated total knee arthroplasty.

PubMed

Schnurr, Christoph; Eysel, Peer; König, Dietmar Pierre

2011-01-01

The use of computer navigation in total knee arthroplasty (TKA) improves the implant alignment but increases the operation time. Studies have shown that the operation time is further prolonged due to the surgeon's learning curve, and longer operation times have been associated with higher morbidity risks. It has been our hypothesis that an improvement in the human-machine interface might reduce the time required during the learning curve. Accordingly, we asked whether the use of navigation devices with a display fixed on the surgical instruments would reduce the operation time in navigated TKAs performed by navigation beginners. Thirty medical students were randomized and used two navigation devices in rotation: these were the Kolibri® device with an external display and the Dash® device with a display that was fixed on the cutting blocks. The time for adjustment of the tibial and femoral cutting blocks on knee models while using these devices was measured. A significant time reduction was demonstration when the Dash® device was used: The time reduction was 21% for the tibial block (p = 0.007), 40% for the femoral block (p < 0.001), and 32% for the whole procedure (p < 0.001). The integrated display, fixed on surgical instruments in a manner similar to a spirit level, seems to be more user-friendly for navigation beginners. Hence, unproductive time losses during the learning curve may be diminished.

Sentinel lymph node navigation surgery for gastric cancer: Does it really benefit the patient?

PubMed

Tani, Tohru; Sonoda, Hiromichi; Tani, Masaji

2016-03-14

Sentinel lymph node (SLN) navigation surgery is accepted as a standard treatment procedure for malignant melanoma and breast cancer. However, the benefit of reduced lymphadenectomy based on SLN examination remains unclear in cases of gastric cancer. Here, we review previous studies to determine whether SLN navigation surgery is beneficial for gastric cancer patients. Recently, a large-scale prospective study from the Japanese Society of Sentinel Node Navigation Surgery reported that the endoscopic dual tracer method, using a dye and radioisotope for SLN biopsy, was safe and effective when applied to cases of superficial and relatively small gastric cancers. SLN mapping with SLN basin dissection was preferred for early gastric cancer since it is minimally invasive. However, previous studies reported that limited gastrectomy and lymphadenectomy may not improve the patient's postoperative quality of life (QOL). As a result, the benefit of SLN navigation surgery for gastric cancer patients, in terms of their QOL, is limited. Thus, endoscopic and laparoscopic limited gastrectomy combined with SLN navigation surgery has the potential to become the standard minimally invasive surgery in early gastric cancer.

A Virtual Water Maze Revisited: Two-Year Changes in Navigation Performance and their Neural Correlates in Healthy Adults

PubMed Central

Daugherty, Ana M.; Raz, Naftali

2016-01-01

Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18–77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits. PMID:27659539

A virtual water maze revisited: Two-year changes in navigation performance and their neural correlates in healthy adults.

PubMed

Daugherty, Ana M; Raz, Naftali

2017-02-01

Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18-77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits. Copyright © 2016 Elsevier Inc. All rights reserved.

[Cost analysis for navigation in knee endoprosthetics].

PubMed

Cerha, O; Kirschner, S; Günther, K-P; Lützner, J

2009-12-01

Total knee arthroplasty (TKA) is one of the most frequent procedures in orthopaedic surgery. The outcome depends on a range of factors including alignment of the leg and the positioning of the implant in addition to patient-associated factors. Computer-assisted navigation systems can improve the restoration of a neutral leg alignment. This procedure has been established especially in Europe and North America. The additional expenses are not reimbursed in the German DRG system (Diagnosis Related Groups). In the present study a cost analysis of computer-assisted TKA compared to the conventional technique was performed. The acquisition expenses of various navigation systems (5 and 10 year depreciation), annual costs for maintenance and software updates as well as the accompanying costs per operation (consumables, additional operating time) were considered. The additional operating time was determined on the basis of a meta-analysis according to the current literature. Situations with 25, 50, 100, 200 and 500 computer-assisted TKAs per year were simulated. The amount of the incremental costs of the computer-assisted TKA depends mainly on the annual volume and the additional operating time. A relevant decrease of the incremental costs was detected between 50 and 100 procedures per year. In a model with 100 computer-assisted TKAs per year an additional operating time of 14 mins and a 10 year depreciation of the investment costs, the incremental expenses amount to 300-395 depending on the navigation system. Computer-assisted TKA is associated with additional costs. From an economical point of view an amount of more than 50 procedures per year appears to be favourable. The cost-effectiveness could be estimated if long-term results will show a reduction of revisions or a better clinical outcome.

Training femoral neck screw insertion skills to surgical trainees: computer-assisted surgery versus conventional fluoroscopic technique.

PubMed

Nousiainen, Markku T; Omoto, Daniel M; Zingg, Patrick O; Weil, Yoram A; Mardam-Bey, Sami W; Eward, William C

2013-02-01

: Femoral neck fractures are among the most common orthopaedic injuries impacting the health care system. Surgical management of such fractures with cannulated screws is a commonly performed procedure. The acquisition of surgical skills necessary to perform this procedure typically involves learning on real patients with fluoroscopic guidance. This study attempts to determine if a novel computer-navigated training model improves the learning of this basic surgical skill. A multicenter, prospective, randomized, and controlled study was conducted using surgical trainees with no prior experience in surgically managing femoral neck fractures. After a training session, participants underwent a pretest by performing the surgical task (screw placement) on a simulated hip fracture using fluoroscopic guidance. Immediately after, participants were randomized into either undergoing a training session using conventional fluoroscopy or computer-based navigation. Immediate posttest, retention (4 weeks later), and transfer tests were performed. Performance during the tests was determined by radiographic analysis of hardware placement. Screw placement by trainees was ultimately equal to the level of an expert surgeon with either training technique. Participants who trained with computer navigation took fewer attempts to position hardware and used less fluoroscopy time than those trained with fluoroscopy. When those trained with fluoroscopy used computer navigation at the transfer test, less fluoroscopy time and dosage was used. The concurrent augmented feedback provided by computer navigation did not affect the learning of this basic surgical skill in surgical novices. No compromise in learning occurred if the surgical novice trained with one type of technology and transferred to using the other. The findings of this study suggest that computer navigation may be safely used to train surgical novices in a basic procedure. This model avoids using both live patients and harmful radiation without a compromise in the acquisition of a 3-dimensional technical skill.

76 FR 45177 - Establishment of Class E Airspace; Nephi, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... at Nephi UT, to accommodate aircraft using new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Nephi Municipal Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC, October...

75 FR 12974 - Establishment of Class E Airspace; Hailey, ID

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... airspace at Hailey, ID, to accommodate aircraft using the Area Navigation (RNAV) Global Positioning System (GPS) Standard Instrument Approach Procedure (SIAP) at Friedman Memorial Airport. This will improve the safety of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective Date: 0901 UTC, June...

76 FR 69608 - Modification of Class E Airspace; Blythe, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... Blythe, CA, to accommodate aircraft using Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Blythe Airport. This action also corrects geographic coordinates in the regulatory text. This improves the safety and management of Instrument Flight Rules (IFR) operations at the...

78 FR 22415 - Amendment of Class E Airspace; Astoria, OR

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-16

... Astoria Regional Airport, Astoria, OR, to accommodate aircraft using Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at the airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC, June...

78 FR 22417 - Modification of Class E Airspace; Lakeview, OR

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-16

... Lakeview, OR, to accommodate aircraft using Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Lakeview County Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. This action also corrects the airport name. DATES...

77 FR 55692 - Establishment of Class E Airspace; Fort Garland, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... accommodate aircraft using new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Trinchera Ranch Airstrip Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC, November 15, 2012...

Performance of magnetic field‐guided navigation system for interventional neurosurgical and cardiac procedures

PubMed Central

Chu, James C.H.; Hsi, Wen Chien; Hubbard, Lincoln; Zhang, Yunkai; Bernard, Damian; Reeder, Pamela; Lopes, Demetrius

2005-01-01

A hospital‐based magnetic guidance system (MGS) was installed to assist a physician in navigating catheters and guide wires during interventional cardiac and neurosurgical procedures. The objective of this study is to examine the performance of this magnetic field‐guided navigation system. Our results show that the system's radiological imaging components produce images with quality similar to that produced by other modern fluoroscopic devices. The system's magnetic navigation components also deflect the wire and catheter tips toward the intended direction. The physician, however, will have to oversteer the wire or catheter when defining the steering angle during the procedure. The MGS could be clinically useful in device navigation deflection and vessel access. PACS numbers: 07.55.Db, 07.85.‐m PMID:16143799

How accurately does high tibial osteotomy correct the mechanical axis of an arthritic varus knee? A systematic review.

PubMed

Van den Bempt, Maxim; Van Genechten, Wouter; Claes, Toon; Claes, Steven

2016-12-01

The aim of this study was to give an overview of the accuracy of coronal limb alignment correction after high tibial osteotomy (HTO) for the arthritic varus knee by performing a systematic review of the literature. The databases PubMed, MEDLINE and Cochrane Library were screened for relevant articles. Only prospective clinical studies with the accuracy of alignment correction by performing HTO as primary or secondary objective were included. Fifteen studies were included in this systematic review and were subdivided in 23 cohorts. A total of 966 procedures were considered. Nine cohorts used computer navigation during HTO and the other 14 cohorts used a conventional method. In seven computer navigation cohorts, at least 75% of the study population fell into the accepted "range of accuracy" (AR) as proposed by the different studies, but only six out of 14 conventional cohorts reached this percentage. Four out of eight conventional cohorts that provided data on under- and overcorrection, had a tendency to undercorrection. The accuracy of coronal alignment corrections using conventional HTO falls short. The number of procedures outside the proposed AR is surprising and exposes a critical concern for modern HTO. Computer navigation might improve the accuracy of correction, but its use is not widespread among orthopedic surgeons. Although HTO procedures have been shown to be successful in the treatment of unicompartmental knee arthritis when performed accurately, the results of this review stress the importance of ongoing efforts in order to improve correction accuracy in modern HTO. Copyright © 2016 Elsevier B.V. All rights reserved.

75 FR 39147 - Establishment of Class E Airspace; Bryce Canyon, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... E airspace at Bryce Canyon, UT, to accommodate aircraft using a new Area Navigation (RNAV) Global Positioning System (GPS) Standard Instrument Approach Procedures (SIAPs) at Bryce Canyon Airport. This will improve the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES...

77 FR 49720 - Establishment of Class E Airspace; Chenega Bay, AK

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... at Chenega Bay, AK, to accommodate aircraft using a new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Chenega Bay Airport. This improves the safety and management of Instrument Flight Rules (IFR) operations at the airport. DATES: Effective date, 0901 UTC...

78 FR 67299 - Modification of Class E Airspace; Cut Bank, MT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

...-0664; Airspace Docket No. 13-ANM-22] Modification of Class E Airspace; Cut Bank, MT AGENCY: Federal... Cut Bank, MT, to accommodate new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Cut Bank Municipal Airport. This improves the safety and management of...

76 FR 2000 - Modification of Class E Airspace; Show Low, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

...-0903; Airspace Docket No. 10-AWP-16] Modification of Class E Airspace; Show Low, AZ AGENCY: Federal... Show Low, AZ, to accommodate aircraft using a new Area Navigation (RNAV) Global Positioning System (GPS) Standard Instrument Approach Procedures at Show Low Regional Airport. This will improve the safety and...

77 FR 62429 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). [[Page 62430

Computer navigation for total knee arthroplasty achieves better postoperative alignment compared to conventional and patient-specific instrumentation in a low-volume setting.

PubMed

Suero, Eduardo M; Lueke, Ulrich; Stuebig, Timo; Hawi, Nael; Krettek, Christian; Liodakis, Emmanouil

2018-04-25

Procedure volume is an important determinant of total knee arthroplasty (TKA) outcomes. We aimed to determine whether computer navigation or patient-specific instrumentation (PSI) would improve postoperative alignment in a low-volume setting. PSI for TKA achieves better limb and implant alignment compared to conventional TKA and to computer navigated TKA. This is a retrospective cohort study of 385 primary TKAs (Women=59%. Mean age=67years. Mean BMI=30.1kg/m 2 ), which were performed using conventional instrumentation (n=117; 30%), computer navigation (n=209; 54%), or patient-specific instrumentation (n=59; 15%) in a low-volume center (<50 TKAs/year). The risk of postoperative leg and implant mechanical alignment outliers in the coronal plane (>3° from neutral), average alignment and operation time were assessed. The risk of postoperative mechanical alignment outliers (>3°) was reduced by 89% in the navigated group (4% outliers) compared to the conventional group (35%) (RR=0.11; p<0.0001). No significant improvement was observed in the PSI group (27%) (RR=0.91; p=0.772). The risk of postoperative femoral component coronal alignment outliers was reduced by 63% in the navigated group (11%) compared to the conventional group (31%) (RR=0.37; p=0.018). No significant reduction in outliers was observed in the PSI group (32%) (RR=1.08; p=0.816). There was a reduction in the risk of tibial component coronal malalignment of 66% in the navigated group (5%) compared to the conventional group (13%) (RR=0.33; p=0.070). There was a two-fold increase in the risk of tibial component alignment outliers in the PSI group (29%) (RR=1.94; p=0.110). Computer navigation improved postoperative alignment in TKA. No evidence of improved alignment was seen with patient-specific instrumentation. The routine use of patient-specific instrumentation in low-volume centers is not supported by the currently available data. Retrospective cohort study. Level IV. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

33 CFR 211.77 - Sale procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Sale procedure. 211.77 Section... DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Sale of... Use § 211.77 Sale procedure. Any individual cottage site offered for sale generally will not contain...

33 CFR 211.77 - Sale procedure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Sale procedure. 211.77 Section... DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Sale of... Use § 211.77 Sale procedure. Any individual cottage site offered for sale generally will not contain...

33 CFR 211.77 - Sale procedure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Sale procedure. 211.77 Section... DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Sale of... Use § 211.77 Sale procedure. Any individual cottage site offered for sale generally will not contain...

33 CFR 211.77 - Sale procedure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Sale procedure. 211.77 Section... DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Sale of... Use § 211.77 Sale procedure. Any individual cottage site offered for sale generally will not contain...

77 FR 59735 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

78 FR 64168 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

Use of Electromagnetic Navigational Transthoracic Needle Aspiration (E-TTNA) for Sampling of Lung Nodules.

PubMed

Arias, Sixto; Lee, Hans; Semaan, Roy; Frimpong, Bernice; Ortiz, Ricardo; Feller-Kopman, David; Oakjones-Burgess, Karen; Yarmus, Lonny

2015-05-23

Lung nodule evaluation represents a clinical challenge especially in patients with intermediate risk for malignancy. Multiple technologies are presently available to sample nodules for pathological diagnosis. Those technologies can be divided into bronchoscopic and non-bronchoscopic interventions. Electromagnetic navigational bronchoscopy is being extensively used for the endobronchial approach to peripheral lung nodules but has been hindered by anatomic challenges resulting in a 70% diagnostic yield. Electromagnetic navigational guided transthoracic needle lung biopsy is novel non-bronchoscopic method that uses a percutaneous electromagnetic tip tracked needle to obtain core biopsy specimens. Electromagnetic navigational transthoracic needle aspiration complements bronchoscopic techniques potentially allowing the provider to maximize the diagnostic yield during one single procedure. This article describes a novel integrated diagnostic approach to pulmonary lung nodules. We propose the use of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) for mediastinal staging; radial EBUS, navigational bronchoscopy and E-TTNA during one single procedure to maximize diagnostic yield and minimize the number of invasive procedures needed to obtain a diagnosis. This manuscript describes in detail how the navigation transthoracic procedure is performed. Additional clinical studies are needed to determine the clinical utility of this novel technology.

High-accuracy self-calibration method for dual-axis rotation-modulating RLG-INS

NASA Astrophysics Data System (ADS)

Wei, Guo; Gao, Chunfeng; Wang, Qi; Wang, Qun; Long, Xingwu

2017-05-01

Inertial navigation system has been the core component of both military and civil navigation systems. Dual-axis rotation modulation can completely eliminate the inertial elements constant errors of the three axes to improve the system accuracy. But the error caused by the misalignment angles and the scale factor error cannot be eliminated through dual-axis rotation modulation. And discrete calibration method cannot fulfill requirements of high-accurate calibration of the mechanically dithered ring laser gyroscope navigation system with shock absorbers. This paper has analyzed the effect of calibration error during one modulated period and presented a new systematic self-calibration method for dual-axis rotation-modulating RLG-INS. Procedure for self-calibration of dual-axis rotation-modulating RLG-INS has been designed. The results of self-calibration simulation experiment proved that: this scheme can estimate all the errors in the calibration error model, the calibration precision of the inertial sensors scale factor error is less than 1ppm and the misalignment is less than 5″. These results have validated the systematic self-calibration method and proved its importance for accuracy improvement of dual -axis rotation inertial navigation system with mechanically dithered ring laser gyroscope.

Broadcast control of air traffic

NASA Technical Reports Server (NTRS)

Litchford, G. B.

1972-01-01

Applications of wide range broadcast procedures to improve air traffic control and make more airspace available are discussed. A combination of the Omega navigation system and the very high frequency omnirange (VOR) is recommended as a means for accomplishing improved air traffic control. The benefits to be derived by commercial and general aviation are described. The air/ground communications aspects of the improved air traffic control system are explained. Research and development programs for implementing the broadcast concept are recommended.

Clinical indications for high-field 1.5 T intraoperative magnetic resonance imaging and neuro-navigation for neurosurgical procedures. Review of initial 100 cases.

PubMed

Maesawa, Satoshi; Fujii, Masazumi; Nakahara, Norimoto; Watanabe, Tadashi; Saito, Kiyoshi; Kajita, Yasukazu; Nagatani, Tetsuya; Wakabayashi, Toshihiko; Yoshida, Jun

2009-08-01

Initial experiences are reviewed in an integrated operation theater equipped with an intraoperative high-field (1.5 T) magnetic resonance (MR) imager and neuro-navigation (BrainSUITE), to evaluate the indications and limitations. One hundred consecutive cases were treated, consisting of 38 gliomas, 49 other tumors, 11 cerebrovascular diseases, and 2 functional diseases. The feasibility and usefulness of the integrated theater were evaluated for individual diseases, focusing on whether intraoperative images (including diffusion tensor imaging) affected the surgical strategy. The extent of resection and outcomes in each histological category of brain tumors were examined. Intraoperative high-field MR imaging frequently affected or modified the surgical strategy in the glioma group (27/38 cases, 71.1%), but less in the other tumor group (13/49 cases, 26.5%). The surgical strategy was not modified in cerebrovascular or functional diseases, but the success of procedures and the absence of complications could be confirmed. In glioma surgery, subtotal or greater resection was achieved in 22 of the 31 patients (71%) excluding biopsies, and intraoperative images revealed tumor remnants resulting in the extension of resection in 21 of the 22 patients (95.4%), the highest rate of extension among all types of pathologies. The integrated neuro-navigation improved workflow. The best indication for intraoperative high-field MR imaging and integrated neuro-navigation is brain tumors, especially gliomas, and is supplementary in assuring quality in surgery for cerebrovascular or functional diseases. Immediate quality assurance is provided in several types of neurosurgical procedures.

The effect of general anesthesia versus intravenous sedation on diagnostic yield and success in electromagnetic navigation bronchoscopy.

PubMed

Bowling, Mark R; Kohan, Matthew W; Walker, Paul; Efird, Jimmy; Ben Or, Sharon

2015-01-01

Navigational bronchoscopy is utilized to guide biopsies of peripheral lung nodules and place fiducial markers for treatment of limited stage lung cancer with stereotactic body radiotherapy. The type of sedation used for this procedure remains controversial. We performed a retrospective chart review to evaluate the differences of diagnostic yield and overall success of the procedure based on anesthesia type. Electromagnetic navigational bronchoscopy was performed using the superDimension software system. Once the targeted lesion was within reach, multiple tissue samples were obtained. Statistical analysis was used to correlate the yield with the type of sedation among other factors. A successful procedure was defined if a diagnosis was made or a fiducial marker was adequately placed. Navigational bronchoscopy was performed on a total of 120 targeted lesions. The overall complication rate of the procedure was 4.1%. The diagnostic yield and success of the procedure was 74% and 87%, respectively. Duration of the procedure was the only significant difference between the general anesthesia and IV sedation groups (mean, 58 vs. 43 min, P=0.0005). A larger tumor size was associated with a higher diagnostic yield (P=0.032). All other variables in terms of effect on diagnostic yield and an unsuccessful procedure did not meet statistical significance. Navigational bronchoscopy is a safe and effective pulmonary diagnostic tool with relatively low complication rate. The diagnostic yield and overall success of the procedure does not seem to be affected by the type of sedation used.

78 FR 75456 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on November...

77 FR 66536 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on October...

78 FR 70491 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on November...

78 FR 68704 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... traffic control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on...

77 FR 59738 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Dated: Issued in Washington, DC, on...

78 FR 68702 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC on October...

78 FR 28133 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on April 26...

76 FR 40598 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-11

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on June 24...

78 FR 50326 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on August 2...

78 FR 78714 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on December...

77 FR 18679 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on March 16...

78 FR 64172 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on October...

78 FR 64170 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on October...

76 FR 47988 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (air). Issued in Washington, DC, on July 22...

78 FR 28135 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Traffic Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on...

78 FR 78713 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... traffic control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on...

77 FR 62427 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on September...

78 FR 50324 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on August 2...

78 FR 25386 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC, on April 12...

78 FR 64167 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed... Control, Airports, Incorporation by reference, and Navigation (Air). Issued in Washington, DC on September...

33 CFR 66.01-5 - Application procedure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 66.01-5 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION Aids to Navigation Other Than Federal or State § 66.01-5 Application... located. You can find application form CG-2554 at http://www.uscgboating.org/safety/aton/aids.htm. You...

[Fusion of MRI, fMRI and intraoperative MRI data. Methods and clinical significance exemplified by neurosurgical interventions].

PubMed

Moche, M; Busse, H; Dannenberg, C; Schulz, T; Schmitgen, A; Trantakis, C; Winkler, D; Schmidt, F; Kahn, T

2001-11-01

The aim of this work was to realize and clinically evaluate an image fusion platform for the integration of preoperative MRI and fMRI data into the intraoperative images of an interventional MRI system with a focus on neurosurgical procedures. A vertically open 0.5 T MRI scanner was equipped with a dedicated navigation system enabling the registration of additional imaging modalities (MRI, fMRI, CT) with the intraoperatively acquired data sets. These merged image data served as the basis for interventional planning and multimodal navigation. So far, the system has been used in 70 neurosurgical interventions (13 of which involved image data fusion--requiring 15 minutes extra time). The augmented navigation system is characterized by a higher frame rate and a higher image quality as compared to the system-integrated navigation based on continuously acquired (near) real time images. Patient movement and tissue shifts can be immediately detected by monitoring the morphological differences between both navigation scenes. The multimodal image fusion allowed a refined navigation planning especially for the resection of deeply seated brain lesions or pathologies close to eloquent areas. Augmented intraoperative orientation and instrument guidance improve the safety and accuracy of neurosurgical interventions.

Single-use instruments, cutting blocks, and trials increase efficiency in the operating room during total knee arthroplasty: a prospective comparison of navigated and non-navigated cases.

PubMed

Mont, Michael A; McElroy, Mark J; Johnson, Aaron J; Pivec, Robert

2013-08-01

The purpose of this prospective controlled trial was to determine if efficiency increases could be achieved in non-navigated and navigated total knee arthroplasties by replacing traditional saws, cutting blocks, and trials with specialized saws and single-use cutting blocks and trials. Various timing metrics during total knee arthroplasty, including operating room preparation times and specific intra-operative times, were measured in 400 procedures performed by eight different surgeons at 6 institutions. Efficiency increases were the result of statistically significant reductions in combined instrument setup and cleanup times as well as in adjusted surgical episode times in navigated total knee arthroplasties. Single-use instruments show promising benefits, but adequate patient follow-up is needed to confirm safety and efficacy before they can be widely adopted. Nevertheless, the authors believe that the use of single-use instruments, cutting guides, and trial implants for total knee arthroplasty will play an increasing role in improving operating room efficiency. Copyright © 2013 Elsevier Inc. All rights reserved.

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.303 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Definitions. 136.303 Section 136.303 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.303 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Definitions. 136.303 Section 136.303 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.303 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Definitions. 136.303 Section 136.303 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.303 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Definitions. 136.303 Section 136.303 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.303 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Definitions. 136.303 Section 136.303 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 159.15 - Certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Certification. 159.15 Section 159.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.15 Certification. (a) The recognized facility...

Sensor-based electromagnetic navigation to facilitate implantation of left ventricular leads in cardiac resynchronization therapy.

PubMed

Döring, Michael; Sommer, Philipp; Rolf, Sascha; Lucas, Johannes; Breithardt, Ole A; Hindricks, Gerhard; Richter, Sergio

2015-02-01

Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and fluoroscopy intense. To facilitate placement of left ventricular (LV) leads, a novel electromagnetic navigation system (MediGuide™, St. Jude Medical, St. Paul, MN, USA) has been developed, displaying real-time 3-D location of sensor-embedded delivery tools superimposed on prerecorded X-ray cine-loops of coronary sinus venograms. We report our experience and advanced progress in the use of this new electromagnetic tracking system to guide LV lead implantation. Between January 2012 and December 2013, 71 consecutive patients (69 ± 9 years, 76% male) were implanted with a CRT device using the new electromagnetic tracking system. Demographics, procedural data, and periprocedural adverse events were gathered. The impact of the operator's experience, optimized workflow, and improved software technology on procedural data were analyzed. LV lead implantation was successfully achieved in all patients without severe adverse events. Total procedure time measured 87 ± 37 minutes and the median total fluoroscopy time (skin-to-skin) was 4.9 (2.5-7.8) minutes with a median dose-area-product of 476 (260-1056) cGy*cm(2) . An additional comparison with conventional CRT device implantations showed a significant reduction in fluoroscopy time from 8.0 (5.8; 11.5) to 4.5 (2.8; 7.3) minutes (P = 0.016) and radiation dose from 603 (330; 969) to 338 (176; 680) cGy*cm(2) , respectively (P = 0.044 ). Use of the new navigation system enables safe and successful LV lead placement with improved orientation and significantly reduced radiation exposure during CRT implantation. © 2014 Wiley Periodicals, Inc.

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND INITIALIZATION OF THE MAGELLAN GPS SATELLITE NAVIGATOR (UA-F-22.1)

EPA Science Inventory

The purpose of this SOP is to describe the general procedures for the operation and initialization of the Magellan Global Positioning System (GPS) Satellite Navigator. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the Borde...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND INITIALIZATION OF THE MAGELLAN GPS SATELLITE NAVIGATOR (UA-F-22.1)

EPA Science Inventory

The purpose of this SOP is to describe the general procedures for the operation and initialization of the Magellan Global Positioning System (GPS) Satellite Navigator. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Bord...

Surgical task analysis of simulated laparoscopic cholecystectomy with a navigation system.

PubMed

Sugino, T; Kawahira, H; Nakamura, R

2014-09-01

   Advanced surgical procedures, which have become complex and difficult, increase the burden of surgeons. Quantitative analysis of surgical procedures can improve training, reduce variability, and enable optimization of surgical procedures. To this end, a surgical task analysis system was developed that uses only surgical navigation information.    Division of the surgical procedure, task progress analysis, and task efficiency analysis were done. First, the procedure was divided into five stages. Second, the operating time and progress rate were recorded to document task progress during specific stages, including the dissecting task. Third, the speed of the surgical instrument motion (mean velocity and acceleration), as well as the size and overlap ratio of the approximate ellipse of the location log data distribution, was computed to estimate the task efficiency during each stage. These analysis methods were evaluated based on experimental validation with two groups of surgeons, i.e., skilled and "other" surgeons. The performance metrics and analytical parameters included incidents during the operation, the surgical environment, and the surgeon's skills or habits.    Comparison of groups revealed that skilled surgeons tended to perform the procedure in less time and involved smaller regions; they also manipulated the surgical instruments more gently.    Surgical task analysis developed for quantitative assessment of surgical procedures and surgical performance may provide practical methods and metrics for objective evaluation of surgical expertise.

33 CFR 136.215 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.215 Section 136.215 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.221 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.221 Section 136.221 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.233 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.233 Section 136.233 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.209 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.209 Section 136.209 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.7 - Foreign claimants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Foreign claimants. 136.7 Section 136.7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.203 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.203 Section 136.203 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.227 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.227 Section 136.227 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.233 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.233 Section 136.233 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.215 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.215 Section 136.215 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.215 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.215 Section 136.215 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.301 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Purpose. 136.301 Section 136.301 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.221 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.221 Section 136.221 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.227 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.227 Section 136.227 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.239 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.239 Section 136.239 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.203 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.203 Section 136.203 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.209 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.209 Section 136.209 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.7 - Foreign claimants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Foreign claimants. 136.7 Section 136.7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.301 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Purpose. 136.301 Section 136.301 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.227 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.227 Section 136.227 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.233 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.233 Section 136.233 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.301 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Purpose. 136.301 Section 136.301 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.233 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.233 Section 136.233 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.233 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.233 Section 136.233 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.215 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.215 Section 136.215 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.227 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.227 Section 136.227 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.209 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.209 Section 136.209 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.221 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.221 Section 136.221 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.227 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.227 Section 136.227 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.203 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.203 Section 136.203 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.7 - Foreign claimants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Foreign claimants. 136.7 Section 136.7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.215 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.215 Section 136.215 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.7 - Foreign claimants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Foreign claimants. 136.7 Section 136.7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.239 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.239 Section 136.239 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.7 - Foreign claimants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Foreign claimants. 136.7 Section 136.7 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.221 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.221 Section 136.221 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.239 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.239 Section 136.239 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.301 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Purpose. 136.301 Section 136.301 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.209 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.209 Section 136.209 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.239 - Proof.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Proof. 136.239 Section 136.239 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.203 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.203 Section 136.203 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.239 - Proof.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Proof. 136.239 Section 136.239 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.209 - Proof.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Proof. 136.209 Section 136.209 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.301 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Purpose. 136.301 Section 136.301 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.203 - Proof.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Proof. 136.203 Section 136.203 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 136.221 - Proof.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Proof. 136.221 Section 136.221 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF...

33 CFR 159.14 - Application for certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Application for certification. 159.14 Section 159.14 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.14 Application for...

33 CFR 273.18 - Clearinghouse coordination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Clearinghouse coordination. 273.18 Section 273.18 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.18 Clearinghouse coordination. Procedures prescribed under...

33 CFR 273.18 - Clearinghouse coordination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Clearinghouse coordination. 273.18 Section 273.18 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.18 Clearinghouse coordination. Procedures prescribed under...

Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures

NASA Astrophysics Data System (ADS)

Zheng, Guoyan

2007-03-01

Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems, where a 3D volume or surface representation of the operated anatomy could be constructed from the preoperatively acquired tomographic data or through intraoperatively digitized anatomy landmarks, a photorealistic rendering of the surgical action has been identified to greatly improve usability of these navigation systems. However, this may not hold true when the virtual representation of surgical instruments and implants is superimposed onto 2D projection images in a fluoroscopy-based navigation system due to the so-called image occlusion problem. Image occlusion occurs when the field of view of the fluoroscopic image is occupied by the virtual representation of surgical implants or instruments. In these situations, the surgeon may miss part of the image details, even if transparency and/or wire-frame rendering is used. In this paper, we propose to use non-photorealistic rendering to overcome this difficulty. Laboratory testing results on foamed plastic bones during various computer-assisted fluoroscopybased surgical procedures including total hip arthroplasty and long bone fracture reduction and osteosynthesis are shown.

Determination of optimal ultrasound planes for the initialisation of image registration during endoscopic ultrasound-guided procedures.

PubMed

Bonmati, Ester; Hu, Yipeng; Gibson, Eli; Uribarri, Laura; Keane, Geri; Gurusami, Kurinchi; Davidson, Brian; Pereira, Stephen P; Clarkson, Matthew J; Barratt, Dean C

2018-06-01

Navigation of endoscopic ultrasound (EUS)-guided procedures of the upper gastrointestinal (GI) system can be technically challenging due to the small fields-of-view of ultrasound and optical devices, as well as the anatomical variability and limited number of orienting landmarks during navigation. Co-registration of an EUS device and a pre-procedure 3D image can enhance the ability to navigate. However, the fidelity of this contextual information depends on the accuracy of registration. The purpose of this study was to develop and test the feasibility of a simulation-based planning method for pre-selecting patient-specific EUS-visible anatomical landmark locations to maximise the accuracy and robustness of a feature-based multimodality registration method. A registration approach was adopted in which landmarks are registered to anatomical structures segmented from the pre-procedure volume. The predicted target registration errors (TREs) of EUS-CT registration were estimated using simulated visible anatomical landmarks and a Monte Carlo simulation of landmark localisation error. The optimal planes were selected based on the 90th percentile of TREs, which provide a robust and more accurate EUS-CT registration initialisation. The method was evaluated by comparing the accuracy and robustness of registrations initialised using optimised planes versus non-optimised planes using manually segmented CT images and simulated ([Formula: see text]) or retrospective clinical ([Formula: see text]) EUS landmarks. The results show a lower 90th percentile TRE when registration is initialised using the optimised planes compared with a non-optimised initialisation approach (p value [Formula: see text]). The proposed simulation-based method to find optimised EUS planes and landmarks for EUS-guided procedures may have the potential to improve registration accuracy. Further work will investigate applying the technique in a clinical setting.

Augmented Endoscopic Images Overlaying Shape Changes in Bone Cutting Procedures.

PubMed

Nakao, Megumi; Endo, Shota; Nakao, Shinichi; Yoshida, Munehito; Matsuda, Tetsuya

2016-01-01

In microendoscopic discectomy for spinal disorders, bone cutting procedures are performed in tight spaces while observing a small portion of the target structures. Although optical tracking systems are able to measure the tip of the surgical tool during surgery, the poor shape information available during surgery makes accurate cutting difficult, even if preoperative computed tomography and magnetic resonance images are used for reference. Shape estimation and visualization of the target structures are essential for accurate cutting. However, time-varying shape changes during cutting procedures are still challenging issues for intraoperative navigation. This paper introduces a concept of endoscopic image augmentation that overlays shape changes to support bone cutting procedures. This framework handles the history of the location of the measured drill tip as a volume label and visualizes the remains to be cut overlaid on the endoscopic image in real time. A cutting experiment was performed with volunteers, and the feasibility of this concept was examined using a clinical navigation system. The efficacy of the cutting aid was evaluated with respect to the shape similarity, total moved distance of a cutting tool, and required cutting time. The results of the experiments showed that cutting performance was significantly improved by the proposed framework.

33 CFR 203.52 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false [Reserved] 203.52 Section 203.52 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation Assistance for Flood...

33 CFR 203.52 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false [Reserved] 203.52 Section 203.52 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation Assistance for Flood...

33 CFR 203.51 - Levee owner's manual.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Levee owner's manual. 203.51 Section 203.51 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.52 - [Reserved

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false [Reserved] 203.52 Section 203.52 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation Assistance for Flood...

33 CFR 203.52 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false [Reserved] 203.52 Section 203.52 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation Assistance for Flood...

33 CFR 203.51 - Levee owner's manual.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Levee owner's manual. 203.51 Section 203.51 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.51 - Levee owner's manual.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Levee owner's manual. 203.51 Section 203.51 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation...

33 CFR 203.52 - [Reserved

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false [Reserved] 203.52 Section 203.52 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation Assistance for Flood...

33 CFR 203.51 - Levee owner's manual.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Levee owner's manual. 203.51 Section 203.51 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.51 - Levee owner's manual.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Levee owner's manual. 203.51 Section 203.51 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Rehabilitation...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR Appendix B to Part 230 - [Reserved

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false [Reserved] B Appendix B to Part 230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA Appendix B to Part 230 [Reserved] ...

33 CFR Appendix B to Part 230 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false [Reserved] B Appendix B to Part 230 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA Appendix B to Part 230 [Reserved] ...

33 CFR 159.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Purpose. 159.1 Section 159.1 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE... construction of marine sanitation devices and procedures for certifying that marine sanitation devices meet the...

33 CFR 159.16 - Authorization to label devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Authorization to label devices. 159.16 Section 159.16 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.16 Authorization to label...

33 CFR 159.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Purpose. 159.1 Section 159.1 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE... construction of marine sanitation devices and procedures for certifying that marine sanitation devices meet the...

33 CFR 159.17 - Changes to certified devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Changes to certified devices. 159.17 Section 159.17 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.17 Changes to certified...

33 CFR 159.19 - Testing equivalency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Testing equivalency. 159.19 Section 159.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.19 Testing equivalency. (a) If a test...

Radiation- and reference base-free navigation procedure for placement of instruments and implants: application to retrograde drilling of osteochondral lesions of the knee joint.

PubMed

Müller, Matthias; Gras, Florian; Marintschev, Ivan; Mückley, Thomas; Hofmann, Gunter O

2009-01-01

A novel, radiation- and reference base-free procedure for placement of navigated instruments and implants was developed and its practicability and precision in retrograde drillings evaluated in an experimental setting. Two different guidance techniques were used: One experimental group was operated on using the radiation- and reference base-free navigation technique (Fluoro Free), and the control group was operated on using standard fluoroscopy for guidance. For each group, 12 core decompressions were simulated by retrograde drillings in different artificial femurs following arthroscopic determination of the osteochondral lesions. The final guide-wire position was evaluated by postoperative CT analysis using vector calculation. High precision was achieved in both groups, but operating time was significantly reduced in the navigated group as compared to the control group. This was due to a 100% first-pass accuracy of drilling in the navigated group; in the control group a mean of 2.5 correction maneuvers per drilling were necessary. Additionally, the procedure was free of radiation in the navigated group, whereas 17.2 seconds of radiation exposure time were measured in the fluoroscopy-guided group. The developed Fluoro Free procedure is a promising and simplified approach to navigating different instruments as well as implants in relation to visually or tactilely placed pointers or objects without the need for radiation exposure or invasive fixation of a dynamic reference base in the bone.

Location tracking forensics on mobile devices

NASA Astrophysics Data System (ADS)

Sack, Stefan; Kröger, Knut; Creutzburg, Reiner

2013-03-01

The spread of navigation devices has increased significantly over the last 10 years. With the help of the current development of even smaller navigation receiver units it is to navigate with almost any current smart phone. Modern navigation systems are no longer limited to satellite navigation, but use current techniques, e.g. WLAN localization. Due to the increased use of navigation devices their relevance to forensic investigations has risen rapidly. Because navigation, for example with navigation equipment and smartphones, have become common place these days, also the amount of saved navigation data has risen rapidly. All of these developments lead to a necessary forensic analysis of these devices. However, there are very few current procedures for investigating of navigation devices. Navigation data is forensically interesting because by the position of the devices in most cases the location and the traveled path of the owner can be reconstructed. In this work practices for forensic analysis of navigation devices are developed. Different devices will be analyzed and it is attempted, by means of forensic procedures to restore the traveled path of the mobile device. For analysis of the various devices different software and hardware is used. There will be presented common procedures for securing and testing of mobile devices. Further there will be represented the specials in the investigation of each device. The different classes considered are GPS handhelds, mobile navigation devices and smartphones. It will be attempted, wherever possible, to read all data of the device. The aim is to restore complete histories of the navigation data and to forensically study and analyze these data. This is realized by the usage of current forensic software e.g. TomTology or Oxygen Forensic Suite. It is also attempted to use free software whenever possible. Further alternative methods are used (e.g. rooting) to access locked data of the unit. To limit the practical work the data extraction is focused on the frequently used device sample of a specific class, as the procedure for many groups of devices can be similar. In the present work a Garmin Dakota 10, a TomTom GO 700, an iPhone 4 (iOS) and a Samsung Galaxy S Plus (Android) is used because they have a wide circulation.

Air Navigation. Flying Training. AFM 51-40. NAVAIR 00-80V-49.

ERIC Educational Resources Information Center

Air Training Command, Randolph AFB, TX.

This manual provides information on all phases of air navigation for navigators and student navigators in training. It develops the art of navigation from the simplest concepts to the most advanced procedures and techniques. The text contains explanations on how to measure, map, and chart the earth; how to use basic instruments to obtain…

Space shuttle navigation analysis. Volume 2: Baseline system navigation

NASA Technical Reports Server (NTRS)

Jones, H. L.; Luders, G.; Matchett, G. A.; Rains, R. G.

1980-01-01

Studies related to the baseline navigation system for the orbiter are presented. The baseline navigation system studies include a covariance analysis of the Inertial Measurement Unit calibration and alignment procedures, postflight IMU error recovery for the approach and landing phases, on-orbit calibration of IMU instrument biases, and a covariance analysis of entry and prelaunch navigation system performance.

Cadaveric in-situ testing of optical coherence tomography system-based skull base surgery guidance

NASA Astrophysics Data System (ADS)

Sun, Cuiru; Khan, Osaama H.; Siegler, Peter; Jivraj, Jamil; Wong, Ronnie; Yang, Victor X. D.

2015-03-01

Optical Coherence Tomography (OCT) has extensive potential for producing clinical impact in the field of neurological diseases. A neurosurgical OCT hand-held forward viewing probe in Bayonet shape has been developed. In this study, we test the feasibility of integrating this imaging probe with modern navigation technology for guidance and monitoring of skull base surgery. Cadaver heads were used to simulate relevant surgical approaches for treatment of sellar, parasellar and skull base pathology. A high-resolution 3D CT scan was performed on the cadaver head to provide baseline data for navigation. The cadaver head was mounted on existing 3- or 4-point fixation systems. Tracking markers were attached to the OCT probe and the surgeon-probe-OCT interface was calibrated. 2D OCT images were shown in real time together with the optical tracking images to the surgeon during surgery. The intraoperative video and multimodality imaging data set, consisting of real time OCT images, OCT probe location registered to neurosurgical navigation were assessed. The integration of intraoperative OCT imaging with navigation technology provides the surgeon with updated image information, which is important to deal with tissue shifts and deformations during surgery. Preliminary results demonstrate that the clinical neurosurgical navigation system can provide the hand held OCT probe gross anatomical localization. The near-histological imaging resolution of intraoperative OCT can improve the identification of microstructural/morphology differences. The OCT imaging data, combined with the neurosurgical navigation tracking has the potential to improve image interpretation, precision and accuracy of the therapeutic procedure.

Refining the Patient Navigation Role in a Colorectal Cancer Screening Program: Results From an Intervention Study.

PubMed

Rohan, Elizabeth A; Slotman, Beth; DeGroff, Amy; Morrissey, Kerry Grace; Murillo, Jennifer; Schroy, Paul

2016-11-01

Oncology patient navigators help individuals overcome barriers to increase access to cancer screening, diagnosis, and timely treatment. This study, part of a randomized intervention trial investigating the efficacy of patient navigation in increasing colonoscopy completion, examined navigators' activities to ameliorate barriers to colonoscopy screening in a medically disadvantaged population. This study was conducted from 2012 through 2014 at Boston Medical Center. We analyzed navigator service delivery and survey data collected on 420 participants who were navigated for colonoscopy screening after randomization to this intervention. Key variables under investigation included barriers to colonoscopy, activities navigators undertook to reduce barriers, time navigators spent on each activity and per contact, and patient satisfaction with navigation services. Descriptive analysis assessed how navigators spent their time and examined what aspects of patient navigation were most valued by patients. Navigators spent the most time assessing patient barriers/needs; facilitating appointment scheduling; reminding patients of appointments; educating patients about colorectal cancer, the importance of screening, and the colonoscopy preparation and procedures; and arranging transportation. Navigators spent an average of 44 minutes per patient. Patients valued the navigators, especially for providing emotional/peer support and explaining screening procedures and bowel preparation clearly. Our findings help clarify the role of the navigator in colonoscopy screening within a medically disadvantaged community. These findings may help further refine the navigator role in cancer screening and treatment programs as facilities strive to effectively and efficiently integrate navigation into their services. Copyright © 2016 by the National Comprehensive Cancer Network.

Refining the Patient Navigation Role in a Colorectal Cancer Screening Program: Results From an Intervention Study

PubMed Central

Rohan, Elizabeth A.; Slotman, Beth; DeGroff, Amy; Morrissey, Kerry Grace; Murillo, Jennifer; Schroy, Paul

2017-01-01

Background Oncology patient navigators help individuals overcome barriers to increase access to cancer screening, diagnosis, and timely treatment. This study, part of a randomized intervention trial investigating the efficacy of patient navigation in increasing colonoscopy completion, examined navigators' activities to ameliorate barriers to colonoscopy screening in a medically disadvantaged population. Methods This study was conducted from 2012 through 2014 at Boston Medical Center. We analyzed navigator service delivery and survey data collected on 420 participants who were navigated for colonoscopy screening after randomization to this intervention. Key variables under investigation included barriers to colonoscopy, activities navigators undertook to reduce barriers, time navigators spent on each activity and per contact, and patient satisfaction with navigation services. Descriptive analysis assessed how navigators spent their time and examined what aspects of patient navigation were most valued by patients. Results Navigators spent the most time assessing patient barriers/needs; facilitating appointment scheduling; reminding patients of appointments; educating patients about colorectal cancer, the importance of screening, and the colonoscopy preparation and procedures; and arranging transportation. Navigators spent an average of 44 minutes per patient. Patients valued the navigators, especially for providing emotional/peer support and explaining screening procedures and bowel preparation clearly. Conclusions Our findings help clarify the role of the navigator in colonoscopy screening within a medically disadvantaged community. These findings may help further refine the navigator role in cancer screening and treatment programs as facilities strive to effectively and efficiently integrate navigation into their services. PMID:27799508

33 CFR 115.40 - Bridge repairs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which do...

33 CFR 230.19 - Comments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Comments. 230.19 Section 230.19 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES....3. District commanders will provide comments directly to the requesting agency. CECW-RE will provide...

33 CFR 203.82 - Requirements of local cooperation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Requirements of local cooperation. 203.82 Section 203.82 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

33 CFR 203.71 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Policy. 203.71 Section 203.71 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance Measures § 203.71 Policy. Advance...

33 CFR 203.82 - Requirements of local cooperation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Requirements of local cooperation. 203.82 Section 203.82 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

33 CFR 203.82 - Requirements of local cooperation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Requirements of local cooperation. 203.82 Section 203.82 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

33 CFR 203.71 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Policy. 203.71 Section 203.71 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance Measures § 203.71 Policy. Advance...

33 CFR 203.82 - Requirements of local cooperation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Requirements of local cooperation. 203.82 Section 203.82 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

33 CFR 203.82 - Requirements of local cooperation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Requirements of local cooperation. 203.82 Section 203.82 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...

33 CFR 203.71 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Policy. 203.71 Section 203.71 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance Measures § 203.71 Policy. Advance...

33 CFR 203.71 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Policy. 203.71 Section 203.71 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance Measures § 203.71 Policy. Advance...

33 CFR 203.71 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Policy. 203.71 Section 203.71 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Advance Measures § 203.71 Policy. Advance...

33 CFR 230.10 - Environmental Assessments (EA).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Environmental Assessments (EA). 230.10 Section 230.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.10 Environmental Assessments (EA). (a) Purpose...

33 CFR 230.10 - Environmental Assessments (EA).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Environmental Assessments (EA). 230.10 Section 230.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.10 Environmental Assessments (EA). (a) Purpose...

33 CFR 230.10 - Environmental Assessments (EA).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Environmental Assessments (EA). 230.10 Section 230.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.10 Environmental Assessments (EA). (a) Purpose...

33 CFR 230.10 - Environmental Assessments (EA).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Environmental Assessments (EA). 230.10 Section 230.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.10 Environmental Assessments (EA). (a) Purpose...

33 CFR 230.10 - Environmental Assessments (EA).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Environmental Assessments (EA). 230.10 Section 230.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.10 Environmental Assessments (EA). (a) Purpose...

33 CFR 115.40 - Bridge repairs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Bridge repairs. 115.40 Section 115.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.40 Bridge repairs. Repairs to a bridge which do...

Utility of an airframe referenced spatial auditory display for general aviation operations

NASA Astrophysics Data System (ADS)

Naqvi, M. Hassan; Wigdahl, Alan J.; Ranaudo, Richard J.

2009-05-01

The University of Tennessee Space Institute (UTSI) completed flight testing with an airframe-referenced localized audio cueing display. The purpose was to assess its affect on pilot performance, workload, and situational awareness in two scenarios simulating single-pilot general aviation operations under instrument meteorological conditions. Each scenario consisted of 12 test procedures conducted under simulated instrument meteorological conditions, half with the cue off, and half with the cue on. Simulated aircraft malfunctions were strategically inserted at critical times during each test procedure. Ten pilots participated in the study; half flew a moderate workload scenario consisting of point to point navigation and holding pattern operations and half flew a high workload scenario consisting of non precision approaches and missed approach procedures. Flight data consisted of aircraft and navigation state parameters, NASA Task Load Index (TLX) assessments, and post-flight questionnaires. With localized cues there was slightly better pilot technical performance, a reduction in workload, and a perceived improvement in situational awareness. Results indicate that an airframe-referenced auditory display has utility and pilot acceptance in general aviation operations.

Initial experience with remote magnetic navigation for left ventricular lead placement.

PubMed

Mischke, Karl; Knackstedt, Christian; Schmid, Michael; Hatam, Nima; Becker, Michael; Spillner, Jan; Fache, Kerstin; Kelm, Malte; Schauerte, Patrick

2009-08-01

A novel magnetic navigation system allows remote steering of guidewires and catheters. This system may be used for left ventricular lead placement for cardiac resynchronization therapy (CRT). We sought to evaluate the feasibility and safety of magnetic guidewire navigation for CRT procedures. 123 consecutive patients underwent CRT implantation/revision procedures (including pacemaker upgrades in n=22 and left ventricular lead placement after dislocation in n=4 patients). Left ventricular lead placement in a coronary sinus side branch was performed either conventionally or using magnetic navigation. The magnetic navigation system (Niobe) consists of two permanent magnets creating a steerable magnetic field. Guidewires with integrated magnets align to the magnetic field and were used for over-the-wire implantation of pacemaker leads in the coronary sinus. Patients were assigned to conventional (n=93) or magnetic (n=30) navigation according to room availability. Venography of the coronary venous system was performed to select a target vessel for lead implantation. Guidewire access to the target vessel was achieved in 100% using magnetic navigation compared to 87% with the conventional approach (P < 0.05). Implantation success rates, total procedure and fluoroscopy times did not differ significantly between groups. No periprocedural death and no intraoperative device dysfunction occurred in either group.The magnetic guidewire ruptured in one patient. Left ventricular lead placement using magnetic guidewire navigation to engage the desired coronary sinus side branch can be successfully performed for CRT.

4D Dynamic Required Navigation Performance Final Report

NASA Technical Reports Server (NTRS)

Finkelsztein, Daniel M.; Sturdy, James L.; Alaverdi, Omeed; Hochwarth, Joachim K.

2011-01-01

New advanced four dimensional trajectory (4DT) procedures under consideration for the Next Generation Air Transportation System (NextGen) require an aircraft to precisely navigate relative to a moving reference such as another aircraft. Examples are Self-Separation for enroute operations and Interval Management for in-trail and merging operations. The current construct of Required Navigation Performance (RNP), defined for fixed-reference-frame navigation, is not sufficiently specified to be applicable to defining performance levels of such air-to-air procedures. An extension of RNP to air-to-air navigation would enable these advanced procedures to be implemented with a specified level of performance. The objective of this research effort was to propose new 4D Dynamic RNP constructs that account for the dynamic spatial and temporal nature of Interval Management and Self-Separation, develop mathematical models of the Dynamic RNP constructs, "Required Self-Separation Performance" and "Required Interval Management Performance," and to analyze the performance characteristics of these air-to-air procedures using the newly developed models. This final report summarizes the activities led by Raytheon, in collaboration with GE Aviation and SAIC, and presents the results from this research effort to expand the RNP concept to a dynamic 4D frame of reference.

A novel technique for tailoring frontal osteoplastic flaps using the ENT magnetic navigation system.

PubMed

Volpi, Luca; Pistochini, Andrea; Bignami, Maurizio; Meloni, Francesco; Turri Zanoni, Mario; Castelnuovo, Paolo

2012-06-01

The ENT magnetic navigation system is potentially useful and offers the most accurate technique for harvesting frontal osteoplastic flaps. It represents a valid tool in the wide range of instruments available to rhinologists. Precise delineation of the boundaries of the frontal sinus is a crucial step when harvesting a frontal osteoplastic flap. We present a novel technique using the ENT magnetic navigation system. Nineteen patients affected by different pathologies involving the frontal sinus underwent an osteoplastic flap procedure using the ENT magnetic navigation system between January 2009 and April 2011. The ENT magnetic navigation system was found to be a safe and accurate tool for delineating the frontal sinus boundaries. No intraoperative complications occurred during the osteoplastic procedures.

Electromagnetic navigational bronchoscopy and robotic-assisted thoracic surgery.

PubMed

Christie, Sara

2014-06-01

With the use of electromagnetic navigational bronchoscopy and robotics, lung lesions can be diagnosed and resected during one surgical procedure. Global positioning system technology allows surgeons to identify and mark a thoracic tumor, and then robotics technology allows them to perform minimally invasive resection and cancer staging procedures. Nurses on the perioperative robotics team must consider the logistics of providing safe and competent care when performing combined procedures during one surgical encounter. Instrumentation, OR organization and room setup, and patient positioning are important factors to consider to complete the procedure systematically and efficiently. This revolutionary concept of combining navigational bronchoscopy with robotics requires a team of dedicated nurses to facilitate the sequence of events essential for providing optimal patient outcomes in highly advanced surgical procedures. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Improved image guidance technique for minimally invasive mitral valve repair using real-time tracked 3D ultrasound

NASA Astrophysics Data System (ADS)

Rankin, Adam; Moore, John; Bainbridge, Daniel; Peters, Terry

2016-03-01

In the past ten years, numerous new surgical and interventional techniques have been developed for treating heart valve disease without the need for cardiopulmonary bypass. Heart valve repair is now being performed in a blood-filled environment, reinforcing the need for accurate and intuitive imaging techniques. Previous work has demonstrated how augmenting ultrasound with virtual representations of specific anatomical landmarks can greatly simplify interventional navigation challenges and increase patient safety. These techniques often complicate interventions by requiring additional steps taken to manually define and initialize virtual models. Furthermore, overlaying virtual elements into real-time image data can also obstruct the view of salient image information. To address these limitations, a system was developed that uses real-time volumetric ultrasound alongside magnetically tracked tools presented in an augmented virtuality environment to provide a streamlined navigation guidance platform. In phantom studies simulating a beating-heart navigation task, procedure duration and tool path metrics have achieved comparable performance to previous work in augmented virtuality techniques, and considerable improvement over standard of care ultrasound guidance.

33 CFR 337.10 - Supervision of Federal projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Supervision of Federal projects. 337.10 Section 337.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.10 Supervision of Federal projects. District engineers...

33 CFR 337.10 - Supervision of Federal projects.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Supervision of Federal projects. 337.10 Section 337.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.10 Supervision of Federal projects. District engineers...

33 CFR 337.10 - Supervision of Federal projects.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Supervision of Federal projects. 337.10 Section 337.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.10 Supervision of Federal projects. District engineers...

33 CFR 337.10 - Supervision of Federal projects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Supervision of Federal projects. 337.10 Section 337.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.10 Supervision of Federal projects. District engineers...

33 CFR 337.10 - Supervision of Federal projects.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Supervision of Federal projects. 337.10 Section 337.10 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PRACTICE AND PROCEDURE § 337.10 Supervision of Federal projects. District engineers...

33 CFR 159.12a - Certification of certain Type III devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Certification of certain Type III devices. 159.12a Section 159.12a Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.12a Certification...

33 CFR 159.12 - Regulations for certification of existing devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Regulations for certification of existing devices. 159.12 Section 159.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.12 Regulations for...

Test and Evaluation of an Image-Matching Navigation System for a UAS Operating in a GPS-Denied Environment

DTIC Science & Technology

2017-09-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS TEST AND EVALUATION OF AN IMAGE-MATCHING NAVIGATION SYSTEM FOR A UAS OPERATING IN A GPS-DENIED...INTENTIONALLY LEFT BLANK ii Approved for public release. Distribution is unlimited. TEST AND EVALUATION OF AN IMAGE-MATCHING NAVIGATION SYSTEM FOR A UAS... Evaluation Setup and Procedures 39 4.1 Test Equipment and Data Collection Procedures . . . . . . . . . . . . 39 4.2 Actual Flight Data Collection

33 CFR 209.335 - Publication.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Publication. 209.335 Section 209... ADMINISTRATIVE PROCEDURE § 209.335 Publication. (a) Section 4 of the Administrative Procedure Act requires publication of general notice of proposed rule making in the Federal Register (unless all persons subject...

33 CFR Appendix C to Part 157 - Procedure for Determining Distribution of Segregated Ballast Tanks To Provide Protection Against...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Ramming, or Collision C Appendix C to Part 157 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... VESSELS CARRYING OIL IN BULK Pt. 157, App. C Appendix C to Part 157—Procedure for Determining Distribution...

33 CFR 209.335 - Publication.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Publication. 209.335 Section 209... ADMINISTRATIVE PROCEDURE § 209.335 Publication. (a) Section 4 of the Administrative Procedure Act requires publication of general notice of proposed rule making in the Federal Register (unless all persons subject...

33 CFR 209.335 - Publication.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Publication. 209.335 Section 209... ADMINISTRATIVE PROCEDURE § 209.335 Publication. (a) Section 4 of the Administrative Procedure Act requires publication of general notice of proposed rule making in the Federal Register (unless all persons subject...

33 CFR 209.335 - Publication.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Publication. 209.335 Section 209... ADMINISTRATIVE PROCEDURE § 209.335 Publication. (a) Section 4 of the Administrative Procedure Act requires publication of general notice of proposed rule making in the Federal Register (unless all persons subject...

33 CFR 209.335 - Publication.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Publication. 209.335 Section 209... ADMINISTRATIVE PROCEDURE § 209.335 Publication. (a) Section 4 of the Administrative Procedure Act requires publication of general notice of proposed rule making in the Federal Register (unless all persons subject...

33 CFR Appendix C to Part 157 - Procedure for Determining Distribution of Segregated Ballast Tanks To Provide Protection Against...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Ramming, or Collision C Appendix C to Part 157 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... VESSELS CARRYING OIL IN BULK Pt. 157, App. C Appendix C to Part 157—Procedure for Determining Distribution...

Navigation technique for MR-endoscope system using a wireless accelerometer-based remote control device.

PubMed

Kumamoto, Etsuko; Takahashi, Akihiro; Matsuoka, Yuichiro; Morita, Yoshinori; Kutsumi, Hiromu; Azuma, Takeshi; Kuroda, Kagayaki

2013-01-01

The MR-endoscope system can perform magnetic resonance (MR) imaging during endoscopy and show the images obtained by using endoscope and MR. The MR-endoscope system can acquire a high-spatial resolution MR image with an intraluminal radiofrequency (RF) coil, and the navigation system shows the scope's location and orientation inside the human body and indicates MR images with a scope view. In order to conveniently perform an endoscopy and MR procedure, the design of the user interface is very important because it provides useful information. In this study, we propose a navigation system using a wireless accelerometer-based controller with Bluetooth technology and a navigation technique to set the intraluminal RF coil using the navigation system. The feasibility of using this wireless controller in the MR shield room was validated via phantom examinations of the influence on MR procedures and navigation accuracy. In vitro examinations using an isolated porcine stomach demonstrated the effectiveness of the navigation technique using a wireless remote-control device.

The influence of CT based attenuation correction on PET/CT registration: an evaluation study

NASA Astrophysics Data System (ADS)

Yaniv, Ziv; Wong, Kenneth H.; Banovac, Filip; Levy, Elliot; Cleary, Kevin

2007-03-01

We are currently developing a PET/CT based navigation system for guidance of biopsies and radiofrequency ablation (RFA) of early stage hepatic tumors. For these procedures, combined PET/CT data can potentially improve current interventions. The diagnostic efficacy of biopsies can potentially be improved by accurately targeting the region within the tumor that exhibits the highest metabolic activity. For RFA procedures the system can potentially enable treatment of early stage tumors, targeting tumors before structural abnormalities are clearly visible on CT. In both cases target definition is based on the metabolic data (PET), and navigation is based on the spatial data (CT), making the system highly dependent upon accurate spatial alignment between these data sets. In our institute all clinical data sets include three image volumes: one CT, and two PET volumes, with and without CT-based attenuation correction. This paper studies the effect of the CT-based attenuation correction on the registration process. From comparing the pairs of registrations from five data sets we observe that the point motion magnitude difference between registrations is on the same scale as the point motion magnitude in each one of the registrations, and that visual inspection cannot identify this discrepancy. We conclude that using non-rigid registration to align the PET and CT data sets is too variable, and most likely does not provide sufficient accuracy for interventional procedures.

33 CFR 155.750 - Contents of transfer procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Monitor the level of cargo in the tank; and (ii) Shut down transfer operations in time to ensure that the... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Contents of transfer procedures... (CONTINUED) POLLUTION OIL OR HAZARDOUS MATERIAL POLLUTION PREVENTION REGULATIONS FOR VESSELS Transfer...

Energy Navigation: Simulation Evaluation and Benefit Analysis

NASA Technical Reports Server (NTRS)

Williams, David H.; Oseguera-Lohr, Rosa M.; Lewis, Elliot T.

2011-01-01

This paper presents results from two simulation studies investigating the use of advanced flight-deck-based energy navigation (ENAV) and conventional transport-category vertical navigation (VNAV) for conducting a descent through a busy terminal area, using Continuous Descent Arrival (CDA) procedures. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, and the subsequent Airspace Super Density Operations (ASDO) research focus area of the Airspace Project. A piloted simulation study addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for high density terminal operations. The procedures and charts were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC.

33 CFR 230.12 - Notice of intent and scoping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Notice of intent and scoping. 230.12 Section 230.12 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.12 Notice of intent and scoping. As soon as...

Advanced Endoscopic Navigation: Surgical Big Data, Methodology, and Applications.

PubMed

Luo, Xiongbiao; Mori, Kensaku; Peters, Terry M

2018-06-04

Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.

76 FR 40797 - Establishment of Class E Airspace; Lincoln City, OR

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

...This action establishes Class E airspace at Lincoln City, OR, to accommodate aircraft using a new Area Navigation (RNAV) Global Positioning System (GPS) standard instrument approach procedures at Samaritan North Lincoln Hospital Heliport. This action also corrects the name of the city were the Heliport is located. This improves the safety and management of Instrument Flight Rules (IFR) operations.

Three-dimensional Cross-Platform Planning for Complex Spinal Procedures: A New Method Adaptive to Different Navigation Systems.

PubMed

Kosterhon, Michael; Gutenberg, Angelika; Kantelhardt, Sven R; Conrad, Jens; Nimer Amr, Amr; Gawehn, Joachim; Giese, Alf

2017-08-01

A feasibility study. To develop a method based on the DICOM standard which transfers complex 3-dimensional (3D) trajectories and objects from external planning software to any navigation system for planning and intraoperative guidance of complex spinal procedures. There have been many reports about navigation systems with embedded planning solutions but only few on how to transfer planning data generated in external software. Patients computerized tomography and/or magnetic resonance volume data sets of the affected spinal segments were imported to Amira software, reconstructed to 3D images and fused with magnetic resonance data for soft-tissue visualization, resulting in a virtual patient model. Objects needed for surgical plans or surgical procedures such as trajectories, implants or surgical instruments were either digitally constructed or computerized tomography scanned and virtually positioned within the 3D model as required. As crucial step of this method these objects were fused with the patient's original diagnostic image data, resulting in a single DICOM sequence, containing all preplanned information necessary for the operation. By this step it was possible to import complex surgical plans into any navigation system. We applied this method not only to intraoperatively adjustable implants and objects under experimental settings, but also planned and successfully performed surgical procedures, such as the percutaneous lateral approach to the lumbar spine following preplanned trajectories and a thoracic tumor resection including intervertebral body replacement using an optical navigation system. To demonstrate the versatility and compatibility of the method with an entirely different navigation system, virtually preplanned lumbar transpedicular screw placement was performed with a robotic guidance system. The presented method not only allows virtual planning of complex surgical procedures, but to export objects and surgical plans to any navigation or guidance system able to read DICOM data sets, expanding the possibilities of embedded planning software.

33 CFR 230.19 - Comments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Comments. 230.19 Section 230.19 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.19 Comments. District commanders shall request comments as set forth in 40 CFR 1503 and 1506.6. A lack of respons...

33 CFR 230.19 - Comments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Comments. 230.19 Section 230.19 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.19 Comments. District commanders shall request comments as set forth in 40 CFR 1503 and 1506.6. A lack of respons...

33 CFR 230.19 - Comments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Comments. 230.19 Section 230.19 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.19 Comments. District commanders shall request comments as set forth in 40 CFR 1503 and 1506.6. A lack of respons...

33 CFR 203.61 - Emergency water supplies due to contaminated water source.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Emergency water supplies due to contaminated water source. 203.61 Section 203.61 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Emergency Water Supplies:...

33 CFR 203.61 - Emergency water supplies due to contaminated water source.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Emergency water supplies due to contaminated water source. 203.61 Section 203.61 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Emergency Water Supplies:...

33 CFR 203.61 - Emergency water supplies due to contaminated water source.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Emergency water supplies due to contaminated water source. 203.61 Section 203.61 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Emergency Water Supplies:...

33 CFR 203.61 - Emergency water supplies due to contaminated water source.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Emergency water supplies due to contaminated water source. 203.61 Section 203.61 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Emergency Water Supplies:...

Augmented reality and image overlay navigation with OsiriX in laparoscopic and robotic surgery: not only a matter of fashion.

PubMed

Volonté, Francesco; Pugin, François; Bucher, Pascal; Sugimoto, Maki; Ratib, Osman; Morel, Philippe

2011-07-01

New technologies can considerably improve preoperative planning, enhance the surgeon's skill and simplify the approach to complex procedures. Augmented reality techniques, robot assisted operations and computer assisted navigation tools will become increasingly important in surgery and in residents' education. We obtained 3D reconstructions from simple spiral computed tomography (CT) slides using OsiriX, an open source processing software package dedicated to DICOM images. These images were then projected on the patient's body with a beamer fixed to the operating table to enhance spatial perception during surgical intervention (augmented reality). Changing a window's deepness level allowed the surgeon to navigate through the patient's anatomy, highlighting regions of interest and marked pathologies. We used image overlay navigation for laparoscopic operations such cholecystectomy, abdominal exploration, distal pancreas resection and robotic liver resection. Augmented reality techniques will transform the behaviour of surgeons, making surgical interventions easier, faster and probably safer. These new techniques will also renew methods of surgical teaching, facilitating transmission of knowledge and skill to young surgeons.

Performance Analysis on Carrier Phase-Based Tightly-Coupled GPS/BDS/INS Integration in GNSS Degraded and Denied Environments

PubMed Central

Han, Houzeng; Wang, Jian; Wang, Jinling; Tan, Xinglong

2015-01-01

The integration of Global Navigation Satellite Systems (GNSS) carrier phases with Inertial Navigation System (INS) measurements is essential to provide accurate and continuous position, velocity and attitude information, however it is necessary to fix ambiguities rapidly and reliably to obtain high accuracy navigation solutions. In this paper, we present the notion of combining the Global Positioning System (GPS), the BeiDou Navigation Satellite System (BDS) and low-cost micro-electro-mechanical sensors (MEMS) inertial systems for reliable navigation. An adaptive multipath factor-based tightly-coupled (TC) GPS/BDS/INS integration algorithm is presented and the overall performance of the integrated system is illustrated. A twenty seven states TC GPS/BDS/INS model is adopted with an extended Kalman filter (EKF), which is carried out by directly fusing ambiguity fixed double-difference (DD) carrier phase measurements with the INS predicted pseudoranges to estimate the error states. The INS-aided integer ambiguity resolution (AR) strategy is developed by using a dynamic model, a two-step estimation procedure is applied with adaptively estimated covariance matrix to further improve the AR performance. A field vehicular test was carried out to demonstrate the positioning performance of the combined system. The results show the TC GPS/BDS/INS system significantly improves the single-epoch AR reliability as compared to that of GPS/BDS-only or single satellite navigation system integrated strategy, especially for high cut-off elevations. The AR performance is also significantly improved for the combined system with adaptive covariance matrix in the presence of low elevation multipath related to the GNSS-only case. A total of fifteen simulated outage tests also show that the time to relock of the GPS/BDS signals is shortened, which improves the system availability. The results also indicate that TC integration system achieves a few centimeters accuracy in positioning based on the comparison analysis and covariance analysis, even in harsh environments (e.g., in urban canyons), thus we can see the advantage of positioning at high cut-off elevations that the combined GPS/BDS brings. PMID:25875191

Performance analysis on carrier phase-based tightly-coupled GPS/BDS/INS integration in GNSS degraded and denied environments.

PubMed

Han, Houzeng; Wang, Jian; Wang, Jinling; Tan, Xinglong

2015-04-14

The integration of Global Navigation Satellite Systems (GNSS) carrier phases with Inertial Navigation System (INS) measurements is essential to provide accurate and continuous position, velocity and attitude information, however it is necessary to fix ambiguities rapidly and reliably to obtain high accuracy navigation solutions. In this paper, we present the notion of combining the Global Positioning System (GPS), the BeiDou Navigation Satellite System (BDS) and low-cost micro-electro-mechanical sensors (MEMS) inertial systems for reliable navigation. An adaptive multipath factor-based tightly-coupled (TC) GPS/BDS/INS integration algorithm is presented and the overall performance of the integrated system is illustrated. A twenty seven states TC GPS/BDS/INS model is adopted with an extended Kalman filter (EKF), which is carried out by directly fusing ambiguity fixed double-difference (DD) carrier phase measurements with the INS predicted pseudoranges to estimate the error states. The INS-aided integer ambiguity resolution (AR) strategy is developed by using a dynamic model, a two-step estimation procedure is applied with adaptively estimated covariance matrix to further improve the AR performance. A field vehicular test was carried out to demonstrate the positioning performance of the combined system. The results show the TC GPS/BDS/INS system significantly improves the single-epoch AR reliability as compared to that of GPS/BDS-only or single satellite navigation system integrated strategy, especially for high cut-off elevations. The AR performance is also significantly improved for the combined system with adaptive covariance matrix in the presence of low elevation multipath related to the GNSS-only case. A total of fifteen simulated outage tests also show that the time to relock of the GPS/BDS signals is shortened, which improves the system availability. The results also indicate that TC integration system achieves a few centimeters accuracy in positioning based on the comparison analysis and covariance analysis, even in harsh environments (e.g., in urban canyons), thus we can see the advantage of positioning at high cut-off elevations that the combined GPS/BDS brings.

Increasing Health Portal Utilization in Cardiac Ambulatory Patients: A Pilot Project.

PubMed

Shaw, Carmen L; Casterline, Gayle L; Taylor, Dennis; Fogle, Maureen; Granger, Bradi

2017-10-01

Increasing health portal participation actively engages patients in their care and improves outcomes. The primary aim for this project was to increase patient health portal utilization. Nurses used a tablet-based demo to teach patients how to navigate the health portal. Assigning health videos to the portal was a tactic used to increase utilization. Each patient participant was surveyed about health portal utilization at initial nurse navigator appointment, day of procedure, and 30 days after discharge. Seventy-three percent (n = 14) of the 19 selected patients received the intervention; 36% (n = 4) of patients reported using a health portal feature; meaningful use metric preintervention increased from 12% to 16% after the intervention; 16% and 18% of patients viewed assigned videos in their health portal prior to procedure and after hospital discharge. Patients need a reason to access their health portal. Education alone is not enough to motivate patient portal use. Further research is needed to specify what tactics are required to motivate patients to use their health portals.

Successful Translation of Fluorescence Navigation During Oncologic Surgery: A Consensus Report.

PubMed

Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Basilion, James P; Biel, Merrill A; Bogyo, Matthew; Bouvet, Michael; Brigman, Brian E; Colson, Yolonda L; DeMeester, Steven R; Gurtner, Geoffrey C; Ishizawa, Takeaki; Jacobs, Paula M; Keereweer, Stijn; Liao, Joseph C; Nguyen, Quyen T; Olson, James M; Paulsen, Keith D; Rieves, Dwaine; Sumer, Baran D; Tweedle, Michael F; Vahrmeijer, Alexander L; Weichert, Jamey P; Wilson, Brian C; Zenn, Michael R; Zinn, Kurt R; van Dam, Gooitzen M

2016-01-01

Navigation with fluorescence guidance has emerged in the last decade as a promising strategy to improve the efficacy of oncologic surgery. To achieve routine clinical use, the onus is on the surgical community to objectively assess the value of this technique. This assessment may facilitate both Food and Drug Administration approval of new optical imaging agents and reimbursement for the imaging procedures. It is critical to characterize fluorescence-guided procedural benefits over existing practices and to elucidate both the costs and the safety risks. This report is the result of a meeting of the International Society of Image Guided Surgery (www.isigs.org) on February 6, 2015, in Miami, Florida, and reflects a consensus of the participants' opinions. Our objective was to critically evaluate the imaging platform technology and optical imaging agents and to make recommendations for successful clinical trial development of this highly promising approach in oncologic surgery. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

30 Years of Neurosurgical Robots: Review and Trends for Manipulators and Associated Navigational Systems.

PubMed

Smith, James Andrew; Jivraj, Jamil; Wong, Ronnie; Yang, Victor

2016-04-01

This review provides an examination of contemporary neurosurgical robots and the developments that led to them. Improvements in localization, microsurgery and minimally invasive surgery have made robotic neurosurgery viable, as seen by the success of platforms such as the CyberKnife and neuromate. Neurosurgical robots can now perform specific surgical tasks such as skull-base drilling and craniotomies, as well as pedicle screw and cochlear electrode insertions. Growth trends in neurosurgical robotics are likely to continue but may be tempered by concerns over recent surgical robot recalls, commercially-driven surgeon training, and studies that show operational costs for surgical robotic procedures are often higher than traditional surgical methods. We point out that addressing performance issues related to navigation-related registration is an active area of research and will aid in improving overall robot neurosurgery performance and associated costs.

Three-dimensional analysis of the surface registration accuracy of electromagnetic navigation systems in live endoscopic sinus surgery.

PubMed

Chang, C M; Fang, K M; Huang, T W; Wang, C T; Cheng, P W

2013-12-01

Studies on the performance of surface registration with electromagnetic tracking systems are lacking in both live surgery and the laboratory setting. This study presents the efficiency in time of the system preparation as well as the navigational accuracy of surface registration using electromagnetic tracking systems. Forty patients with bilateral chronic paranasal pansinusitis underwent endoscopic sinus surgery after undergoing sinus computed tomography scans. The surgeries were performed under electromagnetic navigation guidance after the surface registration had been carried out on all of the patients. The intraoperative measurements indicate the time taken for equipment set-up, surface registration and surgical procedure, as well as the degree of navigation error along 3 axes. The time taken for equipment set-up, surface registration and the surgical procedure was 179 +- 23 seconds, 39 +- 4.8 seconds and 114 +- 36 minutes, respectively. A comparison of the navigation error along the 3 axes showed that the deviation in the medial-lateral direction was significantly less than that in the anterior-posterior and cranial-caudal directions. The procedures of equipment set-up and surface registration in electromagnetic navigation tracking are efficient, convenient and easy to manipulate. The system accuracy is within the acceptable ranges, especially on the medial-lateral axis.

33 CFR 115.50 - Application for bridge permits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Application for bridge permits... BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.50 Application for bridge permits. (a) Application. An application for authorization to construct a bridge across navigable waters of...

Open-source platforms for navigated image-guided interventions.

PubMed

Ungi, Tamas; Lasso, Andras; Fichtinger, Gabor

2016-10-01

Navigation technology is changing the clinical standards in medical interventions by making existing procedures more accurate, and new procedures possible. Navigation is based on preoperative or intraoperative imaging combined with 3-dimensional position tracking of interventional tools registered to the images. Research of navigation technology in medical interventions requires significant engineering efforts. The difficulty of developing such complex systems has been limiting the clinical translation of new methods and ideas. A key to the future success of this field is to provide researchers with platforms that allow rapid implementation of applications with minimal resources spent on reimplementing existing system features. A number of platforms have been already developed that can share data in real time through standard interfaces. Complete navigation systems can be built using these platforms using a layered software architecture. In this paper, we review the most popular platforms, and show an effective way to take advantage of them through an example surgical navigation application. Copyright © 2016 Elsevier B.V. All rights reserved.

Flight Tests of Pilotage Error in Area Navigation with Vertical Guidance: Effects of Navigation Procedural Complexity

DTIC Science & Technology

1974-08-01

contributed substantially to the planning of the flight course used in this study and in the preparation of this report. Assistance in business matters has...CONTENTS Page INTRODUCTION 1 METHOD 5 Subjects 5 Equipment Experimental Plan 8 Procedure 14 Performance Assessment 17 Statistical Treatment 19 RESULTS...implementation of RNAV service. These documents provide the basis for future RNAV planning both procedurally and quantitatively. At the heart of the

Hubble Servicing Challenges Drive Innovation of Shuttle Rendezvous Techniques

NASA Technical Reports Server (NTRS)

Goodman, John L.; Walker, Stephen R.

2009-01-01

Hubble Space Telescope (HST) servicing, performed by Space Shuttle crews, has contributed to what is arguably one of the most successful astronomy missions ever flown. Both nominal and contingency proximity operations techniques were developed to enable successful servicing, while lowering the risk of damage to HST systems, and improve crew safety. Influencing the development of these techniques were the challenges presented by plume impingement and HST performance anomalies. The design of both the HST and the Space Shuttle was completed before the potential of HST contamination and structural damage by shuttle RCS jet plume impingement was fully understood. Relative navigation during proximity operations has been challenging, as HST was not equipped with relative navigation aids. Since HST reached orbit in 1990, proximity operations design for servicing missions has evolved as insight into plume contamination and dynamic pressure has improved and new relative navigation tools have become available. Servicing missions have provided NASA with opportunities to gain insight into servicing mission design and development of nominal and contingency procedures. The HST servicing experiences and lessons learned are applicable to other programs that perform on-orbit servicing and rendezvous, both human and robotic.

33 CFR 115.50 - Application for bridge permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Application for bridge permits... BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.50 Application for bridge permits. (a) Approval of plans. An application for authorization to construct a bridge across navigable waters...

Operational requirements for flight control and navigation systems for short haul transport aircraft

NASA Technical Reports Server (NTRS)

Morrison, J. A.

1978-01-01

To provide a background for evaluating advanced STOL systems concepts, a number of short haul and STOL airline operations in the United States and one operation in Canada were studied. A study of flight director operational procedures for an advanced STOL research airplane, the Augmented Wing Jet STOL Research Airplane, was conducted using the STOLAND simulation facility located at the Ames Changes to the advanced digital flight control system (STOLAND) installed in the Augmentor Wing Airplane are proposed to improve the mode sequencing to simplify pilot procedures and reduce pilot workload.

Experiments on robot-assisted navigated drilling and milling of bones for pedicle screw placement.

PubMed

Ortmaier, T; Weiss, H; Döbele, S; Schreiber, U

2006-12-01

This article presents experimental results for robot-assisted navigated drilling and milling for pedicle screw placement. The preliminary study was carried out in order to gain first insights into positioning accuracies and machining forces during hands-on robotic spine surgery. Additionally, the results formed the basis for the development of a new robot for surgery. A simplified anatomical model is used to derive the accuracy requirements. The experimental set-up consists of a navigation system and an impedance-controlled light-weight robot holding the surgical instrument. The navigation system is used to position the surgical instrument and to compensate for pose errors during machining. Holes are drilled in artificial bone and bovine spine. A quantitative comparison of the drill-hole diameters was achieved using a computer. The interaction forces and pose errors are discussed with respect to the chosen machining technology and control parameters. Within the technological boundaries of the experimental set-up, it is shown that the accuracy requirements can be met and that milling is superior to drilling. It is expected that robot assisted navigated surgery helps to improve the reliability of surgical procedures. Further experiments are necessary to take the whole workflow into account. Copyright 2006 John Wiley & Sons, Ltd.

An integrated platform for image-guided cardiac resynchronization therapy

NASA Astrophysics Data System (ADS)

Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.

2012-05-01

Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets by computing the registration error of the LV pacing lead electrodes which was found to be 2.2 ± 0.9 mm. Furthermore, the use of Unfold Navigation was demonstrated in real-time for four clinical cases.

Clarissa Spoken Dialogue System for Procedure Reading and Navigation

NASA Technical Reports Server (NTRS)

Hieronymus, James; Dowding, John

2004-01-01

Speech is the most natural modality for humans use to communicate with other people, agents and complex systems. A spoken dialogue system must be robust to noise and able to mimic human conversational behavior, like correcting misunderstandings, answering simple questions about the task and understanding most well formed inquiries or commands. The system aims to understand the meaning of the human utterance, and if it does not, then it discards the utterance as being meant for someone else. The first operational system is Clarissa, a conversational procedure reader and navigator, which will be used in a System Development Test Objective (SDTO) on the International Space Station (ISS) during Expedition 10. In the present environment one astronaut reads the procedure on a Manual Procedure Viewer (MPV) or paper, and has to stop to read or turn pages, shifting focus from the task. Clarissa is designed to read and navigate ISS procedures entirely with speech, while the astronaut has his eyes and hands engaged in performing the task. The system also provides an MPV like graphical interface so the procedure can be read visually. A demo of the system will be given.

The latest generation in flexible bronchoscopes: a description and evaluation.

PubMed

Hsia, David W; Tanner, Nichole T; Shamblin, Clayton; Mehta, Hiren J; Silvestri, Gerard A; Musani, Ali I

2013-10-01

Since the introduction of the flexible bronchoscope over 50 years ago, bronchoscopists have seen vast improvement in the technology available for diagnostics and therapeutics in the bronchoscopy laboratory. We set forth to evaluate the latest evolution in flexible bronchoscopes with features designed to improve imaging and airway navigation. The BF-Q190, BF-H190, and/or BF-1TH190 bronchoscopes were evaluated prospectively in 105 patients undergoing bronchoscopy from November 2010 to August 2011 at 2 tertiary care centers in the United States. Data collected from each procedure included method of insertion, airway images, and therapeutic interventions. At the completion of the study, 10 bronchoscopists were surveyed using a 7-point Likert scale to identify the perceived benefits of the design. Insertion methods included nasal, oral, laryngeal mask airway or endotracheal tube, and tracheostomy. Procedures performed included bronchoalveolar lavage, endobronchial biopsy or brushing, transbronchial biopsy, transbronchial needle aspiration or injection, peripheral navigation, and large airway therapeutic interventions. Survey of bronchoscopists revealed that when compared with current bronchoscopes, the features rated as having the most significant impact on functionality are the 210-degree tip angulation (average 2.4/3) and rotational capability of the insertion tube (average 2.4/3). The new-generation flexible bronchoscope offers improvement in image quality, magnification options, unique insertion tube rotation, and an increased 210-degree distal tip angulation over currently available flexible bronchoscopes. The bronchoscopes are an overall improvement to the current generation of bronchoscopes. The increased tip angulation and novel rotating insertion tube add the most to improvement in functionality.

22 CFR 401.25 - Government brief regarding navigable waters.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Government brief regarding navigable waters. 401.25 Section 401.25 Foreign Relations INTERNATIONAL JOINT COMMISSION, UNITED STATES AND CANADA RULES OF PROCEDURE Applications § 401.25 Government brief regarding navigable waters. When in the opinion of the...

33 CFR 209.170 - Violations of laws protecting navigable waters.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Violations of laws protecting... THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.170 Violations of laws protecting..., when considered advisable by the District Engineer to protect the interests of the United States, they...

33 CFR 209.170 - Violations of laws protecting navigable waters.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Violations of laws protecting... THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.170 Violations of laws protecting..., when considered advisable by the District Engineer to protect the interests of the United States, they...

33 CFR 209.170 - Violations of laws protecting navigable waters.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Violations of laws protecting... THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.170 Violations of laws protecting..., when considered advisable by the District Engineer to protect the interests of the United States, they...

Vision based flight procedure stereo display system

NASA Astrophysics Data System (ADS)

Shen, Xiaoyun; Wan, Di; Ma, Lan; He, Yuncheng

2008-03-01

A virtual reality flight procedure vision system is introduced in this paper. The digital flight map database is established based on the Geographic Information System (GIS) and high definitions satellite remote sensing photos. The flight approaching area database is established through computer 3D modeling system and GIS. The area texture is generated from the remote sensing photos and aerial photographs in various level of detail. According to the flight approaching procedure, the flight navigation information is linked to the database. The flight approaching area vision can be dynamic displayed according to the designed flight procedure. The flight approaching area images are rendered in 2 channels, one for left eye images and the others for right eye images. Through the polarized stereoscopic projection system, the pilots and aircrew can get the vivid 3D vision of the flight destination approaching area. Take the use of this system in pilots preflight preparation procedure, the aircrew can get more vivid information along the flight destination approaching area. This system can improve the aviator's self-confidence before he carries out the flight mission, accordingly, the flight safety is improved. This system is also useful in validate the visual flight procedure design, and it helps to the flight procedure design.

Endoscopic trans-nasal approach for biopsy of orbital tumours using image-guided neuro-navigation system.

PubMed

Sieskiewicz, A; Lyson, T; Mariak, Z; Rogowski, M

2008-05-01

Histopathological diagnosis of intraorbital tumours is of crucial value for planning further therapy. The aim of the study was to explore clinical utility of image-guided endoscopy for biopsy of orbital tumours. Trans-nasal endoscopic biopsy of intraorbital mass lesions was performed in 6 patients using a neuro-navigation system (Medtronic Stealth Station Treon plus). The CT and MRI 1 mm slice images were fused by the system in order to visualise both bony and soft tissue structures. The anatomic fiducial registration protocol was used during the procedure. All lesions were precisely localised and the biopsies could be taken from the representative part of the pathological mass. None of the patients developed aggravation of ocular symptoms after the procedure. The operative corridor as well as the size of orbital wall fenestration could be limited to a minimum. The accuracy of neuro-navigation remained high and stable during the entire procedure. The image-guided neuro-navigation system facilitated endoscopic localisation and biopsy of intraorbital tumours and contributed to the reduction of surgical trauma during the procedure. The technique was particularly useful in small, medially located, retrobulbar tumours and in unclear situations when the structure of the lesion resembled surrounding intraorbital tissue.

78 FR 32088 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

75 FR 69331 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...This establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

77 FR 12454 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation.

PubMed

Errahmouni, Abdelkarim; Latcu, Decebal Gabriel; Bun, Sok-Sithikun; Rijo, Nicolas; Dugourd, Céline; Saoudi, Nadir

2015-07-01

The magnetic navigation (MN) system may be coupled with a new advancement system that fully controls both the catheter and a robotic deflectable sheath (RSh) or with a fixed-curve sheath and a catheter-only advancement system (CAS). We aimed to compare these approaches for atrial fibrillation (AF) ablation. Atrial fibrillation ablation patients (45, 23 paroxysmal and 22 persistent) performed with MN-RSh (RSh group) were compared with a control group (37, 18 paroxysmal and19 persistent) performed with MN-CAS (CAS group). Setup duration was measured from the procedure's start to operator transfer to control room. Ablation step duration was defined as the time from the beginning of the first radiofrequency (RF) pulse to the end of the last one and was separately acquired for the left and the right pulmonary vein (PV) pairs. Clinical characteristics, left atrial size, and AF-type distribution were similar between the groups. Setup duration as well as mapping times was also similar. Ablation step duration for the left PVs was similar, but was shorter for the right PVs in RSh group (46 ± 9 vs. 63 ± 12 min, P < 0.0001). Radiofrequency delivery time (34 ± 9 vs. 40 ± 11 min, P = 0.007) and procedure duration (227 ± 36 vs. 254 ± 62 min, P = 0.01) were shorter in RSh group. No complication occurred in RSh group. During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027). The use of the RSh for AF ablation with MN is safe and improves outcome. Right PV isolation is faster, RF delivery time and procedure time are reduced. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation

PubMed Central

Errahmouni, Abdelkarim; Latcu, Decebal Gabriel; Bun, Sok-Sithikun; Rijo, Nicolas; Dugourd, Céline; Saoudi, Nadir

2015-01-01

Aims The magnetic navigation (MN) system may be coupled with a new advancement system that fully controls both the catheter and a robotic deflectable sheath (RSh) or with a fixed-curve sheath and a catheter-only advancement system (CAS). We aimed to compare these approaches for atrial fibrillation (AF) ablation. Methods and results Atrial fibrillation ablation patients (45, 23 paroxysmal and 22 persistent) performed with MN–RSh (RSh group) were compared with a control group (37, 18 paroxysmal and19 persistent) performed with MN–CAS (CAS group). Setup duration was measured from the procedure's start to operator transfer to control room. Ablation step duration was defined as the time from the beginning of the first radiofrequency (RF) pulse to the end of the last one and was separately acquired for the left and the right pulmonary vein (PV) pairs. Clinical characteristics, left atrial size, and AF-type distribution were similar between the groups. Setup duration as well as mapping times was also similar. Ablation step duration for the left PVs was similar, but was shorter for the right PVs in RSh group (46 ± 9 vs. 63 ± 12 min, P < 0.0001). Radiofrequency delivery time (34 ± 9 vs. 40 ± 11 min, P = 0.007) and procedure duration (227 ± 36 vs. 254 ± 62 min, P = 0.01) were shorter in RSh group. No complication occurred in RSh group. During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027). Conclusion The use of the RSh for AF ablation with MN is safe and improves outcome. Right PV isolation is faster, RF delivery time and procedure time are reduced. PMID:25662989

Can Fan-Beam Interactive Computed Tomography Accurately Predict Indirect Decompression in Minimally Invasive Spine Surgery Fusion Procedures?

PubMed

Janssen, Insa; Lang, Gernot; Navarro-Ramirez, Rodrigo; Jada, Ajit; Berlin, Connor; Hilis, Aaron; Zubkov, Micaella; Gandevia, Lena; Härtl, Roger

2017-11-01

Recently, novel mobile intraoperative fan-beam computed tomography (CT) was introduced, allowing for real-time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. A retrospective study of patients undergoing intraoperative CT (iCT)-guided extreme lateral interbody fusion or transforaminal lumbar interbody fusion was conducted. 1) Preoperative, 2) intraoperative (after cage implantation, 3) postoperative, and 4) follow-up radiographic and clinical parameters obtained from radiography or CT were quantified. Thirty-four patients (41 spinal segments) were analyzed. iCT-based navigation was successfully accomplished in all patients. Radiographic parameters showed significant improvement from preoperatively to intraoperatively after cage implantation in both MISS procedures (extreme lateral interbody fusion/transforaminal lumbar interbody fusion) (P ≤ 0.05). Radiologic parameters for both MISS fusion procedures did not show significant differences to the assessed radiographic measures at follow-up (P > 0.05). Radiologic outcome values did not decrease when compared intraoperatively (after cage implantation) to latest follow-up. Intraoperative fan-beam CT is capable of assessing neural decompression intraoperatively with high accuracy, allowing for precise prediction of radiologic outcome and earliest possible feedback during MISS fusion procedures. These findings are highly valuable for routine practice and future investigations toward finding a threshold for neural decompression that translates into clinical improvement. If sufficient neural decompression has been confirmed with iCT imaging studies, additional postoperative and/or follow-up imaging studies might no longer be required if patients remain asymptomatic. Copyright © 2017 Elsevier Inc. All rights reserved.

[Handling modern imaging procedures in a high-tech operating room].

PubMed

Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T

2012-03-01

Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

Intraoperative computed tomography with integrated navigation system in spinal stabilizations.

PubMed

Zausinger, Stefan; Scheder, Ben; Uhl, Eberhard; Heigl, Thomas; Morhard, Dominik; Tonn, Joerg-Christian

2009-12-15

STUDY DESIGN.: A prospective interventional case-series study plus a retrospective analysis of historical patients for comparison of data. OBJECTIVE.: To evaluate workflow, feasibility, and clinical outcome of navigated stabilization procedures with data acquisition by intraoperative computed tomography. SUMMARY OF BACKGROUND DATA.: Routine fluoroscopy to assess pedicle screw placement is not consistently reliable. Our hypothesis was that image-guided spinal navigation using an intraoperative CT-scanner can improve the safety and precision of spinal stabilization surgery. METHODS.: CT data of 94 patients (thoracolumbar [n = 66], C1/2 [n = 12], cervicothoracic instability [n = 16]) were acquired after positioning the patient in the final surgical position. A sliding gantry 40-slice CT was used for image acquisition. Data were imported to a frameless infrared-based neuronavigation workstation. Intraoperative CT was obtained to assess the accuracy of instrumentation and, if necessary, the extent of decompression. All patients were clinically evaluated by Odom-criteria after surgery and after 3 months. RESULTS.: Computed accuracy of the navigation system reached <2 mm (0.95 +/- 0.3 mm) in all cases. Additional time necessary for the preoperative image acquisition including data transfer was 14 +/- 5 minutes. The duration of interrupting the surgical process for iCT until resumption of surgery was 9 +/- 2.5 minutes. Control-iCT revealed incorrect screw position >/=2 mm without persistent neurologic or vascular damage in 20/414 screws (4.8%) leading to immediate correction of 10 screws (2.4%). Control-iCT changed the course of surgery in 8 cases (8.5% of all patients). The overall revision rate was 8.5% (4 wound revisions, 2 CSF fistulas, and 2 epidural hematomas). There was no reoperation due to implant malposition. According to Odom-criteria all patients experienced a clinical improvement. A retrospective analysis of 182 patients with navigated thoracolumbar transpedicular stabilizations in the preiCT era revealed an overall revision rate of 10.4% with 4.4% of patients requiring screw revision. CONCLUSION.: Intraoperative CT in combination with neuronavigation provides high accuracy of screw placement and thus safety for patients undergoing spinal stabilization. Reoperations due to implant malpositions could be completely avoided. The system can be installed into a pre-existing operating environment without need for special surgical instruments. The procedure is rapid and easy to perform without restricted access to the patient and-by replacing pre- and postoperative imaging-is not associated with an additional exposure to radiation. Multidisciplinary use increases utilization of the system and thus improves cost-efficiency relation.

Safety and Long-Term Outcomes of Catheter Ablation of Atrial Fibrillation Using Magnetic Navigation versus Manual Conventional Ablation: A Propensity-Score Analysis.

PubMed

Adragão, Pedro Pulido; Cavaco, Diogo; Ferreira, António Miguel; Costa, Francisco Moscoso; Parreira, Leonor; Carmo, Pedro; Morgado, Francisco Bello; Santos, Katya Reis; Santos, Pedro Galvão; Carvalho, Maria Salomé; Durazzo, Anai; Marques, Hugo; Gonçalves, Pedro Araújo; Raposo, Luís; Mendes, Miguel

2016-03-01

Whether or not the potential advantages of using a magnetic navigation system (MNS) translate into improved outcomes in patients undergoing atrial fibrillation (AF) ablation is a question that remains unanswered. In this observational registry study, we used propensity-score matching to compare the outcomes of patients with symptomatic drug-refractory AF who underwent catheter ablation using MNS with the outcomes of those who underwent catheter ablation using conventional manual navigation. Among 1,035 eligible patients, 287 patients in each group had similar propensity scores and were included in the analysis. The primary efficacy outcome was the rate of AF relapse after a 3-month blanking period. At a mean follow-up of 2.6 ± 1.5 years, AF ablation with MNS was associated with a similar risk of AF relapse as compared with manual navigation (18.4% per year and 22.3% per year, respectively; hazard ratio 0.81, 95% CI 0.63-1.05; P = 0.108). Major complications occurred in two patients (0.7%) using MNS, and in six patients (2.1%) undergoing manually navigated ablation (P = 0.286). Fluoroscopy times were 21 ± 10 minutes in the manual navigation group, and 12 ± 9 minutes in the MNS group (P < 0.001), whereas total procedure times were 152 ± 52 minutes and 213 ± 58 minutes, respectively (P < 0.001). In this propensity-score matched comparison, magnetic navigation and conventional manual AF ablations seem to have similar relapse rates and a similar risk of complications. AF ablations with magnetic navigation take longer to perform but expose patients to significantly shorter fluoroscopy times. © 2015 Wiley Periodicals, Inc.

The accuracy of an electromagnetic navigation system in lateral skull base approaches.

PubMed

Komune, Noritaka; Matsushima, Ken; Matsuo, Satoshi; Safavi-Abbasi, Sam; Matsumoto, Nozomu; Rhoton, Albert L

2017-02-01

Image-guided optical tracking systems are being used with increased frequency in lateral skull base surgery. Recently, electromagnetic tracking systems have become available for use in this region. However, the clinical accuracy of the electromagnetic tracking system has not been examined in lateral skull base surgery. This study evaluates the accuracy of electromagnetic navigation in lateral skull base surgery. Cadaveric and radiographic study. Twenty cadaveric temporal bones were dissected in a surgical setting under a commercially available, electromagnetic surgical navigation system. The target registration error (TRE) was measured at 28 surgical landmarks during and after performing the standard translabyrinthine and middle cranial fossa surgical approaches to the internal acoustic canal. In addition, three demonstrative procedures that necessitate navigation with high accuracy were performed; that is, canalostomy of the superior semicircular canal from the middle cranial fossa, 1 cochleostomy from the middle cranial fossa, 2 and infralabyrinthine approach to the petrous apex. 3 RESULTS: Eleven of 17 (65%) of the targets in the translabyrinthine approach and five of 11 (45%) of the targets in the middle fossa approach could be identified in the navigation system with TRE of less than 0.5 mm. Three accuracy-dependent procedures were completed without anatomical injury of important anatomical structures. The electromagnetic navigation system had sufficient accuracy to be used in the surgical setting. It was possible to perform complex procedures in the lateral skull base under the guidance of the electromagnetically tracked navigation system. N/A. Laryngoscope, 2016 127:450-459, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Electromagnetic Navigation Diagnostic Bronchoscopy

PubMed Central

Gildea, Thomas R.; Mazzone, Peter J.; Karnak, Demet; Meziane, Moulay; Mehta, Atul C.

2006-01-01

Rationale: Electromagnetic navigation bronchoscopy using superDimension/Bronchus System is a novel method to increase diagnostic yield of peripheral and mediastinal lung lesions. Objectives: A prospective, open label, single-center, pilot study was conducted to determine the ability of electromagnetic navigation bronchoscopy to sample peripheral lung lesions and mediastinal lymph nodes with standard bronchoscopic instruments and demonstrate safety. Methods: Electromagnetic navigation bronchoscopy was performed using the superDimension/Bronchus system consisting of electromagnetic board, position sensor encapsulated in the tip of a steerable probe, extended working channel, and real-time reconstruction of previously acquired multiplanar computed tomography images. The final distance of the steerable probe to lesion, expected error based on the actual and virtual markers, and procedure yield was gathered. Measurements: 60 subjects were enrolled between December 2004 and September 2005. Mean navigation times were 7 ± 6 min and 2 ± 2 min for peripheral lesions and lymph nodes, respectively. The steerable probe tip was navigated to the target lung area in all cases. The mean peripheral lesions and lymph nodes size was 22.8 ± 12.6 mm and 28.1 ± 12.8 mm. Yield was determined by results obtained during the bronchoscopy per patient. Results: The yield/procedure was 74% and 100% for peripheral lesions and lymph nodes, respectively. A diagnosis was obtained in 80.3% of bronchoscopic procedures. A definitive diagnosis of lung malignancy was made in 74.4% of subjects. Pneumothorax occurred in two subjects. Conclusion: Electromagnetic navigation bronchoscopy is a safe method for sampling peripheral and mediastinal lesions with high diagnostic yield independent of lesion size and location. PMID:16873767

14 CFR 171.23 - Requests for IFR procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Nondirectional Radio Beacon Facilities § 171.23... beacon facility that he owns must submit the following information with that request: (1) A description...

75 FR 8286 - Proposed Amendment of Area Navigation Route Q-15; California

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

...- day traffic flow on Q-15 within the NAS. Area Navigation Routes are published in paragraph 2006 of FAA... http://www.faa.gov/air_traffic/publications/airspace_amendments/ . You may review the public docket... affect air traffic procedures and air navigation, it is certified that this proposed rule, when...

Does intraoperative navigation improve the accuracy of mandibular angle osteotomy: Comparison between augmented reality navigation, individualised templates and free-hand techniques.

PubMed

Zhu, Ming; Liu, Fei; Zhou, Chaozheng; Lin, Li; Zhang, Yan; Chai, Gang; Xie, Le; Qi, Fazhi; Li, Qingfeng

2018-04-11

Augmented reality (AR)-based navigation surgery has evolved to be an advanced assisted technology. The aim of this study is to manifest the accuracy of AR navigation for the intraoperative mandibular angle osteotomy by comparing the navigation with other interventional techniques. A retrospective study was conducted with 93 post-surgical patients with mandibular angle hypertrophy admitted at our plastic and reconstructive surgery department between September 2011 and June 2016. Thirty-one patients received osteotomy conducted using a navigation system based on augmented reality (AR group), 28 patients received osteotomy conducted using individualised templates (IT group) and the remaining 34 patients received osteotomy performed by free hand (free-hand group). The post-operative computed tomography (CT) images were reviewed and analysed by comparing with pre-surgical planning generated by three-dimensional (3D) software. The preparation time, cutting time, whole operating time and discrepancy in osteotomy lines were measured. The preparation time was much shorter for the free-hand group than that for the AR group and the IT group (P < 0.01). However, no significant difference in the whole operating time was observed among the three groups (P > 0.05). In addition, the discrepancy in osteotomy lines was lower for the AR group and in the IT group than for the free-hand group (P < 0.01). The navigation system based on AR has a higher accuracy, more reliability and better user friendliness for some particular clinical procedures than for other techniques, which has a promising clinical prospect. Copyright © 2018. Published by Elsevier Ltd.

Posterior internal fixation plus vertebral bone implantation under navigational aid for thoracolumbar fracture treatment

PubMed Central

ZHOU, WEI; KONG, WEIQING; ZHAO, BIZHEN; FU, YISHAN; ZHANG, TAO; XU, JIANGUANG

2013-01-01

The aim of this study was to investigate the method of posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid for the treatment of thoracolumbar fractures. The efficacy of the procedure was also measured. Between June 2005 and March 2011, posterior thoracolumbar vertebral pedicle screw reduction and fixation plus artificial bone implantation via the affected vertebral pedicle under navigational aid was used to treat 30 patients with thoracolumbar fractures, including 18 males and 12 females, ranging in age from 21 to 57 years. Compared with the values prior to surgery, intraspinal occupation, vertebral height ratio and Cobb angle at the follow-up were significantly improved. At the long-term follow-up, the postoperative Cobb angle loss was <1° and the anterior vertebral body height loss was <2 mm. Posterior thoracolumbar vertebral pedicle screw reduction and fixation combined with vertebral bone implantation via the affected vertebral body under navigational aid may increase the accuracy and safety of surgery, and it is an ideal method of internal implantation. Bone implantation via the affected vertebral body may increase vertebral stability. PMID:23935737

78 FR 47047 - Proposed Policy for Discontinuance of Certain Instrument Approach Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... procedures. Localizer procedures. TACAN procedures. Standard Instrument Arrivals (STARs). Standard Instrument... Policy for Discontinuance of Certain Instrument Approach Procedures AGENCY: Federal Aviation... facilitates the introduction of area navigation (RNAV) instrument approach procedures over the past decade...

Parameter estimation for terrain modeling from gradient data. [navigation system for Martian rover

NASA Technical Reports Server (NTRS)

Dangelo, K. R.

1974-01-01

A method is developed for modeling terrain surfaces for use on an unmanned Martian roving vehicle. The modeling procedure employs a two-step process which uses gradient as well as height data in order to improve the accuracy of the model's gradient. Least square approximation is used in order to stochastically determine the parameters which describe the modeled surface. A complete error analysis of the modeling procedure is included which determines the effect of instrumental measurement errors on the model's accuracy. Computer simulation is used as a means of testing the entire modeling process which includes the acquisition of data points, the two-step modeling process and the error analysis. Finally, to illustrate the procedure, a numerical example is included.

Comparison between free-hand and O-arm-based navigated posterior lumbar interbody fusion in elderly cohorts with three-level lumbar degenerative disease.

PubMed

Wang, Yucheng; Chen, Kangwu; Chen, Hao; Zhang, Kai; Lu, Jian; Mao, Haiqing; Yang, Huilin

2018-06-06

This retrospective cohort study aims to evaluate the effects of introducing the O-arm-based navigation technique into the traditional posterior lumbar interbody fusion (PLIF) procedure treating elderly patients with three-level lumbar degenerative diseases. Forty-one consecutive elderly patients were enrolled according to the criteria. There were 21 patients in the free-hand group and 20 patients in the O-arm group. Both two groups underwent the PLIF with or without the O-arm-based navigation technique. The demographic features, clinical data and outcomes, and radiological information were collected for further analysis. The average follow-up time was 18.3 (range, 12-28) months in the free-hand group and 16.7 (range, 12-24) months in the O-arm group. Comparison between two groups revealed no significant difference regarding demographic features. The operation time took in the navigation group was significantly less than that in the free-hand group (222.55 ± 38.00 mins versus 255.19 ± 40.26 mins, P < 0.05). Both VAS and ODI were improved post-operatively in two groups while comparison between groups showed no difference. The accuracy rate of pedicle screw positioning was 88.7% in the free-hand group to 96.9% in the O-arm group (P < 0.05). The O-arm-based navigation is an efficacious auxiliary technique which could significantly improve the accuracy of pedicle screw insertion, especially in cases of patients with complex anatomic degenerative diseases, without sacrificing the feasibility and reliable outcome of traditional PLIF.

Assessing Spatial Learning and Memory in Rodents

PubMed Central

Vorhees, Charles V.; Williams, Michael T.

2014-01-01

Maneuvering safely through the environment is central to survival of almost all species. The ability to do this depends on learning and remembering locations. This capacity is encoded in the brain by two systems: one using cues outside the organism (distal cues), allocentric navigation, and one using self-movement, internal cues and nearby proximal cues, egocentric navigation. Allocentric navigation involves the hippocampus, entorhinal cortex, and surrounding structures; in humans this system encodes allocentric, semantic, and episodic memory. This form of memory is assessed in laboratory animals in many ways, but the dominant form of assessment is the Morris water maze (MWM). Egocentric navigation involves the dorsal striatum and connected structures; in humans this system encodes routes and integrated paths and, when overlearned, becomes procedural memory. In this article, several allocentric assessment methods for rodents are reviewed and compared with the MWM. MWM advantages (little training required, no food deprivation, ease of testing, rapid and reliable learning, insensitivity to differences in body weight and appetite, absence of nonperformers, control methods for proximal cue learning, and performance effects) and disadvantages (concern about stress, perhaps not as sensitive for working memory) are discussed. Evidence-based design improvements and testing methods are reviewed for both rats and mice. Experimental factors that apply generally to spatial navigation and to MWM specifically are considered. It is concluded that, on balance, the MWM has more advantages than disadvantages and compares favorably with other allocentric navigation tasks. PMID:25225309

A Review of In-Office Dynamic Image Navigation for Extraction of Complex Mandibular Third Molars.

PubMed

Emery, Robert W; Korj, Oxana; Agarwal, Ravi

2017-08-01

We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS). A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47 years (range, 27 to 72 years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater. Each patient received custom intraoral splints to secure the tracking array and underwent cone beam computed tomography image acquisition. All surgical procedures were performed with a precalibrated tracking straight handpiece under dynamic navigation. All 25 cases were treated successfully with the use of the DINS. Twelve of these cases were associated with pathologic lesions. Three patients were noted to have inferior alveolar nerve paresthesia. One patient sustained a pathologic fracture at week 2. Postoperative infections were noted in 7 cases, 2 of which had a pre-existing infection. One patient reported temporary limitation of mouth opening. A coronectomy was performed in 1 case. We present results using a new technology, the DINS, for removal of complex mandibular third molars. Potential advantages are 1) improved visualization and localization of anatomic structures such as the inferior alveolar nerve, lingual cortical plate, and adjacent roots; 2) improved control during osteotomy; 3) decreased surgical access requirements and reduction in overall bone removal; 4) ability to perform complex procedures successfully in an in-office setting; 5) decreased surgical time resulting from improved visualization; and 6) potential use as a teaching tool. Possible limitations of the use of an in-office DINS include increased cost, increased time attributed to presurgical planning, initial learning curve, and optical array interference by the surgeon or assistants during surgery. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Vdrive Evaluation of Remote Steering and Testing in Lasso Electrophysiology Procedures Study: The VERSATILE Study in Atrial Fibrillation Ablation.

PubMed

Nölker, Georg; Schwagten, Bruno; Deville, J Brian; Burkhardt, J David; Horton, Rodney P; Sha, Qun; Tomassoni, Gery

2016-03-01

Circular mapping catheters (CMC) are an essential tool in most atrial fibrillation ablation procedures. The Vdrive™ with V-Loop™ system enables a physician to remotely manipulate a CMC during electrophysiology studies. Our aim was to compare the clinical performance of the system to conventional CMC navigation according to efficiency and safety endpoints. A total of 120 patients scheduled to undergo a CMC study followed by pulmonary vein isolation (PVI) were included. Treatment allocation was randomized 2:1, remote navigation:manual navigation. The primary effectiveness endpoint was assessed based on both successful navigation to the targeted pulmonary vein (PV) and successful recording of PV electrograms. All PVs were treated independently within and between patients. The primary safety endpoint was assessed based on the occurrence of major adverse events (MAEs) through seven days after the study procedure. Primary effectiveness endpoints were achieved in 295/302 PVs in the Vdrive arm (97.7%) and 167/167 PVs in the manual arm (100%). Effectiveness analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0405; δ = -0.05) per the Cochran-Mantel-Haenszel test adjusted for PV correlation. Five MAEs related to the ablation procedure occurred (three in the Vdrive arm-3.9%; two in the manual arm-2.33%). No device-related MAEs were observed; safety analysis indicates Vdrive non-inferiority (pnon-inferiority = 0.0441; δ = 0.07) per the normal Z test. Remote navigation of a CMC is equivalent to manual in PVI in terms of safety and effectiveness. This allows for single-operator procedures in conjunction with a magnetically guided ablation catheter. © 2016 Wiley Periodicals, Inc.

Computer-assisted navigation in orthopedic surgery.

PubMed

Mavrogenis, Andreas F; Savvidou, Olga D; Mimidis, George; Papanastasiou, John; Koulalis, Dimitrios; Demertzis, Nikolaos; Papagelopoulos, Panayiotis J

2013-08-01

Computer-assisted navigation has a role in some orthopedic procedures. It allows the surgeons to obtain real-time feedback and offers the potential to decrease intra-operative errors and optimize the surgical result. Computer-assisted navigation systems can be active or passive. Active navigation systems can either perform surgical tasks or prohibit the surgeon from moving past a predefined zone. Passive navigation systems provide intraoperative information, which is displayed on a monitor, but the surgeon is free to make any decisions he or she deems necessary. This article reviews the available types of computer-assisted navigation, summarizes the clinical applications and reviews the results of related series using navigation, and informs surgeons of the disadvantages and pitfalls of computer-assisted navigation in orthopedic surgery. Copyright 2013, SLACK Incorporated.

14 CFR 171.203 - Requests for IFR procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VHF Marker Beacons § 171.203 Requests for IFR... beacon facility that he owns must submit the following information with that request: (1) A description...

Kinematic analysis and simulation of a substation inspection robot guided by magnetic sensor

NASA Astrophysics Data System (ADS)

Xiao, Peng; Luan, Yiqing; Wang, Haipeng; Li, Li; Li, Jianxiang

2017-01-01

In order to improve the performance of the magnetic navigation system used by substation inspection robot, the kinematic characteristics is analyzed based on a simplified magnetic guiding system model, and then the simulation process is executed to verify the reasonability of the whole analysis procedure. Finally, some suggestions are extracted out, which will be helpful to guide the design of the inspection robot system in the future.

33 CFR 321.3 - Special policies and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF DEFENSE PERMITS FOR DAMS AND DIKES IN NAVIGABLE WATERS OF THE UNITED STATES § 321.3 Special... (Civil Works) will decide whether DA authorization for a dam or dike in an interstate navigable water of... dam or dike in an intrastate navigable water of the United States will be issued (see 33 CFR 325.8...

History of computer-assisted orthopedic surgery (CAOS) in sports medicine.

PubMed

Jackson, Douglas W; Simon, Timothy M

2008-06-01

Computer-assisted orthopedic surgery and navigation applications have a history rooted in the desire to link imaging technology with real-time anatomic landmarks. Although applications are still evolving in the clinical and research setting, computer-assisted orthopedic surgery has already demonstrated in certain procedures its potential for improving the surgeon's accuracy, reproducibility (once past the learning curve), and in reducing outlier outcomes. It is also being used as an educational tool to assist less experienced surgeons in interpreting measurements and precision placements related to well defined anatomic landmarks. It also can assist experienced surgeons, in real-time, plan their bony cuts, tunnel placement, and with ligament balancing. Presently, the additional time, the expense to acquire the needed software and hardware, and restricted reimbursement have slowed the widespread use of navigation. Its current applications have been primarily in joint replacement surgery, spine surgery, and trauma. It has not been widely used in the clinical setting for sports medicine procedures. Sports medicine applications such as individualizing tunnel placement in ligament surgery, opening wedge osteotomy with and without accompanying ligament reconstruction, and balancing and tensioning of the ligaments during the procedure (allowing real-time corrections if necessary) are currently being evaluated and being used on a limited clinical basis.

Evaluation of a novel flexible snake robot for endoluminal surgery.

PubMed

Patel, Nisha; Seneci, Carlo A; Shang, Jianzhong; Leibrandt, Konrad; Yang, Guang-Zhong; Darzi, Ara; Teare, Julian

2015-11-01

Endoluminal therapeutic procedures such as endoscopic submucosal dissection are increasingly attractive given the shift in surgical paradigm towards minimally invasive surgery. This novel three-channel articulated robot was developed to overcome the limitations of the flexible endoscope which poses a number of challenges to endoluminal surgery. The device enables enhanced movement in a restricted workspace, with improved range of motion and with the accuracy required for endoluminal surgery. To evaluate a novel flexible robot for therapeutic endoluminal surgery. Bench-top studies. Research laboratory. Targeting and navigation tasks of the robot were performed to explore the range of motion and retroflexion capabilities. Complex endoluminal tasks such as endoscopic mucosal resection were also simulated. Successful completion, accuracy and time to perform the bench-top tasks were the main outcome measures. The robot ranges of movement, retroflexion and navigation capabilities were demonstrated. The device showed significantly greater accuracy of targeting in a retroflexed position compared to a conventional endoscope. Bench-top study and small study sample. We were able to demonstrate a number of simulated endoscopy tasks such as navigation, targeting, snaring and retroflexion. The improved accuracy of targeting whilst in a difficult configuration is extremely promising and may facilitate endoluminal surgery which has been notoriously challenging with a conventional endoscope.

A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model

PubMed Central

Wang, Dong; Gan, Qi; Ye, Jian; Yue, Jian; Wang, Benzhong; Povoski, Stephen P.; Martin, Edward W.; Hitchcock, Charles L.; Yilmaz, Alper; Tweedle, Michael F.; Shao, Pengfei; Xu, Ronald X.

2016-01-01

Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG)—fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting. PMID:27367051

A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model.

PubMed

Zhang, Zeshu; Pei, Jing; Wang, Dong; Gan, Qi; Ye, Jian; Yue, Jian; Wang, Benzhong; Povoski, Stephen P; Martin, Edward W; Hitchcock, Charles L; Yilmaz, Alper; Tweedle, Michael F; Shao, Pengfei; Xu, Ronald X

2016-01-01

Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG)-fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting.

Atrial Fibrillation Ablation Guided by a Novel Nonfluoroscopic Navigation System.

PubMed

Ballesteros, Gabriel; Ramos, Pablo; Neglia, Renzo; Menéndez, Diego; García-Bolao, Ignacio

2017-09-01

Rhythmia is a new nonfluoroscopic navigation system that is able to create high-density electroanatomic maps. The aim of this study was to describe the acute outcomes of atrial fibrillation (AF) ablation guided by this system, to analyze the volume provided by its electroanatomic map, and to describe its ability to locate pulmonary vein (PV) reconnection gaps in redo procedures. This observational study included 62 patients who underwent AF ablation with Rhythmia compared with a retrospective cohort who underwent AF ablation with a conventional nonfluoroscopic navigation system (Ensite Velocity). The number of surface electrograms per map was significantly higher in Rhythmia procedures (12 125 ± 2826 vs 133 ± 21 with Velocity; P < .001), with no significant differences in the total procedure time. The Orion catheter was placed for mapping in 99.5% of PV (95.61% in the control group with a conventional circular mapping catheter; P = .04). There were no significant differences in the percentage of PV isolation between the 2 groups. In redo procedures, an ablation gap could be identified on the activation map in 67% of the reconnected PV (40% in the control group; P = .042). The measured left atrial volume was lower than that calculated by computed tomography (109.3 v 15.2 and 129.9 ± 13.2 mL, respectively; P < .001). There were no significant differences in the number of complications. The Rhythmia system is effective for AF ablation procedures, with procedure times and safety profiles similar to conventional nonfluoroscopic navigation systems. In redo procedures, it appears to be more effective in identifying reconnected PV conduction gaps. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

The utilization of cranial models created using rapid prototyping techniques in the development of models for navigation training.

PubMed

Waran, V; Pancharatnam, Devaraj; Thambinayagam, Hari Chandran; Raman, Rajagopal; Rathinam, Alwin Kumar; Balakrishnan, Yuwaraj Kumar; Tung, Tan Su; Rahman, Z A

2014-01-01

Navigation in neurosurgery has expanded rapidly; however, suitable models to train end users to use the myriad software and hardware that come with these systems are lacking. Utilizing three-dimensional (3D) industrial rapid prototyping processes, we have been able to create models using actual computed tomography (CT) data from patients with pathology and use these models to simulate a variety of commonly performed neurosurgical procedures with navigation systems. To assess the possibility of utilizing models created from CT scan dataset obtained from patients with cranial pathology to simulate common neurosurgical procedures using navigation systems. Three patients with pathology were selected (hydrocephalus, right frontal cortical lesion, and midline clival meningioma). CT scan data following an image-guidance surgery protocol in DIACOM format and a Rapid Prototyping Machine were taken to create the necessary printed model with the corresponding pathology embedded. The ability in registration, planning, and navigation of two navigation systems using a variety of software and hardware provided by these platforms was assessed. We were able to register all models accurately using both navigation systems and perform the necessary simulations as planned. Models with pathology utilizing 3D rapid prototyping techniques accurately reflect data of actual patients and can be used in the simulation of neurosurgical operations using navigation systems. Georg Thieme Verlag KG Stuttgart · New York.

Neuroendovascular magnetic navigation: clinical experience in ten patients.

PubMed

Dabus, Guilherme; Gerstle, Ronald J; Cross, Dewitte T; Derdeyn, Colin P; Moran, Christopher J

2007-04-01

The magnetic navigation system consists of an externally generated magnetic field that is used to control and steer a magnetically tipped microguidewire. The goal of this study was to demonstrate that the use of the magnetic navigation system and its magnetic microguidewire is feasible and safe in all types of neuroendovascular procedures. A magnetic navigation system is an interventional workstation that combines a biplanar fluoroscopy system with a computer-controlled magnetic field generator to provide both visualization and control of a magnetically activated endovascular microguidewire. Ten consecutive patients underwent a variety of neuroendovascular procedures using the magnetic guidance system and magnetic microguidewire. All patients presented with a neurovascular disease that was suitable for endovascular treatment. Multiple different devices and embolic agents were used. Of the ten patients, three were male and seven female. Their mean age was 53.9 years. The predominant neurovascular condition was the presence of intracranial aneurysm (nine patients). One patient had a left mandibular arteriovenous malformation. All treatments were successfully performed on the magnetic navigation system suite. The magnetic navigation system and the magnetic microguidewire allowed safe and accurate endovascular navigation allowing placement of the microcatheters in the desired location. There were no neurological complications or death in our series. The use of the magnetic navigation system and the magnetic microguidewire in the endovascular treatment of patients with neurovascular diseases is feasible and safe.

Advancements in Orthopedic Intervention: Retrograde Drilling and Bone Grafting of Osteochondral Lesions of the Knee Using Magnetic Resonance Imaging Guidance

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

Seebauer, Christian J., E-mail: christian.seebauer@charite.d; Bail, Hermann J., E-mail: hermann-josef.bail@klinikum-nuernberg.d; Rump, Jens C., E-mail: jens.rump@charite.de

Computer-assisted surgery is currently a novel challenge for surgeons and interventional radiologists. Magnetic resonance imaging (MRI)-guided procedures are still evolving. In this experimental study, we describe and assess an innovative passive-navigation method for MRI-guided treatment of osteochondritis dissecans of the knee. A navigation principle using a passive-navigation device was evaluated in six cadaveric knee joint specimens for potential applicability in retrograde drilling and bone grafting of osteochondral lesions using MRI guidance. Feasibility and accuracy were evaluated in an open MRI scanner (1.0 T Philips Panorama HFO MRI System). Interactive MRI navigation allowed precise drilling and bone grafting of osteochondral lesionsmore » of the knee. All lesions were hit with an accuracy of 1.86 mm in the coronal plane and 1.4 mm the sagittal plane. Targeting of all lesions was possible with a single drilling. MRI allowed excellent assessment of correct positioning of the cancellous bone cylinder during bone grafting. The navigation device and anatomic structures could be clearly identified and distinguished throughout the entire drilling procedure. MRI-assisted navigation method using a passive navigation device is feasible for the treatment of osteochondral lesions of the knee under MRI guidance and allows precise and safe drilling without exposure to ionizing radiation. This method may be a viable alternative to other navigation principles, especially for pediatric and adolescent patients. This MRI-navigated method is also potentially applicable in many other MRI-guided interventions.« less

Flexible robotic catheters in the visceral segment of the aorta: advantages and limitations.

PubMed

Li, Mimi M; Hamady, Mohamad S; Bicknell, Colin D; Riga, Celia V

2018-06-01

Flexible robotic catheters are an emerging technology which provide an elegant solution to the challenges of conventional endovascular intervention. Originally developed for interventional cardiology and electrophysiology procedures, remotely steerable robotic catheters such as the Magellan system enable greater precision and enhanced stability during target vessel navigation. These technical advantages facilitate improved treatment of disease in the arterial tree, as well as allowing execution of otherwise unfeasible procedures. Occupational radiation exposure is an emerging concern with the use of increasingly complex endovascular interventions. The robotic systems offer an added benefit of radiation reduction, as the operator is seated away from the radiation source during manipulation of the catheter. Pre-clinical studies have demonstrated reduction in force and frequency of vessel wall contact, resulting in reduced tissue trauma, as well as improved procedural times. Both safety and feasibility have been demonstrated in early clinical reports, with the first robot-assisted fenestrated endovascular aortic repair in 2013. Following from this, the Magellan system has been used to successfully undertake a variety of complex aortic procedures, including fenestrated/branched endovascular aortic repair, embolization, and angioplasty.

Using GOMS models and hypertext to create representations of medical procedures for online display

NASA Technical Reports Server (NTRS)

Gugerty, Leo; Halgren, Shannon; Gosbee, John; Rudisill, Marianne

1991-01-01

This study investigated two methods to improve organization and presentation of computer-based medical procedures. A literature review suggested that the GOMS (goals, operators, methods, and selecton rules) model can assist in rigorous task analysis, which can then help generate initial design ideas for the human-computer interface. GOMS model are hierarchical in nature, so this study also investigated the effect of hierarchical, hypertext interfaces. We used a 2 x 2 between subjects design, including the following independent variables: procedure organization - GOMS model based vs. medical-textbook based; navigation type - hierarchical vs. linear (booklike). After naive subjects studies the online procedures, measures were taken of their memory for the content and the organization of the procedures. This design was repeated for two medical procedures. For one procedure, subjects who studied GOMS-based and hierarchical procedures remembered more about the procedures than other subjects. The results for the other procedure were less clear. However, data for both procedures showed a 'GOMSification effect'. That is, when asked to do a free recall of a procedure, subjects who had studies a textbook procedure often recalled key information in a location inconsistent with the procedure they actually studied, but consistent with the GOMS-based procedure.

Evaluation of the eZono 4000 with eZGuide for ultrasound-guided procedures.

PubMed

Gadsden, Jeff; Latmore, Malikah; Levine, Daniel M

2015-05-01

Ultrasound-guided procedures are increasingly common in a variety of acute care settings, such as the operating room, critical care unit and emergency room. However, accurate judgment of needle tip position using traditional ultrasound technology is frequently difficult, and serious injury can result from inadvertently advancing beyond or through the target. Needle navigation is a recent innovation that allows the clinician to visualize the needle position and trajectory in real time as it approaches the target. A novel ultrasound machine has recently been introduced that is portable and designed for procedural guidance. The eZono 4000™ features an innovative needle navigation technology that is simple to use and permits the use of a wide range of commercially available needles, avoiding the inconvenience and cost of proprietary equipment. This article discusses this new ultrasound machine in the context of other currently available ultrasound machines featuring needle navigation.

Plans for Improvement of Navigation Conditions at Greenville Bridge, Mississippi River: Model Investigation

DTIC Science & Technology

1953-06-01

TA7 ,vJ31 (\\0’ 2..- .:;~b £c CORPS OF ENGINEERS, U. S. ARMY PLANS FOR IMPROVEMENT OF NAVIGATION CONDITIONS AT GREENVILLE BRIDGE, MISSISSIPPI...REPORT TYPE 3. DATES COVERED 00-00-1953 to 00-00-1953 4. TITLE AND SUBTITLE Plans for Improvement of Navigation Conditions at Greenville...of plans to improve navigation conditions on the Mississippi River in the vicinity of the Greenville Bridge at Greenville, Mississ:l.ppi, was

SURVIVORSHIP NAVIGATION OUTCOME MEASURES: A report from the ACS Patient Navigation Working Group on Survivorship Navigation

PubMed Central

Pratt-Chapman, Mandi; Simon, Melissa A.; Patterson, Angela; Risendal, Betsy C.; Patierno, Steven

2013-01-01

Survivorship navigation is a relatively new concept in the field of patient navigation, but an important one. This paper highlights the essential functions of the survivorship navigator and defines core outcomes and measures for navigation in the survivorship period. Barriers to access to care experienced by patients during active cancer treatment can continue into the post-treatment period, affecting quality follow-up care for survivors. These barriers to care can be particularly acute for non-English speakers, immigrants, the uninsured, the underinsured and other vulnerable populations. The survivorship navigator can help reduce barriers and facilitate access to survivorship care and services through communication and information exchange for patients. Survivorship navigation may improve appropriate health care utilization through education and care coordination, potentially improving health outcomes and quality of life of survivors while reducing cost to the health care system. Survivorship navigators can also educate survivors on how to improve their overall wellness, thereby directly impacting the health of a growing population of cancer survivors. PMID:21780092

Simulator evaluation of optimal thrust management/fuel conservation strategies for airbus aircraft on short haul routes

NASA Technical Reports Server (NTRS)

Bochem, J. H.; Mossman, D. C.; Lanier, P. D.

1977-01-01

The feasibility of incorporating optimal concepts into a practical system was determined. Various earlier theoretical analyses were confirmed, and insight was gained into the sensitivity of fuel conservation strategies to nonlinear and second order aerodynamic and engine characteristics. In addition to the investigation of optimal trajectories the study ascertained combined fuel savings by utilizing various procedure-oriented improvements such as delayed flap/decelerating approaches and great circle navigation.

Electromagnetic Navigation Bronchoscopy-directed Pleural Tattoo to Aid Surgical Resection of Peripheral Pulmonary Lesions.

PubMed

Tay, Jun H; Wallbridge, Peter D; Larobina, Marco; Russell, Prudence A; Irving, Louis B; Steinfort, Daniel P

2016-07-01

Limited (wedge) resection of pulmonary lesions is frequently performed as a diagnostic/therapeutic procedure. Some lesions may be difficult to locate thoracoscopically with conversion to open thoracotomy or incomplete resection being potential limitations to this approach. Multiple methods have been described to aid video-assisted thoracoscopic surgical (VATS) wedge resection of pulmonary nodules, including hookwire localization, percutaneous tattoo, or intraoperative ultrasound. We report on our experience using electromagnetic navigation bronchoscopic dye marking of small subpleural lesions to aid VATS wedge resection. A retrospective cohort study of consecutive patients undergoing VATS wedge resection of peripheral lesions. Preoperative bronchoscopy with electromagnetic navigation was utilized to guide a 25 G needle to within/adjacent to the target lesion with injection of 1 mL of methylene blue or indigo carmine under fluoroscopic vision. Six patients underwent bronchoscopic marking of peripheral pulmonary lesions, navigation deemed successful in all patients, with no procedural complications. Surgery was performed within 24 hours of bronchoscopic marking. Pleural staining by dye was visible thoracoscopically in all 6 lesions either adjacent to or overlying the lesion. All lesions were fully excised with wedge resection. Pathologic examination confirmed accuracy of dye staining. Electromagnetic navigation bronchoscopic dye marking of peripheral lesions is feasible, without complications commonly associated with percutaneous marking procedures. Further experience is required but early findings suggest that this method may have utility in aiding minimally invasive resection of small subpleural lesions.

Real-time MRI guidance of cardiac interventions.

PubMed

Campbell-Washburn, Adrienne E; Tavallaei, Mohammad A; Pop, Mihaela; Grant, Elena K; Chubb, Henry; Rhode, Kawal; Wright, Graham A

2017-10-01

Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages. Rapid intraprocedural image analysis can extract and highlight critical information about interventional targets and outcomes. In some cases, real-time interactive imaging is used to provide a continuous stream of images displayed to interventionalists for dynamic device navigation. Alternatively, devices are navigated relative to a roadmap of major cardiac structures generated through fast segmentation and registration. Interventional devices can be visualized and tracked throughout a procedure with specialized imaging methods. In a clinical setting, advanced imaging must be integrated with other clinical tools and patient data. In order to perform these complex procedures, interventional cardiac MR relies on customized equipment, such as interactive imaging environments, in-room image display, audio communication, hemodynamic monitoring and recording systems, and electroanatomical mapping and ablation systems. Operating in this sophisticated environment requires coordination and planning. This review provides an overview of the imaging technology used in MRI-guided cardiac interventions. Specifically, this review outlines clinical targets, standard image acquisition and analysis tools, and the integration of these tools into clinical workflow. 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2017;46:935-950. © 2017 International Society for Magnetic Resonance in Medicine.

Combination acetabular radiofrequency ablation and cementoplasty using a navigational radiofrequency ablation device and ultrahigh viscosity cement: technical note.

PubMed

Wallace, Adam N; Huang, Ambrose J; Vaswani, Devin; Chang, Randy O; Jennings, Jack W

2016-03-01

Percutaneous radiofrequency ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance. The tumor ablation databases of two institutions were retrospectively reviewed to identify patients who underwent combination acetabular radiofrequency ablation and cementoplasty using the STAR Tumor Ablation and StabiliT Vertebral Augmentation Systems (DFINE; San Jose, CA). Pre-procedure acetabular tumor volume was measured on cross-sectional imaging. Pre- and post-procedure pain scores were measured using the Numeric Rating Scale (10-point scale) and compared. Partial pain improvement was categorically defined as ≥ 2-point pain score reduction. Patients were evaluated for evidence of immediate complications. Electronic medical records were reviewed for evidence of delayed complications. During the study period, 12 patients with acetabular metastases were treated. The median tumor volume was 54.3 mL (range, 28.3-109.8 mL). Pre- and post-procedure pain scores were obtained from 92% (11/12) of the cohort. The median pre-procedure pain score was 8 (range, 3-10). Post-procedure pain scores were obtained 7 days (82%; 9/11), 11 days (9.1%; 1/11) or 21 days (9.1%; 1/11) after treatment. The median post-treatment pain score was 3 (range, 1-8), a statistically significant difference compared with pre-treatment (P = 0.002). Categorically, 73% (8/11) of patients reported partial pain relief after treatment. No immediate symptomatic complications occurred. Three patients (25%; 3/12) were discharged to hospice within 1 week of treatment. No delayed complications occurred in the remaining 75% (9/12) of patients during median clinical follow-up of 62 days (range, 14-178 days). Palliative percutaneous acetabular radiofrequency ablation and cementoplasty can be feasibly performed from an anterior approach using a navigational ablation probe and ultrahigh viscosity cement instilled under CT-fluoroscopic guidance.

3D point cloud analysis of structured light registration in computer-assisted navigation in spinal surgeries

NASA Astrophysics Data System (ADS)

Gupta, Shaurya; Guha, Daipayan; Jakubovic, Raphael; Yang, Victor X. D.

2017-02-01

Computer-assisted navigation is used by surgeons in spine procedures to guide pedicle screws to improve placement accuracy and in some cases, to better visualize patient's underlying anatomy. Intraoperative registration is performed to establish a correlation between patient's anatomy and the pre/intra-operative image. Current algorithms rely on seeding points obtained directly from the exposed spinal surface to achieve clinically acceptable registration accuracy. Registration of these three dimensional surface point-clouds are prone to various systematic errors. The goal of this study was to evaluate the robustness of surgical navigation systems by looking at the relationship between the optical density of an acquired 3D point-cloud and the corresponding surgical navigation error. A retrospective review of a total of 48 registrations performed using an experimental structured light navigation system developed within our lab was conducted. For each registration, the number of points in the acquired point cloud was evaluated relative to whether the registration was acceptable, the corresponding system reported error and target registration error. It was demonstrated that the number of points in the point cloud neither correlates with the acceptance/rejection of a registration or the system reported error. However, a negative correlation was observed between the number of the points in the point-cloud and the corresponding sagittal angular error. Thus, system reported total registration points and accuracy are insufficient to gauge the accuracy of a navigation system and the operating surgeon must verify and validate registration based on anatomical landmarks prior to commencing surgery.

Initial clinical experience with cardiac resynchronization therapy utilizing a magnetic navigation system.

PubMed

Gallagher, Peter; Martin, Laura; Angel, Lori; Tomassoni, Gery

2007-02-01

The placement of left ventricular (LV) leads during cardiac resynchronization therapy (CRT) involves many technical difficulties. These difficulties increase procedural times and decrease procedural success rates. A total of 50 patients with severe cardiomyopathy (mean LV ejection fraction was 21 +/- 6%) and a wide QRS underwent CRT implantation. Magnetic navigation (Stereotaxis, Inc.) was used to position a magnet-tipped 0.014'' guidewire (Cronus guidewire) within the coronary sinus (CS) vasculature. LV leads were placed in a lateral CS branch, either using a standard CS delivery sheath or using a "bare-wire" approach without a CS delivery sheath. The mean total procedure time was 98.1 +/- 29.1 minutes with a mean fluoroscopy time of 22.7 +/- 15.1 minutes. The mean LV lead positioning time was 10.4 +/- 7.6 minutes. The use of a delivery sheath was associated with longer procedure times 98 +/- 32 minutes vs 80 +/- 18 minutes (P = 0.029), fluoroscopy times 23 +/- 15 minutes vs 13 +/- 4 minutes (P = 0.0007) and LV lead positioning times 10 +/- 6 minutes vs 4 +/- 2 minutes (P = 0.015) when compared to a "bare-wire" approach. When compared with 52 nonmagnetic-assisted control CRT cases, magnetic navigation reduced total LV lead positioning times (10.4 +/- 7.6 minutes vs 18.6 +/- 18.9 minutes; P = 0.005). If more than one CS branch vessel was tested, magnetic navigation was associated with significantly shorter times for LV lead placement (16.2 +/- 7.7 minutes vs 36.4 +/- 23.4 minutes; P = 0.004). Magnetic navigation is a safe, feasible, and efficient tool for lateral LV lead placement during CRT. Magnetic navigation during CRT allows for control of the tip direction of the Cronus 0.014'' guidewire using either a standard CS delivery sheath or "bare-wire" approach. Although there are some important limitations to the 0.014'' Cronus magnetic navigation can decrease LV lead placement times compared with nonmagnetic-assisted control CRT cases, particularly if multiple CS branches are to be tested.

Low-thrust solar electric propulsion navigation simulation program

NASA Technical Reports Server (NTRS)

Hagar, H. J.; Eller, T. J.

1973-01-01

An interplanetary low-thrust, solar electric propulsion mission simulation program suitable for navigation studies is presented. The mathematical models for trajectory simulation, error compensation, and tracking motion are described. The languages, input-output procedures, and subroutines are included.

Image fusion and navigation platforms for percutaneous image-guided interventions.

PubMed

Rajagopal, Manoj; Venkatesan, Aradhana M

2016-04-01

Image-guided interventional procedures, particularly image guided biopsy and ablation, serve an important role in the care of the oncology patient. The need for tumor genomic and proteomic profiling, early tumor response assessment and confirmation of early recurrence are common scenarios that may necessitate successful biopsies of targets, including those that are small, anatomically unfavorable or inconspicuous. As image-guided ablation is increasingly incorporated into interventional oncology practice, similar obstacles are posed for the ablation of technically challenging tumor targets. Navigation tools, including image fusion and device tracking, can enable abdominal interventionalists to more accurately target challenging biopsy and ablation targets. Image fusion technologies enable multimodality fusion and real-time co-displays of US, CT, MRI, and PET/CT data, with navigational technologies including electromagnetic tracking, robotic, cone beam CT, optical, and laser guidance of interventional devices. Image fusion and navigational platform technology is reviewed in this article, including the results of studies implementing their use for interventional procedures. Pre-clinical and clinical experiences to date suggest these technologies have the potential to reduce procedure risk, time, and radiation dose to both the patient and the operator, with a valuable role to play for complex image-guided interventions.

Knee stability before and after total and unicondylar knee replacement: in vivo kinematic evaluation utilizing navigation.

PubMed

Casino, Daniela; Martelli, Sandra; Zaffagnini, Stefano; Lopomo, Nicola; Iacono, Francesco; Bignozzi, Simone; Visani, Andrea; Marcacci, Maurilio

2009-02-01

Surgical navigation systems are currently used to guide the surgeon in the correct alignment of the implant. The aim of this study was to expand the use of navigation systems by proposing a surgical protocol for intraoperative kinematics evaluations during knee arthroplasty. The protocol was evaluated on 20 patients, half undergoing unicondylar knee arthroplasty (UKA) and half undergoing posterior-substituting, rotating-platform total knee arthroplasty (TKA). The protocol includes a simple acquisition procedure and an original elaboration methodology. Kinematic tests were performed before and after surgery and included varus/valgus stress at 0 and 30 degrees and passive range of motion. Both UKA and TKA improved varus/valgus stability in extension and preserved the total magnitude of screw-home motion during flexion. Moreover, compared to preoperative conditions, values assumed by tibial axial rotation during flexion in TKA knees were more similar to the rotating patterns of UKA knees. The analysis of the anteroposterior displacement of the knee compartments confirmed that the two prostheses did not produce medial pivoting, but achieved a postoperative normal behavior. These results demonstrated that proposed intraoperative kinematics evaluations by a navigation system provided new information on the functional outcome of the reconstruction useful to restore knee kinematics during surgery.

Robotic navigation and ablation.

PubMed

Malcolme-Lawes, L; Kanagaratnam, P

2010-12-01

Robotic technologies have been developed to allow optimal catheter stability and reproducible catheter movements with the aim of achieving contiguous and transmural lesion delivery. Two systems for remote navigation of catheters within the heart have been developed; the first is based on a magnetic navigation system (MNS) Niobe, Stereotaxis, Saint-Louis, Missouri, USA, the second is based on a steerable sheath system (Sensei, Hansen Medical, Mountain View, CA, USA). Both robotic and magnetic navigation systems have proven to be feasible for performing ablation of both simple and complex arrhythmias, particularly atrial fibrillation. Studies to date have shown similar success rates for AF ablation compared to that of manual ablation, with many groups finding a reduction in fluoroscopy times. However, the early learning curve of cases demonstrated longer procedure times, mainly due to additional setup times. With centres performing increasing numbers of robotic ablations and the introduction of a pressure monitoring system, lower power settings and instinctive driving software, complication rates are reducing, and fluoroscopy times have been lower than manual ablation in many studies. As the demand for catheter ablation for arrhythmias such as atrial fibrillation increases and the number of centres performing these ablations increases, the demand for systems which reduce the hand skill requirement and improve the comfort of the operator will also increase.

[Development of a Surgical Navigation System with Beam Split and Fusion of the Visible and Near-Infrared Fluorescence].

PubMed

Yang, Xiaofeng; Wu, Wei; Wang, Guoan

2015-04-01

This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI. 2011 1 0292374. 1.

Testing of the high accuracy inertial navigation system in the Shuttle Avionics Integration Lab

NASA Technical Reports Server (NTRS)

Strachan, Russell L.; Evans, James M.

1991-01-01

The description, results, and interpretation is presented of comparison testing between the High Accuracy Inertial Navigation System (HAINS) and KT-70 Inertial Measurement Unit (IMU). The objective was to show the HAINS can replace the KT-70 IMU in the space shuttle Orbiter, both singularly and totally. This testing was performed in the Guidance, Navigation, and Control Test Station (GTS) of the Shuttle Avionics Integration Lab (SAIL). A variety of differences between the two instruments are explained. Four, 5 day test sessions were conducted varying the number and slot position of the HAINS and KT-70 IMUs. The various steps in the calibration and alignment procedure are explained. Results and their interpretation are presented. The HAINS displayed a high level of performance accuracy previously unseen with the KT-70 IMU. The most significant improvement of the performance came in the Tuned Inertial/Extended Launch Hold tests. The HAINS exceeded the 4 hr specification requirement. The results obtained from the SAIL tests were generally well beyond the requirements of the procurement specification.

14 CFR Appendix A to Part 65 - Aircraft Dispatcher Courses

Code of Federal Regulations, 2014 CFR

2014-01-01

... school. For the latest technological advancements refer to the Practical Test Standards as published by.... Instrument Approach Procedures. (1) Transition Procedures. (2) Precision Approach Procedures. (3) Non-precision Approach Procedures. (4) Minimums and the relationship to weather. G. Special Navigation and...

14 CFR Appendix A to Part 65 - Aircraft Dispatcher Courses

Code of Federal Regulations, 2013 CFR

2013-01-01

... school. For the latest technological advancements refer to the Practical Test Standards as published by.... Instrument Approach Procedures. (1) Transition Procedures. (2) Precision Approach Procedures. (3) Non-precision Approach Procedures. (4) Minimums and the relationship to weather. G. Special Navigation and...

14 CFR Appendix A to Part 65 - Aircraft Dispatcher Courses

Code of Federal Regulations, 2010 CFR

2010-01-01

... school. For the latest technological advancements refer to the Practical Test Standards as published by.... Instrument Approach Procedures. (1) Transition Procedures. (2) Precision Approach Procedures. (3) Non-precision Approach Procedures. (4) Minimums and the relationship to weather. G. Special Navigation and...

14 CFR Appendix A to Part 65 - Aircraft Dispatcher Courses

Code of Federal Regulations, 2012 CFR

2012-01-01

... school. For the latest technological advancements refer to the Practical Test Standards as published by.... Instrument Approach Procedures. (1) Transition Procedures. (2) Precision Approach Procedures. (3) Non-precision Approach Procedures. (4) Minimums and the relationship to weather. G. Special Navigation and...

14 CFR Appendix A to Part 65 - Aircraft Dispatcher Courses

Code of Federal Regulations, 2011 CFR

2011-01-01

... school. For the latest technological advancements refer to the Practical Test Standards as published by.... Instrument Approach Procedures. (1) Transition Procedures. (2) Precision Approach Procedures. (3) Non-precision Approach Procedures. (4) Minimums and the relationship to weather. G. Special Navigation and...

Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods.

PubMed

Tang, Rui; Ma, Long-Fei; Rong, Zhi-Xia; Li, Mo-Dan; Zeng, Jian-Ping; Wang, Xue-Dong; Liao, Hong-En; Dong, Jia-Hong

2018-04-01

Augmented reality (AR) technology is used to reconstruct three-dimensional (3D) images of hepatic and biliary structures from computed tomography and magnetic resonance imaging data, and to superimpose the virtual images onto a view of the surgical field. In liver surgery, these superimposed virtual images help the surgeon to visualize intrahepatic structures and therefore, to operate precisely and to improve clinical outcomes. The keywords "augmented reality", "liver", "laparoscopic" and "hepatectomy" were used for searching publications in the PubMed database. The primary source of literatures was from peer-reviewed journals up to December 2016. Additional articles were identified by manual search of references found in the key articles. In general, AR technology mainly includes 3D reconstruction, display, registration as well as tracking techniques and has recently been adopted gradually for liver surgeries including laparoscopy and laparotomy with video-based AR assisted laparoscopic resection as the main technical application. By applying AR technology, blood vessels and tumor structures in the liver can be displayed during surgery, which permits precise navigation during complex surgical procedures. Liver transformation and registration errors during surgery were the main factors that limit the application of AR technology. With recent advances, AR technologies have the potential to improve hepatobiliary surgical procedures. However, additional clinical studies will be required to evaluate AR as a tool for reducing postoperative morbidity and mortality and for the improvement of long-term clinical outcomes. Future research is needed in the fusion of multiple imaging modalities, improving biomechanical liver modeling, and enhancing image data processing and tracking technologies to increase the accuracy of current AR methods. Copyright © 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 104.245 - Communications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Communications. 104.245 Section... MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.245 Communications. (a) The Vessel Security... board the vessel. (b) Communications systems and procedures must allow effective and continuous...

33 CFR 104.245 - Communications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Communications. 104.245 Section... MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.245 Communications. (a) The Vessel Security... board the vessel. (b) Communications systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 104.245 - Communications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Communications. 104.245 Section... MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.245 Communications. (a) The Vessel Security... board the vessel. (b) Communications systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 104.245 - Communications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Communications. 104.245 Section... MARITIME SECURITY: VESSELS Vessel Security Requirements § 104.245 Communications. (a) The Vessel Security... board the vessel. (b) Communications systems and procedures must allow effective and continuous...

32 CFR 761.15 - Aircraft: Individual authorizations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... NAVY JURISDICTION NAVAL DEFENSIVE SEA AREAS; NAVAL AIRSPACE RESERVATIONS, AREAS UNDER NAVY... authorizations. (a) Special procedures. In addition to the entry authorization to enter or navigate within the... special agreements or treaties. (b) Application; Form; Filing. Applications for authorization to navigate...

32 CFR 761.15 - Aircraft: Individual authorizations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... NAVY JURISDICTION NAVAL DEFENSIVE SEA AREAS; NAVAL AIRSPACE RESERVATIONS, AREAS UNDER NAVY... authorizations. (a) Special procedures. In addition to the entry authorization to enter or navigate within the... special agreements or treaties. (b) Application; Form; Filing. Applications for authorization to navigate...

32 CFR 761.15 - Aircraft: Individual authorizations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... NAVY JURISDICTION NAVAL DEFENSIVE SEA AREAS; NAVAL AIRSPACE RESERVATIONS, AREAS UNDER NAVY... authorizations. (a) Special procedures. In addition to the entry authorization to enter or navigate within the... special agreements or treaties. (b) Application; Form; Filing. Applications for authorization to navigate...

32 CFR 761.15 - Aircraft: Individual authorizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NAVY JURISDICTION NAVAL DEFENSIVE SEA AREAS; NAVAL AIRSPACE RESERVATIONS, AREAS UNDER NAVY... authorizations. (a) Special procedures. In addition to the entry authorization to enter or navigate within the... special agreements or treaties. (b) Application; Form; Filing. Applications for authorization to navigate...

32 CFR 761.15 - Aircraft: Individual authorizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... NAVY JURISDICTION NAVAL DEFENSIVE SEA AREAS; NAVAL AIRSPACE RESERVATIONS, AREAS UNDER NAVY... authorizations. (a) Special procedures. In addition to the entry authorization to enter or navigate within the... special agreements or treaties. (b) Application; Form; Filing. Applications for authorization to navigate...

Flight Mechanics/Estimation Theory Symposium

NASA Technical Reports Server (NTRS)

1978-01-01

Satellite attitude determination and control, orbit determination, and onboard and ground attitude determination procedures are among the topics discussed. Other topics covered include: effect of atmosphere on Venus orbiter navigation; satellite-to-satellite tracking; and satellite onboard navigation using global positioning system data.

Proof-of-concept of a laser mounted endoscope for touch-less navigated procedures

PubMed Central

Kral, Florian; Gueler, Oezguer; Perwoeg, Martina; Bardosi, Zoltan; Puschban, Elisabeth J; Riechelmann, Herbert; Freysinger, Wolfgang

2013-01-01

Background and Objectives During navigated procedures a tracked pointing device is used to define target structures in the patient to visualize its position in a registered radiologic data set. When working with endoscopes in minimal invasive procedures, the target region is often difficult to reach and changing instruments is disturbing in a challenging, crucial moment of the procedure. We developed a device for touch less navigation during navigated endoscopic procedures. Materials and Methods A laser beam is delivered to the tip of a tracked endoscope angled to its axis. Thereby the position of the laser spot in the video-endoscopic images changes according to the distance between the tip of the endoscope and the target structure. A mathematical function is defined by a calibration process and is used to calculate the distance between the tip of the endoscope and the target. The tracked tip of the endoscope and the calculated distance is used to visualize the laser spot in the registered radiologic data set. Results In comparison to the tracked instrument, the touch less target definition with the laser spot yielded in an over and above error of 0.12 mm. The overall application error in this experimental setup with a plastic head was 0.61 ± 0.97 mm (95% CI −1.3 to +2.5 mm). Conclusion Integrating a laser in an endoscope and then calculating the distance to a target structure by image processing of the video endoscopic images is accurate. This technology eliminates the need for tracked probes intraoperatively and therefore allows navigation to be integrated seamlessly in clinical routine. However, it is an additional chain link in the sequence of computer-assisted surgery thus influencing the application error. Lasers Surg. Med. 45:377–382, 2013. © 2013 Wiley Periodicals, Inc. PMID:23737122

Evaluating the cost-effectiveness of cancer patient navigation programs: conceptual and practical issues.

PubMed

Ramsey, Scott; Whitley, Elizabeth; Mears, Victoria Warren; McKoy, June M; Everhart, Rachel M; Caswell, Robert J; Fiscella, Kevin; Hurd, Thelma C; Battaglia, Tracy; Mandelblatt, Jeanne

2009-12-01

Patient navigators-individuals who assist patients through the healthcare system to improve access to and understanding of their health and healthcare-are increasingly used for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost-effective. In the current study, the authors outline a conceptual model for evaluating the cost-effectiveness of cancer navigation programs. They describe how this model is being applied to the Patient Navigation Research Program, a multicenter study supported by the National Cancer Institute's Center to Reduce Cancer Health Disparities. The Patient Navigation Research Program is testing navigation interventions that aim to reduce time to delivery of quality cancer care (noncancer resolution or cancer diagnosis and treatment) after identification of a screening abnormality. Examples of challenges to evaluating cost-effectiveness of navigation programs include the heterogeneity of navigation programs, the sometimes distant relation between navigation programs and outcome of interest (eg, improving access to prompt diagnostic resolution and life-years gained), and accounting for factors in underserved populations that may influence both access to services and outcomes. In this article, the authors discuss several strategies for addressing these barriers. Evaluating the costs and impact of navigation will require some novel methods, but will be critical in recommendations concerning dissemination of navigation programs. (c) 2009 American Cancer Society.

Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting.

PubMed

Gabitova, Guzyal; Burke, Nancy J

2014-09-19

Breast cancer mortality rates in the U.S. remain relatively high, particularly among ethnic minorities and low-income populations. Unequal access to quality care, lower follow up rates, and poor treatment adherence contribute to rising disparities among these groups. Healthcare empowerment (HCE) is theorized to improve patient outcomes through collaboration with providers and improving understanding of and compliance with treatment. Patient navigation is a health care organizational intervention that essentially improves healthcare empowerment by providing informational, emotional, and psychosocial support. Patient navigators address barriers to care through multilingual coordination of treatment and incorporation of access to community services, support, and education into the continuum of cancer care. Utilizing survey and qualitative methods, we evaluated the patient navigation program in a Northern California safety-net hospital Breast Clinic by assessing its impact on patients' experiences with cancer care and providers' perspectives on the program. We conducted qualitative interviews with 16 patients and 4 service providers, conducted approximately 66 hours of clinic observations, and received feedback through the self-administered survey from 66 patients. The role of the patient navigator at the Breast Clinic included providing administrative assistance, psychosocial support, improved knowledge, better understanding of treatment process, and ensuring better communication between patients and providers. As such, patient navigators facilitated improved collaboration between patients and providers and understanding of interdisciplinary care processes. The survey results suggested that the majority of patients across all ethnic backgrounds and age groups were highly satisfied with the program and had a positive perception of their navigator. Interviews with patients and providers highlighted the roles of a navigator in ensuring continuity of care, improving treatment completion rates, and reducing providers' workload and waiting time. Uncertainty about the navigator's role among the patients was a weakness of the program. Patient navigation in the Breast Clinic had a positive impact on patients' experiences with care and healthcare empowerment. Clarifying uncertainties about the navigators' role would aid successful outcomes.

14 CFR 91.1069 - Flight crew: Instrument proficiency check requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... procedures. The instrument approach procedure or procedures must include at least one straight-in approach... conducted to published minimums for that procedure. (d) The instrument proficiency checks required by... emergencies, and standard instrument approaches involving navigational facilities which that pilot is to be...

14 CFR 91.1069 - Flight crew: Instrument proficiency check requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... procedures. The instrument approach procedure or procedures must include at least one straight-in approach... conducted to published minimums for that procedure. (d) The instrument proficiency checks required by... emergencies, and standard instrument approaches involving navigational facilities which that pilot is to be...

Preservation of the Acetabular Cup During Revision Total Hip Arthroplasty Using a Novel Mini-navigation Tool: A Case Report.

PubMed

Vincent, John; Alshaygy, Ibrahim; Muir, Jeffrey M; Kuzyk, Paul

2018-01-01

While intraoperative navigation systems have been shown to improve outcomes in primary total hip arthroplasty (THA), their use in the context of revision has been largely overlooked. This case report presents the first documented use of an imageless navigation tool in the context of revision THA, and an unexpected benefit to the surgical procedure as a result. An 84-year-old female patient presented following five episodes of dislocation of the left hip and with pain in the left buttock, groin, and posterior aspect of her hip. Relevant surgical history included primary hip arthroplasty in 1999 and the first revision in 2014. Preoperative analysis revealed a constrained liner that had become disengaged and migrated inferiorly, lodging at the distal aspect of the femoral neck. Acetabular protrusion was also noted. The pre-operative plan included the replacement of the fragmented liner and likely of the acetabular cup due to hardware failure. Intraoperative assessment, however, revealed that the cup was in good condition and would be difficult to remove due to substantial bony ingrowth. With the assistance of imageless navigation, the orientation of the acetabular cup was determined and a new constrained liner was cemented into the preexisting acetabular component at an altered orientation, correcting anteversion by 7°. In revision hip arthroplasty cases, image-based navigation is limited by the presence of existing implants and corresponding metal artefact. This case demonstrates the successful use of an imageless navigation tool for revision surgery. Use of navigation led to the unexpected intraoperative discovery that the acetabular cup was in an acceptable state, and allowed the surgical team to correct the position of the cup using a constrained liner, thus preserving the cup. This significantly benefitted patient outcome, due to the risks associated with the removal of a firmly fixated acetabular cup. While more extensive research is required, this case demonstrates that imageless navigation may be an indispensable tool for revision surgery.

Magnetic navigation system for percutaneous coronary intervention

PubMed Central

Qi, Zhiyong; Wu, Bangwei; Luo, Xinping; Zhu, Jun; Shi, Haiming; Jin, Bo

2016-01-01

Abstract Background: Magnetic navigation system (MNS) allows calculation of the vessel coordinates in real space within the patient's chest for percutaneous coronary intervention (PCI). However, its impact on the procedural parameters and clinical outcomes is still a matter of debate. To derive a more precise estimation of the relationship, a meta-analysis was performed. Methods and Results: Studies exploring the advantages of MNS were identified in English-language articles by search of Medline, Web of Science, and Cochrane Library Databases (inception to October 2015). A standardized protocol was used to extract details on study design, region origin, demographic data, lesion type, and clinical outcomes. The main outcome measures were contrast consumption, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time fluoroscopy time. A total of 12 clinical trials involving 2174 patients were included for analysis (902 patients in the magnetic PCI group and 1272 in the conventional PCI group). Overall, contrast consumption was decreased by 40.45 mL (95% confidence interval [CI] −70.98 to −9.92, P = 0.009) in magnetic PCI group compared with control group. In addition, magnetic PCI was associated with significantly decreasing procedural time by 2.17 minutes (95% CI −3.91 to −0.44, P = 0.01) and the total fluoroscopy time was significantly decreased by 1.43 minutes (95% CI −2.29 to −0.57, P = 0.001) in magnetic PCI group. However, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time to cross the lesions demonstrated that no statistically difference was observed between 2 groups. Conclusion: The present meta-analysis indicated an improvement of overall contrast consumption, total procedural time, and fluoroscopy time in magnetic PCI group. However, no significant advantages were observed associated with procedural success rate. PMID:27442645

Magnetic navigation system for percutaneous coronary intervention: A meta-analysis.

PubMed

Qi, Zhiyong; Wu, Bangwei; Luo, Xinping; Zhu, Jun; Shi, Haiming; Jin, Bo

2016-07-01

Magnetic navigation system (MNS) allows calculation of the vessel coordinates in real space within the patient's chest for percutaneous coronary intervention (PCI). However, its impact on the procedural parameters and clinical outcomes is still a matter of debate. To derive a more precise estimation of the relationship, a meta-analysis was performed. Studies exploring the advantages of MNS were identified in English-language articles by search of Medline, Web of Science, and Cochrane Library Databases (inception to October 2015). A standardized protocol was used to extract details on study design, region origin, demographic data, lesion type, and clinical outcomes. The main outcome measures were contrast consumption, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time fluoroscopy time. A total of 12 clinical trials involving 2174 patients were included for analysis (902 patients in the magnetic PCI group and 1272 in the conventional PCI group). Overall, contrast consumption was decreased by 40.45 mL (95% confidence interval [CI] -70.98 to -9.92, P = 0.009) in magnetic PCI group compared with control group. In addition, magnetic PCI was associated with significantly decreasing procedural time by 2.17 minutes (95% CI -3.91 to -0.44, P = 0.01) and the total fluoroscopy time was significantly decreased by 1.43 minutes (95% CI -2.29 to -0.57, P = 0.001) in magnetic PCI group. However, procedural success rate, contrast used for wire crossing, procedure time to cross the lesions, and the fluoroscopy time to cross the lesions demonstrated that no statistically difference was observed between 2 groups. The present meta-analysis indicated an improvement of overall contrast consumption, total procedural time, and fluoroscopy time in magnetic PCI group. However, no significant advantages were observed associated with procedural success rate.

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

PubMed

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

2005-08-01

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

Evaluating a de-cluttering technique for NextGen RNAV and RNP charts

DOT National Transportation Integrated Search

2012-10-14

The authors propose a de-cluttering technique to simplify the depiction of visually complex Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures by reducing the number of paths shown on a single chart page. An experiment was co...

33 CFR 273.10 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.10 Purpose. This regulation prescribes policies, procedures and guidelines for research, planning and operations for the Aquatic Plant Control Program under authority of section 302 of...

33 CFR 273.10 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE AQUATIC PLANT CONTROL § 273.10 Purpose. This regulation prescribes policies, procedures and guidelines for research, planning and operations for the Aquatic Plant Control Program under authority of section 302 of...

[Surgical Correction of Scoliosis: Does Intraoperative CT Navigation Prolong Operative Time?

PubMed

Skála-Rosenbaum, J; Ježek, M; Džupa, V; Kadeřábek, R; Douša, P; Rusnák, R; Krbec, M

2016-01-01

PURPOSE OF THE STUDY The aim of the study was to compare the duration of corrective surgery for scoliosis in relation to the intra-operative use of either fluoroscopic or CT navigation. MATERIAL AND METHODS The indication for surgery was adolescent idiopathic scoliosis in younger patients and degenerative scoliosis in middleage or elderly patients. In a retrospective study, treatment outcomes in 43 consecutive patients operated on between April 2011 and April 2014 were compared. Only patients undergoing surgical correction of five or more spinal segments (fixation of six and more vertebrae) were included. RESULTS Transpedicular screw fixation of six to 13 vertebrae was performed under C-arm fluoroscopy guidance in 22 patients, and transpedicular screws were inserted in six to 14 vertebrae using the O-arm imaging system in 21 patients. A total of 246 screws were placed using the C-arm system and 340 screws were inserted using the O-arm system (p < 0.001). The procedures with use of the O-arm system were more complicated and required an average operative time longer by 48% (measured from the first skin incision to the completion of skin suture). However, the mean time needed for one screw placement (the sum of all surgical procedures with the use of a navigation technique divided by the number of screws placed using this technique) was the same in both techniques (19 min). DISCUSSION With good teamwork (surgeons, anaesthesiologists and a radiologist attending to the O-arm system), the time required to obtain one intra-operative CT scan is 3 to 5 minutes. The study showed that the mean time for placement of one screw was identical in both techniques although the average operative time was longer in surgery with O-arm navigation. The 19- minute interval was not the real placement time per screw. It was the sum of all operative times of surgical procedures (from first incision to suture completion including the whole approach within the range of planned stabilization) which used the same navigation technique divided by the number of all screws inserted during the procedures. The longer average operative time in procedures using O-arm navigation was not related to taking intra-operative O-arm scans. The authors consider surgery with an O-arm imaging system to be a safer procedure and use it currently in surgical correction of scoliosis. CONCLUSIONS The study focused on the length of surgery to correct scoliosis performed using either conventional fluoroscopy (C-arm) or intra-operative CT scanning (O-arm) showed that the mean placement time for one screw was identical in both imaging techniques when six or more vertebrae were stabilised. The use of intra-operative CT navigation did not make the surgery longer, and the higher number of inserted screws provides evidence that this technique is safer and allows us to achieve good stability of the correction procedure. Key words: virtual CT guidance, O-arm, scoliosis, transpedicular screw.

Use of a 3D Skull Model to Improve Accuracy in Cranioplasty for Autologous Flap Resorption in a 3-Year-Old Child.

PubMed

Maduri, Rodolfo; Viaroli, Edoardo; Levivier, Marc; Daniel, Roy T; Messerer, Mahmoud

2017-01-01

Cranioplasty is considered a simple reconstructive procedure, usually performed in a single stage. In some clinical conditions, such as in children with multifocal flap osteolysis, it could represent a surgical challenge. In these patients, the partially resorbed autologous flap should be removed and replaced with a precustomed prosthesis which should perfectly match the expected bone defect. We describe the technique used for a navigated cranioplasty in a 3-year-old child with multifocal autologous flap osteolysis. We decided to perform a cranioplasty using a custom-made hydroxyapatite porous ceramic flap. The prosthesis was produced with an epoxy resin 3D skull model of the patient, which included a removable flap corresponding to the planned cranioplasty. Preoperatively, a CT scan of the 3D skull model was performed without the removable flap. The CT scan images of the 3D skull model were merged with the preoperative 3D CT scan of the patient and navigated during the cranioplasty to define with precision the cranioplasty margins. After removal of the autologous resorbed flap, the hydroxyapatite prosthesis matched perfectly with the skull defect. The anatomical result was excellent. Thus, the implementation of cranioplasty with image merge navigation of a 3D skull model may improve cranioplasty accuracy, allowing precise anatomic reconstruction in complex skull defect cases. © 2017 S. Karger AG, Basel.

[Impact of digital technology on clinical practices: perspectives from surgery].

PubMed

Zhang, Y; Liu, X J

2016-04-09

Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Being integrated into clinical practice, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes.

47 CFR 80.331 - Bridge-to-bridge communication procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Bridge-to-bridge communication procedure. 80..., Alarm, Urgency and Safety Procedures § 80.331 Bridge-to-bridge communication procedure. (a) Vessels subject to the Bridge-to-Bridge Act transmitting on the designated navigational frequency must conduct...

Evaluation of a technique to simplify depictions of visually complex aeronautical procedures for NextGen

DOT National Transportation Integrated Search

2013-10-04

Performance based navigation supports the design of more precise flight procedures. However, these new procedures can be visually complex, which may impact the usability of charts that depict the procedures. The purpose of the study was to evaluate w...

47 CFR 80.331 - Bridge-to-bridge communication procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Bridge-to-bridge communication procedure. 80..., Alarm, Urgency and Safety Procedures § 80.331 Bridge-to-bridge communication procedure. (a) Vessels subject to the Bridge-to-Bridge Act transmitting on the designated navigational frequency must conduct...

Remote magnetic with open-irrigated catheter vs. manual navigation for ablation of atrial fibrillation: a systematic review and meta-analysis.

PubMed

Proietti, Riccardo; Pecoraro, Valentina; Di Biase, Luigi; Natale, Andrea; Santangeli, Pasquale; Viecca, Maurizio; Sagone, Antonio; Galli, Alessio; Moja, Lorenzo; Tagliabue, Ludovica

2013-09-01

The aim of this study was to determine the efficacy and safety of remote magnetic navigation (RMN) with open-irrigated catheter vs. manual catheter navigation (MCN) in performing atrial fibrillation (AF) ablation. We searched in PubMed (1948-2013) and EMBASE (1974-2013) studies comparing RMN with MCN. Outcomes considered were AF recurrence (primary outcome), pulmonary vein isolation (PVI), procedural complications, and data on procedure's performance. Odds ratios (OR) and mean difference (MD) were extracted and pooled using a random-effect model. Confidence in the estimates of the obtained effects (quality of evidence) was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. We identified seven controlled trials, six non-randomized and one randomized, including a total of 941 patients. Studies were at high risk of bias. No difference was observed between RMN and MCN on AF recurrence [OR 1.18, 95% confidence interval (CI) 0.85 to 1.65, P = 0.32] or PVI (OR 0.41, 95% CI 0.11-1.47, P = 0.17). Remote magnetic navigation was associated with less peri-procedural complications (Peto OR 0.41, 95% CI 0.19-0.88, P = 0.02). Mean fluoroscopy time was reduced in RMN group (-22.22 min; 95% CI -42.48 to -1.96, P = 0.03), although the overall duration of the procedure was longer (60.91 min; 95% CI 31.17 to 90.65, P < 0.0001). In conclusion, RMN is not superior to MCN in achieving freedom from recurrent AF at mid-term follow-up or PVI. The procedure implies less peri-procedural complications, requires a shorter fluoroscopy time but a longer total procedural time. For the low quality of the available evidence, a proper designed randomized controlled trial could turn the direction and the effect of the dimensions explored.

Technician-free system for image-guided bronchoscopy

NASA Astrophysics Data System (ADS)

Khare, Rahul; Bascom, Rebecca; Higgins, William E.

2013-03-01

Previous studies have shown that guidance systems improve accuracy and reduce skill variation among physicians during bronchoscopy. However, most of these systems suffer from one or more of the following limitations: 1) an attending technician must carefully keep the system position synchronized with the bronchoscope position during the procedure; 2) extra bronchoscope tracking hardware may be required; 3) guidance cannot take place in real time; 4) the guidance system is unable to detect and correct faulty bronchoscope maneuvers; and 5) a resynchronization procedure must be followed after adverse events such as patient cough or dynamic airway collapse. Here, we propose an image-based system for technician-free bronchoscopy guidance that relies on two features. First, our system precomputes a guidance plan that suggests natural bronchoscope maneuvers at every bifurcation leading toward a region of interest (ROI). Second, our system enables bronchoscope position verification that relies on a global-registration algorithm to establish the global bronchoscope position and, thus, provide the physician with updated navigational information during bronchoscopy. The system can handle general navigation to an ROI, as well as adverse events, and is directly controlled by the physician by a foot pedal. Guided bronchoscopy results using airway-tree phantoms and human cases demonstrate the efficacy of the system.

Ground Taxi Navigation Problems and Training Solutions

NASA Technical Reports Server (NTRS)

Quinn, Cheryl; Walter, Kim E.; Rosekind, Mark (Technical Monitor)

1997-01-01

Adverse weather conditions can put considerable strain on the National Airspace System. Even small decreases in visibility on the airport surface can create delays, hinder safe movement and lead to errors. Studies of Aviation Safety Reporting System (ASRS) surface movement incidents support the need for technologies and procedures to improve ground operations in low-visibility conditions. This study examined 139 ASRS reports of low-visibility surface movement incidents at 10 major U.S. airports. Errors were characterized in terms of incident type, contributing factors and consequences. The incidents in the present sample were comprised of runway transgressions, taxiway excursions and ground conflicts. The primary contributing factors were Airport Layout and Markings, Communication and Distraction. In half the incidents the controller issued a new clearance or the flight crew took an evasive action and in the remaining half, no recovery attempt was made because the error was detected after the fact. By gaining a better understanding the factors that affect crew navigation in low visibility and the types of errors that are likely to occur, it will be possible to develop more robust technologies to aid pilots in the ground taxi task. Implications for crew training and procedure development for low-visibility ground taxi are also discussed.

Clinical applications of virtual navigation bronchial intervention.

PubMed

Kajiwara, Naohiro; Maehara, Sachio; Maeda, Junichi; Hagiwara, Masaru; Okano, Tetsuya; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

2018-01-01

In patients with bronchial tumors, we frequently consider endoscopic treatment as the first treatment of choice. All computed tomography (CT) must satisfy several conditions necessary to analyze images by Synapse Vincent. To select safer and more precise approaches for patients with bronchial tumors, we determined the indications and efficacy of virtual navigation intervention for the treatment of bronchial tumors. We examined the efficacy of virtual navigation bronchial intervention for the treatment of bronchial tumors located at a variety of sites in the tracheobronchial tree using a high-speed 3-dimensional (3D) image analysis system, Synapse Vincent. Constructed images can be utilized to decide on the simulation and interventional strategy as well as for navigation during interventional manipulation in two cases. Synapse Vincent was used to determine the optimal planning of virtual navigation bronchial intervention. Moreover, this system can detect tumor location and alsodepict surrounding tissues, quickly, accurately, and safely. The feasibility and safety of Synapse Vincent in performing useful preoperative simulation and navigation of surgical procedures can lead to safer, more precise, and less invasion for the patient, and makes it easy to construct an image, depending on the purpose, in 5-10 minutes using Synapse Vincent. Moreover, if the lesion is in the parenchyma or sub-bronchial lumen, it helps to perform simulation with virtual skeletal subtraction to estimate potential lesion movement. By using virtual navigation system for simulation, bronchial intervention was performed with no complications safely and precisely. Preoperative simulation using virtual navigation bronchial intervention reduces the surgeon's stress levels, particularly when highly skilled techniques are needed to operate on lesions. This task, including both preoperative simulation and intraoperative navigation, leads to greater safety and precision. These technological instruments are helpful for bronchial intervention procedures, and are also excellent devices for educational training.

An interactive videogame designed to improve respiratory navigator efficiency in children undergoing cardiovascular magnetic resonance.

PubMed

Hamlet, Sean M; Haggerty, Christopher M; Suever, Jonathan D; Wehner, Gregory J; Grabau, Jonathan D; Andres, Kristin N; Vandsburger, Moriel H; Powell, David K; Sorrell, Vincent L; Fornwalt, Brandon K

2016-09-06

Advanced cardiovascular magnetic resonance (CMR) acquisitions often require long scan durations that necessitate respiratory navigator gating. The tradeoff of navigator gating is reduced scan efficiency, particularly when the patient's breathing patterns are inconsistent, as is commonly seen in children. We hypothesized that engaging pediatric participants with a navigator-controlled videogame to help control breathing patterns would improve navigator efficiency and maintain image quality. We developed custom software that processed the Siemens respiratory navigator image in real-time during CMR and represented diaphragm position using a cartoon avatar, which was projected to the participant in the scanner as visual feedback. The game incentivized children to breathe such that the avatar was positioned within the navigator acceptance window (±3 mm) throughout image acquisition. Using a 3T Siemens Tim Trio, 50 children (Age: 14 ± 3 years, 48 % female) with no significant past medical history underwent a respiratory navigator-gated 2D spiral cine displacement encoding with stimulated echoes (DENSE) CMR acquisition first with no feedback (NF) and then with the feedback game (FG). Thirty of the 50 children were randomized to undergo extensive off-scanner training with the FG using a MRI simulator, or no off-scanner training. Navigator efficiency, signal-to-noise ratio (SNR), and global left-ventricular strains were determined for each participant and compared. Using the FG improved average navigator efficiency from 33 ± 15 to 58 ± 13 % (p < 0.001) and improved SNR by 5 % (p = 0.01) compared to acquisitions with NF. There was no difference in navigator efficiency (p = 0.90) or SNR (p = 0.77) between untrained and trained participants for FG acquisitions. Circumferential and radial strains derived from FG acquisitions were slightly reduced compared to NF acquisitions (-16 ± 2 % vs -17 ± 2 %, p < 0.001; 40 ± 10 % vs 44 ± 11 %, p = 0.005, respectively). There were no differences in longitudinal strain (p = 0.38). Use of a respiratory navigator feedback game during navigator-gated CMR improved navigator efficiency in children from 33 to 58 %. This improved efficiency was associated with a 5 % increase in SNR for spiral cine DENSE. Extensive off-scanner training was not required to achieve the improvement in navigator efficiency.

Comparison Perioperative Factors During Minimally Invasive Pre-Psoas Lateral Interbody Fusion of the Lumbar Spine Using Either Navigation or Conventional Fluoroscopy

PubMed Central

Zhang, Yue-Hui; White, Ian; Potts, Eric; Mobasser, Jean-Pierre

2017-01-01

Study Design: Retrospective clinical study. Objectives: The aim of this study was to compare intraoperative conditions and clinical results of patients undergoing pre-psoas oblique lateral interbody fusion (OLIF) using navigation or conventional fluoroscopy (C-ARM) techniques. Methods: Forty-two patients (22 patients by navigation and 20 by fluoroscopy) underwent the OLIF procedure at 2 medical centers, and records were reviewed. Clinical data was collected and compared between the 2 groups. Patients were followed-up with a range of 6 to 24 months. Results: There were no significant differences on demographic data between groups. The navigation group had zero radiation exposure (RE) to the surgeon and radiation time compared to the C-ARM group, with total RE of 44.59 ± 26.65 mGy and radiation time of 88.30 ± 58.28 seconds (P < .05). The RE to the patient was significantly lower in the O-ARM group (9.38 mGy) compared to the C-ARM group (44.59 ± 26.65 mGy). Operating room time was slightly longer in the navigation group (2.49 ± 1.35 hours) compared to the C-ARM group (2.30 ± 1.17 hours; P > .05), although not statistically significant. No differences were found in estimated blood loss, length of hospitalization, surgery-related complications, and outcome scores with an average of 8-month follow-up. Conclusions: Compared with C-ARM techniques, using navigation can eliminate RE to surgeon and decrease RE to the patient, and it had no significant effect on operating time, estimated blood loss, length of hospitalization, or perioperative complications in the patients with OLIF procedure. This study shows that navigation is a safe alternative to fluoroscopy during the OLIF procedure in the treatment of degenerative lumbar conditions. PMID:28989845

Implementation of a Socio-Ecological System Navigation Approach to Human Development in Sub-Saharan African Communities

PubMed Central

Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R.; Baumgärtner, Johann

2014-01-01

This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management. Significance for public health Recently, there is a growing interest in studying the link between human, animal and environmental health. The connection between these different dimensions is particularly important for developing countries in which people face the challenge of escaping vicious cycle of high diseases prevalence, food insecurity driven by absolute poverty and population growth, and natural capital as a poverty trap. The design and implementation of such efforts, aiming at human health improvement and poverty alleviation, should be framed into adaptive social-ecological system management perspectives. In this paper, we present few case studies dealing with human health improvement through anopheline malaria vectors control in Kenya, cattle health improvement through tsetse vectored nagana control, antitrypanosomal drug administration to cattle in Ethiopia and with the development of rural sustainable communities in Ethiopia. Some recommendations are given to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability. PMID:25170511

Implementation of a socio-ecological system navigation approach to human development in sub-saharan african communities.

PubMed

Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R; Baumgärtner, Johann

2014-03-26

This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management. Significance for public healthRecently, there is a growing interest in studying the link between human, animal and environmental health. The connection between these different dimensions is particularly important for developing countries in which people face the challenge of escaping vicious cycle of high diseases prevalence, food insecurity driven by absolute poverty and population growth, and natural capital as a poverty trap. The design and implementation of such efforts, aiming at human health improvement and poverty alleviation, should be framed into adaptive social-ecological system management perspectives. In this paper, we present few case studies dealing with human health improvement through anopheline malaria vectors control in Kenya, cattle health improvement through tsetse vectored nagana control, antitrypanosomal drug administration to cattle in Ethiopia and with the development of rural sustainable communities in Ethiopia. Some recommendations are given to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability.

Time Demand and Radiation Dose in 3D-Fluoroscopy-based Navigation-assisted 3D-Fluoroscopy-controlled Pedicle Screw Instrumentations.

PubMed

Balling, Horst

2018-05-01

Prospective single-center cohort study to record additional time requirements and radiation dose in navigation-assisted O-arm-controlled pedicle screw (PS) instrumentations. The aim of this study was to evaluate amount of extra-time and radiation dose for navigation-assisted PS instrumentations of the thoracolumbosacral spine using O-arm 3D-real-time-navigation (O3DN) compared to non-navigated spinal procedures (NNSPs) with a single C-arm and postoperative computed tomography (CT) scan for controlling PS positions. 3D-navigation is reported to enhance PS insertion accuracy. But time-consuming navigational steps and considerable additional radiation doses seem to limit this modern technique's attraction. A detailed analysis of additional time demand and extra-radiation dose in 3D-navigated spine surgery is not provided in literature, yet. From February 2011 through July 2015, 306 consecutive posterior instrumentations were performed in vertebral levels T10-S1 using O3DN for PS insertion. The duration of procedure-specific navigational steps of the overall collective (I) and the last cohort of 50 consecutive O3DN-surgeries (II) was compared to the average duration of analogous surgical steps in 100 consecutive NNSP using a single C-arm. 3D-radiation dose (dose-length-product, DLP) of navigational and postinstrumentation O-arm scans in group I and II was compared to the average DLP of 100 diagnostic lumbar CT scans. The average presurgical time from patient positioning on the operating table to skin incision was 46.2 ± 10.1 minutes (O3DN, I) and 40.6 ± 9.8 minutes (O3DN, II) versus 30.6 ± 8.3 minutes (NNSP) (P < 0.001, each). Intraoperative interruptions for scanning and data processing took 3.0 ± 0.6 minutes. DLPs averaged 865.1 ± 360.8 mGycm (O3DN, I) and 562.1 ± 352.6 mGycm (O3DN, II) compared to 575.5 ± 316.5 mGycm in diagnostic lumbar CT scans (P < 0.001 (I), P ≈ 0.81 [II]). After procedural experience, navigated surgeries can be performed with an additional time demand of 13.0 minutes compared to NNSP, and with a total DLP below that of a diagnostic lumbar CT scan (P ≈ 0.81). 4.

Texas ports and navigation districts : overview.

DOT National Transportation Integrated Search

2017-01-01

The first Navigation District was established in 1909, and there are now 24 Navigation Districts statewide.1 Navigation districts generally provide for the construction and improvement of waterways in Texas for the purpose of navigation. The creation...

33 CFR 335.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE OPERATION AND MAINTENANCE OF ARMY CORPS OF ENGINEERS CIVIL WORKS PROJECTS INVOLVING THE DISCHARGE OF DREDGED OR... practices and procedures to be followed by the Corps of Engineers to ensure compliance with the specific...

33 CFR 156.107 - Alternatives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Alternatives. 156.107 Section 156....107 Alternatives. (a) The COTP may consider and approve alternative procedures, methods, or equipment... operator submits a written request for the alternative at least 30 days before operations under the...

33 CFR 127.017 - Alternatives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Alternatives. 127.017 Section 127... General § 127.017 Alternatives. (a) The COTP may allow alternative procedures, methods, or equipment... written request for the alternative at least 30 days before facility operations under the alternative...

33 CFR 148.715 - How is an environmental review conducted?

Code of Federal Regulations, 2010 CFR

2010-07-01

... quality of assessment, probable environmental impacts, and identification of procedures or technology that... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false How is an environmental review... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: GENERAL Environmental Review Criteria for Deepwater...

33 CFR 104.305 - Vessel Security Assessment (VSA) requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... security; (ii) Structural integrity; (iii) Personnel protection systems; (iv) Procedural policies; (v... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Vessel Security Assessment (VSA... SECURITY MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Assessment (VSA) § 104.305 Vessel...

33 CFR 104.305 - Vessel Security Assessment (VSA) requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... security; (ii) Structural integrity; (iii) Personnel protection systems; (iv) Procedural policies; (v... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Vessel Security Assessment (VSA... SECURITY MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Assessment (VSA) § 104.305 Vessel...

33 CFR 104.305 - Vessel Security Assessment (VSA) requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... security; (ii) Structural integrity; (iii) Personnel protection systems; (iv) Procedural policies; (v... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Vessel Security Assessment (VSA... SECURITY MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Assessment (VSA) § 104.305 Vessel...

33 CFR 104.305 - Vessel Security Assessment (VSA) requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... security; (ii) Structural integrity; (iii) Personnel protection systems; (iv) Procedural policies; (v... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Vessel Security Assessment (VSA... SECURITY MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Assessment (VSA) § 104.305 Vessel...

33 CFR 104.305 - Vessel Security Assessment (VSA) requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... security; (ii) Structural integrity; (iii) Personnel protection systems; (iv) Procedural policies; (v... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Vessel Security Assessment (VSA... SECURITY MARITIME SECURITY MARITIME SECURITY: VESSELS Vessel Security Assessment (VSA) § 104.305 Vessel...

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

PubMed

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

2015-09-01

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

Intermuscular pterygoid-temporal abscess following inferior alveolar nerve block anesthesia–A computer tomography based navigated surgical intervention: Case report and review

PubMed Central

Wallner, Jürgen; Reinbacher, Knut Ernst; Pau, Mauro; Feichtinger, Matthias

2014-01-01

Inferior alveolar nerve block (IANB) anesthesia is a common local anesthetic procedure. Although IANB anesthesia is known for its safety, complications can still occur. Today immediately or delayed occurring disorders following IANB anesthesia and their treatment are well-recognized. We present a case of a patient who developed a symptomatic abscess in the pterygoid region as a result of several inferior alveolar nerve injections. Clinical symptoms included diffuse pain, reduced mouth opening and jaw's hypomobility and were persistent under a first step conservative treatment. Since image-based navigated interventions have gained in importance and are used for various procedures a navigated surgical intervention was initiated as a second step therapy. Thus precise, atraumatic surgical intervention was performed by an optical tracking system in a difficult anatomical region. A symptomatic abscess was treated by a computed tomography-based navigated surgical intervention at our department. Advantages and disadvantages of this treatment strategy are evaluated. PMID:24987612

Intermuscular pterygoid-temporal abscess following inferior alveolar nerve block anesthesia-A computer tomography based navigated surgical intervention: Case report and review.

PubMed

Wallner, Jürgen; Reinbacher, Knut Ernst; Pau, Mauro; Feichtinger, Matthias

2014-01-01

Inferior alveolar nerve block (IANB) anesthesia is a common local anesthetic procedure. Although IANB anesthesia is known for its safety, complications can still occur. Today immediately or delayed occurring disorders following IANB anesthesia and their treatment are well-recognized. We present a case of a patient who developed a symptomatic abscess in the pterygoid region as a result of several inferior alveolar nerve injections. Clinical symptoms included diffuse pain, reduced mouth opening and jaw's hypomobility and were persistent under a first step conservative treatment. Since image-based navigated interventions have gained in importance and are used for various procedures a navigated surgical intervention was initiated as a second step therapy. Thus precise, atraumatic surgical intervention was performed by an optical tracking system in a difficult anatomical region. A symptomatic abscess was treated by a computed tomography-based navigated surgical intervention at our department. Advantages and disadvantages of this treatment strategy are evaluated.

Next generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system.

PubMed

Hoffmann, Michael; Schröder, Malte; Lehmann, Wolfgang; Kammal, Michael; Rueger, Johannes Maria; Herrman Ruecker, Andreas

2012-07-01

Distal locking marks one challenging step during intramedullary nailing that can lead to an increased irradiation and prolonged operation times. The aim of this study was to evaluate the reliability and efficacy of an X-ray-radiation-free real-time navigation system for distal locking procedures. A prospective randomized cadaver study with 50 standard free-hand fluoroscopic-guided and 50 electromagnetic-guided distal locking procedures was performed. All procedures were timed using a stopwatch. Intraoperative fluoroscopy exposure time and absorbed radiation dose (mGy) readings were documented. All tibial nails were locked with two mediolateral and one anteroposterior screw. Successful distal locking was accomplished once correct placement of all three screws was confirmed. Successful distal locking was achieved in 98 cases. No complications were encountered using the electromagnetic navigation system. Eight complications arose during free-hand fluoroscopic distal locking. Undetected secondary drill slippage on the ipsilateral cortex accounted for most problems followed by undetected intradrilling misdirection causing a fissural fracture of the contralateral cortex while screw insertion in one case. Compared with the free-hand fluoroscopic technique, electromagnetically navigated distal locking provides a median time benefit of 244 seconds without using ionizing radiation. Compared with the standard free-hand fluoroscopic technique, the electromagnetic guidance system used in this study showed high reliability and was associated with less complications, took significantly less time, and used no radiation exposure for distal locking procedures. Therapeutic study, level II.

Electromagnetic Real Time Navigation in the Region of the Posterior Pelvic Ring: An Experimental In-Vitro Feasibility Study and Comparison of Image Guided Techniques.

PubMed

Pishnamaz, Miguel; Wilkmann, Christoph; Na, Hong-Sik; Pfeffer, Jochen; Hänisch, Christoph; Janssen, Max; Bruners, Philipp; Kobbe, Philipp; Hildebrand, Frank; Schmitz-Rode, Thomas; Pape, Hans-Christoph

2016-01-01

Electromagnetic tracking is a relatively new technique that allows real time navigation in the absence of radiation. The aim of this study was to prove the feasibility of this technique for the treatment of posterior pelvic ring fractures and to compare the results with established image guided procedures. Tests were performed in pelvic specimens (Sawbones®) with standardized sacral fractures (Type Denis I or II). A gel matrix simulated the operative approach and a cover was used to disable visual control. The electromagnetic setup was performed by using a custom made carbon reference plate and a prototype stainless steel K-wire with an integrated sensor coil. Four different test series were performed: Group OCT: Optical navigation using preoperative CT-scans; group O3D: Optical navigation using intraoperative 3-D-fluoroscopy; group Fluoro: Conventional 2-D-fluoroscopy; group EMT: Electromagnetic navigation combined with a preoperative Dyna-CT. Accuracy of screw placement was analyzed by standardized postoperative CT-scan for each specimen. Operation time and intraoperative radiation exposure for the surgeon was documented. All data was analyzed using SPSS (Version 20, 76 Chicago, IL, USA). Statistical significance was defined as p< 0.05. 160 iliosacral screws were placed (40 per group). EMT resulted in a significantly higher incidence of optimal screw placement (EMT: 36/40) compared to the groups Fluoro (30/40; p< 0.05) and OCT (31/40; p< 0.05). Results between EMT and O3D were comparable (O3D: 37/40; n.s.). Also, the operation time was comparable between groups EMT and O3D (EMT 7.62 min vs. O3D 7.98 min; n.s.), while the surgical time was significantly shorter compared to the Fluoro group (10.69 min; p< 0.001) and the OCT group (13.3 min; p< 0.001). Electromagnetic guided iliosacral screw placement is a feasible procedure. In our experimental setup, this method was associated with improved accuracy of screw placement and shorter operation time when compared with the conventional fluoroscopy guided technique and compared to the optical navigation using preoperative CT-scans. Further studies are necessary to rule out drawbacks of this technique regarding ferromagnetic objects.

Efficiency improvement by navigated safety inspection involving visual clutter based on the random search model.

PubMed

Sun, Xinlu; Chong, Heap-Yih; Liao, Pin-Chao

2018-06-25

Navigated inspection seeks to improve hazard identification (HI) accuracy. With tight inspection schedule, HI also requires efficiency. However, lacking quantification of HI efficiency, navigated inspection strategies cannot be comprehensively assessed. This work aims to determine inspection efficiency in navigated safety inspection, controlling for the HI accuracy. Based on a cognitive method of the random search model (RSM), an experiment was conducted to observe the HI efficiency in navigation, for a variety of visual clutter (VC) scenarios, while using eye-tracking devices to record the search process and analyze the search performance. The results show that the RSM is an appropriate instrument, and VC serves as a hazard classifier for navigation inspection in improving inspection efficiency. This suggests a new and effective solution for addressing the low accuracy and efficiency of manual inspection through navigated inspection involving VC and the RSM. It also provides insights into the inspectors' safety inspection ability.

14 CFR 125.287 - Initial and recurrent pilot testing requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS... air navigation aids appropriate to the operation of pilot authorization, including, when applicable, instrument approach facilities and procedures; (5) Air traffic control procedures, including IFR procedures...

An evaluation of the cost-effectiveness of policy navigators to improve access to care for the poor in the Philippines.

PubMed

Solon, Orville; Peabody, John W; Woo, Kimberly; Quimbo, Stella A; Florentino, Jhiedon; Shimkhada, Riti

2009-09-01

Even when health insurance coverage is available, health policies may not be effective at increasing coverage among vulnerable populations. New approaches are needed to improve access to care. We experimentally introduced a novel intervention that uses Policy Navigators to increase health insurance enrollment in a poor population. We used data from the Quality Improvement Demonstration Study (QIDS), a randomized experiment taking place at the district level in the Visayas region of the Philippines. In two arms of the study, we compared the effects of introducing Policy Navigators to controls. The Policy Navigators advocated for improved access to care by providing regular system-level expertise directly to the policy-makers, municipal mayors and governors responsible for paying for and enrolling poor households into the health insurance program. Using regression models, we compared levels of enrollment in our intervention versus control sites. We also assessed the cost-effectiveness of marginal increases in enrollment. We found that Policy Navigators improved enrollment in health insurance between 39% and 102% compared to the controls. Policy navigators were cost-effective at 0.86 USD per enrollee. However, supplementary national government campaigns, which were implemented to further increase coverage, attenuated normal enrollment efforts. Policy Navigators appear to be effective in improving access to care and their success underscores the importance of local-level strategies for improving enrollment.

An Evaluation of the Cost-effectiveness of Policy Navigators to Improve Access to Care for the Poor in the Philippines

PubMed Central

Solon, Orville; Peabody, John W.; Woo, Kimberly; Quimbo, Stella A.; Florentino, Jhiedon; Shimkhada, Riti

2009-01-01

Objectives Even when health insurance coverage is available, health policies may not be effective at increasing coverage among vulnerable populations. New approaches are needed to improve access to care. We experimentally introduced a novel intervention that uses Policy Navigators to increase health insurance enrollment in a poor population. Methods We used data from the Quality Improvement Demonstration Study (QIDS), a randomized experiment taking place at the district level in the Visayas region of the Philippines. In two arms of the study, we compared the effects of introducing Policy Navigators to controls. The Policy Navigators advocated for improved access to care by providing regular system-level expertise directly to the policy-makers, municipal mayors and governors responsible for paying for and enrolling poor households into the health insurance program. Using regression models, we compared levels of enrollment in our intervention versus control sites. We also assessed the cost effectiveness of marginal increases in enrollment. Results We found that Policy Navigators improved enrollment in health insurance between 39 and 102% compared to the controls. Policy navigators were cost-effective at $0.86 USD per enrollee. However, supplementary national government campaigns, which were implemented to further increase coverage, attenuated normal enrollment efforts. Conclusion Policy Navigators appear to be effective in improving access to care and their success underscores the importance of local-level strategies for improving enrollment. PMID:19349090

Image-guided laparoscopic surgery in an open MRI operating theater.

PubMed

Tsutsumi, Norifumi; Tomikawa, Morimasa; Uemura, Munenori; Akahoshi, Tomohiko; Nagao, Yoshihiro; Konishi, Kozo; Ieiri, Satoshi; Hong, Jaesung; Maehara, Yoshihiko; Hashizume, Makoto

2013-06-01

The recent development of open magnetic resonance imaging (MRI) has provided an opportunity for the next stage of image-guided surgical and interventional procedures. The purpose of this study was to evaluate the feasibility of laparoscopic surgery under the pneumoperitoneum with the system of an open MRI operating theater. Five patients underwent laparoscopic surgery with a real-time augmented reality navigation system that we previously developed in a horizontal-type 0.4-T open MRI operating theater. All procedures were performed in an open MRI operating theater. During the operations, the laparoscopic monitor clearly showed the augmented reality models of the intraperitoneal structures, such as the common bile ducts and the urinary bladder, as well as the proper positions of the prosthesis. The navigation frame rate was 8 frames per min. The mean fiducial registration error was 6.88 ± 6.18 mm in navigated cases. We were able to use magnetic resonance-incompatible surgical instruments out of the 5-Gs restriction area, as well as conventional laparoscopic surgery, and we developed a real-time augmented reality navigation system using open MRI. Laparoscopic surgery with our real-time augmented reality navigation system in the open MRI operating theater is a feasible option.

77 FR 37305 - Navigation and Navigable Waters; Technical, Organizational, and Conforming Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

...: Coast Guard, DHS. ACTION: Final rule. SUMMARY: This rule makes non-substantive changes throughout title... substantive effect on the regulated public. These changes are provided to coincide with the annual... comment rulemaking requirements because these changes involve rules of agency organization, procedure, or...

33 CFR 155.785 - Communications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Communications. 155.785 Section..., Procedures, Equipment, and Records § 155.785 Communications. (a) During vessel to vessel transfers, each tank... have a means that enables continuous two-way voice communication between the persons in charge of the...

33 CFR 155.785 - Communications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Communications. 155.785 Section..., Procedures, Equipment, and Records § 155.785 Communications. (a) During vessel to vessel transfers, each tank... have a means that enables continuous two-way voice communication between the persons in charge of the...

33 CFR 203.49 - Rehabilitation of Hurricane and Shore Protection Projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Shore Protection Projects. 203.49 Section 203.49 Navigation and Navigable Waters CORPS OF ENGINEERS... DISASTER PROCEDURES Rehabilitation Assistance for Flood Control Works Damaged by Flood or Coastal Storm... Protection Projects. (a) Authority. The Chief of Engineers is authorized to rehabilitate any Federally...

33 CFR 239.4 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Policy. 239.4 Section 239.4... RESOURCES POLICIES AND AUTHORITIES: FEDERAL PARTICIPATION IN COVERED FLOOD CONTROL CHANNELS § 239.4 Policy. Projects will be formulated and evaluated in accordance with the policies and procedures described in ER...

33 CFR 154.107 - Alternatives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Alternatives. 154.107 Section 154... FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK General § 154.107 Alternatives. (a) The COTP may consider and approve alternative procedures, methods, or equipment standards to be used by a facility...

33 CFR 155.785 - Communications.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Communications. 155.785 Section..., Procedures, Equipment, and Records § 155.785 Communications. (a) During vessel to vessel transfers, each tank... have a means that enables continuous two-way voice communication between the persons in charge of the...

33 CFR 155.785 - Communications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Communications. 155.785 Section..., Procedures, Equipment, and Records § 155.785 Communications. (a) During vessel to vessel transfers, each tank... have a means that enables continuous two-way voice communication between the persons in charge of the...

33 CFR 155.785 - Communications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Communications. 155.785 Section..., Procedures, Equipment, and Records § 155.785 Communications. (a) During vessel to vessel transfers, each tank... have a means that enables continuous two-way voice communication between the persons in charge of the...

33 CFR 209.345 - Water resource policies and authorities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... authorities. 209.345 Section 209.345 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.345 Water resource policies and authorities... accomplishment by local interests, and (iii) periodic and final inspections. (3) The District Engineer will...

33 CFR 209.345 - Water resource policies and authorities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... authorities. 209.345 Section 209.345 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.345 Water resource policies and authorities... accomplishment by local interests, and (iii) periodic and final inspections. (3) The District Engineer will...

33 CFR 209.345 - Water resource policies and authorities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... authorities. 209.345 Section 209.345 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.345 Water resource policies and authorities... accomplishment by local interests, and (iii) periodic and final inspections. (3) The District Engineer will...

33 CFR 203.49 - Rehabilitation of Hurricane and Shore Protection Projects.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Shore Protection Projects. 203.49 Section 203.49 Navigation and Navigable Waters CORPS OF ENGINEERS... DISASTER PROCEDURES Rehabilitation Assistance for Flood Control Works Damaged by Flood or Coastal Storm... Protection Projects. (a) Authority. The Chief of Engineers is authorized to rehabilitate any Federally...

14 CFR 171.45 - Minimum requirements for approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the frequency channel is needed for higher priority common system service. [Doc. No. 5034, 29 FR 11337... (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Instrument Landing System (ILS... must be met before the FAA will approve an IFR procedure for a non-Federal Instrument Landing System...

Remote magnetic navigation vs. manual navigation for ablation of ventricular tachycardia: a meta-analysis.

PubMed

Wu, Y; Li, K-L; Zheng, J; Zhang, C-Y; Liu, X-Y; Cui, Z-M; Yu, Z-M; Wang, R-X; Wang, W

2015-09-01

The purpose of this study was to prospectively evaluate the efficacy and safety of remote magnetic navigation (RMN) in comparison with manual catheter navigation (MCN) in performing ventricular tachycardia ablation. An electronic search was performed using PubMed (1948-2013) and EMBASE (1974-2013) studies comparing RMN with MCN which were published prior to 31 December 2013. Outcomes of interest were as follows: acute success, recurrence rate, complications, total procedure and fluoroscopic times. Standard mean difference (SMD) and its 95 % confidence interval (CI) were used for continuous outcomes; odds ratios (OR) were reported for dichotomous variables. Four non-randomised studies, including a total of 328 patients, were identified. RMN was deployed in 191 patients. Acute success and long-term freedom from arrhythmias were not significantly different between the RMN and control groups (OR 1.845, 95 % CI 0.731-4.659, p = 0.195 and OR 0.676, 95 % CI 0.383-1.194, p = 0.177, respectively). RMN was associated with less peri-procedural complications (OR 0.279, 95 % CI 0.092-0.843, p = 0.024). Shorter procedural and fluoroscopy times were achieved (95 % CI -0.487 to -0.035, p = 0.024 and 95 % CI -1.467 to -0.984, p<0.001, respectively). The acute and long-term success rates for VT ablation are equal between RMN and MCN, whereas the RMN-guided procedure can be performed with a lower complication rate and less procedural and fluoroscopic times. More prospective randomised trials will be needed to better evaluate the superior role of RMN for catheter ablation of ventricular tachycardia.

33 CFR 66.05-30 - Notice to Mariners.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 66.05-30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-30 Notice to Mariners. (a) To improve public safety, the District Commander may publish information concerning State aids to navigation...

33 CFR 66.05-30 - Notice to Mariners.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 66.05-30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-30 Notice to Mariners. (a) To improve public safety, the District Commander may publish information concerning State aids to navigation...

33 CFR 66.05-30 - Notice to Mariners.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 66.05-30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-30 Notice to Mariners. (a) To improve public safety, the District Commander may publish information concerning State aids to navigation...

33 CFR 66.05-30 - Notice to Mariners.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 66.05-30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-30 Notice to Mariners. (a) To improve public safety, the District Commander may publish information concerning State aids to navigation...

33 CFR 66.05-30 - Notice to Mariners.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 66.05-30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-30 Notice to Mariners. (a) To improve public safety, the District Commander may publish information concerning State aids to navigation...

Improving the accuracy of the diagnosis of schizophrenia by means of virtual reality.

PubMed

Sorkin, Anna; Weinshall, Daphna; Modai, Ilan; Peled, Avi

2006-03-01

The authors' goal was to improve the diagnosis of schizophrenia by using virtual reality technology to build a complex, multimodal environment in which cognitive functions can be studied (and measured) in parallel. The authors studied sensory integration within working memory by means of computer navigation through a virtual maze. The simulated journey consisted of a series of rooms, each of which included three doors. Each door was characterized by three features (color, shape, and sound), and a single combination of features--the door-opening rule--was correct. Subjects had to learn the rule and use it. The participants were 39 schizophrenic patients and 21 healthy comparison subjects. Upon completion, each subject was assigned a performance profile, including various error scores, response time, navigation ability, and strategy. A classification procedure based on the subjects' performance profile correctly predicted 85% of the schizophrenic patients (and all of the comparison subjects). Several performance variables showed significant correlations with scores on a standard diagnostic measure (Positive and Negative Syndrome Scale), suggesting potential use of these measurements for the diagnosis of schizophrenia. On the other hand, the patients did not show unusual repetition of response despite stimulus cessation (called "perseveration" in classical studies of schizophrenia), which is a common symptom of the disease. This deficit appeared only when the subjects did not receive proper explanation of the task. The ability to study multimodal performance simultaneously by using virtual reality technology opens new possibilities for the diagnosis of schizophrenia with objective procedures.

Computer-assisted hip and knee arthroplasty. Navigation and active robotic systems: an evidence-based analysis.

PubMed

2004-01-01

The Medical Advisory Secretariat undertook a review of the evidence on the effectiveness and cost-effectiveness of computer assisted hip and knee arthroplasty. The two computer assisted arthroplasty systems that are the topics of this review are (1) navigation and (2) robotic-assisted hip and knee arthroplasty. Computer-assisted arthroplasty consists of navigation and robotic systems. Surgical navigation is a visualization system that provides positional information about surgical tools or implants relative to a target bone on a computer display. Most of the navigation-assisted arthroplasty devices that are the subject of this review are licensed by Health Canada. Robotic systems are active robots that mill bone according to information from a computer-assisted navigation system. The robotic-assisted arthroplasty devices that are the subject of this review are not currently licensed by Health Canada. The Cochrane and International Network of Agencies for Health Technology Assessment databases did not identify any health technology assessments on navigation or robotic-assisted hip or knee arthroplasty. The MEDLINE and EMBASE databases were searched for articles published between January 1, 1996 and November 30, 2003. This search produced 367 studies, of which 9 met the inclusion criteria. NAVIGATION-ASSISTED ARTHROPLASTY: Five studies were identified that examined navigation-assisted arthroplasty.A Level 1 evidence study from Germany found a statistically significant difference in alignment and angular deviation between navigation-assisted and free-hand total knee arthroplasty in favour of navigation-assisted surgery. However, the endpoints in this study were short-term. To date, the long-term effects (need for revision, implant longevity, pain, functional performance) are unknown.(1)A Level 2 evidence short-term study found that navigation-assisted total knee arthroplasty was significantly better than a non-navigated procedure for one of five postoperative measured angles.(2)A Level 2 evidence short-term study found no statistically significant difference in the variation of the abduction angle between navigation-assisted and conventional total hip arthroplasty.(3)Level 3 evidence observational studies of navigation-assisted total knee arthroplasty and unicompartmental knee arthroplasty have been conducted. Two studies reported that "the follow-up of the navigated prostheses is currently too short to know if clinical outcome or survival rates are improved. Longer follow-up is required to determine the respective advantages and disadvantages of both techniques."(4;5) ROBOTIC-ASSISTED ARTHROPLASTY: Four studies were identified that examined robotic-assisted arthroplasty.A Level 1 evidence study revealed that there was no statistically significant difference between functional hip scores at 24 months post implantation between patients who underwent robotic-assisted primary hip arthroplasty and those that were treated with manual implantation.(6)Robotic-assisted arthroplasty had advantages in terms of preoperative planning and the accuracy of the intraoperative procedure.(6)Patients who underwent robotic-assisted hip arthroplasty had a higher dislocation rate and more revisions.(6)Robotic-assisted arthroplasty may prove effective with certain prostheses (e.g., anatomic) because their use may result in less muscle detachment.(6)An observational study (Level 3 evidence) found that the incidence of severe embolic events during hip relocation was lower with robotic arthroplasty than with manual surgery.(7)An observational study (Level 3 evidence) found that there was no significant difference in gait analyses of patients who underwent robotic-assisted total hip arthroplasty using robotic surgery compared to patients who were treated with conventional cementless total hip arthroplasty.(8)An observational study (Level 3 evidence) compared outcomes of total knee arthroplasty between patients undergoing robotic surgery and patients who were historical controls. Brief, qualitative results suggested that there was much broader variation of angles after manual total knee arthroplasty compared to the robotic technique and that there was no difference in knee functional scores or implant position at the 3 and 6 month follow-up.(9).

Computer-Assisted Hip and Knee Arthroplasty. Navigation and Active Robotic Systems

PubMed Central

2004-01-01

Executive Summary Objective The Medical Advisory Secretariat undertook a review of the evidence on the effectiveness and cost-effectiveness of computer assisted hip and knee arthroplasty. The two computer assisted arthroplasty systems that are the topics of this review are (1) navigation and (2) robotic-assisted hip and knee arthroplasty. The Technology Computer-assisted arthroplasty consists of navigation and robotic systems. Surgical navigation is a visualization system that provides positional information about surgical tools or implants relative to a target bone on a computer display. Most of the navigation-assisted arthroplasty devices that are the subject of this review are licensed by Health Canada. Robotic systems are active robots that mill bone according to information from a computer-assisted navigation system. The robotic-assisted arthroplasty devices that are the subject of this review are not currently licensed by Health Canada. Review Strategy The Cochrane and International Network of Agencies for Health Technology Assessment databases did not identify any health technology assessments on navigation or robotic-assisted hip or knee arthroplasty. The MEDLINE and EMBASE databases were searched for articles published between January 1, 1996 and November 30, 2003. This search produced 367 studies, of which 9 met the inclusion criteria. Summary of Findings Navigation-Assisted Arthroplasty Five studies were identified that examined navigation-assisted arthroplasty. A Level 1 evidence study from Germany found a statistically significant difference in alignment and angular deviation between navigation-assisted and free-hand total knee arthroplasty in favour of navigation-assisted surgery. However, the endpoints in this study were short-term. To date, the long-term effects (need for revision, implant longevity, pain, functional performance) are unknown.(1) A Level 2 evidence short-term study found that navigation-assisted total knee arthroplasty was significantly better than a non-navigated procedure for one of five postoperative measured angles.(2) A Level 2 evidence short-term study found no statistically significant difference in the variation of the abduction angle between navigation-assisted and conventional total hip arthroplasty.(3) Level 3 evidence observational studies of navigation-assisted total knee arthroplasty and unicompartmental knee arthroplasty have been conducted. Two studies reported that “the follow-up of the navigated prostheses is currently too short to know if clinical outcome or survival rates are improved. Longer follow-up is required to determine the respective advantages and disadvantages of both techniques.”(4;5) Robotic-Assisted Arthroplasty Four studies were identified that examined robotic-assisted arthroplasty. A Level 1 evidence study revealed that there was no statistically significant difference between functional hip scores at 24 months post implantation between patients who underwent robotic-assisted primary hip arthroplasty and those that were treated with manual implantation.(6) Robotic-assisted arthroplasty had advantages in terms of preoperative planning and the accuracy of the intraoperative procedure.(6) Patients who underwent robotic-assisted hip arthroplasty had a higher dislocation rate and more revisions.(6) Robotic-assisted arthroplasty may prove effective with certain prostheses (e.g., anatomic) because their use may result in less muscle detachment.(6) An observational study (Level 3 evidence) found that the incidence of severe embolic events during hip relocation was lower with robotic arthroplasty than with manual surgery.(7) An observational study (Level 3 evidence) found that there was no significant difference in gait analyses of patients who underwent robotic-assisted total hip arthroplasty using robotic surgery compared to patients who were treated with conventional cementless total hip arthroplasty.(8) An observational study (Level 3 evidence) compared outcomes of total knee arthroplasty between patients undergoing robotic surgery and patients who were historical controls. Brief, qualitative results suggested that there was much broader variation of angles after manual total knee arthroplasty compared to the robotic technique and that there was no difference in knee functional scores or implant position at the 3 and 6 month follow-up.(9) PMID:23074452

Deep-space navigation applications of improved ground-based optical astrometry

NASA Technical Reports Server (NTRS)

Null, G. W.; Owen, W. M., Jr.; Synnott, S. P.

1992-01-01

Improvements in ground-based optical astrometry will eventually be required for navigation of interplanetary spacecraft when these spacecraft communicate at optical wavelengths. Although such spacecraft may be some years off, preliminary versions of the astrometric technology can also be used to obtain navigational improvements for the Galileo and Cassini missions. This article describes a technology-development and observational program to accomplish this, including a cooperative effort with U.S. Naval Observatory Flagstaff Station. For Galileo, Earth-based astrometry of Jupiter's Galilean satellites may improve their ephemeris accuracy by a factor of 3 to 6. This would reduce the requirements for onboard optical navigation pictures, so that more of the data transmission capability (currently limited by high-gain antenna deployment problems) can be used for science data. Also, observations of European Space Agency (ESA) Hipparcos stars with asteroid 243 Ida may provide significantly improved navigation accuracy for a planned August 1993 Galileo spacecraft encounter.

Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency

NASA Technical Reports Server (NTRS)

Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

2006-01-01

International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.

Application of Virtual Navigation with Multimodality Image Fusion in Foramen Ovale Cannulation.

PubMed

Qiu, Xixiong; Liu, Weizong; Zhang, Mingdong; Lin, Hengzhou; Zhou, Shoujun; Lei, Yi; Xia, Jun

2017-11-01

Idiopathic trigeminal neuralgia (ITN) can be effectively treated with radiofrequency thermocoagulation. However, this procedure requires cannulation of the foramen ovale, and conventional cannulation methods are associated with high failure rates. Multimodality imaging can improve the accuracy of cannulation because each imaging method can compensate for the drawbacks of the other. We aim to determine the feasibility and accuracy of percutaneous foramen ovale cannulation under the guidance of virtual navigation with multimodality image fusion in a self-designed anatomical model of human cadaveric heads. Five cadaveric head specimens were investigated in this study. Spiral computed tomography (CT) scanning clearly displayed the foramen ovale in all five specimens (10 foramina), which could not be visualized using two-dimensional ultrasound alone. The ultrasound and spiral CT images were fused, and percutaneous cannulation of the foramen ovale was performed under virtual navigation. After this, spiral CT scanning was immediately repeated to confirm the accuracy of the cannulation. Postprocedural spiral CT confirmed that the ultrasound and CT images had been successfully fused for all 10 foramina, which were accurately and successfully cannulated. The success rates of both image fusion and cannulation were 100%. Virtual navigation with multimodality image fusion can substantially facilitate foramen ovale cannulation and is worthy of clinical application. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Navigation-assisted trans-inferotemporal cortex selective amygdalohippocampectomy for mesial temporal lobe epilepsy; preserving the temporal stem.

PubMed

Kishima, Haruhiko; Kato, Amami; Oshino, Satoru; Tani, Naoki; Maruo, Tomoyuki; Khoo, Hui Ming; Yanagisawa, Takufumi; Edakawa, Kotaro; Kobayashi, Maki; Tanaka, Masataka; Hosomi, Koichi; Hirata, Masayuki; Yoshimine, Toshiki

2017-03-01

Selective amygdalohippocampectomy (SAH) can be used to obtain satisfactory seizure control in patients with mesial temporal lobe epilepsy (MTLE). Several SAH procedures have been reported to achieve satisfactory outcomes for seizure control, but none yield fully satisfactory outcomes for memory function. We hypothesized that preserving the temporal stem might play an important role. To preserve the temporal stem, we developed a minimally invasive surgical procedure, 'neuronavigation-assisted trans-inferotemporal cortex SAH' (TITC-SAH). TITC-SAH was performed in 23 patients with MTLE (MTLE on the language-non-dominant hemisphere, n = 11). The inferior horn of the lateral ventricle was approached via the inferior or middle temporal gyrus along the inferior temporal sulcus under neuronavigation guidance. The hippocampus was dissected in a subpial manner and resected en bloc together with the parahippocampal gyrus. Seizure control at one year and memory function at 6 months postoperatively were evaluated. One year after TITC-SAH, 20 of the 23 patients were seizure-free (ILAE class 1), 2 were class 2, and 1 was class 3. Verbal memory improved significantly in 13 patients with a diagnosis of hippocampal sclerosis, for whom WMS-R scores were available both pre- and post-operatively. Improvements were seen regardless of whether the SAH was on the language-dominant or non-dominant hemisphere. No major complication was observed. Navigation-assisted TITC-SAH performed for MTLE offers a simple, minimally invasive procedure that appears to yield excellent outcomes in terms of seizure control and preservation of memory function, because this procedure does not damage the temporal stem. TITC-SAH should be one of the feasible surgical procedures for MTLE. SAH: Amygdalohippocampectomy; MTLE: Mesial temporal lobe epilepsy (MTLE); TITC-SAH: Ttrans-inferotemporal cortex SAH; ILAE: International League Against Epilepsy (ILAE); MRI: Magnetic resonance imaging; EEG: Electroencephalography (EEG); FDG-PET: 8 F-fluorodeoxyglucose (FDG)-positron emission tomography; ECoG: Electrocorticography; MEG: Magnetoencephalography; IMZ-SPECT: N-isopropyl-p( 123 I)-iodoamphetamine single photon emission computed tomography; WMS-R: Wechsler Memory Scale-Revised.

Research on navigation of satellite constellation based on an asynchronous observation model using X-ray pulsar

NASA Astrophysics Data System (ADS)

Guo, Pengbin; Sun, Jian; Hu, Shuling; Xue, Ju

2018-02-01

Pulsar navigation is a promising navigation method for high-altitude orbit space tasks or deep space exploration. At present, an important reason for restricting the development of pulsar navigation is that navigation accuracy is not high due to the slow update of the measurements. In order to improve the accuracy of pulsar navigation, an asynchronous observation model which can improve the update rate of the measurements is proposed on the basis of satellite constellation which has a broad space for development because of its visibility and reliability. The simulation results show that the asynchronous observation model improves the positioning accuracy by 31.48% and velocity accuracy by 24.75% than that of the synchronous observation model. With the new Doppler effects compensation method in the asynchronous observation model proposed in this paper, the positioning accuracy is improved by 32.27%, and the velocity accuracy is improved by 34.07% than that of the traditional method. The simulation results show that without considering the clock error will result in a filtering divergence.

33 CFR 115.70 - Advance approval of bridges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Advance approval of bridges. 115... BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.70 Advance approval of bridges. (a) The General Bridge Act of 1946 requires the approval of the location and plans of bridges prior...

33 CFR 115.30 - Sufficiency of State authority for bridges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... for bridges. 115.30 Section 115.30 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES BRIDGE LOCATIONS AND CLEARANCES; ADMINISTRATIVE PROCEDURES § 115.30 Sufficiency of State authority for bridges. An opinion of the attorney general of the State as to the sufficiency of State...

76 FR 31831 - Navigation and Navigable Waters; Technical, Organizational, and Conforming Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

..., DHS. ACTION: Final rule. SUMMARY: This rule makes non-substantive changes throughout Title 33 of the... effect on the regulated public. These changes are provided to coincide with the annual recodification of... changes involve rules of agency organization, procedure, or practice. In addition, the Coast Guard finds...

33 CFR 155.810 - Tank vessel security.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Tank vessel security. 155.810..., Procedures, Equipment, and Records § 155.810 Tank vessel security. Operators of tank vessels carrying more oil cargo residue than normal in any cargo tank must assign a surveillance person or persons...

33 CFR 155.815 - Tank vessel integrity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Tank vessel integrity. 155.815..., Procedures, Equipment, and Records § 155.815 Tank vessel integrity. (a) Except as provided in paragraph (b) of this section, a tank vessel underway or at anchor must have all closure mechanisms on the...

33 CFR 155.810 - Tank vessel security.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Tank vessel security. 155.810..., Procedures, Equipment, and Records § 155.810 Tank vessel security. Operators of tank vessels carrying more oil cargo residue than normal in any cargo tank must assign a surveillance person or persons...

33 CFR 155.815 - Tank vessel integrity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Tank vessel integrity. 155.815..., Procedures, Equipment, and Records § 155.815 Tank vessel integrity. (a) Except as provided in paragraph (b) of this section, a tank vessel underway or at anchor must have all closure mechanisms on the...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 203.16 - Federally recognized Indian Tribes and the Alaska Native Corporations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Tribes and the Alaska Native Corporations. 203.16 Section 203.16 Navigation and Navigable Waters CORPS OF..., NATURAL DISASTER PROCEDURES Introduction § 203.16 Federally recognized Indian Tribes and the Alaska Native... recognized Indian Tribe or Alaska Native Corporation, or through the appropriate regional representative of...

33 CFR 136.3 - Information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Information. 136.3 Section 136.3... SOURCE; AND ADVERTISEMENT General § 136.3 Information. Anyone desiring to file a claim against the Fund may obtain general information on the procedure for filing a claim from the Director, National...

33 CFR 136.3 - Information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Information. 136.3 Section 136.3... SOURCE; AND ADVERTISEMENT General § 136.3 Information. Anyone desiring to file a claim against the Fund may obtain general information on the procedure for filing a claim from the Director National...

33 CFR 136.3 - Information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Information. 136.3 Section 136.3... SOURCE; AND ADVERTISEMENT General § 136.3 Information. Anyone desiring to file a claim against the Fund may obtain general information on the procedure for filing a claim from the Director, National...

33 CFR 136.3 - Information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Information. 136.3 Section 136.3... SOURCE; AND ADVERTISEMENT General § 136.3 Information. Anyone desiring to file a claim against the Fund may obtain general information on the procedure for filing a claim from the Director, National...

33 CFR 209.300 - Flood control regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Flood control regulations. 209..., DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.300 Flood control regulations. (a) Regulations for the operation and maintenance of local flood protection works approved by the Secretary of the Army under the...

33 CFR 157.415 - Bridge resource management policy and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... navigational watch are not impaired by fatigue. (3) The need to take into account any known limitation in qualifications or fitness of individuals when making navigational and operational decisions. (4) The need to be..., processing, and interpreting all essential information and making it conveniently available to other members...

33 CFR 136.3 - Information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Information. 136.3 Section 136.3... SOURCE; AND ADVERTISEMENT General § 136.3 Information. Anyone desiring to file a claim against the Fund may obtain general information on the procedure for filing a claim from the Director National...

33 CFR 96.250 - What documents and reports must a safety management system have?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Safety management system document and data maintenance (1) Procedures which establish and maintain control of all documents and data relevant to the safety management system. (2) Documents are available at... safety management system have? 96.250 Section 96.250 Navigation and Navigable Waters COAST GUARD...

33 CFR 148.300 - What does this subpart concern?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false What does this subpart concern... (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: GENERAL Licenses § 148.300 What does this subpart concern? This subpart concerns the license for a deepwater port and the procedures for transferring, amending...

33 CFR 230.13 - Environmental Impact Statement (EIS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Environmental Impact Statement..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.13 Environmental Impact Statement (EIS). An EIS... issues and impacts. The transmittal letter to EPA as well as the cover sheet should clearly identify the...

33 CFR 209.345 - Water resource policies and authorities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Water resource policies and... ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.345 Water resource policies and authorities... other Non-Federal Entities on Authorized Water Resources Projects.” (3) Section 221, FCA of 1970 (Pub. L...

33 CFR 230.16 - Lead and cooperating agencies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Lead and cooperating agencies..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.16 Lead and cooperating agencies. Lead agency, joint lead agency, and cooperating agency designation and responsibilities are covered in 40 CFR 1501.5...

33 CFR 230.16 - Lead and cooperating agencies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Lead and cooperating agencies..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.16 Lead and cooperating agencies. Lead agency, joint lead agency, and cooperating agency designation and responsibilities are covered in 40 CFR 1501.5...

33 CFR 230.16 - Lead and cooperating agencies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Lead and cooperating agencies..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.16 Lead and cooperating agencies. Lead agency, joint lead agency, and cooperating agency designation and responsibilities are covered in 40 CFR 1501.5...

33 CFR 230.16 - Lead and cooperating agencies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Lead and cooperating agencies..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.16 Lead and cooperating agencies. Lead agency, joint lead agency, and cooperating agency designation and responsibilities are covered in 40 CFR 1501.5...

33 CFR 203.84 - Forms of local participation-cost sharing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... sharing. 203.84 Section 203.84 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...; and/or accomplishment of work either concurrently or within a specified reasonable period of time. The...

33 CFR 203.84 - Forms of local participation-cost sharing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sharing. 203.84 Section 203.84 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...; and/or accomplishment of work either concurrently or within a specified reasonable period of time. The...

33 CFR 203.84 - Forms of local participation-cost sharing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sharing. 203.84 Section 203.84 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...; and/or accomplishment of work either concurrently or within a specified reasonable period of time. The...

33 CFR 203.84 - Forms of local participation-cost sharing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sharing. 203.84 Section 203.84 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...; and/or accomplishment of work either concurrently or within a specified reasonable period of time. The...

33 CFR 203.84 - Forms of local participation-cost sharing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sharing. 203.84 Section 203.84 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local...; and/or accomplishment of work either concurrently or within a specified reasonable period of time. The...

33 CFR 230.16 - Lead and cooperating agencies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Lead and cooperating agencies..., DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.16 Lead and cooperating agencies. Lead agency, joint lead agency, and cooperating agency designation and responsibilities are covered in 40 CFR 1501.5...

33 CFR 230.6 - Actions normally requiring an EIS.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... 230.6 Section 230.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.6 Actions normally requiring an EIS. Actions... consider the use of an environmental assessment (EA) on these types of actions if early studies and...

33 CFR 230.6 - Actions normally requiring an EIS.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 230.6 Section 230.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.6 Actions normally requiring an EIS. Actions... consider the use of an environmental assessment (EA) on these types of actions if early studies and...

33 CFR 230.6 - Actions normally requiring an EIS.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... 230.6 Section 230.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.6 Actions normally requiring an EIS. Actions... consider the use of an environmental assessment (EA) on these types of actions if early studies and...

33 CFR 230.6 - Actions normally requiring an EIS.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... 230.6 Section 230.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.6 Actions normally requiring an EIS. Actions... consider the use of an environmental assessment (EA) on these types of actions if early studies and...

33 CFR 230.6 - Actions normally requiring an EIS.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... 230.6 Section 230.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.6 Actions normally requiring an EIS. Actions... consider the use of an environmental assessment (EA) on these types of actions if early studies and...

14 CFR 171.315 - Azimuth monitor system requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Microwave Landing System... system must cause the radiation to cease and a warning must be provided at the designated control point... following procedure. The integral monitor alarm limit should be set to the angular equivalent of ±10 ft. at...

14 CFR 171.315 - Azimuth monitor system requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Microwave Landing System... system must cause the radiation to cease and a warning must be provided at the designated control point... following procedure. The integral monitor alarm limit should be set to the angular equivalent of ±10 ft. at...