Product information representation for feature conversion and implementation of group technology automated coding

Science.gov (United States)

Medland, A. J.; Zhu, Guowang; Gao, Jian; Sun, Jian

1996-03-01

Feature conversion, also called feature transformation and feature mapping, is defined as the process of converting features from one view of an object to another view of the object. In a relatively simple implementation, for each application the design features are automatically converted into features specific for that application. All modifications have to be made via the design features. This is the approach that has attracted most attention until now. In the ideal situation, however, conversions directly from application views to the design view, and to other applications views, are also possible. In this paper, some difficulties faced in feature conversion are discussed. A new representation scheme of feature-based parts models has been proposed for the purpose of one-way feature conversion. The parts models consist of five different levels of abstraction, extending from an assembly level and its attributes, single parts and their attributes, single features and their attributes, one containing the geometric reference element and finally one for detailed geometry. One implementation of feature conversion for rotational components within GT (Group Technology) has already been undertaken using an automated coding procedure operating on a design-feature database. This database has been generated by a feature-based design system, and the GT coding scheme used in this paper is a specific scheme created for a textile machine manufacturing plant. Such feature conversion techniques presented here are only in their early stages of development and further research is underway.

Conversion of Plastic Surgery meeting abstract presentations to full manuscripts: a brazilian perspective.

Science.gov (United States)

Denadai, Rafael; Pinho, André Silveira; Samartine, Hugo; Denadai, Rodrigo; Raposo-Amaral, Cassio Eduardo

2017-01-01

to assess the conversion rate of Plastic Surgery meeting abstract presentations to full manuscript publications and examine factors associated with this conversion. we assessed the abstracts presented at the 47th and 48th Brazilian Congresses of Plastic Surgery by cross-referencing with multiple databases. We analyzed the Abstracts' characteristics associated with full manuscript publications. of the 200 abstracts presented, 50 abstracts were subsequently published in full, giving the conference a conversion rate of 25%. The mean time to publish was 15.00±13.75 months. In total, there were 4.93±1.63 authors per abstract and 67.8±163 subjects per abstract; 43.5% of the abstracts were of retrospective studies; 69% comprised the plastic surgery topics head and neck, and chest and trunk, and 88.5% had no statistical analysis. Overall, 80% of the manuscripts were published in plastic surgery journals, 76% had no impact factor and 52% had no citations. Bivariate and multivariate analyses revealed the presence of statistical analysis to be the most significant (previstas de Cirurgia Plástica, 76% não exibiam fator de impacto e 52% não possuíam citações. As análises bivariada e multivariada revelaram que a presença de análise estatística foi o fator preditivo significativo (p<0,05) para a conversão de resumos em manuscritos completos. a taxa de conversão deste estudo bibliométrico foi inferior à tendência de conversão descrita em congressos internacionais de Cirurgia Plástica, e a presença de análise estatística foi um determinante para o sucesso de conversão.

Preoperative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Surgery - A Systematic Review and Meta-Analysis of Observational Studies

DEFF Research Database (Denmark)

Rothman, Josephine Philip; Burcharth, Jakob; Pommergaard, Hans-Christian

2016-01-01

were suitable for 7 meta-analyses on age, gender, body mass index, previous abdominal surgery, severity of disease, white blood cell count, and gallbladder wall thickness. CONCLUSIONS: A gallbladder wall thicker than 4-5 mm, a contracted gallbladder, age above 60 or 65, male gender, and acute...... cholecystitis were risk factors for the conversion of laparoscopic cholecystectomy to open surgery. Furthermore, there was no association between diabetes mellitus or white blood cell count and conversion to open surgery....

Conversion of a general quantum stabilizer code to an entanglement distillation protocol

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Ryutaroh [Department of Communications and Integrated Systems, Tokyo Institute of Technology, Tokyo 152-8552 (Japan)

2003-07-25

We show how to convert a quantum stabilizer code to a one- or two-way entanglement distillation protocol. The proposed conversion method is a generalization of those of Shor-Preskill and Nielsen-Chuang. The recurrence protocol and the quantum privacy amplification protocol are equivalent to the protocols converted from [[2, 1

Conversion of a general quantum stabilizer code to an entanglement distillation protocol

International Nuclear Information System (INIS)

Matsumoto, Ryutaroh

2003-01-01

We show how to convert a quantum stabilizer code to a one- or two-way entanglement distillation protocol. The proposed conversion method is a generalization of those of Shor-Preskill and Nielsen-Chuang. The recurrence protocol and the quantum privacy amplification protocol are equivalent to the protocols converted from [[2, 1

Calculation of conversion coefficients for clinical photon spectra using the MCNP code.

Science.gov (United States)

Lima, M A F; Silva, A X; Crispim, V R

2004-01-01

In this work, the MCNP4B code has been employed to calculate conversion coefficients from air kerma to the ambient dose equivalent, H*(10)/Ka, for monoenergetic photon energies from 10 keV to 50 MeV, assuming the kerma approximation. Also estimated are the H*(10)/Ka for photon beams produced by linear accelerators, such as Clinac-4 and Clinac-2500, after transmission through primary barriers of radiotherapy treatment rooms. The results for the conversion coefficients for monoenergetic photon energies, with statistical uncertainty <2%, are compared with those in ICRP publication 74 and good agreements were obtained. The conversion coefficients calculated for real clinic spectra transmitted through walls of concrete of 1, 1.5 and 2 m thick, are in the range of 1.06-1.12 Sv Gy(-1).

Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome.

Science.gov (United States)

Munasinghe, A; Chang, D; Mamidanna, R; Middleton, S; Joy, M; Penninckx, F; Darzi, A; Livingston, E; Faiz, O

2014-07-01

Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. In all, 52 544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Successful conversion of post-cardiac surgery electric storm in a child.

Science.gov (United States)

Rastogi, Abhinav; Gupta, Ajay; Singh, Vishal K

2014-08-01

The management of ventricular electrical storm can prove to be a challenge for the clinician given its complexity and life threatening consequences. 8-year-old boy with repeated life-threatening polymorphic ventricular tachycardia following aortic valve replacement surgery. Defibrillated 45 times in addition to multiple antiarrhythmic drugs. Conversion to stable sinus rhythm with normal neurological outcome. Electric storm can be controlled by combination of multiple intravenous antiarrhythmic drugs.

Hybrid code simulation on mode conversion in the second harmonic ICRF heating

International Nuclear Information System (INIS)

Sakai, K.; Takeuchi, S.; Matsumoto, M.; Sugihara, R.

1985-01-01

ICRF second harmonic heating of a single-species plasma is studied by using a 1-1/2 dimensional quasi-neutral hybrid code. Mode conversion, transmission and reflection of the magnetosonic waves are confirmed, both for the high- and low-field-side excitations. The ion heating by waves propagating perpendicularly to the static magnetic field is also observed

Postoperative visual loss due to conversion disorder after spine surgery: a case report

Directory of Open Access Journals (Sweden)

Dailson Mamede Bezerra

Full Text Available Abstract Background and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm followed by capnography and urinary catheterization for diuresis. Maintenance with full target-controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 min, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non-organic origin,including visual component. It is noteworthy that the occurrence of this type of visual dysfunc-tion in the postoperative period of spinal surgery is a rare event and should be remembered asa differential diagnosis.

[Postoperative visual loss due to conversion disorder after spine surgery: a case report].

Science.gov (United States)

Bezerra, Dailson Mamede; Bezerra, Eglantine Mamede; Silva Junior, Antonio Jorge; Amorim, Marco Aurélio Soares; Miranda, Denismar Borges de

Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. A male patient, 39 years old, 71kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target-controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conversion disorders may have different signs and symptoms of non-organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Reasons for conversion and adverse intraoperative events in Endoscopic Port Access™ atrioventricular valve surgery and minimally invasive aortic valve surgery.

Science.gov (United States)

van der Merwe, Johan; Van Praet, Frank; Stockman, Bernard; Degrieck, Ivan; Vermeulen, Yvette; Casselman, Filip

2018-02-14

This study reports the factors that contribute to sternotomy conversions (SCs) and adverse intraoperative events in minimally invasive aortic valve surgery (MI-AVS) and minimally invasive Endoscopic Port Access™ atrioventricular valve surgery (MI-PAS). In total, 3780 consecutive patients with either aortic valve disease or atrioventricular valve disease underwent minimally invasive valve surgery (MIVS) at our institution between 1 February 1997 and 31 March 2016. MI-AVS was performed in 908 patients (mean age 69.2 ± 11.3 years, 45.2% women, 6.2% redo cardiac surgery) and MI-PAS in 2872 patients (mean age 64.1 ± 13.3 years, 46.7% women, 12.2% redo cardiac surgery). A cumulative total of 4415 MIVS procedures (MI-AVS = 908, MI-PAS = 3507) included 1537 valve replacements (MI-AVS = 896, MI-PAS = 641) and 2878 isolated or combined valve repairs (MI-AVS = 12, MI-PAS = 2866). SC was required in 3.0% (n = 114 of 3780) of MIVS patients, which occurred in 3.1% (n = 28 of 908) of MI-AVS patients and 3.0% (n = 86 of 2872) of MI-PAS patients, respectively. Reasons for SC in MI-AVS included inadequate visualization (n = 4, 0.4%) and arterial cannulation difficulty (n = 7, 0.8%). For MI-PAS, SC was required in 54 (2.5%) isolated mitral valve procedures (n = 2183). Factors that contributed to SC in MI-PAS included lung adhesions (n = 35, 1.2%), inadequate visualization (n = 2, 0.1%), ventricular bleeding (n = 3, 0.1%) and atrioventricular dehiscence (n = 5, 0.2%). Neurological deficit occurred in 1 (0.1%) and 3 (3.5%) MI-AVS and MI-PAS conversions, respectively. No operative or 30-day mortalities were observed in MI-AVS conversions (n = 28). The 30-day mortality associated with SC in MI-PAS (n = 86) was 10.5% (n = 9). MIVS is increasingly being recognized as the 'gold-standard' for surgical valve interventions in the context of rapidly expanding catheter-based technology and increasing

Selection and benchmarking of computer codes for research reactor core conversions

International Nuclear Information System (INIS)

Yilmaz, E.; Jones, B.G.

1983-01-01

A group of computer codes have been selected and obtained from the Nuclear Energy Agency (NEA) Data Bank in France for the core conversion study of highly enriched research reactors. ANISN, WIMSD-4, MC 2 , COBRA-3M, FEVER, THERMOS, GAM-2, CINDER and EXTERMINATOR were selected for the study. For the final work THERMOS, GAM-2, CINDER and EXTERMINATOR have been selected and used. A one dimensional thermal hydraulics code also has been used to calculate temperature distributions in the core. THERMOS and CINDER have been modified to serve the purpose. Minor modifications have been made to GAM-2 and EXTERMINATOR to improve their utilization. All of the codes have been debugged on both CDC and IBM computers at the University of Illinois. IAEA 10 MW Benchmark problem has been solved. Results of this work has been compared with the IAEA contributor's results. Agreement is very good for highly enriched fuel (HEU). Deviations from IAEA contributor's mean value for low enriched fuel (LEU) exist but they are small enough in general

Conversion to full sternotomy during minimal-access cardiac surgery: reasons and results during a 9.5-year experience.

Science.gov (United States)

Tabata, Minoru; Umakanthan, Ramanan; Khalpey, Zain; Aranki, Sary F; Couper, Gregory S; Cohn, Lawrence H; Shekar, Prem S

2007-07-01

A hemisternotomy approach to minimal-access cardiac surgery is associated with a faster postoperative recovery because of reduced postoperative pain and improved respiratory function. Conversion to a full sternotomy is occasionally required for reasons that remain inadequately reported. Between January 1996 and June 2005, 907 cardiac surgical patients were planned for an upper hemisternotomy and 528 for a lower hemisternotomy. We retrospectively reviewed 45 patients who required conversion to a full sternotomy. Twenty-four (2.6%) of 907 patients required a conversion from upper hemisternotomy because of bleeding (n = 8), ventricular dysfunction (n = 5), refractory ventricular arrhythmia (n = 3), poor exposure (n = 2), and other causes (n = 6). Eight (33.3%) of 24 patients died perioperatively. Of the 883 patients who went on to have an operation through the upper hemisternotomy approach, the mortality was 1.7% (15/883). Twenty-one (4.0%) of 528 patients required conversion from a lower hemisternotomy because of poor exposure (n = 16), bleeding (n = 1), refractory ventricular arrhythmia (n = 3), and a retained venous cannula (n = 1). None of these patients died postoperatively. Of the 507 patients who went on to have an operation through the lower hemisternotomy approach, the mortality was 1.2% (6/507). Conversion to a full sternotomy occurs infrequently during minimal-access cardiac surgery. Upper hemisternotomy conversions are usually urgent after crossclamp removal and are often associated with serious morbidity and mortality. Conversely, lower hemisternotomy conversions are performed electively in the prebypass period because of poor exposure and are not associated with complications.

Conversion coefficients for individual monitoring calculated with integrated tiger series, ITS3, Monte Carlo code

International Nuclear Information System (INIS)

Devine, R.T.; Hsu, Hsiao-Hua

1994-01-01

The current basis for conversion coefficients for calibrating individual photon dosimeters in terms of dose equivalents is found in the series of papers by Grosswent. In his calculation the collision kerma inside the phantom is determined by calculation of the energy fluence at the point of interest and the use of the mass energy absorption coefficient. This approximates the local absorbed dose. Other Monte Carlo methods can be sued to provide calculations of the conversion coefficients. Rogers has calculated fluence-to-dose equivalent conversion factors with the Electron-Gamma Shower Version 3, EGS3, Monte Carlo program and produced results similar to Grosswent's calculations. This paper will report on calculations using the Integrated TIGER Series Version 3, ITS3, code to calculate the conversion coefficients in ICRU Tissue and in PMMA. A complete description of the input parameters to the program is given and comparison to previous results is included

Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York.

Science.gov (United States)

Altieri, Maria S; Yang, Jie; Nie, Lizhou; Blackstone, Robin; Spaniolas, Konstantinos; Pryor, Aurora

2018-04-01

A primary measure of the success of a procedure is the whether or not additional surgery may be necessary. Multi-institutional studies regarding the need for reoperation after bariatric surgery are scarce. The purpose of this study is to evaluate the rate of revisions/conversions (RC) after 3 common bariatric procedures over 10 years in the state of New York. University Hospital, involving a large database in New York State. The Statewide Planning and Research Cooperative System database was used to identify all patients undergoing laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) between 2004 and 2010. Patients were followed for RC to other bariatric procedures for at least 4 years (up to 2014). Multivariable cox proportional hazard regression analysis was performed to identify risk factors for additional surgery after each common bariatric procedure. Multivariable logistic regression was used to check the factors associated with having ≥2 follow-up procedures. There were 40,994 bariatric procedures with 16,444 LAGB, 22,769 RYGB, and 1781 SG. Rate of RC was 26.0% for LAGB, 9.8% for SG, and 4.9% for RYGB. Multiple RC ( = />2) were more common for LAGB (5.7% for LAGB, .5% for RYGB, and .2% for LSG). Band revision/replacements required further procedures compared with patients who underwent conversion to RYGB/SG (939 compared with 48 procedures). Majority of RC were not performed at initial institution (68.2% of LAGB patients, 75.9% for RYGB, 63.7% of SG). Risk factors for multiple procedures included surgery type, as LAGB was more likely to have multiple RC. Reoperation was common for LAGB, but less common for RYGB (4.9%) and SG (9.8%). RC rate are almost twice after SG than after RYGB. LAGB had the highest rate (5.7%) of multiple reoperations. Conversion was the procedure of choice after a failed LAGB. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Emergency readmissions to paediatric surgery and urology: The impact of inappropriate coding.

Science.gov (United States)

Peeraully, R; Henderson, K; Davies, B

2016-04-01

Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level.

Selection and benchmarking of computer codes for research reactor core conversions

Energy Technology Data Exchange (ETDEWEB)

Yilmaz, Emin [School of Aerospace, Mechanical and Nuclear Engineering, University of Oklahoma, Norman, OK (United States); Jones, Barclay G [Nuclear Engineering Program, University of IL at Urbana-Champaign, Urbana, IL (United States)

1983-09-01

A group of computer codes have been selected and obtained from the Nuclear Energy Agency (NEA) Data Bank in France for the core conversion study of highly enriched research reactors. ANISN, WIMSD-4, MC{sup 2}, COBRA-3M, FEVER, THERMOS, GAM-2, CINDER and EXTERMINATOR were selected for the study. For the final work THERMOS, GAM-2, CINDER and EXTERMINATOR have been selected and used. A one dimensional thermal hydraulics code also has been used to calculate temperature distributions in the core. THERMOS and CINDER have been modified to serve the purpose. Minor modifications have been made to GAM-2 and EXTERMINATOR to improve their utilization. All of the codes have been debugged on both CDC and IBM computers at the University of IL. IAEA 10 MW Benchmark problem has been solved. Results of this work has been compared with the IAEA contributor's results. Agreement is very good for highly enriched fuel (HEU). Deviations from IAEA contributor's mean value for low enriched fuel (LEU) exist but they are small enough in general. Deviation of k{sub eff} is about 0.5% for both enrichments at the beginning of life (BOL) and at the end of life (EOL). Flux ratios deviate only about 1.5% from IAEA contributor's mean value. (author)

Selection and benchmarking of computer codes for research reactor core conversions

International Nuclear Information System (INIS)

Yilmaz, Emin; Jones, Barclay G.

1983-01-01

A group of computer codes have been selected and obtained from the Nuclear Energy Agency (NEA) Data Bank in France for the core conversion study of highly enriched research reactors. ANISN, WIMSD-4, MC 2 , COBRA-3M, FEVER, THERMOS, GAM-2, CINDER and EXTERMINATOR were selected for the study. For the final work THERMOS, GAM-2, CINDER and EXTERMINATOR have been selected and used. A one dimensional thermal hydraulics code also has been used to calculate temperature distributions in the core. THERMOS and CINDER have been modified to serve the purpose. Minor modifications have been made to GAM-2 and EXTERMINATOR to improve their utilization. All of the codes have been debugged on both CDC and IBM computers at the University of IL. IAEA 10 MW Benchmark problem has been solved. Results of this work has been compared with the IAEA contributor's results. Agreement is very good for highly enriched fuel (HEU). Deviations from IAEA contributor's mean value for low enriched fuel (LEU) exist but they are small enough in general. Deviation of k eff is about 0.5% for both enrichments at the beginning of life (BOL) and at the end of life (EOL). Flux ratios deviate only about 1.5% from IAEA contributor's mean value. (author)

The local skin dose conversion coefficients of electrons, protons and alpha particles calculated using the Geant4 code.

Science.gov (United States)

Zhang, Bintuan; Dang, Bingrong; Wang, Zhuanzi; Wei, Wei; Li, Wenjian

2013-10-01

The skin tissue-equivalent slab reported in the International Commission on Radiological Protection (ICRP) Publication 116 to calculate the localised skin dose conversion coefficients (LSDCCs) was adopted into the Monte Carlo transport code Geant4. The Geant4 code was then utilised for computation of LSDCCs due to a circular parallel beam of monoenergetic electrons, protons and alpha particles electrons and alpha particles are found to be in good agreement with the results using the MCNPX code of ICRP 116 data. The present work thus validates the LSDCC values for both electrons and alpha particles using the Geant4 code.

The Role of Hand-Assisted Laparoscopic Technique in the Age of Single-Incision Laparoscopy: An Effective Alternative to Avoid Open Conversion in Colorectal Surgery.

Science.gov (United States)

Jung, Kyung Uk; Yun, Seong Hyeon; Cho, Yong Beom; Kim, Hee Cheol; Lee, Woo Yong; Chun, Ho-Kyung

2018-04-01

Continuous efforts to reduce the numbers and size of incisions led to the emergence of a new technique, single-incision laparoscopic surgery (SILS). It has been rapidly accepted as the preferred surgical approach in the colorectal area. In the age of SILS, what is the role of hand-assisted laparoscopic surgery (HALS)? We introduce the way to take advantage of it, as an effective alternative to avoid open conversion. This is a retrospective review of prospectively collected data of SILS colectomies performed by a single surgeon in Samsung Medical Center between August 2009 and December 2012. Out of 631 cases of SILS colectomy, 47 cases needed some changes from the initial approach. Among these, five cases were converted to HALS. Four of them were completed successfully without the need for open conversion. One patient with rectosigmoid colon cancer invading bladder was finally opened to avoid vesical trigone injury. The mean operation time of the 4 patients was 265.0 minutes. The mean estimated blood loss was 587.5 mL. The postoperative complication rate associated with the operation was 25%. Conversion from SILS to HALS in colorectal surgery was feasible and effective. It seemed to add minimal morbidity while preserving advantages of minimally invasive surgery. It could be considered an alternative to open conversion in cases of SILS, especially when the conversion to conventional laparoscopy does not seem to be helpful.

12G: code for conversion of isotope-ordered cross-section libraries into group-ordered cross-section libraries

International Nuclear Information System (INIS)

Resnik, W.M. II; Bosler, G.E.

1977-09-01

Many current reactor physics codes accept cross-section libraries in an isotope-ordered form, convert them with internal preprocessing routines to a group-ordered form, and then perform calculations using these group-ordered data. Occasionally, because of storage and time limitations, the preprocessing routines in these codes cannot convert very large multigroup isotope-ordered libraries. For this reason, the I2G code, i.e., ISOTXS to GRUPXS, was written to convert externally isotope-ordered cross section libraries in the standard file format called ISOTXS to group-ordered libraries in the standard format called GRUPXS. This code uses standardized multilevel data management routines which establish a strategy for the efficient conversion of large libraries. The I2G code is exportable contingent on access to, and an intimate familiarization with, the multilevel routines. These routines are machine dependent, and therefore must be provided by the importing facility. 6 figures, 3 tables

Chiari malformation Type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm.

Science.gov (United States)

Ladner, Travis R; Greenberg, Jacob K; Guerrero, Nicole; Olsen, Margaret A; Shannon, Chevis N; Yarbrough, Chester K; Piccirillo, Jay F; Anderson, Richard C E; Feldstein, Neil A; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

2016-05-01

OBJECTIVE Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. METHODS The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. RESULTS Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%-94%), whereas the PPV of Algorithm 2 remained high (96%-98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%-97%). CONCLUSIONS An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

Science.gov (United States)

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses

Science.gov (United States)

Lurie, Jon D.; Tosteson, Anna N.A.; Deyo, Richard A.; Tosteson, Tor; Weinstein, James; Mirza, Sohail K.

2014-01-01

Study Design Retrospective analysis of Medicare claims linked to a multi-center clinical trial. Objective The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. We compared the surgical indication derived from Medicare claims to that provided by SPORT surgeons, the “gold standard”. Summary of Background Data Administrative data are frequently used to report procedure rates, surgical safety outcomes, and costs in the management of spinal surgery. However, the accuracy of using diagnosis codes to classify patients by surgical indication has not been examined. Methods Medicare claims were link to beneficiaries enrolled in SPORT. The sensitivity and specificity of three claims-based approaches to group patients based on surgical indications were examined: 1) using the first listed diagnosis; 2) using all diagnoses independently; and 3) using a diagnosis hierarchy based on the support for fusion surgery. Results Medicare claims were obtained from 376 SPORT participants, including 21 with disc herniation, 183 with spinal stenosis, and 172 with degenerative spondylolisthesis. The hierarchical coding algorithm was the most accurate approach for classifying patients by surgical indication, with sensitivities of 76.2%, 88.1%, and 84.3% for disc herniation, spinal stenosis, and degenerative spondylolisthesis cohorts, respectively. The specificity was 98.3% for disc herniation, 83.2% for spinal stenosis, and 90.7% for degenerative spondylolisthesis. Misclassifications were primarily due to codes attributing more complex pathology to the case. Conclusion Standardized approaches for using claims data to accurately group patients by surgical indications has widespread interest. We found that a hierarchical coding approach correctly classified over 90

Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer

Science.gov (United States)

Pigazzi, Alessio; Marshall, Helen; Croft, Julie; Corrigan, Neil; Copeland, Joanne; Quirke, Phil; West, Nick; Rautio, Tero; Thomassen, Niels; Tilney, Henry; Gudgeon, Mark; Bianchi, Paolo Pietro; Edlin, Richard; Hulme, Claire; Brown, Julia

2017-01-01

Importance Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. Objective To compare robotic-assisted vs conventional laparoscopic surgery for risk of conversion to open laparotomy among patients undergoing resection for rectal cancer. Design, Setting, and Participants Randomized clinical trial comparing robotic-assisted vs conventional laparoscopic surgery among 471 patients with rectal adenocarcinoma suitable for curative resection conducted at 29 sites across 10 countries, including 40 surgeons. Recruitment of patients was from January 7, 2011, to September 30, 2014, follow-up was conducted at 30 days and 6 months, and final follow-up was on June 16, 2015. Interventions Patients were randomized to robotic-assisted (n = 237) or conventional (n = 234) laparoscopic rectal cancer resection, performed by either high (upper rectum) or low (total rectum) anterior resection or abdominoperineal resection (rectum and perineum). Main Outcomes and Measures The primary outcome was conversion to open laparotomy. Secondary end points included intraoperative and postoperative complications, circumferential resection margin positivity (CRM+) and other pathological outcomes, quality of life (36-Item Short Form Survey and 20-item Multidimensional Fatigue Inventory), bladder and sexual dysfunction (International Prostate Symptom Score, International Index of Erectile Function, and Female Sexual Function Index), and oncological outcomes. Results Among 471 randomized patients (mean [SD] age, 64.9 [11.0] years; 320 [67.9%] men), 466 (98.9%) completed the study. The overall rate of conversion to open laparotomy was 10.1%: 19 of 236 patients (8.1%) in the robotic-assisted laparoscopic group and 28 of 230 patients (12.2%) in the conventional laparoscopic group (unadjusted risk difference = 4.1% [95% CI, −1.4% to 9.6%]; adjusted odds ratio = 0.61 [95% CI, 0.31 to 1.21]; P = .16). The overall CRM+ rate was

Development of a two-dimensional simulation code (koad) including atomic processes for beam direct energy conversion

International Nuclear Information System (INIS)

Yamamoto, Y.; Yoshikawa, K.; Hattori, Y.

1987-01-01

A two-dimensional simulation code for the beam direct energy conversion called KVAD (Kyoto University Advanced DART) including various loss mechanisms has been developed, and shown excellent agreement with the authors' experiments using the He + beams. The beam direct energy converter (BDC) is the device to recover the kinetic energy of unneutralized ions in the neutral beam injection (NBI) system directly into electricity. The BDC is very important and essential not only to the improvements of NBI system efficiency, but also to the relaxation of high heat flux problems on the beam dump with increase of injection energies. So far no simulation code could have successfully predicted BDC experimental results. The KUAD code applies, an optimized algorithm for vector processing, the finite element method (FEM) for potential calculation, and a semi-automatic method for spatial segmentations. Since particle trajectories in the KVAD code are analytically solved, very high speed tracings of the particle could be achieved by introducing an adjacent element matrix to identify the neighboring triangle elements and electrodes. Ion space charges are also analytically calculated by the Cloud in Cell (CIC) method, as well as electron space charges. Power losses due to atomic processes can be also evaluated in the KUAD code

On video formats and coding efficiency

NARCIS (Netherlands)

Bellers, E.B.; Haan, de G.

2001-01-01

This paper examines the efficiency of MPEG-2 coding for interlaced and progressive video, and compares de-interlacing and picture rate up-conversion before and after coding. We found receiver side de-interlacing and picture rate up-conversion (i.e. after coding) to give better image quality at a

Opening up codings?

DEFF Research Database (Denmark)

Steensig, Jakob; Heinemann, Trine

2015-01-01

doing formal coding and when doing more “traditional” conversation analysis research based on collections. We are more wary, however, of the implication that coding-based research is the end result of a process that starts with qualitative investigations and ends with categories that can be coded...

Calculation of conversion coefficients Hp(3)/K air using the PENELOPE Monte Carlo code and comparison with MCNP calculation results

International Nuclear Information System (INIS)

Daures, J.; Gouriou, J.; Bordy, J.M.

2010-01-01

The authors report calculations performed using the MNCP and PENELOPE codes to determine the Hp(3)/K air conversion coefficient which allows the Hp(3) dose equivalent to be determined from the measured value of the kerma in the air. They report the definition of the phantom, a 20 cm diameter and 20 cm high cylinder which is considered as representative of a head. Calculations are performed for an energy range corresponding to interventional radiology or cardiology (20 keV-110 keV). Results obtained with both codes are compared

COAST code conversion from Cyber to HP

International Nuclear Information System (INIS)

Lee, Hae Cho

1996-04-01

The transient thermal hydraulic behavior of reactor coolant system in a nuclear power plant following loss of coolant flow is analyzed by use of COAST digital computer code. COAST calculates individual loop flow rates and steam generator pressure drops is a function of time following coast-down of any number of reactor coolant pumps. This report firstly describes detailed work carried out for installation of COAST on HP 9000/700 series and code validation results after installation. Secondly, a series of work is also describes in relation to installation of COAST on Apollo DN10000 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new

CONTRANS 2 code conversion from Apollo to HP

International Nuclear Information System (INIS)

Lee, Hae Cho

1996-01-01

CONTRANS2 computer code is used to calculate transient thermal hydraulic responses of containment building to loss of coolant and main steam line break accident. Mass and energy release to the containment following an accident are code inputs. This report firstly describes detailed work carried out for installation of CONTRANS2 on Apollo DN10000 and code validation results after installation. Secondly, A series of work is also describes in relation to installation of CONTRANS2 on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new

Postoperative conversion disorder.

Science.gov (United States)

Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

2016-05-01

Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations. Copyright © 2016 Elsevier Inc. All rights reserved.

MAD parsing and conversion code

International Nuclear Information System (INIS)

Mokhov, Dmitri N.

2000-01-01

The authors describe design and implementation issues while developing an embeddable MAD language parser. Two working applications of the parser are also described, namely, MAD-> C++ converter and C++ factory. The report contains some relevant details about the parser and examples of converted code. It also describes some of the problems that were encountered and the solutions found for them

Organ dose conversion coefficients based on a voxel mouse model and MCNP code for external photon irradiation.

Science.gov (United States)

Zhang, Xiaomin; Xie, Xiangdong; Cheng, Jie; Ning, Jing; Yuan, Yong; Pan, Jie; Yang, Guoshan

2012-01-01

A set of conversion coefficients from kerma free-in-air to the organ absorbed dose for external photon beams from 10 keV to 10 MeV are presented based on a newly developed voxel mouse model, for the purpose of radiation effect evaluation. The voxel mouse model was developed from colour images of successive cryosections of a normal nude male mouse, in which 14 organs or tissues were segmented manually and filled with different colours, while each colour was tagged by a specific ID number for implementation of mouse model in Monte Carlo N-particle code (MCNP). Monte Carlo simulation with MCNP was carried out to obtain organ dose conversion coefficients for 22 external monoenergetic photon beams between 10 keV and 10 MeV under five different irradiation geometries conditions (left lateral, right lateral, dorsal-ventral, ventral-dorsal, and isotropic). Organ dose conversion coefficients were presented in tables and compared with the published data based on a rat model to investigate the effect of body size and weight on the organ dose. The calculated and comparison results show that the organ dose conversion coefficients varying the photon energy exhibits similar trend for most organs except for the bone and skin, and the organ dose is sensitive to body size and weight at a photon energy approximately <0.1 MeV.

Dose conversion coefficients based on the Chinese mathematical phantom and MCNP code for external photon irradiation

International Nuclear Information System (INIS)

Qiu, R.; Li, J.; Zhang, Z.; Liu, L.; Bi, L.; Ren, L.

2009-01-01

A set of conversion coefficients from kerma free-in-air to the organ-absorbed dose are presented for external monoenergetic photon beams from 10 keV to 10 MeV based on the Chinese mathematical phantom, a whole-body mathematical phantom model. The model was developed based on the methods of the Oak Ridge National Laboratory mathematical phantom series and data from the Chinese Reference Man and the Reference Asian Man. This work is carried out to obtain the conversion coefficients based on this model, which represents the characteristics of the Chinese population, as the anatomical parameters of the Chinese are different from those of Caucasians. Monte Carlo simulation with MCNP code is carried out to calculate the organ dose conversion coefficients. Before the calculation, the effects from the physics model and tally type are investigated, considering both the calculation efficiency and precision. In the calculation irradiation conditions include anterior-posterior, posterior-anterior, right lateral, left lateral, rotational and isotropic geometries. Conversion coefficients from this study are compared with those recommended in the Publication 74 of International Commission on Radiological Protection (ICRP74) since both the sets of data are calculated with mathematical phantoms. Overall, consistency between the two sets of data is observed and the difference for more than 60% of the data is below 10%. However, significant deviations are also found, mainly for the superficial organs (up to 65.9%) and bone surface (up to 66%). The big difference of the dose conversion coefficients for the superficial organs at high photon energy could be ascribed to kerma approximation for the data in ICRP74. Both anatomical variations between races and the calculation method contribute to the difference of the data for bone surface. (authors)

Dose conversion coefficients based on the Chinese mathematical phantom and MCNP code for external photon irradiation.

Science.gov (United States)

Qiu, Rui; Li, Junli; Zhang, Zhan; Liu, Liye; Bi, Lei; Ren, Li

2009-02-01

A set of conversion coefficients from kerma free-in-air to the organ-absorbed dose are presented for external monoenergetic photon beams from 10 keV to 10 MeV based on the Chinese mathematical phantom, a whole-body mathematical phantom model. The model was developed based on the methods of the Oak Ridge National Laboratory mathematical phantom series and data from the Chinese Reference Man and the Reference Asian Man. This work is carried out to obtain the conversion coefficients based on this model, which represents the characteristics of the Chinese population, as the anatomical parameters of the Chinese are different from those of Caucasians. Monte Carlo simulation with MCNP code is carried out to calculate the organ dose conversion coefficients. Before the calculation, the effects from the physics model and tally type are investigated, considering both the calculation efficiency and precision. In the calculation irradiation conditions include anterior-posterior, posterior-anterior, right lateral, left lateral, rotational and isotropic geometries. Conversion coefficients from this study are compared with those recommended in the Publication 74 of International Commission on Radiological Protection (ICRP74) since both the sets of data are calculated with mathematical phantoms. Overall, consistency between the two sets of data is observed and the difference for more than 60% of the data is below 10%. However, significant deviations are also found, mainly for the superficial organs (up to 65.9%) and bone surface (up to 66%). The big difference of the dose conversion coefficients for the superficial organs at high photon energy could be ascribed to kerma approximation for the data in ICRP74. Both anatomical variations between races and the calculation method contribute to the difference of the data for bone surface.

SGN III code conversion from Apollo to HP

International Nuclear Information System (INIS)

Lee, Hae Cho

1996-04-01

SGN III computer code is used to analyze transient behavior of reactor coolant system, pressurizer and steam generators in the event of main steam line break (MSLB), and to calculate mass and energy release for containment design. This report firstly describes detailed work carried out for installation of SFN III on Apollo DN 10000 and code validation results after installation. Secondly, a series of work is also describes in relation to installation of SGN III on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 8 refs. (Author) .new

Monte Carlo determination of the conversion coefficients Hp(3)/Ka in a right cylinder phantom with 'PENELOPE' code. Comparison with 'MCNP' simulations.

Science.gov (United States)

Daures, J; Gouriou, J; Bordy, J M

2011-03-01

This work has been performed within the frame of the European Union ORAMED project (Optimisation of RAdiation protection for MEDical staff). The main goal of the project is to improve standards of protection for medical staff for procedures resulting in potentially high exposures and to develop methodologies for better assessing and for reducing, exposures to medical staff. The Work Package WP2 is involved in the development of practical eye-lens dosimetry in interventional radiology. This study is complementary of the part of the ENEA report concerning the calculations with the MCNP-4C code of the conversion factors related to the operational quantity H(p)(3). In this study, a set of energy- and angular-dependent conversion coefficients (H(p)(3)/K(a)), in the newly proposed square cylindrical phantom made of ICRU tissue, have been calculated with the Monte-Carlo code PENELOPE and MCNP5. The H(p)(3) values have been determined in terms of absorbed dose, according to the definition of this quantity, and also with the kerma approximation as formerly reported in ICRU reports. At a low-photon energy (up to 1 MeV), the two results obtained with the two methods are consistent. Nevertheless, large differences are showed at a higher energy. This is mainly due to the lack of electronic equilibrium, especially for small angle incidences. The values of the conversion coefficients obtained with the MCNP-4C code published by ENEA quite agree with the kerma approximation calculations obtained with PENELOPE. We also performed the same calculations with the code MCNP5 with two types of tallies: F6 for kerma approximation and *F8 for estimating the absorbed dose that is, as known, due to secondary electrons. PENELOPE and MCNP5 results agree for the kerma approximation and for the absorbed dose calculation of H(p)(3) and prove that, for photon energies larger than 1 MeV, the transport of the secondary electrons has to be taken into account.

COOLII code conversion from Cyber to HP

International Nuclear Information System (INIS)

Lee, Hae Cho; Kim, Hee Kyung

1996-06-01

COOLII computer code determines the time required to cooldown the plant from shutdown cooling system initiation condition to cold shutdown or refueling condition. Required time for cooldown is calculated under the various assumption on shutdown cooling heat exchanger(SDCHX) availability, reactor coolant system (RCS) low pressure safety injection(LPSI) flowrate. RCS cooldown rates and component cooling system flow rates. This report firstly describes detailed work carried out for installation of COOLII on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new

Quantum computing with Majorana fermion codes

Science.gov (United States)

Litinski, Daniel; von Oppen, Felix

2018-05-01

We establish a unified framework for Majorana-based fault-tolerant quantum computation with Majorana surface codes and Majorana color codes. All logical Clifford gates are implemented with zero-time overhead. This is done by introducing a protocol for Pauli product measurements with tetrons and hexons which only requires local 4-Majorana parity measurements. An analogous protocol is used in the fault-tolerant setting, where tetrons and hexons are replaced by Majorana surface code patches, and parity measurements are replaced by lattice surgery, still only requiring local few-Majorana parity measurements. To this end, we discuss twist defects in Majorana fermion surface codes and adapt the technique of twist-based lattice surgery to fermionic codes. Moreover, we propose a family of codes that we refer to as Majorana color codes, which are obtained by concatenating Majorana surface codes with small Majorana fermion codes. Majorana surface and color codes can be used to decrease the space overhead and stabilizer weight compared to their bosonic counterparts.

CESEC III code conversion from Apollo to HP9000

International Nuclear Information System (INIS)

Lee, Hae Cho

1996-01-01

CESEC code is a computer program used to analyze transient behaviour of reactor coolant systems of nuclear power plants. CESEC III is an extension of original CESEC code in order to apply wide range of accident analysis including ATWS model. Major parameters during the transients are calculated by CESEC. This report firstly describes detailed work carried out for installation of CESEC III on Apollo DN10000 and code validation results after installation. Secondly, A series of work is also described in relation to installation of CESECIII on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new

CESEC III code conversion from Apollo to HP9000

Energy Technology Data Exchange (ETDEWEB)

Lee, Hae Cho [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

1996-01-01

CESEC code is a computer program used to analyze transient behaviour of reactor coolant systems of nuclear power plants. CESEC III is an extension of original CESEC code in order to apply wide range of accident analysis including ATWS model. Major parameters during the transients are calculated by CESEC. This report firstly describes detailed work carried out for installation of CESEC III on Apollo DN10000 and code validation results after installation. Secondly, A series of work is also described in relation to installation of CESECIII on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new.

Conversion from laparoscopic to open cholecystectomy: Multivariate analysis of preoperative risk factors

Directory of Open Access Journals (Sweden)

Khan M

2005-01-01

Full Text Available BACKGROUND: Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. However, there is a need to devise a risk-scoring system based on the identified risk factors to (a predict the risk of conversion preoperatively for selected patients, (b prepare the patient psychologically, (c arrange operating schedules accordingly, and (d minimize the procedure-related cost and help overcome financial constraints, which is a significant problem in developing countries. AIM: This study was aimed to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy in our setting. SETTINGS AND DESIGNS: A case control study of patients who underwent laparoscopic surgery from January 1997 to December 2001 was conducted at the Aga Khan University Hospital, Karachi, Pakistan. MATERIALS AND METHODS: All those patients who were converted to open surgery (n = 73 were enrolled as cases. Two controls who had successful laparoscopic surgery (n = 146 were matched with each case for operating surgeon and closest date of surgery. STATISTICAL ANALYSIS USED: Descriptive statistics were computed and, univariate and multivariate analysis was done through multiple logistic regression. RESULTS: The final multivariate model identified two risk factors for conversion: ultrasonographic signs of inflammation (adjusted odds ratio [aOR] = 8.5; 95% confidence interval [CI]: 3.3, 21.9 and age > 60 years (aOR = 8.1; 95% CI: 2.9, 22.2 after adjusting for physical signs, alkaline phosphatase and BMI levels. CONCLUSION: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors is important for understanding the characteristics of patients at a higher risk of conversion.

Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery.

Science.gov (United States)

Mirnezami, A H; Mirnezami, R; Venkatasubramaniam, A K; Chandrakumaran, K; Cecil, T D; Moran, B J

2010-11-01

Robotic colorectal surgery is an emerging field and may offer a solution to some of the difficulties inherent to conventional laparoscopic surgery. The aim of this review is to provide a comprehensive and critical analysis of the available literature on the use of robotic technology in colorectal surgery. Studies reporting outcomes of robotic colorectal surgery were identified by systematic searches of electronic databases. Outcomes examined included operating time, length of stay, blood loss, complications, cost, oncological outcome, and conversion rates. Seventeen Studies (nine case series, seven comparative studies, one randomized controlled trial) describing 288 procedures were identified and reviewed. Study heterogeneity precluded a meta-analysis of the data. Robotic procedures tend to take longer and cost more, but may reduce the length of stay, blood loss, and conversion rates. Complication profiles and short-term oncological outcomes are similar to laparoscopic surgery. Robotic colorectal surgery is a promising field and may provide a powerful additional tool for optimal management of more challenging pathology, including rectal cancer. Further studies are required to better define its role. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

Factors determining conversion of laparoscopic to open cholecystectomy

Directory of Open Access Journals (Sweden)

Tapash Kumar Maitra

2017-07-01

Full Text Available Background and objectives:Laparoscopic cholecystectomy (LC has virtually replaced conventional open cholecystectomy (OC as the standard procedure of treatment for cholelithiasis and cholecystitis. However, OC sometimes becomes a necessity considering the feasibility and safety of the surgical procedure. But the factors that demand conversion from LC to OC differ widely. The present study aimed to determine the prevalence of conversion from LC to OC and to assess the causes of conversion and risk factors related to conversion. Methods: The study was conducted in a referral hospital – ‘Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM’ from September 2014 to September 2016. Cases of cholelithiasis with or without cholecystitis, and other gall bladder pathology were included in the study. A team of experienced surgeon performed LC of all selected cases. The causes of conversion to OC were systematically recorded by the surgical team and the risk factors (age, sex, obesity, history of previous abdominal surgery, gallbladder thickness related to conversion from LC to OC was investigated. Results: A total of 261 (M / F = 87 /174 patients were considered eligible for the study. The mean age of all patients was 43 (±1.75 years. For the male and female groups the mean ages were 44±1.9 and 42±1.6 years respectively. Of the total 261 cases, 210 (80.5% patients had cholelithiasis with chronic cholecystitis, 47 (18.0% had gallbladder stone plus acute cholecystitis and 4 (1.5% had gallbladder polyp. Open conversion was required in case of 19 patients. Thus, overall conversion rate was 7.3%. The common causes of conversion were a difficulty in defining Calot’s triangle (42.1%, b injury to cystic artery (21.1% and c injury to bile duct (15.8%. Both male and female had equal risk for conversion. The investigated risk factors like history of previous abdominal surgery, preoperative ERCP, acute

A Study of Clinical Coding Accuracy in Surgery: Implications for the Use of Administrative Big Data for Outcomes Management.

Science.gov (United States)

Nouraei, S A R; Hudovsky, A; Frampton, A E; Mufti, U; White, N B; Wathen, C G; Sandhu, G S; Darzi, A

2015-06-01

Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisciplinary teams reviewed the coding of 30,127 patients and assessed accuracy at primary and secondary diagnosis and procedure levels, morbidity level, complications assignment, and financial variance. Postaudit data of a randomly selected sample of 400 cases were reaudited by an independent team. At least 1 coding change occurred in 15,402 patients (51%). There were 3911 (13%) and 3620 (12%) changes to primary diagnoses and procedures, respectively. In 5183 (17%) patients, the Health Resource Grouping changed, resulting in income variance of £3,974,544 (+6.2%). The morbidity level changed in 2116 (7%) patients (P data are a key engine for knowledge-driven health care provision. They are used, increasingly at individual surgeon level, to benchmark performance. Surgical clinical coding is prone to subjectivity, variability, and error (SVE). Having a specialty-by-specialty understanding of the nature and clinical significance of informatics variability and adopting strategies to reduce it, are necessary to allow accurate assumptions and informed decisions to be made concerning the scope and clinical applicability of administrative data in surgical outcomes improvement.

Analysing Afrikaans-English bilingual children's conversational code ...

African Journals Online (AJOL)

Chloros (2009:143) points out, the study of code switching (CS) is lacking in terms of research on children ...... Cutting, J. 2002. Pragmatics and Discourse: A resource book for students. ... MA: Harvard University Press. Hoffman, C. 1991.

[Hand surgery in the German DRG System 2007].

Science.gov (United States)

Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

2007-05-01

Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

Evaluating Coding Accuracy in General Surgery Residents' Accreditation Council for Graduate Medical Education Procedural Case Logs.

Science.gov (United States)

Balla, Fadi; Garwe, Tabitha; Motghare, Prasenjeet; Stamile, Tessa; Kim, Jennifer; Mahnken, Heidi; Lees, Jason

.0043). The survey response rate was 100%. Survey results indicated that inability to find the precise code within the ACGME search interface and unfamiliarity with available CPT codes were by far the most common perceived barriers to accuracy. Survey results also indicated that most residents (74%) believe that they code accurately most of the time and agree that their case log would accurately represent their operative experience (66.6%). This is the first study to evaluate correctness of residents' ACGME case logs in general surgery. The degree of inaccuracy found here necessitates further investigation into the etiology of these discrepancies. Instruction on coding practices should also benefit the residents after graduation. Optimizing communication among attendings and residents, improving ACGME coding search interface, and implementing consistent coding practices could improve accuracy giving a more realistic view of residents' operative experience. Published by Elsevier Inc.

FLOOD 3 code conversion from Apollo to HP

Energy Technology Data Exchange (ETDEWEB)

Lee, Hae Cho [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

1996-01-01

FLOOD3 is a Fortran program used to analyze LOCA Reflood and Post Reflood transients for purpose of mechanistically generating containment sizing mass/energy source terms. The reflood time frame starts when safety injection water first enters the bottom of the core, following the initial LOCA blowdown phase, and the ends when liquid level in the core is high enough to quench the core. The post reflood phase starts at the end of reflood phase and lasts until the end of LOCA transient period. Longterm core cooling is initiated following post reflood phase. FLOOD3 code dose not contain separate capability for longterm cooling analysis. This report firstly describes detailed work carried out for installation of FLOOD3 on Apollo DN10000 and code validation results after installation. Secondly, A series of work is also describes in relation to installation of FLOOD3 on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new.

FLOOD 3 code conversion from Apollo to HP

International Nuclear Information System (INIS)

Lee, Hae Cho

1996-01-01

FLOOD3 is a Fortran program used to analyze LOCA Reflood and Post Reflood transients for purpose of mechanistically generating containment sizing mass/energy source terms. The reflood time frame starts when safety injection water first enters the bottom of the core, following the initial LOCA blowdown phase, and the ends when liquid level in the core is high enough to quench the core. The post reflood phase starts at the end of reflood phase and lasts until the end of LOCA transient period. Longterm core cooling is initiated following post reflood phase. FLOOD3 code dose not contain separate capability for longterm cooling analysis. This report firstly describes detailed work carried out for installation of FLOOD3 on Apollo DN10000 and code validation results after installation. Secondly, A series of work is also describes in relation to installation of FLOOD3 on HP 9000/700 series as well as relevant code validation results. Attached is a report on software verification and validation results. 7 refs. (Author) .new

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

Science.gov (United States)

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

2018-01-01

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

Codes and curves

CERN Document Server

Walker, Judy L

2000-01-01

When information is transmitted, errors are likely to occur. Coding theory examines efficient ways of packaging data so that these errors can be detected, or even corrected. The traditional tools of coding theory have come from combinatorics and group theory. Lately, however, coding theorists have added techniques from algebraic geometry to their toolboxes. In particular, by re-interpreting the Reed-Solomon codes, one can see how to define new codes based on divisors on algebraic curves. For instance, using modular curves over finite fields, Tsfasman, Vladut, and Zink showed that one can define a sequence of codes with asymptotically better parameters than any previously known codes. This monograph is based on a series of lectures the author gave as part of the IAS/PCMI program on arithmetic algebraic geometry. Here, the reader is introduced to the exciting field of algebraic geometric coding theory. Presenting the material in the same conversational tone of the lectures, the author covers linear codes, inclu...

Analysing Afrikaans-English bilingual children's conversational code ...

African Journals Online (AJOL)

It has been observed that children mix languages more often if they have been exposed to mixed speech, especially if they are in bilingual company. Very little research, however, exists on the code switching (CS) of children brought up in multilingual contexts. The study discussed in this paper investigates the grammatical ...

Foot Surgery

Science.gov (United States)

... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... crutches after the surgery or in a cast. Fusions: Fusions are usually performed to treat arthritic or ...

[Orthopedic and trauma surgery in the German DRG System 2007].

Science.gov (United States)

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2007-03-01

The German Diagnosis-Related Groups (DRG) System was further developed into its 2007 version. For orthopedic and trauma surgery, significant changes were made in terms of the coding of diagnoses and medical procedures, as well as in the DRG structure itself. The German Societies for Trauma Surgery and for Orthopedics and Orthopedic Surgery (Deutsch Gesellschaft für Unfallchirurgie, DGU; and Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie, DGOOC) once again cooperated constructively with the German DRG Institute InEK. Among other innovations, new International Classification of Diseases (ICD) codes for second-degree burns were implemented. Procedure codes for joint operations, endoprosthetic-surgery and spine surgery were restructured. Furthermore, a specific code for septic surgery was introduced in 2007. In addition, the DRG structure was improved. Case allocation of patients with more than one significant operation was established. Further DRG subdivisions were established according to the patients age and the Patient Clinical Complexity Level (PCCL). DRG developments for 2007 have improved appropriate case allocation, but once again increased the system's complexity. Clinicians need an ever growing amount of specific coding know-how. Still, further adjustments to the German DRG system are required to allow for a correct allocation of cases and funds.

CONTAIN code calculations of the effects on the source term of CsI to I/sub 2/ conversion due to severe hydrogen burns

International Nuclear Information System (INIS)

Valdez, G.D.; Williams, D.C.

1986-01-01

In experiments conducted at Sandia National Laboratories large amounts of elemental iodine were produced when CsI-Al 2 O 3 aerosol was exposed to hydrogen/air combustion. To evaluate some of the implications of the iodide conversion (observed to occur with up to 75% efficiency) for the severe accident source term, computational simulations of representative accident sequences were conducted with the CONTAIN code. The following conclusions can be drawn from this preliminary source term assessment: (1) If the containment sprays are inoperative during the accident, or failed by the hydrogen burn, the late-time source term is almost tripled when the iodide is converted to I 2 . (2) With the sprays active, the amount released without conversion of the CsI aerosol is 63% higher than for the case when conversion occurs. (3) For the case where CsI is converted to I 2 continued operation of the sprays reduces the release by a factor of 40, relative to the case in which the sprays fail at the time of the hydrogen burn. When there is no conversion, the reduction factor for continued spray operation is about a factor of 9, relative to the failed spray case

Development of a Performance Analysis Code for the Off-design conditions of a S-CO2 Brayton Cycle Energy Conversion System

International Nuclear Information System (INIS)

Yoo, Yong-Hwan; Cha, Jae-Eun; Lee, Tae-Ho; Eoh, Jae-Hyuk; Kim, Seong-O

2008-01-01

For the development of a supercritical carbon dioxide (S-CO2) Brayton cycle energy conversion system coupled to KALIMER-600, a thermal balance has been established on 100% power operating conditions including all the reactor system models such as a primary heat transport system (PHTS), an intermediate heat transport system (IHTS), and an energy conversion system. The S-CO2 Brayton cycle energy conversion system consists of a sodium-CO2 heat exchanger (Hx), turbine, high temperature recuperate (HTR), low temperature recuperate (LTR), precooler, compressor no.1, and compressor no.2. Two compressors were employed to avoid a sharp change of the physical properties near their critical point with a corresponding pressure. The component locations and their operating conditions are illustrated. Energy balance of the power conversion system in KALIMER-600 was designed with the full power condition of each component. Therefore, to predict the off-design conditions and to evaluate each component, an off-design performance analysis code should be accomplished. An off-design performance analysis could be classified into overall system control logic and local system control logic. The former means that mass flow rate and power are controlled by valves, and the latter implies that a bypass or inventory control is an admitted system balance. The ultimate goal of this study is development of the overall system control logic

Conversational Effects of Gender and Children's Moral Reasoning

OpenAIRE

Björnberg, Marina

2007-01-01

This thesis aimed partly to examine the effects of gender on conversation dynamics, partly to investigate whether interaction between participants with contrasting opinions promotes cognitive development on a moral task. Another objective was to explore whether particular conversational features of interaction would have any impact upon a pair’s joint response or on each child’s moral development. The conversations were coded with regard to simultaneous speech acts, psychosocial behaviour and...

Development of a tritium dispersion code

International Nuclear Information System (INIS)

Bell, R.P.; Davis, M.W.; Joseph, S.; Wong, K.Y.

1985-01-01

This paper describes the development and verification of a computer code designed to calculate the radiation dose to man following acute or chronic atmospheric releases of tritium gas and oxide from a point source. The Ontario Hydro Tritium Dispersion Code calculates tritium concentrations in air, soil, and vegetation and doses to man resulting from inhalation/immersion and ingestion of food, milk meat and water. The deposition of HT to soil, conversion of HT to HTO by soil enzymes and resuspension of HTO to air have been incorporated into the terrestrial compartment model and are unique features of the code. Sensitivity analysis has identified the HT deposition velocity and the equivalent water depth of the vegetation compartment as two parameters which have a strong influence on dose calculations. Tritium concentrations in vegetation and soil calculated by the code were in reasonable agreement with experimental results. The radiological significance of including the mechanisms of HT to HTO conversion and resuspension of HTO to air is illustrated

Emergency general surgery: definition and estimated burden of disease.

Science.gov (United States)

Shafi, Shahid; Aboutanos, Michel B; Agarwal, Suresh; Brown, Carlos V R; Crandall, Marie; Feliciano, David V; Guillamondegui, Oscar; Haider, Adil; Inaba, Kenji; Osler, Turner M; Ross, Steven; Rozycki, Grace S; Tominaga, Gail T

2013-04-01

Acute care surgery encompasses trauma, surgical critical care, and emergency general surgery (EGS). While the first two components are well defined, the scope of EGS practice remains unclear. This article describes the work of the American Association for the Surgery of Trauma to define EGS. A total of 621 unique International Classification of Diseases-9th Rev. (ICD-9) diagnosis codes were identified using billing data (calendar year 2011) from seven large academic medical centers that practice EGS. A modified Delphi methodology was used by the American Association for the Surgery of Trauma Committee on Severity Assessment and Patient Outcomes to review these codes and achieve consensus on the definition of primary EGS diagnosis codes. National Inpatient Sample data from 2009 were used to develop a national estimate of EGS burden of disease. Several unique ICD-9 codes were identified as primary EGS diagnoses. These encompass a wide spectrum of general surgery practice, including upper and lower gastrointestinal tract, hepatobiliary and pancreatic disease, soft tissue infections, and hernias. National Inpatient Sample estimates revealed over 4 million inpatient encounters nationally in 2009 for EGS diseases. This article provides the first list of ICD-9 diagnoses codes that define the scope of EGS based on current clinical practices. These findings have wide implications for EGS workforce training, access to care, and research.

Computer codes for neutron data evaluation

International Nuclear Information System (INIS)

Nakagawa, Tsuneo

1979-01-01

Data compilation codes such as NESTOR and REPSTOR, and NDES (Neutron Data Evaluation System) are mainly discussed. NDES is a code for neutron data evaluation using a TSS terminal, TEKTRONIX 4014. Users of NDES can perform plotting of data and calculation with nuclear models under conversational mode. (author)

Neutronic analysis for core conversion (HEU–LEU of the low power research reactor using the MCNP4C code

Directory of Open Access Journals (Sweden)

Aldawahra Saadou

2015-06-01

Full Text Available Comparative studies for conversion of the fuel from HEU to LEU in the miniature neutron source reactor (MNSR have been performed using the MCNP4C code. The HEU fuel (UAl4-Al, 90% enriched with Al clad and LEU (UO2 12.6% enriched with zircaloy-4 alloy clad cores have been analyzed in this study. The existing HEU core of MNSR was analyzed to validate the neutronic model of reactor, while the LEU core was studied to prove the possibility of fuel conversion of the existing HEU core. The proposed LEU core contained the same number of fuel pins as the HEU core. All other structure materials and dimensions of HEU and LEU cores were the same except the increase in the radius of control rod material from 0.195 to 0.205 cm and keeping the outer diameter of the control rod unchanged in the LEU core. The effective multiplication factor (keff, excess reactivity (ρex, control rod worth (CRW, shutdown margin (SDM, safety reactivity factor (SRF, delayed neutron fraction (βeff and the neutron fluxes in the irradiation tubes for the existing and the potential LEU fuel were investigated. The results showed that the safety parameters and the neutron fluxes in the irradiation tubes of the LEU fuels were in good agreements with the HEU results. Therefore, the LEU fuel was validated to be a suitable choice for fuel conversion of the MNSR in the future.

Assessing distractors and teamwork during surgery: developing an event-based method for direct observation.

Science.gov (United States)

Seelandt, Julia C; Tschan, Franziska; Keller, Sandra; Beldi, Guido; Jenni, Nadja; Kurmann, Anita; Candinas, Daniel; Semmer, Norbert K

2014-11-01

To develop a behavioural observation method to simultaneously assess distractors and communication/teamwork during surgical procedures through direct, on-site observations; to establish the reliability of the method for long (>3 h) procedures. Observational categories for an event-based coding system were developed based on expert interviews, observations and a literature review. Using Cohen's κ and the intraclass correlation coefficient, interobserver agreement was assessed for 29 procedures. Agreement was calculated for the entire surgery, and for the 1st hour. In addition, interobserver agreement was assessed between two tired observers and between a tired and a non-tired observer after 3 h of surgery. The observational system has five codes for distractors (door openings, noise distractors, technical distractors, side conversations and interruptions), eight codes for communication/teamwork (case-relevant communication, teaching, leadership, problem solving, case-irrelevant communication, laughter, tension and communication with external visitors) and five contextual codes (incision, last stitch, personnel changes in the sterile team, location changes around the table and incidents). Based on 5-min intervals, Cohen's κ was good to excellent for distractors (0.74-0.98) and for communication/teamwork (0.70-1). Based on frequency counts, intraclass correlation coefficient was excellent for distractors (0.86-0.99) and good to excellent for communication/teamwork (0.45-0.99). After 3 h of surgery, Cohen's κ was 0.78-0.93 for distractors, and 0.79-1 for communication/teamwork. The observational method developed allows a single observer to simultaneously assess distractors and communication/teamwork. Even for long procedures, high interobserver agreement can be achieved. Data collected with this method allow for investigating separate or combined effects of distractions and communication/teamwork on surgical performance and patient outcomes. Published by the

Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

Science.gov (United States)

Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

1988-01-01

The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

Content Coding of Psychotherapy Transcripts Using Labeled Topic Models.

Science.gov (United States)

Gaut, Garren; Steyvers, Mark; Imel, Zac E; Atkins, David C; Smyth, Padhraic

2017-03-01

Psychotherapy represents a broad class of medical interventions received by millions of patients each year. Unlike most medical treatments, its primary mechanisms are linguistic; i.e., the treatment relies directly on a conversation between a patient and provider. However, the evaluation of patient-provider conversation suffers from critical shortcomings, including intensive labor requirements, coder error, nonstandardized coding systems, and inability to scale up to larger data sets. To overcome these shortcomings, psychotherapy analysis needs a reliable and scalable method for summarizing the content of treatment encounters. We used a publicly available psychotherapy corpus from Alexander Street press comprising a large collection of transcripts of patient-provider conversations to compare coding performance for two machine learning methods. We used the labeled latent Dirichlet allocation (L-LDA) model to learn associations between text and codes, to predict codes in psychotherapy sessions, and to localize specific passages of within-session text representative of a session code. We compared the L-LDA model to a baseline lasso regression model using predictive accuracy and model generalizability (measured by calculating the area under the curve (AUC) from the receiver operating characteristic curve). The L-LDA model outperforms the lasso logistic regression model at predicting session-level codes with average AUC scores of 0.79, and 0.70, respectively. For fine-grained level coding, L-LDA and logistic regression are able to identify specific talk-turns representative of symptom codes. However, model performance for talk-turn identification is not yet as reliable as human coders. We conclude that the L-LDA model has the potential to be an objective, scalable method for accurate automated coding of psychotherapy sessions that perform better than comparable discriminative methods at session-level coding and can also predict fine-grained codes.

Cracking the code: the accuracy of coding shoulder procedures and the repercussions.

Science.gov (United States)

Clement, N D; Murray, I R; Nie, Y X; McBirnie, J M

2013-05-01

Coding of patients' diagnosis and surgical procedures is subject to error levels of up to 40% with consequences on distribution of resources and financial recompense. Our aim was to explore and address reasons behind coding errors of shoulder diagnosis and surgical procedures and to evaluate a potential solution. A retrospective review of 100 patients who had undergone surgery was carried out. Coding errors were identified and the reasons explored. A coding proforma was designed to address these errors and was prospectively evaluated for 100 patients. The financial implications were also considered. Retrospective analysis revealed the correct primary diagnosis was assigned in 54 patients (54%) had an entirely correct diagnosis, and only 7 (7%) patients had a correct procedure code assigned. Coders identified indistinct clinical notes and poor clarity of procedure codes as reasons for errors. The proforma was significantly more likely to assign the correct diagnosis (odds ratio 18.2, p code (odds ratio 310.0, p coding department. High error levels for coding are due to misinterpretation of notes and ambiguity of procedure codes. This can be addressed by allowing surgeons to assign the diagnosis and procedure using a simplified list that is passed directly to coding.

Libraries as Facilitators of Coding for All

Science.gov (United States)

Martin, Crystle

2017-01-01

Learning to code has been an increasingly frequent topic of conversation both in academic circles and popular media. Learning to code recently received renewed attention with the announcement of the White House's Computer Science for All initiative (Smith 2016). This initiative intends "to empower all American students from kindergarten…

[Simulation in pediatric surgery].

Science.gov (United States)

Becmeur, François; Lacreuse, Isabelle; Soler, Luc

2011-11-01

Simulation in paediatric surgery is essential for educational, ethical, medicolegal and economic reasons, and is particularly important for rare procedures. There are three different levels of simulation:--simulation of basic techniques in order to learn or improve surgical skills (dissection, intracorporeal knots, etc.);--preparation for surgery using virtual reality, to perfect and test various procedures on a virtual patient, and to determine the best approaches for individual cases;--behavioral simulation underlines the importance of the preoperative check-list and facilitates crisis management (complications, conversion, etc.).

[Orthopedic and trauma surgery in the German DRG system. Recent developments].

Science.gov (United States)

Franz, D; Schemmann, F; Selter, D D; Wirtz, D C; Roeder, N; Siebert, H; Mahlke, L

2012-07-01

Orthopedics and trauma surgery are subject to continuous medical advancement. The correct and performance-based case allocation by German diagnosis-related groups (G-DRG) is a major challenge. This article analyzes and assesses current developments in orthopedics and trauma surgery in the areas of coding of diagnoses and medical procedures and the development of the 2012 G-DRG system. The relevant diagnoses, medical procedures and G-DRGs in the versions 2011 and 2012 were analyzed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes were made for the International Classification of Diseases (ICD) coding of complex cases with medical complications, the procedure coding for spinal surgery and for hand and foot surgery. The G-DRG structures were modified for endoprosthetic surgery on ankle, shoulder and elbow joints. The definition of modular structured endoprostheses was clarified. The G-DRG system for orthopedic and trauma surgery appears to be largely consolidated. The current phase of the evolution of the G-DRG system is primarily aimed at developing most exact descriptions and definitions of the content and mutual delimitation of operation and procedures coding (OPS). This is an essential prerequisite for a correct and performance-based case allocation in the G-DRG system.

Delayed, spontaneous conversion of type 2 closure to type 1 closure following surgery for traumatic macular hole associated with submacular hemorrhage

Directory of Open Access Journals (Sweden)

Pukhraj Rishi

2012-01-01

Full Text Available A 45-year-old man presented with diminution of vision in the left eye following a firecracker injury. Best corrected visual acuity (BCVA was 20/20 in the right eye and 20/125 in the left eye. Fundus examination revealed vitreous hemorrhage, a macular hole, and submacular hemorrhage in the left eye. The patient underwent vitrectomy, tissue plasminogen activator (tPA-assisted evacuation of the submacular hemorrhage, internal limiting membrane (ILM peeling, and 14% C3F8 gas insufflation. After two months, the BCVA remained 20/125 and optical coherence tomography (OCT showed type 2 macular hole closure. On a follow-up, seven months after surgery, BCVA improved to 20/80, N6, with type 1 closure of the macular hole. The clinical findings were confirmed on OCT. Delayed and spontaneous conversion of the traumatic macular hole could occur several months after the primary surgery and may be associated with improved visual outcome. Larger studies are required to better understand the factors implicated in such a phenomenon.

Laparascopic cholecystectomy for acute cholecystitis: Can preoperative factors predict conversion?

International Nuclear Information System (INIS)

Khan, Iftikhar A.; El-Tinay, Omer E.

2004-01-01

To determine if preoperative clinical, laboratory and radiology data can predict conversion of laparascopic cholecystectomy for acute cholecystitis to open procedure. Retrospective analysis of 44 laparascopic cholecystectomies were performed for acute cholecystitisbetween August 2000 and July 2002 at King Khalid University Hospital, Riyadh, kingdom of Saudi Arabia. Data related to age and sex of patients, maximum body temprature,white blood cell count, gallbladder wall thickness or ultrasonography and timing of surgery from onset of symptoms were collected.The procedure was converted from laparascopic to open cholecystectomy in 10 patients (23%). Conversion rate was significantly high (33% versus zero; p=0.01) if the gallbladder wall was thickened. Conversion rate was significantly low ( Zero versus 32%: p=0.01) if the procedure was performed within 48 hours from the onset of the symptoms. The data relawted to age, sex, white blood cell count and body temprature did not reliably predict conversion of laparascopic cholecystectomy (LD) for acute cholecystitis to open procedure. There was no mortality or major morbidity. Laparascopic cholecystectomy is a safe modality of treatment for acute cholecystitis. Factors associated with increased conversion rate are thickened gallbladder wall on ultrasonographyand delay in surgery for more than 48 hours from the onset of symptoms. (author)

Mutation in the B chain coding region is associated with impaired proinsulin conversion in a family with hyperproinsulinemia

International Nuclear Information System (INIS)

Chan, S.J.; Seino, S.; Gruppuso, P.A.; Schwartz, R.; Steiner, D.F.

1987-01-01

A family has recently been described in which hyperproinsulinemia is inherited in an autosomal dominant pattern, suggesting a structural abnormality in the proinsulin molecule as the basis for this disorder. However, unlike two previous kindreds with a similar syndrome, the serum proinsulin-like material in this family did not appear to be an intermediate conversion product but instead behaved like normal human proinsulin by several criteria. To further characterize this disorder the authors isolated and sequenced the insulin gene of the propositus. Leukocyte DNA was cloned in λgt-WES and recombinants containing the two insulin alleles, λMD41 and λMD51, were isolated by plaque hybridization. DNA sequencing of λMD51 showed that it contained the normal coding sequence for human preproinsulin. Sequence analysis of λMD41, however, revealed a single nucleotide substitution in the codon for residue 10 of proinsulin (CAC → GAC) that predicts the exchange of aspartic acid for histidine in the insulin B chain region. This mutation was also found in an insulin allele cloned from a second affected family member (propositus's father). These results strongly implicate this mutation as the cause of the hyperproinsulinemia in this family. Inhibition of the conversion of proinsulin to insulin may be related to altered folding and/or self-association properties of the [Asp 10 ]proinsulin

Does pedagogical documentation support maternal reminiscing conversations?

Directory of Open Access Journals (Sweden)

Bethany Fleck

2015-12-01

Full Text Available When parents talk with their children about lessons learned in school, they are participating in reminiscing of an unshared event. This study sought to understand if pedagogical documentation, from the Reggio Approach to early childhood education, would support and enhance the conversation. Mother–child dyads reminisced two separate times about preschool lessons, one time with documentation available to them and one time without. Transcripts were coded extracting variables indicative of high and low maternal reminiscing styles. Results indicate that mother and child conversation characteristics were more highly elaborative when documentation was present than when it was not. In addition, children added more information to the conversation supporting the notion that such conversations enhanced memory for lessons. Documentation could be used as a support tool for conversations and children’s memory about lessons learned in school.

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Joint Dictionary Learning-Based Non-Negative Matrix Factorization for Voice Conversion to Improve Speech Intelligibility After Oral Surgery.

Science.gov (United States)

Fu, Szu-Wei; Li, Pei-Chun; Lai, Ying-Hui; Yang, Cheng-Chien; Hsieh, Li-Chun; Tsao, Yu

2017-11-01

Objective: This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient's speech may be distorted and difficult to understand. To overcome this problem, VC methods can be applied to convert the distorted speech such that it is clear and more intelligible. To design an effective VC method, two key points must be considered: 1) the amount of training data may be limited (because speaking for a long time is usually difficult for postoperative patients); 2) rapid conversion is desirable (for better communication). Methods: We propose a novel joint dictionary learning based non-negative matrix factorization (JD-NMF) algorithm. Compared to conventional VC techniques, JD-NMF can perform VC efficiently and effectively with only a small amount of training data. Results: The experimental results demonstrate that the proposed JD-NMF method not only achieves notably higher short-time objective intelligibility (STOI) scores (a standardized objective intelligibility evaluation metric) than those obtained using the original unconverted speech but is also significantly more efficient and effective than a conventional exemplar-based NMF VC method. Conclusion: The proposed JD-NMF method may outperform the state-of-the-art exemplar-based NMF VC method in terms of STOI scores under the desired scenario. Significance: We confirmed the advantages of the proposed joint training criterion for the NMF-based VC. Moreover, we verified that the proposed JD-NMF can effectively improve the speech intelligibility scores of oral surgery patients. Objective: This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient

Linguistic Alternants and Code Selection in Baba Malay.

Science.gov (United States)

Pakir, Anne

1989-01-01

Provides a brief account and explanation of the phenomenon of language use among the Baba community, which uses Hokkien, Malay, and English in the process of code selection and code mixing/switching. Data are drawn from recordings of conversation of the Babas and Nyonyas. (Author/OD)

Accuracy of clinical coding for procedures in oral and maxillofacial surgery.

Science.gov (United States)

Khurram, S A; Warner, C; Henry, A M; Kumar, A; Mohammed-Ali, R I

2016-10-01

Clinical coding has important financial implications, and discrepancies in the assigned codes can directly affect the funding of a department and hospital. Over the last few years, numerous oversights have been noticed in the coding of oral and maxillofacial (OMF) procedures. To establish the accuracy and completeness of coding, we retrospectively analysed the records of patients during two time periods: March to May 2009 (324 patients), and January to March 2014 (200 patients). Two investigators independently collected and analysed the data to ensure accuracy and remove bias. A large proportion of operations were not assigned all the relevant codes, and only 32% - 33% were correct in both cycles. To our knowledge, this is the first reported audit of clinical coding in OMFS, and it highlights serious shortcomings that have substantial financial implications. Better input by the surgical team and improved communication between the surgical and coding departments will improve accuracy. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Development of simplified decommissioning cost estimation code for nuclear facilities

International Nuclear Information System (INIS)

Tachibana, Mitsuo; Shiraishi, Kunio; Ishigami, Tsutomu

2010-01-01

The simplified decommissioning cost estimation code for nuclear facilities (DECOST code) was developed in consideration of features and structures of nuclear facilities and similarity of dismantling methods. The DECOST code could calculate 8 evaluation items of decommissioning cost. Actual dismantling in the Japan Atomic Energy Agency (JAEA) was evaluated; unit conversion factors used to calculate the manpower of dismantling activities were evaluated. Consequently, unit conversion factors of general components could be classified into three kinds. Weights of components and structures of the facility were necessary for calculation of manpower. Methods for evaluating weights of components and structures of the facility were studied. Consequently, the weight of components in the facility was proportional to the weight of structures of the facility. The weight of structures of the facility was proportional to the total area of floors in the facility. Decommissioning costs of 7 nuclear facilities in the JAEA were calculated by using the DECOST code. To verify the calculated results, the calculated manpower was compared with the manpower gained from actual dismantling. Consequently, the calculated manpower and actual manpower were almost equal. The outline of the DECOST code, evaluation results of unit conversion factors, the evaluation method of the weights of components and structures of the facility are described in this report. (author)

Supercritical Carbon Dioxide Brayton Cycle Energy Conversion System

Energy Technology Data Exchange (ETDEWEB)

Cha, Jae Eun; Kim, S. O.; Seong, S. H.; Eoh, J. H.; Lee, T. H.; Choi, S. K.; Han, J. W.; Bae, S. W

2007-12-15

This report contains the description of the S-CO{sub 2} Brayton cycle coupled to KALIMER-600 as an alternative energy conversion system. For system development, a computer code was developed to calculate heat balance of 100% power operation condition. Based on the computer code, the S-CO{sub 2} Brayton cycle energy conversion system was constructed for the KALIMER-600. Using the developed turbomachinery models, the off-design characteristics and the sensitivities of the S-CO{sub 2} turbomachinery were investigated. For the development of PCHE models, a one-dimensional analysis computer code was developed to evaluate the performance of the PCHE. Possible control schemes for power control in the KALIMER-600 S-CO{sub 2} Brayton cycle were investigated by using the MARS code. Simple power reduction and recovery event was selected and analyzed for the transient calculation. For the evaluation of Na/CO{sub 2} boundary failure event, a computer was developed to simulate the complex thermodynamic behaviors coupled with the chemical reaction between liquid sodium and CO{sub 2} gas. The long term behavior of a Na/CO{sub 2} boundary failure event and its consequences which lead to a system pressure transient were evaluated.

Supercritical Carbon Dioxide Brayton Cycle Energy Conversion System

International Nuclear Information System (INIS)

Cha, Jae Eun; Kim, S. O.; Seong, S. H.; Eoh, J. H.; Lee, T. H.; Choi, S. K.; Han, J. W.; Bae, S. W.

2007-12-01

This report contains the description of the S-CO 2 Brayton cycle coupled to KALIMER-600 as an alternative energy conversion system. For system development, a computer code was developed to calculate heat balance of 100% power operation condition. Based on the computer code, the S-CO 2 Brayton cycle energy conversion system was constructed for the KALIMER-600. Using the developed turbomachinery models, the off-design characteristics and the sensitivities of the S-CO 2 turbomachinery were investigated. For the development of PCHE models, a one-dimensional analysis computer code was developed to evaluate the performance of the PCHE. Possible control schemes for power control in the KALIMER-600 S-CO 2 Brayton cycle were investigated by using the MARS code. Simple power reduction and recovery event was selected and analyzed for the transient calculation. For the evaluation of Na/CO 2 boundary failure event, a computer was developed to simulate the complex thermodynamic behaviors coupled with the chemical reaction between liquid sodium and CO 2 gas. The long term behavior of a Na/CO 2 boundary failure event and its consequences which lead to a system pressure transient were evaluated

Robotic liver surgery: results for 70 resections.

Science.gov (United States)

Giulianotti, Pier Cristoforo; Coratti, Andrea; Sbrana, Fabio; Addeo, Pietro; Bianco, Francesco Maria; Buchs, Nicolas Christian; Annechiarico, Mario; Benedetti, Enrico

2011-01-01

Robotic surgery is gaining popularity for digestive surgery; however, its use for liver surgery is reported scarcely. This article reviews a surgeon's experience with the use of robotic surgery for liver resections. From March 2002 to March 2009, 70 robotic liver resections were performed at 2 different centers by a single surgeon. The surgical procedure and postoperative outcome data were reviewed retrospectively. Malignant tumors were indications for resections in 42 (60%) patients, whereas benign tumors were indications in 28 (40%) patients. The median age was 60 years (range, 21-84) and 57% of patients were female. Major liver resections (≥ 3 liver segments) were performed in 27 (38.5%) patients. There were 4 conversions to open surgery (5.7%). The median operative time for a major resection was 313 min (range, 220-480) and 198 min (range, 90-459) for minor resection. The median blood loss was 150 mL (range, 20-1,800) for minor resection and 300 mL (range, 100-2,000) for major resection. The mortality rate was 0%, and the overall rate of complications was 21%. Major morbidity occurred in 4 patients in the major hepatectomies group (14.8%) and in 4 patients in the minor hepatectomies group (9.3%). All complications were managed conservatively and none required reoperation. This preliminary experience shows that robotic surgery can be used safely for liver resections with a limited conversion rate, blood loss, and postoperative morbidity. Robotics offers a new technical option for minimally invasive liver surgery. Copyright © 2011 Mosby, Inc. All rights reserved.

Conversion of Input Data between KENO and MCNP File Formats for Computer Criticality Assessments

International Nuclear Information System (INIS)

Schwarz, Randolph A.; Carter, Leland L.; Schwarz Alysia L.

2006-01-01

KENO is a Monte Carlo criticality code that is maintained by Oak Ridge National Laboratory (ORNL). KENO is included in the SCALE (Standardized Computer Analysis for Licensing Evaluation) package. KENO is often used because it was specifically designed for criticality calculations. Because KENO has convenient geometry input, including the treatment of lattice arrays of materials, it is frequently used for production calculations. Monte Carlo N-Particle (MCNP) is a Monte Carlo transport code maintained by Los Alamos National Laboratory (LANL). MCNP has a powerful 3D geometry package and an extensive cross section database. It is a general-purpose code and may be used for calculations involving shielding or medical facilities, for example, but can also be used for criticality calculations. MCNP is becoming increasingly more popular for performing production criticality calculations. Both codes have their own specific advantages. After a criticality calculation has been performed with one of the codes, it is often desirable (or may be a safety requirement) to repeat the calculation with the other code to compare the important parameters using a different geometry treatment and cross section database. This manual conversion of input files between the two codes is labor intensive. The industry needs the capability of converting geometry models between MCNP and KENO without a large investment in manpower. The proposed conversion package will aid the user in converting between the codes. It is not intended to be used as a ''black box''. The resulting input file will need to be carefully inspected by criticality safety personnel to verify the intent of the calculation is preserved in the conversion. The purpose of this package is to help the criticality specialist in the conversion process by converting the geometry, materials, and pertinent data cards

Dose conversion coefficients for high-energy photons, electrons, neutrons and protons

International Nuclear Information System (INIS)

Sakamoto, Yukio

2005-01-01

Dose conversion coefficients for photons, electrons and neutrons based on new ICRP recommendations were cited in the ICRP Publication 74, but the energy ranges of these data were limited and there are no data for high energy radiations produced in accelerator facilities. For the purpose of designing the high intensity proton accelerator facilities at JAERI, the dose evaluation code system of high energy radiations based on the HERMES code was developed and the dose conversion coefficients of effective dose were evaluated for photons, neutrons and protons up to 10 GeV, and electrons up to 100 GeV. The dose conversion coefficients of effective dose equivalent were also evaluated using quality factors to consider the consistency between radiation weighting factors and Q-L relationship. The effective dose conversion coefficients obtained in this work were in good agreement with those recently evaluated by using FLUKA code for photons and electrons with all energies, and neutrons and protons below 500 MeV. There were some discrepancy between two data owing to the difference of cross sections in the nuclear reaction models. The dose conversion coefficients of effective dose equivalents for high energy radiations based on Q-L relation in ICRP Publication 60 were evaluated only in this work. The previous comparison between effective dose and effective dose equivalent made it clear that the radiation weighting factors for high energy neutrons and protons were overestimated and the modification was required. (author)

Studies on DANESS Code Modeling

International Nuclear Information System (INIS)

Jeong, Chang Joon

2009-09-01

The DANESS code modeling study has been performed. DANESS code is widely used in a dynamic fuel cycle analysis. Korea Atomic Energy Research Institute (KAERI) has used the DANESS code for the Korean national nuclear fuel cycle scenario analysis. In this report, the important models such as Energy-demand scenario model, New Reactor Capacity Decision Model, Reactor and Fuel Cycle Facility History Model, and Fuel Cycle Model are investigated. And, some models in the interface module are refined and inserted for Korean nuclear fuel cycle model. Some application studies have also been performed for GNEP cases and for US fast reactor scenarios with various conversion ratios

Measurement and modeling of advanced coal conversion processes

Energy Technology Data Exchange (ETDEWEB)

Solomon, P.R.; Serio, M.A.; Hamblen, D.G.; Smoot, L.D.; Brewster, B.S. (Advanced Fuel Research, Inc., East Hartford, CT (United States) Brigham Young Univ., Provo, UT (United States))

1991-01-01

The overall objective of this program is the development of predictive capability for the design, scale up, simulation, control and feedstock evaluation in advanced coal conversion devices. This program will merge significant advances made in measuring and quantitatively describing the mechanisms in coal conversion behavior. Comprehensive computer codes for mechanistic modeling of entrained-bed gasification. Additional capabilities in predicting pollutant formation will be implemented and the technology will be expanded to fixed-bed reactors.

Fast-track program in laparoscopic liver surgery: Theory or fact?

Science.gov (United States)

Sánchez-Pérez, Belinda; Aranda-Narváez, José Manuel; Suárez-Muñoz, Miguel Angel; Eladel-Delfresno, Moises; Fernández-Aguilar, José Luis; Pérez-Daga, Jose Antonio; Pulido-Roa, Ysabel; Santoyo-Santoyo, Julio

2012-11-27

To analyze our results after the introduction of a fast-track (FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit. All patients (43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups: Control group (CG) from March 2004 until December 2006 with traditional perioperative cares (17 patients) and fast-track group (FTG) from January 2007 until March 2010 with FT program cares (26 patients). Primary endpoint was the influence of the program on the postoperative stay, the amount of re-admissions, morbidity and mortality. Secondarily we considered duration of surgery, use of drains, conversion to open surgery, intensive cares needs and transfusion. Both groups were homogeneous in age and sex. No differences in technique, time of surgery or conversion to open surgery were found, but more malignant diseases were operated in the FTG, and then transfusions were higher in FTG. Readmissions and morbidity were similar in both groups, without mortality. Postoperative stay was similar, with a median of 3 for CG vs 2.5 for FTG. However, the 80.8% of patients from FTG left the hospital within the first 3 d after surgery (58.8% for CG). The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions, which leads to a reduction of the stay and costs.

Fifty Years of Innovation in Plastic Surgery

Directory of Open Access Journals (Sweden)

Richard M Kwasnicki

2016-03-01

Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists

NARCIS (Netherlands)

Blikkendaal, Mathijs D.; Twijnstra, Andries R. H.; Stiggelbout, Anne M.; Beerlage, Harrie P.; Bemelman, Willem A.; Jansen, Frank Willem

2013-01-01

In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a

Deriving Word Order in Code-Switching: Feature Inheritance and Light Verbs

Science.gov (United States)

Shim, Ji Young

2013-01-01

This dissertation investigates code-switching (CS), the concurrent use of more than one language in conversation, commonly observed in bilingual speech. Assuming that code-switching is subject to universal principles, just like monolingual grammar, the dissertation provides a principled account of code-switching, with particular emphasis on OV~VO…

Design of batch audio/video conversion platform based on JavaEE

Science.gov (United States)

Cui, Yansong; Jiang, Lianpin

2018-03-01

With the rapid development of digital publishing industry, the direction of audio / video publishing shows the diversity of coding standards for audio and video files, massive data and other significant features. Faced with massive and diverse data, how to quickly and efficiently convert to a unified code format has brought great difficulties to the digital publishing organization. In view of this demand and present situation in this paper, basing on the development architecture of Sptring+SpringMVC+Mybatis, and combined with the open source FFMPEG format conversion tool, a distributed online audio and video format conversion platform with a B/S structure is proposed. Based on the Java language, the key technologies and strategies designed in the design of platform architecture are analyzed emphatically in this paper, designing and developing a efficient audio and video format conversion system, which is composed of “Front display system”, "core scheduling server " and " conversion server ". The test results show that, compared with the ordinary audio and video conversion scheme, the use of batch audio and video format conversion platform can effectively improve the conversion efficiency of audio and video files, and reduce the complexity of the work. Practice has proved that the key technology discussed in this paper can be applied in the field of large batch file processing, and has certain practical application value.

A Coding System for Analysing a Spoken Text Database.

Science.gov (United States)

Cutting, Joan

1994-01-01

This paper describes a coding system devised to analyze conversations of graduate students in applied linguistics at Edinburgh University. The system was devised to test the hypothesis that as shared knowledge among conversation participants grows, the textual density of in-group members has more cues than that of strangers. The informal…

Laser-accelerated proton conversion efficiency thickness scaling

International Nuclear Information System (INIS)

Hey, D. S.; Foord, M. E.; Key, M. H.; LePape, S. L.; Mackinnon, A. J.; Patel, P. K.; Ping, Y.; Akli, K. U.; Stephens, R. B.; Bartal, T.; Beg, F. N.; Fedosejevs, R.; Friesen, H.; Tiedje, H. F.; Tsui, Y. Y.

2009-01-01

The conversion efficiency from laser energy into proton kinetic energy is measured with the 0.6 ps, 9x10 19 W/cm 2 Titan laser at the Jupiter Laser Facility as a function of target thickness in Au foils. For targets thicker than 20 μm, the conversion efficiency scales approximately as 1/L, where L is the target thickness. This is explained by the domination of hot electron collisional losses over adiabatic cooling. In thinner targets, the two effects become comparable, causing the conversion efficiency to scale weaker than 1/L; the measured conversion efficiency is constant within the scatter in the data for targets between 5 and 15 μm, with a peak conversion efficiency of 4% into protons with energy greater than 3 MeV. Depletion of the hydrocarbon contaminant layer is eliminated as an explanation for this plateau by using targets coated with 200 nm of ErH 3 on the rear surface. The proton acceleration is modeled with the hybrid-particle in cell code LSP, which reproduced the conversion efficiency scaling observed in the data.

Evaluation of fluence to dose equivalent conversion factors for high energy radiations, (1)

International Nuclear Information System (INIS)

Sato, Osamu; Uehara, Takashi; Yoshizawa, Nobuaki; Iwai, Satoshi; Tanaka, Shun-ichi.

1992-09-01

Computer code system and basic data have been investigated for evaluating fluence to dose equivalent conversion factors for photons and neutrons up to 10 GeV. The present work suggested that the conversion factors would be obtained by incorporating effective quality factors of charged particles into the HERMES (High Energy Radiation Monte Carlo Elaborate System) code system. The effective quality factors for charged particles were calculated on the basis of the Q-L relationships specified in the ICRP Publication-60. (author)

Seeking and receiving social support on Facebook for surgery.

Science.gov (United States)

Davis, Matthew A; Anthony, Denise L; Pauls, Scott D

2015-04-01

Social networking sites such as Facebook provide a new way to seek and receive social support, a factor widely recognized as important for one's health. However, few studies have used actual conversations from social networking sites to study social support for health related matters. We studied 3,899 Facebook users, among a sample of 33,326 monitored adults, who initiated a conversation that referred to surgery on their Facebook Wall during a six-month period. We explored predictors of social support as measured by number of response posts from "friends." Among our sample, we identified 8,343 Facebook conversation threads with the term "surgery" in the initial post with, on average, 5.7 response posts (SD 6.2). We used a variant of latent semantic analysis to explore the relationship between specific words in the posts that allowed us to develop three thematic categories of words related to family, immediacy of the surgery, and prayer. We used generalized linear mixed models to examine the association between characteristics of the Facebook user as well as the thematic categories on the likelihood of receiving response posts following the announcement of a surgery. Words from the three thematic categories were used in 32.5% (family), 39.5 (immediacy), and 50.7% (prayer) of root posts. Few user characteristics were associated with response in multivariate models [rate ratios, RR, 1.08 (95% CI 1.01, 1.15) for married/living with partner; 1.10 (95% CI 1.03, 1.19) for annual income > $75,000]. In multivariate models adjusted for Facebook user characteristics and network size, use of family and prayer words in the root post were associated with significantly higher number of response posts, RR 1.40 (95% CI 1.37, 1.43) and 2.07 (95% CI 2.02, 2.12) respectively. We found some evidence of social support on Facebook for surgery and that the language used in the root post of a conversation thread is predictive of overall response. Copyright © 2015 Elsevier Ltd. All

Robot-assisted gastroesophageal surgery: usefulness and limitations.

Science.gov (United States)

Diez Del Val, Ismael; Martinez Blazquez, Cándido; Loureiro Gonzalez, Carlos; Vitores Lopez, Jose Maria; Sierra Esteban, Valentin; Barrenetxea Asua, Julen; Del Hoyo Aretxabala, Izaskun; Perez de Villarreal, Patricia; Bilbao Axpe, Jose Esteban; Mendez Martin, Jaime Jesus

2014-06-01

Robot-assisted surgery overcomes some of the limitations of traditional laparoscopic surgery. We present our experience and lessons learned in two surgical units dedicated to gastro-esophageal surgery. From June 2009 to January 2013, we performed 130 robot-assisted gastroesophageal procedures, including Nissen fundoplication (29), paraesophageal hernia repair (18), redo for failed antireflux surgery (11), esophagectomy (19), subtotal (5) or wedge (4) gastrectomy, Heller myotomy for achalasia (22), gastric bypass for morbid obesity (12), thoracoscopic leiomyomectomy (4), Morgagni hernia repair (3), lower-third esophageal diverticulectomy (1) and two diagnostic procedures. There were 80 men and 50 women with a median age of 54 years (interquartile range: 46-65). Ten patients (7.7 %) had severe postoperative complications: eight after esophagectomy (three leaks-two cervical and one thoracic-managed conservatively), one stapler failure, one chylothorax, one case of gastric migration to the thorax, one case of biliary peritonitis, and one patient with a transient ventricular dyskinesia. One redo procedure needed reoperation because of port-site bleeding, and one patient died of pulmonary complications after a giant paraesophageal hernia repair; 30-day mortality was, therefore, 0.8 %. There were six elective and one forced conversions (hemorrhage), so total conversion was 5.4 %. Median length of stay was 4 days (IQ range 3-7). Robot-assisted gastroesophageal surgery is feasible and safe, and may be applied to most common procedures. It seems of particular value for Heller myotomy, large paraesophageal hernias, redo antireflux surgery, transhiatal dissection, and hand-sewn intrathoracic anastomosis.

SETI-EC: SETI Encryption Code

Science.gov (United States)

Heller, René

2018-03-01

The SETI Encryption code, written in Python, creates a message for use in testing the decryptability of a simulated incoming interstellar message. The code uses images in a portable bit map (PBM) format, then writes the corresponding bits into the message, and finally returns both a PBM image and a text (TXT) file of the entire message. The natural constants (c, G, h) and the wavelength of the message are defined in the first few lines of the code, followed by the reading of the input files and their conversion into 757 strings of 359 bits to give one page. Each header of a page, i.e. the little-endian binary code translation of the tempo-spatial yardstick, is calculated and written on-the-fly for each page.

Evaluating Quality of Chatbots and Intelligent Conversational Agents

OpenAIRE

Radziwill, Nicole M.; Benton, Morgan C.

2017-01-01

Chatbots are one class of intelligent, conversational software agents activated by natural language input (which can be in the form of text, voice, or both). They provide conversational output in response, and if commanded, can sometimes also execute tasks. Although chatbot technologies have existed since the 1960s and have influenced user interface development in games since the early 1980s, chatbots are now easier to train and implement. This is due to plentiful open source code, widely ava...

When symptoms don't fit: a case series of conversion disorder in the pediatric otolaryngology practice.

Science.gov (United States)

Caulley, Lisa; Kohlert, Scott; Gandy, Hazen; Olds, Janet; Bromwich, Matthew

2018-05-29

Conversion disorder refers to functional bodily impairments that can be precipitated by high stress situations including trauma and surgery. Symptoms of conversion disorder may mimic or complicate otolaryngology diseases in the pediatric population. In this report, the authors describe 3 cases of conversion disorder that presented to a pediatric otolaryngology-head and neck surgery practice. This report highlights a unique population of patients who have not previously been investigated. The clinical presentation and management of these cases are discussed in detail. Non-organic otolaryngology symptoms of conversion disorder in the pediatric population are reviewed. In addition, we discuss the challenges faced by clinicians in appropriately identifying and treating these patients and present an approach to management of their care. In this report, the authors highlight the importance of considering psychogenic illnesses in patients with atypical clinical presentations of otolaryngology disorders.

Psychosocial predictors in consideration of cosmetic surgery among women.

Science.gov (United States)

Nerini, Amanda; Matera, Camilla; Stefanile, Cristina

2014-04-01

This study aimed to analyze the influence of psychosocial factors on the consideration of cosmetic surgery. The authors hypothesized that the internalization of thin ideals and social comparisons mediate the relationship between media pressure, family and peer influence (appearance conversations, perception of teasing, and peer attributions), and the desire to pursue cosmetic surgery. The study participants were 429 Italian women (mean age, 33 years). They completed a questionnaire containing the Appearance Conversations With Friends Scale, the Perception of Teasing Scale for Friends, the Peer Attribution Scale, the "Pressure and Internalization-General" subscales of the Sociocultural Attitudes Towards Appearance Questionnaire-3, the Feedback on Physical Appearance Scale, the Physical Appearance Comparison Scale, and the "Consider" subscale of the Acceptance of Cosmetic Surgery Scale. Hierarchical linear regression was performed. The results indicated that media pressure and appearance conversations with peers predicted the outcome variable through the full mediation of internalization of thin ideals. The relation between peer attributions and interest in cosmetic surgery was partially mediated by internalization of thin ideals. Although social comparison was significantly related to both sociocultural variables and consideration of cosmetic procedures, it was not a significant mediator of this relationship. Neither family influence nor perception of teasing predicted the outcome variable. Overall, these results provide important information about the factors implicated in the consideration of cosmetic surgery by women. This research confirms that cosmetic surgeons need to adopt a base psychological approach. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Code-Mixing and Code Switchingin The Process of Learning

Directory of Open Access Journals (Sweden)

Diyah Atiek Mustikawati

2016-09-01

Full Text Available This study aimed to describe a form of code switching and code mixing specific form found in the teaching and learning activities in the classroom as well as determining factors influencing events stand out that form of code switching and code mixing in question.Form of this research is descriptive qualitative case study which took place in Al Mawaddah Boarding School Ponorogo. Based on the analysis and discussion that has been stated in the previous chapter that the form of code mixing and code switching learning activities in Al Mawaddah Boarding School is in between the use of either language Java language, Arabic, English and Indonesian, on the use of insertion of words, phrases, idioms, use of nouns, adjectives, clauses, and sentences. Code mixing deciding factor in the learning process include: Identification of the role, the desire to explain and interpret, sourced from the original language and its variations, is sourced from a foreign language. While deciding factor in the learning process of code, includes: speakers (O1, partners speakers (O2, the presence of a third person (O3, the topic of conversation, evoke a sense of humour, and just prestige. The significance of this study is to allow readers to see the use of language in a multilingual society, especially in AL Mawaddah boarding school about the rules and characteristics variation in the language of teaching and learning activities in the classroom. Furthermore, the results of this research will provide input to the ustadz / ustadzah and students in developing oral communication skills and the effectiveness of teaching and learning strategies in boarding schools.

Analysis of the efficacy of marketing tools in facial plastic surgery.

Science.gov (United States)

Zavod, Matthew B; Adamson, Peter A

2008-06-01

To compare referral sources to a facial plastic surgery practice and to develop models correlating the referral source with the decision for surgery. Retrospective descriptive study. Well-established, metropolitan, private facial plastic surgery practice with training fellowship affiliated with an academic centre. One-thousand eighty-nine new consecutive patients presenting between January 2001 and December 2005 recorded intake data including age, gender, and chief complaint. Final data input was their decision for or against surgery. Main outcome measures included differences in referral sources based on data collected and how those sources related to decision for surgery. A 50% conversion rate was found. Women and older patients were more likely to be referred from magazines, television, and newspapers and for facial rejuvenation. Men and younger patients were more likely to be referred from the website and for rhinoplasty. For facial rejuvenation, both the number of patients interested in and the probability that they agreed to the procedure increased with age. For rhinoplasty, the converse was true. The most likely patients to schedule surgery were those who were referred from other patients, friends, or family members in our practice. The data confirm that word-of-mouth referrals are the most important source for predicting which patients will elect to proceed with surgery in this established facial cosmetic surgery practice.

Gallbladder Nonvisualization in Cholecystectomy: A Factor for Conversion.

Science.gov (United States)

Slack, Daniel R; Grisby, Shaunda; Dike, Uzoamaka Kimberly; Kohli, Harjeet

2018-01-01

Many risk factors have been identified in minimally invasive cholecystectomies that lead to higher complications and conversion rates. No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor. We hypothesized that nonvisualization was associated with an increased risk of complications and could be an early intraoperative identifier of a higher risk procedure. Recognizing this could allow surgeons to be aware of potential risks and to be more likely to convert to open for the safety of the patient. We looked at minimally invasive cholecystectomies performed at our institution from January 2015 through April 2016 and had the performing resident fill out a survey after the surgery. Outcomes were conversion rates, intraoperative complications, and blood loss and were analyzed via Pearson χ 2 test or Mann-Whitney U test. The primary outcome showed a conversion rate of 37% in nonvisualized GBs versus 0% in visualized ( P = .001). Secondary outcomes showed significant differences in GB perforations (74% vs 13%, P = .001), omental vessel bleeding (16% vs. 0%, P = .005), and EBL (46 mL vs 29 mL, P = .001). Intraoperative nonvisualization of the GB after adequate positioning caused significantly increased risk of intraoperative complications and conversion. This knowledge could be useful during intraoperative assessment, to decide whether a case should be continued as a minimally invasive procedure or converted early to help reduce risk to the patient. Further randomized controlled studies should be performed to further demonstrate the value of this assessment.

A flexible coupling scheme for Monte Carlo and thermal-hydraulics codes

Energy Technology Data Exchange (ETDEWEB)

Hoogenboom, J. Eduard, E-mail: J.E.Hoogenboom@tudelft.nl [Delft University of Technology (Netherlands); Ivanov, Aleksandar; Sanchez, Victor, E-mail: Aleksandar.Ivanov@kit.edu, E-mail: Victor.Sanchez@kit.edu [Karlsruhe Institute of Technology, Institute of Neutron Physics and Reactor Technology, Eggenstein-Leopoldshafen (Germany); Diop, Cheikh, E-mail: Cheikh.Diop@cea.fr [CEA/DEN/DANS/DM2S/SERMA, Commissariat a l' Energie Atomique, Gif-sur-Yvette (France)

2011-07-01

A coupling scheme between a Monte Carlo code and a thermal-hydraulics code is being developed within the European NURISP project for comprehensive and validated reactor analysis. The scheme is flexible as it allows different Monte Carlo codes and different thermal-hydraulics codes to be used. At present the MCNP and TRIPOLI4 Monte Carlo codes can be used and the FLICA4 and SubChanFlow thermal-hydraulics codes. For all these codes only an original executable is necessary. A Python script drives the iterations between Monte Carlo and thermal-hydraulics calculations. It also calls a conversion program to merge a master input file for the Monte Carlo code with the appropriate temperature and coolant density data from the thermal-hydraulics calculation. Likewise it calls another conversion program to merge a master input file for the thermal-hydraulics code with the power distribution data from the Monte Carlo calculation. Special attention is given to the neutron cross section data for the various required temperatures in the Monte Carlo calculation. Results are shown for an infinite lattice of PWR fuel pin cells and a 3 x 3 fuel BWR pin cell cluster. Various possibilities for further improvement and optimization of the coupling system are discussed. (author)

A flexible coupling scheme for Monte Carlo and thermal-hydraulics codes

International Nuclear Information System (INIS)

Hoogenboom, J. Eduard; Ivanov, Aleksandar; Sanchez, Victor; Diop, Cheikh

2011-01-01

A coupling scheme between a Monte Carlo code and a thermal-hydraulics code is being developed within the European NURISP project for comprehensive and validated reactor analysis. The scheme is flexible as it allows different Monte Carlo codes and different thermal-hydraulics codes to be used. At present the MCNP and TRIPOLI4 Monte Carlo codes can be used and the FLICA4 and SubChanFlow thermal-hydraulics codes. For all these codes only an original executable is necessary. A Python script drives the iterations between Monte Carlo and thermal-hydraulics calculations. It also calls a conversion program to merge a master input file for the Monte Carlo code with the appropriate temperature and coolant density data from the thermal-hydraulics calculation. Likewise it calls another conversion program to merge a master input file for the thermal-hydraulics code with the power distribution data from the Monte Carlo calculation. Special attention is given to the neutron cross section data for the various required temperatures in the Monte Carlo calculation. Results are shown for an infinite lattice of PWR fuel pin cells and a 3 x 3 fuel BWR pin cell cluster. Various possibilities for further improvement and optimization of the coupling system are discussed. (author)

[Risk management for endoscopic surgery].

Science.gov (United States)

Kimura, Taizo

2010-05-01

The number of medical accidents in endoscopic surgery has recently increased. Surgical complications caused by inadequate preparation or immature technique or those resulting in serious adverse outcomes may be referred to as medical accidents. The Nationwide Survey of Endoscopic Surgery showed that bile duct injury and uncontrollable bleeding were seen in 0.68% and in 0.58%, respectively, of cholecystectomy patients; interoperative and postoperative complications in 0.84% and in 3.8%, respectively, of gastric cancer surgery patients; and operative complications in 6.74% of bowel surgery patients. Some required open repair, and 49 patients died. The characteristic causes of complications in endoscopic surgery are a misunderstanding of anatomy, handling of organs outside the visual field, burn by electrocautery, and injuries caused by forceps. Bleeding that requires a laparotomy for hemostasis is also a complication. Furthermore, since the surgery is usually videorecorded, immature techniques resulting in complications are easily discovered. To decrease the frequency of accidents, education through textbooks and seminars, training using training boxes, simulators, or animals, proper selection of the surgeon depending on the difficulty of the procedure, a low threshold for conversion to laparotomy, and use of the best optical equipment and surgical instruments are important. To avoid malpractice lawsuits, informed consent obtained before surgery and proper communication after accidents are necessary.

SURE: a system of computer codes for performing sensitivity/uncertainty analyses with the RELAP code

International Nuclear Information System (INIS)

Bjerke, M.A.

1983-02-01

A package of computer codes has been developed to perform a nonlinear uncertainty analysis on transient thermal-hydraulic systems which are modeled with the RELAP computer code. Using an uncertainty around the analyses of experiments in the PWR-BDHT Separate Effects Program at Oak Ridge National Laboratory. The use of FORTRAN programs running interactively on the PDP-10 computer has made the system very easy to use and provided great flexibility in the choice of processing paths. Several experiments simulating a loss-of-coolant accident in a nuclear reactor have been successfully analyzed. It has been shown that the system can be automated easily to further simplify its use and that the conversion of the entire system to a base code other than RELAP is possible

Towers of generalized divisible quantum codes

Science.gov (United States)

Haah, Jeongwan

2018-04-01

A divisible binary classical code is one in which every code word has weight divisible by a fixed integer. If the divisor is 2ν for a positive integer ν , then one can construct a Calderbank-Shor-Steane (CSS) code, where X -stabilizer space is the divisible classical code, that admits a transversal gate in the ν th level of Clifford hierarchy. We consider a generalization of the divisibility by allowing a coefficient vector of odd integers with which every code word has zero dot product modulo the divisor. In this generalized sense, we construct a CSS code with divisor 2ν +1 and code distance d from any CSS code of code distance d and divisor 2ν where the transversal X is a nontrivial logical operator. The encoding rate of the new code is approximately d times smaller than that of the old code. In particular, for large d and ν ≥2 , our construction yields a CSS code of parameters [[O (dν -1) ,Ω (d ) ,d ] ] admitting a transversal gate at the ν th level of Clifford hierarchy. For our construction we introduce a conversion from magic state distillation protocols based on Clifford measurements to those based on codes with transversal T gates. Our tower contains, as a subclass, generalized triply even CSS codes that have appeared in so-called gauge fixing or code switching methods.

Dose conversion coefficients for high-energy photons, electrons, neutrons and protons

CERN Document Server

Sakamoto, Y; Sato, O; Tanaka, S I; Tsuda, S; Yamaguchi, Y; Yoshizawa, N

2003-01-01

In the International Commission on Radiological Protection (ICRP) 1990 Recommendations, radiation weighting factors were introduced in the place of quality factors, the tissue weighting factors were revised, and effective doses and equivalent doses of each tissues and organs were defined as the protection quantities. Dose conversion coefficients for photons, electrons and neutrons based on new ICRP recommendations were cited in the ICRP Publication 74, but the energy ranges of theses data were limited and there are no data for high energy radiations produced in accelerator facilities. For the purpose of designing the high intensity proton accelerator facilities at JAERI, the dose evaluation code system of high energy radiations based on the HERMES code was developed and the dose conversion coefficients of effective dose were evaluated for photons, neutrons and protons up to 10 GeV, and electrons up to 100 GeV. The dose conversion coefficients of effective dose equivalent were also evaluated using quality fact...

Dimensioning Method for Conversational Video Applications in Wireless Convergent Networks

Directory of Open Access Journals (Sweden)

Raquel Perez Leal

2007-12-01

Full Text Available New convergent services are becoming possible, thanks to the expansion of IP networks based on the availability of innovative advanced coding formats such as H.264, which reduce network bandwidth requirements providing good video quality, and the rapid growth in the supply of dual-mode WiFi cellular terminals. This paper provides, first, a comprehensive subject overview as several technologies are involved, such as medium access protocol in IEEE802.11, H.264 advanced video coding standards, and conversational application characterization and recommendations. Second, the paper presents a new and simple dimensioning model of conversational video over wireless LAN. WLAN is addressed under the optimal network throughput and the perspective of video quality. The maximum number of simultaneous users resulting from throughput is limited by the collisions taking place in the shared medium with the statistical contention protocol. The video quality is conditioned by the packet loss in the contention protocol. Both approaches are analyzed within the scope of the advanced video codecs used in conversational video over IP, to conclude that conversational video dimensioning based on network throughput is not enough to ensure a satisfactory user experience, and video quality has to be taken also into account. Finally, the proposed model has been applied to a real-office scenario.

Dimensioning Method for Conversational Video Applications in Wireless Convergent Networks

Directory of Open Access Journals (Sweden)

Alonso JoséI

2008-01-01

Full Text Available Abstract New convergent services are becoming possible, thanks to the expansion of IP networks based on the availability of innovative advanced coding formats such as H.264, which reduce network bandwidth requirements providing good video quality, and the rapid growth in the supply of dual-mode WiFi cellular terminals. This paper provides, first, a comprehensive subject overview as several technologies are involved, such as medium access protocol in IEEE802.11, H.264 advanced video coding standards, and conversational application characterization and recommendations. Second, the paper presents a new and simple dimensioning model of conversational video over wireless LAN. WLAN is addressed under the optimal network throughput and the perspective of video quality. The maximum number of simultaneous users resulting from throughput is limited by the collisions taking place in the shared medium with the statistical contention protocol. The video quality is conditioned by the packet loss in the contention protocol. Both approaches are analyzed within the scope of the advanced video codecs used in conversational video over IP, to conclude that conversational video dimensioning based on network throughput is not enough to ensure a satisfactory user experience, and video quality has to be taken also into account. Finally, the proposed model has been applied to a real-office scenario.

Earliest signs and management of leakage after bariatric surgeries ...

African Journals Online (AJOL)

Mohamed Bekheit

2012-10-25

Oct 25, 2012 ... b Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt c Department of ... of sepsis or hemodynamic instability require emergent exploration. .... One failed LGB underwent conversion to LGBP and.

Application of robotics in general surgery: initial experience.

Science.gov (United States)

Nguyen, Ninh T; Hinojosa, Marcelo W; Finley, David; Stevens, Melinda; Paya, Mahbod

2004-10-01

Robotic surgery was recently approved for clinical use in general abdominal surgery. The aim of this study was to review our experience with the da Vinci surgical system during laparoscopic general surgical procedures. Eighteen patients underwent robotically assisted laparoscopic abdominal surgery between June 2002 and March 2003. Main outcome measures were operative time, room setup time, robotic arm-positioning and surgical time, blood loss, conversion to laparoscopy, length of stay, and morbidity. The types of robotically assisted laparoscopic procedures were excision of gastric leiomyoma (n = 1), Heller myotomy (n = 1), cholecystectomy (n = 2), gastric banding (n = 2), Nissen fundoplication (n = 4), and gastric bypass (n = 8). The mean room setup time was 63 +/- 14 minutes, and the mean robotic arm-positioning time was 16 +/- 7 minutes. Conversion to laparoscopy occurred in two (11%) of 18 cases because of equipment difficulty (n = 1) and technical difficulty (n = 1). Estimated blood loss was 91 +/- 71 mL. The mean operative time was 156 +/- 42 minutes, and the robotic operative time was 27% of the total operative time. The mean length of hospital stay was 2.2 +/- 1.5 days. There was one postoperative wound infection and one anastomotic stricture. Robotically assisted laparoscopic abdominal surgery is feasible and safe; however, the theoretical advantages of the da Vinci surgical system were not clinically apparent.

Laparoscopic surgery for complicated diverticular disease: a single-centre experience.

Science.gov (United States)

Royds, J; O'Riordan, J M; Eguare, E; O'Riordan, D; Neary, P C

2012-10-01

The role of laparoscopic surgery in the management of patients with diverticular disease is still not universally accepted. The aim of our study was to evaluate the results of laparoscopic surgery for diverticular disease in a centre with a specialist interest in minimally invasive surgery. All diverticular resections carried out between 2006 and 2010 were reviewed. Data recorded included baseline demographics, indication for surgery, operative details, length of hospital stay and complications. Complicated diverticular disease was defined as diverticulitis with associated abscess, phlegmon, fistula, stricture, obstruction, bleeding or perforation. One hundred and two patients (58 men) who had surgery for diverticular disease were identified (median age 59 years, range 49-70 years). Sixty-four patients (64%) had surgery for complicated diverticular disease. The indications were recurrent acute diverticulitis (37%), colovesical fistula (21%), stricture formation (17%) and colonic perforation (16%). Sixty-nine cases (88%) were completed by elective laparoscopy. Postoperative mortality was 0%. For elective cases there was no difference in morbidity rates between patients with complicated and uncomplicated diverticular disease. The overall anastomotic leakage rate was 1% and the wound infection rate 7%. There was a nonsignificant trend to higher conversion to open surgery in the elective group in complicated (11.4%) compared with uncomplicated patients (5.2%) (P=0.67). Electively, the rate of stoma formation was higher in the complicated (31.6%) than the uncomplicated group (5.2%) (Pdiverticular disease is associated with low rates of postoperative morbidity and relatively low conversion rates. Laparoscopic surgery is now the standard of care for complicated and uncomplicated diverticular disease in our institution. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Implementation of laparoscopic approach in colorectal surgery - a single center's experience.

Science.gov (United States)

Kwiatkowski, Andrzej P; Stępińska, Gabriela; Stanowski, Edward; Paśnik, Krzysztof

2018-03-01

Implementation of the laparoscopic approach in colorectal surgery has not happened as rapidly as in cholecystectomy, because of concerns about oncological safety. The results of controlled trials in multiple centers showed the method to be safe. Consequently, surgeons decided to try the approach with colorectal surgery. This process, in our clinic, began in earnest about four years ago. To analyze and present the clinical outcomes of applying the laparoscopic approach to colorectal surgery in a single center. We retrospectively identified patients from a hospital database who underwent colorectal surgery - laparoscopic and open - between 2013 and 2016. Our focus was on laparoscopic cases. Study points included operative time, duration of the hospital stay, postoperative mortality and rates of complications, conversion, reoperation and readmission. Of 534 cases considered, the results showed that the relation between open and laparoscopic procedures had reversed, in favor of the latter method (2013: open: 82% vs. laparoscopic: 18%; 2016: open: 22.4% vs. laparoscopic: 77.6%). The most commonly performed procedure was right hemicolectomy. The total complication rate was 22%. The total rate of conversion to open surgery was 9.3%. The postoperative mortality rate was 3%. Use of the laparoscopic approach in colorectal surgery has increased in recent years world-wide - including in Poland - but the technique is still underused. Rapid implementation of the miniinvasive method in colorectal surgery, in centers with previous laparoscopic experience, is not only safe and feasible, but also highly recommended.

Floating-to-Fixed-Point Conversion for Digital Signal Processors

Directory of Open Access Journals (Sweden)

Menard Daniel

2006-01-01

Full Text Available Digital signal processing applications are specified with floating-point data types but they are usually implemented in embedded systems with fixed-point arithmetic to minimise cost and power consumption. Thus, methodologies which establish automatically the fixed-point specification are required to reduce the application time-to-market. In this paper, a new methodology for the floating-to-fixed point conversion is proposed for software implementations. The aim of our approach is to determine the fixed-point specification which minimises the code execution time for a given accuracy constraint. Compared to previous methodologies, our approach takes into account the DSP architecture to optimise the fixed-point formats and the floating-to-fixed-point conversion process is coupled with the code generation process. The fixed-point data types and the position of the scaling operations are optimised to reduce the code execution time. To evaluate the fixed-point computation accuracy, an analytical approach is used to reduce the optimisation time compared to the existing methods based on simulation. The methodology stages are described and several experiment results are presented to underline the efficiency of this approach.

Floating-to-Fixed-Point Conversion for Digital Signal Processors

Science.gov (United States)

Menard, Daniel; Chillet, Daniel; Sentieys, Olivier

2006-12-01

Digital signal processing applications are specified with floating-point data types but they are usually implemented in embedded systems with fixed-point arithmetic to minimise cost and power consumption. Thus, methodologies which establish automatically the fixed-point specification are required to reduce the application time-to-market. In this paper, a new methodology for the floating-to-fixed point conversion is proposed for software implementations. The aim of our approach is to determine the fixed-point specification which minimises the code execution time for a given accuracy constraint. Compared to previous methodologies, our approach takes into account the DSP architecture to optimise the fixed-point formats and the floating-to-fixed-point conversion process is coupled with the code generation process. The fixed-point data types and the position of the scaling operations are optimised to reduce the code execution time. To evaluate the fixed-point computation accuracy, an analytical approach is used to reduce the optimisation time compared to the existing methods based on simulation. The methodology stages are described and several experiment results are presented to underline the efficiency of this approach.

Conversion of HSPF Legacy Model to a Platform-Independent, Open-Source Language

Science.gov (United States)

Heaphy, R. T.; Burke, M. P.; Love, J. T.

2015-12-01

Since its initial development over 30 years ago, the Hydrologic Simulation Program - FORTAN (HSPF) model has been used worldwide to support water quality planning and management. In the United States, HSPF receives widespread endorsement as a regulatory tool at all levels of government and is a core component of the EPA's Better Assessment Science Integrating Point and Nonpoint Sources (BASINS) system, which was developed to support nationwide Total Maximum Daily Load (TMDL) analysis. However, the model's legacy code and data management systems have limitations in their ability to integrate with modern software, hardware, and leverage parallel computing, which have left voids in optimization, pre-, and post-processing tools. Advances in technology and our scientific understanding of environmental processes that have occurred over the last 30 years mandate that upgrades be made to HSPF to allow it to evolve and continue to be a premiere tool for water resource planners. This work aims to mitigate the challenges currently facing HSPF through two primary tasks: (1) convert code to a modern widely accepted, open-source, high-performance computing (hpc) code; and (2) convert model input and output files to modern widely accepted, open-source, data model, library, and binary file format. Python was chosen as the new language for the code conversion. It is an interpreted, object-oriented, hpc code with dynamic semantics that has become one of the most popular open-source languages. While python code execution can be slow compared to compiled, statically typed programming languages, such as C and FORTRAN, the integration of Numba (a just-in-time specializing compiler) has allowed this challenge to be overcome. For the legacy model data management conversion, HDF5 was chosen to store the model input and output. The code conversion for HSPF's hydrologic and hydraulic modules has been completed. The converted code has been tested against HSPF's suite of "test" runs and shown

[Emergency Surgery and Treatments for Pneumothorax].

Science.gov (United States)

Kurihara, Masatoshi

2015-07-01

The primary care in terms of emergency for pneumothorax is chest drainage in almost cases. The following cases of pneumothorax and the complications need something of surgery and treatments. Pneumothorax with subcutaneous emphysema often needs small skin incisions around the drainage tube. Tension pneumothorax often needs urgent chest drainage. Pneumothorax with intractable air leakage often needs interventional treatments like endobroncheal occlusion (EBO) or thoracographic fibrin glue sealing method (TGF) as well as urgent thoracoscopic surgery. Pneumothorax with acute empyema also often needs urgent thoracoscopic surgery within 2 weeks if chest drainage or drug therapy are unsuccessful. It will probably become chronic empyema of thorax after then. Pneumothorax with bleeding needs urgent thoracoscopic surgery in case of continuous bleeding over 200 ml/2 hours. In any cases of emergency for pneumothorax, respiratory physicians should collaborate with respiratory surgeons at the 1st stage because it is important to timely judge conversion of surgical treatments from medical treatments.

Plastic Surgery: Tackling Misconceptions

African Journals Online (AJOL)

will succeed. First impressions tend to last, and if young people's first impression of plastic surgeons is that they spend much of their time doing cosmetic surgery then this is a first impression that might be long ... Res 2014;4 Suppl S3:169‑70. Access this article online. Quick Response Code: Website: www.amhsr.org. DOI:.

Conversion of the COBRA-IV-I code from CDC CYBER to HP 9000/700 version

International Nuclear Information System (INIS)

Sohn, D. S.; Yoo, Y. J.; Nahm, K. Y.; Hwang, D. H.

1996-01-01

COBRA-IV-I is a multichannel analysis code for the thermal-hydraulic analysis of rod bundle nuclear fuel elements and cores based on the subchannel approach. The existing COBRA-IV-I code is the control data corporation (CDC) CYBER version, which has limitations on the computer core storage and gives some inconvenience to the user interface. To solve these problems, we have converted the COBRA-IV-I code form the CDC CYBER mainframe to an Hewlett Packard (HP) 9000/700-series workstation version, and have verified the converted code. as a result, we have found almost no difference between the two versions in their calculation results. Therefore we expect the HP 9000/700 version of the COBRA-IV-I code to be the basis for the future development of an improved multichannel analysis code under the more convenient user environment. (author). 3 tabs., 2 figs., 8 refs

Biased Gene Conversion and GC-Content Evolution in the Coding Sequences of Reptiles and Vertebrates

Science.gov (United States)

Figuet, Emeric; Ballenghien, Marion; Romiguier, Jonathan; Galtier, Nicolas

2015-01-01

Mammalian and avian genomes are characterized by a substantial spatial heterogeneity of GC-content, which is often interpreted as reflecting the effect of local GC-biased gene conversion (gBGC), a meiotic repair bias that favors G and C over A and T alleles in high-recombining genomic regions. Surprisingly, the first fully sequenced nonavian sauropsid (i.e., reptile), the green anole Anolis carolinensis, revealed a highly homogeneous genomic GC-content landscape, suggesting the possibility that gBGC might not be at work in this lineage. Here, we analyze GC-content evolution at third-codon positions (GC3) in 44 vertebrates species, including eight newly sequenced transcriptomes, with a specific focus on nonavian sauropsids. We report that reptiles, including the green anole, have a genome-wide distribution of GC3 similar to that of mammals and birds, and we infer a strong GC3-heterogeneity to be already present in the tetrapod ancestor. We further show that the dynamic of coding sequence GC-content is largely governed by karyotypic features in vertebrates, notably in the green anole, in agreement with the gBGC hypothesis. The discrepancy between third-codon positions and noncoding DNA regarding GC-content dynamics in the green anole could not be explained by the activity of transposable elements or selection on codon usage. This analysis highlights the unique value of third-codon positions as an insertion/deletion-free marker of nucleotide substitution biases that ultimately affect the evolution of proteins. PMID:25527834

[ENT and head and neck surgery in the German DRG system 2007].

Science.gov (United States)

Franz, D; Roeder, N; Hörmann, K; Alberty, J

2007-07-01

The German DRG system has been further developed into version 2007. For ENT and head and neck surgery, significant changes in the coding of diagnoses and medical operations as well as in the the DRG structure have been made. New ICD codes for sleep apnoea and acquired tracheal stenosis have been implemented. Surgery on the acoustic meatus, removal of auricle hyaline cartilage for transplantation (e. g. rhinosurgery) and tonsillotomy have been coded in the 2007 version. In addition, the DRG structure has been improved. Case allocation of more than one significant operation has been established. The G-DRG system has gained in complexity. High demands are made on the coding of complex cases, whereas standard cases require mostly only one specific diagnosis and one specific OPS code. The quality of case allocation for ENT patients within the G-DRG system has been improved. Nevertheless, further adjustments of the G-DRG system are necessary.

Reduction Mammoplasty: A Comparison Between Operations Performed by Plastic Surgery and General Surgery.

Science.gov (United States)

Kordahi, Anthony M; Hoppe, Ian C; Lee, Edward S

2015-01-01

Reduction mammoplasty is an often-performed procedure by plastic surgeons and increasingly by general surgeons. The question has been posed in both general surgical literature and plastic surgical literature as to whether this procedure should remain the domain of surgical specialists. Some general surgeons are trained in breast reductions, whereas all plastic surgeons receive training in this procedure. The National Surgical Quality Improvement Project provides a unique opportunity to compare the 2 surgical specialties in an unbiased manner in terms of preoperative comorbidities and 30-day postoperative complications. The National Surgical Quality Improvement Project database was queried for the years 2005-2012. Patients were identified as having undergone a reduction mammoplasty by Current Procedural Terminology codes. RESULTS were refined to include only females with an International Classification of Diseases, Ninth Revision, code of 611.1 (hypertrophy of breasts). Information was collected regarding age, surgical specialty performing procedure, body mass index, and other preoperative variables. The outcomes utilized were presence of superficial surgical site infection, presence of deep surgical site infection, presence of wound dehiscence, postoperative respiratory compromise, pulmonary embolism, deep vein thrombosis, perioperative transfusion, operative time, reintubation, reoperation, and length of hospital stay. During this time period, there were 6239 reduction mammaplasties performed within the National Surgical Quality Improvement Project database: 339 by general surgery and 5900 by plastic surgery. No statistical differences were detected between the 2 groups with regard to superficial wound infections, deep wound infections, organ space infections, or wound dehiscence. There were no significant differences noted between within groups with regard to systemic postoperative complications. Patients undergoing a procedure by general surgery were more likely

Audio watermarking robust against D/A and A/D conversions

Directory of Open Access Journals (Sweden)

Xiang Shijun

2011-01-01

Full Text Available Abstract Digital audio watermarking robust against digital-to-analog (D/A and analog-to-digital (A/D conversions is an important issue. In a number of watermark application scenarios, D/A and A/D conversions are involved. In this article, we first investigate the degradation due to DA/AD conversions via sound cards, which can be decomposed into volume change, additional noise, and time-scale modification (TSM. Then, we propose a solution for DA/AD conversions by considering the effect of the volume change, additional noise and TSM. For the volume change, we introduce relation-based watermarking method by modifying groups of the energy relation of three adjacent DWT coefficient sections. For the additional noise, we pick up the lowest-frequency coefficients for watermarking. For the TSM, the synchronization technique (with synchronization codes and an interpolation processing operation is exploited. Simulation tests show the proposed audio watermarking algorithm provides a satisfactory performance to DA/AD conversions and those common audio processing manipulations.

Esophageal hiatus surgery: video laparoscopic approach

International Nuclear Information System (INIS)

Rodriguez, G.; Fernandez, G.; Gatti, A.; Balboa, O.

2003-01-01

Since the early nineties,surgery of esophageal hiatus(treatment of disease due to gastroesophageal reflux,gastric denervation surgery in treatment of duodenal chronic ulcer)through video laparoscopic approach,has gained broad dissemination and acceptance at world level.This phenomenon is explained by the excellent exposure and visualization of an anatomic region which is deeply situated in the upper hemi abdomen, added to the advantages of an approach which, while minimally invasive, attains short and medium term results comparable to those of conventional surgery.The describes the initial experience of the authors with this type of surgery as well as a review of literature, with special emphasis on the surgical technique employed.Case material covers 23 patient: fourteen had Nissen Rossetti fun duplication, 4 suffered from miotomies associated with fun duplications of varying type and 5 were gastric denervation surgeries by reason of duodenal ulcer.There were 2 conversions, both due to esophageal perforation.There were no major postoperative complications and mortality was nil. while functional results were highly satisfactory.The authors therefore conclude that since results which they obtained were coincidental with those of international bibliography, work along these lines should continue

Supercritical CO2 Brayton Cycle Energy Conversion System Coupled with SFR

International Nuclear Information System (INIS)

Cha, Jae Eun; Kim, S. O.; Seong, S. H.; Eoh, J. H.; Lee, T. H.; Choi, S. K.; Han, J. W.; Bae, S. W.

2008-12-01

This report contains the description of the S-CO 2 Brayton cycle coupled to KALIMER-600 as an alternative energy conversion system. For a system development, a computer code was developed to calculate heat balance of normal operation condition. Based on the computer code, the S-CO 2 Brayton cycle energy conversion system was constructed for the KALIMER-600. Computer codes were developed to analysis for the S-CO 2 turbomachinery. Based on the design codes, the design parameters were prepared to configure the KALIMER-600 S-CO 2 turbomachinery models. A one-dimensional analysis computer code was developed to evaluate the performance of the previous PCHE heat exchangers and a design data for the typical type PCHE was produced. In parallel with the PCHE-type heat exchanger design, an airfoil shape fin PCHE heat exchanger was newly designed. The new design concept was evaluated by three-dimensional CFD analyses. Possible control schemes for power control in the KALIMER-600 S-CO 2 Brayton cycle were investigated by using the MARS code. The MMS-LMR code was also developed to analyze the transient phenomena in a SFR with a supercritical CO 2 Brayton cycle to develop the control logic. Simple power reduction and recovery event was selected and analyzed for the transient calculation. For the evaluation of Na-CO 2 boundary failure event, a computer was developed to simulate the complex thermodynamic behaviors coupled with the chemical reaction between liquid sodium and CO 2 gas. The long term behavior of a Na-CO 2 boundary failure event and its consequences which lead to a system pressure transient were evaluated

Minimal access surgery in children: An initial experience of 28 months

Directory of Open Access Journals (Sweden)

Gupta Abhaya

2009-01-01

Full Text Available Background : This study reports our 28 months experience with minimal access surgery (MAS in children. Materials and Methods : This was a review of all children who underwent MAS between December 2004 and March 2007 at the Departments of Paediatric Surgery, Seth Gordhandas Sunderdas Medical College (GSMC and King Edward the VII Memorial (KEM Hospital, India. Results and observations were tabulated and analysed, comparing with observations by various other authors regarding variety of indications such as, operative time, hospital stay, conversion rate, complications, safety, and feasibilty of MAS in neonates, in the appropriate operative groups. Results : A total of 199 procedures were performed in 193 children aged between 10 days and 12 years (average age: 5.7 years. One case of each, adrenal mass, retroperitoneoscopic nephrectomy, laparoscopic congenital diaphragmatic hernia (CDH repair, and abdominoperineal pull-through for anorectal malformation, were converted to open surgeries due to technical difficulty. The overall conversion rate was 3%. Morbidity and mortality were very minimal and the procedures were well tolerated in majority of cases. Conclusion : We concluded that MAS procedures appear to be safe for a wide range of indications in neonates and children. Further development and expansion of its indications in neonatal and paediatric surgery requires further multi-institutional studies and larger cohort of patients, to compare with standards of open surgery.

The psychological impact of body contouring surgery

DEFF Research Database (Denmark)

Mikkelsen Lorenzen, Mike; Poulsen, Lotte; Poulsen, Signe

2018-01-01

INTRODUCTION: Body contouring surgery is associated with changes in body image and identity. The primary aim of the study was to investigate a multidisciplinary assessment of potential psychological challenges before and after body contouring surgery. METHODS: Eight pre- and post-operative patients...... relevant codes had been extracted. RESULTS: A total of seven psychological themes were iden- tified, indicating that surgery alone cannot improve the pa- tients’ psychological difficulties and that psychological care and management of the expected discomfort and body im- age is of considerable importance...... in providing continuity of care. CONCLUSIONS: The reported quality of life is of consider- able importance to patients undergoing body contouring surgery after massive weight loss. Our findings may provide useful information for surgeons and healthcare profes- sionals allowing them to develop patient education...

Examination of bariatric surgery Facebook support groups: a content analysis.

Science.gov (United States)

Koball, Afton M; Jester, Dylan J; Domoff, Sarah E; Kallies, Kara J; Grothe, Karen B; Kothari, Shanu N

2017-08-01

Support following bariatric surgery is vital to ensure long-term postoperative success. Many individuals undergoing bariatric surgery are turning to online modalities, especially the popular social media platform Facebook, to access support groups and pages. Despite evidence suggesting that the majority of patients considering bariatric surgery are utilizing online groups, little is known about the actual content of these groups. The purpose of the present study was to conduct a content analysis of bariatric surgery support groups and pages on Facebook. Online via Facebook, independent academic medical center, United States. Data from bariatric surgery-related Facebook support groups and pages were extracted over a 1-month period in 2016. Salient content themes (e.g., progress posts, depression content, eating behaviors) were coded reliably (all κ> .70). More than 6,800 posts and replies were coded. Results indicated that seeking recommendations (11%), providing information or recommendations (53%), commenting on changes since surgery (19%), and lending support to other members (32%) were the most common types of posts. Content surrounding anxiety, eating behaviors, depression, body image, weight bias, and alcohol was found less frequently. Online bariatric surgery groups can be used to receive support, celebrate physical and emotional accomplishments, provide anecdotal accounts of the "bariatric lifestyle" for preoperative patients, and comment on challenges with mental health and experiences of weight bias. Providers should become acquainted with the content commonly found in online groups and exercise caution in recommending these platforms to information-seeking patients. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

I2D: code for conversion of ISOTXS structured data to DTF and ANISN structured tables

International Nuclear Information System (INIS)

Resnik, W.M. II.

1977-06-01

The I2D code converts neutron cross-section data written in the standard interface file format called ISOTXS to a matrix structured format commonly called DTF tables. Several BCD and binary output options are available including FIDO (ANISN) format. The I2D code adheres to the guidelines established by the Committee on Computer Code Coordination for standardized code development. Since some machine dependency is inherent regardless of the degree of standardization, provisions have been made in the I2D code for easy implementation on either short-word machines (IBM) or on long-word machines (CDC). 3 figures, 5 tables

Feasibility of using administrative data for identifying medical reasons to delay hip fracture surgery: a Canadian database study.

Science.gov (United States)

Guy, Pierre; Sheehan, Katie J; Morin, Suzanne N; Waddell, James; Dunbar, Michael; Harvey, Edward; Sirett, Susan; Sobolev, Boris; Kuramoto, Lisa; Tang, Michael

2017-10-05

Failure to account for medically necessary delays may lead to an underestimation of early surgery benefits. This study investigated the feasibility of using administrative data to identify the National Institute for Health and Care Excellence (NICE) 124 guideline list of conditions that appropriately delay hip fracture surgery. We assembled a list of diagnosis and procedure codes to reflect the NICE 124 conditions. The list was reviewed and updated by an advanced clinical coder. The list was refined by five clinical experts. We then screened Canadian Institute for Health Information discharge abstracts for 153 918 patients surgically treated for a non-pathological first hip fracture between 1 January 2004 and 31 December 2012 for diagnosis codes present on admission and procedure codes that antedated hip fracture surgery. We classified abstracts as having medical reasons for delaying surgery based on the presence of these codes. In total, 10 237 (6.7%; 95% CI 6.5% to 6.8%) patients had diagnostic and procedure codes indicating medical reasons for delay. The most common reasons for medical delay were exacerbation of a chronic chest condition (35.9%) and acute chest infection (23.2%). The proportion of patients with reasons for medical delays increased with time from admission to surgery: 3.9% (95% CI 3.6% to 4.1%) for same day surgery; 4.7% (95% CI 4.5% to 4.8%) for surgery 1 day after admission; 7.1% (95% CI 6.9% to 7.4%) for surgery 2 days after admission; and 15.5% (95% CI 15.1% to 16.0%) for surgery more than 2 days after admission. The trend was seen for admissions on weekday working hours, weekday after hours and on weekends. Administrative data can be considered to identify conditions that appropriately delay hip fracture surgery. Accounting for medically necessary delays can improve estimates of the effectiveness of early surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

Organizational Factors and Long-Term Mortality after Hip Fracture Surgery. A Cohort Study of 6143 Consecutive Patients Undergoing Hip Fracture Surgery

DEFF Research Database (Denmark)

Lund, Caterina A; Møller, Ann M; Wetterslev, Jørn

2014-01-01

OBJECTIVE: In hospital and health care organizational factors may be changed to reduce postoperative mortality. The aim of this study is to evaluate a possible association between mortality and 'length of hospital stay', 'priority of surgery', 'time of surgery', or 'surgical delay' in hip fracture...... surgery. DESIGN: Observational cohort study. SETTING: Prospectively and consecutively reported data from the Danish Anaesthesia Database were linked to The Danish National Registry of Patients and The Civil Registration System. Records on vital status, admittance, discharges, codes of diagnosis......; therefore cluster randomized clinical trials comparing different clinical set ups may be warranted evaluating health care organizational factors....

A feasibility assessment of calculation procedure with case study and the modification of dose conversion factor in STARDOSE

International Nuclear Information System (INIS)

Ko, H. S.; Jang, M.; Kim, S. H.; Kang, C. S.

2003-01-01

STARDOSE computer code is the designed code for which is calculated the dose of control room and off-site dose on design basis accident of nuclear power plant. Input files of STARDOSE are libfile1.txt which has decay constant and dose conversion factor, and input.dat which structurally expresses the real plant model by editor. It is given much advanced result with using newer dose conversion factor in libfile1.txt. In this study, therefore, case study is performed that is made input.dat file for LOCA and libfile1.txt which is included newer dose conversion factor and core inventory on APR-1400 and UCN 5 and 6. The result of case study is compared and analyzed

VARSKIN MOD 2 and SADDE MOD2: Computer codes for assessing skin dose from skin contamination

International Nuclear Information System (INIS)

Durham, J.S.

1992-12-01

The computer code VARSKIN has been modified to calculate dose to skin from three-dimensional sources, sources separated from the skin by layers of protective clothing, and gamma dose from certain radionuclides correction for backscatter has also been incorporated for certain geometries. This document describes the new code, VARSKIN Mod 2, including installation and operation instructions, provides detailed descriptions of the models used, and suggests methods for avoiding misuse of the code. The input data file for VARSKIN Mod 2 has been modified to reflect current physical data, to include the contribution to dose from internal conversion and Auger electrons, and to reflect a correction for low-energy electrons. In addition, the computer code SADDE: Scaled Absorbed Dose Distribution Evaluator has been modified to allow the generation of scaled absorbed dose distributions for mixtures of radionuclides and intereat conversion and Auger electrons. This new code, SADDE Mod 2, is also described in this document. Instructions for installation and operation of the code and detailed descriptions of the models used in the code are provided

THIDA: code system for calculation of the exposure dose rate around a fusion device

International Nuclear Information System (INIS)

Iida, Hiromasa; Igarashi, Masahito.

1978-12-01

A code system THIDA has been developed for calculation of the exposure dose rates around a fusion device. It consists of the following: one- and two-dimensional discrete ordinate transport codes; induced activity calculation code; activation chain, activation cross section, radionuclide gamma-ray energy/intensity and gamma-ray group constant files; and gamma ray flux to exposure dose rate conversion coefficients. (author)

[Initial experience in robot-assisted colorectal surgery in Mexico].

Science.gov (United States)

Villanueva-Sáenz, Eduardo; Ramírez-Ramírez, Moisés Marino; Zubieta-O'Farrill, Gregorio; García-Hernández, Luis

Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Pursuing Information: A Conversation Analytic Perspective on Communication Strategies

Science.gov (United States)

Burch, Alfred R.

2014-01-01

Research on second language (L2) communication strategies over the past three decades has concerned itself broadly with defining their usage in terms of planning and compensation, as well as with the use of taxonomies for coding different types of strategies. Taking a Conversation Analytic (CA) perspective, this article examines the fine-grained…

Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis: An Individual Patient Data Metaanalysis.

Science.gov (United States)

Fox, Gregory J; Mitnick, Carole D; Benedetti, Andrea; Chan, Edward D; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S; Menzies, Dick; Ahuja, S; Ashkin, D; Avendaño, M; Banerjee, R; Bauer, M; Burgos, M; Centis, R; Cobelens, F; Cox, H; D'Ambrosio, L; de Lange, W C M; DeRiemer, K; Enarson, D; Falzon, D; Flanagan, K; Flood, J; Gandhi, N; Garcia-Garcia, L; Granich, R M; Hollm-Delgado, M G; Holtz, T H; Hopewell, P; Iseman, M; Jarlsberg, L G; Kim, H R; Lancaster, J; Lange, C; Leimane, V; Leung, C C; Li, J; Menzies, D; Migliori, G B; Narita, M; Nathanson, E; Odendaal, R; O'Riordan, P; Pai, M; Palmero, D; Park, S K; Pena, J; Pérez-Guzmán, C; Ponce-de-Leon, A; Quelapio, M I D; Quy, H T; Riekstina, V; Royce, S; Salim, M; Schaaf, H S; Seung, K J; Shah, L; Shean, K; Sifuentes-Osornio, J; Sotgiu, G; Strand, M J; Sung, S W; Tabarsi, P; Tupasi, T E; Vargas, M H; van Altena, R; van der Walt, M; van der Werf, T S; Westenhouse, J; Yew, W W

2016-04-01

Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual patient data metaanalysis to evaluate the effectiveness of surgery as adjunctive therapy for MDR-tuberculosis. Individual patient data, was obtained from the authors of 26 cohort studies, identified from 3 systematic reviews of MDR-tuberculosis treatment. Data included the clinical characteristics and medical and surgical therapy of each patient. Primary analyses compared treatment success (cure and completion) to a combined outcome of failure, relapse, or death. The effects of all forms of resection surgery, pneumonectomy, and partial lung resection were evaluated. A total of 4238 patients from 18 surgical studies and 2193 patients from 8 nonsurgical studies were included. Pulmonary resection surgery was performed on 478 patients. Partial lung resection surgery was associated with improved treatment success (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.5-5.9; I(2)R, 11.8%), but pneumonectomy was not (aOR, 1.1; 95% CI, .6-2.3; I(2)R, 13.2%). Treatment success was more likely when surgery was performed after culture conversion than before conversion (aOR, 2.6; 95% CI, 0.9-7.1; I(2)R, 0.2%). Partial lung resection, but not pneumonectomy, was associated with improved treatment success among patients with MDR-tuberculosis. Although improved outcomes may reflect patient selection, partial lung resection surgery after culture conversion may improve treatment outcomes in patients who receive optimal medical therapy. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

Science.gov (United States)

Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

2015-02-01

The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

Benchmarking in Thoracic Surgery. Third Edition.

Science.gov (United States)

Freixinet Gilart, Jorge; Varela Simó, Gonzalo; Rodríguez Suárez, Pedro; Embún Flor, Raúl; Rivas de Andrés, Juan José; de la Torre Bravos, Mercedes; Molins López-Rodó, Laureano; Pac Ferrer, Joaquín; Izquierdo Elena, José Miguel; Baschwitz, Benno; López de Castro, Pedro E; Fibla Alfara, Juan José; Hernando Trancho, Florentino; Carvajal Carrasco, Ángel; Canalís Arrayás, Emili; Salvatierra Velázquez, Ángel; Canela Cardona, Mercedes; Torres Lanzas, Juan; Moreno Mata, Nicolás

2016-04-01

Benchmarking entails continuous comparison of efficacy and quality among products and activities, with the primary objective of achieving excellence. To analyze the results of benchmarking performed in 2013 on clinical practices undertaken in 2012 in 17 Spanish thoracic surgery units. Study data were obtained from the basic minimum data set for hospitalization, registered in 2012. Data from hospital discharge reports were submitted by the participating groups, but staff from the corresponding departments did not intervene in data collection. Study cases all involved hospital discharges recorded in the participating sites. Episodes included were respiratory surgery (Major Diagnostic Category 04, Surgery), and those of the thoracic surgery unit. Cases were labelled using codes from the International Classification of Diseases, 9th revision, Clinical Modification. The refined diagnosis-related groups classification was used to evaluate differences in severity and complexity of cases. General parameters (number of cases, mean stay, complications, readmissions, mortality, and activity) varied widely among the participating groups. Specific interventions (lobectomy, pneumonectomy, atypical resections, and treatment of pneumothorax) also varied widely. As in previous editions, practices among participating groups varied considerably. Some areas for improvement emerge: admission processes need to be standardized to avoid urgent admissions and to improve pre-operative care; hospital discharges should be streamlined and discharge reports improved by including all procedures and complications. Some units have parameters which deviate excessively from the norm, and these sites need to review their processes in depth. Coding of diagnoses and comorbidities is another area where improvement is needed. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

Single-incision laparoscopic bariatric surgery

Directory of Open Access Journals (Sweden)

Huang Chih-Kun

2011-01-01

Full Text Available Background: Bariatric surgery has been established as the best option of treatment for morbid obesity. In recent years single-incision laparoscopic surgery (SILS has emerged as another modality of carrying out the bariatric procedures. While SILS represents an advance, its application in morbid obesity at present is limited. In this article, we review the technique and results of SILS in bariatric surgery. Methods: The PubMed database was searched and totally 11 series reporting SILS in bariatric surgery were identified and analyzed. The case reports were excluded. Since 2008, 114 morbidly obese patients receiving SILS bariatric surgeries were reported. Results: The procedures performed included SILS gastric banding, sleeve gastrectomy and gastric bypass. No mortality was reported in the literatures. Sixteen patients (14.05% needed an additional incision for a liver retractor, a trocar or for conversion. Only one complication of wound infection was reported in these series. All the surgeons reported that the patients were highly satisfied with the scar. Conclusion: Because of abundant visceral and subcutaneous fat and multiple comorbidities in morbid obesity, it is more challenging for surgeons to perform the procedures with SILS. It is clear that extensive development of new instruments and technical aspects of these procedures as well as randomized studies to compare them with traditional laparoscopy are essential before these procedures can be utilized in day-to-day clinical practice.

Errors and complications in laparoscopic surgery

Directory of Open Access Journals (Sweden)

Liviu Drăghici

2017-05-01

Full Text Available Background. In laparoscopic surgery errors are unavoidable and require proper acknowledgment to reduce the risk of intraoperative and accurately assess the appropriate therapeutic approach. Fortunately, their frequency is low and cannot overshadow the benefits of laparoscopic surgery. Materials and Methods. We made an epidemiological investigation in General Surgery Department of Emergency Clinical Hospital "St. John" Bucharest, analyzing 20 years of experience in laparoscopic surgery, during 1994-2014. We wanted to identify evolution trends in complications of laparoscopic surgery, analyzing the dynamic of errors occurred in all patients with laparoscopic procedures. Results. We recorded 26847 laparoscopic interventions with a total of 427 intra-or postoperative complications that required 160 conversions and 267 reinterventions to resolve inconsistencies. The average frequency of occurrence of complications was 15.9‰ (15.9 of 1,000 cases. In the period under review it was a good momentum of laparoscopic procedures in our department. Number of minimally invasive interventions increased almost 10 times, from 266 cases operated laparoscopically in 1995 to 2638 cases in 2008. Annual growth of the number of laparoscopic procedures has surpassed the number of complications. Conclusions. Laborious work of laparoscopic surgery and a specialized centre with well-trained team of surgeons provide premises for a good performance even in the assimilation of new and difficult procedures.

A study on the nuclear computer code maintenance and management system

International Nuclear Information System (INIS)

Kim, Yeon Seung; Huh, Young Hwan; Lee, Jong Bok; Choi, Young Gil; Suh, Soong Hyok; Kang, Byong Heon; Kim, Hee Kyung; Kim, Ko Ryeo; Park, Soo Jin

1990-12-01

According to current software development and quality assurance trends. It is necessary to develop computer code management system for nuclear programs. For this reason, the project started in 1987. Main objectives of the project are to establish a nuclear computer code management system, to secure software reliability, and to develop nuclear computer code packages. Contents of performing the project in this year were to operate and maintain computer code information system of KAERI computer codes, to develop application tool, AUTO-i, for solving the 1st and 2nd moments of inertia on polygon or circle, and to research nuclear computer code conversion between different machines. For better supporting the nuclear code availability and reliability, assistance from users who are using codes is required. Lastly, for easy reference about the codes information, we presented list of code names and information on the codes which were introduced or developed during this year. (Author)

Absorbed dose conversion coefficients for embryo and foetus in neutron fields

International Nuclear Information System (INIS)

Chen, J.

2007-01-01

The Monte Carlo code MCNPX has been used to determine mean absorbed doses to the embryo and foetus when the mother is exposed to neutron fields. There are situations, such as on-board aircraft, where high-energy neutrons are often peaked in top down (TOP) direction. In addition to previous publications for standard irradiation geometries, this study provides absorbed dose conversion coefficients for the embryo of 8 weeks and the foetus of 3, 6 or 9 months at TOP irradiation geometry. The conversion coefficients are compared with the coefficients in isotropic irradiation (ISO). With increasing neutron energies, the conversion coefficients in TOP irradiation become dominant. A set of conversion coefficients is constructed from the higher value in either ISO or TOP irradiation at a given neutron energy. In cases where the irradiation geometry is not adequately known, this set of conversion coefficients can be used in a conservative dose assessment for embryo and foetus in neutron fields. (authors)

WEC3: Wave Energy Converter Code Comparison Project: Preprint

Energy Technology Data Exchange (ETDEWEB)

Combourieu, Adrien; Lawson, Michael; Babarit, Aurelien; Ruehl, Kelley; Roy, Andre; Costello, Ronan; Laporte Weywada, Pauline; Bailey, Helen

2017-01-01

This paper describes the recently launched Wave Energy Converter Code Comparison (WEC3) project and present preliminary results from this effort. The objectives of WEC3 are to verify and validate numerical modelling tools that have been developed specifically to simulate wave energy conversion devices and to inform the upcoming IEA OES Annex VI Ocean Energy Modelling Verification and Validation project. WEC3 is divided into two phases. Phase 1 consists of a code-to-code verification and Phase II entails code-to-experiment validation. WEC3 focuses on mid-fidelity codes that simulate WECs using time-domain multibody dynamics methods to model device motions and hydrodynamic coefficients to model hydrodynamic forces. Consequently, high-fidelity numerical modelling tools, such as Navier-Stokes computational fluid dynamics simulation, and simple frequency domain modelling tools were not included in the WEC3 project.

A browser-based tool for conversion between Fortran NAMELIST and XML/HTML

Science.gov (United States)

Naito, O.

A browser-based tool for conversion between Fortran NAMELIST and XML/HTML is presented. It runs on an HTML5 compliant browser and generates reusable XML files to aid interoperability. It also provides a graphical interface for editing and annotating variables in NAMELIST, hence serves as a primitive code documentation environment. Although the tool is not comprehensive, it could be viewed as a test bed for integrating legacy codes into modern systems.

A browser-based tool for conversion between Fortran NAMELIST and XML/HTML

Directory of Open Access Journals (Sweden)

O. Naito

2017-01-01

Full Text Available A browser-based tool for conversion between Fortran NAMELIST and XML/HTML is presented. It runs on an HTML5 compliant browser and generates reusable XML files to aid interoperability. It also provides a graphical interface for editing and annotating variables in NAMELIST, hence serves as a primitive code documentation environment. Although the tool is not comprehensive, it could be viewed as a test bed for integrating legacy codes into modern systems.

Conversion of the agent-oriented domain-specific language ALAS into JavaScript

Science.gov (United States)

Sredojević, Dejan; Vidaković, Milan; Okanović, Dušan; Mitrović, Dejan; Ivanović, Mirjana

2016-06-01

This paper shows generation of JavaScript code from code written in agent-oriented domain-specific language ALAS. ALAS is an agent-oriented domain-specific language for writing software agents that are executed within XJAF middleware. Since the agents can be executed on various platforms, they must be converted into a language of the target platform. We also try to utilize existing tools and technologies to make the whole conversion process as simple as possible, as well as faster and more efficient. We use the Xtext framework that is compatible with Java to implement ALAS infrastructure - editor and code generator. Since Xtext supports Java, generation of Java code from ALAS code is straightforward. To generate a JavaScript code that will be executed within the target JavaScript XJAF implementation, Google Web Toolkit (GWT) is used.

Bilingual processing of ASL-English code-blends: The consequences of accessing two lexical representations simultaneously

OpenAIRE

Emmorey, Karen; Petrich, Jennifer; Gollan, Tamar H.

2012-01-01

Bilinguals who are fluent in American Sign Language (ASL) and English often produce code-blends - simultaneously articulating a sign and a word while conversing with other ASL-English bilinguals. To investigate the cognitive mechanisms underlying code-blend processing, we compared picture-naming times (Experiment 1) and semantic categorization times (Experiment 2) for code-blends versus ASL signs and English words produced alone. In production, code-blending did not slow lexical retrieval for...

[Orthopedic and trauma surgery in the German-DRG-System 2009].

Science.gov (United States)

Franz, D; Windolf, J; Siebert, C H; Roeder, N

2009-01-01

The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

Identifying clinically disruptive International Classification of Diseases 10th Revision Clinical Modification conversions to mitigate financial costs using an online tool.

Science.gov (United States)

Venepalli, Neeta K; Qamruzzaman, Yusuf; Li, Jianrong John; Lussier, Yves A; Boyd, Andrew D

2014-03-01

To quantify coding ambiguity in International Classification of Diseases Ninth Revision Clinical Modification conversions (ICD-9-CM) to ICD-10-CM mappings for hematology-oncology diagnoses within an Illinois Medicaid database and an academic cancer center database (University of Illinois Cancer Center [UICC]) with the goal of anticipating challenges during ICD-10-CM transition. One data set of ICD-9-CM diagnosis codes came from the 2010 Illinois Department of Medicaid, filtered for diagnoses generated by hematology-oncology providers. The other data set of ICD-9-CM diagnosis codes came from UICC. Using a translational methodology via the Motif Web portal ICD-9-CM conversion tool, ICD-9-CM to ICD-10-CM code conversions were graphically mapped and evaluated for clinical loss of information. The transition to ICD-10-CM led to significant information loss, affecting 8% of total Medicaid codes and 1% of UICC codes; 39 ICD-9-CM codes with information loss accounted for 2.9% of total Medicaid reimbursements and 5.3% of UICC billing charges. Prior work stated hematology-oncology would be the least affected medical specialty. However, information loss affecting 5% of billing costs could evaporate the operating margin of a practice. By identifying codes at risk for complex transitions, the analytic tools described can be replicated for oncology practices to forecast areas requiring additional training and resource allocation. In summary, complex transitions and diagnosis codes associated with information loss within clinical oncology require additional attention during the transition to ICD-10-CM.

The impact of balloon catheter dilation on frequency of sinus surgery in the United States

Directory of Open Access Journals (Sweden)

Holy CE

2014-04-01

Full Text Available Chantal E Holy,1 John M Ellison,1 Charles Schneider,1 Howard L Levine2,3 1Health Economics and Reimbursement, 2Medical Affairs, Acclarent Inc., a Johnson & Johnson Company, Menlo Park, CA, USA; 3Cleveland Nasal-Sinus and Sleep Center, Cleveland, OH, USA Purpose: Endoscopic sinus surgery for patients with chronic rhinosinusitis (CRS unresponsive to medical therapy has traditionally been performed under general anesthesia and in the operating room. Balloons for catheter dilation of paranasal sinuses were introduced in 2005, allowing sinus surgery to be safely performed either in the operating room or the office care setting, under local anesthesia. This change in care setting has raised concerns of overuse or expanded indications for sinus surgery. This study was thus designed to evaluate changes in surgical volumes in the United States, for the period 2006–2011, and to evaluate the impact of the sinus balloons on surgical practice. Methods: The MarketScan® Commercial Claims and Encounter Database was queried for the period 2006 to 2011 using CRS International Classification of Diseases, Ninth Revision codes (473.X and sinus surgery US-based Common Procedural Terminology (CPT codes (endoscopic sinus surgery: CPT codes 31254–31294 and 31299; balloon catheter dilation: CPT codes 31295–31297. MarketScan's projection methodology was applied to estimate the nationwide prevalence of CRS and the incidence of sinus surgery. Procedural case mix and total average payment per surgery were analyzed. Results: From 2006 to 2011, the yearly prevalence of CRS and sinus surgery volume remained flat with ~430 patients with CRS per 100,000 in the employer-sponsored insured population, of which ~117/100,000 underwent surgery. In 2006, 2.69 paranasal sinuses (95% confidence interval [95% CI]: 2.65–2.71 were treated during each individual sinus surgery, with an additional 1.11 nasal procedures (95% CI: 1.08–1.13 performed concurrently. By 2011, the

Robot-assisted laparoscopic (RAL) procedures in general surgery.

Science.gov (United States)

Alimoglu, Orhan; Sagiroglu, Julide; Atak, Ibrahim; Kilic, Ali; Eren, Tunc; Caliskan, Mujgan; Bas, Gurhan

2016-09-01

Robotics was introduced in clinical practice more than two decades ago, and it has gained remarkable popularity for a wide variety of laparoscopic procedures. We report our results of robot-assisted laparoscopic surgery (RALS) in the most commonly applied general surgical procedures. Ninety seven patients underwent RALS from 2009 to 2012. Indications for RALS were cholelithiasis, gastric carcinoma, splenic tumors, colorectal carcinoma, benign colorectal diseases, non-toxic nodular goiter and incisional hernia. Records of patients were analyzed for demographic features, intraoperative and postoperative complications and conversion to open surgery. Forty six female and 51 male patients were operated and mean age was 58,4 (range: 25-88). Ninety three out of 97 procedures (96%) were completed robotically, 4 were converted to open surgery and there were 15 postoperative complications. There was no mortality. Wide variety of procedures of general surgery can be managed safely and effectively by RALS. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study.

Science.gov (United States)

Weems, Shelley; Heller, Pamela; Fenton, Susan H

2015-01-01

The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.

Development of CAD-Based Geometry Processing Module for a Monte Carlo Particle Transport Analysis Code

International Nuclear Information System (INIS)

Choi, Sung Hoon; Kwark, Min Su; Shim, Hyung Jin

2012-01-01

As The Monte Carlo (MC) particle transport analysis for a complex system such as research reactor, accelerator, and fusion facility may require accurate modeling of the complicated geometry. Its manual modeling by using the text interface of a MC code to define the geometrical objects is tedious, lengthy and error-prone. This problem can be overcome by taking advantage of modeling capability of the computer aided design (CAD) system. There have been two kinds of approaches to develop MC code systems utilizing the CAD data: the external format conversion and the CAD kernel imbedded MC simulation. The first approach includes several interfacing programs such as McCAD, MCAM, GEOMIT etc. which were developed to automatically convert the CAD data into the MCNP geometry input data. This approach makes the most of the existing MC codes without any modifications, but implies latent data inconsistency due to the difference of the geometry modeling system. In the second approach, a MC code utilizes the CAD data for the direct particle tracking or the conversion to an internal data structure of the constructive solid geometry (CSG) and/or boundary representation (B-rep) modeling with help of a CAD kernel. MCNP-BRL and OiNC have demonstrated their capabilities of the CAD-based MC simulations. Recently we have developed a CAD-based geometry processing module for the MC particle simulation by using the OpenCASCADE (OCC) library. In the developed module, CAD data can be used for the particle tracking through primitive CAD surfaces (hereafter the CAD-based tracking) or the internal conversion to the CSG data structure. In this paper, the performances of the text-based model, the CAD-based tracking, and the internal CSG conversion are compared by using an in-house MC code, McSIM, equipped with the developed CAD-based geometry processing module

[ENT medicine and head and neck surgery in the G-DRG system 2008].

Science.gov (United States)

Franz, D; Roeder, N; Hörmann, K; Alberty, J

2008-09-01

Further developments in the German DRG system have been incorporated into the 2008 version. For ENT medicine and head and neck surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focussed on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. The G-DRG system has gained in complexity again. High demands are made on correct and complete coding of complex ENT and head and neck surgery cases. Quality of case allocation within the G-DRG system has been improved. For standard cases quality of case allocation is adequate. Nevertheless, further adjustments of the G-DRG system especially for cases with complex neck surgery are necessary.

Robotic assisted surgery in pediatric gynecology: promising innovation in mini invasive surgical procedures.

Science.gov (United States)

Nakib, Ghassan; Calcaterra, Valeria; Scorletti, Federico; Romano, Piero; Goruppi, Ilaria; Mencherini, Simonetta; Avolio, Luigi; Pelizzo, Gloria

2013-02-01

Robotic assisted surgery is not yet widely applied in the pediatric field. We report our initial experience regarding the feasibility, safety, benefits, and limitations of robot-assisted surgery in pediatric gynecological patients. Descriptive, retrospective report of experience with pediatric gynecological patients over a period of 12 months. Department of Pediatric Surgery, IRCCS Policlinico San Matteo Foundation. Children and adolescents, with a surgical diagnosis of ovarian and/or tubal lesions. Robot assembly time and operative time, days of hospitalization, time to cessation of pain medication, complication rate, conversion rate to laparoscopic procedure and trocar insertion strategy. Six children and adolescents (2.4-15 yrs), weighing 12-55 kg, underwent robotic assisted surgery for adnexal pathologies: 2 for ovarian cystectomy, 2 for oophorectomy, 1 for right oophorectomy and left salpingo-oophorectomy for gonadal disgenesis, 1 for exploration for suspected pelvic malformation. Mean operative time was 117.5 ± 34.9 minutes. Conversion to laparatomy was not necessary in any of the cases. No intra- or postoperative complications occurred. Initial results indicate that robotic assisted surgery is safely applicable in the pediatric gynecological population, although it is still premature to conclude that it provides better clinical outcomes than traditional laparoscopic surgery. Randomized, prospective, comparative studies will help characterize the advantages and disadvantages of this new technology in pediatric patients. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Perceptual coding of stereo endoscopy video for minimally invasive surgery

Science.gov (United States)

Bartoli, Guido; Menegaz, Gloria; Yang, Guang Zhong

2007-03-01

In this paper, we propose a compression scheme that is tailored for stereo-laparoscope sequences. The inter-frame correlation is modeled by the deformation field obtained by elastic registration between two subsequent frames and exploited for prediction of the left sequence. The right sequence is lossy encoded by prediction from the corresponding left images. Wavelet-based coding is applied to both the deformation vector fields and residual images. The resulting system supports spatio temporal scalability, while providing lossless performance. The implementation of the wavelet transform by integer lifting ensures a low computational complexity, thus reducing the required run-time memory allocation and on line implementation. Extensive psychovisual tests were performed for system validation and characterization with respect to the MPEG4 standard for video coding. Results are very encouraging: the PSVC system features the functionalities making it suitable for PACS while providing a good trade-off between usability and performance in lossy mode.

[Robotics in pediatric surgery].

Science.gov (United States)

Camps, J I

2011-10-01

Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

A Population-Based Analysis of Time to Surgery and Travel Distances for Brachial Plexus Surgery.

Science.gov (United States)

Dy, Christopher J; Baty, Jack; Saeed, Mohammed J; Olsen, Margaret A; Osei, Daniel A

2016-09-01

Despite the importance of timely evaluation for patients with brachial plexus injuries (BPIs), in clinical practice we have noted delays in referral. Because the published BPI experience is largely from individual centers, we used a population-based approach to evaluate the delivery of care for patients with BPI. We used statewide administrative databases from Florida (2007-2013), New York (2008-2012), and North Carolina (2009-2010) to create a cohort of patients who underwent surgery for BPI (exploration, repair, neurolysis, grafting, or nerve transfer). Emergency department and inpatient records were used to determine the time interval between the injury and surgical treatment. Distances between treating hospitals and between the patient's home ZIP code and the surgical hospital were recorded. A multivariable logistic regression model was used to determine predictors for time from injury to surgery exceeding 365 days. Within the 222 patients in our cohort, median time from injury to surgery was 7.6 months and exceeded 365 days in 29% (64 of 222 patients) of cases. Treatment at a smaller hospital for the initial injury was significantly associated with surgery beyond 365 days after injury. Patient insurance type, travel distance for surgery, distance between the 2 treating hospitals, and changing hospitals between injury and surgery did not significantly influence time to surgery. Nearly one third of patients in Florida, New York, and North Carolina underwent BPI surgery more than 1 year after the injury. Patients initially treated at smaller hospitals are at risk for undergoing delayed BPI surgery. These findings can inform administrative and policy efforts to expedite timely referral of patients with BPI to experienced centers. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Strategic laparoscopic surgery for improved cosmesis in general and bariatric surgery: analysis of initial 127 cases.

Science.gov (United States)

Nguyen, Ninh T; Smith, Brian R; Reavis, Kevin M; Nguyen, Xuan-Mai T; Nguyen, Brian; Stamos, Michael J

2012-05-01

Strategic laparoscopic surgery for improved cosmesis (SLIC) is a less invasive surgical approach than conventional laparoscopic surgery. The aim of this study was to examine the feasibility and safety of SLIC for general and bariatric surgical operations. Additionally, we compared the outcomes of laparoscopic sleeve gastrectomy with those performed by the SLIC technique. In an academic medical center, from April 2008 to December 2010, 127 patients underwent SLIC procedures: 38 SLIC cholecystectomy, 56 SLIC gastric banding, 26 SLIC sleeve gastrectomy, 1 SLIC gastrojejunostomy, and 6 SLIC appendectomy. SLIC sleeve gastrectomy was initially performed through a single 4.0-cm supraumbilical incision with extraction of the gastric specimen through the same incision. The technique evolved to laparoscopic incisions that were all placed within the umbilicus and suprapubic region. There were no 30-day or in-hospital mortalities or 30-day re-admissions or re-operations. For SLIC cholecystectomy, gastric banding, appendectomy, and gastrojejunostomy, conversion to conventional laparoscopy occurred in 5.3%, 5.4%, 0%, and 0%, respectively; there were no major or minor postoperative complications. For SLIC sleeve gastrectomy, there were no significant differences in mean operative time and length of hospital stay compared with laparoscopic sleeve gastrectomy; 1 (3.8%) of 26 SLIC patients required conversion to five-port laparoscopy. There were no major complications. Minor complications occurred in 7.7% in the SLIC sleeve group versus 8.3% in the laparoscopic sleeve group. SLIC in general and bariatric operations is technically feasible, safe, and associated with a low rate of conversion to conventional laparoscopy. Compared with laparoscopic sleeve gastrectomy, SLIC sleeve gastrectomy can be performed without a prolonged operative time with comparable perioperative outcomes.

DART: A simulation code for charged particle beams

International Nuclear Information System (INIS)

White, R.C.; Barr, W.L.; Moir, R.W.

1989-01-01

This paper presents a recently modified version of the 2-D code, DART, which can simulate the behavior of a beam of charged particles whose trajectories are determined by electric and magnetic fields. This code was originally used to design laboratory-scale and full-scale beam direct converters. Since then, its utility has been expanded to allow more general applications. The simulation includes space charge, secondary electrons, and the ionization of neutral gas. A beam can contain up to nine superimposed beamlets of different energy and species. The calculation of energy conversion efficiency and the method of specifying the electrode geometry are described. Basic procedures for using the code are given, and sample input and output fields are shown. 7 refs., 18 figs

Functions of Arabic-English Code-Switching: Sociolinguistic Insights from a Study Abroad Program

Science.gov (United States)

Al Masaeed, Khaled

2013-01-01

This sociolinguistic study examines the functions and motivations of code-switching, which is used here to mean the use of more than one language in the same conversation. The conversations studied here take place in a very particular context: one-on-one speaking sessions in a study abroad program in Morocco where English is the L1 and Arabic the…

Coding and Billing in Surgical Education: A Systems-Based Practice Education Program.

Science.gov (United States)

Ghaderi, Kimeya F; Schmidt, Scott T; Drolet, Brian C

Despite increased emphasis on systems-based practice through the Accreditation Council for Graduate Medical Education core competencies, few studies have examined what surgical residents know about coding and billing. We sought to create and measure the effectiveness of a multifaceted approach to improving resident knowledge and performance of documenting and coding outpatient encounters. We identified knowledge gaps and barriers to documentation and coding in the outpatient setting. We implemented a series of educational and workflow interventions with a group of 12 residents in a surgical clinic at a tertiary care center. To measure the effect of this program, we compared billing codes for 1 year before intervention (FY2012) to prospectively collected data from the postintervention period (FY2013). All related documentation and coding were verified by study-blinded auditors. Interventions took place at the outpatient surgical clinic at Rhode Island Hospital, a tertiary-care center. A cohort of 12 plastic surgery residents ranging from postgraduate year 2 through postgraduate year 6 participated in the interventional sequence. A total of 1285 patient encounters in the preintervention group were compared with 1170 encounters in the postintervention group. Using evaluation and management codes (E&M) as a measure of documentation and coding, we demonstrated a significant and durable increase in billing with supporting clinical documentation after the intervention. For established patient visits, the monthly average E&M code level increased from 2.14 to 3.05 (p coding and billing of outpatient clinic encounters. Using externally audited coding data, we demonstrate significantly increased rates of higher complexity E&M coding in a stable patient population based on improved documentation and billing awareness by the residents. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of the fluence to dose conversion coefficients for high energy neutrons using a voxel phantom coupled with the GEANT4 code

CERN Document Server

Paganini, S

2005-01-01

Crews working on present-day jet aircraft are a large occupationally exposed group with a relatively high average effective dose from Galactic cosmic radiation. Crews of future high-speed commercial flying at higher altitudes would be even more exposed. To help reduce the significant uncertainties in calculations of such exposures, the male adult voxels phantom MAX, developed in the Nuclear Energy Department of Pernambuco Federal University in Brazil, has been coupled with the Monte Carlo simulation code GEANT4. This toolkit, distributed and upgraded from the international scientific community of CERN/Switzerland, simulates thermal to ultrahigh energy neutrons transport and interactions in the matter. The high energy neutrons are pointed as the component that contribute about 70% of the neutron effective dose that represent the 35% to 60% total dose at aircraft altitude. In this research calculations of conversion coefficients from fluence to effective dose are performed for neutrons of energies from 100 MeV ...

[Differentiation of coding quality in orthopaedics by special, illustration-oriented case group analysis in the G-DRG System 2005].

Science.gov (United States)

Schütz, U; Reichel, H; Dreinhöfer, K

2007-01-01

We introduce a grouping system for clinical practice which allows the separation of DRG coding in specific orthopaedic groups based on anatomic regions, operative procedures, therapeutic interventions and morbidity equivalent diagnosis groups. With this, a differentiated aim-oriented analysis of illustrated internal DRG data becomes possible. The group-specific difference of the coding quality between the DRG groups following primary coding by the orthopaedic surgeon and final coding by the medical controlling is analysed. In a consecutive series of 1600 patients parallel documentation and group-specific comparison of the relevant DRG parameters were carried out in every case after primary and final coding. Analysing the group-specific share in the additional CaseMix coding, the group "spine surgery" dominated, closely followed by the groups "arthroplasty" and "surgery due to infection, tumours, diabetes". Altogether, additional cost-weight-relevant coding was necessary most frequently in the latter group (84%), followed by group "spine surgery" (65%). In DRGs representing conservative orthopaedic treatment documented procedures had nearly no influence on the cost weight. The introduced system of case group analysis in internal DRG documentation can lead to the detection of specific problems in primary coding and cost-weight relevant changes of the case mix. As an instrument for internal process control in the orthopaedic field, it can serve as a communicative interface between an economically oriented classification of the hospital performance and a specific problem solution of the medical staff involved in the department management.

Low-temperature plasma simulations with the LSP PIC code

Science.gov (United States)

Carlsson, Johan; Khrabrov, Alex; Kaganovich, Igor; Keating, David; Selezneva, Svetlana; Sommerer, Timothy

2014-10-01

The LSP (Large-Scale Plasma) PIC-MCC code has been used to simulate several low-temperature plasma configurations, including a gas switch for high-power AC/DC conversion, a glow discharge and a Hall thruster. Simulation results will be presented with an emphasis on code comparison and validation against experiment. High-voltage, direct-current (HVDC) power transmission is becoming more common as it can reduce construction costs and power losses. Solid-state power-electronics devices are presently used, but it has been proposed that gas switches could become a compact, less costly, alternative. A gas-switch conversion device would be based on a glow discharge, with a magnetically insulated cold cathode. Its operation is similar to that of a sputtering magnetron, but with much higher pressure (0.1 to 0.3 Torr) in order to achieve high current density. We have performed 1D (axial) and 2D (axial/radial) simulations of such a gas switch using LSP. The 1D results were compared with results from the EDIPIC code. To test and compare the collision models used by the LSP and EDIPIC codes in more detail, a validation exercise was performed for the cathode fall of a glow discharge. We will also present some 2D (radial/azimuthal) LSP simulations of a Hall thruster. The information, data, or work presented herein was funded in part by the Advanced Research Projects Agency-Energy (ARPA-E), U.S. Department of Energy, under Award Number DE-AR0000298.

Modified radial v/s biatrial maze for atrial fibrillation in rheumatic valvular heart surgery

Directory of Open Access Journals (Sweden)

Sajid A. Sayed

2014-09-01

Discussion: In patients with AF undergoing rheumatic valvular surgery, radiofrequency radial approach is as effective as modified Cox's maze III for conversion to NSR with better atrial transport function.

DART: a simulation code for charged particle beams

International Nuclear Information System (INIS)

White, R.C.; Barr, W.L.; Moir, R.W.

1988-01-01

This paper presents a recently modified verion of the 2-D DART code designed to simulate the behavior of a beam of charged particles whose paths are affected by electric and magnetic fields. This code was originally used to design laboratory-scale and full-scale beam direct converters. Since then, its utility has been expanded to allow more general applications. The simulation technique includes space charge, secondary electron effects, and neutral gas ionization. Calculations of electrode placement and energy conversion efficiency are described. Basic operation procedures are given including sample input files and output. 7 refs., 18 figs

Laparoscopic paediatric surgery: A potential for paradigm shift in developing countries

Directory of Open Access Journals (Sweden)

M A Misauno

2012-01-01

Full Text Available Background: Until recently, surgical conditions in children requiring operation were managed by the traditional open method. The introduction of the laparoscopic surgical technique seems to be reversing this trend in many centres. We are pioneering some laparoscopic surgery procedures in our environment and the aim of this study was to document our experience with laparoscopic paediatric surgical procedures in a developing country. Materials and Methods: This was a prospective analysis of all consecutive children that had laparoscopic surgery at 5 hospitals in Northern Nigeria from June 2008 to February 2011. Results: Twenty-one patients had laparoscopic surgeries during the study period with a mean age of 12.5 ± 2.6 years and age range of 10-16 years. There were 14 females and 7 males with a M:F ratio of 1:2. Seven patients (33.3% had cholecystectomies and 13 (61.9% had appendicectomies and the remaining one patient (4.8% had adhesiolysis for partial adhesive intestinal obstruction following previous open appendicectomy. The mean operating time was 89 min with a range of 45-110 min for appendicectomies, 55-150 min for cholecystectomies and the adhesiolysis took 50 min. The mean hospital stay was 2 days except for the conversions that stayed up to 7 days. There were 2 (9.5% conversions with no mortality. Conclusion: We solicit a paradigm shift in our approach to surgical management and implore other centres to embrace laparoscopic surgery in the management of surgical conditions in children since it confers obvious advantages over open surgery.

Robotic Gastric Bypass Surgery in the Swiss Health Care System: Analysis of Hospital Costs and Reimbursement.

Science.gov (United States)

Hagen, Monika E; Rohner, Peter; Jung, Minoa K; Amirghasemi, Nicolas; Buchs, Nicolas C; Fakhro, Jassim; Buehler, Leo; Morel, Philippe

2017-08-01

Robotic technology shows some promising early outcomes indicating potentially improved outcomes particularly for challenging bariatric procedures. Still, health care providers face significant clinical and economic challenges when introducing innovations. Prospectively derived administrative cost data of patients who were coded with a primary diagnosis of obesity (ICD-10 code E.66.X), a procedure of gastric bypass surgery (CHOP code 44.3), and a robotic identifier (CHOP codes 00.90.50 or 00.39) during the years 2012 to 2015 was analyzed and compared to the triggered reimbursement for this patient cohort. A total of 348 patients were identified. The mean number of diagnoses was 2.7 and the mean length of stay was 5.9 days. The overall mean cost per patients was Swiss Francs (CHF) from 2012 to 2014 that was 21,527, with a mean reimbursement of CHF 24,917. Cost of the surgery in 2015 was comparable to the previous years with CHF 22,550.0 (p = 0.6618), but reimbursement decreased significantly to CHF 20,499.0 (0.0001). The average cost for robotic gastric bypass surgery fell well below the average reimbursement within the Swiss DRG system between 2012 and 2014, and this robotic procedure was a DRG winner for that period. However, the Swiss DRG system has matured over the years with a significant decrease resulting in a deficit for robotic gastric bypass surgery in 2015. This stipulates a discussion as to how health care providers should continue offering robotic gastric bypass surgery, particularly in the light of developing clinical evidence.

Technology transfer and design conversion of a dry spent fuel storage system in Ukraine

International Nuclear Information System (INIS)

Peacock, R.C.; Marcelli, D.G.

1998-01-01

A number of unique issues surfaced in the technology transfer and design conversion of a US dry spent fuel storage technology in Ukraine. Unique challenges were encountered in the areas of nuclear design conversion, technical codes and standards, material selection and qualification, fabrication, construction and testing, quality assurance, documentation, and translation and verification processes. Technology transfer and design conversion were undertaken for both concrete and steel components for the project. The overall effort presented significant technical and cultural challenges to both the US and Ukrainian side, but technical exchange and design improvements to achieve a common goal have been reached. (author)

Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes.

Science.gov (United States)

Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney

2014-10-21

Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological (pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic (0%-41.3%) and laparoscopic (5.5%-29.3%) surgery regarding morbidity and anastomotic complications (respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be

Extending the capabilities of CFD codes to assess ash related problems

DEFF Research Database (Denmark)

Kær, Søren Knudsen; Rosendahl, Lasse Aistrup; Baxter, B. B.

2004-01-01

This paper discusses the application of FLUENT? in theanalysis of grate-fired biomass boilers. A short description of theconcept used to model fuel conversion on the grate and the couplingto the CFD code is offered. The development and implementation ofa CFD-based deposition model is presented...... in the reminder of thepaper. The growth of deposits on furnace walls and super heatertubes is treated including the impact on heat transfer rates determinedby the CFD code. Based on the commercial CFD code FLUENT?,the overall model is fully implemented through the User DefinedFunctions. The model is configured...

Measurement and modeling of advanced coal conversion processes. Annual report, October 1990--September 1991

Energy Technology Data Exchange (ETDEWEB)

Solomon, P.R.; Serio, M.A.; Hamblen, D.G.; Smoot, L.D.; Brewster, B.S. [Advanced Fuel Research, Inc., East Hartford, CT (United States)]|[Brigham Young Univ., Provo, UT (United States)

1991-12-31

The overall objective of this program is the development of predictive capability for the design, scale up, simulation, control and feedstock evaluation in advanced coal conversion devices. This program will merge significant advances made in measuring and quantitatively describing the mechanisms in coal conversion behavior. Comprehensive computer codes for mechanistic modeling of entrained-bed gasification. Additional capabilities in predicting pollutant formation will be implemented and the technology will be expanded to fixed-bed reactors.

Causes and frequency of conversion during laparoscopic cholecystectomy in own material

Directory of Open Access Journals (Sweden)

Bogdan Kopeć

2010-12-01

Full Text Available Aim: To assess the causes, frequency and time of conversion from laparoscopic to classic cholecystectomy in our ownmaterial.Material and methods: 547 patients were qualified for laparoscopic cholecystectomy in the Surgery Department ofthe Mogilno District Hospital in Strzelno during the period of 1999-2005; 515 minimally invasive operations were performedand 32 patients required conversion.Results: The 547 patients were qualified for the laparoscopic operation; of these 148 were operated on as emergencycases and 399 as elective cases. There were 20 conversions among emergency patients and 12 conversions amongelective patients. On average the decision to convert was made in the 35th min of the operation. The shortest time toconversion was 15 min and the longest was 90 min. Five conversions were performed in the 25th and 35th minand 4 in the 20th, 30th, and 40th mine. Most frequently conversions occurred between the 20th and 40th min of theprocedure. Intentional conversions were performed in 27 patients. Adhesions and clumps around the gallbladder werethe cause of conversion in 10 patients and that was the most frequent reason for the operative modality change. Thenext cause of conversion was changes observed in the course of acute cholecystitis in the form of gallbladder empyemaor cholecystocele (9 patients. Small, fibrotic gallbladder, immersed in the liver, was the reason for conversion ina further 4 patients. In 4 cases the conversion was caused by difficulties in the identification of anatomical structures.Four cases of forced conversions and 1 anticipated conversion were found in the analysed material.Conclusions: A change of operative modality during laparoscopic cholecystectomy was made on average in 5.85% ofoperations. The average time before the conversion was 35 min. Emergency patients required a change of operativemodality 4 times more often. The most frequent were intentional conversions (84%, caused by pericystic adhesionsand by

High Girth Column-Weight-Two LDPC Codes Based on Distance Graphs

Directory of Open Access Journals (Sweden)

Gabofetswe Malema

2007-01-01

Full Text Available LDPC codes of column weight of two are constructed from minimal distance graphs or cages. Distance graphs are used to represent LDPC code matrices such that graph vertices that represent rows and edges are columns. The conversion of a distance graph into matrix form produces an adjacency matrix with column weight of two and girth double that of the graph. The number of 1's in each row (row weight is equal to the degree of the corresponding vertex. By constructing graphs with different vertex degrees, we can vary the rate of corresponding LDPC code matrices. Cage graphs are used as examples of distance graphs to design codes with different girths and rates. Performance of obtained codes depends on girth and structure of the corresponding distance graphs.

Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

Science.gov (United States)

Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

2017-06-01

Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

A simple model for the influence of meiotic conversion tracts on GC content.

Directory of Open Access Journals (Sweden)

Marie-Claude Marsolier-Kergoat

Full Text Available A strong correlation between GC content and recombination rate is observed in many eukaryotes, which is thought to be due to conversion events linked to the repair of meiotic double-strand breaks. In several organisms, the length of conversion tracts has been shown to decrease exponentially with increasing distance from the sites of meiotic double-strand breaks. I show here that this behavior leads to a simple analytical model for the evolution and the equilibrium state of the GC content of sequences devoid of meiotic double-strand break sites. In the yeast Saccharomyces cerevisiae, meiotic double-strand breaks are practically excluded from protein-coding sequences. A good fit was observed between the predictions of the model and the variations of the average GC content of the third codon position (GC3 of S. cerevisiae genes. Moreover, recombination parameters that can be extracted by fitting the data to the model coincide with experimentally determined values. These results thus indicate that meiotic recombination plays an important part in determining the fluctuations of GC content in yeast coding sequences. The model also accounted for the different patterns of GC variations observed in the genes of Candida species that exhibit a variety of sexual lifestyles, and hence a wide range of meiotic recombination rates. Finally, the variations of the average GC3 content of human and chicken coding sequences could also be fitted by the model. These results suggest the existence of a widespread pattern of GC variation in eukaryotic genes due to meiotic recombination, which would imply the generality of two features of meiotic recombination: its association with GC-biased gene conversion and the quasi-exclusion of meiotic double-strand breaks from coding sequences. Moreover, the model points out to specific constraints on protein fragments encoded by exon terminal sequences, which are the most affected by the GC bias.

How to deal with benign hilar or interlobar lymphadenopathy during video-assisted thoracoscopic surgery lobectomy.

Science.gov (United States)

Yan, Shi; Lv, Chao; Wang, Xing; Wu, Nan

2016-01-01

Video-assisted thoracoscopic surgery (VATS) surgery has changed the way lobectomy procedure was performed over the past few decades. However, some difficulties impede the accomplishment of VATS lobectomy, which of them, benign lymphadenopathy may pose a threat to safety of surgery. We reported a case with enlarged hilar and interlobar lymph nodes. The video showed the instrumentation and techniques that we had adopted to deal with the complicated dilemma during the operation. Critical experience was also suggested in some hypothetical scenarios. AS techniques were further refined, successful VATS segmentectomy or lobectomy with challenging hilar or interlobar lymphadenopathy could be performed without uncontrolled bleeding or unexpected conversion. A VATS approach is acceptable in the management of benign hilar or interlobar lymphadenopathy. However, facile technique is necessary to deal with intraoperative dilemma. To those who are not sure about the practicability of the VATS procedure, planned conversion is still an effective method to ensure safety of the operation.

Improved laser-to-proton conversion efficiency in isolated reduced mass targets

Energy Technology Data Exchange (ETDEWEB)

Morace, A. [Center for Energy Research, University of California, 9500 Gilman Drive, La Jolla, California 92093 (United States); Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, 20133 Milano (Italy); Bellei, C.; Patel, P. K. [Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550 (United States); Bartal, T.; Kim, J.; Beg, F. N. [Center for Energy Research, University of California, 9500 Gilman Drive, La Jolla, California 92093 (United States); Willingale, L.; Maksimchuk, A.; Krushelnick, K. [University of Michigan, 2200 Bonisteel Blvd. Ann Arbor, Michigan 48109 (United States); Wei, M. S. [Center for Energy Research, University of California, 9500 Gilman Drive, La Jolla, California 92093 (United States); General Atomics, 3550 General Atomics Court, San Diego, California 92121 (United States); Batani, D. [Univ. Bordeaux, CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, F-33405 Talence (France); Piovella, N. [Dipartimento di Fisica, Università degli Studi di Milano, via Celoria 16, 20133 Milano (Italy); Stephens, R. B. [General Atomics, 3550 General Atomics Court, San Diego, California 92121 (United States)

2013-07-29

We present experimental results of laser-to-proton conversion efficiency as a function of lateral confinement of the refluxing electrons. Experiments were carried out using the T-Cubed laser at the Center for Ultrafast Optical Science, University of Michigan. We demonstrate that the laser-to-proton conversion efficiency increases by 50% with increased confinement of the target from surroundings with respect to a flat target of the same thickness. Three-dimensional hybrid particle-in-cell simulations using LSP code agree with the experimental data. The adopted target design is suitable for high repetition rate operation as well as for Inertial Confinement Fusion applications.

Calculation of conversion coefficients for radiological protection against external radiation exposures

International Nuclear Information System (INIS)

Zankl, M.

2001-01-01

Calculations are essential for radiation protection practice because organ doses and effective doses cannot be measured directly. Conversion coefficients describe the numerical relationships of protection quantities and operational quantities. The latter can be measured in practical situations using suitable dosimeters. The conversion coefficients are calculated using radiation transport codes - usually based on Monte Carlo methods - that simulate the interactions of radiation with matter in computational models of the human body. A new generation of human body models, the so-called voxel models, are constructed from image data of real persons using suitable image processing systems, consequently, they represent the human anatomy more realistically than the so-called mathematical models. The numerical effects of realistic body anatomy on the calculated conversion coefficients can amount to 70% and more for external exposures. (orig.) [de

Status of HEU-LEU conversion of FRJ-2

International Nuclear Information System (INIS)

Damm, G.; Nabbi, R.

2002-01-01

The operator of the German FRJ-2 research reactor, 'Research Center Juelich', has participated from the beginning in the RERTR programme and made comprehensive contributions to the test and use of LEU fuel for HEU-LEU-conversion measures. The originally planned time scale for the conversion of FRJ-2 was significantly delayed because of a change of the manufacturer of the LEU fuel elements and a 4 years shutdown of the reactor for refurbishment purposes. In the meantime the new LEU fuel elements are qualified and tested in the reactor. In the moment calculations for the safety report are made and it is planned to apply for the license of FRJ-2 operation with LEU fuel at the beginning of 2003. In order to get most reliable results a sophisticated computational method based on a MCNP model coupled with the depletion code BURN was developed for reactor physical calculations, core conversion studies and fuel element performance analysis and applied to the mixed and LEU core. The licensing schedule and results of latest calculations for the conversion study will be presented. The simulations shows that the thermal flux in the LEU core is about 19% resulting in a lower burnup rate. But in the reflector area around the core and in the center of the cold n source the neutron flux reduction remains limited to 6%. Due to a harder neutron spectrum in the LEU core the kinetic and safety related parameters are slightly reduced. Using the ORIGEN code it could be shown that the increase of the total fission products inventory amounts to about 6% compared to a HEU core. As a consequence of the high amount of U-238, the amount of U-235 in the LEU core has to be about 27% higher than in the HEU core but the U-235 burnup is approx. 5% lower due to the contribution of fissile plutonium. (author)

Gene conversion homogenizes the CMT1A paralogous repeats

Directory of Open Access Journals (Sweden)

Hurles Matthew E

2001-12-01

Full Text Available Abstract Background Non-allelic homologous recombination between paralogous repeats is increasingly being recognized as a major mechanism causing both pathogenic microdeletions and duplications, and structural polymorphism in the human genome. It has recently been shown empirically that gene conversion can homogenize such repeats, resulting in longer stretches of absolute identity that may increase the rate of non-allelic homologous recombination. Results Here, a statistical test to detect gene conversion between pairs of non-coding sequences is presented. It is shown that the 24 kb Charcot-Marie-Tooth type 1A paralogous repeats (CMT1A-REPs exhibit the imprint of gene conversion processes whilst control orthologous sequences do not. In addition, Monte Carlo simulations of the evolutionary divergence of the CMT1A-REPs, incorporating two alternative models for gene conversion, generate repeats that are statistically indistinguishable from the observed repeats. Bounds are placed on the rate of these conversion processes, with central values of 1.3 × 10-4 and 5.1 × 10-5 per generation for the alternative models. Conclusions This evidence presented here suggests that gene conversion may have played an important role in the evolution of the CMT1A-REP paralogous repeats. The rates of these processes are such that it is probable that homogenized CMT1A-REPs are polymorphic within modern populations. Gene conversion processes are similarly likely to play an important role in the evolution of other segmental duplications and may influence the rate of non-allelic homologous recombination between them.

The omni-relevance of surgery: how medical specialization shapes orthopedic surgeons' treatment recommendations.

Science.gov (United States)

Hudak, Pamela L; Clark, Shannon J; Raymond, Geoffrey

2013-01-01

This article examines treatment recommendations in orthopedic surgery consultations and shows how surgery is treated as "omni-relevant" within this activity, providing a context within which the broad range of treatment recommendations proposed by surgeons is offered. Using conversation analysis to analyse audiotaped encounters between orthopedic surgeons and patients, we highlight how surgeons treat surgery as having a special, privileged status relative to other treatment options by (1) invoking surgery (whether or not it is actually being recommended) and (2) presenting surgery as the "last best resort" (in relation to which other treatment options are calibrated, described and considered). This privileged status surfaces in the design and delivery of recommendations as a clear asymmetry: Recommendations for surgery are proposed early, in relatively simple and unmitigated form. In contrast, recommendations not for surgery tend to be delayed and involve significantly more interactional work in their delivery. Possible implications of these findings, including how surgeons' structuring of recommendations may shape patient expectations (whether for surgery or some alternative), and potentially influence the distribution of orthopedic surgery procedures arising from these consultations, are considered.

Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

Science.gov (United States)

Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2018-04-01

The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

Efficiency calculations for the direct energy conversion system of the Cadarache neutral beam injectors

International Nuclear Information System (INIS)

White, R.C.

1988-01-01

A prototype energy conversion system is presently in operation at Cadarache, France. Such a device is planned for installation on each six neutral beam injectors for use in the Tore Supra experiment in 1989. We present calculations of beam performance that may influence design considerations. The calculations are performed with the DART charged particle beam code. We investigate the effects of cold plasma, direct energy conversion and neutral beam production. 4 refs., 6 figs., 4 tabs

Clinical implication of negative conversion of predicted circumferential resection margin status after preoperative chemoradiotherapy for locally advanced rectal cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Nam Kwon [Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Chul Yong, E-mail: kcyro@korea.ac.kr [Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Young Je; Yang, Dae Sik; Yoon, Won Sup [Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Seon Hahn; Kim, Jin [Division of Colorectal Surgery, Department of Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul (Korea, Republic of)

2014-02-15

Objective: To evaluate the prognostic implication of the negative conversion of predicted circumferential resection margin status before surgery in patients with locally advanced rectal cancer with predicted circumferential resection margin involvement. Methods: Thirty-eight patients (28 men, 10 women; median age, 61 years; age range, 39–80 years) with locally advanced rectal cancer with predicted circumferential resection margin involvement who underwent preoperative chemoradiotherapy followed by radical surgery were analyzed. Involvement of the circumferential resection margin was predicted on the basis of pre- and post-chemoradiotherapy magnetic resonance imaging. The primary endpoints were 3-year local recurrence-free survival and overall survival. Results: The median follow-up time was 41.1 months (range, 13.9–85.2 months). The negative conversion rate of predicted circumferential resection margin status after preoperative chemoradiotherapy was 65.8%. Patients who experienced negative conversion of predicted circumferential resection margin status had a significantly higher 3-year local recurrence-free survival rate (100.0% vs. 76.9%; P = 0.013), disease-free survival rate (91.7% vs. 59.3%; P = 0.023), and overall survival rate (96.0% vs. 73.8%; P = 0.016) than those who had persistent circumferential resection margin involvement. Conclusions: The negative conversion of the predicted circumferential resection margin status as predicted by magnetic resonance imaging will assist in individual risk stratification as a predictive factor for treatment response and survival before surgery. These findings may help physicians determine whether to administer more intense adjuvant chemotherapy or change the surgical plan for patients displaying resistance to preoperative chemoradiotherapy.

Summary of State-of-the-Art Power Conversion Systems for Energy Storage Applications

Energy Technology Data Exchange (ETDEWEB)

Atcitty, S.; Gray-Fenner, A.; Ranade, S.

1998-09-01

The power conversion system (PCS) is a vital part of many energy storage systems. It serves as the interface between the storage device, an energy source, and an AC load. This report summarizes the results of an extensive study of state-of-the-art power conversion systems used for energy storage applications. The purpose of the study was to investigate the potential for cost reduction and performance improvement in these power conversion systems and to provide recommendations for fiture research and development. This report provides an overview of PCS technology, a description of several state-of-the-art power conversion systems and how they are used in specific applications, a summary of four basic configurations for l:he power conversion systems used in energy storage applications, a discussion of PCS costs and potential cost reductions, a summary of the stancku-ds and codes relevant to the technology, and recommendations for future research and development.

Code conversion from signed-digit to complement representation based on look-ahead optical logic operations

Science.gov (United States)

Li, Guoqiang; Qian, Feng

2001-11-01

We present, for the first time to our knowledge, a generalized lookahead logic algorithm for number conversion from signed-digit to complement representation. By properly encoding the signed-digits, all the operations are performed by binary logic, and unified logical expressions can be obtained for conversion from modified-signed- digit (MSD) to 2's complement, trinary signed-digit (TSD) to 3's complement, and quarternary signed-digit (QSD) to 4's complement. For optical implementation, a parallel logical array module using an electron-trapping device is employed and experimental results are shown. This optical module is suitable for implementing complex logic functions in the form of the sum of the product. The algorithm and architecture are compatible with a general-purpose optoelectronic computing system.

Full-wave modeling of the O-X mode conversion in the Pegasus toroidal experiment

Energy Technology Data Exchange (ETDEWEB)

Koehn, A. [Institut fuer Plasmaforschung, Universitaet Stuttgart, D-70569 (Germany); Jacquot, J. [IRFM, CEA, F-13108 Saint-Paul-lez-Durance (France); Bongard, M. W.; Hinson, E. T.; Volpe, F. A. [Department of Engineering Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States); Gallian, S. [Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States)

2011-08-15

The ordinary-extraordinary (O-X) mode conversion is modeled with the aid of a 2D full-wave code in the Pegasus toroidal experiment as a function of the launch angles. It is shown how the shape of the plasma density profile in front of the antenna can significantly influence the mode conversion efficiency and, thus, the generation of electron Bernstein waves (EBWs). It is therefore desirable to control the density profile in front of the antenna for successful operation of an EBW heating and current drive system. On the other hand, the conversion efficiency is shown to be resilient to vertical displacements of the plasma as large as {+-}10 cm.

Cost Differences Between Open and Minimally Invasive Surgery.

Science.gov (United States)

Fitch, Kathryn; Engel, Tyler; Bochner, Andrew

2015-09-01

To analyze the cost difference between minimally invasive surgery (MIS) and open surgery from a commercial payer perspective for colectomy, ventral hernia repair, thoracic resection (resection of the lung), and hysterectomy. A retrospective claims data analysis was conducted using the 2011 and 2012 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. Study eligibility criteria included age 18-64 years, pharmacy coverage, ≥ 1 month of eligibility in 2012, and a claim coded with 1 of the 4 surgical procedures of interest; the index year was 2012. Average allowed facility and professional costs were calculated during inpatient stay (or day of surgery for outpatient hysterectomy) and the 30 days after discharge for MIS vs open surgery. Cost difference was compared after adjusting for presence of cancer, geographic region, and risk profile (age, gender, and comorbidities). In total, 46,386 cases in the 2012 MarketScan database represented one of the surgeries of interest. The difference in average allowed surgical procedure cost (facility and professional) between open surgery vs adjusted MIS was $10,204 for colectomy; $3,721, ventral hernia repair; $12,989, thoracic resection; and $1,174, noncancer hysterectomy (P average allowed cost in the 30 days after surgery between open surgery vs adjusted MIS was $1,494 for colectomy, $1,320 for ventral hernia repair, negative $711 for thoracic resection, and negative $425 for noncancer hysterectomy (P costs than open surgery for all 4 analyzed surgeries.

Thyroid Cancer Treatment Choice: A pilot study of a tool to facilitate conversations with patients with papillary microcarcinomas considering treatment options.

Science.gov (United States)

Brito, Juan P; Moon, Jae Hoon; Zeuren, Rebecca; Kong, Sung Hye; Kim, Yeo Koon; Iñiguez-Ariza, Nicole M; Choi, June Young; Lee, Kyu Eun; Kim, Ji-Hoon; Hargraves, Ian; Bernet, Victor; Montori, Victor; Park, Young Joo; Tuttle, R Michael

2018-06-15

The 2015 American Thyroid Association guidelines recognize active surveillance as an alternative to immediate surgery in patients with papillary microcarcinomas (PMCs). As a way to incorporate active surveillance as one of the management options for patients with PMCs, we describe the development and initial testing of a tool to support conversations between clinicians and patients with PMCs considering treatment options. Thyroid Cancer Treatment Choice was developed using an iterative process based on the principles of interaction, design and participatory action research. To evaluate the impact of the tool on treatment choice, a prospective study was conducted in two thyroid cancer clinics in Seongnam-si and Seoul, South Korea: both clinics had the expertise to offer active surveillance as well as immediate surgery. One clinic was trained in the use of the conversation aid, while the other clinic continued to care for patients without access to the conversation aid. Between May 2016 and April 2017, 278 patients mostly women (n=220, 79%) were included in the study; 152 (53%) received care at the clinic using the conversation aid. Age, gender, and mean tumor size [6.6 mm (SD 1.6) and 6.5 mm (SD 1.9)] distributions were similar across clinics. Overall, 233 (84%) patients opted for active surveillance and 53 (16%) for thyroid surgery. Patients in the conversation aid group were more likely to choose active surveillance than the patients seen in the usual care clinic [relative risk (RR) = 1.16; 95% confidence interval (CI), 1.04 - 1.29]. Of all patients opting for active surveillance, more patients in the conversation aid group had thyroid cancer nodules > 5 mm than in the usual care group (81% vs. 67% P = 0.013). Thyroid Cancer Treatment Choice is an evidence-based tool that supports the presentation of treatment options for PMCs. Pilot testing suggests that this conversation tool increases acceptance of active surveillance, suggesting that this option is an

Calculation of neutron fluence to dose equivalent conversion coefficients using GEANT4

International Nuclear Information System (INIS)

Ribeiro, Rosane M.; Santos, Denison de S.; Queiroz Filho, Pedro P. de; Mauricio, CLaudia L.P.; Silva, Livia K. da; Pessanha, Paula R.

2014-01-01

Fluence to dose equivalent conversion coefficients provide the basis for the calculation of area and personal monitors. Recently, the ICRP has started a revision of these coefficients, including new Monte Carlo codes for benchmarking. So far, little information is available about neutron transport below 10 MeV in tissue-equivalent (TE) material performed with Monte Carlo GEANT4 code. The objective of this work is to calculate neutron fluence to personal dose equivalent conversion coefficients, H p (10)/Φ, with GEANT4 code. The incidence of monoenergetic neutrons was simulated as an expanded and aligned field, with energies ranging between thermal neutrons to 10 MeV on the ICRU slab of dimension 30 x 30 x 15 cm 3 , composed of 76.2% of oxygen, 10.1% of hydrogen, 11.1% of carbon and 2.6% of nitrogen. For all incident energy, a cylindrical sensitive volume is placed at a depth of 10 mm, in the largest surface of the slab (30 x 30 cm 2 ). Physic process are included for neutrons, photons and charged particles, and calculations are made for neutrons and secondary particles which reach the sensitive volume. Results obtained are thus compared with values published in ICRP 74. Neutron fluence in the sensitive volume was calculated for benchmarking. The Monte Carlo GEANT4 code was found to be appropriate to calculate neutron doses at energies below 10 MeV correctly. (author)

Numerical study of the particle transport in fast neutron detectors with conversion layer

International Nuclear Information System (INIS)

Sedlackova, K.; Zatko, B.; Necas, V.

2012-01-01

This paper deals with fast neutron and recoil proton transport simulation using statistical analysis of Monte Carlo radiation transport code (MCNPX). Its possibilities in the detector design and optimization are presented. MCNPX proved as a very advantageous self-contained simulation program for fast neutron and secondary proton tracking. Simulations of respective particle transport through conversion layer of HDPE and further in the active volume of detector let us to follow important characteristics as neutron/proton flux density, reaction rate of elastic scattering on hydrogen nuclei and deposited energy as well as their dependencies on incident neutron energy and conversion layer/active region thickness. The efficiency of neutrons to protons conversion has been calculated and its maximum was reached for 500 μm thick conversion layer. The minimum active region thickness has been estimated to be about 300 μm.(authors)

Code-Switching in Persian-English and Telugu-English Conversations: With a Focus on Light Verb Constructions

Science.gov (United States)

Moradi, Hamzeh

2014-01-01

Depending on the demands of a particular communicative situation, bilingual or multilingual speakers ("bilingualism-multilingualism") will switch between language varieties. Code-switching is the practice of moving between variations of languages in different contexts. In an educational context, code-switching is defined as the practice…

A unique approach to quantifying the changing workload and case mix in laparoscopic colorectal surgery.

Science.gov (United States)

Shah, P R; Gupta, V; Haray, P N

2011-03-01

Laparoscopic colorectal surgery includes a range of operations with differing technical difficulty, and traditional parameters, such as conversion and complication rates, may not be sensitive enough to assess the complexity of these procedures. This study aims to define a reproducible and reliable tool for quantifying the total workload and the complexity of the case mix. This is a review of a single surgeon's 10-year experience. The intermediate equivalent value scoring system was used to code complexity of cases. To assess changes in the workload and case mix, the period has been divided into five phases. Three hundred and forty-nine laparoscopic operations were performed, of which there were 264 (75.6%) resections. The overall conversion rate was 17.8%, with progressive improvement over the phases. Complex major operation (CMO), as defined in the British United Provident Association (BUPA) schedule of procedures, accounted for 35% of the workload. In spite of similar numbers of cases in each phase, there was a steady increase in the workload score, correlating with the increasing complexity of the case mix. There was no significant difference in the conversion and complications rates between CMO and non-CMO. The paradoxical increase in the mean operating time with increasing experience corresponded to the progressive increase in the workload score, reflecting the increasing complexity of the case mix. This article establishes a reliable and reproducible tool for quantifying the total laparoscopic colorectal workload of an individual surgeon or of an entire department, while at the same time providing a measure of the complexity of the case mix. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

The lacrimal system: diagnosis, management, and surgery

National Research Council Canada - National Science Library

Cohen, Adam J; Mercandetti, Michael; Brazzo, Brian G

2006-01-01

... and techniques presented represent the state of the art of lacrimal diagnosis and surgery. There is mention of lacrimal infection dating back to the Code of Hammurabi in 2250 BC, but it was not until the late 1800s that real progress began to be made. Toti, an ENT surgeon in Florence, Italy, described external dacryocystorhinostomy (DCR) with turb...

Robot-Assisted Thoracoscopic Surgery versus Video-Assisted Thoracoscopic Surgery for Lung Lobectomy: Can a Robotic Approach Improve Short-Term Outcomes and Operative Safety?

Science.gov (United States)

Mahieu, Julien; Rinieri, Philippe; Bubenheim, Michael; Calenda, Emile; Melki, Jean; Peillon, Christophe; Baste, Jean-Marc

2016-06-01

Background Minimally invasive surgery has been recently recommended for treatment of early-stage non-small cell lung cancer. Despite the recent increase of robotic surgery, the place and potential advantages of the robot in thoracic surgery has not been well defined until now. Methods We reviewed our prospective database for retrospective comparison of our first 28 video-assisted thoracoscopic surgery lobectomies (V group) and our first 28 robotic lobectomies (R group). Results No significant difference was shown in median operative time between the two groups (185 vs. 190 minutes, p = 0.56). Median preincision time was significantly longer in the R group (80 vs. 60 minutes, P < 0.0001). The rate of emergency conversion for uncontrolled bleeding was lower in the R group (one vs. four). Median length of stay was comparable (6 days in the R group vs. 7 days in the V group, p = 0.4) with no significant difference in the rate of postoperative complications (eight Grade I in both groups, four Grade III or IV in the V group vs. six in the R group, according to the Clavien-Dindo classification, p = 0.93). No postoperative cardiac morbidity was observed in the R group. Median drainage time was similar (5 days, p = 0.78), with a rate of prolonged air leak slightly higher in the R group (25 vs. 17.8%, p = 0.74). Conclusion Perioperative outcomes are similar even in the learning period but robotic approach seems to offer more operative safety with fewer conversions for uncontrolled bleeding. Georg Thieme Verlag KG Stuttgart · New York.

Hand-assisted laparoscopic surgery and its applications in gynecology

Directory of Open Access Journals (Sweden)

Yueqian Wu

2016-02-01

Full Text Available Laparoscopic surgery has been used extensively since it was first applied in the 1980s. The advantages are generally accepted and include less pain, smaller incisions, faster recovery, and shorter hospital stays. However, several limitations associated with standard laparoscopic surgery (SLS have become apparent and include the loss of tactile sensation, problems with the removal of bulky and intact specimens, and the restriction of visualization of the entire operating field. These problems with SLS helped to inspire the development of laparoscopically assisted surgery followed by hand-assisted laparoscopic surgery (HALS. In a hand-assisted laparoscopic procedure, an incision is made in the patient’s abdomen. Then, a uniquely designed appliance is introduced into the abdominal cavity through the incision to maintain pneumoperitoneum. With the inserting hand, surgeons can provide manual exposure, traction, palpation, and dissection because of the feedback of tactile sensation. HALS has gained acceptance for a wide range of abdominal procedures in general surgery and urology and is now feasible for complicated surgeries such as splenectomy, nephroureterectomy, and colectomy. It has been demonstrated in numerous specialties that HALS is a safe and efficacious technique that combines the benefits of laparoscopy with the advantages of a conventional laparotomy. Standard laparoscopic surgery also has limitations in gynecological surgery. A patient may have high risks with conventional laparoscopic surgery when she has deep invasive endometriosis, multiple or massive myoma, or dense pelvic adhesions from prior surgery. HALS overcomes many of the aforementioned limitations, has less conversion to open surgery, and broadens the indications for minimally invasive surgery, not only for benign tumors but also for pelvic malignancies.

Conversion ratio in epithermal PWR, in thorium and uranium cycle

International Nuclear Information System (INIS)

Barroso, D.E.G.

1982-01-01

Results obtained for the conversion ratio in PWR reactors with close lattices, operating in thorium and uranium cycles, are presented. The study of those reactors is done in an unitary fuel cell of the lattices with several ratios V sub(M)/V sub(F), considering only the equilibrium cycles and adopting a non-spatial depletion calculation model, aiming to simulate mass flux of reactor heavy elements in the reactor. The neutronic analysis and the cross sections generation are done with Hammer computer code, with one critical apreciation about the application of this code in epithermal systems and with modifications introduced in the library of basic data. (E.G.) [pt

Prevention and management of intraoperative crisis in VATS and open chest surgery: how to avoid emergency conversion.

Science.gov (United States)

Safdie, Fernando M; Sanchez, Manuel Villa; Sarkaria, Inderpal S

2017-01-01

Video assisted thoracic surgery (VATS) has become a routinely utilized approach to complex procedures of the chest, such as pulmonary resection. It has been associated with decreased postoperative pain, shorter length of stay and lower incidence of complications such as pneumonia. Limitations to this modality may include limited exposure, lack of tactile feedback, and a two-dimensional view of the surgical field. Furthermore, the lack of an open incision may incur technical challenges in preventing and controlling operative misadventures leading to major hemorrhage or other intraoperative emergencies. While these events may occur in the best of circumstances, prevention strategies are the primary means of avoiding these injuries. Unplanned conversions for major intraoperative bleeding or airway injury during general thoracic surgical procedures are relatively rare and often can be avoided with careful preoperative planning, review of relevant imaging, and meticulous surgical technique. When these events occur, a pre-planned, methodical response with initial control of bleeding, assessment of injury, and appropriate repair and/or salvage procedures are necessary to maximize outcomes. The surgeon should be well versed in injury-specific incisions and approaches to maximize adequate exposure and when feasible, allow completion of the index operation. Decisions to continue with a minimally invasive approach should consider the comfort and experience level of the surgeon with these techniques, and the relative benefit gained against the risk incurred to the patient. These algorithms may be expected to shift in the future with increasing sophistication and capabilities of minimally invasive technologies and approaches.

A Morphological Analysis of English-Igbo Merged Verbs in Code ...

African Journals Online (AJOL)

This study examines the influence of Igbo morphemes on English verb structure in code-mixed/switched utterances. There is overwhelming evidence that English and Igbo languages interfere with each other in informal conversations of the Igbo-English bilinguals. This calls for researches to ascertain the degree of English ...

High conversion Th-U{sup 233} fuel assembly for current generation of PWRs

Energy Technology Data Exchange (ETDEWEB)

Baldova, D.; Fridman, E. [Reactor Safety Div., Helmholtz-Zentrum Dresden-Rossendorf, POB 510119, Dresden, 01314 (Germany)

2012-07-01

This paper presents a preliminary design of a high conversion Th-U{sup 233} fuel assembly applicable for current generation of Pressurized Water Reactor (PWRs). The considered fuel assembly has a typical 17 x 17 PWR lattice. However in order to increase the conversion of Th{sup 232} to U{sup 233}, the assembly was subdivided into the two regions called seed and blanket. The central seed region has a higher than blanket U{sup 233} content and acts as a neutron source for the peripheral blanket region. The latest acts as a U{sup 233} breeder. While the seed fuel pins have a standard dimensions the blanket fuel radius was increased in order to reduce the moderation and to facilitate the resonance neutron absorption in blanket Th{sup 232}. The U{sup 233} content in the seed and blanket regions was optimized to achieve maximal initial to discharged fissile inventory ratio (FIR) taking into account the target fuel cycle length of 12 months with 3-batch reloading scheme. In this study the neutronic calculations were performed on the fuel assembly level using Helios deterministic lattice transport code. The fuel cycle length and the core k{sub eff} were estimated by applying the Non Linear Reactivity Model. The applicability of the HELIOS code for the analysis of the Th-based high conversion designs was confirmed with the help of continuous-energy Monte-Carlo code SERPENT. The results of optimization studies show that for the heterogeneous seed and blanket (SB) fuel assembly the FIR of about 0.95 can be achieved. (authors)

Improving the accuracy of operation coding in surgical discharge summaries

Science.gov (United States)

Martinou, Eirini; Shouls, Genevieve; Betambeau, Nadine

2014-01-01

Procedural coding in surgical discharge summaries is extremely important; as well as communicating to healthcare staff which procedures have been performed, it also provides information that is used by the hospital's coding department. The OPCS code (Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures) is used to generate the tariff that allows the hospital to be reimbursed for the procedure. We felt that the OPCS coding on discharge summaries was often incorrect within our breast and endocrine surgery department. A baseline measurement over two months demonstrated that 32% of operations had been incorrectly coded, resulting in an incorrect tariff being applied and an estimated loss to the Trust of £17,000. We developed a simple but specific OPCS coding table in collaboration with the clinical coding team and breast surgeons that summarised all operations performed within our department. This table was disseminated across the team, specifically to the junior doctors who most frequently complete the discharge summaries. Re-audit showed 100% of operations were accurately coded, demonstrating the effectiveness of the coding table. We suggest that specifically designed coding tables be introduced across each surgical department to ensure accurate OPCS codes are used to produce better quality surgical discharge summaries and to ensure correct reimbursement to the Trust. PMID:26734286

[Inpatient Salivary Gland Surgery in Germany: A DRG-Based Nationwide Analysis, 2007-2011].

Science.gov (United States)

Jensen, J E; Schlattmann, P; Guntinas-Lichius, O

2016-09-01

This is the first population-based analysis of inpatient salivary gland surgery across Germany. Nationwide Diagnosis-Related Groups (DRG) statistics for 2007 to 2011 were analyzed regarding indications for salivary gland surgery based on ICD-10 codes. Age specific surgery rates were calculated for both sexes. Inpatient salivary gland surgical rates in 2007-2011 amounted for incisions (OPS [Classification of Operations and Procedures] code 5-260) 1.43 per 100 000 population, for excisions (5-261) 2.06 per 100 000, for salivary gland resections (5-262) 2.06 per 100 000, and for external incisions (5-270) 0.43 per 100 000. Regarding the mentioned four OPS codes, the surgical rates for benign tumors accounted to 10.08 per 100 000, for sialadenitis (without sialoliths) to 4.00 per 100 000, for malignant tumors to 3.90 per 100 000, and for sialolithiasis to 2.09 per 100 000. The increase of surgical rates from 2007 to 2011 was significant for malignant and benign tumors as well as for salivary stones. The surgical rates were highest for patients>60 years. Especially surgery for malignant tumors was more frequent than expected. In spite of the introduction of minimal invasive technique the rates for salivary gland resections in case of sialadenitis or sialolithiasis still seem to be high. © Georg Thieme Verlag KG Stuttgart · New York.

Ion-Bernstein wave mode conversion in hot tokamak plasmas

International Nuclear Information System (INIS)

Jaun, A.; Hellsten, T.; Chiu, S.C.

1997-08-01

Mode conversion at the second harmonic cyclotron resonance is studied in a toroidal plasma, showing how the ion-Bernstein wave can dramatically affect the power profile and partition among the species. The results obtained with the gyrokinetic toroidal PENN code in particular suggest that off-axis electron and second harmonic core ion heating should become important when the temperatures in JET reach 10 keV. (author) 1 fig., 11 refs

Laparoscopy Improves Short-term Outcomes After Surgery for Diverticular Disease

Science.gov (United States)

RUSS, ANDREW J.; OBMA, KARI L.; RAJAMANICKAM, VICTORIA; WAN, YIN; HEISE, CHARLES P.; FOLEY, EUGENE F.; HARMS, BRUCE; KENNEDY, GREGORY D.

2012-01-01

BACKGROUND & AIMS Observational studies and small randomized controlled trials have shown that the use of laparoscopy in colon resection for diverticular disease is feasible and results in fewer complications. We analyzed data from a large, prospectively maintained, multicenter database (National Surgical Quality Initiative Program) to determine whether the use of laparoscopy in the elective treatment of diverticular disease decreases rates of complications compared with open surgery, independent of preoperative comorbid factors. METHODS The analysis included data from 6970 patients who underwent elective surgeries for diverticular disease from 2005 to 2008. Patients with diverticular disease were identified by International Classification of Diseases, 9th revision codes and then categorized into open or laparoscopic groups based on Current Procedural Terminology codes. Preoperative, intraoperative, and postoperative data were analyzed to determine factors associated with increased risk for postoperative complications. RESULTS Data were analyzed from 3468 patients who underwent open surgery and 3502 patients who underwent laparoscopic procedures. After correcting for probability of morbidity, American Society of Anesthesiology class, and ostomy creation, overall complications (including superficial surgical site infections, deep incisional surgical site infections, sepsis, and septic shock) occurred with significantly lower incidence among patients who underwent laparoscopic procedures compared with those who received open operations. CONCLUSIONS The use of laparoscopy for treating diverticular disease, in the absence of absolute contraindications, results in fewer postoperative complications compared with open surgery. PMID:20193685

Perforated Peptic Ulcer Repair: Factors Predicting Conversion in Laparoscopy and Postoperative Septic Complications.

Science.gov (United States)

Muller, Markus K; Wrann, Simon; Widmer, Jeannette; Klasen, Jennifer; Weber, Markus; Hahnloser, Dieter

2016-09-01

The surgical treatment for perforated peptic ulcers can be safely performed laparoscopically. The aim of the study was to define simple predictive factors for conversion and septic complications. This retrospective case-control study analyzed patients treated with either laparoscopic surgery or laparotomy for perforated peptic ulcers. A total of 71 patients were analyzed. Laparoscopically operated patients had a shorter hospital stay (13.7 vs. 15.1 days). In an intention-to-treat analysis, patients with conversion to open surgery (analyzed as subgroup from laparoscopic approach group) showed no prolonged hospital stay (15.3 days) compared to patients with a primary open approach. Complication and mortality rates were not different between the groups. The statistical analysis identified four intraoperative risk factors for conversion: Mannheim peritonitis index (MPI) > 21 (p = 0.02), generalized peritonitis (p = 0.04), adhesions, and perforations located in a region other than the duodenal anterior wall. We found seven predictive factors for septic complications: age >70 (p = 0.02), cardiopulmonary disease (p = 0.04), ASA > 3 (p = 0.002), CRP > 100 (p = 0.005), duration of symptoms >24 h (p = 0.02), MPI > 21(p = 0.008), and generalized peritonitis (p = 0.02). Our data suggest that a primary laparoscopic approach has no disadvantages. Factors necessitating conversions emerged during the procedure inhibiting a preoperative selection. Factors suggesting imminent septic complications can be assessed preoperatively. An assessment of the proposed parameters may help optimize the management of possible septic complications.

Results from the Metis code participation to the Hydrocoin exercise

International Nuclear Information System (INIS)

Raimbault, P.

1987-04-01

The METIS code, developed at the ENSMP is a 2D finite element radionuclide transport and groundwater flow model based on the hypothesis of an equivalent porous medium with an explicit description of the main fractures. It is integrated in the global risk assessment code MELODIE for nuclear waste repositories in geological formations. The participation of the METIS code to the HYDROCOIN exercise is of prime importance for its development and its incorporation in the performance assessment procedure in France. Results from HYDROCOIN cases show that the code can handle correctly fractured media, high permeability contrast formations and buoyancy effects. A 3D version of the code has been developed for carrying comparisons of field experiments and groundwater flow models in HYDROCOIN level 2. In order to carry out the exercise, several pre and post-processing programs were developed and integrated in a conversational module. They include: contour plots, velocity field representations, interpolations, particule tracking routines and uncertainty and sensitivity analysis modules

Target vessel detection by epicardial ultrasound in off-pump coronary bypass surgery.

Science.gov (United States)

Hayakawa, Masato; Asai, Tohru; Kinoshita, Takeshi; Suzuki, Tomoaki; Shiraishi, Shoichiro

2013-01-01

The detection of embedded coronary arteries is difficult especially in off-pump coronary bypass surgery. From June 2010, we introduced high-frequency epicardial ultrasound (ECUS) to assess and evaluate embedded arteries during off-pump coronary bypass surgery. Between June 2010 and June 2011, a total of 89 consecutive patients underwent isolated coronary bypass surgery at our institution. The patients consisted of 72 men and 17 women with a mean age of 67.9 years. We routinely use the VeriQC system (MediStim, Oslo, Norway) to detect the target vessels in the operation. The patients were assigned to one of two groups, depending on whether ECUS was used in the operation (n = 10, ECUS group) or not (n = 79, non-ECUS group). We analyzed the impact of introducing the ECUS in terms of operative outcome. All patients underwent revascularization using the off-pump technique without emergent conversion to cardiopulmonary bypass during surgery. The total number of distal anastomoses was 299, and 12 target vessels could not be identified either visually or on palpation. Thus, the frequency of the embedded coronary arteries was 4.01% (12/299 cases). The preoperative profiles of the two groups were not significantly different. Operation time was significantly longer in the ECUS group (P = 0.02). There were no significant differences in postoperative outcome between the two groups. In the present study, in which the target coronary arteries could not be detected either visually or on palpation in 12 (4.01%) of 299 cases, the use of high-frequency ECUS allowed all patients to undergo off-pump coronary bypass surgery without conversion to cardiopulmonary bypass during the operation. High-frequency ECUS is therefore useful in off-pump coronary bypass surgery.

Plotting system for the MINCS code

International Nuclear Information System (INIS)

Watanabe, Tadashi

1990-08-01

The plotting system for the MINCS code is described. The transient two-phase flow analysis code MINCS has been developed to provide a computational tool for analysing various two-phase flow phenomena in one-dimensional ducts. Two plotting systems, namely the SPLPLOT system and the SDPLOT system, can be used as the plotting functions. The SPLPLOT system is used for plotting time transients of variables, while the SDPLOT system is for spatial distributions. The SPLPLOT system is based on the SPLPACK system, which is used as a general tool for plotting results of transient analysis codes or experiments. The SDPLOT is based on the GPLP program, which is also regarded as one of the general plotting programs. In the SPLPLOT and the SDPLOT systems, the standardized data format called the SPL format is used in reading data to be plotted. The output data format of MINCS is translated into the SPL format by using the conversion system called the MINTOSPL system. In this report, how to use the plotting functions is described. (author)

Development of throughflow calculation code for axial flow compressors

International Nuclear Information System (INIS)

Kim, Ji Hwan; Kim, Hyeun Min; No, Hee Cheon

2005-01-01

The power conversion systems of the current HTGRs are based on closed Brayton cycle and major concern is thermodynamic performance of the axial flow helium gas turbines. Particularly, the helium compressor has some unique design challenges compared to the air-breathing compressor such as high hub-to-tip ratios throughout the machine and a large number of stages due to the physical property of the helium and thermodynamic cycle. Therefore, it is necessary to develop a design and analysis code for helium compressor that can estimate the design point and off-design performance accurately. KAIST nuclear system laboratory has developed a compressor design and analysis code by means of throughflow calculation and several loss models. This paper presents the outline of the development of a throughflow calculation code and its verification results

Bilingual Voicing: A Study of Code-Switching in the Reported Speech of Finnish Immigrants in Estonia

Science.gov (United States)

Frick, Maria; Riionheimo, Helka

2013-01-01

Through a conversation analytic investigation of Finnish-Estonian bilingual (direct) reported speech (i.e., voicing) by Finns who live in Estonia, this study shows how code-switching is used as a double contextualization device. The code-switched voicings are shaped by the on-going interactional situation, serving its needs by opening up a context…

Discourse Matrix in Filipino-English Code-Switching: Students' Attitudes and Feelings

Science.gov (United States)

dela Rosa, Rona

2016-01-01

Undeniably, one language may be considered more valuable than other languages. Hence, most bilingual communities suffer from language imbalances. The present study attempts to identify the factors of code-switching during classroom presentations. Its functions were identified through analysing conversational contexts in which it occurs. Through…

Rates of intraoperative complications and conversion to laparotomy during laparoscopic ovariectomy performed by veterinary students: 161 cases (2010-2014).

Science.gov (United States)

Nylund, Adam M; Drury, Adam; Weir, Heather; Monnet, Eric

2017-07-01

OBJECTIVE To assess rates of intraoperative complications and conversion to laparotomy associated with supervised veterinary students performing laparoscopic ovariectomy in dogs. DESIGN Retrospective case series. ANIMALS 161 female shelter dogs for which elective laparoscopic ovariectomy had been performed by supervised senior (fourth-year) veterinary students from 2010 through 2014. PROCEDURES Medical records of all dogs were reviewed and data collected regarding duration of surgery, surgical complications and other characteristics, and whether conversion to laparotomy was required. RESULTS Laparoscopic ovariectomy was performed with a 2-cannula technique and a 10-mm vessel-sealing device for hemostasis in all dogs. A Veress needle was used for initial insufflation in 144 (89.4%) dogs; method of insufflation was not reported for the remaining 17 (10.6%) dogs. Mean ± SD duration of surgery was 114.90 ± 33.40 minutes. Surgical complications, all classified as minor blood loss, occurred in 24 (14.9%) dogs. These included splenic puncture during insertion of the Veress needle (n = 20 [12.4%]) and minor bleeding from the ovarian pedicle (4 [2.5%]). Splenic puncture required no intervention, and ovarian pedicle bleeding required application of the vessel-sealing device an additional time to control the bleeding. Two ovaries were dropped in the abdominal cavity at the time of removal. Both were retrieved without complication. Conversion to laparotomy was not required for any dog. All dogs were discharged from the hospital within 24 hours after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Laparoscopic ovariectomy in dogs was performed safely by closely supervised novice surgeons, with only minor intraoperative complications encountered and no need for conversion to laparotomy.

Safety of Laparoscopic Surgery for Colorectal Cancer in Patients with Severe Comorbidities.

Science.gov (United States)

Sawazaki, Sho; Numata, Masakatsu; Morita, Junya; Maezawa, Yukio; Amano, Shinya; Aoyama, Toru; Tamagawa, Hiroshi; Sato, Tsutomu; Oshima, Takashi; Mushiake, Hiroyuki; Yukawa, Norio; Shiozawa, Manabu; Rino, Yasushi; Masuda, Munetaka

2018-06-01

Previous studies have shown that laparoscopic colorectal cancer surgery is highly safe and effective compared to laparotomy. However, whether laparoscopic colorectal cancer surgery can be safely performed in patients with severe comorbidities remains unclear. The aim of this study was to evaluate the safety of laparoscopic colorectal cancer surgery in patients with severe comorbidities. A total of 82 consecutive patients with colorectal cancer who underwent laparoscopic surgery were retrospectively divided into two groups according to whether they had severe comorbidity (50 patients) or non-severe comorbidity (32 patients). An age-adjusted Charlson comorbidity index of ≥6 was defined as severe comorbidity. Operative time, blood loss, and rate of conversion to laparotomy did not differ between the groups. Postoperative complications and the length of the postoperative hospital stay also did not differ significantly between the groups. Laparoscopic colorectal cancer surgery is feasible and safe, even in patients with severe comorbidities. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Remembering a criminal conversation: beyond eyewitness testimony.

Science.gov (United States)

Campos, Laura; Alonso-Quecuty, María L

2006-01-01

Unlike the important body of work on eyewitness memory, little research has been done on the accuracy and completeness of "earwitness" memory for conversations. The present research examined the effects of mode of presentation (audiovisual/ auditory-only) on witnesses' free recall for utterances in a criminal conversation at different retention intervals (immediate/delayed) within a single experiment. Different forms of correct recall (verbatim/gist) of the verbal information as well as different types of errors (distortions/fabrications) were also examined. It was predicted that participants in the audiovisual modality would provide more correct information, and fewer errors than participants in the auditory-only modality. Participants' recall was predicted to be impaired over time, dropping to a greater extent after a delay in the auditory-only modality. Results confirmed these hypotheses. Interpretations of the overall findings are offered within the context of dual-coding theory, and within the theoretical frameworks of source monitoring and fuzzy-trace theory.

Prioritizing quality improvement in general surgery.

Science.gov (United States)

Schilling, Peter L; Dimick, Justin B; Birkmeyer, John D

2008-11-01

Despite growing interest in quality improvement, uncertainty remains about which procedures offer the most room for improvement in general surgery. In this context, we sought to describe the relative contribution of different procedures to overall morbidity, mortality, and excess length of stay in general surgery. Using data from the American College of Surgeons' National Surgery Quality Improvement Program (ACS-NSQIP), we identified all patients undergoing a general surgery procedure in 2005 and 2006 (n=129,233). Patients were placed in 36 distinct procedure groups based on Current Procedural Terminology codes. We first examined procedure groups according to their relative contribution to overall morbidity and mortality. We then assessed procedure groups according to their contribution to overall excess length of stay. Ten procedure groups alone accounted for 62% of complications and 54% of excess hospital days. Colectomy accounted for the greatest share of adverse events, followed by small intestine resection, inpatient cholecystectomy, and ventral hernia repair. In contrast, several common procedures contributed little to overall morbidity and mortality. For example, outpatient cholecystectomy, breast procedures, thyroidectomy, parathyroidectomy, and outpatient inguinal hernia repair together accounted for 34% of procedures, but only 6% of complications (and only 4% of major complications). These same procedures accounted for surgery. Focusing quality improvement efforts on these procedures may be an effective strategy for improving patient care and reducing cost.

Acute care surgery: defining mortality in emergency general surgery in the state of Maryland.

Science.gov (United States)

Narayan, Mayur; Tesoriero, Ronald; Bruns, Brandon R; Klyushnenkova, Elena N; Chen, Hegang; Diaz, Jose J

2015-04-01

Emergency general surgery (EGS) is a major component of acute care surgery, however, limited data exist on mortality with respect to trauma center (TC) designation. We hypothesized that mortality would be lower for EGS patients treated at a TC vs non-TC (NTC). A retrospective review of the Maryland Health Services Cost Review Commission database from 2009 to 2013 was performed. The American Association for the Surgery of Trauma EGS ICD-9 codes were used to identify EGS patients. Data collected included demographics, TC designation, emergency department admissions, and All Patients Refined Severity of Illness (APR_SOI). Trauma center designation was used as a marker of a formal acute care surgery program. Primary outcomes included in-hospital mortality. Multivariable logistic regression analysis was performed controlling for age. There were 817,942 EGS encounters. Mean ± SD age of patients was 60.1 ± 18.7 years, 46.5% were males; 71.1% of encounters were at NTCs; and 75.8% were emergency department admissions. Overall mortality was 4.05%. Mortality was calculated based on TC designation controlling for age across APR_SOI strata. Multivariable logistic regression analysis did not show statistically significant differences in mortality between hospital levels for minor APR_SOI. For moderate APR_SOI, mortality was significantly lower for TCs compared with NTCs (p surgery patients treated at TCs had lower mortality for moderate APR_SOI, but increased mortality for extreme APR_SOI when compared with NTCs. Additional investigation is required to better evaluate this unexpected finding. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

Science.gov (United States)

McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

2017-12-06

For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

Examination of spent fuel radiation energy conversion for electricity generation

Energy Technology Data Exchange (ETDEWEB)

Lee, Haneol; Yim, Man-Sung, E-mail: msyim@kaist.ac.kr

2016-04-15

Highlights: • Utilizing conversion of radiation energy of spent fuel to electric energy. • MCNPX modeling and experiment were used to estimate energy conversion. • The converted energy may be useful for nuclear security applications. • The converted energy may be utilized for safety applications through energy storage. - Abstract: Supply of electricity inside nuclear power plant is one of the most important considerations for nuclear safety and security. In this study, generation of electric energy by converting radiation energy of spent nuclear fuel was investigated. Computational modeling work by using MCNPX 2.7.0 code along with experiment was performed to estimate the amount of electric energy generation. The calculation using the developed modeling work was validated through comparison with an integrated experiment. The amount of electric energy generation based on a conceptual design of an energy conversion module was estimated to be low. But the amount may be useful for nuclear security applications. An alternative way of utilizing the produced electric energy could be considered for nuclear safety application through energy storage. Further studies are needed to improve the efficiency of the proposed energy conversion concept and to examine the issue of radiation damage and economic feasibility.

External dose conversion factor from canal water

International Nuclear Information System (INIS)

Bhargava, Pradeep; Chitra, S.; Mhatre, Arti S.; Singh, Kapil Deo

2016-01-01

External dose needs to be estimated for the radioactivity discharged into the canal, as it constitutes one of the pathways of exposure to the public. Two activities are considered here: i) a walk along the bank of the canal ii) and the walk on the bridge. A concentration of 1 Bq/l is assumed here for the gross beta activity for the estimation of the dose conversion factor. A canal of width 14.39 m and the depth of 2.5 m is considered for this study. Length of the canal is taken to be infinite. Canal side wall is assumed to be the 25 cm thick concrete. Two points are selected, one on the bank, and the second on a bridge 1 m above the top surface of canal water. Dose Conversion factors for the person moving on the Bridge (at one meter above the water surface) and standing on bank of canal is estimated by using the QAD CG code for 137 Cs. Dose conversion factors for the location mentioned above are found to be 1.11E-10 Sv/hr/(Bq/l) and 1.55 E-11 Sv/hr/(Bq/l) for bridge and bank of canal respectively. (author)

Lead-cooled flexible conversion ratio fast reactor

International Nuclear Information System (INIS)

Nikiforova, Anna; Hejzlar, Pavel; Todreas, Neil E.

2009-01-01

Lead-cooled reactor systems capable of accepting either zero or unity conversion ratio cores depending on the need to burn actinides or operate in a sustained cycle are presented. This flexible conversion ratio reactor is a pool-type 2400 MWt reactor coupled to four 600 MWt supercritical CO 2 (S-CO 2 ) power conversion system (PCS) trains through intermediate heat exchangers. The cores which achieve a power density of 112 kW/l adopt transuranic metallic fuel and reactivity feedbacks to achieve inherent shutdown in anticipated transients without scram, and lead coolant in a pool vessel arrangement. Decay heat removal is accomplished using a reactor vessel auxiliary cooling system (RVACS) complemented by a passive secondary auxiliary cooling system (PSACS). The transient simulation of station blackout (SBO) using the RELAP5-3D/ATHENA code shows that inherent shutdown without scram can be accommodated within the cladding temperature limit by the enhanced RVACS and a minimum (two) number of PSACS trains. The design of the passive safety systems also prevents coolant freezing in case all four of the PSACS trains are in operation. Both cores are also shown able to accommodate unprotected loss of flow (ULOF) and unprotected transient overpower (UTOP) accidents using the S-CO 2 PCS.

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear.

Science.gov (United States)

Aydin, Nuri; Karaismailoglu, Bedri

2017-07-21

Partial-thickness rotator cuff tears (PTRCTs) are one of the leading causes of shoulder dysfunction. Successful results have been reported with different treatment techniques, but the long-term consequences of these procedures are not yet clearly known. The purposes of this study were to evaluate and compare the mid- and long-term clinical outcomes of arthroscopically repaired bursal-side PTRCTs after conversion to full-thickness tears and identify the possible effects of age, gender, and hand dominance on clinical outcomes. Twenty-nine patients who had undergone arthroscopic repair of a significant bursal-side PTRCT were functionally evaluated. The repair was made after conversion to a full-thickness tear. The average patient age was 55.2 years (range 35-69 years, SD ±7.6 years). Clinical outcomes were evaluated at 2 and 5 years after surgery. Constant Shoulder Score (CSS) and Visual Analogue Scale for Pain (VAS pain) were used as outcome measures. The average CSS improved from 38.9 preoperatively to 89.2 and 87.8 at 2 and 5 years after surgery, respectively (p functional outcomes and VAS pain scores at 2 and 5 years after surgery compared with the preoperative period. The patients who underwent surgery from their non-dominant extremity showed a significantly higher CSS increase relative to those who underwent surgery on the dominant extremity (p = 0.022). Arthroscopic repair of high-grade bursal-side PTRCTs after conversion to full-thickness tears is a reliable surgical technique with good functional outcomes and pain relief both at mid- and long-term follow-ups. Surgery on the non-dominant side may be related to better functional outcomes.

Mechatronics Engineers’ Perception of Code Mixing: Philadelphia University and Hashemite University as a Case Study

Directory of Open Access Journals (Sweden)

Mustafa Al-Khawaldeh

2016-11-01

Full Text Available It has recently been widely recognized that code-switching is prevalent in Jordanians' daily conversation in various situations such as home, cafés, universities, restaurants and clubs. Abalhassan and Alshalawi (2000: 183 made a very related observation on code switching behavior among Arab speakers of English that “without exception, all respondents switched into English to some degree”. This could be referred to the increase number of technological advances and people travelling across countries for pleasure or for pursuing further education. In light of this observation, the crucial role of language in people's life, ambivalent attitudes towards code-switching (Akbar, 2007, the dearth of research in this area, such a present study is required to explore Jordanian university students’ and instructors’ perceptions of code-switching in their daily classroom conversation and its expected impact on their language proficiency. In particular, it investigates the factors leading them to code mix and their underlying attitudes towards its expected future impact on their language proficiency. To the best knowledge of the present researcher, this study is the first of its kind in Jordan. Data was collected via semi-structured interviews and a questionnaire from 70 university students and 30 instructors from both Philadelphia University and the Hashemite University. Data revealed that code mixing between English and Arabic is a common phenomenon in lectures they have attended in their academic institutions. The participants also show that they find code mixing fascinating and believe that though code switching might have a positive impact on their learning as it helps them better understand the topic. The instructors revealed that code mixing fulfill a set of functions that serve the educational process.

Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

Science.gov (United States)

Peponis, Thomas; Bohnen, Jordan D; Sangji, Naveen F; Nandan, Anirudh R; Han, Kelsey; Lee, Jarone; Yeh, D Dante; de Moya, Marc A; Velmahos, George C; Chang, David C; Kaafarani, Haytham M A

2017-08-01

The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision

Robotic surgery for rectal cancer: a single center experience of 100 consecutive cases.

Science.gov (United States)

Stănciulea, O; Eftimie, M; David, L; Tomulescu, V; Vasilescu, C; Popescu, I

2013-01-01

Minimally invasive techniques have revolutionized the field of general surgery over the few last decades. Despite its advantages, in complex procedures such as rectal surgery, laparoscopy has not achieved a high penetration rate because of its steep learning curve, its relatively high conversion rate and technical challenges. The aim of this study was to present a single center experience with robotic surgery for rectal cancer focusing mainly on early and mid-term postoperative outcome. A series of 100 consecutive patients who underwent robotic rectal surgery between January 2008 and June 2012 was analyzed retrospectively in terms of demographics, pathological data, surgical and oncological outcomes. Seventy-seven patients underwent robotic sphincter-saving resection, and 23 patients underwent robotic abdominoperineal resection. There were 4 conversions. The median operative time for sphincter-saving procedures was 180 min. The median time for robotic abdominoperineal resection was 160 min. The median distal resection margin of the operative specimen was 3 cm. The median number of retrieved lymph nodes was 14. The median hospital stay was 10 days. In-hospital mortality was nil. The overall morbidity was 30%. Four patients presented transitory postoperative urinary dysfunction. Severe erectile dysfunction was reported by 3 patients. The median length of follow-up was 24 months. The 3-year overall survival rate was 90%. Robotic surgery is advantageous for both surgeons (in that it facilitates dissection in a narrow pelvis) and patients (in that it affords a very good quality of life via the preservation of sexual and urinary function in the vast majority of patients and it has low morbidity and good midterm oncological outcomes). In rectal cancer surgery, the robotic approach is a promising alternative and is expected to overcome the low penetration rate of laparoscopy in this field. Celsius.

Brain surgery breathes new life into aging plants

Energy Technology Data Exchange (ETDEWEB)

Makansi, J. [Pearl Street Inc. (United States)

2006-04-15

Unlike managing the human aging process, extending the life of a power plant often includes brain surgery, modernizing its control and automation system. Lately, such retrofits range from wholesale replacing of existing controls to the addition of specific control elements that help optimize performance. Pending revisions to safety codes and cybersecurity issues also need to be considered. 4 figs.

A positive return on investment: research funding by the Thoracic Surgery Foundation for Research and Education (TSFRE).

Science.gov (United States)

Jones, David R; Mack, Michael J; Patterson, G Alexander; Cohn, Lawrence H

2011-05-01

The Thoracic Surgery Foundation for Research and Education (TSFRE) was formed in 1991 with the primary goals of generating new knowledge and nurturing the development of surgeon-scientists. The purpose of this article is to determine how effective the TSFRE has been in achieving these goals. A survey instrument was sent electronically to all former and current TSFRE research award recipients. Major themes included the benefits on TSFRE award recipients with respect to career choices of thoracic surgery, progress toward research independence, and the ability to leverage TSFRE funds to more substantive National Institutes of Health (NIH) awards. Success rates for NIH funding were confirmed using NIH Research Portfolio Online Reporting Tools. The total completed survey response rate was 70% (75/107). The response rates for each group were as follows: resident 74% (28/38), faculty 85% (29/34), Braunwald 50% (9/18), and TSFRE/NIH K-award 65% (11/17). The funding rate for all grants was 14% (90/619). For resident research awardees, 81% (34/42) are cardiothoracic surgeons or are thoracic surgery residents. The conversion rate for existing TSFRE/NIH co-sponsored K-awards to R01 grants is 40% at 5 years compared with a 20% K to R conversion rate for all NIH K-award recipients. K to R conversion rates for junior faculty grant awardees without a prior K-award is 44%, which is much higher than NIH rates for all new investigator R01 awards. The return on investment for TSFRE funding for surgeon-scientists is resoundingly positive with respect to promoting careers in cardiothoracic surgery and to obtaining subsequent NIH funding for thoracic surgeon investigators. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Conversion of Percutaneous Cholecystostomy to Endoscopic Gallbladder Stenting by Using the Rendezvous Technique.

Science.gov (United States)

Nam, Kwangwoo; Choi, Jun-Ho

2017-05-01

We report the successful conversion of percutaneous cholecystostomy (PC) to endoscopic transpapillary gallbladder stenting (ETGS) with insertion of an antegrade guidewire into the duodenum. An 84-year-old man presented with severe acute cholecystitis and septic shock. He had significant comorbidities, and emergent PC was successfully performed. Subsequent ETGS was attempted but unsuccessful owing to difficulties with cystic duct cannulation. However, via the PC tract, the guidewire was passed antegradely into the duodenum, and ETGS with a double-pigtail plastic stent was successfully performed with the rendezvous technique. The PC tube was removed, and no recurrence was reported during the 17-month follow-up period. Conversion of PC to ETGS is a viable option in patients with acute cholecystitis who are not candidates for surgery. Antegrade guidewire insertion via the PC tract may increase the success rate of conversion and decrease the risk of procedure-related complications.

Conversion of Percutaneous Cholecystostomy to Endoscopic Gallbladder Stenting by Using the Rendezvous Technique

Directory of Open Access Journals (Sweden)

Kwangwoo Nam

2017-05-01

Full Text Available We report the successful conversion of percutaneous cholecystostomy (PC to endoscopic transpapillary gallbladder stenting (ETGS with insertion of an antegrade guidewire into the duodenum. An 84-year-old man presented with severe acute cholecystitis and septic shock. He had significant comorbidities, and emergent PC was successfully performed. Subsequent ETGS was attempted but unsuccessful owing to difficulties with cystic duct cannulation. However, via the PC tract, the guidewire was passed antegradely into the duodenum, and ETGS with a double-pigtail plastic stent was successfully performed with the rendezvous technique. The PC tube was removed, and no recurrence was reported during the 17-month follow-up period. Conversion of PC to ETGS is a viable option in patients with acute cholecystitis who are not candidates for surgery. Antegrade guidewire insertion via the PC tract may increase the success rate of conversion and decrease the risk of procedure-related complications.

DOSE COEFFICIENTS FOR LIVER CHEMOEMBOLISATION PROCEDURES USING MONTE CARLO CODE.

Science.gov (United States)

Karavasilis, E; Dimitriadis, A; Gonis, H; Pappas, P; Georgiou, E; Yakoumakis, E

2016-12-01

The aim of the present study is the estimation of radiation burden during liver chemoembolisation procedures. Organ dose and effective dose conversion factors, normalised to dose-area product (DAP), were estimated for chemoembolisation procedures using a Monte Carlo transport code in conjunction with an adult mathematical phantom. Exposure data from 32 patients were used to determine the exposure projections for the simulations. Equivalent organ (H T ) and effective (E) doses were estimated using individual DAP values. The organs receiving the highest amount of doses during these exams were lumbar spine, liver and kidneys. The mean effective dose conversion factor was 1.4 Sv Gy -1 m -2 Dose conversion factors can be useful for patient-specific radiation burden during chemoembolisation procedures. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Bariatric Surgery Improves Hyperandrogenism, Menstrual Irregularities, and Metabolic Dysfunction Among Women with Polycystic Ovary Syndrome (PCOS).

Science.gov (United States)

Christ, Jacob P; Falcone, Tommaso

2018-03-02

To characterize the impact of bariatric surgery on reproductive and metabolic features common to polycystic ovary syndrome (PCOS) and to assess the relevance of preoperative evaluations in predicting likelihood of benefit from surgery. A retrospective chart review of records from 930 women who had undergone bariatric surgery at the Cleveland Clinic Foundation from 2009 to 2014 was completed. Cases of PCOS were identified from ICD coding and healthy women with pelvic ultrasound evaluations were identified using Healthcare Common Procedure Coding System coding. Pre- and postoperative anthropometric evaluations, menstrual cyclicity, ovarian volume (OV) as well as markers of hyperandrogenism, dyslipidemia, and dysglycemia were evaluated. Forty-four women with PCOS and 65 controls were evaluated. Both PCOS and non-PCOS had significant reductions in body mass index (BMI) and markers of dyslipidemia postoperatively (p PCOS had significant reductions in androgen levels (p irregular menses (p PCOS, independent of preoperative BMI and age, preoperative OV associated with change in hemoglobin A1c (β 95% (confidence interval) 0.202 (0.011-0.393), p = 0.04) and change in triglycerides (6.681 (1.028-12.334), p = 0.03), and preoperative free testosterone associated with change in total cholesterol (3.744 (0.906-6.583), p = 0.02) and change in non-HDL-C (3.125 (0.453-5.796), p = 0.03). Bariatric surgery improves key diagnostic features seen in women with PCOS and ovarian volume, and free testosterone may have utility in predicting likelihood of metabolic benefit from surgery.

Effect of cataract surgery and pupil dilation on iris pattern recognition for personal authentication.

Science.gov (United States)

Dhir, L; Habib, N E; Monro, D M; Rakshit, S

2010-06-01

The purpose of this study was to investigate the effect of cataract surgery and pupil dilation on iris pattern recognition for personal authentication. Prospective non-comparative cohort study. Images of 15 subjects were captured before (enrolment), and 5, 10, and 15 min after instillation of mydriatics before routine cataract surgery. After cataract surgery, images were captured 2 weeks thereafter. Enrolled and test images (after pupillary dilation and after cataract surgery) were segmented to extract the iris. This was then unwrapped onto a rectangular format for normalization and a novel method using the Discrete Cosine Transform was applied to encode the image into binary bits. The numerical difference between two iris codes (Hamming distance, HD) was calculated. The HD between identification and enrolment codes was used as a score and was compared with a confidence threshold for specific equipment, giving a match or non-match result. The Correct Recognition Rate (CRR) and Equal Error Rates (EERs) were calculated to analyse overall system performance. After cataract surgery, perfect identification and verification was achieved, with zero false acceptance rate, zero false rejection rate, and zero EER. After pupillary dilation, non-elastic deformation occurs and a CRR of 86.67% and EER of 9.33% were obtained. Conventional circle-based localization methods are inadequate. Matching reliability decreases considerably with increase in pupillary dilation. Cataract surgery has no effect on iris pattern recognition, whereas pupil dilation may be used to defeat an iris-based authentication system.

Risk-adjusted hospital outcomes for children's surgery.

Science.gov (United States)

Saito, Jacqueline M; Chen, Li Ern; Hall, Bruce L; Kraemer, Kari; Barnhart, Douglas C; Byrd, Claudia; Cohen, Mark E; Fei, Chunyuan; Heiss, Kurt F; Huffman, Kristopher; Ko, Clifford Y; Latus, Melissa; Meara, John G; Oldham, Keith T; Raval, Mehul V; Richards, Karen E; Shah, Rahul K; Sutton, Laura C; Vinocur, Charles D; Moss, R Lawrence

2013-09-01

BACKGROUND The American College of Surgeons National Surgical Quality Improvement Program-Pediatric was initiated in 2008 to drive quality improvement in children's surgery. Low mortality and morbidity in previous analyses limited differentiation of hospital performance. Participating institutions included children's units within general hospitals and free-standing children's hospitals. Cases selected by Current Procedural Terminology codes encompassed procedures within pediatric general, otolaryngologic, orthopedic, urologic, plastic, neurologic, thoracic, and gynecologic surgery. Trained personnel abstracted demographic, surgical profile, preoperative, intraoperative, and postoperative variables. Incorporating procedure-specific risk, hierarchical models for 30-day mortality and morbidities were developed with significant predictors identified by stepwise logistic regression. Reliability was estimated to assess the balance of information versus error within models. In 2011, 46 281 patients from 43 hospitals were accrued; 1467 codes were aggregated into 226 groupings. Overall mortality was 0.3%, composite morbidity 5.8%, and surgical site infection (SSI) 1.8%. Hierarchical models revealed outlier hospitals with above or below expected performance for composite morbidity in the entire cohort, pediatric abdominal subgroup, and spine subgroup; SSI in the entire cohort and pediatric abdominal subgroup; and urinary tract infection in the entire cohort. Based on reliability estimates, mortality discriminates performance poorly due to very low event rate; however, reliable model construction for composite morbidity and SSI that differentiate institutions is feasible. The National Surgical Quality Improvement Program-Pediatric expansion has yielded risk-adjusted models to differentiate hospital performance in composite and specific morbidities. However, mortality has low utility as a children's surgery performance indicator. Programmatic improvements have resulted in

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

Science.gov (United States)

Mackenzie, H; Markar, S R; Askari, A; Ni, M; Faiz, O; Hanna, G B

2016-01-01

Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Evolution of models for conversion of smectite to non-expandable minerals

International Nuclear Information System (INIS)

Pusch, R.

1993-12-01

Hydrothermal alteration of smectite has long been regarded as conversion to illite and chlorite as concluded from investigations of Gulf sediments. As manifested by statements given earlier at various international scientific meetings and in the literature, smectite-to-illite conversion (S→I) has been assumed to be a solid-state reaction with layer-by-layer alteration via mixed layer I/S to illite. In the last 10 years this opinion has successively changed and in recent years the concept of dissolution of smectite and accessory minerals and precipitation of illite and possibly I/S has been favored by many investigators. The present report reports laboratory and field investigations on bentonite and also calculations based on geochemical codes, which all support the dissolution/precipitation process. Applying Pytte's model for calculating the rate of conversion to illite, one finds good agreement with a number of experiments and field data, and this model is therefore recommended for practical use

Automatic modeling for the monte carlo transport TRIPOLI code

International Nuclear Information System (INIS)

Zhang Junjun; Zeng Qin; Wu Yican; Wang Guozhong; FDS Team

2010-01-01

TRIPOLI, developed by CEA, France, is Monte Carlo particle transport simulation code. It has been widely applied to nuclear physics, shielding design, evaluation of nuclear safety. However, it is time-consuming and error-prone to manually describe the TRIPOLI input file. This paper implemented bi-directional conversion between CAD model and TRIPOLI model. Its feasibility and efficiency have been demonstrated by several benchmarking examples. (authors)

Robotic surgery of the liver: Italian experience and review of the literature

Science.gov (United States)

Reggiani, P; Antonelli, B; Rossi, G

2013-01-01

Robotic liver resection is a new promising minimally invasive surgical technique not yet validated by level I evidence. During recent years, the application of the laparoscopic approach to liver resection has grown less than other abdominal specialties due to the intrinsic limitations of laparoscopic instruments. Robotics can overcome these limitations above all for complex operations. A review of the literature on major hepatic surgery was conducted on PubMed using selected keywords. Two hundred and thirty-five patients in 17 series were analysed and outcomes such as operative time, estimated blood loss, length of hospital stay, complications, conversion rate, and costs were described. The most commonly performed procedures were wedge resection and segmentectomy, but the predominance of major hepatectomies performed with robotic surgery is likely due to the superior control achieved by the robotic system. The conversion and complication rates were 4.2% and 13.4%, respectively. Intracavitary fluid collections and bile leaks were the most frequently occurring morbidities. The mean operation time was 285 min. The mean intraoperative blood loss was 50–280 mL. The mean postoperative hospital stay was four to seven days. Overall survival and long-term outcomes were not reported. Robotic liver surgery in Italy has become a clinical reality that is gaining increasing acceptance; a survey was carried out on robotic surgery, which showed that it is perceived as a significant advantage for operators and a consistent gain for the patient. More than 100 robotic hepatic resections have been performed in Italy where important robotic training schools are active. Robotic liver surgery is feasible and safe in trained and experienced hands. Further evaluation is required to assess the improvement in outcomes and long-term oncologic follow-up. PMID:24174991

Facial Expression Generation from Speaker's Emotional States in Daily Conversation

Science.gov (United States)

Mori, Hiroki; Ohshima, Koh

A framework for generating facial expressions from emotional states in daily conversation is described. It provides a mapping between emotional states and facial expressions, where the former is represented by vectors with psychologically-defined abstract dimensions, and the latter is coded by the Facial Action Coding System. In order to obtain the mapping, parallel data with rated emotional states and facial expressions were collected for utterances of a female speaker, and a neural network was trained with the data. The effectiveness of proposed method is verified by a subjective evaluation test. As the result, the Mean Opinion Score with respect to the suitability of generated facial expression was 3.86 for the speaker, which was close to that of hand-made facial expressions.

Conversion from depression to bipolar disorder in a cohort of young people in England, 1999-2011: A national record linkage study.

Science.gov (United States)

James, Anthony; Wotton, Clare J; Duffy, Anne; Hoang, Uy; Goldacre, Michael

2015-10-01

To estimate the conversion rate from unipolar depression (ICD10 codes F32-F33) to bipolar disorder (BP) (ICD10 codes F31) in an English national cohort. It was hypothesised that early-onset BP (age disorder, with a more rapid, and higher rate of conversion from depression to BP. This record linkage study used English national Hospital Episode Statistics (HES) covering all NHS inpatient and day case admissions between 1999 and 2011. The overall rate of conversion from depression to BP for all ages was 5.65% (95% CI: 5.48-5.83) over a minimum 4-year follow-up period. The conversion rate from depression to BP increased in a linear manner with age from 10-14 years - 2.21% (95% C: 1.16-4.22) to 30-34 years - 7.06% (95% CI: 6.44-7.55) (F1,23=77.6, p=0.001, R(2)=0.77). The time to conversion was constant across the age range. The rate of conversion was higher in females (6.77%; 95% CI: 6.53-7.02) compared to males, (4.17%; 95% CI: 3.95-4.40) (χ(2)=194, pconversion rate from depression to bipolar disorder with age, and constant time for conversion across the age range does not support the notion that early-onset BP is a more severe form of the disorder. Copyright © 2015 Elsevier B.V. All rights reserved.

[Orthopedic and trauma surgery in the German DRG system 2008].

Science.gov (United States)

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2008-04-01

The German DRG (diagnosis-related groups) system has been modified and updated into version 2008. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and the DRG structure were made. The modified version has been analyzed in order to ascertain whether the DRG system is suitably qualified to fulfill the demands of the reimbursement system or whether further improvements are necessary. Analysis of the severity of relevant side-effect diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 was carried out based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focused on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. G-DRG system has become even more complex and the new regulations have also resulted in new problems associated with complications.. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case allocation within the G-DRG system has been improved. Nevertheless, further improvements of the G-DRG system are necessary, especially for cases with severe injuries.

[QR-Code based patient tracking: a cost-effective option to improve patient safety].

Science.gov (United States)

Fischer, M; Rybitskiy, D; Strauß, G; Dietz, A; Dressler, C R

2013-03-01

Hospitals are implementing a risk management system to avoid patient or surgery mix-ups. The trend is to use preoperative checklists. This work deals specifically with a type of patient identification, which is realized by storing patient data on a patient-fixed medium. In 127 ENT surgeries data relevant for patient identification were encrypted in a 2D-QR-Code. The code, as a separate document coming with the patient chart or as a patient wristband, has been decrypted in the OR and the patient data were presented visible for all persons. The decoding time, the compliance of the patient data, as well as the duration of the patient identification was compared with the traditional patient identification by inspection of the patient chart. A total of 125 QR codes were read. The time for the decrypting of QR-Code was 5.6 s, the time for the screen view for patient identification was 7.9 s, and for a comparison group of 75 operations traditional patient identification was 27.3 s. Overall, there were 6 relevant information errors in the two parts of the experiment. This represents a ratio of 0.6% for 8 relevant classes per each encrypted QR code. This work allows a cost effective way to technically support patient identification based on electronic patient data. It was shown that the use in the clinical routine is possible. The disadvantage is a potential misinformation from incorrect or missing information in the HIS, or due to changes of the data after the code was created. The QR-code-based patient tracking is seen as a useful complement to the already widely used identification wristband. © Georg Thieme Verlag KG Stuttgart · New York.

Conversion of palatal rugae pattern to scanable Quick Response code in an Arabian population

Directory of Open Access Journals (Sweden)

Sadatullah Syed

2016-09-01

Conclusion: The alphanumeric and QR code of the rugae pattern are unique for each individual and can be used for digital record keeping and person identification. A high degree of sexual dimorphism in PR exists in the studied Arab population studied.

Spike train generation and current-to-frequency conversion in silicon diodes

Science.gov (United States)

Coon, D. D.; Perera, A. G. U.

1989-01-01

A device physics model is developed to analyze spontaneous neuron-like spike train generation in current driven silicon p(+)-n-n(+) devices in cryogenic environments. The model is shown to explain the very high dynamic range (0 to the 7th) current-to-frequency conversion and experimental features of the spike train frequency as a function of input current. The devices are interesting components for implementation of parallel asynchronous processing adjacent to cryogenically cooled focal planes because of their extremely low current and power requirements, their electronic simplicity, and their pulse coding capability, and could be used to form the hardware basis for neural networks which employ biologically plausible means of information coding.

Single-incision laparoscopic surgery for pyloric stenosis.

Science.gov (United States)

Kozlov, Yury; Novogilov, Vladimir; Podkamenev, Alexey; Rasputin, Andrey; Weber, Irina; Solovjev, Alexey; Yurkov, Pavel

2012-04-01

Laparoscopy is the most common procedure for correction of congenital pyloric stenosis. The standard laparoscopic approach is based on the three-port technique. In contrast to the standard laparoscopic technique, the single-incision laparoscopic surgery (SILS) requires only one incision. We report on our experience with this surgical approach. Between September 2009 and August 2010 a total of 24 children underwent a laparoscopic pyloromyotomy, 12 in SILS technique. The single incision was carried through the center of the umbilicus. The working instruments were introduced in a two-dimensional direction into the peritoneal cavity via the same umbilical incision. The two groups were compared for patients' demographics, operative report and early postoperative outcomes. All SILS procedures were performed successfully with no conversion rate. There were no differences in the preoperative parameters between the two groups regarding age before surgery and body weight at operation. Operative time and time of full enteral intake was similar to comparable procedures with usage of a standard laparoscopic approach. There were no operative or postoperative complications. The early experience described in this study confirms that SILS can be applied for treatment of pyloric stenosis with outcomes similar to the standard laparoscopic surgery.

Numerical modelling of biomass combustion: Solid conversion processes in a fixed bed furnace

Science.gov (United States)

Karim, Md. Rezwanul; Naser, Jamal

2017-06-01

Increasing demand for energy and rising concerns over global warming has urged the use of renewable energy sources to carry a sustainable development of the world. Bio mass is a renewable energy which has become an important fuel to produce thermal energy or electricity. It is an eco-friendly source of energy as it reduces carbon dioxide emissions. Combustion of solid biomass is a complex phenomenon due to its large varieties and physical structures. Among various systems, fixed bed combustion is the most commonly used technique for thermal conversion of solid biomass. But inadequate knowledge on complex solid conversion processes has limited the development of such combustion system. Numerical modelling of this combustion system has some advantages over experimental analysis. Many important system parameters (e.g. temperature, density, solid fraction) can be estimated inside the entire domain under different working conditions. In this work, a complete numerical model is used for solid conversion processes of biomass combustion in a fixed bed furnace. The combustion system is divided in to solid and gas phase. This model includes several sub models to characterize the solid phase of the combustion with several variables. User defined subroutines are used to introduce solid phase variables in commercial CFD code. Gas phase of combustion is resolved using built-in module of CFD code. Heat transfer model is modified to predict the temperature of solid and gas phases with special radiation heat transfer solution for considering the high absorptivity of the medium. Considering all solid conversion processes the solid phase variables are evaluated. Results obtained are discussed with reference from an experimental burner.

Asynchronous Knowledge Sharing and Conversation Interaction Impact on Grade in an Online Business Course

Science.gov (United States)

Strang, Kenneth David

2011-01-01

Student knowledge sharing and conversation theory interactions were coded from asynchronous discussion forums to measure the effect of learning-oriented utterances on academic performance. The sample was 3 terms of an online business course (in an accredited MBA program) at a U.S.-based university. Correlation, stepwise regression, and multiple…

Highly efficient power system based on direct fission fragment energy conversion utilizing magnetic collimation

International Nuclear Information System (INIS)

Tsvetkov, Pavel V.; Hart, Ron R.; Parish, Theodore A.

2003-01-01

The present study was focused on developing a technologically feasible power system that is based on direct fission fragment energy conversion utilizing magnetic collimation. The new concept is an attempt to combine several advantageous design solutions, which have been proposed for application in both fission and fusion reactors, into one innovative system that can offer exceptional energy conversion efficiency. The analysis takes into consideration a wide range of operational aspects including fission fragment escape from the fuel, collimation, collection, criticality, long-term performance, energy conversion efficiency, heat removal, and safety characteristics. Specific characteristics of the individual system components and the entire system are evaluated. Consistent analysis and evaluation of the technological feasibility of the concept were achieved using state-of-the-art computer codes that allowed realistic and consistent modeling. The calculated energy conversion efficiencies for the presented designs without a thermodynamic cycle and with the heavy water cycle are 52% and 62%, respectively. The analysis indicates that efficiencies up to 90% are potentially achievable. (author)

Variable-Length Coding with Stop-Feedback for the Common-Message Broadcast Channel

DEFF Research Database (Denmark)

Trillingsgaard, Kasper Fløe; Yang, Wei; Durisi, Giuseppe

2016-01-01

This paper investigates the maximum coding rate over a K-user discrete memoryless broadcast channel for the scenario where a common message is transmitted using variable-length stop-feedback codes. Specifically, upon decoding the common message, each decoder sends a stop signal to the encoder...... of these bounds reveal that---contrary to the point-to-point case---the second-order term in the asymptotic expansion of the maximum coding rate decays inversely proportional to the square root of the average blocklength. This holds for certain nontrivial common-message broadcast channels, such as the binary......, which transmits continuously until it receives all K stop signals. We present nonasymptotic achievability and converse bounds for the maximum coding rate, which strengthen and generalize the bounds previously reported in Trillingsgaard et al. (2015) for the two-user case. An asymptotic analysis...

The Relationship Between Length of Stay and Readmissions in Bariatric Surgery Patients

Science.gov (United States)

Lois, Alex W.; Frelich, Matthew J.; Sahr, Natasha A.; Hohmann, Samuel F.; Wang, Tao; Gould, Jon C.

2015-01-01

Background Hospital readmissions are a quality indicator in bariatric surgery. In recent years, length of stay following bariatric surgery has trended down significantly. We hypothesized that a shorter postoperative hospitalization does not increase the likelihood of readmission. Methods The University HealthSystem Consortium (UHC) is an alliance of academic medical centers and affiliated hospitals. The UHC’s clinical database contains information on inpatient stay and returns (readmissions) up to 30 days post-discharge. A multicenter analysis of outcomes was performed using data from the January 2009 to December 2013 for patients 18 years and older. Patients were identified by bariatric procedure ICD-9 codes and restricted by diagnosis codes for morbid obesity. Results A total of 95,294 patients met inclusion criteria. The mean patient age was 45.4 (±0.11) years and 73,941 (77.6%) subjects were female. There were 5,423 (5.7%) readmissions within the study period. Patients with hospitalizations of 3 days and more than 3 days were twice and four times as likely to be readmitted than those with hospitalizations of one day, respectively (pbariatric surgery. Early discharge does not appear to be associated with increased readmission rates. PMID:26032831

Lift-(gasless) laparoscopic surgery under regional anesthesia.

Science.gov (United States)

Kruschinski, Daniel; Homburg, Shirli

2005-01-01

The objective of this Chapter was to investigate the feasibility and outcome of gasless laparoscopy under regional anesthesia. A prospective evaluation of Lift-(gasless) laparoscopic procedures under regional anesthesia (Canadian Task Force classification II-1) was done at three endoscopic gynecology centers (franchise system of EndGyn(r)). Sixty-three patients with gynecological diseases comprised the cohort. All patients underwent Lift-laparoscopic surgery under regional anesthesia: 10 patients for diagnostic purposes, 17 for surgery of ovarian tumors, 14 to remove fibroids, and 22 for hysterectomies. All patients were operated without conversion to general anesthesia and without perioperative or anesthesiologic complications. Lift-laparoscopy under regional anesthesia can be recommended to all patients who desire laparoscopic intervention without general anesthesia. For elderly patients, those with cardiopulmonary risks, during pregnancy, or with contraindications for general anesthesia, Lift-laparoscopy under regional anesthesia should be the procedure of choice.

The Burden of Clostridium difficile after Cervical Spine Surgery.

Science.gov (United States)

Guzman, Javier Z; Skovrlj, Branko; Rothenberg, Edward S; Lu, Young; McAnany, Steven; Cho, Samuel K; Hecht, Andrew C; Qureshi, Sheeraz A

2016-06-01

Study Design Retrospective database analysis. Objective The purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after cervical spine surgery. Methods A total of 1,602,130 cervical spine surgeries from the Nationwide Inpatient Sample database from 2002 to 2011 were included. Patients were included for study based on International Classification of Diseases Ninth Revision, Clinical Modification procedural codes for cervical spine surgery for degenerative spine diagnoses. Baseline patient characteristics were determined. Multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. Results Incidence of C. difficile infection in postoperative cervical spine surgery hospitalizations is 0.08%, significantly increased since 2002 (p difficile infection were significantly increased in patients with comorbidities such as congestive heart failure, renal failure, and perivascular disease. Circumferential cervical fusion (odds ratio [OR] = 2.93, p difficile infection after degenerative cervical spine surgery. C. difficile infection after cervical spine surgery results in extended length of stay (p costs (p difficile after cervical spine surgery is nearly 8% versus 0.19% otherwise (p difficile to be a significant predictor of inpatient mortality (OR = 3.99, p difficile increases the risk of in-hospital mortality and costs approximately $6,830,695 per year to manage in patients undergoing elective cervical spine surgery. Patients with comorbidities such as renal failure or congestive heart failure have increased probability of developing infection after surgery. Accepted antibiotic guidelines in this population must be followed to decrease the risk of developing postoperative C. difficile colitis.

Surgical volume and conversion rate in laparoscopic hysterectomy: does volume matter? A multicenter retrospective cohort study.

Science.gov (United States)

Keurentjes, José H M; Briët, Justine M; de Bock, Geertruida H; Mourits, Marian J E

2018-02-01

A multicenter, retrospective, cohort study was conducted in the Netherlands. The aim was to evaluate whether surgical volume of laparoscopic hysterectomies (LHs) performed by proven skilled gynecologists had an impact on the conversion rate from laparoscopy to laparotomy. In 14 hospitals, all LHs performed by 19 proven skilled gynecologists between 2007 and 2010 were included in the analysis. Surgical volume, conversion rate and type of conversion (reactive or strategic) were retrospectively assessed. To estimate the impact of surgical volume on the conversion rate, logistic regressions were performed. These regressions were adjusted for patient's age, Body Mass Index (BMI), ASA classification, previous abdominal surgery and the indication (malignant versus benign) for the LH. During the study period, 19 proven skilled gynecologists performed a total of 1051 LHs. Forty percent of the gynecologists performed over 20 LHs per year (median 17.3, range 5.4-49.5). Conversion to laparotomy occurred in 5.0% of all LHs (53 of 1051); 38 (3.6%) were strategic and 15 (1.4%) were reactive conversions. Performing over 20 LHs per year was significantly associated with a lower overall conversion rate (OR adjusted 0.43, 95% CI 0.24-0.77), a lower strategic conversion rate (OR adjusted 0.32, 95% CI 0.16-0.65), but not with a lower reactive conversion rate (OR adjusted 0.96, 95% CI 0.33-2.79). A higher annual surgical volume of LHs by proven skilled gynecologists is inversely related to the conversion rate to laparotomy, and results in a lower strategic conversion rate.

Automatic conversational scene analysis in children with Asperger syndrome/high-functioning autism and typically developing peers.

Science.gov (United States)

Tavano, Alessandro; Pesarin, Anna; Murino, Vittorio; Cristani, Marco

2014-01-01

Individuals with Asperger syndrome/High Functioning Autism fail to spontaneously attribute mental states to the self and others, a life-long phenotypic characteristic known as mindblindness. We hypothesized that mindblindness would affect the dynamics of conversational interaction. Using generative models, in particular Gaussian mixture models and observed influence models, conversations were coded as interacting Markov processes, operating on novel speech/silence patterns, termed Steady Conversational Periods (SCPs). SCPs assume that whenever an agent's process changes state (e.g., from silence to speech), it causes a general transition of the entire conversational process, forcing inter-actant synchronization. SCPs fed into observed influence models, which captured the conversational dynamics of children and adolescents with Asperger syndrome/High Functioning Autism, and age-matched typically developing participants. Analyzing the parameters of the models by means of discriminative classifiers, the dialogs of patients were successfully distinguished from those of control participants. We conclude that meaning-free speech/silence sequences, reflecting inter-actant synchronization, at least partially encode typical and atypical conversational dynamics. This suggests a direct influence of theory of mind abilities onto basic speech initiative behavior.

Evaluation formulas of manpower needs for dismantling of equipments in uranium refining and conversion plant

International Nuclear Information System (INIS)

Izumo, Sari; Usui, Hideo; Kubota, Shintaro; Tachibana, Mitsuo; Kawagoshi, Hiroshi; Tokuyasu, Takashi; Takahashi, Nobuo; Morimoto, Yasuyuki; Tanaka, Yoshio; Sugitsue, Noritake

2014-07-01

Japan Atomic Energy Agency has developed PROject management data evaluation code for DIsmantling Activities (PRODIA) to make an efficient decommissioning for nuclear facilities. PRODIA is a source code which provides estimated value such as manpower needs, costs, etc., for dismantling by evaluation formulas according to the type of nuclear facility. Evaluation formulas of manpower needs for dismantling of equipments about reprocessed uranium conversion in Uranium Refining and Conversion Plant (URCP) have been developed in this report. In the result, evaluation formulas of manpower needs for dismantling of equipment were derived based on the classifications of equipment's functions or work items. These evaluation formulas are widely applicable to the estimation of the manpower needs for dismantling the other nuclear facilities, in particular uranium handling facilities. It was confirmed that some of these evaluation formulas with the same applicable condition could be unified to some inclusive evaluation formulas. It turned out that all steel equipment contaminated by uranium could be evaluated by one evaluation formula. (author)

Optimal codes as Tanner codes with cyclic component codes

DEFF Research Database (Denmark)

Høholdt, Tom; Pinero, Fernando; Zeng, Peng

2014-01-01

In this article we study a class of graph codes with cyclic code component codes as affine variety codes. Within this class of Tanner codes we find some optimal binary codes. We use a particular subgraph of the point-line incidence plane of A(2,q) as the Tanner graph, and we are able to describe ...

Mechatronics Engineers’ Perception of Code Mixing: Philadelphia University and Hashemite University as a Case Study

OpenAIRE

Mustafa Al-Khawaldeh; Nisreen Al-Khawaldeh; Baker Bani-Khair; Hussein Algwery

2016-01-01

It has recently been widely recognized that code-switching is prevalent in Jordanians' daily conversation in various situations such as home, cafés, universities, restaurants and clubs. Abalhassan and Alshalawi (2000: 183) made a very related observation on code switching behavior among Arab speakers of English that “without exception, all respondents switched into English to some degree”. This could be referred to the increase number of technological advances and people travelling across cou...

Reoperative bariatric surgery for treatment of type 2 diabetes mellitus.

Science.gov (United States)

Yan, Jingliang; Cohen, Ricardo; Aminian, Ali

2017-08-01

Primary bariatric surgery has been proven to be effective in weight loss and improvement of weight-related metabolic co-morbidities. However, a small proportion of patients after bariatric surgery either have persistent hyperglycemia or relapse after initial remission of their metabolic disease. Revisional bariatric surgery has been evaluated extensively for weight recidivism and postoperative complications. However, there has not been any high-level evidence validating the utility of revisional bariatric surgery on recurrent metabolic diseases, especially diabetes. In this review of 30 studies, we aimed to summarize the evidence and determine whether revisional surgery can have a positive impact on metabolic diseases that were not reversed by initial bariatric intervention. Overall, 14-38% of patients had residual diabetes at the time of revisional surgery. Depending on the index surgery and subsequent reconstruction, revisions induced 20-80% additional excess weight loss, or further decrease of body mass index by 10-30%. Improvement of diabetes was seen in 65-100% of patients. Specifically, conversion to Roux-en-Y gastric bypass (RYGB) yielded improvement of diabetes in 79%, 72%, and 62% of patients who previously had vertical banded gastroplasty (VBG), adjustable gastric banding (AGB), or sleeve gastrectomy (SG), respectively. Converting AGB to SG improved diabetes in 65% of patients, and SG to duodenal switch improved diabetes in 79% of patients. Revision of the gastric pouch or stoma in RYGB yielded improvement of diabetes in 79% of patients. Further clinical and mechanistic research is needed to better delineate the role of revisional bariatric surgery in patients with residual metabolic disease. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Xanthogranulomatous cholecystitis: challenges in management & feasibility of laparoscopic surgery

Directory of Open Access Journals (Sweden)

Vikram Singh Chauhan

2013-04-01

Full Text Available Objective: Xanthogranulomatous cholecystitis (XGC is a rare, unusual and destructive form of chronic cholecystitis. It is clinically indistinguishable from other forms of cholecystitis and hence difficult to diagnose. Due to its propensity to form dense adhesions with stuctures surrounding the gall bladder and mimic malignancy of gall bladder intra-operatively, it’s difficult to manage. This retrospective study was conducted with the aim to review the clinico-pathologic presentation of XGC and the possibility of its laparoscopic management. Patient and methods: All cases of histo-pathologically diagnosed XGC from January 2008 to December 2012 at Sharda Hospital, School of Medical Sciences & Research, Greater Noida were analyzed retrospectively. Results: Sixty two cases of biopsy proved XGC were studied.The mean age at presentation was 56.4 ± 14.3 years (range 30 – 72 years, with a male: female ratio of 1.6:1. Gall bladder wall thickening on ultrasonography was seen in 91.9% cases and all (100% had cholelithiasis. Laparoscopic cholecystectomy was possible in 18 (29% cases, with a high conversion rate of 71% to open surgery. Two cases of carcinoma gall bladder accompanying XGC were documented. Both the mean operative time and hospital stay for laparoscopic surgery were longer for cases with XGC (105 minutes & 4.2 days respectively. No mortality occurred during the study period. Conclusion: XGC is difficult to diagnose preoperatively due to lack of distinguishing clinical features and imaging study results. Due to dense peri-cholecystic adhesions laparoscopic surgery though feasible in some cases is difficult to perform with a high conversion rate. Overall morbidity is also increased due to same reasons.

Insect olfactory coding and memory at multiple timescales.

Science.gov (United States)

Gupta, Nitin; Stopfer, Mark

2011-10-01

Insects can learn, allowing them great flexibility for locating seasonal food sources and avoiding wily predators. Because insects are relatively simple and accessible to manipulation, they provide good experimental preparations for exploring mechanisms underlying sensory coding and memory. Here we review how the intertwining of memory with computation enables the coding, decoding, and storage of sensory experience at various stages of the insect olfactory system. Individual parts of this system are capable of multiplexing memories at different timescales, and conversely, memory on a given timescale can be distributed across different parts of the circuit. Our sampling of the olfactory system emphasizes the diversity of memories, and the importance of understanding these memories in the context of computations performed by different parts of a sensory system. Published by Elsevier Ltd.

Robotic surgery in supermorbidly obese patients with endometrial cancer.

Science.gov (United States)

Stephan, Jean-Marie; Goodheart, Michael J; McDonald, Megan; Hansen, Jean; Reyes, Henry D; Button, Anna; Bender, David

2015-07-01

Morbid obesity is a known risk factor for the development of endometrial cancer. Several studies have demonstrated the overall feasibility of robotic-assisted surgical staging for endometrial cancer as well as the benefits of robotics compared with laparotomy. However, there have been few reports that have evaluated robotic surgery for endometrial cancer in the supermorbidly obese population (body mass index [BMI], ≥50 kg/m(2)). We sought to evaluate safety, feasibility, and outcomes for supermorbidly obese patients who undergo robotic surgery for endometrial cancer, compared with patients with lower body mass indices. We performed a retrospective chart review of 168 patients with suspected early-stage endometrial adenocarcinoma who underwent robotic surgery for the management of their disease. Analysis of variance and univariate logistic regression were used to compare patient characteristics and surgical variables across all body weights. Cox proportional hazard regression was used to determine the impact of body weight on recurrence-free and overall survival. The mean BMI of our cohort was 40.9 kg/m(2). Median follow up was 31 months. Fifty-six patients, 30% of which had grade 2 or 3 tumors, were supermorbidly obese with a BMI of ≥50 kg/m(2) (mean, 56.3 kg/m(2)). A comparison between the supermorbidly obese and lower-weight patients demonstrated no differences in terms of length of hospital stay, blood loss, complication rates, numbers of pelvic and paraaortic lymph nodes retrieved, or recurrence and survival. There was a correlation between BMI and conversion to an open procedure, in which the odds of conversion increased with increasing BMI (P = .02). Offering robotic surgery to supermorbidly obese patients with endometrial cancer is a safe and feasible surgical management option. When compared with patients with a lower BMI, the supermorbidly obese patient had a similar outcome, length of hospital stay, blood loss, complications, and numbers of lymph

The finite element structural analysis code SAP IV conversion from CDC to IBM

International Nuclear Information System (INIS)

Harrop, L.P.

1977-02-01

SAP IV is a general three dimensional, linear, static and dynamic finite element structural analysis program. The program which was obtained from the Earthquake Engineering Research Center, University of California, Berkeley, was written in FORTRAM for a CDC 6400. Its main use was anticipated to be the seismic analysis of reactor structures. SAP IV may also prove useful for fracture mechanics studies as well as the usual elastic stress analysis of structures. A brief description of SAP IV and a more detailed account of the FORTRAN conversion required to make SAP IV run successfully on the UKAEA Harwell IBM 370/168 are given. (author)

Conversion program in Sweden

Energy Technology Data Exchange (ETDEWEB)

Jonsson, E.B. [Studsvik Nuclear AB, Nykoeping (Sweden)

1997-08-01

The conversion of the Swedish 50 MW R2 reactor from HEU to LEU fuel has been successfully accomplished over a 16 cycles long process. The conversion started in January 1991 with the introduction of 6 LEU assemblies in the 8*8 core. The first all LEU core was loaded in March 1993 and physics measurements were performed for the final licensing reports. A total of 142 LEU fuel assemblies have been irradiated up until September 1994 without any fuel incident. The operating licence for the R2 reactor was renewed in mid 1994 taking into account new fuel type. The Swedish Nuclear Inspectorate (SKI) pointed out one crucial problem with the LEU operation, that the back end of the LEU fuel cycle has not yet been solved. For the HEU fuel Sweden had the reprocessing alternative. The country is now relying heavily on the success of the USDOEs Off Site Fuels Policy to take back the spent fuel from the research reactors. They have in the meantime increased their intermediate storage facilities. There is, however, a limit both in time and space for storage of MTR-type of assemblies in water. The penalty of the lower thermal neutron flux in LEU cores has been reduced by improvements of the new irradiation rigs and by fine tuning the core calculations. The Studsvik code package, CASMO-SIMULATE, widely used for ICFM in LWRs has been modified to suit the compact MTR type of core.

Coding Model and Mapping Method of Spherical Diamond Discrete Grids Based on Icosahedron

Directory of Open Access Journals (Sweden)

LIN Bingxian

2016-12-01

Full Text Available Discrete Global Grid(DGG provides a fundamental environment for global-scale spatial data's organization and management. DGG's encoding scheme, which blocks coordinate transformation between different coordination reference frames and reduces the complexity of spatial analysis, contributes a lot to the multi-scale expression and unified modeling of spatial data. Compared with other kinds of DGGs, Diamond Discrete Global Grid(DDGG based on icosahedron is beneficial to the spherical spatial data's integration and expression for much better geometric properties. However, its structure seems more complicated than DDGG on octahedron due to its initial diamond's edges cannot fit meridian and parallel. New challenges are posed when it comes to the construction of hierarchical encoding system and mapping relationship with geographic coordinates. On this issue, this paper presents a DDGG's coding system based on the Hilbert curve and designs conversion methods between codes and geographical coordinates. The study results indicate that this encoding system based on the Hilbert curve can express space scale and location information implicitly with the similarity between DDG and planar grid put into practice, and balances efficiency and accuracy of conversion between codes and geographical coordinates in order to support global massive spatial data's modeling, integrated management and all kinds of spatial analysis.

Uranium conversion

International Nuclear Information System (INIS)

Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina

2006-03-01

FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF 6 and UF 4 are present require equipment that is made of corrosion resistant material

Risk factors for postoperative complications in robotic general surgery.

Science.gov (United States)

Fantola, Giovanni; Brunaud, Laurent; Nguyen-Thi, Phi-Linh; Germain, Adeline; Ayav, Ahmet; Bresler, Laurent

2017-03-01

The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2-2.4)], hematocrit value surgery [OR 1.5; 95 % CI (1-2)], advanced dissection [OR 5.8; 95 % CI (3.1-10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7-3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9-9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3-8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.

Sexy gene conversions: locating gene conversions on the X-chromosome.

Science.gov (United States)

Lawson, Mark J; Zhang, Liqing

2009-08-01

Gene conversion can have a profound impact on both the short- and long-term evolution of genes and genomes. Here, we examined the gene families that are located on the X-chromosomes of human (Homo sapiens), chimpanzee (Pan troglodytes), mouse (Mus musculus) and rat (Rattus norvegicus) for evidence of gene conversion. We identified seven gene families (WD repeat protein family, Ferritin Heavy Chain family, RAS-related Protein RAB-40 family, Diphosphoinositol polyphosphate phosphohydrolase family, Transcription Elongation Factor A family, LDOC1-related family, Zinc Finger Protein ZIC, and GLI family) that show evidence of gene conversion. Through phylogenetic analyses and synteny evidence, we show that gene conversion has played an important role in the evolution of these gene families and that gene conversion has occurred independently in both primates and rodents. Comparing the results with those of two gene conversion prediction programs (GENECONV and Partimatrix), we found that both GENECONV and Partimatrix have very high false negative rates (i.e. failed to predict gene conversions), which leads to many undetected gene conversions. The combination of phylogenetic analyses with physical synteny evidence exhibits high resolution in the detection of gene conversions.

The Exchange of Social Support on Online Bariatric Surgery Discussion Forums: A Mixed-Methods Content Analysis.

Science.gov (United States)

Atwood, Molly E; Friedman, Aliza; Meisner, Brad A; Cassin, Stephanie E

2018-05-01

Bariatric surgery patients often experience physical and psychosocial stressors, and difficulty adjusting to significant lifestyle changes. As a result, social support groups that provide patients with support, coping skills, and nutritional information are valuable components of bariatric care. Support group attendance at bariatric centers is associated with greater post-surgery weight loss; however, several barriers hinder attendance at in-person support groups (e.g., travel distance to bariatric centers). Consequently, online support forums are an increasingly utilized resource for patients both before and after surgery. This study examined and described the type and frequency of social support provided on a large online bariatric surgery forum. A total of 1,412 messages in the pre- (n = 822) and post-surgery (n = 590) sections of the forum were coded using qualitative content analysis according to Cutrona and Suhr's (1992) Social Support Behavior Code model (i.e., including informational, tangible, esteem, network, and emotional support types). The majority of messages provided informational and emotional support regarding: a) factual information about the bariatric procedure and nutrition; b) advice for coping with the surgery preparation process, and physical symptoms; and c) encouragement regarding adherence to surgical guidelines, and weight loss progress. Network, esteem, and tangible support types were less frequent than informational and emotional support types. The results inform healthcare providers about the types of social support available to bariatric patients on online support forums and, thus, encourage appropriate referrals to this resource.

Renewal and maintenance of a nuclear structure data file used for the calculations of dose conversion factors

International Nuclear Information System (INIS)

Togawa, Orihiko; Yamaguchi, Yukichi

1996-02-01

The ENSDF decay data are used as fundamental data to compute radiation data in the DOSDAC code system, which was developed at JAERI, for the calculation of dose conversion factors. The ENSDF decay data have been periodically revised by reviewing new experimental data in the literature under an international network. The use of this data file enables us to calculate radiation data from information which is the newest and internationally recognized. In spite of this advantage, the decay data file is seldom used in applied fields. This is due to some problems to be solved from a viewpoint of the calculation of radiation data, as well as its complicated structure. This report describes methods for renewal and maintenance of the ENSDF decay data used for the calculation of dose conversion factors. In case that the decay data are used directly, attention should be sometimes paid to some problems, for example defects in data. In renewing and using the ENSDF decay data, the DOSDAC code system tries to avoid wrong calculations of radiation data by check and modification of defects in data through four supporting computer codes. (author)

A vectorized Monte Carlo code for modeling photon transport in SPECT

International Nuclear Information System (INIS)

Smith, M.F.; Floyd, C.E. Jr.; Jaszczak, R.J.

1993-01-01

A vectorized Monte Carlo computer code has been developed for modeling photon transport in single photon emission computed tomography (SPECT). The code models photon transport in a uniform attenuating region and photon detection by a gamma camera. It is adapted from a history-based Monte Carlo code in which photon history data are stored in scalar variables and photon histories are computed sequentially. The vectorized code is written in FORTRAN77 and uses an event-based algorithm in which photon history data are stored in arrays and photon history computations are performed within DO loops. The indices of the DO loops range over the number of photon histories, and these loops may take advantage of the vector processing unit of our Stellar GS1000 computer for pipelined computations. Without the use of the vector processor the event-based code is faster than the history-based code because of numerical optimization performed during conversion to the event-based algorithm. When only the detection of unscattered photons is modeled, the event-based code executes 5.1 times faster with the use of the vector processor than without; when the detection of scattered and unscattered photons is modeled the speed increase is a factor of 2.9. Vectorization is a valuable way to increase the performance of Monte Carlo code for modeling photon transport in SPECT

Monte Carlo calculation of dose rate conversion factors for external exposure to photon emitters in soil

CERN Document Server

Clouvas, A; Antonopoulos-Domis, M; Silva, J

2000-01-01

The dose rate conversion factors D/sub CF/ (absorbed dose rate in air per unit activity per unit of soil mass, nGy h/sup -1/ per Bq kg/sup -1/) are calculated 1 m above ground for photon emitters of natural radionuclides uniformly distributed in the soil. Three Monte Carlo codes are used: 1) The MCNP code of Los Alamos; 2) The GEANT code of CERN; and 3) a Monte Carlo code developed in the Nuclear Technology Laboratory of the Aristotle University of Thessaloniki. The accuracy of the Monte Carlo results is tested by the comparison of the unscattered flux obtained by the three Monte Carlo codes with an independent straightforward calculation. All codes and particularly the MCNP calculate accurately the absorbed dose rate in air due to the unscattered radiation. For the total radiation (unscattered plus scattered) the D/sub CF/ values calculated from the three codes are in very good agreement between them. The comparison between these results and the results deduced previously by other authors indicates a good ag...

Robot-assisted pancreatic surgery: a systematic review of the literature

Science.gov (United States)

Strijker, Marin; van Santvoort, Hjalmar C; Besselink, Marc G; van Hillegersberg, Richard; Borel Rinkes, Inne HM; Vriens, Menno R; Molenaar, I Quintus

2013-01-01

Background To potentially improve outcomes in pancreatic resection, robot-assisted pancreatic surgery has been introduced. This technique has possible advantages over laparoscopic surgery, such as its affordance of three-dimensional vision and increased freedom of movement of instruments. A systematic review was performed to assess the safety and feasibility of robot-assisted pancreatic surgery. Methods The literature published up to 30 September 2011 was systematically reviewed, with no restrictions on publication date. Studies reporting on over five patients were included. Animal studies, studies not reporting morbidity and mortality, review articles and conference abstracts were excluded. Data were extracted and weighted means were calculated. Results A total of 499 studies were screened, after which eight cohort studies reporting on a total of 251 patients undergoing robot-assisted pancreatic surgery were retained for analysis. Weighted mean operation time was 404 ± 102 min (510 ± 107 min for pancreatoduodenectomy only). The rate of conversion was 11.0% (16.4% for pancreatoduodenectomy only). Overall morbidity was 30.7% (n = 77), most frequently involving pancreatic fistulae (n = 46). Mortality was 1.6%. Negative surgical margins were obtained in 92.9% of patients. The rate of spleen preservation in distal pancreatectomy was 87.1%. Conclusions Robot-assisted pancreatic surgery seems to be safe and feasible in selected patients and, in left-sided resections, may increase the rate of spleen preservation. Randomized studies should compare the respective outcomes of robot-assisted, laparoscopic and open pancreatic surgery. PMID:23216773

The Role of Conversation Policy in Carrying Out Agent Conversations

International Nuclear Information System (INIS)

Link, Hamilton E.; Phillips, Laurence R.

1999-01-01

Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word ''policy'' connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification

No Easy Talk: A Mixed Methods Study of Doctor Reported Barriers to Conducting Effective End-of-Life Conversations with Diverse Patients.

Directory of Open Access Journals (Sweden)

Vyjeyanthi S Periyakoil

Full Text Available Though most patients wish to discuss end-of-life (EOL issues, doctors are reluctant to conduct end-of-life conversations. Little is known about the barriers doctors face in conducting effective EOL conversations with diverse patients. This mixed methods study was undertaken to empirically identify barriers faced by doctors (if any in conducting effective EOL conversations with diverse patients and to determine if the doctors' age, gender, ethnicity and medical sub-specialty influenced the barriers reported.Mixed-methods study of multi-specialty doctors caring for diverse, seriously ill patients in two large academic medical centers at the end of the training; data were collected from 2010 to 2012.Doctor-reported barriers to EOL conversations with diverse patients.1040 of 1234 potential subjects (84.3% participated. 29 participants were designated as the development cohort for coding and grounded theory analyses to identify primary barriers. The codes were validated by analyses of responses from 50 randomly drawn subjects from the validation cohort (n= 996 doctors. Qualitative responses from the validation cohort were coded and analyzed using quantitative methods. Only 0.01% doctors reported no barriers to conducting EOL conversations with patients. 99.99% doctors reported barriers with 85.7% finding it very challenging to conduct EOL conversations with all patients and especially so with patients whose ethnicity was different than their own. Asian-American doctors reported the most struggles (91.3%, followed by African Americans (85.3%, Caucasians (83.5% and Hispanic Americans (79.3% in conducting EOL conversations with their patients. The biggest doctor-reported barriers to effective EOL conversations are (i language and medical interpretation issues, (ii patient/family religio-spiritual beliefs about death and dying, (iii doctors' ignorance of patients' cultural beliefs, values and practices, (iv patient/family's cultural differences in truth

Toroidal mode-conversion in the ICRF

International Nuclear Information System (INIS)

Jaun, A.; Hellsten, T.; Chiu, S.C.

1997-08-01

Mode-conversion is studied in the ion-cyclotron range of frequencies (ICRF) taking into account the toroidal geometry relevant for tokamaks. The global wavefields obtained using the gyrokinetic toroidal PENN code illustrate how the fast wave propagates to the neighborhood of the ion-ion hybrid resonance, where it is converted to a slow wave which deposits the wave energy through resonant interactions with the particles. The power deposition profiles obtained are dramatically different from the toroidal resonance absorption, showing that Budden's model is not a good approximation in the torus. Radially and poloidally localized wavefield structures characteristic of slow wave eigenmodes are predicted and could in experiments be driven to large amplitudes so as to interact efficiently with fast particles. (author) 5 figs., 1 tab., 48 refs

Analysis of Korean Nuclear Fuel Cycle System by Using DANESS Code

International Nuclear Information System (INIS)

Jeong, Chang Joon

2009-08-01

Korean fast reactor scenarios have been analyzed for various kinds of conversion ratio (CR) by the DANESS system dynamic analysis code. The once-through fuel cycle analysis was modeled based on the Korean 'National Energy Basic Plan' up to 2030 and a postulated nuclear demand growth rate until 2150. The fast reactor scenario analysis has been performed for three kinds of conversion ratios such as 0.3, 0.61 and 1.0. Through the calculations, the nuclear reactor deployment scenario, front-end cycle, back-end cycle, and long-term heat load have been investigated. From the once-through results, it is shown that the nuclear power demand would be ∼70 GWe and the total amount of the spent fuel accumulated by 2150 would be ∼168000 t. The fast reactor (FR) scenario analysis results show that the spent fuel inventory and out-pile transuranic element (TRU) can be reduced by increasing the fast reactor conversion ratio. Furthermore, the long-term heat load of spent fuel decreases with increasing the conversion ratio. However, it is known that the deployment of a fast reactor of low conversion ratio does not much reduce the spent fuel and out-pile TRU inventory due to the fast reactor deployment limitation which is related to the availability of TRU

Towards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation

Directory of Open Access Journals (Sweden)

Deyo Richard A

2006-06-01

Full Text Available Abstract Background Independent of efficacy, information on safety of surgical procedures is essential for informed choices. We seek to develop standardized methodology for describing the safety of spinal operations and apply these methods to study lumbar surgery. We present a conceptual model for evaluating the safety of spine surgery and describe development of tools to measure principal components of this model: (1 specifying outcome by explicit criteria for adverse event definition, mode of ascertainment, cause, severity, or preventability, and (2 quantitatively measuring predictors such as patient factors, comorbidity, severity of degenerative spine disease, and invasiveness of spine surgery. Methods We created operational definitions for 176 adverse occurrences and established multiple mechanisms for reporting them. We developed new methods to quantify the severity of adverse occurrences, degeneration of lumbar spine, and invasiveness of spinal procedures. Using kappa statistics and intra-class correlation coefficients, we assessed agreement for the following: four reviewers independently coding etiology, preventability, and severity for 141 adverse occurrences, two observers coding lumbar spine degenerative changes in 10 selected cases, and two researchers coding invasiveness of surgery for 50 initial cases. Results During the first six months of prospective surveillance, rigorous daily medical record reviews identified 92.6% of the adverse occurrences we recorded, and voluntary reports by providers identified 38.5% (surgeons reported 18.3%, inpatient rounding team reported 23.1%, and conferences discussed 6.1%. Trained observers had fair agreement in classifying etiology of 141 adverse occurrences into 18 categories (kappa = 0.35, but agreement was substantial (kappa ≥ 0.61 for 4 specific categories: technical error, failure in communication, systems failure, and no error. Preventability assessment had moderate agreement (mean weighted

Calculation of age-dependent dose conversion coefficients for radionuclides uniformly distributed in air

International Nuclear Information System (INIS)

Hung, Tran Van; Satoh, Daiki; Takahashi, Fumiaki; Tsuda, Shuichi; Endo, Akira; Saito, Kimiaki; Yamaguchi, Yasuhiro

2005-02-01

Age-dependent dose conversion coefficients for external exposure to photons emitted by radionuclides uniformly distributed in air were calculated. The size of the source region in the calculation was assumed to be effectively semi-infinite in extent. Firstly, organ doses were calculated with a series of age-specific MIRD-5 type phantoms using MCNP code, a Monte Carlo transport code. The calculations were performed for mono-energetic photon sources of twelve energies from 10 keV to 5 MeV and for phantoms of newborn, 1, 5, 10 and 15 years, and adult. Then, the effective doses to the different age-phantoms from the mono-energetic photon sources were estimated based on the obtained organ doses. The calculated effective doses were used to interpolate the conversion coefficients of the effective doses for 160 radionuclides, which are important for dose assessment of nuclear facilities. In the calculation, energies and intensities of emitted photons from radionuclides were taken from DECDC, a recent compilation of decay data for radiation dosimetry developed at JAERI. The results are tabulated in the form of effective dose per unit concentration and time (Sv per Bq s m -3 ). (author)

Automatic conversational scene analysis in children with Asperger syndrome/high-functioning autism and typically developing peers.

Directory of Open Access Journals (Sweden)

Alessandro Tavano

Full Text Available Individuals with Asperger syndrome/High Functioning Autism fail to spontaneously attribute mental states to the self and others, a life-long phenotypic characteristic known as mindblindness. We hypothesized that mindblindness would affect the dynamics of conversational interaction. Using generative models, in particular Gaussian mixture models and observed influence models, conversations were coded as interacting Markov processes, operating on novel speech/silence patterns, termed Steady Conversational Periods (SCPs. SCPs assume that whenever an agent's process changes state (e.g., from silence to speech, it causes a general transition of the entire conversational process, forcing inter-actant synchronization. SCPs fed into observed influence models, which captured the conversational dynamics of children and adolescents with Asperger syndrome/High Functioning Autism, and age-matched typically developing participants. Analyzing the parameters of the models by means of discriminative classifiers, the dialogs of patients were successfully distinguished from those of control participants. We conclude that meaning-free speech/silence sequences, reflecting inter-actant synchronization, at least partially encode typical and atypical conversational dynamics. This suggests a direct influence of theory of mind abilities onto basic speech initiative behavior.

Robotic surgery for rectal cancer: A systematic review of current practice

Science.gov (United States)

Mak, Tony Wing Chung; Lee, Janet Fung Yee; Futaba, Kaori; Hon, Sophie Sok Fei; Ngo, Dennis Kwok Yu; Ng, Simon Siu Man

2014-01-01

AIM: To give a comprehensive review of current literature on robotic rectal cancer surgery. METHODS: A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: “robotic surgery”, “surgical robotics”, “laparoscopic computer-assisted surgery”, “colectomy” and “rectal resection”. RESULTS: After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann’s operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost. PMID:24936229

Evaluation of equivalent and effective dose by KAP for patient and orthopedic surgeon in vertebral compression fracture surgery

International Nuclear Information System (INIS)

Santos, Felipe A.; Galeano, Diego C.; Santos, William S.; Silva, Ademir X.; Souza, Susana O.; Carvalho Júnior, Albérico B.

2017-01-01

Clinical scenarios were virtually modeled to estimate both the equivalent and effective doses normalized by KAP (Kerma Area Product) to vertebra compression fracture surgery in patient and surgeon. This surgery is known as kyphoplasty and involves the use of X-ray equipment, the C-arm, which provides real-time images to assist the surgeon in conducting instruments inserted into the patient and in the delivery of surgical cement into the fractured vertebra. The radiation transport code used was MCNPX (Monte Carlo N-Particle eXtended) and a pair of UFHADM (University of Florida Hybrid ADult Male) virtual phantoms. The developed scenarios allowed us to calculate a set of equivalent dose (H T ) and effective dose (E) for patients and surgeons. In additional, the same scenario was calculated KAP in the tube output and was used for calculating conversion coefficients (E/KAP and H T /KAP). From the knowledge of the experimental values of KAP and the results presented in this study, it is possible to estimate absolute values of effective doses for different exposure conditions. In this work, we developed scenarios with and without the surgical table with the purpose of comparison with the existing data in the literature. The absence of the bed in the scenario promoted a percentage absolute difference of 56% in the patient effective doses in relation to scenarios calculated with a bed. Regarding the surgeon, the use of the personal protective equipment (PPE) reduces between 75% and 79% the effective dose and the use of the under table shield (UTS) reduces the effective dose of between 3% and 7%. All these variations emphasize the importance of the elaboration of virtual scenarios that approach the actual clinical conditions generating E/KAP and H T /KAP closer to the actual values. - Highlights: • Virtual scenarios of vertebra compression fracture surgery. • MC simulations using virtual anthropomorphic phantoms and surgical setups. • Estimation of E/KAP and H T /KAP

From Novice to Expert: Problem Solving in ICD-10-PCS Procedural Coding

Science.gov (United States)

Rousse, Justin Thomas

2013-01-01

The benefits of converting to ICD-10-CM/PCS have been well documented in recent years. One of the greatest challenges in the conversion, however, is how to train the workforce in the code sets. The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) has been described as a language requiring higher-level reasoning skills because of the system's increased granularity. Training and problem-solving strategies required for correct procedural coding are unclear. The objective of this article is to propose that the acquisition of rule-based logic will need to be augmented with self-evaluative and critical thinking. Awareness of how this process works is helpful for established coders as well as for a new generation of coders who will master the complexities of the system. PMID:23861674

Hysterical conversion paralysis in an adolescent boy with lumbar spondylolysis.

Science.gov (United States)

Higuchi, Tadahiro; Tonogai, Ichiro; Sakai, Toshinori; Takata, Yoichiro; Goda, Yuichiro; Abe, Mitsunobu; Jha, Subash C; Fukuta, Shoji; Higashino, Kosaku; Nagamachi, Akihiro; Sairyo, Koichi

2016-05-01

We describe a case of recurrent hysterical paralysis triggered by low back pain because of lumbar spondylolysis. A 16-year-old male soccer player was referred to our institution with five previous episodes of acute paralysis triggered by severe low back pain. We performed direct surgical repair of the terminal-stage bilateral spondylolysis at L4 using a hook-rod system. His chronic low back pain was completely resolved, and no further episodes of hysterical paralysis have occurred after surgery. Spine surgeons should be aware of possible hysterical conversion paralysis when there is discrepancy between radiological and neurological findings.

Aneurysm growth after late conversion of thoracic endovascular aortic repair

Directory of Open Access Journals (Sweden)

Hirofumi Kasahara

2015-01-01

Full Text Available A 69-year-old man underwent thoracic endovascular aortic repair of a descending aortic aneurysm. Three years later, he developed impending rupture due to aneurysmal expansion that included the proximal landing zone. Urgent open surgery was performed via lateral thoracotomy, and a Dacron graft was sewn to the previous stent graft distally with Teflon felt reinforcement. Postoperatively, four sequential computed tomography scans demonstrated that the aneurysm was additionally increasing in size probably due to continuous hematoma production, suggesting a possibility of endoleaks. This case demonstrates the importance of careful radiologic surveillance after endovascular repair, and also after partial open conversion.

[When a patient falls (asleep) and can't get up: conversion disorder - paraplegia following general anesthesia].

Science.gov (United States)

Mason, Chawla LaToya

This case report describes the rare occurrence of paraplegia caused by conversion disorder in a woman who received general anesthesia for breast surgery. A 46-year-old healthy woman received general anesthesia for excision of a left breast fibroepithelial lesion. In the post-anesthesia care unit, she reported bilateral loss of both sensation and motor function below the knees. Physical signs and symptoms did not correlate with any anatomical or neurological patterns; imaging revealed no abnormalities. Psychiatric consultation was performed wherein familial stressor circumstances were identified, leading to diagnosis and management of conversion disorder. Conversion disorder is characterized by alteration of physical function due to expression of an underlying psychological ailment. Its diagnosis requires thorough evaluation including appropriate workup to exclude organic causes. The meshing together of anesthesiology and psychiatry - as demonstrated by this case report - offers an opportunity to highlight important information pertaining to the definition, diagnosis, and management of conversion disorder as it may be encountered in the postanesthesia recovery period. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Surgical outcomes of robot-assisted rectal cancer surgery using the da Vinci Surgical System: a multi-center pilot Phase II study.

Science.gov (United States)

Tsukamoto, Shunsuke; Nishizawa, Yuji; Ochiai, Hiroki; Tsukada, Yuichiro; Sasaki, Takeshi; Shida, Dai; Ito, Masaaki; Kanemitsu, Yukihide

2017-12-01

We conducted a multi-center pilot Phase II study to examine the safety of robotic rectal cancer surgery performed using the da Vinci Surgical System during the introduction period of robotic rectal surgery at two institutes based on surgical outcomes. This study was conducted with a prospective, multi-center, single-arm, open-label design to assess the safety and feasibility of robotic surgery for rectal cancer (da Vinci Surgical System). The primary endpoint was the rate of adverse events during and after robotic surgery. The secondary endpoint was the completion rate of robotic surgery. Between April 2014 and July 2016, 50 patients were enrolled in this study. Of these, 10 (20%) had rectosigmoid cancer, 17 (34%) had upper rectal cancer, and 23 (46%) had lower rectal cancer; six underwent high anterior resection, 32 underwent low anterior resection, 11 underwent intersphincteric resection, and one underwent abdominoperineal resection. Pathological stages were Stage 0 in 1 patient, Stage I in 28 patients, Stage II in 7 patients and Stage III in 14 patients. Pathologically complete resection was achieved in all patients. There was no intraoperative organ damage or postoperative mortality. Eight (16%) patients developed complications of all grades, of which 2 (4%) were Grade 3 or higher, including anastomotic leakage (2%) and conversion to open surgery (2%). The present study demonstrates the feasibility and safety of robotic rectal cancer surgery, as reflected by low morbidity and low conversion rates, during the introduction period. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Editor's Choice - Late Open Surgical Conversion after Endovascular Abdominal Aortic Aneurysm Repair.

Science.gov (United States)

Kansal, Vinay; Nagpal, Sudhir; Jetty, Prasad

2018-02-01

conversion is markedly low. More data are required to elucidate the impact of increasing liberalisation of EVAR outside of IFU. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

An Analysis of Language Code Used by the Cross- Married Couples, Banjarese- Javanese Ethnics: A Case Study in South Kalimantan Province, Indonesia

Directory of Open Access Journals (Sweden)

- Supiani

2016-08-01

Full Text Available This research aims to describe the use of language code applied by the participants and to find out the factors influencing the choice of language codes. This research is qualitative research that describe the use of language code in the cross married couples. The data are taken from the discourses about language code phenomena dealing with the cross- married couples, Banjarese- Javanese ethnics in Tanah Laut regency South Kalimantan, Indonesia. The conversations occur in the family and social life such as between a husband and a wife, a father and his son/daughter, a mother and her son/daughter, a husband and his friends, a wife and her neighbor, and so on. There are 23 data observed and recoded by the researcher based on a certain criteria. Tanah Laut regency is chosen as a purposive sample where this regency has many different ethnics so that they do cross cultural marriage for example between Banjarese- Javanese ethnics. Findings reveal that mostly the cross married couple used code mixing and code switching in their conversation of daily activities. Code mixing is uttered by Javanese father or mother to their children. Mixed codes are used namely Banjarese+Javanese+Indonesian. Meanwhile, code switching occurs when there is another factor or a new participant who join in the discourse. The codes change from Banjarese to Indonesian codes or Javanese to Indonesian codes due to new participant who involve himself/herself in the dialogue. The influential factors are situational factors, the environment (neighborhood, relative status, and ethnicity. Keywords: Language codes, Cross- married couples, Banjarese and Javanese ethics, Dialects

Comparison of Radiation Dose Rates with the Flux to Dose Conversion Factors Recommended in ICRP-74 and ICRP-116

International Nuclear Information System (INIS)

Jeong, Hae Sun; Kil, A Reum; Lee, Jo Eun; Jeong, Hyo Joon; Kim, Eun Han; Han, Moon Hee; Hwang, Won Tae

2016-01-01

The evaluation of radiation shielding has been performed for the design and maintenance of various facilities using radioactive sources such as nuclear fuel, accelerator, and radionuclide. The conversion of flux to dose mainly used in nuclear and radiation fields has been generally made with the dose coefficients presented in ICRP Publication 74 (ICRP- 74), which are produced based on ICRP Publication 60. On the other hand, ICRP Publication 116 (ICRP-116), which adopts the protection system of ICRP Publication 103, has recently been published and provides the dose conversion coefficients calculated with a variety of Monte Carlo codes. The coefficients have more than an update of those in ICRP-74, including new particle types and a greatly expanded energy range. In this study, a shielding evaluation of a specific container for neutron and gamma sources was performed with the MCNP6 code. The dose rates from neutron and gamma-ray sources were calculated using the MCNP6 codes, and these results were based on the flux to dose conversion factors recommended in ICRP-74 and ICRP-116. As a result, the dose rates evaluated with ICRP-74 were generally shown higher than those with ICRP-116. For neutrons, the difference is mainly occurred by the decrease of radiation weighting factors in a part of energy ranges in the ICRP-116 recommendations. For gamma-rays, the ICRP-74 recommendation applied with the kerma approximation leads to overestimated results than the other assessment

"Like a trip to McDonalds": a grounded theory study of patient experiences of day surgery.

Science.gov (United States)

Mottram, Anne

2011-02-01

The amount and complexity of (ambulatory) day surgery is rapidly expanding internationally. Nurses have a responsibility to provide quality care for day surgery patients. To do this they must understand all aspects of the patient experience. There is dearth of research into day surgery using a sociological frame of reference. The study investigated patients' experiences of day surgery using a sociological frame of reference. A qualitative study using the grounded theory approach was used. The study was based in two day surgery units in two urban public hospitals in the United Kingdom. 145 patients aged 18-70 years and 100 carers were purposely selected from the orthopaedic, ear nose and throat and general surgical lists. They were all English speaking and were of varied socio-economic background. The data was collected from 2004 to 2006. Semi-structured interviews were conducted on three occasions: before surgery, 48 h following surgery and one month following discharge. Permission was received from the Local Research Ethics Committee. Analysis of the data involved line-by-line analysis, compilation of key words and phrases (codes) and constant comparison of the codes until categories emerged. Patients liked day surgery and placed it within the wider societal context of efficiency and speed. Time was a major issue for them. They wished surgery, like all other aspects of their life to be a speedy process. They likened it to a McDonald's experience with its emphasis on speed, predictability and control. This study throws new light on patient experiences and offers an understanding of day surgery against a western culture which emphasises the importance of speed and efficiency. It is a popular choice for patients but at times it can be seen to be a mechanistic way of providing care. The implications for nurses to provide education and information to add to the quality of the patient experience are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluation of an electrocardiogram on QR code.

Science.gov (United States)

Nakayama, Masaharu; Shimokawa, Hiroaki

2013-01-01

An electrocardiogram (ECG) is an indispensable tool to diagnose cardiac diseases, such as ischemic heart disease, myocarditis, arrhythmia, and cardiomyopathy. Since ECG patterns vary depend on patient status, it is also used to monitor patients during treatment and comparison with ECGs with previous results is important for accurate diagnosis. However, the comparison requires connection to ECG data server in a hospital and the availability of data connection among hospitals is limited. To improve the portability and availability of ECG data regardless of server connection, we here introduce conversion of ECG data into 2D barcodes as text data and decode of the QR code for drawing ECG with Google Chart API. Fourteen cardiologists and six general physicians evaluated the system using iPhone and iPad. Overall, they were satisfied with the system in usability and accuracy of decoded ECG compared to the original ECG. This new coding system may be useful in utilizing ECG data irrespective of server connections.

Safety And Transient Analyses For Full Core Conversion Of The Dalat Nuclear Research Reactor

International Nuclear Information System (INIS)

Luong Ba Vien; Le Vinh Vinh; Huynh Ton Nghiem; Nguyen Kien Cuong

2011-01-01

Preparing for full core conversion of Dalat Nuclear Research Reactor (DNRR), safety and transient analyses were carried out to confirm about ability to operate safely of proposed Low Enriched Uranium (LEU) working core. The initial LEU core consisting 92 LEU fuel assemblies and 12 Beryllium rods was analyzed under initiating events of uncontrolled withdrawal of a control rod, cooling pump failure, earthquake and fuel cladding fail. Working LEU core response were evaluated under these initial events based on RELAP/Mod3.2 computer code and other supported codes like ORIGEN, MCNP and MACCS2. Obtained results showed that safety of the reactor is maintained for all transients/accidents analyzed. (author)

Improvement of skeleton conversion in ICRP reference phantom conversion project

Energy Technology Data Exchange (ETDEWEB)

Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong [Dept. of Nuclear Engineering, Hanyang University, Seoul (Korea, Republic of); Kim, Seong Hoon [Dept. of Radiation Oncology, College of Medicine, Hanyang University, Seoul (Korea, Republic of)

2014-11-15

In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future.

Improvement of skeleton conversion in ICRP reference phantom conversion project

International Nuclear Information System (INIS)

Wang, Zhao Jun; Yeom, Yeon Soo; Thang, Nguyen Tat; Kim, Han Sung; Han, Min Cheol; Kim, Chan Hyeong; Kim, Seong Hoon

2014-01-01

In the previous skeleton conversion, most bones were directly converted from the ICRP voxel phantoms by using the 3D rendering method whereas several complex-shape bones (cranium, ribs, spines, feet, and hands) were not able to be directly converted. We alternatively employed the corresponding well-defined polygonal models and attempted to adjust them to match the voxel models. However, this approach was unsatisfactory. The shapes of the alternative models were significantly different from those of the voxel models, making it virtually impossible to exactly match the voxel models as shown in Fig. 3 (left). In order to overcome the difficulty in the complex bone conversion, the present study developed a new conversion method and converted these complex bones voxel models of the ICRP male phantom to polygonal models. The present study developed the new conversion method and successfully improved polygonal models for cranium, ribs, and spines for the ICRP male phantom. The new conversion method will be also applied to the complex bone conversion for the ICRP female phantom as well as other complex organ conversion in the future

Clostridium difficile colitis in patients undergoing lumbar spine surgery.

Science.gov (United States)

Skovrlj, Branko; Guzman, Javier Z; Silvestre, Jason; Al Maaieh, Motasem; Qureshi, Sheeraz A

2014-09-01

Retrospective database analysis. To investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after lumbar spine surgery. C. difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on estimates of C. difficile infection rates and its consequences on patient outcomes and health care resources among patients undergoing lumbar spine surgery. The Nationwide Inpatient Sample was examined from 2002 to 2011. Patients were included for study based on International Classification of Diseases, Ninth Revision, Clinical Modification, procedural codes for lumbar spine surgery for degenerative diagnoses. Baseline patient characteristics were determined and multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. The incidence of C. difficile infection in patients undergoing lumbar spine surgery is 0.11%. At baseline, patients infected with C. difficile were significantly older (65.4 yr vs. 58.9 yr, Pinfection. Small hospital size was associated with decreased odds (odds ratio [OR], 0.5; Pinfection. Uninsured (OR, 1.62; Pinfection. C. difficile increased hospital length of stay by 8 days (Pdifficile infection after lumbar spine surgery carries a 36.4-fold increase in mortality and costs approximately $10,658,646 per year to manage. These data suggest that great care should be taken to avoid C. difficile colitis in patients undergoing lumbar spine surgery because it is associated with longer hospital stays, greater overall costs, and increased inpatient mortality. 3.

Venous thromboembolism in women undergoing pelvic reconstructive surgery with mechanical prophylaxis alone.

Science.gov (United States)

Montoya, T Ignacio; Leclaire, Edgar L; Oakley, Susan H; Crane, Andrea K; Mcpencow, Alexandra; Cichowski, Sara; Rahn, David D

2014-07-01

The objective of this study was determine the frequency of symptomatic perioperative venous thromboembolism (VTE) and risk factor(s) associated with VTE occurrence in women undergoing elective pelvic reconstructive surgery using only intermittent pneumatic compression (IPC) for VTE prophylaxis. A multi-center case-cohort retrospective review was conducted at six clinical sites over a 66-month period. All sites utilize IPC as standard VTE prophylaxis for urogynecological surgery. VTE cases occurring during the same hospitalization and up to 6 weeks postoperatively were identified by ICD9 code query. Four controls were temporally matched to each case. Information collected included demographics, medical history, route of surgery, operative time, and intraoperative characteristics. Univariate and multivariate backward stepwise logistic regression analyses were performed to identify potential risk factors for VTE. Symptomatic perioperative VTE was diagnosed in 27 subjects from a cohort of 10,627 women who underwent elective urogynecological surgery (0.25 %). Univariate analysis identified surgical route (laparotomy vs others), type of surgery ("major" vs "minor"), history of gynecological cancer, surgery time, and patient age as risk factors for VTE (P h. In our study cohort, the frequency of symptomatic perioperative VTE was low. Laparotomy, age ≥ 70 years, and surgery duration ≥ 5 h were associated with VTE occurrence.

Technical evaluation of Aerojet Energy Conversion Company's topical report on a mobile volume reduction system

International Nuclear Information System (INIS)

Henscheid, J.W.

1984-01-01

This report summarizes EG and G Idaho's review of Aerojet Energy Conversion Company's (AECC's) topical report on a Mobile Volume Reduction System. The review evaluated compliance with pertinent codes, standards and regulations. The initial review was discussed with AECC by EG and G Idaho and the NRC, and all outstanding issues resolved before this final evaluation was made

Ureteral catheters for colorectal surgery: Influence on operative times and complication outcomes: An observational study

Directory of Open Access Journals (Sweden)

Julio T. Chong

2018-03-01

Full Text Available Purpose: Placement of pre-operative ureteral catheters for colorectal surgery can aid in the identification of ureteral injuries. This study investigates whether simultaneous ureteral catheterization with surgery skin preparation can minimize operating room times without increasing post-operative complications. Materials and Methods: Patients undergoing simultaneous colorectal surgery skin preparation and placement of pre-operative ureteral catheters (n=21 were compared to those who underwent these events sequentially (n=28. Operative time-points of anesthesia ready (AR, surgery procedure start (PS, dorsal lithotomy and catheter insertion (CI times were compared to assess for differences between groups. Complications were compared between groups. Results: There were no differences in age, gender, body mass index (BMI, American Society of Anesthesiologists (ASA, comorbidities, current procedure terminology (CPT or International Classification of Diseases, 9th revision (ICD-9 codes between groups. Simultaneous catheterization saved 11.82 minutes of operative time between CI to PS (p=0.005, t-test. There was a significant difference in mean time between CI to PS (11.82 minutes, p=0.008 between simultaneous and sequential ureteral catheterization groups in a linear regression multivariate analysis controlling for age, BMI, CPT and ICD-9 codes. There were 4 complications in the simultaneous (19% and 3 in the sequential group (11% (p=0.68. Conclusions: Ureteral catheterization and colorectal surgery skin preparation in a simultaneous fashion decreases the time between CI and PS without significant increase in complications. Mean time saved with simultaneous ureteral catheterization was 11.82 minutes per case. Simultaneous ureteral catheterization may be an option in colorectal surgery and may result in cost savings without additional complications.

Verification and validation of the PLTEMP/ANL code for thermal hydraulic analysis of experimental and test reactors

International Nuclear Information System (INIS)

Kalimullah, M.; Olson, A.O.; Feldman, E.E.; Hanan, N.; Dionne, B.

2012-01-01

The document compiles in a single volume several verification and validation works done for the PLTEMP/ANL code during the years of its development and improvement. Some works that are available in the open literature are simply referenced at the outset, and are not included in the document. PLTEMP has been used in conversion safety analysis reports of several US and foreign research reactors that have been licensed and converted. A list of such reactors is given. Each chapter of the document deals with the verification or validation of a specific model. The model verification is usually done by comparing the code with hand calculation, Microsoft spreadsheet calculation, or Mathematica calculation. The model validation is done by comparing the code with experimental data or a more validated code like the RELAP5 code.

Verification and Validation of the PLTEMP/ANL Code for Thermal-Hydraulic Analysis of Experimental and Test Reactors

Energy Technology Data Exchange (ETDEWEB)

Kalimullah, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Olson, Arne P. [Argonne National Lab. (ANL), Argonne, IL (United States); Feldman, E. E. [Argonne National Lab. (ANL), Argonne, IL (United States); Hanan, N. [Argonne National Lab. (ANL), Argonne, IL (United States); Dionne, B. [Argonne National Lab. (ANL), Argonne, IL (United States)

2015-04-07

The document compiles in a single volume several verification and validation works done for the PLTEMP/ANL code during the years of its development and improvement. Some works that are available in the open literature are simply referenced at the outset, and are not included in the document. PLTEMP has been used in conversion safety analysis reports of several US and foreign research reactors that have been licensed and converted. A list of such reactors is given. Each chapter of the document deals with the verification or validation of a specific model. The model verification is usually done by comparing the code with hand calculation, Microsoft spreadsheet calculation, or Mathematica calculation. The model validation is done by comparing the code with experimental data or a more validated code like the RELAP5 code.

Discourse analysis: Conversational analysis of the internal conversation in Oracle Corporation Malaysia

Directory of Open Access Journals (Sweden)

Marwa Marwa

2017-07-01

Full Text Available This study highlights the internal conversation which takes place in Oracle CorporationMalaysia. Through the study, it will be shown how conversational analysis is used toanalyze the transcription of a telephone conversation between Oracle staffs. The analysisof the transcriptions will apply a few basic concepts of conversational analysis; turntakingorganization, and the adjacency pair. The objective of the study is to find out howthe internal conversations takes place by focusing on the conversation itself, that is, theconversational structures spontaneously produced by people during talk ranging fromturn-taking strategies, how topics are introduced, conversation closings and so on. Bylooking in detail at such talk, we can gain a detailed understanding of how the staffs seethemselves in relation to the company that influence their daily lives.Keywords: conversational analysis, turn-taking, adjacency pairs

Application of the dose conversion factor for a NaI(Tl) detector to the radwaste drum assay

International Nuclear Information System (INIS)

Ji, Young-Yong; Hong, Dae-Seok; Kim, Tae-Kuk; Kwak, Kyung-Kil; Ryu, Woo-Seog

2011-01-01

The dose-to-curie (DTC) conversion method has been known that there could be extremely high uncertainty associated with establishing the radioactivity of gamma emitters in a drum. However, the DTC conversion method is still an effective assay method to calculate the radioisotope inventory because of the simple and easy procedures to be applied. In order to make the DTC conversion method practical, numerous assumptions and limitations placed on its use. These assumptions and limitations are related to the dose rate measurement and the relative abundance of gamma emitters in a drum. However, these two variables were generally obtained from the different detection mechanisms even using the different radwaste each other. Unfortunately, that expanded the limitation of using the DTC conversion method. In order to obtain two variables in a drum to be assayed at once, the dose conversion factor for a NaI(Tl) detector was first calculated from the MCNP code. The pulse height spectrum from a simulated drum inserted into a standard source was measured by a NaI(Tl) detector, and then, two variables were calculated from the dose conversion factor and the net count rate of detected gamma emitters in the pulse height spectrum.

Oophorectomy by natural orifice transluminal endoscopic surgery: feasibility study in dogs.

Science.gov (United States)

Freeman, Lynetta J; Rahmani, Emad Y; Sherman, Stuart; Chiorean, Michael V; Selzer, Don J; Constable, Peter D; Snyder, Paul W

2009-06-01

Natural orifice transluminal endoscopic surgery (NOTES) represents a potentially less-invasive alternative to conventional or laparoscopic surgery. Our purpose was to develop a canine oophorectomy model for prospective evaluation of intraoperative complications, surgical stress, and postoperative pain and recovery with NOTES. Feasibility study. Academic preclinical research. Ten healthy female dogs. NOTES procedures were performed through gastric access with an electrocautery snare to resect and retrieve the ovaries. The gastrotomy was closed with prototype T-fasteners. Operative time; complications; postoperative pain scores, and nociceptive threshold; surgical stress markers (interleukin-6 [IL-6], C-reactive protein); systemic stress parameters (cortisol, glucose); necropsy evaluation at 10 to 14 days. The mean operative time was 154 minutes (SD +/- 58 minutes) and no animals died as a result of complications from the procedure. The primary difficulty was incomplete ovarian excision and conversion to an open procedure in 1 dog. Serum glucose concentrations increased after surgery and remained elevated for at least 36 hours. The serum cortisol concentration was transiently increased from baseline at 2 hours after surgery. The serum IL-6 concentration peaked at 2 hours after surgery and returned to the baseline value by 18 hours. The serum C-reactive protein concentration increased significantly from baseline, peaked at 12 hours after surgery, and then slowly declined toward baseline but remained elevated at 72 hours after surgery. Nociceptive threshold measurements indicated increased sensitivity to pain for 2 to 24 hours after surgery. At necropsy, surgical sites were healing uneventfully with no significant damage to surrounding organs, no significant growth on bacterial cultures, and no evidence of peritonitis. Small number of animals, single center. The NOTES approach to oophorectomy in dogs appears to be a reasonable alternative to traditional surgery

The effects of enactment on communicative competence in aphasic casual conversation: a functional linguistic perspective.

Science.gov (United States)

Groenewold, Rimke; Armstrong, Elizabeth

2018-05-14

Previous research has shown that speakers with aphasia rely on enactment more often than non-brain-damaged language users. Several studies have been conducted to explain this observed increase, demonstrating that spoken language containing enactment is easier to produce and is more engaging to the conversation partner. This paper describes the effects of the occurrence of enactment in casual conversation involving individuals with aphasia on its level of conversational assertiveness. To evaluate whether and to what extent the occurrence of enactment in speech of individuals with aphasia contributes to its conversational assertiveness. Conversations between a speaker with aphasia and his wife (drawn from AphasiaBank) were analysed in several steps. First, the transcripts were divided into moves, and all moves were coded according to the systemic functional linguistics (SFL) framework. Next, all moves were labelled in terms of their level of conversational assertiveness, as defined in the previous literature. Finally, all enactments were identified and their level of conversational assertiveness was compared with that of non-enactments. Throughout their conversations, the non-brain-damaged speaker was more assertive than the speaker with aphasia. However, the speaker with aphasia produced more enactments than the non-brain-damaged speaker. The moves of the speaker with aphasia containing enactment were more assertive than those without enactment. The use of enactment in the conversations under study positively affected the level of conversational assertiveness of the speaker with aphasia, a competence that is important for speakers with aphasia because it contributes to their floor time, chances to be heard seriously and degree of control over the conversation topic. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Visual Iconic Patterns of Instant Messaging: Steps Towards Understanding Visual Conversations

Science.gov (United States)

Bays, Hillary

An Instant Messaging (IM) conversation is a dynamic communication register made up of text, images, animation and sound played out on a screen with potentially several parallel conversations and activities all within a physical environment. This article first examines how best to capture this unique gestalt using in situ recording techniques (video, screen capture, XML logs) which highlight the micro-phenomenal level of the exchange and the macro-social level of the interaction. Of particular interest are smileys first as cultural artifacts in CMC in general then as linguistic markers. A brief taxonomy of these markers is proposed in an attempt to clarify their frequency and patterns of their use. Then, focus is placed on their importance as perceptual cues which facilitate communication, while also serving as emotive and emphatic functional markers. We try to demonstrate that the use of smileys and animation is not arbitrary but an organized interactional and structured practice. Finally, we discuss how the study of visual markers in IM could inform the study of other visual conversation codes, such as sign languages, which also have co-produced, physical behavior, suggesting the possibility of a visual phonology.

[Surgery for benign goiter in Germany: fewer operations, changed resectional strategy, fewer complications].

Science.gov (United States)

Dralle, H; Stang, A; Sekulla, C; Rusner, C; Lorenz, K; Machens, A

2014-03-01

The increase of certain operations in the wake of the introduction of the German Diagnosis-Related Groups (G-DRG) system rekindled debate on the risk-benefit profile of what is widely being perceived as a too high number of thyroidectomies for benign goiter in Germany. The numbers of thyroidectomy for benign goiter from 2005-2011 were obtained from the Federal Bureau of Statistics ("Statistisches Bundesamt"). For the purpose of the study, the following operation and procedure key (OPS) codes were selected: hemithyroidectomy (OPS code 5-061); partial thyroid resection (OPS code 5-062); total thyroidectomy (OPS code 5-063); and thyroid surgeries via sternotomy (OPS code 5-064). The rates of permanent hypoparathyroidism and vocal cord palsy were calculated based on two prospective multicenter evaluation studies conducted in 1998-2001 (PETS 1) and 2010-2013 (PETS 2) in Germany. Between 2005 and 2011, the number of thyroidectomies for benign thyroid goiter decreased by 8 %, and the age-standardized surgery rate decreased by 6 % in men (2005: 599 per 1 million; 2011: 565 per 1 million) and 11 % in women (2005: 1641 per 1 million; 2011: 1463 per 1 million). At the same time, the rates of partial and subtotal thyroidectomy decreased by 59 % in men and 64 % in women, whereas the rates of hemithyroidectomy and total thyroidectomy increased by 65 % (113 %) in men and 42 % (97 %) in women. Despite a greater proportion of thyroidectomies over time, the approximated rates for postoperative hypoparathyroidism were reduced from 2.98 to 0.83 % and for postoperative vocal cord palsy from 1.06 to 0.86 %. Irrespective of that decline, either complication was more frequent after total than after subtotal thyroidectomy. The total number of thyroid surgeries due to benign goiter has decreased substantially in Germany from 2005 through 2011. Despite changes in the resectional strategy with an increase in the total number thyroidectomies and a decrease of subtotal

Consideration of the Construction Code for TBM-body in ASME BPVC

International Nuclear Information System (INIS)

Kim, Dongjun; Kim, Yunjae; Kim, Suk Kwon; Park, Sung Dae; Lee, Dong Won

2016-01-01

In this paper, ASME code is briefly introduced, and the TBM-body is classified for selecting the ASME section. With the classification of TBM-body, the appropriate section is determined. Helium Cooled Ceramic Reflector (HCCR) Test Blanket System (TBS) has been designed to research on the functions of breeding blanket by KO TBM team. The functions has three subjects as 1) Tritium breeding, 2) Heat conversion and extraction, and 3) Neutron and Gamma-ray shielding. For the process of design, it is needed to select the appropriate construction code as the design criteria. ITER Organization (IO) has proposed that RCC-MR Edition 2007 ver. shall be used for TBM-shield. Because the TBM-shield is connected to the vacuum boundary. For the other part of TBM-set, TBM-body, there is no constraint on the selected code, and the manufacturer can appropriately select the construction code to apply design and fabrication parts. KO TBM Team has considered whether it is appropriate to choose any code for TBM-body. One of the things is ASME code. The advantage of ASME choice is suitable to the domestic status. In the domestic nuclear plant, ASME or KEPIC code is used as regulatory requirements. Based on this, it is possible to prepare a domestic fusion plant regulatory. In this paper, the construction code of TBM-body was determined in ASME BPVC. For the determination of code, the structure of ASME BPVC was introduced and the classification for TBM-body was conducted by the ITER criteria. And the operation conditions of TBM-body that contained creep and irradiation effects was considered to determine the construction code

Consideration of the Construction Code for TBM-body in ASME BPVC

Energy Technology Data Exchange (ETDEWEB)

Kim, Dongjun; Kim, Yunjae [Korea Univ., Seoul (Korea, Republic of); Kim, Suk Kwon; Park, Sung Dae; Lee, Dong Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

In this paper, ASME code is briefly introduced, and the TBM-body is classified for selecting the ASME section. With the classification of TBM-body, the appropriate section is determined. Helium Cooled Ceramic Reflector (HCCR) Test Blanket System (TBS) has been designed to research on the functions of breeding blanket by KO TBM team. The functions has three subjects as 1) Tritium breeding, 2) Heat conversion and extraction, and 3) Neutron and Gamma-ray shielding. For the process of design, it is needed to select the appropriate construction code as the design criteria. ITER Organization (IO) has proposed that RCC-MR Edition 2007 ver. shall be used for TBM-shield. Because the TBM-shield is connected to the vacuum boundary. For the other part of TBM-set, TBM-body, there is no constraint on the selected code, and the manufacturer can appropriately select the construction code to apply design and fabrication parts. KO TBM Team has considered whether it is appropriate to choose any code for TBM-body. One of the things is ASME code. The advantage of ASME choice is suitable to the domestic status. In the domestic nuclear plant, ASME or KEPIC code is used as regulatory requirements. Based on this, it is possible to prepare a domestic fusion plant regulatory. In this paper, the construction code of TBM-body was determined in ASME BPVC. For the determination of code, the structure of ASME BPVC was introduced and the classification for TBM-body was conducted by the ITER criteria. And the operation conditions of TBM-body that contained creep and irradiation effects was considered to determine the construction code.

The Gender Issue in Congenital and Developmental Cataract Surgery

Directory of Open Access Journals (Sweden)

Marzieh Katibeh

2013-01-01

Full Text Available Purpose: To describe the demographic pattern of congenital cataract surgery at a referral ophthalmology center in Iran and to evaluate any possible difference between the genders. Methods: Subjects aged 15 years or less scheduled for cataract surgery were enrolled in this cross-sectional study. Data was retrieved from the electronic medical records according to the ICD-10 coding system. Age and proportion of operations by sex were the main parameters of interest. We employed analysis of covariance to compare age at surgery and logistic regression to obtain the trend for the number of cataract procedures in boys and girls. Results: Overall, 314 congenital cataract procedures were performed during the study period, 55 (17.5% of which were related to second eye surgery. Operated eyes belonged to male subjects in 172 (54.8% cases and female subjects in 142 (45.2% cases. Mean age at operation for both first and second eyes was 3.2±3.0 years overall, and 3.1±2.9 versus 3.4±3.0 years in girls and boys, respectively (P= 0.62. Surgery was performed before one year of age in 33.2% and before 5 years in 75% of cases. Among patients undergoing second eye surgery, girls presented significantly later than boys (at 4.2±3.3 vs. 2.6±1.7 years, P= 0.012. Conclusion: The rate of congenital/infantile cataract surgery in boys was almost 10% higher than girls. We observed a significant difference only regarding age at second eye surgery which comprised 17.5% of all operations. One third and two thirds of the procedures were performed under the age of one and five years, respectively.

From concatenated codes to graph codes

DEFF Research Database (Denmark)

Justesen, Jørn; Høholdt, Tom

2004-01-01

We consider codes based on simple bipartite expander graphs. These codes may be seen as the first step leading from product type concatenated codes to more complex graph codes. We emphasize constructions of specific codes of realistic lengths, and study the details of decoding by message passing...

Blood-loss Management in Spine Surgery.

Science.gov (United States)

Bible, Jesse E; Mirza, Muhammad; Knaub, Mark A

2018-01-15

Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding. Conversely, the use of intraoperative blood salvage has come into question, both for its potential inability to reduce the need for allogeneic transfusions as well as its cost-effectiveness. Allogeneic blood transfusion is associated with elevated risks, including surgical site infection. Thus, desirable transfusion thresholds should remain restrictive.

[Ultrasound-guided cutaneous intercostal branches nerves block: A good analgesic alternative for gallbladder open surgery].

Science.gov (United States)

Fernández Martín, M T; López Álvarez, S; Mozo Herrera, G; Platero Burgos, J J

2015-12-01

Laparoscopic cholecystectomy has become the standard treatment for gallbladder diseases. However, there are still some patients for whom conversion to open surgery is required. This surgery can produce significant post-operative pain. Opioids drugs have traditionally been used to treat this pain, but side effects have led to seeking alternatives (plexus, nerve or fascia blocks or wound). The cases are presented of 4 patients subjected to ultrasound-guided intercostal branches blocks in the mid-axillary line from T6 to T12 with levobupivacaine as an analgesic alternative in open surgery of gallbladder, with satisfactory results. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital

Directory of Open Access Journals (Sweden)

Sait KH

2011-07-01

Full Text Available Khalid H SaitObstetrics and Gynecology Department, Faculty of Medicine, Gynecology Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBackground: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital.Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times.Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%, and none were directly related to the robotic system.Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.Keywords: da Vinci robot, gynecological surgery, laparoscopy

Navigating the pathway to robotic competency in general thoracic surgery.

Science.gov (United States)

Seder, Christopher W; Cassivi, Stephen D; Wigle, Dennis A

2013-01-01

Although robotic technology has addressed many of the limitations of traditional videoscopic surgery, robotic surgery has not gained widespread acceptance in the general thoracic community. We report our initial robotic surgery experience and propose a structured, competency-based pathway for the development of robotic skills. Between December 2008 and February 2012, a total of 79 robot-assisted pulmonary, mediastinal, benign esophageal, or diaphragmatic procedures were performed. Data on patient characteristics and perioperative outcomes were retrospectively collected and analyzed. During the study period, one surgeon and three residents participated in a triphasic, competency-based pathway designed to teach robotic skills. The pathway consisted of individual preclinical learning followed by mentored preclinical exercises and progressive clinical responsibility. The robot-assisted procedures performed included lung resection (n = 38), mediastinal mass resection (n = 19), hiatal or paraesophageal hernia repair (n = 12), and Heller myotomy (n = 7), among others (n = 3). There were no perioperative mortalities, with a 20% complication rate and a 3% readmission rate. Conversion to a thoracoscopic or open approach was required in eight pulmonary resections to facilitate dissection (six) or to control hemorrhage (two). Fewer major perioperative complications were observed in the later half of the experience. All residents who participated in the thoracic surgery robotic pathway perform robot-assisted procedures as part of their clinical practice. Robot-assisted thoracic surgery can be safely learned when skill acquisition is guided by a structured, competency-based pathway.

The new CMSS code for interactions with companies managing relationships to minimize conflicts.

Science.gov (United States)

Kahn, Norman B; Lichter, Allen S

2011-09-01

Conflicts of interest in medicine have received significant attention in recent years, through the public and professional media, federal and state governments, and through a 2009 report of the Institute of Medicine on Conflict of Interest in Medical Research, Education and Practice. The Council of Medical Specialty Societies (CMSS) Code for Interactions with Companies was adopted by the CMSS in April 2010. The Code guides specialty societies in the profession of medicine in ethical relationships between societies and the pharmaceutical and medical device industries. The Code serves to protect and promote the independence of specialty societies and their leaders in corporate sponsorships, licensing, advertising, society meetings, exhibits, educational programs, journals, clinical practice guidelines, and research. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Ambulatory surgery for the patient with breast cancer: current perspectives

Directory of Open Access Journals (Sweden)

Pek CH

2016-08-01

Full Text Available Chong Han Pek,1 John Tey,2 Ern Yu Tan1 1Department of General Surgery, 2Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore, Singapore Abstract: Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefits of better psychological adjustment for the patient, economic savings, and a more efficient utilization of health care resources. The minimal care needed post-discharge also means that the caregiver is not unduly burdened. Unplanned conversions to inpatient admission and readmission rates are low. Wound complications are infrequent and no issues with drain care have been reported. Because the period of postoperative observation is short and monitoring is not as intensive, ambulatory surgery is only suitable for low-risk procedures such as breast cancer surgery and in patients without serious comorbidities, where the likelihood of major perioperative events is low. Optimal management of pain, nausea, and vomiting is essential to ensure a quick recovery and return to normal function. Regional anesthesia such as the thoracic paravertebral block has been employed to improve pain control during the surgery and in the immediate postoperative period. The block provides excellent pain relief and reduces the need for opiates, which also consequently reduces the incidence of nausea and vomiting. The increasing popularity of total intravenous anesthesia with propofol has also helped reduce the incidence of nausea and vomiting in the postoperative period. Ambulatory surgery can be safely carried out in centers where there is a well-designed workflow to ensure proper patient selection, counseling, and education, and where patients and caregivers have easy access to

Trends in adolescent bariatric surgery evaluated by UHC database collection.

Science.gov (United States)

Pallati, Pradeep; Buettner, Shelby; Simorov, Anton; Meyer, Avishai; Shaligram, Abhijit; Oleynikov, Dmitry

2012-11-01

With increasing childhood obesity, adolescent bariatric surgery has been increasingly performed. We used a national database to analyze current trends in laparoscopic bariatric surgery in the adolescent population and related short-term outcomes. Discharge data from the University Health System Consortium (UHC) database was accessed using International Classification of Disease codes during a 36 month period. UHC is an alliance of more than 110 academic medical centers and nearly 250 affiliate hospitals. All adolescent patients between 13 and 18 years of age, with the assorted diagnoses of obesity, who underwent laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) were evaluated. The main outcome measures analyzed were morbidity, mortality, length of hospital stay (LOS), overall cost, intensive care unit (ICU) admission rate, and readmission rate. These outcomes were compared to those of adult bariatric surgery. Adolescent laparoscopic bariatric surgery was performed on 329 patients. At the same time, 49,519 adult bariatric surgeries were performed. One hundred thirty-six adolescent patients underwent LAGB, 47 had SG, and 146 patients underwent LRYGB. LAGB has shown a decreasing trend (n = 68, 34, and 34), while SG has shown an increasing trend (n = 8, 15, and 24) over the study years. LRYGB remained stable (n = 44, 60, and 42) throughout the study period. The individual and summative morbidity and mortality rates for these procedures were zero. Compared to adult bariatric surgery, 30 day in-hospital morbidity (0 vs. 2.2 %, p adolescent bariatric surgery, while the ICU admission rate (9.78 vs. 6.30 %, p adolescent laparoscopic bariatric surgery reveal the increased use of sleeve gastrectomy and adjustable gastric banding falling out of favor.

Conversion of laproscopic cholecystectomy into open cholecystectomy: an experience in 300 cases

International Nuclear Information System (INIS)

Rashid, T.; Farooq, U.; Naheed, A.; Iqbal, M.; Barkat, N.

2016-01-01

Background: Laparoscopic cholecystectomy is getting popularity in developing countries especially in Pakistan. Conversion from laparoscopic to open cholecystectomy is also common. This study intends to evaluate the causes of conversion from laparoscopic cholecystectomy to open cholecystectomy and to establish the efficacy and safety of the procedure. Methods: This descriptive case series was conducted in the department of General Surgery at Social Security Teaching Hospital Islamabad from November 2012 to October 2015. Patients of more than 20 years of age presenting in OPD with symptomatic gallstones were included in the study. Patients with dilated CBD (>8 mm in diameter), jaundice, acute cholecystitis, mass at porta hepatis and positive hepatitis B or C virology were excluded. Results: A total of 300 patients were included in the study; 262 (87.33 percentage) were females and 38 (12.67 percentage) were males. Twenty-one (7 percentage) patients were converted to open cholecystectomy. Most common cause of conversion was dense adhesions followed by obscure anatomy at Calots triangle. Other common causes were bleeding, bile leakage, visceral injuries and instrument failure. In the first 100 cases, 10 percentage patients were converted to open cholecystectomy followed by 6 percentage in the next 100 cases. Only 5 percentage patients were converted to open cholecystectomy in the last 100 cases. Conclusion: Most common cause of conversion from laparoscopic cholecystectomy to open cholecystectomy was dense adhesions followed by obscure anatomy at Calots triangle. (author)

Cost assessment of robotics in gynecologic surgery: a systematic review.

Science.gov (United States)

Iavazzo, Christos; Papadopoulou, Eleni K; Gkegkes, Ioannis D

2014-11-01

The application of robotics is an innovation in the field of gynecologic surgery. Our objective was to evaluate the currently available literature on the cost assessment of robotic surgery of various operations in the field of gynecologic surgery. PubMed and Scopus databases were systematically searched in order to retrieve the included studies in our review. We retrieved 23 studies on a variety of gynecologic operations. The mean cost for robotic, open and laparoscopic surgery ranged from 1731 to 48,769, 894 to 20,277 and 411 to 41,836 Euros, respectively. Operative charges, in hysterectomy, for robotic, open and laparoscopic technique ranged from 936 to 33,920, 684 to 25,616 and 858 to 25,578 Euros, respectively. In sacrocolpopexy, these costs ranged from 2067 to 7275, 2904 to 69,792 and 1482 to 2000 Euros, respectively. Non-operative charges ranged from 467 to 39,121 Euros. The mean total costs for myomectomy ranged from 27,342 to 42,497 and 13,709 to 20,277 Euros, respectively, for the robotic and open methods, while the mean total cost of the laparoscopic technique was 26,181 Euros. Conversions to laparotomy were present in 79/36,185 (0.2%) cases of laparoscopic surgery and in 21/3345 (0.62%) cases of robotic technique. Duration of robotic, open and laparoscopic surgery ranged from 50 to 445, 83.7 to 701 and 74 to 330 min, respectively. Robotic surgery has the potential to become cost-effective in centers with many patients while industry competition could reduce the cost of the robotic instrumentation, making robotic technology more affordable and cost-effective. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Uranium conversion; Urankonvertering

Energy Technology Data Exchange (ETDEWEB)

Oliver, Lena; Peterson, Jenny; Wilhelmsen, Katarina [Swedish Defence Research Agency (FOI), Stockholm (Sweden)

2006-03-15

FOI, has performed a study on uranium conversion processes that are of importance in the production of different uranium compounds in the nuclear industry. The same conversion processes are of interest both when production of nuclear fuel and production of fissile material for nuclear weapons are considered. Countries that have nuclear weapons ambitions, with the intention to produce highly enriched uranium for weapons purposes, need some degree of uranium conversion capability depending on the uranium feed material available. This report describes the processes that are needed from uranium mining and milling to the different conversion processes for converting uranium ore concentrate to uranium hexafluoride. Uranium hexafluoride is the uranium compound used in most enrichment facilities. The processes needed to produce uranium dioxide for use in nuclear fuel and the processes needed to convert different uranium compounds to uranium metal - the form of uranium that is used in a nuclear weapon - are also presented. The production of uranium ore concentrate from uranium ore is included since uranium ore concentrate is the feed material required for a uranium conversion facility. Both the chemistry and principles or the different uranium conversion processes and the equipment needed in the processes are described. Since most of the equipment that is used in a uranium conversion facility is similar to that used in conventional chemical industry, it is difficult to determine if certain equipment is considered for uranium conversion or not. However, the chemical conversion processes where UF{sub 6} and UF{sub 4} are present require equipment that is made of corrosion resistant material.

Unplanned Readmission in Outpatient Hand Surgery: An Analysis of 23,613 Patients in the NSQIP Data Set.

Science.gov (United States)

Donato, Daniel P; Kwok, Alvin C; Bishop, Michael O; Presson, Angela P; Agarwal, Jayant P

2017-01-01

Objective: In an era of controlling cost and improving care, 30-day readmission rates have become an important quality measure. The purpose of this study was to identify the rates of 30-day unplanned readmission and the associated risk factors in patients undergoing outpatient hand surgery. Methods: The 2011-2014 National Surgical Quality Improvement Project data were queried for patients who met 368 hand-specific Current Procedural Terminology codes. Univariable and multivariable analyses were performed to identify patient- and surgery-specific risk factors associated with unplanned readmission within 30 days. Results: Of the 368 Current Procedural Terminology codes queried, 208 were represented in the data, for a total of 23,613 patients. The overall unplanned readmission rate was 0.88% (207/23,613). On both univariable and multivariable analyses, operative year (2012), increasing age, obesity, smoking status, chronic obstructive pulmonary disease, preoperative steroid use, preoperative anemia, increasing American Society of Anesthesiologists classification, increasing operative time, and a procedure performed by a surgeon other than a plastic or orthopedic surgeon were associated with increased readmission rates. Diabetes, hypertension, low albumin levels, elevated international normalized ratio, and dirty/infected wound classification were only significant in univariable analysis. Current Procedural Terminology codes associated with the highest readmission rates were related to amputations. The most common readmission diagnoses were wound complications, followed by uncontrolled postoperative pain. Conclusions: The incidence of unplanned readmission is low in patients undergoing outpatient hand surgery. Specific patient comorbidities are associated with increased unplanned readmission rates. This information may be useful in identifying patients at higher risk for unplanned readmission and in counseling of high-risk patients preparing for surgery.

Beyond the Business Model: Incentives for Organizations to Publish Software Source Code

Science.gov (United States)

Lindman, Juho; Juutilainen, Juha-Pekka; Rossi, Matti

The software stack opened under Open Source Software (OSS) licenses is growing rapidly. Commercial actors have released considerable amounts of previously proprietary source code. These actions beg the question why companies choose a strategy based on giving away software assets? Research on outbound OSS approach has tried to answer this question with the concept of the “OSS business model”. When studying the reasons for code release, we have observed that the business model concept is too generic to capture the many incentives organizations have. Conversely, in this paper we investigate empirically what the companies’ incentives are by means of an exploratory case study of three organizations in different stages of their code release. Our results indicate that the companies aim to promote standardization, obtain development resources, gain cost savings, improve the quality of software, increase the trustworthiness of software, or steer OSS communities. We conclude that future research on outbound OSS could benefit from focusing on the heterogeneous incentives for code release rather than on revenue models.

Conversion of a Temporary Tent with Steel Frame into a Permanent Warehouse

Science.gov (United States)

Georgescu, Mircea; Ungureanu, Viorel; Grecea, Daniel; Petran, Ioan

2017-10-01

The paper is dealing with the problem of a functional conversion (involving both architectural and structural issues) applied to the case of an industrial building. As well known, temporary tents, designed according to the European Code EN13782, represent a remarkable stake on the building market and a fast and practical solution for some situations. It is exactly the case approached by the paper, where the investor has initially decided to erect on his platform a provisional shelter for agricultural machines and subsequent staff, built of a light steel structure covered by PVC roofing and cladding. This temporary tent has been acquired from a specialized supplier in form of a series product. After using the tent for a number of years, the investor has decided to convert the existing structure from architectural and structural point of view by switching to a permanent structure designed accordingly. Important changes were thus imposed both to the architectural part (technological flows, openings, facades) and especially to the structural part where this switch imposed a re-design to the codes of permanent structures (especially as far as climatic loadings are concerned). The required architectural change implied the building of a 70 cm high concrete plinth and replacing the PVC membrane temporary roofing and cladding by permanent 60 mm thick PUR sandwich panels. Together with a new system of openings this has led to renewed facades of the buildings. As for the structural change, the required conversion has imposed a thorough checking of the existing steel structure (very slender and typical to a tent) in view of transforming it into a permanent structure. The consolidation measures of the existing galvanized steel structure are described, together with the measures applied at infrastructure level in order to implement the required conversion.

Building shared situational awareness in surgery through distributed dialog

Directory of Open Access Journals (Sweden)

Gillespie BM

2013-03-01

"overhearing" conversations that occurred at the operating table. Behaviors that compromised a team's shared situational awareness included tunneling and fixating on one aspect of the situation.Keywords: shared situational awareness, surgery, distributed dialog

Iris recognition as a biometric method after cataract surgery.

Science.gov (United States)

Roizenblatt, Roberto; Schor, Paulo; Dante, Fabio; Roizenblatt, Jaime; Belfort, Rubens

2004-01-28

Biometric methods are security technologies, which use human characteristics for personal identification. Iris recognition systems use iris textures as unique identifiers. This paper presents an analysis of the verification of iris identities after intra-ocular procedures, when individuals were enrolled before the surgery. Fifty-five eyes from fifty-five patients had their irises enrolled before a cataract surgery was performed. They had their irises verified three times before and three times after the procedure, and the Hamming (mathematical) distance of each identification trial was determined, in a controlled ideal biometric environment. The mathematical difference between the iris code before and after the surgery was also compared to a subjective evaluation of the iris anatomy alteration by an experienced surgeon. A correlation between visible subjective iris texture alteration and mathematical difference was verified. We found only six cases in which the eye was no more recognizable, but these eyes were later reenrolled. The main anatomical changes that were found in the new impostor eyes are described. Cataract surgeries change iris textures in such a way that iris recognition systems, which perform mathematical comparisons of textural biometric features, are able to detect these changes and sometimes even discard a pre-enrolled iris considering it an impostor. In our study, re-enrollment proved to be a feasible procedure.

Toric Varieties and Codes, Error-correcting Codes, Quantum Codes, Secret Sharing and Decoding

DEFF Research Database (Denmark)

Hansen, Johan Peder

We present toric varieties and associated toric codes and their decoding. Toric codes are applied to construct Linear Secret Sharing Schemes (LSSS) with strong multiplication by the Massey construction. Asymmetric Quantum Codes are obtained from toric codes by the A.R. Calderbank P.W. Shor and A.......M. Steane construction of stabilizer codes (CSS) from linear codes containing their dual codes....

An audit of the nature and impact of clinical coding subjectivity variability and error in otolaryngology.

Science.gov (United States)

Nouraei, S A R; Hudovsky, A; Virk, J S; Chatrath, P; Sandhu, G S

2013-12-01

To audit the accuracy of clinical coding in otolaryngology, assess the effectiveness of previously implemented interventions, and determine ways in which it can be further improved. Prospective clinician-auditor multidisciplinary audit of clinical coding accuracy. Elective and emergency ENT admissions and day-case activity. Concordance between initial coding and the clinician-auditor multi-disciplinary teams (MDT) coding in respect of primary and secondary diagnoses and procedures, health resource groupings health resource groupings (HRGs) and tariffs. The audit of 3131 randomly selected otolaryngology patients between 2010 and 2012 resulted in 420 instances of change to the primary diagnosis (13%) and 417 changes to the primary procedure (13%). In 1420 cases (44%), there was at least one change to the initial coding and 514 (16%) health resource groupings changed. There was an income variance of £343,169 or £109.46 per patient. The highest rates of health resource groupings change were observed in head and neck surgery and in particular skull-based surgery, laryngology and within that tracheostomy, and emergency admissions, and specially, epistaxis management. A randomly selected sample of 235 patients from the audit were subjected to a second audit by a second clinician-auditor multi-disciplinary team. There were 12 further health resource groupings changes (5%) and at least one further coding change occurred in 57 patients (24%). These changes were significantly lower than those observed in the pre-audit sample, but were also significantly greater than zero. Asking surgeons to 'code in theatre' and applying these codes without further quality assurance to activity resulted in an health resource groupings error rate of 45%. The full audit sample was regrouped under health resource groupings 3.5 and was compared with a previous audit of 1250 patients performed between 2007 and 2008. This comparison showed a reduction in the baseline rate of health resource

Modeling power electronics and interfacing energy conversion systems

CERN Document Server

Simões, Marcelo Godoy

2017-01-01

Discusses the application of mathematical and engineering tools for modeling, simulation and control oriented for energy systems, power electronics and renewable energy. This book builds on the background knowledge of electrical circuits, control of dc/dc converters and inverters, energy conversion and power electronics. The book shows readers how to apply computational methods for multi-domain simulation of energy systems and power electronics engineering problems. Each chapter has a brief introduction on the theoretical background, a description of the problems to be solved, and objectives to be achieved. Block diagrams, electrical circuits, mathematical analysis or computer code are covered. Each chapter concludes with discussions on what should be learned, suggestions for further studies and even some experimental work.

Automatic coding method of the ACR Code

International Nuclear Information System (INIS)

Park, Kwi Ae; Ihm, Jong Sool; Ahn, Woo Hyun; Baik, Seung Kook; Choi, Han Yong; Kim, Bong Gi

1993-01-01

The authors developed a computer program for automatic coding of ACR(American College of Radiology) code. The automatic coding of the ACR code is essential for computerization of the data in the department of radiology. This program was written in foxbase language and has been used for automatic coding of diagnosis in the Department of Radiology, Wallace Memorial Baptist since May 1992. The ACR dictionary files consisted of 11 files, one for the organ code and the others for the pathology code. The organ code was obtained by typing organ name or code number itself among the upper and lower level codes of the selected one that were simultaneous displayed on the screen. According to the first number of the selected organ code, the corresponding pathology code file was chosen automatically. By the similar fashion of organ code selection, the proper pathologic dode was obtained. An example of obtained ACR code is '131.3661'. This procedure was reproducible regardless of the number of fields of data. Because this program was written in 'User's Defined Function' from, decoding of the stored ACR code was achieved by this same program and incorporation of this program into program in to another data processing was possible. This program had merits of simple operation, accurate and detail coding, and easy adjustment for another program. Therefore, this program can be used for automation of routine work in the department of radiology

Radiant Energy Measurements from a Scaled Jet Engine Axisymmetric Exhaust Nozzle for a Baseline Code Validation Case

Science.gov (United States)

Baumeister, Joseph F.

1994-01-01

A non-flowing, electrically heated test rig was developed to verify computer codes that calculate radiant energy propagation from nozzle geometries that represent aircraft propulsion nozzle systems. Since there are a variety of analysis tools used to evaluate thermal radiation propagation from partially enclosed nozzle surfaces, an experimental benchmark test case was developed for code comparison. This paper briefly describes the nozzle test rig and the developed analytical nozzle geometry used to compare the experimental and predicted thermal radiation results. A major objective of this effort was to make available the experimental results and the analytical model in a format to facilitate conversion to existing computer code formats. For code validation purposes this nozzle geometry represents one validation case for one set of analysis conditions. Since each computer code has advantages and disadvantages based on scope, requirements, and desired accuracy, the usefulness of this single nozzle baseline validation case can be limited for some code comparisons.

Uranium Dispersion and Dosimetry (UDAD) Code

International Nuclear Information System (INIS)

Momeni, M.H.; Yuan, Y.; Zielen, A.J.

1979-05-01

The Uranium Dispersion and Dosimetry (UDAD) Code provides estimates of potential radiation exposure to individuals and to the general population in the vicinity of a uranium processing facility. The UDAD Code incorporates the radiation dose from the airborne release of radioactive materials, and includes dosimetry of inhalation, ingestion, and external exposures. The removal of raioactive particles from a contaminated area by wind action is estimated, atmospheric concentrations of radioactivity from specific sources are calculated, and source depletion as a result of deposition, fallout, and ingrowth of radon daughters are included in a sector-averaged Gaussian plume dispersion model. The average air concentration at any given receptor location is assumed to be constant during each annual release period, but to increase from year to year because of resuspension. Surface contamination and deposition velocity are estimated. Calculation of the inhalation dose and dose rate to an individual is based on the ICRP Task Group Lung Model. Estimates of the dose to the bronchial epithelium of the lung from inhalation of radon and its short-lived daughters are calculated based on a dose conversion factor from the BEIR report. External radiation exposure includes radiation from airborne radionuclides and exposure to radiation from contaminated ground. Terrestrial food pathways include vegetation, meat, milk, poultry, and eggs. Internal dosimetry is based on ICRP recommendations. In addition, individual dose commitments, population dose commitments, and environmental dose commitments are computed. This code also may be applied to dispersion of any other pollutant

[The DRG responsible physician in trauma and orthopedic surgery. Surgeon, encoder, and link to medical controlling].

Science.gov (United States)

Ruffing, T; Huchzermeier, P; Muhm, M; Winkler, H

2014-05-01

Precise coding is an essential requirement in order to generate a valid DRG. The aim of our study was to evaluate the quality of the initial coding of surgical procedures, as well as to introduce our "hybrid model" of a surgical specialist supervising medical coding and a nonphysician for case auditing. The department's DRG responsible physician as a surgical specialist has profound knowledge both in surgery and in DRG coding. At a Level 1 hospital, 1000 coded cases of surgical procedures were checked. In our department, the DRG responsible physician who is both a surgeon and encoder has proven itself for many years. The initial surgical DRG coding had to be corrected by the DRG responsible physician in 42.2% of cases. On average, one hour per working day was necessary. The implementation of a DRG responsible physician is a simple, effective way to connect medical and business expertise without interface problems. Permanent feedback promotes both medical and economic sensitivity for the improvement of coding quality.

ORBIT: A CODE FOR COLLECTIVE BEAM DYNAMICS IN HIGH INTENSITY RINGS

International Nuclear Information System (INIS)

HOLMES, J.A.; DANILOV, V.; GALAMBOS, J.; SHISHLO, A.; COUSINEAU, S.; CHOU, W.; MICHELOTTI, L.; OSTIGUY, J.F.; WEI, J.

2002-01-01

We are developing a computer code, ORBIT, specifically for beam dynamics calculations in high-intensity rings. Our approach allows detailed simulation of realistic accelerator problems. ORBIT is a particle-in-cell tracking code that transports bunches of interacting particles through a series of nodes representing elements, effects, or diagnostics that occur in the accelerator lattice. At present, ORBIT contains detailed models for strip-foil injection, including painting and foil scattering; rf focusing and acceleration; transport through various magnetic elements; longitudinal and transverse impedances; longitudinal, transverse, and three-dimensional space charge forces; collimation and limiting apertures; and the calculation of many useful diagnostic quantities. ORBIT is an object-oriented code, written in C++ and utilizing a scripting interface for the convenience of the user. Ongoing improvements include the addition of a library of accelerator maps, BEAMLINE/MXYZPTLK, the introduction of a treatment of magnet errors and fringe fields; the conversion of the scripting interface to the standard scripting language, Python; and the parallelization of the computations using MPI. The ORBIT code is an open source, powerful, and convenient tool for studying beam dynamics in high-intensity rings

ORBIT: A Code for Collective Beam Dynamics in High-Intensity Rings

Science.gov (United States)

Holmes, J. A.; Danilov, V.; Galambos, J.; Shishlo, A.; Cousineau, S.; Chou, W.; Michelotti, L.; Ostiguy, J.-F.; Wei, J.

2002-12-01

We are developing a computer code, ORBIT, specifically for beam dynamics calculations in high-intensity rings. Our approach allows detailed simulation of realistic accelerator problems. ORBIT is a particle-in-cell tracking code that transports bunches of interacting particles through a series of nodes representing elements, effects, or diagnostics that occur in the accelerator lattice. At present, ORBIT contains detailed models for strip-foil injection, including painting and foil scattering; rf focusing and acceleration; transport through various magnetic elements; longitudinal and transverse impedances; longitudinal, transverse, and three-dimensional space charge forces; collimation and limiting apertures; and the calculation of many useful diagnostic quantities. ORBIT is an object-oriented code, written in C++ and utilizing a scripting interface for the convenience of the user. Ongoing improvements include the addition of a library of accelerator maps, BEAMLINE/MXYZPTLK; the introduction of a treatment of magnet errors and fringe fields; the conversion of the scripting interface to the standard scripting language, Python; and the parallelization of the computations using MPI. The ORBIT code is an open source, powerful, and convenient tool for studying beam dynamics in high-intensity rings.

ORBIT: A code for collective beam dynamics in high-intensity rings

International Nuclear Information System (INIS)

Holmes, J.A.; Danilov, V.; Galambos, J.; Shishlo, A.; Cousineau, S.; Chou, W.; Michelotti, L.; Ostiguy, J.-F.; Wei, J.

2002-01-01

We are developing a computer code, ORBIT, specifically for beam dynamics calculations in high-intensity rings. Our approach allows detailed simulation of realistic accelerator problems. ORBIT is a particle-in-cell tracking code that transports bunches of interacting particles through a series of nodes representing elements, effects, or diagnostics that occur in the accelerator lattice. At present, ORBIT contains detailed models for strip-foil injection, including painting and foil scattering; rf focusing and acceleration; transport through various magnetic elements; longitudinal and transverse impedances; longitudinal, transverse, and three-dimensional space charge forces; collimation and limiting apertures; and the calculation of many useful diagnostic quantities. ORBIT is an object-oriented code, written in C++ and utilizing a scripting interface for the convenience of the user. Ongoing improvements include the addition of a library of accelerator maps, BEAMLINE/MXYZPTLK; the introduction of a treatment of magnet errors and fringe fields; the conversion of the scripting interface to the standard scripting language, Python; and the parallelization of the computations using MPI. The ORBIT code is an open source, powerful, and convenient tool for studying beam dynamics in high-intensity rings

Starting a robotic program in general thoracic surgery: why, how, and lessons learned.

Science.gov (United States)

Cerfolio, Robert J; Bryant, Ayesha S; Minnich, Douglas J

2011-06-01

We report our experience in starting a robotic program in thoracic surgery. We retrospectively reviewed our experience in starting a robotic program in general thoracic surgery on a consecutive series of patients. Between February 2009 and September 2010, 150 patients underwent robotic operations. Types of procedures were lobectomy in 62, thymectomy in 30, and benign esophageal procedures in 6. No thymectomy or esophageal procedures required conversion. One conversion was needed for suspected bleeding for a mediastinal mass. Twelve patients were converted for lobectomy (none for bleeding, 1 in the last 24). Median operative time for robotic thymectomy was 119 minutes, and median length of stay was 1 day. The median time for robotic lobectomy was 185 minutes, and median length of stay was 2 days. There were no operative deaths. Morbidity occurred in 23 patients (15%). All patients with cancer had R0 resections and resection of all visible mediastinal and hilar lymph nodes. Robotic surgery is safe and oncologically sound. It requires training of the entire operating room team. The learning curve is steep, involving port placement, availability of the proper instrumentation, use of the correct robotic arms, and proper patient positioning. The robot provides an ideal surgical approach for thymectomy and other mediastinal tumors. Its advantage over thoracoscopy for pulmonary resection is unproven; however, we believe complete thoracic lymph node dissection and teaching is easier. Importantly, defined credentialing for surgeons and cost analysis studies are needed. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Indications for Use of Damage Control Surgery in Civilian Trauma Patients: A Content Analysis and Expert Appropriateness Rating Study.

Science.gov (United States)

Roberts, Derek J; Bobrovitz, Niklas; Zygun, David A; Ball, Chad G; Kirkpatrick, Andrew W; Faris, Peter D; Brohi, Karim; D'Amours, Scott; Fabian, Timothy C; Inaba, Kenji; Leppäniemi, Ari K; Moore, Ernest E; Navsaria, Pradeep H; Nicol, Andrew J; Parry, Neil; Stelfox, Henry T

2016-05-01

To characterize and evaluate indications for use of damage control (DC) surgery in civilian trauma patients. Although DC surgery may improve survival in select, severely injured patients, the procedure is associated with significant morbidity, suggesting that it should be used only when appropriately indicated. Two investigators used an abbreviated grounded theory method to synthesize indications for DC surgery reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications. An international panel of trauma surgery experts (n = 9) then rated the appropriateness (expected benefit-to-harm ratio) of the coded indications for use in surgical practice. The 1107 indications identified in the literature were synthesized into 123 unique pre- (n = 36) and intraoperative (n = 87) indications. The panel assessed 101 (82.1%) of these indications to be appropriate. The indications most commonly reported and assessed to be appropriate included pre- and intraoperative hypothermia (median temperature 10 units), inability to close the abdominal wall without tension, development of abdominal compartment syndrome during attempted abdominal wall closure, and need to reassess extent of bowel viability. This study identified a comprehensive list of candidate indications for use of DC surgery. These indications provide a practical foundation to guide surgical practice while studies are conducted to evaluate their impact on patient care and outcomes.

Coding in pigeons: Multiple-coding versus single-code/default strategies.

Science.gov (United States)

Pinto, Carlos; Machado, Armando

2015-05-01

To investigate the coding strategies that pigeons may use in a temporal discrimination tasks, pigeons were trained on a matching-to-sample procedure with three sample durations (2s, 6s and 18s) and two comparisons (red and green hues). One comparison was correct following 2-s samples and the other was correct following both 6-s and 18-s samples. Tests were then run to contrast the predictions of two hypotheses concerning the pigeons' coding strategies, the multiple-coding and the single-code/default. According to the multiple-coding hypothesis, three response rules are acquired, one for each sample. According to the single-code/default hypothesis, only two response rules are acquired, one for the 2-s sample and a "default" rule for any other duration. In retention interval tests, pigeons preferred the "default" key, a result predicted by the single-code/default hypothesis. In no-sample tests, pigeons preferred the key associated with the 2-s sample, a result predicted by multiple-coding. Finally, in generalization tests, when the sample duration equaled 3.5s, the geometric mean of 2s and 6s, pigeons preferred the key associated with the 6-s and 18-s samples, a result predicted by the single-code/default hypothesis. The pattern of results suggests the need for models that take into account multiple sources of stimulus control. © Society for the Experimental Analysis of Behavior.

Robotics in general surgery: A systematic cost assessment.

Science.gov (United States)

Gkegkes, Ioannis D; Mamais, Ioannis A; Iavazzo, Christos

2017-01-01

The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from 2539 to 57,002, 7888 to 16,851 and 1799 to 50,408 Euros, respectively. The mean operative charges ranged from 273.74 to 13,670 Euros. More specifically, for the robotic and laparoscopic gastric fundoplication, the cost ranged from 1534 to 2257 and 657 to 763 Euros, respectively. For the robotic and laparoscopic colectomy, it ranged from 3739 to 17,080 and 3109 to 33,865 Euros, respectively. For the robotic and laparoscopic cholecystectomy, ranged from 1163.75 to 1291 and from 273.74 to 1223 Euros, respectively. The mean non-operative costs ranged from 900 to 48,796 from 8347 to 8800 and from 870 to 42,055 Euros, for robotic, open and laparoscopic technique, respectively. Conversions to laparotomy were present in 34/18,620 (0.18%) cases of laparoscopic and in 22/1488 (1.5%) cases of robotic technique. Duration of surgery robotic, open and laparoscopic ranged from 54.6 to 328.7, 129 to 234, and from 50.2 to 260 min, respectively. The present evidence reveals that robotic surgery, under specific conditions, has the potential to become cost-effective. Large number of cases, presence of industry competition and multidisciplinary team utilisation are some of the factors that could make more reasonable and cost-effective the robotic-assisted technique.

Photon dose conversion coefficients for the human teeth in standard irradiation geometries

Energy Technology Data Exchange (ETDEWEB)

Ulanovsky, A; Wieser, A; Zankl, M; Jacob, P

2005-07-01

Photon dose conversion coefficients for the human tooth materials are computed in energy range from 0.01 to 10 MeV by the Monte Carlo method. The voxel phantom Golem of the human body with newly defined tooth region and a modified version of the EGS4 code have been used to compute the coefficients for 30 tooth cells with different locations and materials. The dose responses are calculated for cells representing buccal and lingual enamel layers. The computed coefficients demonstrate a strong dependence on energy and geometry of the radiation source and a weaker dependence on location of the enamel voxels. For isotropic and rotational radiation fields the enamel dose does not show a significant dependence on tooth sample locations. The computed coefficients are used to convert from absorbed dose in teeth to organ dose or to integral air kerma. Examples of integral conversion factors from enamel dose to air kerma are given for several photon fluences specific for the Mayak reprocessing plant in Russia. The integral conversion factors are strongly affected by the energy and angular distributions of photon fluence, which are important characteristics of an exposure scenario for reconstruction of individual occupational doses. (orig.)

Code Cactus; Code Cactus

Energy Technology Data Exchange (ETDEWEB)

Fajeau, M; Nguyen, L T; Saunier, J [Commissariat a l' Energie Atomique, Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

1966-09-01

This code handles the following problems: -1) Analysis of thermal experiments on a water loop at high or low pressure; steady state or transient behavior; -2) Analysis of thermal and hydrodynamic behavior of water-cooled and moderated reactors, at either high or low pressure, with boiling permitted; fuel elements are assumed to be flat plates: - Flowrate in parallel channels coupled or not by conduction across plates, with conditions of pressure drops or flowrate, variable or not with respect to time is given; the power can be coupled to reactor kinetics calculation or supplied by the code user. The code, containing a schematic representation of safety rod behavior, is a one dimensional, multi-channel code, and has as its complement (FLID), a one-channel, two-dimensional code. (authors) [French] Ce code permet de traiter les problemes ci-dessous: 1. Depouillement d'essais thermiques sur boucle a eau, haute ou basse pression, en regime permanent ou transitoire; 2. Etudes thermiques et hydrauliques de reacteurs a eau, a plaques, a haute ou basse pression, ebullition permise: - repartition entre canaux paralleles, couples on non par conduction a travers plaques, pour des conditions de debit ou de pertes de charge imposees, variables ou non dans le temps; - la puissance peut etre couplee a la neutronique et une representation schematique des actions de securite est prevue. Ce code (Cactus) a une dimension d'espace et plusieurs canaux, a pour complement Flid qui traite l'etude d'un seul canal a deux dimensions. (auteurs)

Reading Comprehension in Boys with ADHD: The Mediating Roles of Working Memory and Orthographic Conversion.

Science.gov (United States)

Friedman, Lauren M; Rapport, Mark D; Raiker, Joseph S; Orban, Sarah A; Eckrich, Samuel J

2017-02-01

Reading comprehension difficulties in children with ADHD are well established; however, limited information exists concerning the cognitive mechanisms that contribute to these difficulties and the extent to which they interact with one another. The current study examines two broad cognitive processes known to be involved in children's reading comprehension abilities-(a) working memory (i.e., central executive processes [CE], phonological short-term memory [PH STM], and visuospatial short-term memory [VS STM]) and (b) orthographic conversion (i.e., conversion of visually presented text to a phonological code)-to elucidate their unique and interactive contribution to ADHD-related reading comprehension differences. Thirty-one boys with ADHD-combined type and 30 typically developing (TD) boys aged 8 to 12 years (M = 9.64, SD = 1.22) were administered multiple counterbalanced tasks assessing WM and orthographic conversion processes. Relative to TD boys, boys with ADHD exhibited significant deficits in PH STM (d = -0.70), VS STM (d = -0.92), CE (d = -1.58), and orthographic conversion (d = -0.93). Bias-corrected, bootstrapped mediation analyses revealed that CE and orthographic conversion processes modeled separately mediated ADHD-related reading comprehension differences partially, whereas PH STM and VS STM did not. CE and orthographic conversion modeled jointly mediated ADHD-related reading comprehension differences fully wherein orthographic conversion's large magnitude influence on reading comprehension occurred indirectly through CE's impact on the orthographic system. The findings suggest that adaptive cognitive interventions designed to improve reading-related outcomes in children with ADHD may benefit by including modules that train CE and orthographic conversion processes independently and interactively.

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

Science.gov (United States)

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

International Nuclear Information System (INIS)

Hong, Julian C.; Kruser, Tim J.; Gondi, Vinai; Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M.; Bentzen, Søren M.

2013-01-01

Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients

Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

Energy Technology Data Exchange (ETDEWEB)

Hong, Julian C.; Kruser, Tim J. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Gondi, Vinai [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Bentzen, Søren M., E-mail: bentzen@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States)

2013-10-01

Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients.

Risk of Adverse Cardiac and Bleeding Events Following Cardiac and Noncardiac Surgery in Patients With Coronary Stent: How Important Is the Interplay Between Stent Type and Time From Stenting to Surgery?

Science.gov (United States)

Saia, Francesco; Belotti, Laura Maria Beatrice; Guastaroba, Paolo; Berardini, Alessandra; Rossini, Roberta; Musumeci, Giuseppe; Tarantini, Giuseppe; Campo, Gianluca; Guiducci, Vincenzo; Tarantino, Fabio; Menozzi, Alberto; Varani, Elisabetta; Santarelli, Andrea; Tondi, Stefano; De Palma, Rossana; Rapezzi, Claudio; Marzocchi, Antonio

2016-01-01

Epidemiology and consequences of surgery in patients with coronary stents are not clearly defined, as well as the impact of different stent types in relationship with timing of surgery. Among 39 362 patients with previous coronary stenting enrolled in a multicenter prospective registry and followed for 5 years, 13 128 patients underwent 17 226 surgical procedures. The cumulative incidence of surgery at 30 days, 6 months, 1 year, and 5 years was 3.6%, 9.4%, 14.3%, and 40.0%, respectively, and of cardiac and noncardiac surgery was 0.8%, 2.1%, 2.6%, and 4.0% and 1.3%, 5.1%, 9.1%, and 31.7%, respectively. We assessed the incidence and the predictors of cardiac death, myocardial infarction, and serious bleeding event within 30 days from surgery. Cardiac death occurred in 438 patients (2.5%), myocardial infarction in 256 (1.5%), and serious bleeding event in 1099 (6.4%). Surgery increased 1.58× the risk of cardiac death during follow-up. Along with other risk factors, the interplay between stent type and time from percutaneous coronary intervention to surgery was independently associated with cardiac death/myocardial infarction. In comparison with bare-metal stent implanted >12 months before surgery, old-generation drug-eluting stent was associated with higher risk of events at any time point. Conversely, new-generation drug-eluting stent showed similar safety as bare-metal stent >12 months and between 6 and 12 months and appeared trendly safer between 0 and 6 months. Surgery is frequent in patients with coronary stents and carries a considerable risk of ischemic and bleeding events. Ischemic risk is inversely related with time from percutaneous coronary intervention to surgery and is influenced by stent type. © 2015 American Heart Association, Inc.

Porting plasma physics simulation codes to modern computing architectures using the libmrc framework

Science.gov (United States)

Germaschewski, Kai; Abbott, Stephen

2015-11-01

Available computing power has continued to grow exponentially even after single-core performance satured in the last decade. The increase has since been driven by more parallelism, both using more cores and having more parallelism in each core, e.g. in GPUs and Intel Xeon Phi. Adapting existing plasma physics codes is challenging, in particular as there is no single programming model that covers current and future architectures. We will introduce the open-source libmrc framework that has been used to modularize and port three plasma physics codes: The extended MHD code MRCv3 with implicit time integration and curvilinear grids; the OpenGGCM global magnetosphere model; and the particle-in-cell code PSC. libmrc consolidates basic functionality needed for simulations based on structured grids (I/O, load balancing, time integrators), and also introduces a parallel object model that makes it possible to maintain multiple implementations of computational kernels, on e.g. conventional processors and GPUs. It handles data layout conversions and enables us to port performance-critical parts of a code to a new architecture step-by-step, while the rest of the code can remain unchanged. We will show examples of the performance gains and some physics applications.

Key textbooks in the development of modern american plastic surgery: the first half of the twentieth century.

Science.gov (United States)

Haddock, Nicholas T; McCarthy, Joseph G

2013-07-01

A number of historical texts published during the first half of the twentieth century played a pivotal role in shaping and defining modern plastic surgery in the United States. Blair's Surgery and Diseases of the Mouth and Jaws (1912), John Staige Davis's Plastic Surgery: Its Principles and Practice (1919), Gillies's Plastic Surgery of the Face (1920), Fomon's Surgery of Injury and Plastic Repair (1939), Ivy's Manual of Standard Practice of Plastic and Maxillofacial Surgery, Military Surgery Manuals (1943), Padgett and Stephenson's Plastic and Reconstructive Surgery (1948), and Kazanjian and Converse's The Surgical Treatment of Facial Injuries (1949) were reviewed. These texts were published at a time when plastic surgery was developing as a distinct specialty. Each work represents a different point in this evolution. All were not inclusive of all of plastic surgery, but all had a lasting impact. Four texts were based on clinical experience from World War I; one included experience from World War II; and two included experience from both. One text became a military surgical handbook in World Wars I and II, playing an important role in care for the wounded. History has demonstrated that times of war spark medical/surgical advancements, and these wars had a dramatic impact on the development of reconstructive plastic surgery. Each of these texts documented surgical advancements and provided an intellectual platform that helped shape and create the independent discipline of plastic surgery during peacetime. For many future leaders of plastic surgery, these books served as their introduction to this new field.

A model for a career in a specialty of general surgery: One surgeon's opinion.

Science.gov (United States)

Ko, Bona; McHenry, Christopher R

2018-01-01

The integration of general and endocrine surgery was studied as a potential career model for fellowship trained general surgeons. Case logs collected from 1991-2016 and academic milestones were examined for a single general surgeon with a focused interest in endocrine surgery. Operations were categorized using CPT codes and the 2017 ACGME "Major Case Categories" and there frequencies were determined. 10,324 operations were performed on 8209 patients. 412.9 ± 84.9 operations were performed yearly including 279.3 ± 42.7 general and 133.7 ± 65.5 endocrine operations. A high-volume endocrine surgery practice and a rank of tenured professor were achieved by years 11 and 13, respectively. At year 25, the frequency of endocrine operations exceeded general surgery operations. Maintaining a foundation in broad-based general surgery with a specialty focus is a sustainable career model. Residents and fellows can use the model to help plan their careers with realistic expectations. Copyright © 2017. Published by Elsevier Inc.

Computers and conversation

CERN Document Server

Luff, Paul; Gilbert, Nigel G

1986-01-01

In the past few years a branch of sociology, conversation analysis, has begun to have a significant impact on the design of human*b1computer interaction (HCI). The investigation of human*b1human dialogue has emerged as a fruitful foundation for interactive system design.****This book includes eleven original chapters by leading researchers who are applying conversation analysis to HCI. The fundamentals of conversation analysis are outlined, a number of systems are described, and a critical view of their value for HCI is offered.****Computers and Conversation will be of interest to all concerne

A code MOGRA for predicting and assessing the migration of ground additions

International Nuclear Information System (INIS)

Amano, Hikaru; Atarashi-Andoh, Mariko; Uchida, Shigeo; Matsuoka, Syungo; Ikeda, Hiroshi; Hayashi, Hiroko; Kurosawa, Naohiro

2004-01-01

The environment should be protected from the toxic effects of not only ionizing radiation but also any other environmental load materials. A Code MOGRA (Migration Of GRound Additions) is a migration prediction code for toxic ground additions including radioactive materials in a terrestrial environment, which consists of computational codes that are applicable to various evaluation target systems, and can be used on personal computers for not only the purpose of the migration analysis but also the environmental assessment to livings of the environmental load materials. The functionality of MOGRA has been verified by applying it in the analyses of the migration rates of radioactive substances from the atmosphere to soils and plants and flow rates into the rivers. Migration of radionuclides in combinations of hypothetical various land utilization areas was also verified. The system can analyze the dynamic changes of target radionuclide's concentrations in each compartment, fluxes from one compartment to another compartment. The code MOGRA has varieties of databases, which is included in an additional code MOGRA-DB. This additional code MOGRA-DB consists of radionuclides decay chart, distribution coefficients between solid and liquid, transfer factors from soil to plant, transfer coefficients from feed to beef and milk, concentration factors, and age dependent dose conversion factors for many radionuclides. Another additional code MOGRA-MAP can take in graphic map such as JPEG, TIFF, BITMAP, and GIF files, and calculate the square measure of the target land. (author)

Difficulties in laparoscopic cholecystectomy: conversion versus surgeon's failure

International Nuclear Information System (INIS)

Ali, A.; Saeed, S.; Khawaja, R.; Samnani, S.S

2017-01-01

Laparoscopic cholecystectomy is considered to be gold standard treatment for symptomatic gall stones. Despite several benefits there are still disadvantages of laparoscopic cholecystectomy in difficult cases where anatomy is disturbed even in experienced hand. Aim of this study is to identify advantages of early conversion to open cholecystectomy in difficult cases and how it should not be associated with surgeon's failure. Methods: Observational study was conducted at tertiary care hospital of Karachi, Pakistan from January 2012 till June 2015. All patients who presented to general surgery department with symptomatic gall stones and planned for laparoscopic cholecystectomy was included in the study. Demographic data was collected. Preoperative workup includes baselines investigations with liver profile test and imaging study (ultrasound scan). All patient underwent laparoscopic cholecystectomy at first. Operative difficulties, incidence of conversion, reason for conversion and complication intra-operative or postoperative were recorded. Data was analyzed using SPSS 20. Results: Out of 1026 patients, 78.26 percent (803) were female. Mean age of patients were 41.30+-8.43 years (range 26-68 years). Common presenting symptoms were pain at upper abdomen and dyspepsia. Most of the patients had multiple gall stones (93.85 percent). Nine hundred and ninety-two patients (96.68 percent) of patients underwent successful laparoscopic cholecystectomy. This includes patients in whom dissections were difficult because of disturbed anatomy of calots triangle. Only 3.13 percent of patients were converted to open cholecystectomy. There was a significant difference (<0.05) in complications observed between completed and converted cholecystectomies. Conclusion: Conversion from laparoscopic to open procedure should be done in cases of technically difficult situations to avoid significant mortality and morbidity. Surgeons experience had a pivotal role in determining its need and

Evaluation Codes from an Affine Veriety Code Perspective

DEFF Research Database (Denmark)

Geil, Hans Olav

2008-01-01

Evaluation codes (also called order domain codes) are traditionally introduced as generalized one-point geometric Goppa codes. In the present paper we will give a new point of view on evaluation codes by introducing them instead as particular nice examples of affine variety codes. Our study...... includes a reformulation of the usual methods to estimate the minimum distances of evaluation codes into the setting of affine variety codes. Finally we describe the connection to the theory of one-pointgeometric Goppa codes. Contents 4.1 Introduction...... . . . . . . . . . . . . . . . . . . . . . . . 171 4.9 Codes form order domains . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 4.10 One-point geometric Goppa codes . . . . . . . . . . . . . . . . . . . . . . . . 176 4.11 Bibliographical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 References...

Suture Coding: A Novel Educational Guide for Suture Patterns.

Science.gov (United States)

Gaber, Mohamed; Abdel-Wahed, Ramadan

2015-01-01

This study aims to provide a helpful guide to perform tissue suturing successfully using suture coding-a method for identification of suture patterns and techniques by giving full information about the method of application of each pattern using numbers and symbols. Suture coding helps construct an infrastructure for surgical suture science. It facilitates the easy understanding and learning of suturing techniques and patterns as well as detects the relationship between the different patterns. Guide points are fixed on both edges of the wound to act as a guideline to help practice suture pattern techniques. The arrangement is fixed as 1-3-5-7 and a-c-e-g on one side (whether right or left) and as 2-4-6-8 and b-d-f-h on the other side. Needle placement must start from number 1 or letter "a" and continue to follow the code till the end of the stitching. Some rules are created to be adopted for the application of suture coding. A suture trainer containing guide points that simulate the coding process is used to facilitate the learning of the coding method. (120) Is the code of simple interrupted suture pattern; (ab210) is the code of vertical mattress suture pattern, and (013465)²/3 is the code of Cushing suture pattern. (0A1) Is suggested as a surgical suture language that gives the name and type of the suture pattern used to facilitate its identification. All suture patterns known in the world should start with (0), (A), or (1). There is a relationship between 2 or more surgical patterns according to their codes. It can be concluded that every suture pattern has its own code that helps in the identification of its type, structure, and method of application. Combination between numbers and symbols helps in the understanding of suture techniques easily without complication. There are specific relationships that can be identified between different suture patterns. Coding methods facilitate suture patterns learning process. The use of suture coding can be a good

SolTrace: A Ray-Tracing Code for Complex Solar Optical Systems

Energy Technology Data Exchange (ETDEWEB)

Wendelin, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Dobos, Aron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lewandowski, Allan [Allan Lewandowski Solar Consulting LLC, Evergreen, CO (United States)

2013-10-01

SolTrace is an optical simulation tool designed to model optical systems used in concentrating solar power (CSP) applications. The code was first written in early 2003, but has seen significant modifications and changes since its inception, including conversion from a Pascal-based software development platform to C++. SolTrace is unique in that it can model virtually any optical system utilizingthe sun as the source. It has been made available for free and as such is in use worldwide by industry, universities, and research laboratories. The fundamental design of the code is discussed, including enhancements and improvements over the earlier version. Comparisons are made with other optical modeling tools, both non-commercial and commercial in nature. Finally, modeled results are shownfor some typical CSP systems and, in one case, compared to measured optical data.

Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists.

Science.gov (United States)

Blikkendaal, Mathijs D; Twijnstra, Andries R H; Stiggelbout, Anne M; Beerlage, Harrie P; Bemelman, Willem A; Jansen, Frank Willem

2013-12-01

In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a uniform definition of conversion. On the basis of definitions currently used in the literature, a web-based Delphi consensus study was conducted among members of all four Dutch endoscopic societies. The rate of agreement (RoA) was calculated; a RoA of >70% suggested consensus. The survey was completed by 268 respondents in the first Delphi round (response rate, 45.6%); 43% were general surgeons, 49% gynecologists, and 8% urologists. Average ± standard deviation laparoscopic experience was 12.5 ± 7.2 years. On the basis of the results of round 1, a consensus definition was compiled. Conversion to laparotomy is an intraoperative switch from a laparoscopic to an open abdominal approach that meets the criteria of one of the two subtypes: strategic conversion, a standard laparotomy that is made directly after the assessment of the feasibility of completing the procedure laparoscopically and because of anticipated operative difficulty or logistic considerations; and reactive conversion, the need for a laparotomy because of a complication or (extension of an incision) because of (anticipated) operative difficulty after a considerable amount of dissection (i.e., >15 min in time). A laparotomy after a diagnostic laparoscopy (i.e., to assess the curability of the disease) should not be considered a conversion. In the second Delphi round, a RoA of 90% was achieved with this definition. After two Delphi rounds, consensus on a uniform multidisciplinary definition of conversion was achieved within a representative group of general surgeons, gynecologists, and urologists. An unambiguous interpretation will result in a more reliable clinical registration of conversion and scientific

Identifying Adverse Events Using International Classification of Diseases, Tenth Revision Y Codes in Korea: A Cross-sectional Study

Directory of Open Access Journals (Sweden)

Minsu Ock

2018-01-01

Full Text Available Objectives The use of administrative data is an affordable alternative to conducting a difficult large-scale medical-record review to estimate the scale of adverse events. We identified adverse events from 2002 to 2013 on the national level in Korea, using International Classification of Diseases, tenth revision (ICD-10 Y codes. Methods We used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC. We relied on medical treatment databases to extract information on ICD-10 Y codes from each participant in the NHIS-NSC. We classified adverse events in the ICD-10 Y codes into 6 types: those related to drugs, transfusions, and fluids; those related to vaccines and immunoglobulin; those related to surgery and procedures; those related to infections; those related to devices; and others. Results Over 12 years, a total of 20 817 adverse events were identified using ICD-10 Y codes, and the estimated total adverse event rate was 0.20%. Between 2002 and 2013, the total number of such events increased by 131.3%, from 1366 in 2002 to 3159 in 2013. The total rate increased by 103.9%, from 0.17% in 2002 to 0.35% in 2013. Events related to drugs, transfusions, and fluids were the most common (19 446, 93.4%, followed by those related to surgery and procedures (1209, 5.8% and those related to vaccines and immunoglobulin (72, 0.3%. Conclusions Based on a comparison with the results of other studies, the total adverse event rate in this study was significantly underestimated. Improving coding practices for ICD-10 Y codes is necessary to precisely monitor the scale of adverse events in Korea.

Conversations and Chimneypieces: the imagery of the hearth in eighteenth-century English family portraiture

Directory of Open Access Journals (Sweden)

Matthew Craske

2016-04-01

Full Text Available This is a study of the conventional settings that were employed by painters of conversation piece portraits in eighteenth-century England. The focus is upon the placement of groups “in conversation” around the hearth, in front of a chimney piece. My argument is that this situation was commonly used because it was understood that the hearth was a desirable place at which to greet one’s guests. I suggest that one of the main functions of the hearth conversation piece was to replicate the experience of meeting hosts who had placed themselves in a highly appropriate location. The main argument here is that this type of portrait generally replicated the experience of a private greeting. I suggest that this type of picture points to the strong connection between conversation piece portraits and rituals of hospitality. Hearth conversations were, it is argued here, not likely to be acts of conspicuous consumption. Similarly, it is unlikely that they functioned to project codes of politeness, as sometimes argued. These pictures undoubtedly reflect notions of good or polite behaviour, particularly as regarded the meeting and greeting of guests. It is, I suggest, open to question whether they were ever intended to promulgate values.

A finite element simulation of biological conversion processes in landfills

International Nuclear Information System (INIS)

Robeck, M.; Ricken, T.; Widmann, R.

2011-01-01

Landfills are the most common way of waste disposal worldwide. Biological processes convert the organic material into an environmentally harmful landfill gas, which has an impact on the greenhouse effect. After the depositing of waste has been stopped, current conversion processes continue and emissions last for several decades and even up to 100 years and longer. A good prediction of these processes is of high importance for landfill operators as well as for authorities, but suitable models for a realistic description of landfill processes are rather poor. In order to take the strong coupled conversion processes into account, a constitutive three-dimensional model based on the multiphase Theory of Porous Media (TPM) has been developed at the University of Duisburg-Essen. The theoretical formulations are implemented in the finite element code FEAP. With the presented calculation concept we are able to simulate the coupled processes that occur in an actual landfill. The model's theoretical background and the results of the simulations as well as the meantime successfully performed simulation of a real landfill body will be shown in the following.

Elements of energy conversion

CERN Document Server

Russell, Charles R

2013-01-01

Elements of Energy Conversion brings together scattered information on the subject of energy conversion and presents it in terms of the fundamental thermodynamics that apply to energy conversion by any process. Emphasis is given to the development of the theory of heat engines because these are and will remain most important power sources. Descriptive material is then presented to provide elementary information on all important energy conversion devices. The book contains 10 chapters and opens with a discussion of forms of energy, energy sources and storage, and energy conversion. This is foll

External validation of the Cairns Prediction Model (CPM) to predict conversion from laparoscopic to open cholecystectomy.

Science.gov (United States)

Hu, Alan Shiun Yew; Donohue, Peter O'; Gunnarsson, Ronny K; de Costa, Alan

2018-03-14

Valid and user-friendly prediction models for conversion to open cholecystectomy allow for proper planning prior to surgery. The Cairns Prediction Model (CPM) has been in use clinically in the original study site for the past three years, but has not been tested at other sites. A retrospective, single-centred study collected ultrasonic measurements and clinical variables alongside with conversion status from consecutive patients who underwent laparoscopic cholecystectomy from 2013 to 2016 in The Townsville Hospital, North Queensland, Australia. An area under the curve (AUC) was calculated to externally validate of the CPM. Conversion was necessary in 43 (4.2%) out of 1035 patients. External validation showed an area under the curve of 0.87 (95% CI 0.82-0.93, p = 1.1 × 10 -14 ). In comparison with most previously published models, which have an AUC of approximately 0.80 or less, the CPM has the highest AUC of all published prediction models both for internal and external validation. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Conversion of control systems, protection and engineering safeguard system signals of Almaraz NPP model from RELAP5 into TRAC-M

International Nuclear Information System (INIS)

Mulas, J.; Queral, C.; Collazo, I.; Concejal, A.; Burbano, N.; Lopez Lechas, A.; Tarrega, I.

2002-01-01

In the scope of a joint project between the Spanish Regulatory Commission (CSN) and the electric energy industry of Spain (UNESA) about the USNRC state-of-art thermal hydraulic code, TRAC-M, there is a task relating to the translation of the Spanish NPP models from other TH codes to the new one. As a part of this project, our team is working on the translation of Almaraz NPP model from RELAP5/MOD3.2 to TRAC-M. One of the goals of the project is to analyze the conversion of control blocks, signal variables and trips in order to correct modelling all instrumentation and control systems, and also protection and engineering safeguard system-signals of the NPP. At present, several portions of the input deck have been converted to TRAC-M, and the output data have also been compared with RELAP5 data. This paper describes the problems found in the conversion and the solutions achieved.(author)

An Optimal Linear Coding for Index Coding Problem

OpenAIRE

Pezeshkpour, Pouya

2015-01-01

An optimal linear coding solution for index coding problem is established. Instead of network coding approach by focus on graph theoric and algebraic methods a linear coding program for solving both unicast and groupcast index coding problem is presented. The coding is proved to be the optimal solution from the linear perspective and can be easily utilize for any number of messages. The importance of this work is lying mostly on the usage of the presented coding in the groupcast index coding ...

Use of Hip Arthroscopy and Risk of Conversion to Total Hip Arthroplasty: A Population-Based Analysis.

Science.gov (United States)

Schairer, William W; Nwachukwu, Benedict U; McCormick, Frank; Lyman, Stephen; Mayman, David

2016-04-01

To use population-level data to (1) evaluate the conversion rate of total hip arthroplasty (THA) within 2 years of hip arthroscopy and (2) assess the influence of age, arthritis, and obesity on the rate of conversion to THA. We used the State Ambulatory Surgery Databases and State Inpatient Databases for California and Florida from 2005 through 2012, which contain 100% of patient visits. Hip arthroscopy patients were tracked for subsequent primary THA within 2 years. Out-of-state patients and patients with less than 2 years follow-up were excluded. Multivariate analysis identified risks for subsequent hip arthroplasty after arthroscopy. We identified 7,351 patients who underwent hip arthroscopy with 2 years follow-up. The mean age was 43.9 ± 13.7 years, and 58.8% were female patients. Overall, 11.7% of patients underwent THA conversion within 2 years. The conversion rate was lowest in patients aged younger than 40 years (3.0%) and highest in the 60- to 69-year-old group (35.0%) (P arthroscopy. Patients treated at high-volume hip arthroscopy centers had a lower THA conversion rate than those treated at low-volume centers (15.1% v 9.7%, P arthroscopy is performed in patients of various ages, including middle-aged and elderly patients. Older patients have a higher rate of conversion to THA, as do patients with osteoarthritis or obesity. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Neutronic design of mixed oxide-silicide cores for the core conversion of rsg-gas reactor

International Nuclear Information System (INIS)

Sembiring, Tagor Malem; Tukiran; Pinem surian; Febrianto

2001-01-01

The core conversion of rsg-gas reactor from an all-oxide (U 3 O 8 -Al) core, through a series of mixed oxide-silicide core, to an all-silicide (U 3 Si 2 -Al) core for the same meat density of 2.96 g U/cc is in progress. The conversion is first step of the step-wise conversion and will be followed by the second step that is the core conversion from low meat density of silicide core, through a series of mixed lower-higher density of silicide core, to an all-higher meat density of 3.55 g/cc core. Therefore, the objectives of this work is to design the mixed cores on the neutronic performance to achieve safety a first full-silicide core for the reactor with the low uranium meat density of 2.96gU/cc. The neutronic design of the mixed cores was performed by means of Batan-EQUIL-2D and Batan-3DIFF computer codes for 2 and 3 dimension diffusion calculation, respectively. The result shows that all mixed oxide-silicide cores will be feasible to achieve safety a fist full-silicide core. The core performs the same neutronic core parameters as those of the equilibrium silicide core. Therefore, the reactor availability and utilization during the core conversion is not changed

Covering bariatric surgery has minimal effect on insurance premium costs within the Affordable Care Act.

Science.gov (United States)

English, Wayne; Williams, Brandon; Scott, John; Morton, John

2016-06-01

Currently, of the 51 state health exchanges operating under the Affordable Care Act, only 23 include benchmark plans that cover bariatric surgery coverage. Bariatric surgery coverage is not considered an essential health benefit in 28 state exchanges, and this lack of coverage has a discriminatory and detrimental impact on millions of Americans participating in state exchanges that do not provide bariatric surgery coverage. We examined 3 state exchanges in which a portion of their plans provided coverage for bariatric surgery to determine if bariatric surgery coverage is correlated with premium costs. State health exchanges; United States. Data from the 2015 state exchange plans were analyzed using information from the Centers for Medicare & Medicaid Services' Individual Market Landscape file and Benefits and Cost Sharing public use files. Only 3 states (Oklahoma, Oregon, and Virginia) in the analysis have 1 or more rating regions in which a portion of the plans cover bariatric surgery. In Oklahoma and Oregon, the average monthly premiums for all bronze, silver, and gold coverage levels are higher for plans covering bariatric surgery. Only 1 of these states included platinum plans that cover bariatric surgery. The average difference in premiums was between $1 to $45 higher in Oklahoma, and $18 to $32 higher in Oregon. Conversely, in Virginia, the average monthly premiums are between $2 and $21 lower for each level for plans covering bariatric surgery. Monthly premiums for plans covering versus not covering bariatric surgery ranged from 6% lower to 15% higher in the same geographic rating region. Across all 3 states in the sample, the average monthly premiums do not differ consistently on the basis of whether the state exchange plans cover bariatric surgery. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Robotic-assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials

Science.gov (United States)

2014-01-01

Background Robotic-assisted laparoscopy is popularly performed for colorectal disease. The objective of this meta-analysis was to compare the safety and efficacy of robotic-assisted colorectal surgery (RCS) and laparoscopic colorectal surgery (LCS) for colorectal disease based on randomized controlled trial studies. Methods Literature searches of electronic databases (Pubmed, Web of Science, and Cochrane Library) were performed to identify randomized controlled trial studies that compared the clinical or oncologic outcomes of RCS and LCS. This meta-analysis was performed using the Review Manager (RevMan) software (version 5.2) that is provided by the Cochrane Collaboration. The data used were mean differences and odds ratios for continuous and dichotomous variables, respectively. Fixed-effects or random-effects models were adopted according to heterogeneity. Results Four randomized controlled trial studies were identified for this meta-analysis. In total, 110 patients underwent RCS, and 116 patients underwent LCS. The results revealed that estimated blood losses (EBLs), conversion rates and times to the recovery of bowel function were significantly reduced following RCS compared with LCS. There were no significant differences in complication rates, lengths of hospital stays, proximal margins, distal margins or harvested lymph nodes between the two techniques. Conclusions RCS is a promising technique and is a safe and effective alternative to LCS for colorectal surgery. The advantages of RCS include reduced EBLs, lower conversion rates and shorter times to the recovery of bowel function. Further studies are required to define the financial effects of RCS and the effects of RCS on long-term oncologic outcomes. PMID:24767102

Iris recognition as a biometric method after cataract surgery

Directory of Open Access Journals (Sweden)

Roizenblatt Jaime

2004-01-01

Full Text Available Abstract Background Biometric methods are security technologies, which use human characteristics for personal identification. Iris recognition systems use iris textures as unique identifiers. This paper presents an analysis of the verification of iris identities after intra-ocular procedures, when individuals were enrolled before the surgery. Methods Fifty-five eyes from fifty-five patients had their irises enrolled before a cataract surgery was performed. They had their irises verified three times before and three times after the procedure, and the Hamming (mathematical distance of each identification trial was determined, in a controlled ideal biometric environment. The mathematical difference between the iris code before and after the surgery was also compared to a subjective evaluation of the iris anatomy alteration by an experienced surgeon. Results A correlation between visible subjective iris texture alteration and mathematical difference was verified. We found only six cases in which the eye was no more recognizable, but these eyes were later reenrolled. The main anatomical changes that were found in the new impostor eyes are described. Conclusions Cataract surgeries change iris textures in such a way that iris recognition systems, which perform mathematical comparisons of textural biometric features, are able to detect these changes and sometimes even discard a pre-enrolled iris considering it an impostor. In our study, re-enrollment proved to be a feasible procedure.

Left hepatic vein injury during laparoscopic antireflux surgery for large para-oesophageal hiatus hernia

Directory of Open Access Journals (Sweden)

Nagpal Anish

2009-01-01

Full Text Available Although the advent of laparoscopic fundoplication has increased both patient and physician acceptance of antireflux surgery, it has become apparent that the laparoscopic approach is associated with an increased risk of some complications and as well as the occurrence of new complications specific to this approach. One such complication occurred in our patient who had intra-operative left hepatic vein injury during laparoscopic floppy Nissen fundoplication for large para-oesophageal rolling hernia. With timely conversion to open procedure, the bleeding was controlled and the antireflux and the procedure were completed uneventfully. However, this suggests that even with an experience in advanced laparoscopy surgery, complications can occur. Clear understanding of the normal and pathologic anatomy and its variations facilitates laparoscopic surgery and should help the surgeon avoid complications. The incidence of some of these complications decreases as surgeons gain experience; however, new complications can arise due to the increase in such procedures.

Iterated multidimensional wave conversion

International Nuclear Information System (INIS)

Brizard, A. J.; Tracy, E. R.; Johnston, D.; Kaufman, A. N.; Richardson, A. S.; Zobin, N.

2011-01-01

Mode conversion can occur repeatedly in a two-dimensional cavity (e.g., the poloidal cross section of an axisymmetric tokamak). We report on two novel concepts that allow for a complete and global visualization of the ray evolution under iterated conversions. First, iterated conversion is discussed in terms of ray-induced maps from the two-dimensional conversion surface to itself (which can be visualized in terms of three-dimensional rooms). Second, the two-dimensional conversion surface is shown to possess a symplectic structure derived from Dirac constraints associated with the two dispersion surfaces of the interacting waves.

Validation of a continuous-energy Monte Carlo burn-up code MVP-BURN and its application to analysis of post irradiation experiment

International Nuclear Information System (INIS)

Okumura, Keisuke; Mori, Takamasa; Nakagawa, Masayuki; Kaneko, Kunio

2000-01-01

In order to confirm the reliability of a continuous-energy Monte Carlo burn-up calculation code MVP-BURN, it was applied to the burn-up benchmark problems for a high conversion LWR lattice and a BWR lattice with burnable poison rods. The results of MVP-BURN have shown good agreements with those of a deterministic code SRAC95 for burn-up changes of infinite neutron multiplication factor, conversion ratio, power distribution, and number densities of major fuel nuclides. Serious propagation of statistical errors along burn-up was not observed even in a highly heterogeneous lattice. MVP-BURN was applied to the analysis of a post irradiation experiment for a sample fuel irradiated up to 34.1 GWd/t, together with SRAC95 and SWAT. It was confirmed that the effect of statistical errors of MVP-BURN on a burned fuel composition was sufficiently small, and it could give a reference solution for other codes. In the analysis, the results of the three codes with JENDL-3.2 agreed with measured values within an error of 10% for most nuclides. However, large underestimation by about 20% was observed for 238 Pu, 242m Am and 244 Cm. It is probable that these discrepancies are a common problem for most current nuclear data files. (author)

Corrective Jaw Surgery

Medline Plus

Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

Notes on the Mesh Handler and Mesh Data Conversion

International Nuclear Information System (INIS)

Lee, Sang Yong; Park, Chan Eok

2009-01-01

At the outset of the development of the thermal-hydraulic code (THC), efforts have been made to utilize the recent technology of the computational fluid dynamics. Among many of them, the unstructured mesh approach was adopted to alleviate the restriction of the grid handling system. As a natural consequence, a mesh handler (MH) has been developed to manipulate the complex mesh data from the mesh generator. The mesh generator, Gambit, was chosen at the beginning of the development of the code. But a new mesh generator, Pointwise, was introduced to get more flexible mesh generation capability. An open source code, Paraview, was chosen as a post processor, which can handle unstructured as well as structured mesh data. Overall data processing system for THC is shown in Figure-1. There are various file formats to save the mesh data in the permanent storage media. A couple of dozen of file formats are found even in the above mentioned programs. A competent mesh handler should have the capability to import or export mesh data as many as possible formats. But, in reality, there are two aspects that make it difficult to achieve the competence. The first aspect to consider is the time and efforts to program the interface code. And the second aspect, which is even more difficult one, is the fact that many mesh data file formats are proprietary information. In this paper, some experience of the development of the format conversion programs will be presented. File formats involved are Gambit neutral format, Ansys-CFX grid file format, VTK legacy file format, Nastran format and CGNS

Design and analysis of Helium Brayton cycle for energy conversion system of RGTT200K

International Nuclear Information System (INIS)

Ignatius Djoko Irianto

2016-01-01

The helium Brayton cycle for the design of cogeneration energy conversion system for RGTT200K have been analyzed to obtain the higher thermal efficiency and energy utilization factor. The aim of this research is to analyze the potential of the helium Brayton cycle to be implemented in the design of cogeneration energy conversion system of RGTT200K. Three configuration models of cogeneration energy conversion systems have been investigated. In the first configuration model, an intermediate heat exchanger (IHX) is installed in series with the gas turbine, while in the second configuration model, IHX and gas turbines are installed in parallel. The third configuration model is similar to the first configuration, but with two compressors. Performance analysis of Brayton cycle used for cogeneration energy conversion system of RGTT200K has been done by simulating and calculating using CHEMCAD code. The simulation result shows that the three configuration models of cogeneration energy conversion system give the temperature of thermal energy in the secondary side of IHX more than 800 °C at the reactor coolant mass flow rate of 145 kg/s. Nevertheless, the performance parameters, which include thermal efficiency and energy utilization factor (EUF), are different for each configuration model. By comparing the performance parameter in the three configurations of helium Brayton cycle for cogeneration energy conversion systems RGTT200K, it is found that the energy conversion system with a first configuration has the highest thermal efficiency and energy utilization factor (EUF). Thermal efficiency and energy utilization factor for the first configuration of the reactor coolant mass flow rate of 145 kg/s are 35.82 % and 80.63 %. (author)

Physics and safety studies of a low conversion ratio sodium cooled fast reactor

International Nuclear Information System (INIS)

Cahalan, J. E.; Smith, M. A.; Hill, R. N.; Dunn, F. E.

2004-01-01

This paper explores the feasibility of a compact fast burner reactor that can achieve a low transuranic conversion ratio. The major design option considered is the reduction of fissile breeding by the removal of fertile material from the fast reactor system. Reductions in the fuel pin diameter and thus fuel loading were employed to remove fertile material. Reactor performance parameters and reactivity coefficients were evaluated for a compact core design with a targeted conversion ratio of 0.25. To assess the safety implications, a detailed transient analysis model was employed using the SAS4A/SASSYS-1 computer code. A series of calculations was performed to assess the behavior of the reactor and plant in an unprotected loss-of-flow accident (ULOF). A parametric study was also carried out using increasingly conservative modeling assumptions. The computational results show that for nominal, best-estimate analysis assumptions and input data, the low conversion ratio reactor design responds to the ULOF with a very high level of self-protection. Both short-term and long-term quasi-equilibrium reactor conditions predicted in the analysis indicate very large margins of safety. (authors)

Fundamentals of the DIGES code

Energy Technology Data Exchange (ETDEWEB)

Simos, N.; Philippacopoulos, A.J.

1994-08-01

Recently the authors have completed the development of the DIGES code (Direct GEneration of Spectra) for the US Nuclear Regulatory Commission. This paper presents the fundamental theoretical aspects of the code. The basic modeling involves a representation of typical building-foundation configurations as multi degree-of-freedom dynamic which are subjected to dynamic inputs in the form of applied forces or pressure at the superstructure or in the form of ground motions. Both the deterministic as well as the probabilistic aspects of DIGES are described. Alternate ways of defining the seismic input for the estimation of in-structure spectra and their consequences in terms of realistically appraising the variability of the structural response is discussed in detaiL These include definitions of the seismic input by ground acceleration time histories, ground response spectra, Fourier amplitude spectra or power spectral densities. Conversions of one of these forms to another due to requirements imposed by certain analysis techniques have been shown to lead, in certain cases, in controversial results. Further considerations include the definition of the seismic input as the excitation which is directly applied at the foundation of a structure or as the ground motion of the site of interest at a given point. In the latter case issues related to the transferring of this motion to the foundation through convolution/deconvolution and generally through kinematic interaction approaches are considered.

Outcomes of minimally invasive strabismus surgery for horizontal deviation.

Science.gov (United States)

Merino, P; Blanco Domínguez, I; Gómez de Liaño, P

2016-02-01

To study the outcomes of minimally invasive strabismus surgery (MISS) for treating horizontal deviation Case Series of the first 26 consecutive patients operated on using the MISS technique in our hospital from February 2010 to March 2014. A total of 40 eyes were included: 26 patients (mean age: 7.7 years old ± 4.9); 34.61%: male. A total of 43 muscles were operated on: 20 medial, and 23 lateral recti; 28 recessions (range: 3-7.5mm), 6 resections (6-7 mm), and 9 plications (6.5-7.5 mm) were performed. No significant difference was found (P>0.05) for visual acuity at postoperative day 1, and 6 months after surgery. A mild hyperaemia was observed in 29.27%, moderate in 48.78%, and severe in 21.95% at postoperative day 1 and in 63.41%, 31.70% and 4.87%, respectively, at 4 days after surgery. The complications observed were 4 intraoperative conjunctival haemorrhages, 1 scleral perforation, and 2 Tenon's prolapses. A conversion from MISS to a fornix approach was necessary in 1 patient because of bad visualization. The operating time range decreased from 30 to 15 minutes. The MISS technique has obtained good results in horizontal strabismus surgery. The conjunctival inflammation was mild in most of the cases at postoperative day 4. The visual acuity was stable during follow-up, and operating time decreased after a 4-year learning curve. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Cancer risk coefficient for patient undergoing kyphoplasty surgery using Monte Carlo method

Science.gov (United States)

Santos, Felipe A.; Santos, William S.; Galeano, Diego C.; Cavalcante, Fernanda R.; Silva, Ademir X.; Souza, Susana O.; Júnior, Albérico B. Carvalho

2017-11-01

Kyphoplasty surgery is widely used for pain relief in patients with vertebral compression fracture (VCF). For this surgery, an X-ray emitter that provides real-time imaging is employed to guide the medical instruments and the surgical cement used to fill and strengthen the vertebra. Equivalent and effective doses related to high temporal resolution equipment has been studied to assess the damage and more recently cancer risk. For this study, a virtual scenario was prepared using MCNPX code and a pair of UF family simulators. Two projections with seven tube voltages for each one were simulated. The organ in the abdominal region were those who had higher cancer risk because they receive the primary beam. The risk of lethal cancer is on average 20% higher in AP projection than in LL projection. This study aims at estimating the risk of cancer in organs and the risk of lethal cancer for patient submitted to kyphoplasty surgery.

[History of cranial surgery, cerebral tumor surgery and epilepsy surgery in Mexico].

Science.gov (United States)

Chico-Ponce de León, F

2009-08-01

The first report of intra-cerebral tumor surgery was provided by Bennett & Goodle, in London, 1884. Worldwide this kind of surgery was performed in France by Chipault, in Italy by Durante, in the United States by Keen and in Deutchland by Krause & Oppenheim. Lavista in Mexico City operated on intra-cerebral tumor in 1891, and the report was printed in 1892. In the same publication, Lavista exhibited the first cases of epilepsy surgery. Since now, it is the first report of this kind of surgery in the Spanish-speaking world.

Amplitude-to-code converter for photomultipliers operating at high loadings

International Nuclear Information System (INIS)

Arkhangel'skij, B.V.; Evgrafov, G.N.; Pishchal'nikov, Yu.M.; Shuvalov, R.S.

1982-01-01

An 11-bit amplitude-to-code converter intended for the analysis of photomultiplier pulses under high loadings is described. To decrease the volume of digit electronics in the converter an analog memory on capacities is envisaged. A well-known bridge circuit with diodes on the main carriers is selected as a gating circuit. The gate control is realized by a switching circuit on fast-response transistors with boundary frequency of 1.2-1.5 GHz. The converter main characteristics are given, namely, maximum output signal amplitude equal to -1.5 V, minimum pulse selection duration of 10 ns, maximum number of counts at Usub(input)=-1.0 V and tsub(selection)=50 ns amounting to 1400, integral nonlinearity of +-0.1%, conversion temperature instability of 0.2%/deg C in the temperature range of (+10-+40) deg C, maximum time of data storage equal to 300 ms, conversion coefficient instability of 0.42 counts, number of channels in a unit CAMAC block equal to 12

Late Causes of Death After Pediatric Cardiac Surgery: A 60-Year Population-Based Study.

Science.gov (United States)

Raissadati, Alireza; Nieminen, Heta; Haukka, Jari; Sairanen, Heikki; Jokinen, Eero

2016-08-02

Comprehensive information regarding causes of late post-operative death following pediatric congenital cardiac surgery is lacking. The study sought to analyze late causes of death after congenital cardiac surgery by era and defect severity. We obtained data from a nationwide pediatric cardiac surgery database and Finnish population registry regarding patients who underwent cardiac surgery at Causes of death were determined using International Classification of Diseases diagnostic codes. Deaths among the study population were compared to a matched control population. Overall, 10,964 patients underwent 14,079 operations, with 98% follow-up. Early mortality (death rates correlated with defect severity. Heart failure was the most common mode of CHD-related death, but decreased after surgeries performed between 1990 and 2009. Sudden death after surgery for atrial septal defect, ventricular septal defect, tetralogy of Fallot, and transposition of the great arteries decreased to zero following operations from 1990 to 2009. Deaths from neoplasms, respiratory, neurological, and infectious disease were significantly more common among study patients than controls. Pneumonia caused the majority of non-CHD-related deaths among the study population. CHD-related deaths have decreased markedly but remain a challenge after surgery for severe cardiac defects. Premature deaths are generally more common among patients than the control population, warranting long-term follow-up after congenital cardiac surgery. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Introduction and preparation of the nuclear fuel cycle facility risk analysis code: STAR

International Nuclear Information System (INIS)

Nomura, Yasushi

1990-09-01

STAR code is a computer program, by which one can perform the probabilistic safety assessment (PSA) for the nuclear fuel cycle facility in both the normal and the accidental event of environmental radioactive material release. This code was originally developed by NUKEM GmbH in West Germany as a fruit of the PSE (Projekt Sicherheitsstudien Entsorgung) aiming at R and D of safety analysis methods for use in nuclear fuel cycle facilities such as reprocessing plants. In JAERI, efforts have been made to research and develop safety assessment methods applicable to the accidental situations assumed to happen in the reprocessing plants. In this line of objectives, the STAR code was introduced from NUKEM GmbH in 1986 and, since then, has been improved and prepared to add an ability to analyze public radiation exposure by released activities from the plants. At the first stage of this code preparation, the program conversion was made to adapt the STAR code, originally operative on IBM-compatible PC's and Hewlett Packard 7550A plotters, to NEC PC 9801RX and NEC PR 602R page printers installed in the Fuel Cycle Safety Assessment Laboratory of JAERI. This report describes calculational performances of the STAR code, results of the improvement and preparation works together with input/output data format in illustration of a sample HALW (High Activity Liquid Waste) tank PSA problem, thus making a users' manual for the STAR code. (author)

HADOC: a computer code for calculation of external and inhalation doses from acute radionuclide releases

International Nuclear Information System (INIS)

Strenge, D.L.; Peloquin, R.A.

1981-04-01

The computer code HADOC (Hanford Acute Dose Calculations) is described and instructions for its use are presented. The code calculates external dose from air submersion and inhalation doses following acute radionuclide releases. Atmospheric dispersion is calculated using the Hanford model with options to determine maximum conditions. Building wake effects and terrain variation may also be considered. Doses are calculated using dose conversion factor supplied in a data library. Doses are reported for one and fifty year dose commitment periods for the maximum individual and the regional population (within 50 miles). The fractional contribution to dose by radionuclide and exposure mode are also printed if requested

Neural code alterations and abnormal time patterns in Parkinson’s disease

Science.gov (United States)

Andres, Daniela Sabrina; Cerquetti, Daniel; Merello, Marcelo

2015-04-01

Objective. The neural code used by the basal ganglia is a current question in neuroscience, relevant for the understanding of the pathophysiology of Parkinson’s disease. While a rate code is known to participate in the communication between the basal ganglia and the motor thalamus/cortex, different lines of evidence have also favored the presence of complex time patterns in the discharge of the basal ganglia. To gain insight into the way the basal ganglia code information, we studied the activity of the globus pallidus pars interna (GPi), an output node of the circuit. Approach. We implemented the 6-hydroxydopamine model of Parkinsonism in Sprague-Dawley rats, and recorded the spontaneous discharge of single GPi neurons, in head-restrained conditions at full alertness. Analyzing the temporal structure function, we looked for characteristic scales in the neuronal discharge of the GPi. Main results. At a low-scale, we observed the presence of dynamic processes, which allow the transmission of time patterns. Conversely, at a middle-scale, stochastic processes force the use of a rate code. Regarding the time patterns transmitted, we measured the word length and found that it is increased in Parkinson’s disease. Furthermore, it showed a positive correlation with the frequency of discharge, indicating that an exacerbation of this abnormal time pattern length can be expected, as the dopamine depletion progresses. Significance. We conclude that a rate code and a time pattern code can co-exist in the basal ganglia at different temporal scales. However, their normal balance is progressively altered and replaced by pathological time patterns in Parkinson’s disease.

Infrared up-conversion microscope

DEFF Research Database (Denmark)

2014-01-01

There is presented an up-conversion infrared microscope (110) arranged for imaging an associated object (130), wherein the up-conversion infrared microscope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein an objective optical...

Infrared up-conversion telescope

DEFF Research Database (Denmark)

2014-01-01

There is presented to an up-conversion infrared telescope (110) arranged for imaging an associated scene (130), wherein the up-conversion infrared telescope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein a first optical...

Open-source tool for automatic import of coded surveying data to multiple vector layers in GIS environment

Directory of Open Access Journals (Sweden)

Eva Stopková

2016-12-01

Full Text Available This paper deals with a tool that enables import of the coded data in a singletext file to more than one vector layers (including attribute tables, together withautomatic drawing of line and polygon objects and with optional conversion toCAD. Python script v.in.survey is available as an add-on for open-source softwareGRASS GIS (GRASS Development Team. The paper describes a case study basedon surveying at the archaeological mission at Tell-el Retaba (Egypt. Advantagesof the tool (e.g. significant optimization of surveying work and its limits (demandson keeping conventions for the points’ names coding are discussed here as well.Possibilities of future development are suggested (e.g. generalization of points’names coding or more complex attribute table creation.

Incidence and Risk Factors for Prolonged Hospitalization and Readmission after Transsphenoidal Pituitary Surgery.

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Bur, Andrés M; Brant, Jason A; Newman, Jason G; Hatten, Kyle M; Cannady, Steven B; Fischer, John P; Lee, John Y K; Adappa, Nithin D

2016-10-01

To evaluate the incidence and factors associated with 30-day readmission and to analyze risk factors for prolonged hospital length of stay following transsphenoidal pituitary surgery. Retrospective longitudinal claims analysis. American College of Surgeons National Surgical Quality Improvement Program. The database of the American College of Surgeons National Surgical Quality Improvement Program was queried for patients who underwent transsphenoidal pituitary surgery (Current Procedural Terminology code 61548 or 62165) between 2005 and 2014. Patient demographic information, indications for surgery, and incidence of hospital readmission and length of stay were reviewed. Risk factors for readmission and prolonged length of stay, defined as >75th percentile for the cohort, were identified through logistic regression modeling. A total of 1006 patients were included for analysis. Mean hospital length of stay after surgery was 4.1 ± 0.2 days. Predictors of prolonged length of stay were operative time (P surgery between 2012 and 2014, 7.2% (n = 38) required hospital readmission. History of congestive heart failure (CHF) was a predictor of hospital readmission (P = 0.03, OR = 12.7, 95% CI = 1.1-144.0). This review of a large validated surgical database demonstrates that CHF is an independent predictor of hospital readmission after transsphenoidal surgery. Although CHF is a known risk factor for postoperative complications, it poses unique challenges to patients with potential postoperative pituitary dysfunction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Rate-adaptive BCH codes for distributed source coding

DEFF Research Database (Denmark)

Salmistraro, Matteo; Larsen, Knud J.; Forchhammer, Søren

2013-01-01

This paper considers Bose-Chaudhuri-Hocquenghem (BCH) codes for distributed source coding. A feedback channel is employed to adapt the rate of the code during the decoding process. The focus is on codes with short block lengths for independently coding a binary source X and decoding it given its...... strategies for improving the reliability of the decoded result are analyzed, and methods for estimating the performance are proposed. In the analysis, noiseless feedback and noiseless communication are assumed. Simulation results show that rate-adaptive BCH codes achieve better performance than low...... correlated side information Y. The proposed codes have been analyzed in a high-correlation scenario, where the marginal probability of each symbol, Xi in X, given Y is highly skewed (unbalanced). Rate-adaptive BCH codes are presented and applied to distributed source coding. Adaptive and fixed checking...

The erasure of gender in academic surgery: a qualitative study.

Science.gov (United States)

Webster, Fiona; Rice, Kathleen; Christian, Jennifer; Seemann, Natashia; Baxter, Nancy; Moulton, Carol-Anne; Cil, Tulin

2016-10-01

The number of women in surgery has steadily increased, yet their numbers in academic surgery positions and in high-ranking leadership roles remain low. To create strategies to address and improve this problem, it is essential to examine how gender plays into the advancement of a woman's career in academic surgery. Focus group (1) and one-on-one qualitative interviews (8) were conducted with women academic surgeons from various subspecialties in a large university setting. Interviews examined women surgeons' accounts of their experiences as women in surgery. Audio-recorded data were transcribed verbatim and coded thematically. NVivo10 software was used for cross-referencing of data and categorization of data into themes. Focus group data suggested that gender discrimination was pervasive in academic surgery. However, in interviews, most interviewees strongly disavowed the possibility that their gender had any bearing on their professional lives. These surgeons attempted to distance themselves from the possibility of discrimination by suggesting that differences in men and women surgeons' experiences are due to personality issues and personal choices. However, their narratives highlighted deep contradiction; they both affirmed and denied the relevance of gender for their experience as surgeons. As overt acts of discrimination become less acceptable in society, it does not necessarily disappear but rather manifests itself in covert forms. By disavowing and distancing themselves from discrimination, these women exposed the degree to which these issues continue to be pervasive in surgery. Women surgeons' ability to both identify and resist discrimination was hobbled by narratives of individualism, gender equality, and normative ideas of gender difference. Copyright © 2016. Published by Elsevier Inc.

A Model for Conversation

DEFF Research Database (Denmark)

Ayres, Phil

2012-01-01

This essay discusses models. It examines what models are, the roles models perform and suggests various intentions that underlie their construction and use. It discusses how models act as a conversational partner, and how they support various forms of conversation within the conversational activity...

Age-dependent conversion coefficients for organ doses and effective doses for external neutron irradiation

International Nuclear Information System (INIS)

Nishizaki, Chihiro; Endo, Akira; Takahashi, Fumiaki

2006-06-01

To utilize dose assessment of the public for external neutron irradiation, conversion coefficients of absorbed doses of organs and effective doses were calculated using the numerical simulation technique for six different ages (adult, 15, 10, 5 and 1 years and newborn), which represent the member of the public. Calculations were performed using six age-specific anthropomorphic phantoms and a Monte Carlo radiation transport code for two irradiation geometries, anterior-posterior and rotational geometries, for 20 incident energies from thermal to 20 MeV. Effective doses defined by the 1990 Recommendation of ICRP were calculated from the absorbed doses in 21 organs. The calculated results were tabulated in the form of absorbed doses and effective doses per unit neutron fluence. The calculated conversion coefficients are used for dose assessment of the public around nuclear facilities and accelerator facilities. (author)

Nutrition adequacy in enhanced recovery after surgery: a single academic center experience.

Science.gov (United States)

Gillis, Chelsia; Nguyen, Thi Haiyen; Liberman, A Sender; Carli, Francesco

2015-06-01

A prospective observational study was initiated to determine the prevalence of nutrition risk before surgery and assess nutrition adequacy of food choices after elective colorectal surgery. Patient-Generated Subjective Global Assessment was used to screen all preoperative clinic patients (n = 70) scheduled for elective colorectal surgery. Adequacy of dietary intake (n = 40) was determined for the first 3 postoperative days by estimating total energy and protein intake from leftover food at each meal based on standard hospital portions with food composition tables. Food access questionnaire provided a rationale for observed food intake. All patients received Enhanced Recovery After Surgery (ERAS) and room service system care. Before surgery, 63% of patients were considered well-nourished, 29% suspected or moderately undernourished, and 8% severely undernourished. Fifty-one percent of patients scored > 4 on the Patient-Generated Subjective Global Assessment, indicating requirement for dietary intervention or symptom management. On average, 77% ± 27%, 63% ± 28%, and 92% ± 39% of energy requirements were met on postoperative days 1, 2, and 3, respectively; conversely, 55% ± 24%, 43% ± 16%, and 45% ± 12% of protein requirements were met. Most common reasons for missed meals included loss of appetite and feelings of fatigue or worry. Preoperative nutrition risk tended to result in a greater 30-day hospital readmission rate compared to well-nourished patients (P = .07). A third of patients scheduled for elective colorectal surgery were at nutrition risk. An acceptable intake of dietary protein was not achieved during the first 3 days of hospitalization. Preoperative nutrition education, as part of Enhanced Recovery Programs, may be useful to optimize nutrition status before surgery to mitigate clinical consequences associated with undernutrition and empower patients to make adequate food choices for recovery. NCT 01727570. © 2014 American Society for Parenteral and

Self-complementary circular codes in coding theory.

Science.gov (United States)

Fimmel, Elena; Michel, Christian J; Starman, Martin; Strüngmann, Lutz

2018-04-01

Self-complementary circular codes are involved in pairing genetic processes. A maximal [Formula: see text] self-complementary circular code X of trinucleotides was identified in genes of bacteria, archaea, eukaryotes, plasmids and viruses (Michel in Life 7(20):1-16 2017, J Theor Biol 380:156-177, 2015; Arquès and Michel in J Theor Biol 182:45-58 1996). In this paper, self-complementary circular codes are investigated using the graph theory approach recently formulated in Fimmel et al. (Philos Trans R Soc A 374:20150058, 2016). A directed graph [Formula: see text] associated with any code X mirrors the properties of the code. In the present paper, we demonstrate a necessary condition for the self-complementarity of an arbitrary code X in terms of the graph theory. The same condition has been proven to be sufficient for codes which are circular and of large size [Formula: see text] trinucleotides, in particular for maximal circular codes ([Formula: see text] trinucleotides). For codes of small-size [Formula: see text] trinucleotides, some very rare counterexamples have been constructed. Furthermore, the length and the structure of the longest paths in the graphs associated with the self-complementary circular codes are investigated. It has been proven that the longest paths in such graphs determine the reading frame for the self-complementary circular codes. By applying this result, the reading frame in any arbitrary sequence of trinucleotides is retrieved after at most 15 nucleotides, i.e., 5 consecutive trinucleotides, from the circular code X identified in genes. Thus, an X motif of a length of at least 15 nucleotides in an arbitrary sequence of trinucleotides (not necessarily all of them belonging to X) uniquely defines the reading (correct) frame, an important criterion for analyzing the X motifs in genes in the future.

Diagonal Eigenvalue Unity (DEU) code for spectral amplitude coding-optical code division multiple access

Science.gov (United States)

Ahmed, Hassan Yousif; Nisar, K. S.

2013-08-01

Code with ideal in-phase cross correlation (CC) and practical code length to support high number of users are required in spectral amplitude coding-optical code division multiple access (SAC-OCDMA) systems. SAC systems are getting more attractive in the field of OCDMA because of its ability to eliminate the influence of multiple access interference (MAI) and also suppress the effect of phase induced intensity noise (PIIN). In this paper, we have proposed new Diagonal Eigenvalue Unity (DEU) code families with ideal in-phase CC based on Jordan block matrix with simple algebraic ways. Four sets of DEU code families based on the code weight W and number of users N for the combination (even, even), (even, odd), (odd, odd) and (odd, even) are constructed. This combination gives DEU code more flexibility in selection of code weight and number of users. These features made this code a compelling candidate for future optical communication systems. Numerical results show that the proposed DEU system outperforms reported codes. In addition, simulation results taken from a commercial optical systems simulator, Virtual Photonic Instrument (VPI™) shown that, using point to multipoint transmission in passive optical network (PON), DEU has better performance and could support long span with high data rate.

Coding Strategies and Implementations of Compressive Sensing

Science.gov (United States)

Tsai, Tsung-Han

This dissertation studies the coding strategies of computational imaging to overcome the limitation of conventional sensing techniques. The information capacity of conventional sensing is limited by the physical properties of optics, such as aperture size, detector pixels, quantum efficiency, and sampling rate. These parameters determine the spatial, depth, spectral, temporal, and polarization sensitivity of each imager. To increase sensitivity in any dimension can significantly compromise the others. This research implements various coding strategies subject to optical multidimensional imaging and acoustic sensing in order to extend their sensing abilities. The proposed coding strategies combine hardware modification and signal processing to exploiting bandwidth and sensitivity from conventional sensors. We discuss the hardware architecture, compression strategies, sensing process modeling, and reconstruction algorithm of each sensing system. Optical multidimensional imaging measures three or more dimensional information of the optical signal. Traditional multidimensional imagers acquire extra dimensional information at the cost of degrading temporal or spatial resolution. Compressive multidimensional imaging multiplexes the transverse spatial, spectral, temporal, and polarization information on a two-dimensional (2D) detector. The corresponding spectral, temporal and polarization coding strategies adapt optics, electronic devices, and designed modulation techniques for multiplex measurement. This computational imaging technique provides multispectral, temporal super-resolution, and polarization imaging abilities with minimal loss in spatial resolution and noise level while maintaining or gaining higher temporal resolution. The experimental results prove that the appropriate coding strategies may improve hundreds times more sensing capacity. Human auditory system has the astonishing ability in localizing, tracking, and filtering the selected sound sources or

List Decoding of Matrix-Product Codes from nested codes: an application to Quasi-Cyclic codes

DEFF Research Database (Denmark)

Hernando, Fernando; Høholdt, Tom; Ruano, Diego

2012-01-01

A list decoding algorithm for matrix-product codes is provided when $C_1,..., C_s$ are nested linear codes and $A$ is a non-singular by columns matrix. We estimate the probability of getting more than one codeword as output when the constituent codes are Reed-Solomon codes. We extend this list...... decoding algorithm for matrix-product codes with polynomial units, which are quasi-cyclic codes. Furthermore, it allows us to consider unique decoding for matrix-product codes with polynomial units....

Bariatric surgery insurance requirements independently predict surgery dropout.

Science.gov (United States)

Love, Kaitlin M; Mehaffey, J Hunter; Safavian, Dana; Schirmer, Bruce; Malin, Steven K; Hallowell, Peter T; Kirby, Jennifer L

2017-05-01

Many insurance companies have considerable prebariatric surgery requirements despite a lack of evidence for improved clinical outcomes. The hypothesis of this study is that insurance-specific requirements will be associated with a decreased progression to surgery and increased delay in time to surgery. Retrospective data collection was performed for patients undergoing bariatric surgery evaluation from 2010-2015. Patients who underwent surgery (SGY; n = 827; mean body mass index [BMI] 49.1) were compared with those who did not (no-SGY; n = 648; mean BMI: 49.4). Univariate and multivariate analysis were performed to identify specific co-morbidity and insurance specific predictors of surgical dropout and time to surgery. A total of 1475 patients using 12 major insurance payors were included. Univariate analysis found insurance requirements associated with surgical drop out included longer median diet duration (no-SGY = 6 mo; SGY = 3 mo; Psurgery dropout. Additionally, surgical patients had an average interval between initial visit and surgery of 5.8±4.6 months with significant weight gain (2.1 kg, Psurgery insurance requirements were associated with lack of patient progression to surgery in this study. In addition, delays in surgery were associated with preoperative weight gain. Although prospective and multicenter studies are needed, these findings have major policy implications suggesting insurance requirements may need to be reconsidered to improve medical care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

An Integration of the Restructured Melcor for the Midas Computer Code

International Nuclear Information System (INIS)

Sunhee Park; Dong Ha Kim; Ko-Ryu Kim; Song-Won Cho

2006-01-01

The developmental need for a localized severe accident analysis code is on the rise. KAERI is developing a severe accident code called MIDAS, which is based on MELCOR. In order to develop the localized code (MIDAS) which simulates a severe accident in a nuclear power plant, the existing data structure is reconstructed for all the packages in MELCOR, which uses pointer variables for data transfer between the packages. During this process, new features in FORTRAN90 such as a dynamic allocation are used for an improved data saving and transferring method. Hence the readability, maintainability and portability of the MIDAS code have been enhanced. After the package-wise restructuring, the newly converted packages are integrated together. Depending on the data usage in the package, two types of packages can be defined: some use their own data within the package (let's call them independent packages) and the others share their data with other packages (dependent packages). For the independent packages, the integration process is simple to link the already converted packages together. That is, the package-wise structuring does not require further conversion of variables for the integration process. For the dependent packages, extra conversion is necessary to link them together. As the package-wise restructuring converts only the corresponding package's variables, other variables defined from other packages are not touched and remain as it is. These variables are to be converted into the new types of variables simultaneously as well as the main variables in the corresponding package. Then these dependent packages are ready for integration. In order to check whether the integration process is working well, the results from the integrated version are verified against the package-wise restructured results. Steady state runs and station blackout sequences are tested and the major variables are found to be the same each other. In order to verify the results, the integrated

Life history, code of honor, and emotional responses to inequality in an economic game.

Science.gov (United States)

Pedersen, Eric J; Forster, Daniel E; McCullough, Michael E

2014-10-01

The code of honor, which is characterized by a preoccupation with reputation and willingness to take retaliatory action, has been used extensively to explain individual and cultural differences in peoples' tendencies to behave aggressively. However, research on the relationship between the code of honor and emotional responses to social interactions has been limited in scope, focusing primarily on anger in response to insults and reputational threats. Here we broaden this scope by examining the relationship between code of honor and emotional reactions in response to an unfair economic exchange that resulted in unequal monetary earnings among 3 laboratory participants. We found that endorsement of the code of honor was related to anger and envy in response to unfair monetary distributions. Interestingly, code of honor predicted envy above and beyond what could be accounted for by anger, but the converse was not the case. This suggests that the code of honor influenced perceptions of how subjects viewed their own earnings relative to those of others, which consequently was responsible for their apparent anger as a result of the economic transaction. Furthermore, the unique relationship between code of honor and envy was present only for subjects who received unfair treatment and not for subjects who merely witnessed unfair treatment. Additionally, we replicated previous findings that harsh childhood environmental conditions are associated with endorsement of the code of honor, highlighting the potential value of incorporating a life history theoretical approach to investigating individual differences in endorsement of the code of honor. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

Directory of Open Access Journals (Sweden)

Michael Y. Wang

2012-01-01

Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

Coding Partitions

Directory of Open Access Journals (Sweden)

Fabio Burderi

2007-05-01

Full Text Available Motivated by the study of decipherability conditions for codes weaker than Unique Decipherability (UD, we introduce the notion of coding partition. Such a notion generalizes that of UD code and, for codes that are not UD, allows to recover the ``unique decipherability" at the level of the classes of the partition. By tacking into account the natural order between the partitions, we define the characteristic partition of a code X as the finest coding partition of X. This leads to introduce the canonical decomposition of a code in at most one unambiguouscomponent and other (if any totally ambiguouscomponents. In the case the code is finite, we give an algorithm for computing its canonical partition. This, in particular, allows to decide whether a given partition of a finite code X is a coding partition. This last problem is then approached in the case the code is a rational set. We prove its decidability under the hypothesis that the partition contains a finite number of classes and each class is a rational set. Moreover we conjecture that the canonical partition satisfies such a hypothesis. Finally we consider also some relationships between coding partitions and varieties of codes.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

Combinatorial neural codes from a mathematical coding theory perspective.

Science.gov (United States)

Curto, Carina; Itskov, Vladimir; Morrison, Katherine; Roth, Zachary; Walker, Judy L

2013-07-01

Shannon's seminal 1948 work gave rise to two distinct areas of research: information theory and mathematical coding theory. While information theory has had a strong influence on theoretical neuroscience, ideas from mathematical coding theory have received considerably less attention. Here we take a new look at combinatorial neural codes from a mathematical coding theory perspective, examining the error correction capabilities of familiar receptive field codes (RF codes). We find, perhaps surprisingly, that the high levels of redundancy present in these codes do not support accurate error correction, although the error-correcting performance of receptive field codes catches up to that of random comparison codes when a small tolerance to error is introduced. However, receptive field codes are good at reflecting distances between represented stimuli, while the random comparison codes are not. We suggest that a compromise in error-correcting capability may be a necessary price to pay for a neural code whose structure serves not only error correction, but must also reflect relationships between stimuli.

[Femtosecond laser in cataract surgery. A critical appraisal].

Science.gov (United States)

Menapace, R M; Dick, H B

2014-01-01

The use of femtosecond lasers (FSL) is increasingly spreading in cataract surgery. Potential advantages over standard manual cataract surgery are the superior precision of corneal incisions and capsular openings as well as the reduction of ultrasound energy for lens nucleus work-up. Exact positioning and dimensioning of the anterior capsular opening should help reduce decentration and tilt of the intraocular lens (IOL) optics and thus achieve better target refraction. Together with the possibility to correct low-grade corneal astigmatism by precise arcuate incision, FSL technology is expected to convert cataract surgery from a purely curative into a refractive procedure. Apart from own experiences this review article critically analyses the pertinent literature published so far as well as congress presentations and personal reports of other FSL surgeons. The advantages and disadvantages are scrutinized with regard to their impact on the surgical and refractive results and compared with those experienced by the authors with manual cataract surgery over several decades. Economic and healthcare political aspects are also addressed. The use of FSL surgery improves the precision and reproducibility of corneal incisions and the capsular opening and reduces the amount of ultrasound energy required for lens nucleus work-up. However, the clinical benefits must be put into perspective due to the subsequent surgical manipulation of the incisions (during lens emulsification, aspiration and IOL injection), the lacking possibility to visualize the crystalline lens equator as the reference for correct capsulotomy centration and the relativity of ultrasound energy consumption on the corneal endothelial trauma. This is of particular relevance against the background of the significantly higher costs. Conversely, tears of the anterior capsule edge which, apart from interfering with correct IOL positioning, may entail serious complications presently occur more frequently with all FSL

Approaches and perioperative management in periacetabular osteotomy surgery